WATER AND SANITATION GUIDE

Collecting water in Chennai Peter Armstrong The achievement of providing two billion people with access to safe drinking water since 1990 is diminished by the absence of matching investment in sanitation. The consequent indignities undergone by more than a third of the worlds population is a major cause of child mortality and chronic health problems in developing countries. Climate change uncertainties cast a menacing shadow over national efforts to honour citizens rights to safe water and sanitation. Water Scarcity Guide

Drinking Water Goals Sanitation Goals Finance

Capacity Limitations Right to Water Climate Change

Drinking Water Goals UN figures released in 2012 present the drinking water target as one of the few success stories of the Millennium Development Goals (MDGs) programme. Aggregate global coverage has advanced from 76% to 89% between 1990 and 2010, thereby exceeding the 2015 target of 88%.

However, the inclusion of rich countries in these statistics masks the lower percentage coverage experienced by much of the developing world. In the 48 Least Developed Countries, the figure is only 63%. Only 19 out of 50 countries in sub-Saharan Africa are likely to reach the MDG target. Publicity surrounding the attainment of one of the MDGs has prompted a desire to understand what exactly has been achieved. Working from a baseline of 1990, the wording of the Goal calls on governments to "halve, by 2015, the proportion of people without sustainable access to safe drinking water and sanitation."

A source which separates the delivery of drinking water from potential contamination, such as a piped supply or a protected well or spring, is deemed to be safe. Interpretation of access has varied between countries but generally refers to a household supply of 20 litres that can be fetched within a 30 minute round trip, a distance of about one kilometre.

Given that simple low cost, low maintenance technologies are available to fulfil these undemanding criteria, many observers have questioned why the water Goal did not aspire to universal access. In 2010, 783 million people continued to gamble their health with unsafe drinking water, a figure which is projected to fall only to 605 million by 2015. There is also much concern about the absence of qualitative indicators to support these measures of coverage, a shortcoming acknowledged by Joint Monitoring Programme (JMP) which compiles the biennial UN report. Apart from deterioration caused by poor maintenance, some regions are prone to chemical pollution (as in China) or natural contamination (as in the arsenic crisis in parts of South Asia).

Sanitation Goals Defined as a facility which removes excreta from the risk of human contact, safe sanitation encompasses covered pit latrines as well as flush toilets.

Since its belated addition to the MDGs in 2002, the sanitation target has been the Cinderella of the cause, attracting little over 10% of funds earmarked for water and sanitation programmes. More Africans have access to mobile phones than toilets. The same is true in India, a country which boasts nuclear weapons and a space programme. Development agencies must accept some responsibility, their publicity cameras preferring to linger on happy children pumping water. Latrines offer less inspiring images and copy. Even the UNs declaration of the period 2005-2015 as the International Decade for Action - Water for Life betrayed neglect of sanitation, in presentation if not intent.

The consequence is that global access to safe sanitation increased only from 49% to 63% in the period 1990-2010, leaving 2.5 billion people unprotected. This figure has barely changed in recent years and is projected to be 2.4 billion in 2015, dooming the MDG target of 75% to almost certain failure. Open defecation, the most degrading consequence, is still practised by 1.1 billion people, including half the population of India. In sub-Saharan Africa, access to safe sanitation has advanced from 26% to just 30% over the last two decades, extrapolating to arrive at the MDG target sometime during the 22nd century. In 2010 the UN corrected its earlier omission by establishing the Sanitation Drive to 2015, an advocacy initiative to persuade governments to close the sanitation gap. Development agencies too have overhauled their presentations, in particular by linking diarrhoea to unsafe sanitation and hygiene practices as well as dirty water. They are also striving harder to convince rural communities of the value of safe sanitation and improved hygiene practices. Offering government subsidies for latrine construction without context has been notoriously unsuccessful. Promising results have been achieved in an approach known as community-led total sanitation which promotes behaviour change through peer group condemnation of open defecation as an anti-social habit.

