November 18, 2016 by Nameerah Khan
Last year WHO and UNICEF’s Joint Monitoring Programme for Water Supply and Sanitation reported that Bangladesh had made significant progress in reducing the proportion of people practising open defecation –to just 1 per cent, down from 34 per cent in 1990. The report also lauded Bangladesh for being the only country in South Asia which made significant progress in reducing open defecation among the poorest (and therefore reducing the gap between the richest and the poorest) which other countries in the region had failed to do.
This is an incredible feat for a low-income country with limited resources. It is, in fact, a huge victory and a big step forward for Bangladesh. (To put things in perspective, our neighbour India still has an open defecation rate of 44 per cent).
Then why is it that this incredible statistic of 1 per cent open defecation has become a bane to those working in the water and sanitation sector?
Because it has lulled people into a false sense of security – the comfortable notion that our work here is pretty much done, so no more support is needed for sanitation efforts.
However, this isn’t the end of the journey. Rather the beginning of a more difficult one. About 38 per cent of the Bangladesh population are still using unimproved or unhygienic sanitation facilities. The most important thing to understand is that just going from defecating openly to defecating in a fixed place is not enough – all the public health concerns associated with open defecation will still remain as long as people continue to use unhygienic facilities.
There is still a lot of work left to do in Bangladesh. We still have to continue motivating people to build toilets or convert unhygienic ones to hygienic ones. And we still have to ensure inclusion of the poor and ultra poor through appropriate financial mechanisms. We have to continue supporting and building the capacity of local sanitation entrepreneurs (those who sell the necessary hardware to build latrines in rural areas), so that they can cater to a variety of needs and demands in the community.
Also important to keep in mind is climbing the sanitation ‘ladder’. For example, a rural household may have a hygienic latrine, but they might want to upgrade – eg, from a single-pit latrine to double-pit latrine, from pit latrine to septic tank, from plastic pan to a more durable ceramic pan, etc. They might want to bring in running water in or near the latrine, and even bring the facility closer to their house for convenience, privacy and safety. This is especially critical for women and girls, since lack of access to sanitation facilities means lack of proper menstrual hygiene management, which can lead to reproductive health issues.
Issues of access to sanitation are not just limited to rural areas; there is unchecked urban growth throughout the country, leading to large pockets of low-income areas where sanitation conditions are deplorable due to lack of resources and space constraints.
There are also issues of sustainability – often poor quality construction can lead to damaged infrastructure. This is also a major concern for areas that are vulnerable to natural disasters and the effects of climate change.
And speaking of sustainability, the last (and perhaps the most critical) challenge for us is faecal sludge management – millions of people have gained access to hygienic sanitation facilities, but what happens to all the pits and septic tanks that are getting filled up? Safe handling, management and disposal are essential. But there are also many opportunities within this challenge – faecal waste can be converted to organic fertiliser, biogas and energy. Waste can become a valuable resource.
We need to continue investing time, efforts and resources to achieve higher levels of access. It is important to understand that support is needed across the spectrum – from raising awareness (and therefore demand) in the community, strengthening the supply chain to ensure quality and variety of products, ensuring inclusion of the poor(est), empowering women and girls to have their concerns addressed, mobilising service providers and creating linkages between them and the community, and investing in research to develop sustainable context-specific technologies.
Moreover, robust monitoring and research is needed to measure actual outcomes and impacts in the community; to ensure that investments in the sector are being utilised fruitfully; and to make periodic adjustments in implementation approaches whenever necessary.
On World Toilet Day 2016, we should not only celebrate the near-elimination of open defecation in Bangladesh, but also remember the very difficult and important work that lies ahead.
Nameerah Khan works as manager, knowledge management, innovation and fundraising at BRAC’s water, sanitation and hygiene (WASH) programme.