Dear all,
Reading with surprise the increases in stunting in some Indian states despite real advances in decreasing Open Defecation. Surprise, becasue it has been theorized that children growing up in Open Defecation Free communities have a much better chance of not being stunted (26% according to a 2015 study in Mali)- https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00144-8/fulltext, and environmental enteropathies, casued by fecal contamination, have always been seen as one of the main causes of long-term malnutrition and therefore stunting...oh, oh, we might have to revise our theories.
I am attaching a presentation which has often been used to demonstrate the importance of sanitation, making emphasis on its impact on malnutrition...we need to dig further into this, I think. Slide 4 below is of special importance:
Season's Greetings to all of you,
Susana Sandoz
ex WASH officer, manager and chief.
"Remember that when you leave this earth, you can take with you nothing that you have received - only what you have given."
Sorry I can't comment about the Clean India Movement, the gvt's or UNICEF's involvement , I know practically nothing of this topic.
ReplyDeleteWhat I can say is that we have since discovered the eliminating Open Defecation (OD) is mainly about changing behaviours wrt OD, and reduction of fecal pathogens (combined) and NOTabout building toilets. Once we learn this lesson, we will advance in the kind of impacts the WASH programme needs to achieve.
Don't get me wrong OD is only one aspect, we need to reduce fecal contamination as well to have this impact. A clear example was work in rural areas with UNICEF Guatemala: when we started the OD campaign in 2016: 92% of the population in the areas we were tackling HAD and PROBABLY USED latrines...but fecal contamination was rampant (no handwashing, dirty diapers everywhere, children's feces, flies spreading contamination, dirty latrines...and chronic child malnutrition was at 43% (and ODF was APROX 92%!)...this might help explain why despite "access to latrines" malnutrition is increasing in some states, probably becasue fecal contaminatio is still rampant.
Dear all,
ReplyDeleteIt was a very interesting discussion . I had no intention to start any debate but just tried to point out why the well intentioned intentions do not bring in expected results because people planning it or designing it either do not implement it with knowledge of lessons learned or do not intend to use the tools properly.
Let me put some historical facts. These are apolitical and unemotional :
1. The first sanitation problem of India was recognised by Sri Rajiv Gandhi and it was with his direct intervention he launched the National Sanitation programme in 1985 to improve the rural sanitation in India. yes, it is true he did not make any announcement from the Red Fort!
2. That programme was based on toilet building only and as I mentioned before it was stopped with his approval in 1988 after the UNICEF survey . I took over the charge after it was launched and then requested UNICEF to do that survey which they did ( incidentally through a reputed NGO)
3. The Sanitation committee of the Planning Commission of which I was the chair recommended the restructured programme starting with education of hygiene and behavioural changes and construction of the toilets with full participation of the community with their partial contribution to its cost.
4. The programme again started in its new form and UNICEF also focussed on the school sanitation with success.
5. The announcement of Clean India or Swachch Bharat was not any new programme but a campaign to give a boost to sanitation but the programme to be implemented under the same National sanitation Programme of 1985. Incidentally when the WASH campaign was launched in Bonn by WSSCC with the support of DFID, SDC and Dutch AID to get the sanitation goals in WSSD Johannesburg, the Indian Minister of the then NDA govt refused to attend the ceremony. South Africa took the lead and in 2002 we got sanitation as one of the Millennium goals.
Continued
ReplyDelete6. Agreeing with Susana , I did not dismiss the CLTS or ODF campaign. I only said they are the tolls and part of the whole. Here comes the hoax with deliberate use of a term or methodology but not following in practise on ground. Susana may calculate how much time should take to sensitize the Billion plus population and nearly 665000 villages to be covered in four years after changing the behaviour , mobilise the community with at least three visits to each village and then to construct . Is it possible physically ? I can add pictures after picture but here we were not criticizing the political leaders but the implementation !
