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November 2016

Reaching the last mile in Latin America and the Caribbean: How to provide sustainable water supply and sanitation to Indigenous Peoples

Clementine Marie Stip's picture
Young Wayúu girls go fetch water in La Guajira, Colombia

Extending the human right of access to water supply and sanitation (WSS) services to Indigenous Peoples represents the final step for many countries to reach universal coverage in Latin America and the Caribbean (LAC). As the 7th Rural Water Supply Network Forum is underway in Abidjan, Côte d'Ivoire, we must remind ourselves what “inclusion” means in the WSS sector. Poverty levels among Indigenous Peoples are more than twice those found among other Latin Americans, and they are 10 to 25 percent less likely to have access to piped water and 26 percent less likely to have access to improved sanitation.

With dire consequences on health, productivity, and well-being, these access gaps also exemplify two shortcomings of past engagement with Indigenous Peoples in the WSS sector: Indigenous territories have often been overlooked, and, even where investments specifically target Indigenous Peoples, WSS service sustainability remains a large issue. Several barriers explain this: investors’ and service providers’ lack of understanding of Indigenous Peoples' unique social and cultural characteristics, limited engagement with Indigenous authorities and attention to their priorities and aspirations, and the remoteness and difficult access to many Indigenous communities, to name a few. More generally, we need a tailored approach that responds to these challenges through institutional development, partnership with Indigenous authorities, and local capacity building for WSS services management in order to overcome the existing system that incentivizes physical interventions in easily accessible areas with limited social accompaniment. 

Managing water challenges: Learning from our development partners

Aroha Bahuguna's picture

California is suffering from its fifth year of drought, the states of Tamil Nadu and Karnataka in India are arguing over the sharing of Cauvery river water, and food security for 36 million people is threatened due to drought in large regions of Africa. On the flip side, Bangladesh, Maldives, and other island nations are confronted with the threat of rising seas, while extreme rainfall and flooding (as experienced by Haiti just a few weeks ago) are expected to become increasingly common. Even without these extremes, almost every country is facing its own challenges in managing water resources.

As Operations Analysts in the World Bank Water Global Practice, and as water management newbies, we were excited to go to the Netherlands and Israel, respectively, to understand how these two countries have overcome their unique obstacles to become prime examples in water engineering. Upon examining the findings alongside senior specialists in the Practice and practitioners from client countries, it is clear that despite each country’s distinct topography, they share a focus on collaboration among stakeholders and an emphasis on efficiency powered by innovative technology.

Benchmarking rural water systems by a simple score

Kristoffer Welsien's picture
 
Improved water supply in Kipanduka village, Tanzania
Photo: Alessandra Argenti/ World Bank

Can the ability to sustain rural water systems be captured by a simple score? A new multipurpose four-page tool seeks to measure the likelihood of sustainability by assessing the capacity of a village water committee. Previously, such tools were often either too lengthy and academic or the assessment was left to the discretion of local officials with the risk of omitting critical components. Now a more practical model has been developed that aims to be user-friendly but detailed enough to detect gaps and prioritize interventions for village water committees.
 

This journey started in a rural village in the district of Karatu, Tanzania where a new water system had just been commissioned. The district water engineer was about to inaugurate the water scheme after a five-day training of the village water committee, giving them full ownership of their water scheme. During the opening ceremony, one question kept puzzling her: “Was the village water committee fully equipped to manage, operate and maintain their newly installed water scheme?”

Helping children survive and thrive: How toilets play a part

Claire Chase's picture



While child mortality rates have plummeted worldwide, nearly one-third of all children under 5 in developing countries are stunted. Children who are stunted (having low height-for-age) suffer from a long-term failure to grow, reflecting the cumulative effects of chronic deficits in food intake, poor care practices, and illness. The early years of life, especially the first 1,000 days, are critical; if a child’s growth is stunted during this period, the effects are irreversible and have lifelong and intergenerational consequences on their future human capital and potential to succeed.  
 
For the water and sanitation community the year 2009 marked a turning point in our understanding of the role that Water, Sanitation and Hygiene (WASH) has on child stunting. A provocative Lancet article (Humphrey 2009) put forth the hypothesis that a key cause of child stunting is asymptomatic gut infection caused by ingestion of fecal bacteria. Small children living in poor sanitary environments are especially at risk, through frequent mouthing of fingers and objects during exploratory play, playing in areas contaminated with human and animal feces and ingesting contaminated food and water (Ngure et al. 2013). Researchers now estimate that up to 43 percent of stunting may be due to these gut infections, known as environmental enteric dysfunction (EED) (Guerrant et al. 2013).
 
Just last week estimates were released suggesting that poor sanitation is the second leading cause of child stunting worldwide (Danaei et al. 2016). In a key departure from previous work, the researchers defined risk as the sanitation level of a community, rather than an individual. This is consistent with mounting evidence showing that a community’s coverage of sanitation is more important than any one household’s (Andres et al. 2013). Across different studies, data sets and outcomes the evidence consistently shows that a threshold of around 60–70 percent household usage within a community is needed before the health and nutrition benefits of sanitation begin to accrue. Studies that have focused on an individual’s toilet use as a predictor, rather than a community’s use, may have vastly underestimated the impacts (Hunter and Prüss-Ustün 2016).  
 
As we advance our understanding of the ways in which a poor sanitary environment impacts growth in small children, we can better design water and sanitation interventions to target these pathways. While there is a role for multi-sectoral interventions, which can simultaneously target the underlying determinants of child undernutrition, such as food security, access to health services, and childcare practices — there are ways that the water sector can adapt its own approaches so that they are more nutrition-sensitive, and more impactful on nutrition. Here are four key actions:

Addressing the urban sanitation crisis: Time for a radical shift

Martin Gambrill's picture

Co-authors:

The Bill & Melinda Gates Foundation – Jan Willem Rosenboom
The University of Leeds – Barbara Evans
Emory University – Christine Moe & Eduardo Perez
The World Bank – Sophie Trémolet, Valérie Sturm, Clémentine Stip
WaterAid – Andrés Hueso
Plan International – Darren Saywell

Children in Maputo, Mozambique 
Photo credit: 
Isabel Blackett/The World Bank

A successful city is economically and culturally vibrant, healthy, safe, clean and attractive to business and tourism, and provides quality of life to its citizens. This vision is appealing but remains hard to realize as developing cities have to cope with changing demographics and climate with limited financial and human resources. The sustainable development goals have given a new impetus for cities to be inclusive, safe, resilient and sustainable (SDG11), ensure citizens’ health and wellbeing (SDG3) and secure access to sustainable water and sanitation services (SDG6).

World Toilet Day on November 19th is the opportunity to remind ourselves of a few facts and propose a set of guiding principles for a renewed and revitalized urban sanitation agenda.

Looking ahead towards a water-secure world for all

Guangzhe CHEN's picture

To many people, it is a surprise to learn that in an age of such advanced technology, at least 663 million people still lack access to basic needs, like safe drinking water, or that 2.5 billion people lack access to sanitation, such as a toilet or latrine. And while much progress has been made, receiving safe drinking water 24 hours a day, seven days a week simply by turning a tap is still a dream for many in the developing world.
 
Even fewer realize this is not just a problem for families, but also for those on which families rely and that also need water: the farmers who grow the families’ food, the environment that protects and sustains their homes and communities, the businesses that employ them, the cities that house them, the schools that educate their children, the clinics and hospitals that treat them, and even the power plants that generate their electricity.
 
Why does this challenge persist? How can this challenge be met? And an increasingly urgent question: is there enough water to go around?