Showing posts from category environmental health.
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Elizabeth Malone on Climate Change and Glacial Melt in High Asia
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“There’s nothing more iconic, I think, about the climate change issue than glaciers,” says Elizabeth Malone, senior research scientist at the Joint Global Change Research Institute and Pacific Northwest National Laboratory. Malone served as the technical lead on “Changing Glaciers and Hydrology in Asia: Addressing Vulnerability to Glacier Melt Impacts,” a USAID report released in late 2010 that explores the linkages between climate change, demographic change, and glacier melt in the Himalayas and other nearby mountain systems.
Describing glaciers as “transboundary in the largest sense,” Malone points out that meltwater from High Asian glaciers feeds many of the region’s largest rivers, including the Indus, Ganges, Tsangpo-Brahmaputra, and Mekong. While glacial melt does not necessarily constitute a large percentage of those rivers’ downstream flow volume, concern persists that continued rapid glacial melt induced by climate change could eventually impact water availability and food security in densely populated areas of South and East Asia.
Rapid demographic change has potentially factored into accelerated glacial melt, even though the connection may not be a direct one, Malone adds.
Atmospheric pollution generated by growing populations contributes to global warming, while black carbon emissions from cooking and home heating can eventually settle on glacial ice fields, accelerating melt rates. Given such cause-and-effect relationships, Malone says that rapid population growth and the continued retreat of High Asian glaciers are “two problems that seem distant,” yet “are indeed very related.”
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Andrew Morton, UNEP
Haiti 2011: Looking One Year Back and Twenty Years Forward
›January 14, 2011 // By Wilson Center StaffThis piece first appeared on the website of the Haiti Regeneration Initiative – a new collaborative venture between the UN, the government of Haiti, the Earth Institute at Columbia University, Catholic Relief Services, and a wide range of other implementing partners.
In 2010, Haiti endured a year like no other. The country was struck by a devastating earthquake, a cholera epidemic, floods, violence, and political uncertainty. At the same time, Haiti witnessed heroic rescue and relief efforts and an enormous demonstration of international goodwill. Today, recovery and reconstruction are taking place, albeit at a frustratingly slow pace and not currently at the scale of existing needs.
Just as importantly, 2010 brought a renewed awareness of the need for lasting solutions and improvements in the design and delivery of international aid. During the next few days, we will look back on the tragic events of January 12th, 2010, while at the same time, we must look forward, not just one year, but 20.
A Failed Recovery in a Fragile State
Already before the earthquake, Haiti was a fragile state trapped in a slow but vicious negative spiral. A tightly interconnected trio of chronic environmental, political, and socio-economic crises has gradually ensured that Haiti has had the lowest human development indicators in the Western Hemisphere, with life-long poverty, chronic hunger, and violence. Catastrophic events, such as natural disasters, epidemics, and political violence, have simply steepened the descent. Moreover, disaster recovery efforts to date have systematically failed to bring the country back to pre-disaster levels.
In spite of this depressing analysis and forecast, we should not resign ourselves to failure. The situation can be turned around but only with great effort and by foregoing “business as usual.”
The first step towards change is full recognition of the situation. In the case of Haiti, this means recognizing the marked failure of foreign recovery and development assistance to date. It is pointless to blame any particular institution or individual for this: The current state of Haiti is the culmination of generations of efforts and decisions, good and bad, combined with rapid population growth and an inherent vulnerability to natural hazards. (Editor’s note: according to the UN, Haiti’s fertility rate tripled in the immediate aftermath of the earthquake last year.)
The second step is planning. While relatively solid recovery plans have been developed by the government of Haiti with international assistance, their implementation has not so far met with success, due to four interlinked problems.
First, the humanitarian imperative for urgent and chronic relief is overrunning all good intentions for recovery and development – it is politically impossible, inhumane, and simply unwise to ignore the basic resource needs of a cholera epidemic and a million people living in tents.
Second, nothing suppresses development investments like political violence and uncertainty: Few donors, and even fewer companies, will invest while riots and political uncertainty paralyze the country and destroy its reputation.
Third, the planning process is necessarily democratic and participatory; as a result, however, virtually all of the country’s needs are listed with no reliable process of thematic or geographic prioritization.
