WASH preparedness in disaster management

WASH preparedness in disaster management

July 30, 2010

UNICEF organized third WASH Cluster meeting on July 29, 2010 at UNICEF Country Office to discuss on the progress on ongoing WASH preparedness intervention and identification of life saving intervention for Central Emergency Response Fund (CERF) Fund. Different WASH Cluster members including Oxfam, Save the Children, Nepal Red Cross Society and Department of Water Supply and Sewerage shared about the ongoing WASH preparedness intervention in their working areas.  

Sharing that Central Emergency Response Fund—a multi-donor trust fund comprising 119 donors—has allocated US $ 500,000 for life saving WASH intervention from the total US $ 2 million provided to Nepal, Madhav Pahari, Lead-Wash Cluster requested all WASH cluster members to identify best and appropriate option for life saving interventions for CERF funding.

Sharing that door-to-door campaign, community awareness on safe drinking water and sanitation and effective media mobilization are the best options to prevent occurrences of water-borne diseases in the urban areas, Anil Sthapit, Director, GUTHI told to give continuity to such campaign to prevent diarrhoeal diseases. He shared that similar campaign had helped to reduce diarrhoeal cases in the past. Similarly, Dr. Suman K. Shakya, Executive Director, Environment and Public Health Organization informed that ENPHO in association with UN-HABITAT formed Paschim Paaila immediately after the first outbreak of diarrhoea epidemic in Jajarkot, Rukum, Surkhet, and Dailekh districts and sent 63 volunteers to the epidemic-hit regions. He further told that it was the vigor and willingness in youths that made a rapid response to the outbreak possible. “So, we must prepare more of such youths for immediate response to such epidemic in the future,” said Shakya. He informed that ENPHO has now the capacity to produce 2500 units of Piyush, chorine solution, per day.

Sharing that there are more than 20 water kiosks in a short distance of 2.5 km from Naradevi to Swoyambhu in Kathmandu, Executive Director of NGO Forum for Urban Water and Sanitation Prakash Amatya told that the urban population, mostly tenants, in the core areas are purchasing water from such informal water kiosks, who sell the water brought from private water tanker suppliers. “I think that there is need to carry out a quality survey of the water sold by such water vendors as this is the water the consumers are actually consuming,” said Amatya. “However, this survey is not intended to discourage such water vendors. This is just to get clear picture of the quality of water consumed by a large mass of urban poor and raise awareness on water quality and strategize the water treatment promotion at the household level,” he added. “We should seek support from the media and they can play a pivotal role to highlight the issue,” Amatya suggests.

(Source: ngoforum.net)

झाडापखालाको प्रकोप

झाडापखालाको प्रकोप
Editorial,
2nd July, 2010

हरेक वर्ष डुबानमा पर्ने नेपालगन्जका केही बस्तीहरू गणेशपुर, देवाफुल्बारी, घरबारी टोल, कोरियनपुर्बा, सल्यानीबाग र फुल्टेक्रा यसपटक डुबानमा मात्रै परेनन्, दूषित पानीका कारण यहाँ झाडापखालाको महामारी नै भित्रियो । दुई साताअघि आएको वर्षाले डुबानमा परेको बस्तीमा झाडापखालाले प्रकोपको रूप लिएको छ । झन्डै एक सातादेखि सुरु भएको झालापखाला अझै नियन्त्रणमा आउन सकेको छैन । बरु यस महामारीका कारण पाँच जनाको मृत्यु भइसकेको छ भने दर्जनौं बिरामी परेका छन् ।

नेपालगन्जस्थित भेरी अञ्चल अस्पताल र शिक्षण अस्पताल दुवैमा बिरामी खचाखच भरिएका छन् । दुवै अस्पतालमा एउटै बेडमा दुई तीन जनासम्म बिरामी राख्दा पनि नपुगेर बेन्च र भुइँमा सुताएर उपचार गर्नुपर्ने बाध्यात्मक अवस्था आएको छ । शनिबार मात्रै भेरी अञ्चल अस्पतालमा १ सय ३३ बिरामी भर्ना भए भने आइतबार बिहानैदेखि बिरामीको चाप बढेको छ ।

