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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.” -
Hans Rosling Double Feature: ‘The Joy of Stats’ on BBC and Population Growth at TED
›Hans Rosling, creator of Gapminder and professor of international health at Sweden’s Karolinska Institute, hosts a new documentary on the BBC called The Joy of Stats that takes a look at the breadth and depth of data available today to analysts and private citizens alike.
In the clip above, Rosling demonstrates his primary interest in world health, tracking life expectancy and income over the last 200 years to show both the remarkable progress that has been made but also the tremendous gap that remains between those at the top (the very rich and healthy) and those at the bottom (the very poor and sick).
Rosling has been a vocal (and visual) advocate for expanding people’s knowledge of the world by presenting statistics in innovative ways. “Statistics should be the intellectual sidewalks of a society, and people should be able to build businesses and operate on the side of them,” he said at a discussion at the Wilson Center in May 2009.
In particular, Rosling’s focus has been on health, poverty, and the developing world, where he’s advocated for increased focus on child and maternal health and education. “The role of the old West in the new world is to become the foundation of the modern world – nothing more, nothing less,” he said during a TED talk on population growth (see below) where he broke from his more flashy visuals and went analog – using IKEA boxes to illustrate population and consumption growth. “But it’s a very important role. Do it well and get used to it.”
Rosling’s Gapminder software has been incorporated into Google’s Public Data Explorer, where many development indicators from the World Bank, World Health Organization, and others can now be easily tracked by anyone. For more on Google Data and to see an example set of indicators (agriculture as a percentage of GDP vs. fertility rates over the last 50 years), check out this previous Eye On, on The New Security Beat.
Video Credit: “Hans Rosling’s 200 Countries, 200 Years, 4 Minutes – The Joy of Stats – BBC Four,” courtesy of BBC, via YouTube, and “Hans Rosling on global population growth,” courtesy of TED. -
Watch: Blue Ventures PHE Program in Madagascar
›“All conservation efforts will be in vain if family planning issues aren’t addressed,” says Rebecca Hill, project manager for the Sexual and Reproductive Health Programme at Blue Ventures in a video highlighting their population, health, and environment (PHE) programming in Madagascar.
While primarily a marine conservation group, Blue Ventures also recognizes the need for integrating population into their efforts. They began a family planning program in southwestern Madagascar in 2008 as part of a “holistic approach to conservation.” The project aims to address the high unmet need for family planning, high fertility and maternal and infant mortality, and conserve the coastal environment. “We are directly saving lives,” Hill says.
Rapid population growth is creating an unsustainable strain on natural resources, as Matthew Erdman of Blue Ventures wrote in a previous post on The New Security Beat:The average total fertility rate in Velondriake is 6.7 children per woman, according to our data. On average women are only 15 years old when they first conceive. To compound this problem, a majority of the population is under the age of 15 – at or approaching reproductive age. At the current growth rate, the local population will double in only 10 to 15 years. The local food sources, already heavily depleted, barely feed the current population, let alone twice that amount. Without enabling these coastal communities to stabilize their population growth, efforts to improve the state of marine resources and the community’s food security are considerably hindered.
Hill describes the situation in the village when she joined the Blue Ventures in 2008 as “alarming,” with women “having up to 17 children despite not wanting children.” Many people in the town had never heard of condoms and had no idea how to use them, she said, and “they are desperate to have access to contraception.”
Today, the initial family planning program has been scaled up to the surrounding region and generated significant community involvement by peer educators teaching community members about sexual and reproductive health. It’s also become the first PHE project to receive support from the UNFPA within Madagascar.
There are currently 18 community-based distributors who give out two types of contraception in their villages. The fact that the community has so fully embraced the project shows that it can be replicated elsewhere, says Hill in the video. “Communities themselves have harnessed the ideas and consider that what we’re doing is vitally important.”
“Addressing family planning needs and issues is inextricably linked with conservation issues,” says Hill. “All conservation efforts will be in vain, if family planning issues are not addressed.”
Video Credit: Blue Ventures Family Planning Project from Alexander Goodman on Vimeo. -
Yale Environment 360: ‘When The Water Ends: Africa’s Climate Conflicts’
›November 10, 2010 // By Wilson Center StaffOriginally posted on Yale Environment 360:
For thousands of years, nomadic herdsmen have roamed the harsh, semi-arid lowlands that stretch across 80 percent of Kenya and 60 percent of Ethiopia. Descendants of the oldest tribal societies in the world, they survive thanks to the animals they raise and the crops they grow, their travels determined by the search for water and grazing lands.These herdsmen have long been accustomed to adapting to a changing environment. But in recent years, they have faced challenges unlike any in living memory: As temperatures in the region have risen and water supplies have dwindled, the pastoralists have had to range more widely in search of suitable water and land. That search has brought tribal groups in Ethiopia and Kenya in increasing conflict, as pastoral communities kill each other over water and grass.