Finally – and perhaps most importantly – although the plans are official and uncontested, they generally lack broad credibility and commitment. Weary aid workers, government officials, donors and the general public look back at the fate of previous plans and, not surprisingly, expect these latest efforts to fail just as others have before.
Regenerating Haiti
Unlike virtually all other aid organizations I have met in Haiti, the team behind the Haiti Regeneration Initiative (HRI) has fortunately been given the vital time and seed funding to reflect on these issues and try something really different. After two years of preparation, on January 4, 2010, we launched a long-term rural sustainable development initiative for the southwestern tip of Haiti. The Côte Sud Initiative aims to transform the lives and the degraded environment of 200,000 people living in one of the poorest yet most beautiful parts of Haiti.
This specific initiative will only directly assist two percent of the population of Haiti, but just as importantly, we aim to demonstrate that sustainable development is truly possible in this country. Because national-scale issues require national-scale efforts, we also aim to promote change through dialogue and assisting the government of Haiti to develop and deliver on sustainable development plans that work. This is the primary mission of the HRI.
We must arrest the long-term decline as soon as possible. This includes, but is not limited to, basic recovery from the earthquake. At the same time, we need to establish the foundations for the long-term radical changes that are an absolute prerequisite to achieving sustainable development in Haiti. We must prepare to turn the vicious circles into virtuous ones.
So what are the short- to medium-term priorities?
The first is political stabilization, as vital foreign aid and direct foreign investment will simply not arrive in the face of such negative news and uncertainty.
Second, a massive aid investment in potable water and sanitation is required to suppress cholera in the longer term. No country can develop in the midst of recurrent major epidemics. This investment needs to be designed for sustainability; in other words, infrastructure needs to be accompanied by realistic, locally financed mechanisms for maintenance. Otherwise it will become useless within weeks of installation.
Third, persistence is needed on the current debris clearance and rebuilding efforts; we know from many other countries that such efforts can take years to be completed.
Finally, development aid should move out of Port-au-Prince and into the regions. In 2010, the massive influx of earthquake relief and reconstruction aid actually increased the economic pull of the capital and exacerbated existing urban problems.
What to do to prepare for the long term? Implementing radical change requires political support and even cultural reform, so in addition to good ideas, the HRI partnership will work hard to develop a sense of national ownership of the solutions as well as the problems.
Many of the ideas are not new: mildly decentralized development, diversified and value-added agriculture, niche tourism, improved aid coordination, public-private partnerships, etc.
Many, however, are radical, including a proposed paradigm change on migration and remittances, education, food security and import policies, widespread privatization, harsh revisions and rebuttals of traditional development models and assumptions, and adaptation to the new types of religious NGOs. These are just a few of the concepts and opportunities we have identified and will work to make a reality in Haiti.
Over the next few years, the HRI hopes to foster an intelligent and useful dialogue on sustainable development in Haiti. We look forward to having all of those who are concerned about and interested in helping Haiti join us in the debate.
Andrew Morton is the Haiti Regeneration coordinator and a senior staff member at UNEP. For more information on the Haiti Regeneration Initiative please see www.haitiregeneration.org.
Sources: BBC, Haiti Regeneration Initiative, United Nations Development Programme.
Image Credit: “Rebuilding as a community,” courtesy of flickr user Save the Children. -
Greater Than the Sum of Its Parts: Quantifying the Integration of Population, Health, and Environment in Development
›It makes intrinsic sense that integrated approaches working across development sectors are a good thing – especially when it comes to the complex issues facing people in developing countries and the environment in which they live. After all, integration avoids overlap and redundancies, and adds value to results on the ground. Yet, quantifying the benefit of integration has been difficult and to date, little on this topic has been published in the peer-reviewed literature.
Not anymore. Our article, “Integrated management of coastal resources and human health yields added value: a comparative study in Palawan (Philippines),” recently published in the journal Environmental Conservation, breaks new ground. Rigorous time-series data and regression analysis document evidence of different disciplines working together to produce synergies not obtainable by any one of the disciplines alone.
