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bismi-lLahi-rRahmani-rRahiem
In the Name of Allah, the Compassionate, the Merciful



=== News Update ===

Proof Of The Brilliance Of Islam Number
1001  Found In New Statesman Article : Wash your hands

<http://www.newstatesman.com/writers/barbara_gunnell>Barbara Gunnell

Every day, 5,000 children die because of poor
sanitation. Villagers in Madagascar tell Barbara
Gunnell how cheap interventions can transform their chances

[]


"What did we tell you last time we were here?"
shouts the man with the microphone.

"Wash Your Hands!" yell back 200 children aged
around 5-11. They are seated on the grass verges
of the crossroads at Amparatanana, a village on
Madagascar's east coast, the audience for a
travelling marionette show spreading the word
about hygienic use of latrines, keeping water
uncontaminated and, above all, hand-washing.

As Mr Clean upbraids Mr Dirty for his bad habits,
the children scold along; as Mr Dirty goes home
to his wife clutching his stomach with diarrhoea
pains, they giggle uncontrollably.

The puppets are part of this region's response to
the international rural water, sanitation and
hygiene (WASH) project that got under way in
Madagascar soon after the country suffered a
severe cholera outbreak early in 2000. Water Aid,
the key international NGO in this field in the
country, is working here with local partners, the Frères Saint-Gabriel.

Yvon, one of the FSG hygiene educators, regularly
updates the puppet-show scripts to keep the
children hooked on the message. His aim, he told
me, is to use storylines as close to the
children's home lives as possible, so that
hand-washing becomes second nature. This sounds
easy until you consider that, in the middle of
our own culture of abundant soap and hot water,
medical staff still manage to spread MRSA because
they fail to wash their hands between patients.

In fact, educators like Yvon have to work
miracles. The wood and thatch huts of these
east-coast villages are tightly packed in to
small compounds without running water. Soap is a
luxury and such latrines as exist are poorly
designed, badly sited and almost always a health hazard.

Yet the children do absorb the hand-washing
message and the impact of the singing, dancing,
12-foot-high marionettes has been rapid in the
schools. Albertine-Rosalie Clode, a teacher for
37 years, whom we met fetching water at the new
water kiosk, told us that her school of 1,686
pupils aged 6-17 was already seeing improvements.

"Awareness has changed in just one year [since
WaterAid and FSG came to this village],
particularly among the children. When the
ice-cream seller comes by, they ask him, 'What
water did you use to make it?' The puppets show
families as they know them. In the past we could
have 20 children off sick out of a class of
44-60, particularly in the rainy season," says
Mme Clode, who lives alongside the families of
her pupils, and whose many grandchildren are as
vulnerable to the debilitating water-borne
diseases of the area as the children of poorer neighbours.

The hand-washing message - enormously effective
in its own right - also underscores the urgent
need to speed up provision of clean water and
appropriate sanitation. The poorest villagers
here still depend on river collection for some
water and still manage without toilets. The few
existing wells, some provided only in the past
few years, are uncovered and vulnerable to
impurities from the buckets of different users.
And, as the area has an unusually high water
table, there is considerable risk of groundwater
contamination from badly designed and sited latrines.

The proportion of people with safe water and
adequate sanitation in the villages of the
Analanjirofo district (to which New Statesman
subscri bers' contributions are directed) is
estimated to be as low as 9 per cent, inflicting
a heavy penalty on the local economy in hours
lost to education and productive work.

Persuading officialdom of the economic good sense
of developing a national sanitation strategy has
been an important part of WaterAid's work in
Madagascar. In 2003, its research showed that the
country was losing five million working days and
3.5 million schooldays each year as a result of
ill-health caused by dirty water and inadequate
sanitation. To this must be added the human cost.
Every day around the globe, 5,000 children die
from the diarrhoeal diseases associated with
contaminated water; it is the second-biggest
childhood killer after tuberculosis and respiratory disease.

"Sanitation is the invisible sector," says Lucky
Lowe, WaterAid's representative in Madagascar.
She confirms that it is far easier to get
politicians to talk about water and to promise
pumps and new mains supplies than it is to get a
constructive debate going about pit latrines.
Clean water is a good election promise. Talking
about building latrines that help make that possible isn't.

On top of the hard statistics must be added less
tangible human costs: the drudgery of walking
miles each day to collect contaminated water for
the family, or the sheer unpleasantness and
indignity of using a foul-smelling, poorly
draining communal latrine day in and day out. Or,
for those who have nowhere else, a patch of land
that has become accepted as the local open-air
toilet. We should not suppose that force of habit
appreciably lessens the disgust.

