INCREASED advocacy at international level is seen these days for girls’ education. Good education enables them to successfully handle the challenges that come their way. It is a sort of continuing education as the benefits of a girls’ education pass on to her children. Hence it serves as a multiplier effect.

Girls’ education is largely dependent on the provision of water, sanitation and hygiene (WASH) facilities in school. Girls’ dropout occurs when WASH facilities are poor. This is proved by a large volume of research and publications available.

In Sindh, schools do not have the provision of safe drinking water. Separate and decent toilets for girls are not available. Toilets for boys are filthy and non-functional.

WASH facilities improve primary school attendance, health and cognitive development. It has been shown that WASH facilities encourage greater girls’ participation in schools. Hygiene promotion in schools leads to positive and lasting hygiene behaviour in girls and, the benefits reach out to families and communities.

The Colombo Declaration at the Fourth South Asian Conference on Sanitation, to which Pakistan is a signatory, says: “To raise the profile of WASH in schools with the objective of ensuring that every new and existing school at every educational level has functioning, child-friendly toilets, separate for girls and boys, with facilities for menstrual hygiene management.”

The July 17 resolution of the UN Assembly on ‘Sanitation for All’ encourages all member-states, UN organisations and system and international organisations and other stakeholders to approach the sanitation issue in a broader context and to encompass all its aspects, including hygiene promotion, the provision of basic sanitation services ...”

The resolution designates Nov 19 as World Toilet Day.

The UN Secretary General’s panel on the post-2015 development agenda has proposed the following sanitation target: End open defecation and ensure universal access to sanitation at school and work, and increase access to sanitation at home by (to be decided).

Here are some of the pathways through which poor sanitation can have an adverse effect on health and overall well-being of children in schools:

Diarrhoea: Diarrhoea causes 1.40m preventable child deaths a year. This is attributed to unsafe drinking water, poor sanitation and hygiene. Positive association has been established between childhood diarrhoea and stunting, due to the cyclical effect of diarrhoea causing under-nutrition, which predisposes children to subsequent, longer episodes of diarrhoea (Moore et al, 2010).

Stunting: In developing countries, 32pc of schoolchildren are stunted. According to a Sindh government report, the stunting percentage among schoolchildren is 49.80. This percentage is high and shows poor sanitation facilities in schools.

Stunting is the result of poor sanitation. Threats to children’s health can result in long-term cognitive deficits, poorer school performance, fewer years of completed schooling and lower adult productivity, as well as in increased risk of infections and higher mortality rates.

Evidence confirms that these early life deficits are not easily made up for later in life, suggesting potential loss of equity in life outcomes over time (Hutton and Hathi, 2013). Open defecation, common in Sindh, produces airborne germs. When a child’s environment is infested with germs, the child inhales airborne germs and, over the time, this is reflected in child’s stunting.

Environmental enteropathy: It is a subclinical condition in children, caused by exposure to poor sanitation and hygiene (Korpe and Petri, 2012). Frequent ingestion of fecal bacteria causes inflammation and structural changes in intestine, which reduces the ability of intestine to absorb nutrients, resulting in the reduced growth of the child.

Malnutrition: Children are underweight because of poor sanitation. In Sindh, 40.50pc of children are underweight. Poor sanitation causes infectious diseases and, frequent attacks of infectious diseases cause imbalance in a child’s intestinal bacteria, which contributes to malnutrition.

The World Bank-funded Sindh Education Reform Programme (SERP) has the mandate to improve girls’ attendance in schools in Sindh.

It is not known what it would take for the SERP management to appreciate the importance of WASH interventions in schools.

F.H. MUGHAL

Karachi