ACCORDING to the Unicef and WHO Joint Monitoring Programme (JMP, 2006), some 50 million people practised open defecation as of 2006 in Pakistan. Since the sanitation facilities have not improved over the years, the figure now is expected to be 100 million.

Unicef estimates that some 20 to 40 per cent of hospital beds in Pakistan are occupied by patients suffering from water and sanitation-related diseases. About 60 per cent of the total number of child mortality cases in Pakistan are caused by water and sanitation-related diseases, says a USAID report.According to the Pakistan Strategic Environmental Assessment of the World Bank, 2006, about 2,000 mgd of wastewater is discharged to surface water bodies in Pakistan. The WB report estimates that the water and sanitation sector has the highest financial cost to Pakistan from environmental degradation at Rs112bn a year. This is based on health cost of only diarrhoea and typhoid and accounts for 1.81 per cent of the GDP.

While figures for Sindh are not available, considering the extremely low priority given to sanitation and the current dismal scenario of sanitation, a large percentage of population in Sindh is without proper sanitation.

In Sindh, the bureaucracy is indifferent to sanitation. Nobody in the government wants to know how human waste is disposed of even when the surface water bodies in Sindh are getting polluted at an accelerated pace. Many have washed their hands of sanitation as the past development efforts have not resulted in improved sanitation in decades. The media has least consideration for improvement in sanitation. Even major English-language newspapers hardly print articles on sanitation.

Discussions on sanitation are left halfway, due to lack of interest.

Women and young girls are often made vulnerable to violence because the lack of latrines forces them to relieve themselves in unsafe areas or in darkness. In some areas, young girls do not go to school because there are no lavatories for them — affecting not only their education, but their dignity and self-esteem as well. Recognising the important role of sanitation, the ADB has increased investments from $300 million for 2003-2007 to $710 million for 2008-2010.

High population growth demands increased attention to sanitation. Absence of sanitation, in turn, breeds poverty. Poor sanitation and hygiene are causes for diarrhoeal and infectious diseases. Poor sanitation also limits the impact of drinking water quality improvements.

About 4,000 people, mostly children, die every day as a result of diarrhoeal diseases. This accounts for more than 40 per cent of the total number of deaths related to unsafe water, inadequate sanitation facilities and poor hygiene behaviour.

Diarrhoea remains the second leading cause of death among children under five globally; killing more children than AIDS, malaria and measles combined. Other water -, sanitation-and hygiene-related diseases such as trachoma, schistosomiasis and chronic infestations by intestinal parasites (nematode worms), affect over one billion people globally.

There is a need for priority actions on the part of the Sindh government to boost sanitation agenda in the province, create momentum and enthusiasm so as to mainstream sanitation and make it everybody’s business.

While the Target 7C of the Millennium Development Goals speaks of halving, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation, the Sindh government should go for the initiative of sanitation for all,’ by providing 100 per cent sanitation in Sindh by 2015.

F. H. Mughal Karachi