झाडापखाला दूषित पानीका कारण फैलिएको र उक्त पानीमा हैजाका कीटाणु हुन सक्ने अनुमान चिकित्सकहरूको छ । त्यसकारण सरकारका सम्बन्धित स्वास्थ्य सेवाका निकायहरूले यसलाई गम्भीरतापूर्वक लिनुपर्छ । हैजाको प्रकोपको पीडा कस्तो हुन्छ भन्ने हामीले यसअघि पनि बेहोरिसकेका छौं । पोहोरसाल झाडापखालाको महामारी फैलिएर मध्यपश्चिमका जिल्लाहरू जाजरकोट, रुकुममा दर्जनौं मानिसले अनाहकमा ज्यान गुमाउनुपरेको दृष्टान्त पुरानो भएको छैन । गाउँमा औषधि र स्वास्थ्यकर्मी नहुने र केन्द्रको राज्यले हैजा फैलिएको प्रारम्भिक दिनहरूमा नागरिकको स्वास्थ्यप्रति जिम्मेवारीबोध गर्न नसक्दा उक्त प्रकोपले भयावह रूप लिएको थियो । एक सालअघिको यो घटनालाई पाठका रूपमा लिँदै नेपालगन्जका यी बस्तीमा फैलिएको झाडापखालाको महामारी नियन्त्रण गर्नतिर केन्दि्रत हुनुपर्छ ।
नेपालगन्जको झाडापखाला प्रकोपमा सरकारले चासो देखाएको छ । नेपालगन्ज जनस्वास्थ्य कार्यालयले घुम्ती स्वास्थ्यटोली खटाएको छ भने स्वास्थ्य विभाग महामारी नियन्त्रण महाशाखाले हैजा परीक्षणका लागि विशेषज्ञसहतिको टोली त्यहाँ पुगेको छ । यद्यपि यो चासो पर्याप्त होइन । क्षेत्रीयस्तरको अस्पतालमा अहिलेसम्म पनि हैजाका कीटाणु परीक्षण गर्ने प्रविधि नहुनुले हाम्रो स्वास्थ्य सेवा निकायमा साधनस्रोतको कतिको अभाव रहेछ भन्ने उजागर गर्छ । त्यस्तै नागरिकहरू बर्सेनि एकातिर डुबानको मारमा पर्न विवश छन् भने उनीहरूको न्यूनतम र आधारभूत आवश्यकता सफा खानेपानीको समेत व्यवस्था भएको पाइँदैन । यो अवस्थामा एकातिर नेपालगन्जका बस्तीहरूमा स्वच्छ वातावरण र खानेपानीको दीर्घकालीन प्रबन्ध गरिनुपर्छ भने अहिले तत्कालका लागि सरुवा रोगको रूपमा रहेको झाडापखाला अन्यत्र बस्तीमा फैलिन नपाओस् भनेर विशेष ध्यान पुर्‍याउनुपर्छ ।
बाढी/डुबानको समय भएकाले अन्यत्र जिल्लामा पनि झाडापखाला फैलिन सक्ने डर हुन्छ । त्यसकारण सरकारी स्वास्थ्य सेवा जोखिममा रहेका अन्य जिल्लामा प्रकोपले रूप नलिँदै विभिन्न जनचेतनामूलक कार्यक्रमसहित केन्दि्रत हुनुपर्छ । नेपालगन्जमा फैलिएको झाडापखालको प्रकोपबाट जनतालाई बचाउनु र यसको नियन्त्रणलाई अहिले मुख्य प्राथामिकतामा राखिनु जरुरी छ । यसका लागि आवश्यक स्रोधसाधनको प्रबन्ध गरिनुपर्छ र प्रकोपका समयमा मात्रै स्वास्थ्य सेवा, जनचेतनाका कार्यक्रम लगेर पुग्दैन, सरकारले जनताका आधारभूत आवश्यकताको सूचीमा पर्ने स्वास्थ्य, खानेपानी, सरसफाइको उचित र उपयुक्त प्रबन्ध नियमित गर्नुपर्छ । हरेक वर्ष सरकारी बजेटमा यी शीर्षकमा रकम विनियोजन गरिएको हुन्छ । त्यसको सदुपयोग गर्दै यस्ता महामारी फैलिनुपूर्व बस्तीहरूमा पुगी सरकारले नागरिकको स्वास्थ्य अधिकारलाई सुनिश्चित गर्न सक्नुपर्छ ।

