Dwifina loves art. Every day she looks forward to making her thread canvasses. Her only wish is that she had more time to spend on them. Being paralyzed, she spends a significant amount of time on mundane activities like getting ready for school and sorting out school supplies and books. She needs to ask friends to assist her in using the bathroom in school, as it lacks the design features for her to use it independently. Between homework and these extended activities of daily living, Dwifina finds little time for her true passion.
There are about a billion people with physical, cognitive, or psychological disabilities in the world, who struggle to access basic services required to perform daily functions. Unfortunately, most of these barriers to access are socially constructed.
Co-authors: William Young, Lead Water Resources Management Specialist, the World Bank
The Ganges Basin in South Asia is home to some of the world’s poorest and most vulnerable communities. Annual floods during monsoon season cause widespread human suffering and economic losses. This year, torrential rains and catastrophic floods affected more than 45 million people, including 16 million children. By 2030, with ongoing climate change and socioeconomic development, floods may cost the region as much as $215 billion annually.
We’re used to talking about how the failure to invest in water management can impede economic growth, but the positive case for water management investments can be just as compelling. With support from the Israeli government, my colleagues and I recently took a study tour to Israel, and what we saw on the ground showed that combining policy and technology can lead not only to better local water management, but also result in a multi-billion dollar, export-driven industry.
Two years ago, I visited a village in Rudaki, a hilly district located to the south of Dushanbe, Tajikistan. It lies about forty kilometres from the capital, but it feels like a thousand kilometres away. On our drive up a hill, we saw women carrying buckets of water from a nearby spring. Moving further up, we saw children bathing and animals drinking from the same river. Once in the village, it was clear that life is largely shaped by water scarcity—the backyards were filled with pots and buckets, fuel and stoves for boiling water, and pit latrines that were no longer used because of lack of water. Although we could spot remnants of a once-functional water supply network, people living there had not had access to piped water for at least two decades. Without it, they were only able to practice the most basic forms of sanitation and hygiene.
The conditions we witnessed in Rudaki were harsh, but not rare. Located on the western tip of the Himalayas, Tajikistan is a country blessed with large fresh water resources in its lakes, rivers, and glaciers. Yet, access to safe drinking water and sanitation connected to a functioning sewer system is lacking, particularly for rural residents and the poor. Much of the existing infrastructure was built during the Soviet era and has not been upgraded for decades. Tajikistan is one of the few countries outside Africa that did not meet the Millennium Development Goal on drinking water and basic sanitation. Because poor water and sanitation conditions, together with poor nutrition and care, are key determinants of childhood stunting, Tajikistan’s childhood stunting rates remain high. Recent estimates indicate that in Tajikistan more than one in five children under the age of five are stunted and will not reach their full potential as adults.
In a new report, Glass Half Full: Poverty Diagnostic of Water Supply, Sanitation and Hygiene (WASH) Conditions in Tajikistan, we document the realities of Tajikistan’s WASH-deprived population. Our analysis builds on one of the largest data collection efforts of its kind – including national surveys of households and schools, water quality tests, ethnographic work, and case studies of existing WASH projects. It also includes poverty mapping and analysis of other secondary data, including a UNICEF nutrition survey that shared a subsample with our WASH survey.
This blogpost is part of a series of thematic blogs for the World Bank's Water Supply, Sanitation, and Hygiene (WASH) Poverty Diagnostic.
Addressing gender and sex inequalities in WASH is not only recognized in Sustainable Development Goals (SDGs) 4 and 6, it is central to the entire ambition of the SDGs themselves. Some water, sanitation, and hygiene issues are faced only by women because of their biological sex, whereas others are more influenced by gendered societal norms. To truly leave no one behind, we need to be mindful of and work against gender and sex inequalities in all development work.
“What’s wrong with this picture?” Louisa Gosling of WaterAid asked the participants at her training on Disability-inclusive Water Operations at the World Bank Water Week in March 2017. She pointed to a photo of a woman standing on the wall of a well. It was round and high, the ground around it muddy, and there was no lifting mechanism in sight.
More pictures followed… latrines and water sources with steep steps, narrow doorways, unstable construction without handles or rails. The more pictures we saw, the clearer it became what was wrong - all the facilities shown were inaccessible and dangerous, quite likely impossible to use for many people.
While the share of poor people in Sub-Saharan Africa decreased from 56 percent in 1990 to 43 percent in 2012, the region’s rapid population growth outpaced the decrease in poverty, resulting in higher number of poor people than before. More specifically, Africa’s urban population is expected to triple in size in the next half century, which is putting pressure on scarce resources in cities, exacerbated by capacity, budget and governance bottlenecks. The densely-populated areas with low levels of water and sanitation services pose a serious threat to public health – cholera epidemics have broken out in urban areas in several African countries in recent years.
Crowded slums, poor sanitation and unhealthy diets. It’s a potent cocktail and for too many families across the world, a daily reality. Right now, an estimated one billion people live in slums and that number is expected to double by 2030. Slums are where the many deprivations facing the urban poor collide, including lack of access to clean drinking water, sanitation, safe and nutritious foods, sufficient living space, durable housing and secure tenure (UN Habitat). They’re where human waste is routinely emptied into streets, canals, and garbage dumps. And where overcrowding and low rates of immunization and breastfeeding combine to exacerbate the already perilous problems children face.
Children growing up in these surroundings are at a higher risk of death and disease and are more likely to be chronically malnourished (Ezeh et al. 2017). For example, forthcoming World Bank research from Bangladesh shows that children living in slums are 50 percent more likely to be stunted than children living in other urban areas. This doesn’t just have implications for today - children who are stunted early in life go on to learn and earn less, and face a higher risk of chronic disease as they grow older. Tragically, these effects are often passed on to offspring, trapping families in poverty and malnutrition for generations, as per findings in a forthcoming World Bank report called Uncharted Waters.