-Photo by Uzair A. Khan

The abysmal state of sanitation stinks to high heaven in Pakistan. The economic losses resulting from poor water supply and sanitation in Pakistan equal $6 billion. Alarmed by the under spending on basic disease prevention in Pakistan, Rachid Benmessaoud of the World Bank noted that the “total amount of the losses caused by poor sanitation in Pakistan is 7 times higher than the national health budget.”

Realising that millions of lives are lost each year due to poor sanitation, water supply, and hygiene, The Bill & Melinda Gates Foundation has decided to challenge engineers and innovators to redesign the toilet to offer safe sanitation to billions who are forced to relieve themselves in open.

According to recent estimates more than 2.5 million lives could be saved globally if sanitation facilities were improved for the underserved populations. Because of inadequate sanitation facilities and lack of access to potable water, millions perish, whereas millions more fall ill and are crushed under the burden of disease. Despite recent progress, Pakistan continues to fall short of meeting the minimum global standards in water, sanitation, and hygiene (WASH). The economic losses resulting from inadequate sanitation in Pakistan are almost 4 per cent of the GDP. In Nigeria, economic losses due to sanitation, counted as healthcare costs and premature deaths, equal 1.3 per cent of its GDP. Put together, Asian and African countries are estimated to lose 6 per cent of their GDP to health concerns resulting from inadequate sanitation and water supply.

The Millennium Development Goals (MDG) has set out to reduce by half the proportion of people without access to safe drinking water by 2015. The sanitation-focused MDG has not been met. Water Aid, a UK based not-for-profit agency, reports that approximately 400,000 additional children’s lives could be saved if the 57 countries that have fallen behind in meeting the sanitation MDG by 2015 would strive to meet the MDG targets by 2015.

The return on investment (RoI) in water supply and sanitation projects is huge for the community and the economy. A study by the World Health Organisation revealed that every dollar invested in WASH returns on average $8 in economic benefits. Try estimating the RoI for holding on to Pakistan’s nuclear arsenal and conventional weapons that have consumed billions of dollars while millions of Pakistanis have no choice but to defecate in open.

I often wonder what kind of misguided priorities would result in a scenario where a nation can engineer sophisticated weapons but cannot provide potable water and decent sanitation facilities to one-half of its population. Pakistan is in fact not alone in this conundrum: India, with a much larger economy, faces similar stark contrasts.

An Indian colleague, Professor Dinesh Mohan, explains how scarce funds were misspent in the subcontinent, which has left the people without toilets and the armies flush with cash. According to Professor Mohan there are two types of sciences: the Brahmin science and the Shudra science. The Brahmin science is occupied with the cosmos and the celestial. Whereas, the Shudra science is concerned with sanitation, water supply, and food. Professor Mohan laments the fact that the scientists in the subcontinent overwhelmingly pursued the Brahmin science, which delivered missiles, satellites, and nuclear bombs. Whereas had they pursued the Shudra science, the people of subcontinent could at least have focused on achieving the absolute minimum standards of sanitation decency.

And while the educated elite in Pakistan pursued nuclear science and missile technology, the task of providing affordable and safe water supply and sanitation was left to the disenfranchised masses who have been motivated, over the years, by the teachings of Dr. Akhtar Hameed Khan, the ultimate development professional, and his intellectual protégées, such as Hafeez Arain and Nazir Ahmed Wattoo. From Orangi Pilot Project in Karachi to Hassanpura in Faisalabad, the successful, community-built water supply and sanitation projects are evident of the fact that the road to economic and social salvation in Pakistan will be paved by the masses and the state will only have a tangential role in the impending reforms in Pakistan.

Hasanpura, Faisalabad, is a shining example of a community-led water supply and sanitation scheme. Motivated by Anjuman Samaji Behbood, a Faisalabad-based NGO led by Nazir Ahmad Wattoo, the community self-financed and constructed sanitation facilities at a fraction of the cost the municipal authorities had estimated for the project. Irteza Haider, a development professional working for the National Rural Support Program, reviewed Hasanpura scheme for Water Aid and wrote the following in his report:

“Since 1996, the community led sanitation project has led to the dramatic transformation of Hasanpura. That the streets, once filled with sewage and refuse, have been transformed into clean, safe environments where healthy children play and seniors relax is testimony to the success of improved sanitation in Hasanpura. The burden of disease has been reduced considerably; children are clean, healthy and happy. Parents are delighted that they do not have to pay huge medical bills or see their children suffer in pain.”

Source: Haider, Irteza (2008). Development of community- based sanitation infrastructure in Hasanpura, Faisalabad. Water Aid, UK.

The Bill & Melinda Gates Foundation is soliciting interests in developing new toilet designs that could be introduced in remote parts of the world inhabited by the very poor who lack access to running water or sewerage pipes. Successful applicants will receive funding to design, prototype, and test “entirely stand alone, self-contained, practical sanitation modules which intake bodily wastes and swiftly dispose of them without any incoming water piping, outgoing sewer piping or electric or gas utilities.” If interested, submit your letter of intent by May 10, 2012.

When it comes to public health, Pakistan indeed has a choice. Its establishment can continue ignoring the dire needs of millions of poor and force them into misery and disease, or it can invest in sanitation to meet the MDG for 2015. Should it choose to invest in sanitation and not bombs, experts believe that 13,000 additional children’s lives could be saved by 2015 in Pakistan.


Murtaza Haider, Ph.D. is the Associate Dean of research and graduate programs at the Ted Rogers School of Management at Ryerson University in Toronto. He can be reached by email at murtaza.haider@ryerson.ca


The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.

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