Unsafe water and sanitation facilities account for most of the 1.2 million deaths of children under five each year caused by diarrhoea. They also cause great suffering in both adults and children through diseases associated with intestinal parasites.

Financing Water and Sanitation This disappointing sanitation picture defies the logic of the economics. World Banks Economics of Sanitation Initiative demonstrates convincingly that the cost of inaction is impossible to defend.

This series of studies evaluates the losses within a national economy attributable to the lack of safe sanitation. These encompass the time spent fetching water, the loss of education of teenage girls who stay away from school due to the lack of toilet facilities, the expense of treating illnesses caused by poor sanitation and hygiene, and the human loss through untimely mortality.

The results have been published for separate countries. In sub-Saharan Africa, the cost of inadequate sanitation ranges from 1%-2% of GDP. Corresponding figures for India and Bangladesh exceed a staggering 6% of GDP. The implication is that investment in safe sanitation will generate a return which is of similar order to a countrys spending on health services. An outcome on this scale was also suggested in a World Health Organization study which concluded that each $1 of investment in sanitation delivers a formidable $9 return. This type of analysis also illustrates the contribution of water and sanitation to other MDG targets such as child mortality, gender equity, universal education, and poverty reduction. Despite the compelling nature of this social and economic case, the proportion of total foreign aid allocated to the sector fell from 8% to just over 5% between 1997 and 2010. Less than half of the $8 billion figure in 2010 was directed to the two regions most in need sub-Saharan Africa and South Asia. Furthermore, a 2008 commitment by African governments to allocate a minimum of 0.5% of GDP to sanitation has not been fulfilled. The alternative model of private sector finance for municipal water and sanitation projects in developing countries has fallen out of favour since peaking in the late 1990s. Criticism of privatisation has centred on the tendency for commercial providers to favour middle class households at the expense of poorer peri-urban settlements. This mismatch led to many failures of private capital and confrontation with authorities.

Pressure to restore relationships with the private sector is bound to resurface as aid budgets come under pressure from the current austerity culture prevailing in the donor economies.

Capacity Limitations Coordination between ministries in developing countries is often poor, not helped by the abundance of projects in the water and sanitation sector sponsored by separate donors. For example, questions are increasingly raised about inadequate maintenance resources for existing installations, perhaps further drained in a sector prone to corruption.

Capacity limitations for implementing complex water projects may contribute to lack of donor enthusiasm and is particularly worrying in the context of the mushrooming city populations in the developing world. Young migrants flooding in from rural areas have nowhere to go but the unplanned slum settlements where infrastructure planning is most difficult. The 2012 JMP report reveals that the number of urban citizens

using unsafe water increased from 109 million to 130 million between 1990 and 2010, a worrying inversion of the achievement in rural areas. The population of indian cities is projected to double by 2030 and triple by 2050.

The Right to Water and Sanitation The Universal Declaration of Human Rights and its relevant legal embodiment, the International Covenant on Economic, Social and Cultural Rights, refer to the right to an adequate standard of living, without elaboration.

Years of campaigning to capture the right to water and sanitation within this broad terminology eventually came to fruition in a resolution passed by the UN General Assembly in July 2010. It recognised the right to safe and clean drinking water and sanitation as a human right that is essential for the full enjoyment of life and all human rights.

Almost 50 countries now acknowledge their citizens right to water, either in their constitutions or through other legal instruments. However, the struggle to extend this list is likely to be long and hard as the UN governance structure for water and sanitation lacks teeth. UN Water is not an implementing agency with powers to bring pressure to bear on the distant political processes involved in protecting the poor through national laws. There are already signs of backsliding, as some countries appear to be rejecting the custom of acknowledging human rights in preambles to multilateral agreements. The outcome of the Rio+20 UN conference on sustainable development will be an important test.

Official recognition of the right to water has bolstered opponents of privatisation who argue that the profit motive has no place in the provision of human lifes most essential need. However, the UN resolution has no direct bearing on how water infrastructure should be financed, nor does it preclude charging fees for supplies.