When the Water Ends, a 16-minute video produced by Yale Environment 360 in collaboration with MediaStorm, tells the story of this conflict and of the increasingly dire drought conditions facing parts of East Africa. To report this video, Evan Abramson, a 32-year-old photographer and videographer, spent two months in the region early this year, living among the herding communities. He returned with a tale that many climate scientists say will be increasingly common in the 21st century and beyond — how worsening drought in parts of Africa, the Middle East, and elsewhere will pit group against group, nation against nation. As one UN official told Abramson, the clashes between Kenyan and Ethiopian pastoralists represent “some of the world’s first climate-change conflicts.”
But the story recounted in When the Water Ends is not only about climate change. It’s also about how deforestation and land degradation — due in large part to population pressures — are exacting a toll on impoverished farmers and nomads as the earth grows ever more barren.
The video focuses on four groups of pastoralists — the Turkana of Kenya and the Dassanech, Nyangatom, and Mursi of Ethiopia — who are among the more than two dozen tribes whose lives and culture depend on the waters of the Omo River and the body of water into which it flows, Lake Turkana. For the past 40 years at least, Lake Turkana has steadily shrunk because of increased evaporation from higher temperatures and a steady reduction in the flow of the Omo due to less rainfall, increased diversion of water for irrigation, and upstream dam projects. As the lake has diminished, it has disappeared altogether from Ethiopian territory and retreated south into Kenya. The Dassanech people have followed the water, and in doing so have come into direct conflict with the Turkana of Kenya.
The result has been cross-border raids in which members of both groups kill each other, raid livestock, and torch huts. Many people in both tribes have been left without their traditional livelihoods and survive thanks to food aid from nonprofit organizations and the UN.
The future for the tribes of the Omo-Turkana basin looks bleak. Temperatures in the region have risen by about 2 degrees F since 1960. Droughts are occurring with a frequency and intensity not seen in recent memory. Areas once prone to drought every ten or eleven years are now experiencing a drought every two or three. Scientists say temperatures could well rise an additional 2 to 5 degrees F by 2060, which will almost certainly lead to even drier conditions in large parts of East Africa.
In addition, the Ethiopian government is building a dam on the upper Omo River — the largest hydropower project in sub-Saharan Africa — that will hold back water and prevent the river’s annual flood cycles, upon which more than 500,000 tribesmen in Ethiopia and 300,000 in Kenya depend for cultivation, grazing, and fishing.
The herdsmen who speak in this video are caught up in forces over which they have no real control. Although they have done almost nothing to generate the greenhouse gas emissions that cause global warming, they may already be among its first casualties. “I am really beaten by hunger,” says one elderly, rail-thin Nyangatom tribesman. “There is famine — people are dying here. This happened since the Turkana and the Kenyans started fighting with us. We fight over grazing lands. There is no peace at all.”
Watch When the Water Ends: Africa’s Climate Conflicts on Yale Environment 360.
For more on integrated PHE development and the Horn of Africa, see “The Beat on the Ground: Video: Population, Health, and Environment in Ethiopia” and “As Somalia Sinks, Neighbors Face a Fight to Stay Afloat,” on The New Security Beat. -
PATH Foundation’s ‘Population, Health, and Environment Leadership as a Way of Life’
›PATH Foundation Philippines, Inc. (PFPI) just released a short documentary, Population-Health-Environment (PHE) Leadership as a Way of Life in All Walks of Life. The video features interviews with peer educators and local government officials who have partnered with PFPI on integrated coastal resource management in the Philippines that combines family planning and reproductive health services with environmental services.
According to those interviewed, an integrated approach is the best way to alleviate food insecurity in the area. “We cannot separate population, health, and environment, they should be implemented hand in hand,” said Marlyn Alcanises, a Fisheries and Coastal Resource Management program officer. “Even if we manage our coastal resources well, if there are many children due to high fertility and population growth, many people are hungry.”
The comprehensive program has been successful in addressing the social and environmental problems in the Verde Island Passage of the Philippines, one of Asia’s most densely populated regions, as well as a marine biodiversity hotspot and sea lane for many commercial ships.
The program uses community-based distribution of contraceptives to increase access to family planning, micro-credit schemes to finance sustainable livelihoods and alleviate poverty, and advocacy campaigns to increase government support for integrated health and environment programs.
Municipal Planning and Development Coordinator Cecilia Zulueta praised the integrated approach, saying “it can slow down population growth, decrease the number of malnutrition cases, lessen the number of out-of-school youth, and it can also decrease the crime rate, because if one does not have a stable source of income it may force him to engage in illegal activities.”
