PROMOTING HEALTH

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PROMOTING HEALTH DIGNITY THRU SAFE WATER,
SANITATION AND HYGIENE HOW CAN COMMUNITY
RADIO HELP? AMARC, AMMAN, NOVEMBER 2006
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WORKSHOP OVERVIEW

1. Aspirations - 5
2. Overview of the WSH sector - 10
3. Challenges and Problems - 15
4. Grounds for Optimism - 10
5. Some tough issues - 10
6. Questions Discussion 20
7. Small group Discussion Plenary 3020 total 120

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Aspirations (5 mins)

• What would you like to learn about WSH?
• Ask your questions / identify topics
• Now in the workshop
• After this session
• After the conference

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AIMS OF WORKSHOP

• 1. to encourage participants to consider how your
  radio station could increase the coverage of WSH
  issues and messages in your broadcasting
• 2. to provide a background briefing on some of
  the main issues of the WSH sector to help inform
  your programming

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The global picture

• 1,100,000,000 (18) without safe water
• 2,600,000,000 (42) without safe, hygienic
  latrine
• 1,700,000 deaths a year / 4,700 per day
• 90 are children / 4,200 die every day

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Millennium Development Goals

• To halve the proportion without safe water by
  2015
• To halve the proportion without safe sanitation
  by 2015
• To improve the lives of 100 million slum dwellers
  by 2015

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MDG calculation example

• Nation or city or district
• Baseline 1990 population 10 million, 40 with
  water ( 4 million served)
• By 2015 population (2 pa) 16.4 million, target
  70 coverage ( 11.5 million)
• Average Annual target 7.5 million / 15 years
  500,000 / year 1370 people / every day (250
  households)
• And 4.9 million still unserved !

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Water Sanitation 8 major diseases

• Diarrhoeal cholera, dysentery, typhoid
• Worms- bilharzia, guinea worm, hookworms
• Water washed trachoma, scabies

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diarrhoea

• Diarrhoeal diseases 88 attributed to drinking
  unsafe water, inadequate sanitation, poor hygiene
• Severe diarrhoea causes death by dehydration

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Hygiene 1
11
Hygiene 2
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Estimated Impacts of different WSH strategies -
reduction in child diarrhoeal disease

• Excreta disposal - 25
• Personal and domestic cleanliness 18
• Water availability 18
• Food hygiene 17
• Excreta treatment 15
• Water quality 11
• Drainage and sullage disposal 6
• (Source Feacham et al, Sanitation Disease,
  1983)

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Combining W,S H

• Water quantity
• water quality
• safe sanitation
• effective hygiene
• reduce diarrhoeal disease incidence by two-thirds

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Impacts of safe water basic sanitation

• Better health
• More time
• Increased schooling attendance
• Cleaner environment
• Less spend on medicines
• Better family life, less fatigue
• Kitchen gardens, water based enterprises
• Less risk for girls and women
• Dignity and privacy

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Challenges Problems

• Investment requirements more resources, better
  targeting
• Annual spend on water sanitation needs to
  double from 14 billion to 30 billion
• Only 40 of aid for water goes to 30 most needy
  countries with 90 of unserved
• (source Getting to the boiling point, WaterAid,
  2005)

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Challenges Problems

• Sustainability Many new WatSan systems do not
  deliver benefits for their design life
• Inadequate operations maintenance (OM)
  resources
• Low sense of community ownership and
  responsibility
• Questionable technology choices
• Poor workmanship
• Weak quality control

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Challenges Problems

• Social Inclusion poor and vulnerable groups do
  not obtain full benefits of new investments
• Excluded on basis of income, health status,
  location etc
• Widows, disabled, HIV, low caste, orphans,
  remote residence, migration etc

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Challenges Problems

• Gender
• Women and girl children responsible for the bulk
  of water, sanitation management and domestic
  cleanliness
• Typically excluded from project management,
  scheme operations
• Women consistently demonstrate higher standards
  of honesty in financial management and system
  operations

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Challenges Problems

• Water Resource Availability since 1950 water use
  has increased six fold while the population has
  doubled
• Groundwater levels (aquifers) dropping in many
  areas e.g. South Asia 1 4 m / yr
• 1 billion threatened by drought deserts
• Rainfall disrupted by climate change

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Challenges Problems

• Water Quality
• Pollution from agriculture phosphates, nitrates
• From industry in developing countries 70 of
  waste is dumped untreated
• From households human animal faecal waste are
  the major source of bacteriological pollution

