Why Sanitation Access Doesn’t Work Unless the Entire Village Buys In
Jitender is a four-year old boy with forward-thinking parents. Although it’s common in his village, in the Indian state of Uttar Pradesh, for most people to defecate in the open, his parents have taken the lessons of the government’s sanitation campaign to heart. They know that open defecation spreads disease—so they construct a private toilet that hygienically isolates their waste from human contact. Nonetheless, a few months later, Jitender develops persistent diarrhea. He is often dehydrated, loses weight, and becomes pale. His immune system is weakened by multiple bouts of disease, and for the next several years he struggles with recurrent illness. He has trouble keeping up with his schoolwork, and, more perniciously, even though he ate more than enough calories each day, the diarrhea eventually caused malnourishment. He remains small for his height and suffers from subtle intellectual deficits that make it difficult for him to follow the teacher’s lessons even during those periods when he does manage to attend. Because of his low marks, his family isn’t able to fulfill their dream of sending him on to university. The village takes note of Jitender’s example and concludes that improved sanitation doesn’t provide much, if any, benefit. This is a fictional story; however, similar stories are being heard every day in South Asia.
Why Sanitation Access Doesn’t Work Unless the Entire Village Buys In
South Asia is the least integrated region in the world. Intra-regional trade in South Asia is less than 2% of GDP compared to over 20% in East Asia. Labor mobility and regional travel is minimal, with few exceptions. Even remote communication is low – only 7% of international telephone calls in South Asia are to countries within the region, compared to 71% for East Asia. The case for closer integration has remained strong for a while now, and it is refreshing to see that some movement, albeit watchful, in addressing some of the region's deep rooted political economy issues, particularly between India and Pakistan.
The discussions around closer integration have centered on energy, trade, connectivity and stability. All of these offer strong potential to enhance growth in the region. However, financial sector integration overall, and access to finance in particular, hardly ever make it to the agenda of regional integration forums and deliberations. This is unfortunate, because the region has a long way to go in providing adequate access to financial services and insurance products, especially to the vulnerable segments of the population. Given that South Asia is home to more than half a billion of the world’s poor, this becomes a poverty reduction goal as much as a financial inclusion goal.
Losses due to disasters to human and physical capital are on the rise across the world. Over the past 30 years, total losses have tripled, amounting to $3.5 trillion. While the majority of these losses were experienced in OECD countries, the trend is increasingly moving towards losses in rapidly growing states.
In a sense, increasing risk and losses caused by disaster are the byproduct of a positive trend - strong development gains and economic growth. This is because disaster loss is a function of the amount of human and physical assets exposed to seismic or hydrometeorological hazards, and the level of vulnerability of the assets. The richer a country gets, the more assets it builds or acquires, and therefore the more losses it potentially faces.
Rapid development across South Asia signals the need to commit greater efforts to increase resilience to disaster and climate risk. It also requires governments to develop a strategy to both protect against events today and to develop strategies to address the losses of the future. This is a challenge somewhat unique to South Asia. The losses of today, predominantly rural flooding that impacts wide swaths of vulnerable populations, will begin to diminish in relative importance to the losses of the future.
On the second day of the three day regional workshop on affordable land and housing in Thimphu, Bhutan, country representatives continued to share policies and projects that their countries have devised and implemented and with that, the ideas that have or have not worked. One common theme was the interest in the development of secondary cities either around the periphery of rapidly urbanizing growth centers or as growth nodes strategically located along infrastructure such as regional transportation networks to create a ‘system of cities’. These growth centers often present a wealth of opportunities for the poor who flock to the cities from villages with the aspirations of a better life. However, this influx often strains the city’s services and infrastructure at an unsustainable rate.
“Young people ought not to be idle,” quipped Margaret Thatcher, “It is very bad for them.” That was twenty years ago. With over a million youth currently out of work in Britain today – 21% of the population – her words remain unfortunately prophetic. And it’s not just industrial countries that are in a funk. The “arc of unemployment” does not discriminate: it cuts across southern Europe through the Middle East to South Asia. Almost half of the world’s young people live along this arc, and it is a demographic dividend that is quickly becoming a demographic liability.
Consider South Asia: a region home to the largest proportion of unemployed and inactive youth in the developing world, a whopping 31%. Many attribute this to social norms, as many South Asian women do not work for cultural reasons. But with a growing middle class, gender norms are rapidly evolving.
Violence against women is a pervasive problem worldwide, causing the deaths of more women between the ages of 19 and 44 than wars, cancer, or car accidents. In South Asia, gender violence is widespread and persists in many forms, as the statistics below demonstrate:
- Every week in Bangladesh, more than ten women suffer from an acid attack
- In India, 22 women are killed every day in dowry-related murders
- In Sri Lanka, 60 percent of women report having suffered physical abuse
- In Pakistan, more than 450 women and girls die every year in so-called “honor killings”
- And in Nepal, the practice of enslaving young girls, whereby parents sell their young daughters – typically age 6-7 – to be girl servants is still widely practiced
Let’s take a second and ponder over the word “Youth,” and play a game of word association. What comes to your mind? Given that I fall into the youth bucket, my list of associations is mostly positive, with a few exceptions. Yet, from a development perspective, youth can sometimes be perceived as the (excuse the word play) “problem child” demographic - What can we do with them, and how do we do it?
Did you know that approximately 1/5th of South Asia’s population lies between the ages 15 to 24? What is more, young adults also comprise 50% of the unemployed in the region. While many may view this as a sad state of affairs, Youth Solutions, the recent collaboration between Microsoft and the World Bank, viewed it as an opportunity for empowerment.
According to recent estimates, South Asia is facing a shortage of 38 million housing units, largely affecting low and middle-income households. It comes as no surprise that informal settlements, slums and squatters are growing in all major urban centers across Asia to supplement the demand from urban poor. India alone has 52,000 slums inhabited by 14 percent of its total urban population. Almost, 50 percent of total population in Karachi, i.e. 7.6 million persons, lives in Katchi-Abadis. Bangladesh has 2,100 slums and more than 2 million slum dwellers in Dhaka. Even in Afghanistan, 80 percent of residents in capital city, Kabul, live in informal settlements.
Considering the costs, it was never obvious to me how investments in a national identity program might add development value in a resource-crunched country like Nepal with so many competing priorities. It clicked when a senior official at Pakistan’s National Database and Registration Authority (NADRA) said, “The national identity program has allowed us to construct one big family tree of all Pakistani nationals. It is helping Pakistan establish a relationship between each member of our extended family and to redefine our obligations to one another — state to citizen and citizen to citizen.”