Its significance lies more in the obligation for projects to reach out to all areas, however inaccessible, to ensure that fees are affordable and to observe principles of non-discrimination on gender or other grounds. A rights perspective also illustrates the weakness of the MDG programme. The Goal to halve the proportion of the population which lacks water and sanitation is an implicit licence to neglect the rights of the poorer half who are invariably the most difficult to reach.

Any post-2015 successor to the MDGs must surely aspire to achieve universal access. And an improved understanding of the right to water could translate into wider citizenship movements to b Climate Change Global warming represents the worst possible intervention to the challenge of providing safe water and sanitation for all. Rising planetary temperatures will accelerate the pump of the natural water cycle through faster evaporation from land and sea into a warmer atmosphere.

Precious water for desert herdsmen, Niger Edward Parsons / IRIN News The implications for rainfall are of course the subject of intensive research. There is broad agreement that monsoon patterns will change in timing and intensity, that arid and semi-arid regions will become drier, and that extremes of drought and flooding will become more frequent. Rising sea levels will aggravate the problem of groundwater salinity. Much uncertainty remains and the implications for drinking water cannot be separated from those for agriculture and commerce. The

response of integrated water resources management (which combines these needs) to climate change will focus on steps that are consistent anyway with establishing greater resilience to variable rainfall. For example, underground aquifers are by nature ideal for adaptation because they smooth out short term changes in rainfall. Groundwater recharge in developing countries can be revived by maintenance of neglected storage tanks and drainage, supported by simple rainwater harvesting technologies. It seems clear that the poorest countries will be hardest hit by the impact of climate change. The 2011 emergency water relief for the Pacific island of Tuvalu delivered a preview of water scarcity in a warming world. ring local and national governments to account.

Water, Environment and Sanitation

UNICEFs long standing support for improving water supply, sanitation and hygiene stems from a firm conviction and based on sound evidence that these are central to ensuring the rights of children. In fact, it is essential for children to survive, grow and develop into healthy and fulfilled citizens of the world. In the broader context, UNICEFs activities in Water, Sanitation and Hygiene (WASH) contribute to the achievement of the Millennium Development Goals. Fast Facts Hand washing with soap, particularly after contact with excreta, can reduce diarrhoeal diseases by over 40 per cent and respiratory infections by 30 per cent. Diarrhoea and respiratory infections are the number one cause for child deaths in India. Hand washing with soap is among the most effective and inexpensive ways to prevent diarrhoeal diseases and pneumonia. With 638 million people defecating in the open and 44 per cent mothers disposing their childrens faeces in the open, there is a very high risk of microbial contamination (bacteria, viruses, amoeba) of water which causes diarrhoea in children. Children weakened by frequent diarrhoea episodes are more vulnerable to malnutrition and opportunistic infections such as pneumonia. About 48 per cent of children in India are suffering from some degree of malnutrition. Diarrhoea and worm infection are two major health conditions that affect school age children impacting their learning abilities.

Adequate, well-maintained water supply and sanitation facilities in schools encourage children to attend school regularly and help them achieve their educational goals. Inadequate water supply and sanitation in schools are health hazards and affect school attendance, retention and educational performance. Adolescent girls are especially vulnerable to dropping out, as many are reluctant to continue their schooling because toilet facilities are not private, not safe or simply not available Women and girls face shame and a loss of personal dignity and safety risk if there is no toilet at home. They have to wait for the night to relieve themselves to avoid being seen by others. Sanitation It is estimated that Only 31 per cent of Indias population use improved sanitation (2008) In rural India 21 per cent use improved sanitation facilities (2008) One Hundred Forty Five million people in rural India gained access to improved sanitation between 1990-2008 Two hundred and Eleven Million people gained access to improved sanitation in whole of India between 1990-2008 India is home to 638 million people defecating in the open; over 50 per cent of the population.