The article presents quasi-experimental research recently conducted in the Philippines that tested the hypothesis that a specific model of integration – one in which family planning information, advocacy, and service delivery were integrated with coastal resources management – yields better results than single-sector models that provide only family planning or coastal resources management services.The study collected data from three island municipalities in the Palawan region of the Philippines, where the residents are dependent on coastal resources for their livelihoods. The integrated model was implemented in one municipality, while the single-sector models (one coastal resource management program and one reproductive health management program) were conducted in two separate municipalities.
The results of the study provide strong evidence that the integrated model outperformed the single-sector models in terms of improvements in coral reef and mangrove health; individual family planning and reproductive health practices; and community-level indicators of food security and vulnerability to poverty. Young adults – especially young men – at the integrated site were more likely to use family planning and delay early sex than at the sites where only family planning and reproductive health interventions were provided.
Coral reef health – as measured by a composite condition index – and mangrove health increased significantly at the integrated site, compared to the site where only coastal resource management interventions were provided. Data from the integrated site also showed a significant decline in the number of full-time fishers, as well as fewer people who knew someone that used cyanide or dynamite to fish – both factors that amplify a community’s vulnerability to food insecurity. Finally, the proportion of young people with income below the poverty threshold decreased by a significant margin in areas where the integrated population and coastal resources management (IPOPCORM) model was applied.
Let’s hope this research is just the beginning of a more thoughtful and effective approach to meeting multiple development goals in a lasting mannerEducational activities at the integrated site focused on illuminating the intrinsic relationship between fast-growing coastal communities in the Philippines and the diminishing health of the coral reefs and fisheries that they depend on for food and livelihoods. Community change agents, often fishermen and their families, talked to their neighbors and fellow fishers about the importance of planning and spacing families and establishing and respecting marine reserves to protect the supplies of food from the sea. They referred those interested in family planning to community-based social marketers of contraceptives or the nearest health center for other services.
These same community members also participated in activities to sustainably manage their coastal resources: working with local government officials to establish marine reserves, replant mangroves, serve as community fish wardens to patrol those reserves, test out alternative livelihoods such as seaweed farming, and start small businesses to diversify their income and reduce fishing pressure.
Development professionals should pay close attention to the conclusions of this study. In environmentally significant areas where human population growth is high, it will be difficult to sustain conservation gains without parallel efforts to address demographic factors and inequities in the distribution of health and family planning services. Integrating responses to population, health, and environment (PHE) issues provides an opportunity to address multiple stresses on communities and their environments and, as this study demonstrates, adds value in such a way that significantly improves community resilience and other outcomes.
This research allows those of us who believe strongly in integrating population, health, and environment programming to point to quantitative proof that the approach works. We now need to expand PHE programming to reach more people in other parts of the world where communities face a similar nexus of challenges. New initiatives have started taking the lessons from this research, applying them to new contexts in Africa and Asia, and scaling them up to reach many more in the Philippines.
Let’s hope this research is just the beginning of a more thoughtful and effective approach to meeting multiple development goals in a lasting manner in the places that need it most.Leona D’Agnes is the technical director of IPOPCORM, Joan Castro is the executive vice president of PATH Foundation Philippines Inc, and Heather D’Agnes is the Population, Health, Environment Technical Advisor in the U.S. Agency for International Development’s (USAID) Office of Population and Reproductive Health.
Sources: BALANCED, Link TV, PATH Foundation Philippines Inc., World Wildlife Foundation.
Image Credit: Philippines village (adapted) and municipalities map courtesy of PATH Foundation Philippines Inc. -
Bringing PHE to a Muslim Community in Tanzania
Abdalah Overcomes the Odds
›This PHE Champion profile was produced by the BALANCED Project.
“Now, people can plan their families and know how to use a condom,” says Abdalah Masingano as he proudly tells how his community has come to accept integrated population, health, and environment (PHE) activities.
The 35 year-old Abdalah is a PHE provider. He lives near the Saadani National Park (SANAPA) — one of Tanzania’s newest, and the only terrestrial park with a contiguous marine area in southeastern Tanzania. Saadani is home to the rare Roosevelt Sable antelope and the nesting grounds for several endangered species of marine turtles. One of the largest threats to biodiversity in this area is the clearing of mangroves and coastal forests for firewood and charcoal-making. About 95 percent of households in the area depend on firewood for cooking and most use a three-stone fireplace that utilizes only about 10 percent of its energy potential. These are just some of many pressures that people living around the park place on the biodiversity-rich forest and marine resources of the area.