Source: e-kantipur

नेपालगन्जमा झाडापखाला

जनक नेपाल
नेपालगन्ज, श्रावण १३ -
३ को मृत्यु / २०० बिरामी / ३० को स्थिति गम्भीर

नगरको डुबानग्रस्त बस्तीमा बुधबारदेखि फैलिएको झाडापखालाले प्रकोपको रूप लिएको छ । पखालाबाट दुई बालबालिकासहित तीन जनाको मृत्यु भएको छ भने ३० भन्दा बढी बिरामीको अवस्था गम्भीर रहेको छ । नेपालगन्जका अस्पतालहरूमा १ सय ३० जना भर्ना छन्् । उपचार गरी घर गएकाहरू समेत पुनः बिरामी परी अस्पताल आउन थालेका छन्् ।
नेपालगन्ज-५ स्थित सल्यानीबागका ५ वषर्ीया जस्मिन हल्वाई र वडा नं. ४ का तानिया हल्वाईको बिहीबार बिहान अस्पताल लैजाँदै गर्दा मृत्यु भएको हो भने दाङ तुलसीपुरकी ६५ वषर्ीया कलावती बुढाथोकीको बुधबार शिक्षण अस्पतालमा मृत्यु भएको थियो ।
मेडिकल कलेजको शिक्षण अस्पतालमा मात्र बिहीबार साँझसम्म १ सय ५८ बिरामी उपचारका लागि आएका छन्् । तीमध्ये ९० भन्दा धेरै बिरामीको अस्पतालमा उपचार जारी रहेको आकस्मिक कक्षका इन्चार्ज डा. मधु अर्यालले बताए । भेरी अञ्चल अस्पतालमा ५१ र नेपालगन्ज युनाइटेड अस्पतालमा दुई बिरामी भर्ना छन्् ।
भेरी र शिक्षण अस्पतालका आकस्मिक कक्षका वार्डहरू भरिभराउ छन्् । भेरीमा एउटै बेडमा दुई/तीन जनालाई राख्दा पनि नपुगेर बेन्चमा र भुइँमा सुताएर उपचार भइरहेको छ । बिरामी राख्न छुट्टै कोठा थपिएको छ । त्यस्तै शिक्षणमा ८ बेड थपिएको छ भने वार्डहरू भरिभराउ छन्् । भेरीमा १२ र शिक्षण अस्पतालमा २२ बेडका आकस्मिक वार्डहरू छन्् । मंगलबार रातिदेखि पखालाका बिरामी अस्पताल आउन थालेका थिए । बुधबारदेखि बिरामी अत्यधिक बढेको स्वास्थ्यकर्मीले बताए ।
'उपचारपछि घर फर्केका पनि पुनः बिरामी भएर अस्पताल आएका छन्,' डा. अर्यालले भने, 'हैजाको लक्षण देखिएकाले दिसा परीक्षण हँुदैछ, रिपोर्ट नआउँदासम्मका लागि एन्टिबायोटिक दिएका छौं ।' पखाला लागेको केही घन्टामै बिरामी बेहोस हुने र नाडी नचल्ने गरी सिकिस्त हुने गरेकाले हैजाको शंका गरिएको उनले बताए । स्वास्थ्य विभाग महामारी नियन्त्रण महाशाखाले हैजा परीक्षणका लागि शुक्रबार विशेषज्ञसहितको टोली पठाउने भएको छ ।
मध्य तथा सुदूरपश्चिमको सबैभन्दा ठूलो भेरी अञ्चल अस्पतालमा हैजा परीक्षणको सुविधा छैन । हैजा परीक्षणको सुविधा यहाँ नभएकैले प्याथोलोजिस्ट विशेषज्ञ टोली आउन लागेको भेरी अस्पताल प्रमुख डा. विमल ढकालले बताए । उनले भने, 'एकैपटक महामारी फैलिएकाले हैजाको आशंका गरिएको हो ।' निजीस्तरको नेपालगन्ज मेडिकल कलेजमा भने हैजा परीक्षणको सुविधा छ । झाडापखालाका बिरामीको दिसामा हैजा परीक्षण भइरहेको र पुष्टि हुन अझै दुई दिन लाग्ने डा. अर्यालले बताए ।
नगरका गणेशपुर, देवाफुल्बारी, घरबारी टोल, कोरियनपुर्वा, सल्यानीबाग र फुल्टेक्रामा झाडापखाला फैलिएको हो । ती बर्सेनि डुबानमा पर्ने क्षेत्र हुन्् । दुई साताअघिको वषर्ाले डुबानमा रहेका नेपालगन्जमा गर्मी बढेपछि एकाएक प्रकोप फैलिएको हो । डुबानग्रस्त बस्तीमा दूषित पानीका कारण झाडापखाला फैलिएको हुनसक्ने जनस्वास्थ्य कार्यालयले जनाएको छ । नियन्त्रणका लागि जनस्वास्थ्यले स्वास्थ्यकर्मीहरूको घुम्ती टोली खटाएको छ । 'चिकित्सकसहितका चारवटा टोलीले बिहीबार दिनभर महामारीग्रस्त बस्तीमा पुगेर उपचार गर्‍यो,' जनस्वास्थ्य कार्यालयका रोग नियन्त्रण संयोजक रामबहादुर चन्दले भने । घुम्ती टोलीमा चिकित्सकसहित १३ जना छन्् ।