 In Bangladesh and Brazil, only seven per cent of the population defecate in the open. In China, only four per cent of the population defecate in the open. Water 88 per cent of the population of 1.2 billion has access to drinking water from improved sources in 2008, as compared to 68 per cent in 1990. Only a quarter the total population in India has drinking water on their premise. Women, who have to collect the drinking water, are vulnerable to a number of unsafe practices. Only 13 per cent of adult males collect water. Sixty seven per cent of Indian households do not treat their drinking water, even though it could be chemically or bacterially contaminated. Hygiene According to the Public Health Association, only 53 per cent of the population wash hands with soap after defecation, 38 per cent wash hands with soap before eating and only 30 per cent wash hands with soap before preparing food. Only 11 per cent of the Indian rural families dispose child stools safely. 80 per cent childrens stools are left in the open or thrown into the garbage. Only 6 per cent of rural children less than five years of age use toilets. WASH Interventions significantly reduce diarrhoeal morbidity; statistically it has been shown that: Handwashing with soap reduces it by 44 per cent

 Household water treatment by 39 per cent Sanitation by 36 per cent Water supply by 23 per cent Source water treatment by 11 per cent. Key Issues Newborn Infants: Hand washing by birth attendants before delivery has been shown to reduce mortality rates by 19 per cent while a 4 per cent reduction in risk of death was found if mothers washed their hands prior to handling their newborns. Children under five years: Poor WASH causes diarrhoea, which is the second biggest cause of death in children under five years. Diarrhoea is an immediate cause of under nutrition School-aged children: Children prefer to attend schools having adequate and private WASH facilities. Schools provide an excellent opportunity for children to learn about hygiene practices. Older Girls: Giving girls the knowledge and facilities necessary for good menstrual hygiene is key to their dignity, their privacy, their educational achievement and their health. Adolescent girls are empowered through improved menstrual hygiene management. Mothers and Caregivers: Hand washing with soap at critical times is important for protecting the health of the whole family. By being a role model, mothers and caregivers can also help instill in their children the good hygiene practices which will serve them for life.

 Children in emergencies: During emergencies, children are especially vulnerable to the effects of inadequate access to water and sanitation services. WASH is a key component of any emergency response. Chemical contamination in water ensuring water quality at the source is crucial. In India, there is a widespread natural occurrence of arsenic and fluoride in the groundwater. UNICEF is supporting Government of India programs on arsenic and fluoride mitigation and identifying water quality testing technologies which are appropriate for use in field situations. All emergencies cause disruption to basic services. People are less likely to be able to drink safe water, use basic sanitation facilities and maintain improved hygiene practices. Children, especially those under the age of five, are particularly vulnerable to the diseases which can result during emergencies. These diseases include diarrhoea, cholera, typhoid, respiratory infections, skin and eye infections which are all likely to occur when water supplies and sanitation services are disrupted. UNICEF has set out minimum standards of response for any emergency situation. These describe the life saving actions which UNICEF will take within the first six to eight weeks of an emergency, along with the longer term role in the subsequent weeks and months. UNICEF Action UNICEF supports the national and state governments in developing and implementing a range of replicable intervention models for sanitation, hygiene and water supply. UNICEFs Childs Environment Programme in

India supports the governments flagship programmes of Total Sanitation Campaign to improve access to and use of sanitation facilities and the National Rural Drinking Water Programme to provide adequate safe water to every rural household in India. The Childs Environment program also works with Sarva Siksha Abhiyan and Integrated Child Development Services, to promote hygiene water and sanitation services in schools, Anganwadi centers and health centers with lasting outcomes. CRC@20 - The Right to Survival: Water, Sanitation and Hygiene On the 20th anniversary of the Convention on the Rights of the Child (CRC), UNICEFs long- standing support to improving water supply, sanitation and hygiene is highlighted and it is reinforced that these are central to ensuring the rights of children. Nirmal Gram award - A New Dawn for a Village in Uttar Pradesh On the 20th anniversary of the Convention on the Rights of the Child (CRC), UNICEFs long- standing support to improving water supply, sanitation and hygiene is highlighted and it is reinforced that these are central to ensuring the rights of children.