Rats in maternity wards
ACCORDING to a news item (Nov 19), 88 per cent of Thar population does not have toilets; 90 per cent of the schools do not have toilets and more than 90 per cent of people do not have access to safe water.
According to a report (Aug 9), the high levels of fluorides in Thar groundwaters (32 mg/l) is wrecking the lives of Tharis. The high level of fluorides in drinking waters causes crippling skeletal fluorosis, bone deformities, calcification of ligaments, pain, immobility and paralysis. In other areas of rural Sindh, access to safe water and sanitation is low and hygiene is nowhere to be found.
A Sanitation and Water for All 2012 meeting was held on April 20 in Washington DC on improving access to water and sanitation (W & S). Our representative reaffirmed Pakistan’s commitment and obligations to the Millennium Development Goals (MDGs) relating to W&S.
The relevant MDG target is: “halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation.” The targets were set in 2000. In case of Tharparkar, the time has stood still, as there is zero progress on W&S, as of 2012, and the same will continue until 2015.
Assuming that currently only 10 per cent of Sindh rural population has access to W & S, then, at the current rate of infrastructure provision the MDG for 2015 for W & S will not be reached for more than 60 years, and full coverage will not be reached for more than 120 years.
This will have serious implications for people in rural Sindh in terms of health, and the victims would be mainly women and children.
Currently more than 40,000 mothers in Pakistan lose a child every year to diarrhoeal diseases caused due to unavailability of clean drinking water According to a WB report, the total economic cost of poor sanitation in Pakistan is Rs343.7bn, or, equivalent to 3.94 per cent of GDP. In rural Sindh, safe drinking water supply is still a distant dream. Sanitation coverage is poor and without proper water and sanitation facilities there can be no proper hygiene.
People in rural Sindh are poor. It is not expected of these poor people to build water supply and sanitation facilities on their own. Rural Sindh people need external aid and a couple of honest people to meet their W&S requirements and bring a change in hygiene behaviour.
There are some international institutions that can help in the provision of W & S facilities. These include, among others, USAID and Bill and Melinda Gates Foundation. USAID is already working with the Sindh government on some projects in the province.
Rural W & S can be included in the portfolio of USAID. Bill & Melinda Gates Foundation intend to invest over $400 million on water, sanitation and hygiene, with about 90 per cent of this amount committed to sanitation.
The basic lesson of the last three decades is that the success or failure of W & S interventions is determined by the consumer demand. Where demand for W & S is strong, programmes have high success rates, as the facilities they provide have been tailored, in terms of quality, level of service and cost to that demand. The poor success rate results from the supply-driven approaches which lack beneficiaries’ inputs. Success is achieved when technologies are fully absorbed and adapted to users’ needs. Where the demand is not strong, the first priority should be to develop it. The perspective of the programme’s management must be that of marketing a product rather than providing a service.
F. H. MUGHAL