Source: e-kantipur.com

Diarrhoea, Typhoid patients on rise

MAHOTTARI,  July 21: 


Patients of diarrhoea, cold and typhoid has increased in remote northern areas of Mahottari district. 

According to Bardibas Hospital, many people of Gauribas, Maisthan, Khayarmara, Hattilet, Kisannagar and Bardibas VDCs are suffering from the diseases. 

Radhe Shyam Jha, senior health worker of the hospital, said at least 50 patients of the six VDCs has been coming for treatment every day since the first day of Shrawan. 

It is said that consumption of drinking water contaminated by incessant rainfall since five days, lack of cleanliness in villages as well as lack of mosquito nets has increased diarrhoea, cold and typhoid patients. 




(Source:http://www.myrepublica.com/portal/index.php?action=news_details&news_id=21277)

SANIHEALTH CONCERN

Perhaps in the next 30 years

Monday, 22 March 2010

Today I am very happy I am getting my turn to fetch water after a week But I am sad too, Because, someone stole away a bucketful of water from my house today I reported the incidence to the police, I don’t think that they will be able to trace the thief But, I will not leave this here Today my body feels light I got a change to take bath with 3 mugs of water after a week My heart is even lighter Because, my son had the opportunity to have a glass of water in his tiffin Some guest visited me with an excuse of drinking water But, I cleverly sent them away without giving them a drop of water to drink I am annoyed with the borrowers who borrow water but never pay back I owe twenty-five bucketful of water from my neighbors Today I have to go to Rani Pokhari (historic pond in Kathmandu) to watch a football match there Once, it used to be full of water but it’s hard to believe now Yesterday, an elderly showed me a dug well and said, “Son, there used to be a lot of water in this dug well.” Oh! I dreamt of collecting water from the same dug well throughout the night Nowadays, I am embarrassed with these fantasy dreams Let’s start from ourselves! Save Water! Save Life! (Source: http://www.ngoforum.net)

Lifeline: Kathmandu’s Stone Water Spouts

Wednesday, 05 May 2010

Across the Kathmandu valley one encounters stone water spouts beautifully carved in the form of water deities- a crocodile head representing the carrier of the Goddess Ganga, or a serpent head. The divinely engraved hitis also serve a more earthly purpose- a vital source of drinking water to the valley’s Parched populace. In the Lalipur sub-metropolis, for instance, the water demand of 43 million liters far outstrips the government water supply of 27 million liters, much of it made up be the stone spouts of the area.  The Alok Hiti Conservation and Drinking Water Committee then devised a simple scheme to conserve the historical stone spouts, boost water supply to their homes, and reclaim the community’s sense of pride. READ MORE and Watch!!!! http://downtoearth.org.in/dte_slideshow/nepal/nepal.ht (Source:  http://www.ngoforum.net/index.php?option=com_content&task=view&id=8523&Itemid=1)

 

Indonesia, Jakarta: slums struggle with sanitation

May 7, 2010

In Jakarta’s northern Muara Angke coastal area, a lack of access to piped water has forced people to bathe and wash clothes using murky grey water from fish ponds.

“I don’t feel disgusted at all. I’ve gotten used to it,” Ibu Nunung, who shells mussels for a living, told IRIN outside her house in Muara Angke Blok Empang, a slum in the area.

Nunung said residents, many of whom live on less than US$2 a day, had to fork out the equivalent of up to $1 daily to buy clean water for drinking and cooking from vendors transporting water in jugs.