Abdalah and his 31 year-old wife have two children: a 14-year-old boy and a six-year-old girl. His wife has been on the pill for four years. For two years now, Abdalah has been selling condoms in his village store. He made this decision for simple reasons. He saw that people needed condoms for both family planning and health, and he had come to understand the linkages between the behaviors of people living in the area and the health of the environment.
Abdalah gained this understanding when he was recruited to become a PHE provider by the Tanzania Coastal Management Partnership as part of its work through the USAID-supported BALANCED Project, which is promoting PHE implementation in biodiversity-rich countries. In a two-day training, Abdalah learned about integrated PHE and the links between population (family planning), health, and the environment. He has been educating villagers ever since.
“In the past, it was difficult for people to plan their families because they were embarrassed,” recalls Abdalah. As a PHE provider, Abdalah delivers integrated PHE messages to his fellow villagers. After attending the BALANCED training, Abdalah learned that promoting family planning makes sense for reasons beyond health. Forest and marine resources found both around and inside the Saadani are heavily exploited by local villages – and from a biodiversity conservation perspective, reducing population pressures is just one critical step in protecting this biodiversity.
When people visit his shop, Abdalah takes the opportunity to explain the population and environment connection. Because deforestation is a particular problem in the area where Abdalah lives and works, he promotes the use of fuel-efficient stoves.
Showcasing his own stove, his explains that by using a simple clay stove – which is made locally – a household can save almost 1.5 tons of fuelwood annually and reduce by 50 percent the time women spend collecting fuelwood. At the same time, he reminds villagers that when they plan their families they help keep mothers and children healthy. Healthier families also tend to put fewer pressures on – and thus keep healthier – the very natural resources they depend on for food and income.
Initially, Abdalah’s Muslim neighbors were unhappy with him promoting family planning and condom use. They believed what he was doing encouraged sex and prostitution. “They thought I was lost,” he explains smiling. Fortunately, his wife has been very supportive of him despite the discouraging reactions of his fellow villagers early on in his efforts.
Today, Abdalah’s perseverance has paid off. He now sells more than 200 condoms monthly and takes the time to demonstrate to his customers how to use them properly. When there is the opportunity, he also refers his customers to the local health dispensaries for additional family planning services and commodities. Abdalah believes people respect him now. “I feel good because I am able to help,” he concludes. That “help” impacts both the health and well-being of his fellow villagers and the health and well-being of the environment. Abdalah and his wife plan to have their third child two years from now.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Sources: Darfur Stoves Project, IPS News, TSN Daily News, UN.
Photo Credit: Abdalah showing a box of condoms for sale in his small shop by Juma Dyegula, courtesy of the BALANCED Project. -
The Cholera Quandary
›The original version of this article first appeared in the Stimson Center Spotlight series, November 19, 2010.
Cholera is usually seen as one of the most devastating infections of the 19th century. Trade routes carried cholera from India to the great cities of Europe and the United States. Disease, fear, and political unrest spread in great waves that cost millions of lives. After much destruction, it was only with science and resources that certain populations were able to curb the epidemic.One of the most celebrated lessons in the history of public health involves a cholera outbreak in London in 1854 and efforts by John Snow – celebrated as the father of epidemiology – to control it. At the time, it was not clear that cholera was a waterborne bacterial infection that caused severe diarrhea and vomiting, and sometimes fatal dehydration. Snow proved that the outbreaks decimating communities spread from contaminated water. Water and sanitation services had virtually eliminated cholera epidemics in the developed world by the early 1900s.
Today, cholera has been nearly eradicated in the developed world, but continues to be endemic in poorer countries. Risks seem to be rising as larger populations are crowded into unsanitary conditions. The World Health Organization (WHO) estimates three to five million illnesses and 100,000-200,000 deaths from cholera each year. If caught early, infections are treatable with inexpensive oral rehydration solutions. For much of the world, these options are unavailable or underused – the mere presence of cholera serves as an indicator of a country’s socioeconomic status and health system capabilities.
The cholera epidemics that are currently menacing countries on three different continents – Asia, Africa, and North America – raise tough questions about what is required to protect the world’s vulnerable populations. We know how to predict the crisis of cholera, prevent outbreaks, and contain them when they occur. To control cholera, what is needed is not cutting-edge technologies, but will, transparency, and resources – and where cholera appears, at least one of these three factors has failed.
