Interview with Clarissa Brocklehurst, UNICEF Water and Environmental Sanitation Chief
UNITED NATIONS, Sep 17 2007 (IPS) – When it comes to discussing the critical health problem of inadequate sanitation, few politicians want to take the lead, despite the mountains of scientific evidence that poor hygiene and lack of proper toilet facilities are the cause of many deadly but preventable diseases.
Clarissa Brocklehurst at UNICEF House Credit: UNICEF/Susan Markisz
Still, Clarissa Brocklehurst, chief of UNICEF s Water and Environmental Sanitation division, is optimistic that the upcoming International Year of Sanitation in 2008 will put this issue much higher on the policy-making agenda.
IPS correspondent Nergui Manalsuren spoke with Brocklehurst at UNICEF headquarters in New York. Excerpts of the interview follow.
IPS: There are an estimated 2.6 billion people living without adequate sanitation, of whom 980 million are children. How is UNICEF working to resolve this problem?
CB: Whereas water supply is often a community decision, and a community responsibility, we find that sanitation is a household decision. Many families actually want to have a toilet for the privacy, convenience and the dignity that it offers. And we value that too, particularly because we work a lot with women as mothers of children. For those women, the health impact of the toilet is less important than the impact it has on their dignity and comfort, not having to go and defecate out in a public place.
We are finding that once families are convinced of the need for sanitation, they are willing to go to great lengths in order to provide their family with sanitation, which means building a toilet. And that means making sure that sanitarian equipment is available on the local market, and that we have lots of different designs of toilets so that people can chose the one that they think is the most appropriate to them.
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IPS: Why is sanitation considered one of the most neglected of all the U.N. s Millennium Development Goals (MDGs)?
CB: It is pretty easy to see why sanitation is neglected; it s something that people are embarrassed to talk about. It s what one author called the last taboo . It s embarrassing, it s seen as a very personal, private issue. It s not the one that is seen as particularly sexy or interesting. It doesn t lead to a nice photograph.
One of the things we ve been trying really hard to do is to get positive photographs of latrines, the same way that UNICEF has lots of wonderful positive photographs of water supply. And you can imagine how difficult that is, right? So in a way we compare ourselves in the sanitation sector to the people who pioneered HIV/AIDS. When the issue of AIDS first came up, advocates had to break through the fact that in order to talk about HIV and AIDS, you had to be willing to talk about people s sexual practices, and this was very difficult, but they did it. And it became very matter of fact, and people realised that it is something that needed to be discussed if the disease would be combated.
If the health MDGs are going to be met, we have to improve water supply, improve sanitation, and improve people s hygiene practices, particularly washing their hands with soap. And that means that we have to talk about people s defecation practices the same way that we had to talk about people s sexual practices. And this is a difficult thing to do, because people get embarrassed and shy, and start to giggle. So it s something that we have to address head-on.
IPS: How do you think you can generate more media and donor attention for NGOs that deal with sanitation issues?
CB: One way is through scientific evidence. There are studies available today that were not available even five or 10 years ago. They show very clearly the link between sanitation and health and particularly between hand washing with soap and health. When I say sanitation, I mean toilet, solid waste management, rubbish management, hand washing with soap, and hygiene practices, we see them all as the same thing.
It is women whose dignity and even security are threatened when there s no proper sanitation, women who have to wait all day for darkness of night to be able to go out and go to the toilet. So we want to help women to push sanitation up on the agenda, not as a health issue, but as a quality of life and a dignity issue.
IPS: Why is the subject of sanitation and human waste so rarely aired in public, and what can be done to change this mindset?
CB: It is a brave politician who will get up and talk about sanitation and publicly say that he or she supports investment in more toilets. Politicians usually like to talk about investments in modern equipment projects and things like that. But we do find brave politicians who are willing to break through the taboo and talk about it.
Sanitation is also an institutional orphan, in the sense that the agency or ministry that is responsible for water supply in a country is not necessarily the agency that is responsible for sanitation. So there will be a ministry of water, for instance, that is responsible for water resources and water supply. But then sanitation will be buried in the ministry of health. The ministry of health would be much more interested in curing a disease than in sanitation, which is sort of poorly resourced, and an embarrassing topic. So we do a lot of work to raise the profile of sanitation within health ministries.
IPS: What are the consequences of lack of sanitation among children?
CB: The thing that we re most worried about is diarrheal diseases. Most are fecal or oral, which means that you catch that disease by coming into contact with human fecal matter. And obviously in an environment where there are no toilets, if there is human fecal material available, it gets on people s hands, it gets to some people s feet, it gets into food, and it gets into water, and then we have a very high risk of diarrheal diseases like cholera, and they are deadly to small children. We also worry about worm infections. And most worm infections are caused by poor disposal of human feces and animal feces.
Then there s an issue of lost days of school. If children don t have clean toilets to go to at school, their parents are most likely to keep them at home. Especially girls, when they start menstruating. So we find that for girls, school toilets are just as important for menstrual hygiene as they are for defecation, and that means we have to design many tools to respond to those needs.
IPS: What regions of the world are most affected by lack of proper sanitation?
CB: The coverage rate for sanitation in India and China has a huge impact on the coverage rate for Asia overall. And India and China, advanced as they are in many ways, have very low, surprisingly low rates of sanitation. India is not on track to meet the sanitation target. China overall comes out as being on track, but what that hides is that there s enormous rural China that is not on track. Russia is not on track as well. Most of Africa is not on track to meet the sanitation target.