World Toilet Day: Celebrating a basic human right

By: Sylvie Hughes
Gurgaon, India
19th November 2013

The figures provided by World Toilet Day reveal that 2.5 billion people in the world do not have access to clean toilets. India has the largest number of people defecating in the open in the world. A staggering 638 million still practice open defecation, and less than half of India’s population are using  toilets.  Lack of hygiene awareness, lack of access to facilities, and social and behavioral patterns are the main causes of high disease rates, lack of education opportunities and deaths across the country.

By viewing statistics of toilet access in schools, one can gain an idea of the condition of the country as a whole regarding access to toilet facilities: Of all of India’s rural primary schools, only 1 in 6 have toilet facilities. Often the children have to walk home just to use the toilet, or walk further away to defecate in the open. The amount of time that children have to spend walking a distance to relieve themselves severely disrupts productivity in schools.

In girl’s schools in particular, the problem is graver: 66 % of girls’ schools do not have functioning toilets. Around 23 % of girls drop out of school every year in India due to lack of proper toilet facilities. Many school toilets are not gender segregated, making trips to the toilet uncomfortable or intimidating experiences for girls. Many toilets also do not provide adequate menstrual hygiene facilities such a bins to dispose sanitary pads. Girls are either forced to return home to use the toilet or change pads, or decide to drop out of school completely.

The female population are particularly suffering due to these conditions, becoming victims of health problems due to economic disparity. They are unable to grow to find a good career if they drop out of schools with poor sanitation facilities. This in turn leads to a lower living standard, where women face problems of sexual harassment and abuse.
1 in 3 women worldwide risk shame, sexual harassment and attacks due to lack of toilet facilities. In rural areas, where women have to defecate in the open, they face the risk of sexual assault if they have to walk further out to a remote area to defecate, particularly during the night time. As a result, many women are facing health problems caused by waiting until the morning to relieve themselves.  For other women, the only time to relieve themselves would be at night time, to avoid being seen by others. In rural areas, incidents of rape are commonly caused by lack of toilet facilities.

In addition to lack of clean toilets, there is a lack in proper sanitation facilities, such as clean running water and soap. In India over 1600 children die every day due to diarrhea related diseases. This is because more than half the population do not wash their hands after defecation, making diseases such as respiratory and gastrointestinal infections major killers among children and adults alike.

A key element to breaking the practice of open defecation is changing the behavior of people who have practiced open defecation for generations. Many rural communities have not had access to education on hygiene practices, therefore are unaware of the serious health risks caused by open defecation. Installing toilet facilities in the area is not sufficient, as they still may not be used by the majority of people who are not used to using toilets. Therefore, providing hand washing and toilet hygiene awareness is crucial to changing the toilet practices of the population.

To those who have lived their whole lives using clean, safe toilets, the figures provided by World Toilet Day would be shocking. The lives of 2.5 billion people are severely affected and even cut short because they have no toilets. Access to toilets should not be a privilege but a basic right for every person.

Let’s celebrate our toilets on World Toilet Day!  Join HEEALS in our mission to provide clean toilet facilities to schools and rural and urban slum areas across India.

HEEALS (Health, Education, Environment And Livelihood Society), is working on Water Sanitation, Menstrual Hygiene and Toilet Building projects in five states: Delhi (National Capital Region), Uttar Pradesh, Rajasthan, Leh Ladakh, Himachal Pradesh and Haryana.
HEEALS works in slum schools, schools in unauthorised colonies, orphanages and refugee camps.  Through spreading education on Sanitation and  Menstrual Hygiene and building clean safe, toilets HEEALS is working to increase the attendance rates of pupils in schools, reduce the number of diseases and deaths and improve the health of people across Indian society. Find out more about its projects at http://www.heeals.org and support our work!

Sources: UNICEF, RTE Forum

Health care access in India

By: Sylvie Hughes 
Gurgaon, India
18th November 2013


Despite improvements in healthcare in India, accessibility to quality health care remains a challenge for a large number of the population.

                                 



The provisional census of 2011 reveals that 68.84% of India’s population live in rural areas. However, according to the National Commission on Macroeconomics & Health (NCMH), 80% of of health infrastructure and resources are situated in urban  areas, where only 31% of the population live. This shows a clear imbalance in access to health care facilities. Half of the rural population of India live below the poverty line. They do not have the means of access to hospitals due to lack of proximity to their homes.

Those living in urban slum areas also face problems accessing quality health care. Even at government hospitals, it is necessary to pay fees for general health check-ups, which many families cannot afford to pay. Despite living in closer proximity to hospitals, many people lack sanitation and health care awareness. In Uttar Pradesh, the most common reason for not getting vaccinations for children was lack of awareness about vaccines.