Currently, cholera outbreaks in Pakistan, Haiti, and Nigeria are piling misery upon misery. Cholera in post-flood Pakistan comes as no surprise. When floodwaters left millions homeless and without access to clean drinking water in a region where cholera remains endemic, health officials could have reasonably assumed infected human waste would seep into water supplies and spread disease. The inability of health networks on the ground to prevent and then detect cholera demonstrates cracks in the country’s health system. What is apparent here is a lack of will and resources. Disease surveillance is especially vital in a post-disaster scenario where steps can be taken, such as treating water with chlorine, to prevent an outbreak.
Haiti had been free of cholera for at least 50 years, but the disease struck and spread rapidly 10 months after the devastating January 2010 earthquake. It reached Haiti’s capital and spread to its neighbor, the Dominican Republic. Since October, more than 114,000 people have become ill and more than 2,500 have died (Editor’s note: updated since original publication).
Haiti lacked resources for basic infrastructure even prior to the earthquake; the cholera crisis is not only costing lives, but also diverting aid from “building back better.” But regardless of the source of the cholera strain, if basic infrastructure and resources to protect Haiti’s vulnerable populations had been in place, cholera’s re-emergence would have been far less devastating.
This particular outbreak draws attention to the practical and political challenges of identifying health risks in humanitarian workers and peacekeepers, many of whom come from developing countries themselves. Evidence suggests that peacekeepers from Nepal, housed at a UN base, may have been the source of the outbreak clustered around the Artibonite River. Cholera outbreaks frequently exacerbate frictions between communities and aid workers – suspicions that have led to riots and murder more than once in recent years. At least two people were killed in Haiti in riots with peacekeepers during November.The delayed decision by the UN to investigate whether the outbreak originated with peacekeepers may have conserved resources for the race to stave off more cases, but did little to build trust between communities and foreign workers. Further violence and protests surrounding the recent disputed presidential election in Haiti do little to ease the devastation and in fact, threaten the relief effort. There has been discussion in Congress of cutting direct aid and suspending visas for Haitian officials until the dispute as been resolved. The Organization of American States is now reviewing the results.
In Africa, Nigeria is experiencing its worst cholera outbreak since 1991, and the disease is crossing borders. An onslaught of cases raised the 2010 death toll to more than 1,500 fatalities out of 40,000 cases. This mortality rate is three times higher than the seasonal cholera outbreaks of 2009, and seven times higher than 2008. Despite Nigeria’s oil wealth, most of the population is impoverished. Two-thirds of rural Nigerians lack access to safe drinking water and fewer than 40 percent of people in cholera-affected areas have access to toilet facilities, according to the Nigerian Health Ministry. A combined lack of will, transparency, and resources mean that cholera epidemics occur annually, and in clusters throughout sub-Saharan Africa.
A century and a half after John Snow’s discovery, we know how to control cholera. Globally, the resources exist, but the question of a collective will remains. For those who lack clean water to drink, to wash, or even proper toilets, the gap between knowing and doing is not easily closed. The international community has shown repeatedly that it can confront cholera outbreaks like those in Haiti, Pakistan, and Nigeria in the midst of crisis. The question remains as to how those efforts can eliminate the conditions that fostered outbreaks in the first place. The answer is not as riveting as the causes that often receive funding: basic infrastructure and resources. Roads, wells, clean water, toilets, education, and the willingness to recognize that if the foundation is not sound, nothing will be able to stand. Sometimes the simplest problems are the most difficult to solve.
Sarah Kornblet is a research fellow at the Global Health Security Program at the Stimson Center. Her research focuses on the International Health Regulations, health systems strengthening, global health diplomacy, the intersection of public health and security, and the potential for innovative and dynamic health policy solutions in developing countries.
Sources: Agence France-Presse, BBC, Washington Post, World Health Organization.
Photo Credit: “UN Peacekeepers Provide Security During Port-au-Prince Food Distribution,” courtesy of flickr user United Nations Photo. -
The Role of Population Dynamics in Climate Adaptation
›December 21, 2010 // By Wilson Center StaffThis post is a synthesis of a panel discussion at the UNFPA Population Dynamics and Climate Change conference in Mexico City with Marcia Castro, of the Harvard School of Public Health; Heather D’Agnes, of USAID; and Lori Hunter, of the University of Colorado at Boulder.