She admitted that itchy skin was a common problem among locals.

Jakarta, a city of 10 million people, is dotted with slums like the one in Muara Angke.

Many people live without running water in shanty towns built in the shadow of gleaming skyscrapers, and gutters are clogged with rubbish, causing foul smells.

“Poor sanitation, lack of access to clean water, overcrowding and poor nutrition are among [the] major problems in Jakarta, and the government’s commitment is needed to address these problems,” said Erlyn Sulistyaningsih, a project manager with Mercy Corps Indonesia.

Less than 50 percent of Jakarta’s residents have access to piped water, according to the NGO, which runs water, sanitation and health programmes in the city.

More than 75 percent of the city’s residents rely on shallow groundwater, but an official study found that 90 percent of shallow wells are contaminated with coliform bacteria or heavy metals, Mercy Corps said in a 2008 publication entitled Urban Poverty Reduction Strategy.

Jakarta produces 6,000 tons of waste each day, but can only manage 50 percent of it, it said.

Sulistyaningsih heads a project aimed at increasing access to sanitary facilities, including toilets, providing access to clean water, and educating child caregivers about nutrition in several villages in Jakarta and neighbouring Bekasi District.

“Our programme seeks to prevent diseases which are spread by the faeces-to-mouth route, and we hope it can be replicated by other communities,” she told IRIN.

Premature deaths

A study released by the World Bank’s Water and Sanitation Programme in 2008 revealed that only 57 percent of Indonesian households had easy access to a private and safe place to urinate and defecate in 2004.

Poor sanitation, including poor hygiene, causes at least 120 million disease episodes and 50,000 premature deaths annually, the report said.

The study also found that poor sanitation costs the Indonesian economy $6.3 billion per year, or equal to 2.3 percent of the country’s gross domestic product.

Nugroho Tri Utomo, head of the subdirectorate of drinking water and waste water at the National Development Planning Agency, said part of the problem was a lack of funding, with spending on sanitation accounting for only 1 percent of the city’s budget.

“Both the general public and authorities have yet to realize the importance of sanitation, not only to health but also to the economy,” he said.

Improvement plans under way

The government last month launched a programme to provide access to adequate sanitation to 80 percent of urban households by 2014.

The Settlement Sanitation Development Programme, estimated to cost $5.5 billion, aims to develop waste water services in 226 cities, build sanitary landfills serving 240 urban areas, and stop inundations in strategic urban locations covering 22,500 hectares.

Under a separate programme called the National Strategy for Community-Based Total Sanitation, launched in 2008, the government aims to provide access to sanitation and introduce more effective water treatment methods in 10,000 villages by 2012.

See also:

• Mercy Corps Indonesia - Ibu Rumyati, Making Behavior Change Possible in Urban Slums
• Community-led Total Sanitation – Indonesia
• Portal Sanitasi Indonesia

(Source: IRIN, 16 Apr 2010)

Striking Maoists contract dysentary, diarrhoea

May 4, 2010
KATHMANDU: Change in the Kathmandu weather, stale food and vegetables, contaminated drinking water, dirty dishes and lack of sanitation facilities in the shelter camps are beginning to take a toll on the UCPN-Maoist cadres involved in the general strike.

Hospital sources said up to 400 demonstrators had to be rushed to different hospitals in the capital city for treatment as they suffered from water-borne diseases like dysentary and diarrhoea. The UCPN-Maoist put the estimate at 300.


The sick include women, children and the elderly citizens, brought to Kathmandu from several parts of the country, according to hospital sources. Health workers, who had cautioned the Maoist party to ensure supply of hygienic food and safe drinking water to the demonstrators mobilised into Kathmandu, have also warned of an impending outbreak of water-borne diseases.


The UCPN-Maoist has reportedly assembled an estimated five lakh cadres for the protests and demonstrations aimed at marshalling the Madhav Kumar Nepal-led government that completes its first year in office this week.


The demonstrators are having to live in congested rooms in the shelters, including schools and public places.


Sukraraj Tropical and Infectious Diseases Hospital, Tribhuvan University Teaching Hospital and Bir Hospital have reported increased number of diarrhoea cases in the past two days.


Dr Saroj Prasad Rajendra, Director, Sukraraj Tropical and Infectious Diseases Hospital, said they had recorded around 18 cases of water-borne diseases among the cadres living in Kirtipur. Most of the patients are critical and have been kept under observation, said Dr Rajendra.