India is the open defecation capital of the world, with 638 million people defecating in the open. Every day in India over 1600 children die due to diarrhea-related diseases. This is because more than half the population do not wash their hands after defecation, making diseases such as respiratory and gastrointestinal infections major killers among children and adults alike.
These figures give only a glimpse of the problems faced by lack of hygiene awareness and sanitation facilities.

HEEALS (Health, Education, Environment And Livelihood Society), is working on its Free Health Camp pilot project in rural and urban slum areas of Uttar Pradesh, to provide access to free health check-ups in schools and orphanages, as well as providing free water purification tablets, water filtration systems and mosquito nets to families. Through providing health care education and awareness to those in need, HEEALS is working to reduce the number of disease related deaths and school dropout rates. We need your help – find out more about HEEALS projects and what we do at http://www.heeals.org and support our work!

Sources: Government of India Ministry of Health & Family Welfare;  UNICEF;  NCMH;  Provisional Census of India (2011)

HEEALS Report On Water Sanitation Menstrual Hygiene & Girl Education

In August 2013, HEEALS carried out a monitoring and evaluation  exercise on its Water Sanitation Menstrual Hygiene and Girl Education projects in three schools following the delivery of previous awareness training. Results of the monitoring and evaluation are now available to view in our HEEALS report.

One issue to consider is that despite many girls having a good awareness and knowledge of Menstrual Hygiene, they are unable to practice what they know due to lack of facilities available in school.  The bad conditions of toilet facilities were reported by most participants, who stated that there was nowhere to place sanitary pads and no soap or water for hand washing. Similarly, many girls displayed an awareness of the importance of hand washing, yet were unable to put this into practice at school.

Schools greatly influence the behavior and mentality of children – they look to school as a source of knowledge. Yet through lack of sanitation facilities, schools are contributing to creating the mentality that hand washing and hygiene practices are not necessary. Lack of Menstrual Hygiene facilities  lead to menstrual hygiene becoming an invisible issue which is not addressed, increasing the  embarrassment  of young girls to discuss Menstrual Hygiene.

Another key point to consider is that most girls reported being treated differently by their family during menstruation, and cited parental choice as the main factor in the girl’s education. Parents need to be included in Menstrual Hygiene and Water Sanitation awareness projects as well as teachers and male students, to develop understanding surrounding these issues and to support girls in obtaining a good education.

Read the full report here: https://docs.google.com/file/d/0B3-sg3TTDoppTmdYdW0yWUVEc3M/edit

It’s Not About Size… It’s About Sanitation

In 2012, India was home to six of the 25 largest metropolitan regions in the world. Delhi and Mumbai actually made it to the top 10. Normally this would be worth publicising, except that it isn’t always about size. Not a single Indian city made it into the top 50 of Mercer Consulting’s 2012 global ranking of cities offering the highest quality of life. In fact, Delhi and Mumbai actually made it to Mercer’s list of the 25 dirtiest cities in the world, with the lowest sanitation and health scores. This is the sad reality every urban Indian resident wakes up to each stinking, smoggy morning, and goes back to bed with.

Copyright: All rights reserved by Louhan
http://www.flickr.com/photos/johanpics/2958133966/sizes/z/in/gallery-karmadude-72157623844824948/

India’s cities have much to offer—a diversity of opportunities, experiences, people, food… They are fascinating places, but the slow rot makes me wonder whether they’re worth staying for. A recent study that used 20 years of data to compare life expectancy in more and less polluted parts of China highlighted that residents in more polluted cities died approximately six years earlier than those in less polluted ones. On a base of 500 million people, that translates to 2.5 billion lost years. A study of this scale and intent in Indian cities would likely lead to very similar results. Work funded by the Blacksmith Institute and the Global Alliance on Health and Pollutionhave also highlighted the heavy toll that unsanitary conditions and environmental toxins take on the brains and bodies of children. Rich or poor, we breathe the same air and even if we’re sipping from bottles of Evian in our Maybachs in Mumbai, we’re no better off. In essence we’re leaving cities in India and large swathes of the developing world to a generation that will live shorter, unhealthier and less productive lives for no fault of their own.