It is well-known that environmental change — including climate change — has important impacts on human health. However, it is less well understood how health systems shape the responses of individuals and households to environmental change. Population dynamics — such as fertility, migration, and mortality and morbidity — influence community health and greatly affect community resilience in the face of environmental changes, including the capacity to adapt to climate change.
Mortality and Morbidity
Morbidity and mortality dramatically shape a household’s ability to adapt its livelihood strategies to a changing climate. For example, in areas of high HIV prevalence, such as sub-Saharan Africa, adult mortality seriously undermines livelihood options. In the face of such loss, the household’s reliance on local natural resources intensifies. If environmental change reduces the amount of available resources, the household has fewer options for energy and sustenance.
Morbidity also affects adaptive capacity, and morbidity itself can be shaped by environmental change. For example, environmental scarcity can increase poverty, which can lead to an increase in risky transactional sex, further fueling the HIV pandemic. Malnutrition resulting from drought and environmental shocks can suppress the immune systems of HIV-positive people, making them more vulnerable to illness and less able to adapt to other external changes.
Fertility and Family Planning
Healthier households are more resilient households, so increasing access to health services, including reproductive health services, is essential for building adaptive capacity. High fertility poses challenges to a family’s livelihood and has negative health effects on women and children. Providing reproductive health services is an effective way to improve the capacity of these vulnerable groups to adapt to climate change. For example, a recent study argues that lowering fertility rates in the Himalayan region could increase community resilience to the predicted fluctuations in water quantity.
However, there is a high level of unmet demand for contraception across the globe. How can community adaptation programs help meet this need? Importantly, research from the Philippines suggests that integrating population, health, and environment programs in a package approach to community development is more effective than single-sector interventions. Including family planning and reproductive health services in community-based climate adaptation programs could not only more effectively meet the community’s needs, but could also improve its adaptive capacity better than health or climate programs alone.
Migration
Another population process, migration, can both impact health and affect the capacity for adaptation. For example, internal migration in the Brazilian Amazon appears associated with the spread of malaria, which negatively impacts the adaptive capacity of households. To mitigate climate change’s health impacts, states should more effectively plan settlements and health systems, including health impact assessments for infrastructure and development projects. (Editor’s Note – northern Nigeria and Niger present another example of similar climate-related migratory patterns that significantly impact health and economic resilience.)
In summary, the scientific evidence is clear that population dynamics — such as mortality, fertility, and migration — and environmental trends are linked. Projects intended to improve a community’s ability to adapt to a changing climate should consider and address these linkages in their design and implementation.
Sources: Foundation for Environmental Conservation, UNFPA, USAID.
Photo Credit: “Toureg family in Niger,” courtesy of flickr user ILRI. -
The World’s Toilet Crisis
›Forty percent of the world’s population – 2.6 billion people – do not have access to toilets, and some in the international aid community are finally dispensing with the euphemisms and calling this sanitation crisis what it is: “shit.”
In “The World’s Toilet Crisis” (trailer above), Adam Yamaguchi sets off in an episode of Current TV’s Vanguard program to tell the story of “the deadliest killer in the world…something no one wants to talk about.” All around the developing world, thanks in part to rapid population growth and poor development and environmental standards, “people are literally eating their own shit,” he said.
His journey takes him to India, where more people own cell phones, than toilets. The 55 percent of Indians who practice open defecation have contributed to another grim statistic: an estimated 840,000 children under the age of five die in India each year from diarrheal diseases.
India’s water quality is especially affected by lack of sanitation. In the documentary, Yamaguchi visits the Yamuna River, which is Delhi’s primary source of drinking water, and has become a “giant toilet” literally bubbling with methane gas. This phenomenon is not unique to India. Approximately 80 percent of sewage in developing countries goes untreated, polluting local water resources.
But it is women who feel the effects of lack of access to clean water and toilets most keenly. In 72 percent of households around the world, women are the primary water collectors, often travelling long distances for drinkable water. They face shame and harassment when going to the bathroom, causing them to suppress their need until dark, causing negative health effects. Waiting until nightfall also means that when women openly defecate, they often face molestation, violence, and rape. Teenage girls also often drop out of school once they begin to menstruate because toilets are not private, unsafe, or are simply nonexistent.