7. Today's headline in Indian lead papers shows the slip of India further to 131 in the Human Right Index. The GDP is now lower and as per the IMF forecast going to be even lower further in the coming years . I attach a link below as in 2017 where the UN representative expressed concern about the human right violations in the Clean India campaign. In the name of stopping open defecation, low caste people were beaten to death! all these in the name of CLTS !
https://www.outlookindia.com/website/story/top-un-expert-says-pm-modis-swachh-bharat-mission-flawed-it-lacks-a-holistic-hum/304173
8. Looking at India through a binocular is very nice but the realities on ground are different and specially when the truth is like an onion ! My only humble submission is that if anyone wants to do good for the country then one has to be physically here and work with facts and people to understand not with emotion and their beliefs. Development programmes are not 'surgical strikes' , a phrase again became very popular due to media publicity.
9. So far UNICEF India is concerned , I really have no opinion or interest. I do not consider at the given position any UN agency is influential . They are all in a peripheral position just towing the lines given to them. So though I lamented for their inaction it is immaterial in the current context.
I still will adhere to my choice of word 'hoax' as it was in the case of demonetisation , Gujarat Model , Seven Trillion dream , etc. etc. However this is not the forum to discuss politics. But as we know politics is a reflection of a society and directly connected to social development . The social fabric is being torn and the Indian society is in turmoil.
Gouri
Gouri,
DeleteA great wealth of history based on your extraordinary role in both with GOI and UNICEF is moving the country forward in the water and sanitation area. Also you and your WASH compatriates are absolutely correct in hi-lighting the criticallink bewteen sanitation and child nutrition.
Why did I introduce the link between the issue of apparent recent regression in child nutrition and what I could find about UNICEF's involvement? I think all in the x-unicef community hope and pray that the organization continues to be relevant in addressing the long standing and emerging challenges to child survival, well beng and development. So when I encounter news of a new (continuing and/or returned) challenge, I really, really want to know what UNICEF is doing on the ground.
Now the country office websites may or may not be the best available place to look, but it is at least a start. We of course can guess that part of the puropose of these websites if for profile and fundraising, but we should hope and expect that they might also reflect operations and actions on the ground. I find that the "Research and Reports" tab on most of the UNICEF country office websites tends to be the most substantive. So I found a reasonably hot-of-the-press (April 2020) study "Children and Adolescents in Urban India - Scale andN
atureof Deprevation". And indeed it has a major section on Nutrition and another on Water, Sanitation and Hygene Facilities.
With my aging eyes not up for reading dozens and dozens of pages, I had a look at the three pages of "Conclusion and Policy Implications" for the nutrition section. (I lifed it out and its attached). Reading it I found my optimistic and less optimistic selves have different takes.
The optimistic: This coopeeration between UNICEF Delhi and the Institute of Urban Affairs is a really good piece of work -- comprehensive and very well presented. I can see us back in the 70s,80s and 90s being very please and with a sense of accomplished once the final copies were on our desksfor distribution to policy makers, HQ and donors.
My less optimistic: Could we not have arrived at much of the same conclusions back in the 80s? Could there not be more references to recent history and why some of the problems are still with us. If some of the incredible initiatives that Gouri and others recount have not had a long-lasting impact, then why? No mention in the study of regression, as suggested in the recent report.
Please be assured that my interest is NOT to be critical of UNICEF, but merely to discover if an how they may be addressing various needs of children. It may be that UNCEF in India is doing absolutely the best job possible in addressing child malnutrition in India -- and if so, as a member of UNICEF-UK I would to know exacdtly how.
And on a lighter note, even the best editing cannot catch every blooper. So in the middle of the attached conclusion section is the passage: "The low level of malnutrition is reinvorced by illiteracy, an inadequate housing environmennt, sanitation and water." Should we be going for illiteracy?
Steve
Dear Steve and others,
DeleteOf course, I follow your discussion with great interest, nutrition and sanitation being issues close to my heart. But I don’t think it is fair to involve the whole xUNICEF group in what is essentially an India discussion. So suggest not copying the mails to the entire group.
Eimi
Dear Steve,
DeleteI for one do not agree with you. We may not all be burnt out and may have the mental and physical power to contribute but our role as former staff members is very limited. We cannot and should not compare our group to Unicef National Committees, some of which are large and powerful in terms of fundraising they do on behalf of Unicef and therefore are in a position to influence policy at country, regional and/or global level.
