Sanitation is…?
UNICEF’s entry into water was clear-cut and dramatic when the India programme procured 125 high-speed drilling rigs in response to the 1966-7 drought. Martin Beyer, the consultant who proposed the project, went on to become the first Global Chief of Water (then WATSAN, then WES). I am quite sure Martin was upset that USAID beat us to the acronym WASH with their Water and Sanitation for Health programme.
UNICEF entry into sanitation is nowhere near as dramatic or clear-cut. Under the Basic Services approach the training of Public Health Inspectors was undertaken and health education components added to health programmes in a number of countries, but they lacked focus and tended to be quite general in nature. In the Anglophone world the inspectors generally enforced British Public Health Acts that had been written decades before independence; they certainly did not represent the normative behaviour in the countries in which they were enacted. Even in 2005, when I got into Sri Lanka as Regional Advisor, they were still enforcing the Public Health Act of 1868!
In 1977, the United Nations Conference on Water held in Mar Del Plata led to The International Drinking Water and Sanitation Decade. The Decade promised safe water and sanitation for everyone by the year 1990.
This aspiration caused a crazy young Peace Corp volunteer working on a World Bank Integrated Agriculture Development Project to join UNICEF rather than returning to the States; boy was he disappointed! His career took off when he got on a plane for a preparatory for the Decade in Arusha Tanzania in April of 1980. The Decade also caused Martin to create a Sanitation Advisor post in New York into which Muriel Glasgow was promoted. Muriel in turn hosted the first global sanitation workshop in April 1985, the record of which seems to have disappeared from the face of the earth. I remember the date quite clearly as President Nimeiri was overthrown while I was stuck in Cairo while my wife with our two small children was stuck in Kadugli, but that’s another story.
Participation in the Decade meant that UNICEF’s water projects had to radically change. In countries that had UNICEF water projects (remember projects and project officers meant something very different back then!), offices undertook to add sanitation components. TV Luong was, I believe, the first international sanitation officer, joining the India Office in the early 80s. The first UNICEF project to integrate water and sanitation was the Imo State Water and Sanitation Project. It was the brain child of Ludo Wellens, with Carel DeRoy as the first Project Manager and Richard Reid also having a hand in it.
An amazingly large amount of time has been spent in trying to define exactly what we mean by Sanitation. The UN’s official English (Oxford) dictionary defines sanitation as “the equipment and systems that keep places clean, especially by removing human waste”. Depending on whether you focus on the first phrase or the second, the definition can be quite broad or narrow. The first regional sanitation workshop held in Africa resulted in the following definition, which made it into the UNICEF Handbook on Better Sanitation Programming:
By the time the Millennium Decade Goals came around, we had reduced our expectations significantly, only calling to halve the proportion of people without sustainable access to safe drinking water and basic sanitation. The indicator for basic sanitation was excreta disposal. As the timeworn management saying goes, what is being measured gets done, and subsequently sanitation programmes came to wholly and solely focus on excreta disposal. In an effort to broaden what we do and with the USAID programme having been folded into other initiatives, the third UNICEF policy document on water and sanitation changed the acronym to WASH - Water, Sanitation and Hygiene.
The attempt only met with limited success, but anyone who has ever worked in NY knows that people in the field do not always pay much attention to what is decided in Headquarters. In 1997, UNICEF helped Uganda to adopt a sanitation policy that contained the following definition: “For the purpose of this policy, sanitation means and includes the process whereby individuals, families and communities improve their quality of lives through
I find it interesting that the Sierra Leone National Strategy for Sanitation and Hygiene developed last year, again with UNICEF assistance, defines sanitation as: “Access to and use of facilities and services for the safe disposal of human urine and faeces.” Hence the need to add the word Hygiene.
Despite the toing and froing about exactly what we are talking about when we talk about sanitation, we take the small victories when we can. Late in my career, the focus was on illuminating open defecation, without a doubt the most dangerous sanitation practice; a great deal of progress has been made on that particular behaviour. There are problems with monitoring and sustainability, but as a good friend of mine likes to say, that is a better class of problem.
We have long understood the importance of political will in making progress on sanitation. UNICEF once got the Ban Ki-Moon to agree to be filmed washing his hands on camera in support of Global Handwashing Day. But those around him killed the idea as in their view “it was beneath the dignity of the office” – they knew well enough that the UN Secretary General never has the need to wash his hands. Just before I retired, we got Ban Ki-moon on camera at a news conference to use the words “Open Defecation” in a call to end the practice worldwide. Therese Dooley, the Senior Advisor for Sanitation, looked over at me and said: “Bill, now you can retire in peace!” It would have been even better if the Ugandan Minister of Water and Environment had joined him, but she kept mispronouncing the word and called for an end to Open Defection, which in Uganda is, of course, a very different thing.
The attempt only met with limited success, but anyone who has ever worked in NY knows that people in the field do not always pay much attention to what is decided in Headquarters. In 1997, UNICEF helped Uganda to adopt a sanitation policy that contained the following definition: “For the purpose of this policy, sanitation means and includes the process whereby individuals, families and communities improve their quality of lives through
- Safely disposing of human excreta by any appropriate means,
- Developing and maintaining safe water chain,
- Attaining and maintaining personal, domestic and food hygiene,
- Safely disposing of solid and liquid wastes.
- Controlling disease vectors and vermin in and around the home and working environment.
I find it interesting that the Sierra Leone National Strategy for Sanitation and Hygiene developed last year, again with UNICEF assistance, defines sanitation as: “Access to and use of facilities and services for the safe disposal of human urine and faeces.” Hence the need to add the word Hygiene.
Despite the toing and froing about exactly what we are talking about when we talk about sanitation, we take the small victories when we can. Late in my career, the focus was on illuminating open defecation, without a doubt the most dangerous sanitation practice; a great deal of progress has been made on that particular behaviour. There are problems with monitoring and sustainability, but as a good friend of mine likes to say, that is a better class of problem.
We have long understood the importance of political will in making progress on sanitation. UNICEF once got the Ban Ki-Moon to agree to be filmed washing his hands on camera in support of Global Handwashing Day. But those around him killed the idea as in their view “it was beneath the dignity of the office” – they knew well enough that the UN Secretary General never has the need to wash his hands. Just before I retired, we got Ban Ki-moon on camera at a news conference to use the words “Open Defecation” in a call to end the practice worldwide. Therese Dooley, the Senior Advisor for Sanitation, looked over at me and said: “Bill, now you can retire in peace!” It would have been even better if the Ugandan Minister of Water and Environment had joined him, but she kept mispronouncing the word and called for an end to Open Defection, which in Uganda is, of course, a very different thing.
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