“Contaminated drinking water, unhygienic food and an increasing temperature are the main reasons behind the outbreak,” said Dr Rajendra, urging UCPN-M to show seriousness towards the health of its cadres.


She added that repeatedly consuming beaten rice with stale vegetables at polluted places is also behind the transmission of disease. She urged the cadres to drink safe water and to maintain minimum personal hygiene.


Dr Basu Dev Pandey, consultant physician of the hospital, said most of the patients admitted there were in the age-group 15-45 years and lived in squalid conditions in the camps. He added that they were being provided with free treatment and medicines. Dr DP Singh, Chief, Emergency Ward, Bir Hospital, said most of the cadres were admitted in the emergency ward suffering from gastritis and food poisoning.


TUTH too has admitted a number of critical cases of water-borne diseases. Chandra Kumar Rai, Chief, Administration Department, TUTH, said the hospital admitted patients in critical stage. Non-serious patients are given treatment by the primary health service providers, he added.
Mangal Bishwokarma, president of the All Nepal Progressive Public Health Workers’ Association, said they had recorded around 300 patients suffering from diseases like diarrhoea, common cold, fever and throat pain.


“We are giving preventive as well as curative treatment to the ill cadres” added Bishwokarma. He said the party was taking care of its cadres and has directed them to drink water that contained chlorine.

(Source: The himalayan times)


Timor-Leste: water supplies running on empty

May 4, 2010
Despite significant donor investment in the water sector in Timor-Leste, sustainability remains the biggest challenge. Much of the country’s rural water systems fell into disrepair years ago. The government has made water a national priority for 2010.
According to Timor-Leste’s National Statistics Directorate, almost 40 percent of the country’s 1.1 million inhabitants lack access to an improved water source.
The problem is most evident in rural areas where approximately 75 percent of the population lives – 44.4 percent do not have access against about 15 percent in urban areas.
In the eastern districts of Baucau, Lautem and Viqueque, and Oecussi District, an enclave inside Indonesia, that figure tops more than 50 percent.


One community’s story

Of Lisapat’s 800 households, only 18 have access to piped water, with the rest relying on a nearby spring. Before 2002, everyone had access.
“It’s a big problem and one that we need to fix,” said Julio do Rosario Lemos, 34, who was recently elected the village’s head.

Between 70 and 80 percent of the country’s water system was destroyed in the violence and displacement that occurred after Timor-Leste’s indepence in 199.

“In many villages there are pipes with no water. In others there never have been,” Bishnu Pokhrel, a water and hygiene specialist with the UN Children’s Fund (UNICEF), told IRIN, citing poor management, lack of awareness, low institutional capacity and the impact of the 1999 political crisis.

Sustainability
“Sustainable water systems is the key goal,” Keryn Clark, programme team leader for the Timor-Leste Rural Water Supply and Sanitation Programme (RWSSP), an AusAID-funded project working with the Timorese government to improve water supplies, told IRIN.
On some projects in the past, the focus had been more on laying pipes that on community management, she said. It was critical that the community, which ultimately will be managing the system, is fully on board from the very beginning.
Maintenance of the infrastructure is also critical and outside Dili, the capital, few spare parts are available.


While many of the country’s community water management groups are well organized, others are less so and may not have the knowledge or means to undertake necessary repairs.
“You need to determine what the community can realistically manage and what they can’t, and then how you can support them,” Clark said, emphasizing that community training is key.

Institutional capacityUntil recently, each district had just one non-technical rural water supply and there was only one fully trained water engineer in the whole country.
Now with support from AusAID, another district level technical person has been added, as well as one or two community facilitators at the sub-district level, focusing on community management and sanitation.
“These are all key points in making the system more sustainable,” Clark said. “If we can actually make the systems that have been built, or are in the process of being built, work properly and [be] more sustainable, more people will have access to water.”
(Source: IRIN, 08 Feb 2010)