Reflecting on his motivations for making the documentary, Yamaguchi said that in order to expose this “global public health crisis,” he needed to be as graphic, shocking, and disgusting as possible.If you’re not grossed out by, or incensed by the fact that there is shit everywhere, you’re not really moved to act or change your ways. And that’s ultimately what’s happened in many places in the world. It’s a normal fact of life. You see it everywhere, and you think nothing of it. There are causes out there that are deep sexy causes or marketable causes. Shit or toilets – not the most marketable thing in the world.
“The World’s Toilet Crisis” forms part of a broader trend among sanitation advocates to use crude language to address a problem the international health and development community has traditionally shied away from talking about directly.
Tales of shit: Community-Led Total Sanitation in Africa, published shortly before World Toilet Day by the International Institute for Environment and Development, takes an equally direct approach to sanitation.
Community-Led Total Sanitation (CLTS) is an approach begun with great success by Dr. Kamal Kar in Bangladesh that relies on “triggering” to change community behavior. The report, which is prefaced by a three-page “International Glossary of Shit” listing the words for shit in other languages, emphasizes the need to “explicitly [talk] about and [make] visible the shit that is normally hidden beneath taboos and polite language.” By almost literally thrusting people’s shit right under their noses, communities learn what they have been ignoring: that they are “eating each others’ shit.”
Traditional sanitation programs often fail because “a high proportion of latrines constructed with subsidies are never used as toilets, but as storage space, animal shelters, or prayer rooms – the buildings are too high quality to be wasted on toilets!” says the report. CLTS, on the other hand, focuses on changing behavior at the community, rather than the individual level to create sustainable change that responds and adapts to a community’s distinct culture and needs.
“The World’s Toilet Crisis” shows the promise CLTS has of meeting the needs of the billions without toilets. In East Java, Yamaguchi joins a community leader to collect a “specimen” from a well-traveled river bank near the town, which he proceeds to show to a group of women in the town who are, predictably, revolted. The community then takes collective action to become “open-defecation free” and invest in toilets.
“The World’s Toilet Crisis” is not easy to watch, nor was it easy to film – seven minutes in, Yamaguchi vomits on the banks of the polluted Yamuna River. Disgust, however, is central to raising awareness and affecting change on both the community and global levels. As Yamaguchi explains, “You’re going to get grossed out by seeing this piece, and that’s part of the point.”
Sources: Community-Led Total Sanitation, Current TV, Earth Times, IIED, Water.org, World Toilet Organization, WHO, United Nations University.
Video Credit: “The World’s Toilet Crisis – Vanguard Trailer,” courtesy of Current TV’s Vanguard. -
Watch: Joel E. Cohen on Solving the Resource-Population Equation in the Developing World
›December 14, 2010 // By Wilson Center Staff“It’s very hard to put a number on a quantity that depends on future events, processes we don’t understand, and values that may change over time,” said Joel E. Cohenof the Rockefeller University in this interview with ECSP. “That doesn’t mean we have no problems and it doesn’t mean there’s nothing we can do.”
There are three schools of thought or proposed “panaceas,” when it comes to balancing natural resources and population, said Cohen: a bigger pie (new technology to increase productivity), fewer forks (reduced consumption), and better manners (reduced irrational market inequities and better governance).
In the 15 years since his book How Many People Can the Earth Support? was published, Cohen’s approach has changed. While the 1996 book lacked a definitive policy recommendation, he is now analyzing options. “The evolution of my thought has moved from ‘how many people can the Earth support?’ to ‘what do we need to solve problems?’” he said.
You need adequate child and maternal nutrition to produce potential problem solvers and you need education to give them the tools to do it with, said Cohen, who studied the impact of universal primary and secondary education with colleagues at the American Academy of Arts and Sciences.
“If you look at a map of stunting in the world, there are parts of South Asia and sub-Saharan Africa where more than half the children are stunted – that means two standard deviations [of] height below normal for their age,” said Cohen. “Those populations are handicapped at the starting gate because they don’t have the problem solvers.”