Disgust was certainly written on the face of
eight-year-old Sidonie when we talked to her
mother before the puppet show about the field
"toilet" in her village. We had gone there with
Claudia Lemalade, FSG's hygiene educator for
Amparatanana, to talk to a family due to receive
one of the project's new latrines. We stood on a
pathway that led down to a small river with the
typical wooden huts on one side and lush
vegetation - banana plants, coconut palms and
vivid, flowering shrubs - on the other.

The path, even before the rainy season, was wet
in patches and drained into the small river
below, as, inevitably, would the open-air
defecation site a few yards from the path.

Claudia chatted with three generations of one
family: Toto Suzanne, her daughter Marceline and
Sidonie, Marceline's daughter. Finally the family
was to get a latrine - paying around 10 per cent
of the cost price (approximately £30). They had
been able to pay their £3 contribution as and
when they liked, in whatever instalments suited
them, but the contribution had to be paid upfront
before work could begin on the structure. The
family had been targeted because of financial
need; FSG has set families' contributions low
enough to put latrines within reach of most of the poorest.

It is not hard to understand why Marceline wanted
to divert her family's limited budget to pay for
a latrine. "Down there is where we have to go.
After dark it is really horrible for the
children." Sidonie refused to discuss the matter
though she had been lively enough before. As we
talked, a young woman came up the hill from the
river carrying a bucket. "This is to wash my
baby's feet," she told us, as if to assure us
that the murky water would not be used for
drinking or cooking. For household use, she
explained, she had limited access to a
neighbour's well (itself also contaminated,
according to Claudia). She understood clearly the
WASH message that the puppets would later be
blasting out across the village, but what, she asked us, could she do?

There is a standard image of hopeless poverty
that we see on television and in poster
campaigns, images usually connected with appeals
for emergency aid. Yet life in these villages is
far from miserable or hopeless. Men and women are
visibly industrious - most have family members in
work as fishermen or farmers; good-quality food
is available and at this time of year the trees
are laden with coconuts, lychees and jackfruit.
The literacy rate of 71 per cent is reasonably
high and, despite a high poverty rate of 70 per
cent, when news spreads of a visit from the
WaterAid people, the women come out to meet us in well-kept best clothes.

Quite small investments in sanitation could turn
around that high poverty rate. But at the moment,
for the vast majority of Madagascar's people,
energy that could be put into education and
wealth creation is being dissipated by avoidable
ill-health. The Madagascan economy loses to
illness around 300 times the amount the
government has allocated to sanitation in its
national budget, according to WaterAid.

WaterAid estimates that if Madagascar is to
achieve its Millennium Development Goals (MDGs),
the country has to increase the number of rural
households being newly supplied with adequate
sanitation, from roughly 485 households per month now to more than 12,000.

More and carefully focused international aid is,
as always, one solution. Determined local
politicians unafraid to champion an unpopular
cause is another. Mme Clode said she intends to
run as a local councillor next year and wants
politicians to speak up for the Cinderella sector of sanitation.

Of Madagascar's local MDG targets, she said: "I
expected things to move faster. Many things need
doing. For example, there is no water in the
market in Fenerive Est [the nearby town]. And we
need more latrines." Against current orthodoxy,
Mme Clode believes in communal latrines as a way
of speeding things up, while government and
international policy very much favours and
directs finance towards family-based facilities,
on the grounds that only families will keep them
clean enough to prevent water-borne disease.

But her concern about the slippage in local
millennium targets exactly mirrors WaterAid's
concern about the big picture. The millennium
goals included halving the proportion of those
living without water and sanitation by 2015. Of
all the targets (including poverty, education,
health and environmental concerns), sanitation is
most off-track. At the present rate of progress,
the goal would be reached 61 years late. Yet
hopes of eradicating extreme poverty and hunger
depend more on sorting out safe sanitation than on any other intervention.

A report commissioned by WaterAid and released in
October spelled out that, for every dollar spent
on sanitation, the return on investment is
roughly $9. Worldwide, the need is enormous, but
tiny interventions and local ingenuity can still
have a big impact. In Madagascar, a puppet show
costing just £31 can make 200 children laugh. And possibly save their lives.


Sanitation by numbers

   * £15 Cost per head of hygiene education and good sanitation
   * £31 Cost of puppet show promoting hand-washing
   * £31.25 Cost of effective latrine with simple concrete pit lining
   * $23.4m Most expensive toilet in the world (for space shuttle)
   * $10bn Annual cost of achieving Millennium Goals
   * $20bn Global annual spending on bottled mineral water
   * 1.1bn People worldwide without access to clean water
   * 2.6bn People worldwide without an adequate toilet

The full story in
http://www.newstatesman.com/200711290026

===



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