Talking toilets might not be to everyone’s taste but let’s face it we all use them and sanitation - or lack of it – is a major cause of ill health and death amongst millions of vulnerable children.
Every day, 4,000 children are dying from poor sanitation and dirty water. The world is way off track to achieve the Millennium Development Goal for adequate sanitation by 2015. This is wrong. I recently travelled to Bolivia with UNICEF to see how they are trying to put it right.
Diarrhoea kills
Diarrhoea is still the biggest cause of death for children under five in the remote, Amazonian communities I visited in the north-east of Latin America’s poorest country. Lack of sanitation seriously affects children’s health and contributes to malnutrition. It also affects their ability to go to school and to develop mentally and physically. Parents – if they can afford it - often bring their children to hospital only when it’s too late. Those who make it in time just go home to fall ill again.
Not a question of hand outs...
The answer to this problem is not as easy as just giving people toilets though. People need to change the way they think and behave so that they stop defecating in open woods and near their livestock and use toilets and wash their hands.
There also needs to be opportunities to encourage local people to help themselves, improve local economies and create entrepreneurs.
UNICEF has a history of training local entrepreneurs to provide similar communities with clean drinking water. I met one such entrepreneur, Augusto Noe, who, for the last 15 years, has travelled many extra miles to provide clean water for some of Bolivia's hardest to reach children. Unlike sanitation, Bolivia is on track to meet the MDG target for safe drinking water by 2015 - its people like Augusto who are helping to ensure that the most remote children are part of this achievement.
Creating entrepreneurs and a market to support them has been critical to this success with water and UNICEF want to use the same approach to up access to sanitation. Augusto charges poor communities a subsidised rate for the water pumps and his private clients more to make a living. The communities make the rest up in kind by providing raw materials or free labour. They receive training in how to maintain the pump so they are able to be as self-reliant as possible.
Creating a demand for supply
First, the demand for latrines must be created though. Communities are encouraged to mobilise themselves and change their behaviour. They decide how and where to build their latrines. A top down approach doesn’t work - the process has to be driven from within the community.
My initial thought was that the pit latrines look very primitive, but they are the first – and most difficult to achieve – step up the “sanitation ladder” and away from open defecation. As usage of pit latrines increases, communities start to call for the next step up - safer, more hygienic ecological latrines.
UNICEF plans to meet this demand by creating livelihoods for local people to not only provide a latrine-building service, but also borehole drilling for water pumps, water purification and containment and maintenance. One provider would be skilled up at a mobile school and be the main point of contact for a cluster of communities.
Time to take notice
Meeting the children and families in these rural communities and seeing their pride at showing me their latrines seems worlds away from New York and discussions taking place next week amongst world leaders at the UN MDG Review.
But these communities are where they need to focus their attention. I have seen that the most remote children can be reached - but there are many more out there that need support. It is not enough to reach the MDGs for some children and not others.
The UN Review falls at a difficult time financially. There needs to be sound investment in sustainable solutions like community development and entrepreneurship. By prioritising the most vulnerable children and investing in smart, effective projects we will have the best chance of securing the greatest progress towards 2015.
Watch my video from the trip.