We have had our day and should now let current management and staff members do what they are there to do. I do not believe professional skills are lacking in country offices particularly like the India Country Office where I served for almost six years in the mid 1990s. Of course if our advice is sought on an individual basis, I am sure we will happy to help given our dedication to the good work of the organisation and some of us may be doing that right now.
Otherwise let us enjoy our retirement and stop thinking that we know best.
Keep well and keep safe.
Jag Jugessur
Dear Friends,
ReplyDeleteI fully agree with Gourishankar ji's comments and experiences shared in his mails.
Being part of the Water programme, initially from the private sector side in the 70s and then WESS (now WASH) team in UNICEF, India programme during the 80s, I was very much involved in the water and sanitation programme and under UNICEF's new initiative of building toilets.
From my experience on toilets in Orissa, which I was covering among other states, I personally witnessed not only poorly constructed toilets in rural areas, but it's misuse of being used as storage rooms. From another post Gouri ji shared in this group, it is seen that the situation hasn't changed even after 40 years and all fanfare by the current government under Swatchha Bharat, which you rightly term as a hoax. Apparently and as usual "No Lessons were Learned".
Why Hoax?, because UNICEF and even the government of India realised that "KAP was lacking" and the "Top down approach" wasn't working and "Bottom up approach" would only work (which was later adopted not only by GOI, but World Bank and UNICEF globally, particularly in the water sector. Hygiene education was then added as an essential component to correct the strategy. It seems those lessons have been forgotten.
On another note, a young girl acquaintance of mine tried to get involved for the "effective use" and "monitoring use of toilets" through a software developed by her. She was in touch with UNICEF Delhi office, IIT, Mumbai and even Govt of India to promote and partner, but she gave up fully frustrated by the prevailing bureaucracy, corruption and lack of interest.
So, while the so-called target construction percentages may have been achieved (viz in UP) albeit various reports of high corruption and poor quality, the "effective use" of toilets is still emerging as a major challenge. As we have learnt, numbers don't mean anything. I can't say that the efforts of the current government towards awareness building campaigns are lacking in any way, it is the change of behaviour that is lacking focus.
I can't forget the scams of Drilling borewells and installing handumps in many states but particularly in Rajasthan during 1987-88 (I reckon) where either no wells were drilled at all or very shallow wells were drilled which could not pump water where a massive target based programme was launched by the then government. Reports of similar nature have been trickling on toilet construction, which are being suppressed by the government with iron fist and main line media. So, how are they different from previous governments?
Similar is the situation on Nutrition which is candidly highlighted by Geetha ji, Nilanjana ji and others with skeletons of Gujrat model in the backdrop.
Let us not forget that the Ruling government/s were praised for their good work as well as criticized for their failures in the past and the same goes with the current government/s. No discrimination there, but sadly the trend since 2015 onwards has been to totally destroy any argument of criticizing the current government/s and brand crtics as Anti-national and what not. Taking political mileage v/s real development have always been two contradictory things for all governments.
Bottom line is that advocacy, pressure and constructive criticism only will bring about some results in any democratic set up. As Chopra ji rightly says, we may probably see it in our next life.
As regards UNICEF's working, I have a lot to disclose based on my 27 years of UNICEF experience, but would rather prefer not to open a pindora's box as the previous discussion on that subject created a lot of flutter and ultimately an admin directive.
Amar Raj Singh Sehmi
Dear Dev ji and Friends,
ReplyDeleteWhen Gauri Sankar Ghosh raised the issue of malnutrition in India in a discussion in the xUNICEFers network, there was and is quite a number of reactions and comments with some former colleagues even saying that this is "India bashing". If friends on this exchange are not members of the xUNICEFers group, may I direct you to the link below to read the comments and exchanges.
https://xunicefnewsandviews.blogspot.com/2020/12/india-stunting-despite-decreased-open.html
Wishing everyone a Merry Christmas and a safe one at that.
Peter