LINNETTE VASSELL, GUEST COLUMNISTWHEN WE speak about sanitation we are referring to measures that are effective in creating and sustaining healthy environmental conditions. These measures include the safeguarding of food and water and the control and elimination of disease-carrying insects and animals.
Generally, issues of sanitation centre on the disposal of human excreta, and attention is also given to the matter of disposal or use of garbage and grey water from households.
With great respect and sensitivity to Sunday dinner, the unsanitary and appalling conditions under which many men and women and children carry out these basic human functions, and the negative effects on sustainable human development, make sanitation a big issue in our country.
This issue is often not the subject of polite conversation or up-front political action for a number of reasons including the view that many people regard the conditions under which people defecate or urinate as a personal and private matter (in spite of the fact that we see so many grown men urinating in public places seemingly quite unperturbed by public gaze or the health implications).
UNSAFE WATER
Yet, globally, some 6,000 children die every day from diseases related to poor sanitation and hygiene and some 2.4 billion women, men and children do not have a safe, clean and private place to defecate and urinate while over one billion people do not have clean, safe and adequate water to meet their daily needs.
It is estimated that half of the hospital beds in the developing world are occupied by persons suffering from the effects of unsafe water and poor sanitation. Here in Jamaica, we know that the Government's policy and action are directed towards making potable water accessible to the entire population by 2010 and initiatives are being pursued through various agencies to accelerate water supply to the rural population in particular. However, it is being recognised increasingly that attention to water without the concomitant focus on sanitation and hygiene, will not necessarily safeguard human health; as a matter of fact, under certain circumstances, the health status of the community can deteriorate with access to increased supplies of water.
The 2001 census informs that some 19,000 households (2.4 per cent of total households reporting) nationally, do not have any sanitary conveniences. In a corner of an urban inner-city area with which I am familiar, data reveal that some 144 families comprising 567 persons living in close, crowded conditions in the main, have access to 137 toilets, 84 showers and 18 urinals. At least 26 per cent of these sanitary facilities are adjudged to be inadequate and 35 per cent of the households have no sanitary facilities whatsoever! This is why many residents in both urban and parts of rural Jamaica are 'kiting' or 'parashooting' i.e. defecating in plastic bags and throwing these wherever. This is why in many of these communities we see adult men and women as well as children bathing in a corner of an open yard or at standpipes with little that shields their nakedness or protects them from the gaze of onlookers nor the diseases on the ground around them.
SAMPLE
In our sample, children make up 12 per cent of occupants in what are largely, single parent, female-headed households. It is not difficult to imagine the pressure that the parents face in terms of scarce resources, in terms of time spent to deal with the health issues. The doctor and nurse who serve in the weekly family clinic at the Women's Resource and Outreach Centre see the evidence among the young patients and broader national data point to the same problem. For example, we can recall this year's summer outbreak of gastro-enteritis which killed 10 children. This was directly related to lack of adequate water and sanitation. Data from the Ministry of Health show the pattern over the past 10 years. In the Epidemiological Profile of Selected Health Conditions and Services in Jamaica for the 1990-1999 period, data reveal that for all age groups, gastrointestinal illnesses ranked fifth among the causes for discharge from hospitals.
Among the age ranges in the 5-44 age band, gastrointestinal illnesses of children ranked third. Sanitation along with the related services of water and hygiene is therefore a serious matter of building and preserving the dignity of the individual and the health, livelihood and development of the community, including the environment within which we live.
The world is paying more attention to water and sanitation and so must we here in Jamaica. Globally, the world community through the United Nations has established the Millennium Development Goals (MDGs) that include a commitment to halve by 2015, the proportion of people without sustainable access to safe drinking water and the World Summit on Social Development (WSSD) set the same target for sanitation.
Indeed, the agreement for a target for sanitation was influenced by an international programme of advocacy led by Water Supply and Sanitation Collaborative Council (WSSCC) in collaboration with the World Health Organisation (WHO) and other partners. The WSSCC has launched a global campaign called WASH (water, sanitation and hygiene) which is aimed at the achievement of the global targets through principles and measures that meaningfully involve the communities affected in the solutions.
We are part of that global movement and there are many positive signs and initiatives being taken, for example in the Innercity Renewal Programme by Government, and innovative approaches to water and sanitation resource management being pursued by different agencies; in the work of civil society bodies, including that of the Build Jamaica Foundation that is seeking to support sanitation in basic schools.
While the public sector must do more, the private sector and other civil organisations like the churches should look at WASH provision and promotion as an programme for services in and with our communities.
The problems are complex, and there are no simple answers. That is why there is need for greater dialogue on WASH towards action. One urgent task is for us to explore options for sanitary conveniences that are economically, socially and environmentally acceptable and sustainable.
SOLUTIONS
The issue of pit toilets and our attitude as Jamaicans to this as an option for the future is one matter for wide discussion. This links with the need for a policy, as there is no established policy relating to sanitation in Jamaica. This coming week, discussions will continue on this aspect. It's a serious thing.
Send responses to Linnette Vassell at cvas@cwjamaica.com.