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Challenges Problems

• Loss of wetlands
• purify water, absorb silt, regulate river flows,
  add moisture to the atmosphere
• Without them rivers flow too fast, lakes are
  overburdened and coastlines erode fish and
  wildlife extinction and loss of livelihoods
• Half of all wetlands lost in 20th century
• waste land drain and provide land for
  development
• Malaria prevention another rationale

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Challenges Problems

• Political will?
• Easy to promise - hard to deliver
• free water populism
• Lack of Transparency informed public scrutiny
• Allocations not transferred
• Transfers not spent

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Challenges Problems

• Poverty
• All rich people have water and sanitation
• Poor people usually pay more per litre than
  richer neighbours in cash or coping costs or both

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GROUNDS FOR OPTIMISM

• WATSAN POLICY REFORMS
• Rural VLOM hand pumps community management
  WatSan committees grant financing community
  contracting, federations of user groups
• Urban utility autonomy connection charges
  subsidised cost-recovery tariffs incentives for
  utility staff to reduce water losses innovative
  investment financing

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GROUNDS FOR OPTIMISM

• CIVIL SOCIETY ENGAGEMENT
• Sector pluralism Governments / Private Sector /
  NGOs / users
• Utility score cards / citizens voice
• Community mobilization by NGOs, CBOs for
  self-help for community contributions

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GROUNDS FOR OPTIMISM

• COMMUNITY LED TOTAL SANITATION
• Increase community awareness re the volume,
  distribution and implications of open defecation
• Community plans for total latrines, community
  waste management etc
• Non- subsidised latrines extended choice of
  options,
• no one defecates in the open in this village
• daughters from our village do not marry into
  villages where open defecation is practiced

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GROUNDS FOR OPTIMISM

• SANITATION MARKETING
• Most latrines are private investments
• Strengthen both demand and supply for private
  sector delivery of private latrines
• Informed choice, more options, improved quality,
  lower costs
• Privacy, safety, convenience, status, modernism

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GROUNDS FOR OPTIMISM

• Alternative Technologies
• Eco san / composting sanitation
• Separates urine from faeces
• Dilutes urine to become fertilizer
• Produces compost from faeces
• Small bore / settled sewerage
• interceptor boxes
• narrow pipes,
• Condominial layouts,

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GROUNDS FOR OPTIMISM

• RAIN WATER HARVESTING
• For storage
• For ground water re-charge

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GROUNDS FOR OPTIMISM

• COMMUNITY BASED WATER RESOURCE MANAGEMENT
• No groundwater extraction for irrigation within a
  community or within 500 m of a drinking water
  source
• Catchment management fencing, vegetation,
  cleaning, check dams, - rural urban

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GROUNDS FOR OPTIMISM Hygiene 3 key messages

• safe disposal of human excreta
• effective handwashing at critical times
• protect drinking water from contamination
• food management and preparation
• wear chappels, flip flops, sandals

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GROUNDS FOR OPTIMISM Water quality

• Point of use chlorination a few cents per HH
  per month
• solar disinfection (SODIS) minimal cost
• CCS (ceramic colloidal silver) filter - 3 per HH
  per year
• Arsenic removal e.g. Al2 O3 filter cost 4 per
  family / year

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TOUGH ISSUES

• WATER PRICING PAYMENTS
• Is water a social service or commodity?
• Low cost vs. sustainable reliable service
• Recurrent budgets required for operations,
  maintenance and repairs
• tariff structure with social safety net
• First 6,000 litres per HH / month free in SA
  where cross subsidy possible

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TOUGH ISSUES

• CITIZEN BEHAVIOURS THAT UNDERMINE GOOD WS
  SERVICES
• Illegal connections
• Meter resistance / tampering
• Payment avoidance
• Solid waste disposal blocks drains
• Water wastage / tariff levels too low to
  discourage

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TOUGH ISSUES

• LOW AWARENESS OF WATER AVAILABILITY
• Increasing extractions by agriculture and
  industry
• pollution of drains and sewers
• Ground water mining
• Water resource crisis looms

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• QUESTIONS
• DISCUSSION

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SMALL GROUP DISCUSSIONS

• What is your radio station doing now to address
  water, sanitation issues?
• What ( more) could you do?
• Audiences?
• Messages?
• Formats?
• Partners?

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• Presenter Alan Etherington
• Contact alanether13_at_gmail.com

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Broadcasting ideas

• Start with your own lives where do you obtain
  water? Defecate? Urinate? Dispose of waste? Cost
  in cash and time and other?
• Site visits, features, communication strategy for
  WatSan project testimonies
• Phone in water staff, health officials
• PSA, jingles, vox pop, Soap opera Talk shows
  link radio water networks use local languages