Imagine life without a toilet
Sometimes we need to create a big stink to change people’s minds. I’d like to create a Big Stink.
We forget the lessons of history at our peril.
In the late 19th century it took the stench of raw sewage in our cities to convince politicians to pass legislation and provide safe sanitation and water to protect Australians who were dying daily of preventable diseases like diarrhoea.
To mark World Toilet Day today, let me ask you to imagine for just one moment the indignity of life without a toilet.
If you’re a woman you might only go to the toilet when it’s dark, often having to walk long distances to find an isolated spot, exposing yourself to the danger of sexual harassment, assault and animal attacks, never mind the discomfort and resulting illnesses caused by poor sanitation.
Some 1.2 billion people habitually defecate in the open – in fields, in gutters and in bushes.
That’s 165 million litres of excreta every day - enough to fill one of great sporting arenas everyday.
Around 150 years ago that the stench of raw sewage in Melbourne’s Yarra river was so vile that the city became known as Smelbourne and child mortality rates were higher than they are in Sub-Saharan Africa today.
The introduction of sewerage systems, water supply and hygiene education in the following decades contributed to an unprecedented reduction in child deaths. It’s hard to imagine any other single intervention which has brought greater public health returns in developing countries.
This is perhaps why the readers of the British Medical Journal voted sanitation the single greatest medical advance in the last 150 years, ahead of antibiotics or anesthesia.
For World Toilet Day 2010, WaterAid is calling on Foreign Minister Rudd to make toilets a development priority.
The World Bank suggests that lack of access to sanitation – alongside safe drinking water - costs developing countries up to 9% of their annual GDP; over 400
million school days are lost every year from associated illness such as diarrhoea; and, in sub-Saharan Africa, half of all hospital beds at any one time are occupied by people suffering from these diseases.
But the hardest statistic of all to stomach is the cost in children’s lives. Existing evidence suggests poor sanitation may be linked to the deaths of over 2 million children annually causing more child deaths than HIV/AIDS, malaria and tuberculosis combined.
As history has shown, the potential of sanitation to deliver far-reaching development outcomes is huge. And the economic case is sound.
Fewer people get sick, meaning they can work, earning precious money to support their families; children can go to school, and hospitals are no longer overwhelmed by people suffering preventable diseases such as diarrhoea. With far reaching consequences like these, sanitation - together with safe water - are the fundamental building blocks of development.
Given the scale of the crisis, and the potential benefits on offer, why has there been no great stink? Why are politicians still not talking about this crisis?
Perhaps one reason is that the burden of this crisis is borne so disproportionately by women and children and those in extreme poverty – the very people who have little or no voice when decisions are made.
But maybe it’s simpler than that. Can you think of a single politician who’s had their photo taken at the grand opening of a new toilet block? Health centres and schools are far easier, dare I say sexier, ideas to sell.
Yet this is exactly what is needed: strong leadership, sanitation superheroes if you like, who are prepared to talk shit and address this global crisis with the political attention it deserves.
With strong commitment from all sides of politics to increase both the size of Australia’s aid program and this week’s announcement of an independent review to ensure the quality of our aid, there is a real opportunity over the coming months to build momentum and push sanitation up the agenda.
Based on current trends, the MDG target - to halve the proportion of people without access to adequate sanitation by 2015 - will not be met until 2108 in sub-Saharan Africa, some hundred years too late.
In the face of this terrible lack of progress, leaders around the world must make binding commitments matched with concrete action plans.
Without this action on sanitation, gains in other development sectors – such as in health and education – stand to be undermined.
Of course it’s not only governments who can make a difference. The public also has a crucial role to play in ensuring that people across the globe have a safe and clean place to spend a penny. Join us in our plea to Kevin Rudd to become a sanitation champion by adding your voice to our petition.
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