With access to the toilet came access to dignity


May 3, 2010

There have been encouraging increases in the number of poorer people who are able to access toilets in Deoghar and Pakur districts of Jharkhand, India, thanks to the Total Sanitation Campaign. While this is a reason for optimism, questions do arise: “Who benefits? Is this programme really catering to ALL?”
This Government of India programme offers incentives for families below the poverty line to construct toilets with technical designs approved by the District Water and Sanitation Mission (DWSM) responsible for sanitation.
However, the evidence is that people with special needs, or the differently abled are being left out, since even if their families have toilets, these are not user friendly or appropriate. This means that, despite the programme designed to be ‘total’, there is not really universal access and not all people can live with dignity.
To enhance the inclusiveness of access and to sensitise the service providers and the community on the need for inclusive approaches in planning, design and implementation, several initiatives were undertaken by the Regional Office East for the state of Jharkhand along with Gram Jyoti, a partner of WaterAid. All this was possible because of one person, Jitendra Turi of Sisanathur village, Jharkhand who proved to be really special.
Jitendra suffers from multiple disabilities, with locomotor, visual and mental impairments. He comes from a Scheduled Caste (‘lower caste’ in India) family and lives with his parents. Even at the age of 25, he is still dependent on his mother for most activities. He is not a child and cannot go to school and he cannot participate in village activities.
The family did not have a toilet at home, unaware of its importance in reducing dependency and increasing dignity for their son so that he could lead as normal a life as possible. For defecation, his mother usually took him to the outskirts of the village. Sometimes, when was unable to take him out, she would ask him to defecate in a corner of the village lane, which earned him the ridicule of children and villagers. “I felt such shame in telling my mother to help me for defecation. I am grown up but how can I go out? I cannot see, nor am I able to walk,” recalls Jitendra.
Jitendra’s family has a small land holding. Burdened with poverty and looking after the needs of their son, his parents did not participate in village meetings. They were unaware of government incentives and entitlements, or of toilet options which could help their son.
Gram Jyoti was working on sanitation in this village when Jitendra was spotted by the programme team. He brought up Jitendra’s case at a village water and sanitation committee that had formed to work on sanitation and hygiene related issues. His family was approached, and the benefits of having a toilet at home explained. The family contributed labour and the mason charges for constructing a toilet.
Jitendra’s toilet is made of mud and bricks, with a raised squatting platform fitted with a rural pan, which can be used as a commode. The walls are fitted with a supporting rail for easy movement. To help him with his visual disability, a bamboo pole leads from the main door to the toilet.
After a few rounds of demonstration and practice with Gram Jyoti village motivators, Jitendra now locates and uses the toilet on his own. He is more self reliant and motivates others saying, “If I can use toilet why can’t you?”
Locating toilet with help of bamboo.
Pix: Jitendra in his toilet
Extending the campaign for disability rights
Gram Jyoti has taken up the cause of disabled people on other fronts as well. Abha the project coordinator says that the organisation is advocating for the restoration of pension for people with special needs, provisioned under the Swami Vivekananda Scheme, but now discontinued. The organisation is also helping his family with activities/ benefits under the Mahatama Gandhi National Rural Employment Guarantee Act. Jitendra’s family has been provided with an irrigation well under this scheme.
Key lessons from the community process:
- People with disabilities like Jitendra should not be limited to being the recipients of charity. They need to be brought into village forums, where they can also have a say in village processes.
- The environment surrounding people with disabilities is a problem, not the people who have these special needs. In case of Jitendra, his disability was a result of social shortcomings in terms of awareness, attitude, approaches and accessibility to services.
- Sometimes what is required is not a new hardware technology per se, but new and sensitive ways to implement technology, with appropriate modifications. In this case, the adaptations were such that the toilet can be used by all family members.
Linking Community processes to District forums at Deoghar and Pakur
The work supporting Jitendra to live his life independently and with dignity was used to influence and reach out to more people with disabilities.
A district consultation was organised in Deoghar and Pakur on “Influencing WASH Service delivery for people with disabilities” in collaboration with DWSMs, and this was attended by representatives of NGOs working on water, sanitation and hygiene, and governmental departments for Women and Child Development, Education and Drinking Water and Sanitation.
This led to the following actions at the government level:
- Restructuring village water and sanitation committees (VWSC) to ensure representation of people with disabilities.
- A promise to revise district project implementation plans so that they include special needs.
- Raised awareness of district officials on WASH provisions for people with special needs.
- Incorporation of technical modifications to existing water and sanitation facilities to make them more user-friendly
-Design and cost estimates to make government institutions in Pakur and in Deoghar districts accessible for people with disabilities.
Meeta Jaruhar (Water Aid India)