In ECSP’s FOCUS Issue 15, “Fishing for Families: Reproductive Health and Integrated Coastal Management in the Philippines,” Joan Castro and Leona D’Agnes demonstrated that PFPI’s Integrated Population and Coastal Resource Management project (IPOPCORM) was more cost-effective and had a greater impact on the wellbeing of both human reproductive health and coastal resources than non-integrated programs. In a study measuring the impacts of integrated versus single-sector reproductive health (RH) or coastal resource management (CRM) programs, they found the integrated approach met or exceeded single-sector outcomes for 26 out of 27 indicators.
Reducing high fertility rates reduces pressure on natural resources, decreases high rates of malnutrition, crime and HIV/AIDS, and preserves local fisheries, “making life sustainable for both humans and nature,” as PFPI puts it in the documentary. The hope is that the community leaders featured in the documentary will inspire others in similar situations to take the lead on integrated issues in their communities.
“Even if we are doing environmental conservation through population management in our province but the others are not, it will still create conflict somehow,” said Alcanises. “I believe that whatever program is being done in one province should also be done in other provinces, in order to avoid conflict and promote balance in program implementation.”
Julio Lopez, president of the Galera Association of Managers and Entertainers said, “this land is ours, and we are responsible in taking care of it.”
PFPI, along with the University of Rhode Island’s Coastal Resource Center and Conservation International, is part of the BALANCED project, which last year launched the PHE Toolkit as a resource for PHE professionals. For more on PFPI’s IPOPCORM program, see ECSP’s interviews with Joan Casto and Leona D’Agnes on our YouTube channel: “Joan Castro – Integrated Population and Coastal Resource Management (IPOPCORM)” and “Leona D’Agnes on Population, Health, and Environment.”
Video Credit: “Population-Health-Environment (PHE) A Video Documentary,” courtesy of YouTube user PATHFoundationPhils.
Sources: Population Reference Bureau. -
Watch: David Aylward on How Wireless Technology is Changing Global Health and Empowering Women
›“We have millions of young children, babies, dying unnecessarily, hundreds of thousands of women dying in childbirth – most of them unnecessarily – in large part for lack of access to health, lack of access to health information,” said David Aylward, executive director of the UN Foundation’s mHealth Alliance. “And while wireless doesn’t solve any of those problems by itself, it is a conduit, a pathway to solve those problems.”
We spoke to Aylward before the Global Health Initiative (GHI) event “New Applications for Existing Technologies to Improve Maternal Health,” at the Wilson Center earlier this week.
“We’ve gone from a billion subscribers to five billion subscribers in the last six years, and 70 percent of those are in the developing world,” he said. “So almost everywhere you go a woman has a cellphone or has access to a cellphone.”
This access allows women in the developing world to do basic things those in the developed world take for granted, like call for help or set up reminders. The most important thing to think about in the future is to continue empowering women with the tools and knowledge to understand their own healthcare and supporting them with better care.
“All of which are possible in the very near term if we can get the different parties to get together and work on them together,” said Aylward, “and that’s what our mission is.”
Check out the the full event summary from GHI here. -
Watch: Alex Evans on Natural Resource Supply and Demand, Scarcity, and Resilience
›October 27, 2010 // By Schuyler Null“The backdrop to the whole issue of scarcity is that demand is rising, but on the supply side, we’re increasingly hitting restraints,” said Alex Evans of NYU’s Center for International Cooperation in this interview with ECSP.
“Global population is growing, a kind of new global middle class is expanding, especially in emerging economies, and that means demand is rising across the board – particularly for energy, for food, water, and air space for our carbon emissions.”
Evans joined Mathew Burrows of the National Intelligence Council this September at the Wilson Center to talk about scarcity, natural resources, and conflict. He argued that building resilience and improving governance of natural resources is key to addressing growing demand, particularly in developing countries.
“With the Millennium Development Goals there’s been tremendous emphasis on increasing access to services, like health and education, which is important,” he said. “But we haven’t always brought the risk management aspect to the fore, and I think the emphasis we’re starting to see now on areas like social protection, climate adaptation, disaster risk reduction – these are areas that are much more concerned with resilience and it’s very welcome that they’re moving to the front of the development agenda.”
Poor governance in some developing countries has resulted in cases like in Nigeria and the Democratic Republic of the Congo, where natural resources are seen as more of a curse to the local people than a blessing. The intersection between supply and demand will continue to make these problems more acute.
“Over the last 10 years when international aid agencies have thought about governance, it’s usually been in terms of capacity building in the executive branch – areas like public financial management,” said Evans. “I think increasingly we’ll see more of the very, very political issues surrounding who owns natural resources like land, or water, or fisheries, or forests.”
Evans also highlighted other international governance issues like transboundary agreements (or lack thereof), the resiliency of the international trade system (or lack thereof), and existing legal infrastructure that will be challenged by a changing climate and growing demand.
“We haven’t really begun to think these issues through,” he said, “but these are potential conflict flashpoints for the future.”
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