Some good news about loos in the news?

Horaay! Some good news in the news… maybe… at least in theory anyway. According to this BBC article here India’s Supreme Court has given the central and state governments six months to ensure that all schools have proper toilets and drinking water. This follows on from a court order made last year that toilets, especially for girls, should be built in all schools.

The fact that the importance of this issue has been recognised at such a high level is definitely news to be welcomed – and the BBC article points out that around 10% of schools in India lack drinking water facilities, 40% lack a functional communal toilet and another 40% lack separate facilities for girls.

This is part of a wider sanitation crisis in India, with two thirds of the population not having access to improved sanitation facilities and just over half carrying out open defecation (JMP 2012). With a population of over a billion people living in India – the importance of addressing water and sanitation in India is unquestionable.

It is not just in India where the lack of proper water, sanitation and hygiene (WASH) facilities in schools is an issue – more than half of all primary schools in the developing countries do not have adequate water facilities and nearly two thirds lack adequate sanitation (UNICEF 2010). While it is encouraging that the BBC ran with this story, perhaps what is lacking is recognition of the significance – both within India and globally – aspects of which I attempt to summarise below;

(c) Will Boase Photography

Impact on education

  • Diarrhoea is one of the top global killers in the world and 88% is caused by poor WASH (WHO 2008). Each year children lose 272 million school days due to diarrhoea (UNICEF 2010).
  • 93% of the 181 million school-aged children in sub Saharan Africa suffer nematode (worm) infections. Nematode infections impact physical growth and impact intellectual development.  This is wholly attributable to poor WASH (Hotez & Kameth 2009).

Impact on girls

  • About 50% of girls in sub-Saharan Africa who drop out of primary school do so because of poor water and sanitation facilities (UN 2006).
  • Girls in particular need privacy and the impacts of poor WASH on girls are especially detrimental once girls hit puberty: absenteeism can reach 10-20% of school time due to lack of WASH facilities at schools when girls are menstruating (UNICEF 2010). One study found over half of girls interviewed had missed school at least once while on their period with lack of privacy being cited as the number one cause (WaterAid 2009).

What must happen now?

The Supreme Court should be applauded for this move and for both prioritising and bringing attention to this issue. However we must not forget that there is a big step from ordering toilets to be built and actually seeing it happen – I hope that it does happen, and that it happens well. Building toilets in themselves will not have the desired impact unless the following points are considered and accounted for;

  • Hygiene promotion is alongside the implementation of these facilities.
  • The facilities are well maintained, and that soap is always available. An evaluation conducted in India showed soap was used by only 2% or less of children when washing their hands – thus severely cutting their effectiveness as use of soap has an enormous impact on reducing the presence of pathogens (UNICEF 2010).
  • Involve the communities in this process –the families of the children, the teachers and the local authorities as this can have multiplier effects when people respond to improve hygiene and sanitation within their homes as well.
  • The toilets are not isolated far away from the protective environment of the school – a study in South Africa revealed more than 30% of the girls attending school had been raped at school – many of those in the school toilets (UNICEF 2010).

Finally the health sector needs to have a key role in this process and work closely with the education authorities. They must play a key role in advocating for effective and adequate WASH facilities in schools and holding the government into account – in 2008 the Lancet stated wrote ‘the shamefully weak presence of the health sector in advocating for improved access to water and sanitation is incomprehensible and completely short-sighted’.

I will watch with interest over the next six months to see what the outcome will be – and hope that this decree does have an immense impact – on the education, dignity, safety and quality of life of children in India. 

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