UK-based journalist and author Rose George doubles up as a global champion for sanitation. Her book The Big Necessity: Adventures in the World of Human Waste
(2008) is regarded as a primer on managing human waste. She calls diarrhoea a “weapon of mass destruction”. The lack of access to toilets is at the root of the global public health crisis, killing millions of children under five. George was in Kathmandu this week to study menstrual taboos. WaterAid’s Ashutosh Tiwari and Govind Shrestha interviewed her for Nepali Times
Nepali Times: Since the time you started the research for your book, what has changed globally about sanitation?
Rose George: Public perception toward sanitation has changed positively in the last 10 years. In 2004, hardly anybody was making the connection between water and sanitation, let alone with health. NGOs talked about dirty water, brackish water, and the like. The conversation was primarily about supplying clean water and expanding water supply. There was much prudishness around talking openly about keeping toilet waste separate from water supply mains.
Now, through his Reinventing the Toilet program, Bill Gates talks about toilet and that has made a huge difference. Through his charity, Matt Damon has started talking about sanitation. The king of the Netherlands has been a sanitation champion for years. More than 180 countries have signed on with the UN to mark 19 November as annual World Toilet Day.
Policy makers have started to understand that a relatively small investment on sanitation pays off big in an increase in school attendance, women’s empowerment, and having a productive workforce. These changes have been gradual and with 2.5 billion people around the world still lacking access to toilets there is lots to be done. But over time, it’s been clear that sanitation has emerged as an issue worth funding and an issue worth talking openly about. An evidence for this is that sanitation has been added as the unambiguous goal number six in the UN’s post-2015 development agenda, whereas previously, in the MDGs, it was there as an afterthought.
In the last two years, we’ve seen an unprecedented momentum toward declaring villages and towns open defecation-free (ODF) areas in Nepal. Does this alone solve sanitation problems?
We have to see ODF as the sharp end of the wedge. On one hand, its effects are tangible. It tips the scale in terms of community members addressing their own sanitation problems. The entire community is indeed galvanised for change and every ODF declaration is accompanied by a sense of real collective achievement. On the other hand, declaration alone is not enough the practices need to be monitored over a period of time.
Moreover, there’s some danger that ODF campaigns may fail when there is no corresponding work on water supply. I have come across villages and schools which have been declared open-defecation free, but continue to lack adequate, clean water supply. For sanitation work to be successful, it is critical to pay attention to water.
Globally, more people these days live in urban areas than in villages. What do you see as challenges for urban sanitation in rapidly growing cities?
Urban sanitation is both complex and challenging. In many rapidly growing cities, the nature of informal settlements, with insecure land tenure and apathy from the officials, additionally makes the task of providing water and sanitation to those who need the most difficult. Not everybody’s waste can be connected to sewer lines. Often, sewer lines themselves end up in the rivers, with untreated waste spilling all over: they thus pose health risks to nearby residents, who are often in slums. Bill Gates and others have been trying to promote non-network sewers, but that will take some time.
Bindeshwar Pathak of Sulab International in India and Jack Sim of the World Toilet Organisation in Singapore have promoted sanitation, but is there a lesson from them for NGOs to scale up work rapidly?
NGOs advocate a rights-centric model, which is based on the argument that the right to sanitation is a part of human rights. The issues of dignity, privacy, community empowerment, and behaviour changes are important to them. Social entrepreneurs think in terms of marketing and selling sanitation to as many customers as possible by branding it differently from what is available out there. Given that so many people have mobile phones and not toilets, the challenge for NGOs is to make toilets as desirable and as a marker of social status, as mobile phones are. For this, they can look for ways to work with entrepreneurs and private sector to market and sell sanitation as a desirable good.
Holding up half the district