It’s a cultural cop out in South Asia to apportion responsibility for all that goes wrong to some higher power. I doubt one of the many Gods that pepper the collective conscience had anything to do with untreated industrial effluent being dumped in an open sewer, or a very full bag of garbage being tossed out of a tenth storey window. We’re quick to point to corrupt, morally bankrupt governments and municipal administrations as the root of our problems, but the real culprits are likely pointing back at us in the mirror. Every plastic wrapper tossed on the street, every paan spat out on a wall, every plastic water bottle used and discarded add up to an enormous mountain of shit!

photo credit: Sharad Haksar
http://www.flickr.com/photos/sharadhaksar/3832170847/sizes/z/in/gallery-karmadude-72157623844824948/

In the midst of this gloom, there is always a sliver of hope. A small group of motivated Indians decided they wanted change. Under the banner of The Ugly Indian, with the slogan “Kaam chalu mooh bandh. Stop Talking, Start Doing”, they are cleaning up their neighbourhood one eyesore at a time. I came across them a few years ago when a friend posted pictures of their work on Facebook. Driven by a few motivated individuals who believe that only “we can save us from ourselves”, they turned cleaning up neighbourhoods into a very effective community engagement exercise. Using just a little bit of money to buy paint and potted plants, and armed with brooms, groups of people mobilise to blitz a neighbourhood or intersection and clean it up.

Before
photo credit: http://www.theuglyindian.com

After
photo credit: http://www.theuglyindian.com

Even though they clearly state on their website that they will not “moralize”, this is public shaming at its most effective. The group’s core base of well-intentioned youngsters, through these acts, support each other in stepping out of their comfort zones, their economic privileges, and class and caste clans to make a difference. Though small, this is significant for a part of the world so concerned about status.

Margaret Mead famously said “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” In beautifying their neighbourhoods, in making such a strong public comment on the state of their environments, in establishing this new social order and precedent, they are, in Gandhi’s words, being the change that they want to see in the world.

Read more: http://forbesindia.com/blog/economy-policy/its-not-about-size-its-about-sanitation/#ixzz2k1wKc7qX

Fighting Child Marriage Through Hygiene Awareness

by Sylvie Hughes
Gurgaon,India
5th November 2013

Child marriage in India affects a large portion of adolescent girls in the country.  With 47% of girls in India marrying below the legal minimum age of 18,  India has the highest number of child brides than any other nation in the world. 

However, despite its huge  number of illegal marriages, in October India refused to sign the first ever UN resolution against the practice of child marriage – an initiative which is being supported by 107 other countries worldwide.

Child brides face a multitude of serious mental and physical health problems.  Young married  girls face problems of sexual and domestic abuse, causing high rates of severe depression.  Girls as young as 13 drop out of school once they get married, and as a result they are unable to continue their education or seek help. The section of society who are the most in need of education, health and hygiene awareness are unable to access  it. This leads to  an increase in serious health risks caused by early childbirth and lack of menstrual hygiene awareness.

 

Girls below the age of 15 are five times more likely to die in childbirth than women in their 20s. With over 50% of adolescent girls in India suffering from anaemia, the increased blood supply demand during pregnancy causes even more of a strain on their health. According to the  National Commission for Protection of Child Rights (NCPCR), early marriage and adolescent pregnancies are one of the main causes of anaemia amongst girls in India.

 

Adolescent pregnancies are also one of the main reasons for infant deaths in hospitals. Children born to adolescent mothers are twice more at risk of neonatal mortality (death within the first month) than those born to older mothers, and the younger the mother, the higher the risk.  Many infants are born underweight due to the mother suffering from malnutrition and anaemia, which further increases the risk of health problems and death for the infant.

 

Educating girls in Menstrual Hygiene and healthcare can be a crucial element in reducing the number of child marriages in India. Access to Menstrual Hygiene awareness projects provide girls with knowledge on proper nutrition and hygiene practices to avoid suffering from anaemia on the onset of menstruation, as well as educating girls about the numerous health risks that are caused by early marriage. Increased awareness decreases not only the 23% school drop out rate from menstruation-related problems, but  also the number of girls entering into child marriage.

Preventing adolescent births have been proven to significantly lower population growth rates, improving the health of adolescent girls and potentially generating large economic and social benefits for the country as a whole.

 

HEEALS (Health, Education, Environment And Livelihood Society), is working on a Menstrual Hygiene awareness and Girl Education project in five states: Delhi (National Capital Region), Uttar Pradesh, Rajasthan, Leh Ladakh, Himachal Pradesh and Haryana. HEEALS works in slum schools, schools in unauthorised colonies, orphanages and refugee camps.  Through spreading education on Menstrual Hygiene and providing iron supplement tablets through our Free Health Camp initiative, HEEALS is working to eradicate the practice of child marriage and provide better futures for girls across India’s society. Find out more about its Menstrual Hygiene and Girl Education Project at www.heeals.org and support our work!

 

 

Stats Sources: UNICEF, PLAN India, NCPCR, UNFPA