Sanitation shortfalls loom as development deadlines near

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Experts call for an end to open defecation a major threat to public health and economic development

A latrine on a Mekong River tributary in Ca Mau Province. Experts have called for an end to open defecation that could affect human health and hinder development.

Vo Thi Giong and her family don't have an indoor toilet.

When nature calls, they trek to a nearby hill, dig a shallow hole and do their business.

"We don't have other option," said the poor woman from the coastal Hai An Commune in the north-central province of Quang Tri. "Many people here have to do the same thing."

Nguyen Quoc Danh, deputy chairman of Hai An Commune's People's Committee, the local government, said that most of the commune's 170 poor households lack proper toilets.

"They often dispose of feces in uncultivated dunes," he told Thanh Nien Weekly. "Clearly, the practice poses a threat to environmental health and safety."

Danh also said the unhygienic practice could harm tourism in the coastal area despite the fact that Hai An is home to a beautiful beach.

Nguyen Thanh Vu of the Long An Province's Chau Thanh District also has a habit of disposing of feces in the open"”but in a different way. Like many families in the Mekong Delta, he built a latrine over a fish pond.

"I've used it since I was a kid," he said, adding that his family built a proper toilet several years ago but few of them use it. "Outdoor toilets create a relaxing and refreshing space."

Open defecation remains a problem in Vietnam and the country plans to improve sanitation to curb the spread of deadly diseases and meet its United Nations Millennium Development Goals (MDGs), a set of targets for education, poverty, health and other areas. The MDGs were established with the hope that participating nations will achieve the goals by 2015.

One of Vietnam's seven MDGs is to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015.

"In the past few decades, the government of Vietnam has made impressive progress in providing clean water and safe sanitation for people, especially for households living in rural areas," said UNICEF representative to Vietnam Lotta Sylwander.

"While Vietnam is at the position to achieve the millennium target for water supply, the target for rural sanitation is still lagging significantly behind," she told Thanh Nien Weekly via email.

The World Health Organization (WHO) estimates that more than 20,000 people in Vietnam (mostly children) die each year from lack of clean water and proper hygiene.

According to Graham Harrison, the acting WHO representative to Vietnam, a majority of these cases could be avoided if families boiled their drinking water, used hygienic latrines and washed their hands before eating and after using toilets.

Insufficient hygiene

Harrison said that Vietnam now needs to focus on ensuring its population uses proper hygienic practices.

"There is a national target program on rural water and sanitation and other water and sanitation projects, but sanitation has not always been a key focus and has received less technical support and financial allocation than water," he said.

"There are quite a lot of sanitation pilots in Vietnam involving a lot of efforts, but their results haven't been summarized comprehensively, systematically and scientifically so that the best practices can be scaled up."

Sylwander stressed that the country still has far to go"”particularly in terms of providing its children with basic health and safety.

"It is shocking that today, in 2011, half of all children in Vietnam [around 14 million] live without access to hygienic latrines and safe drinking water. Clean water and sanitation are vital for life, a prerequisite for human health and central to preservation of the environment," she said.

Poor sanitation, unsafe water and unhygienic practices make millions of Vietnamese children suffer needlessly from diseases, she said.

In 2007, only 18 percent of rural households, 12 percent of rural schools and 37 percent of communal health stations were equipped with hygienic latrines that meet the Ministry of Health standards. Every third of rural household in Vietnam uses human feces for cultivating and feeding fish, and most households fail to decompose feces, Sylwander said.

"These issues are interrelated with child nutrition and poverty rates. Almost every third pregnant woman and child under five years of age suffer from anemia, which is partly caused by worm infection-a water and sanitation-related disease. Unsafe water and poor sanitation are also associated with a high malnutrition rate (28.7 percent) among children under five years of age in Vietnam."

The right to toilets

A 2010 joint monitoring program between UNICEF and the WHO found that 2.6 billion people do not have proper toilets worldwide, and the majority of them live in Southeast Asia.

In a bid to improve the health and well-being of millions of people worldwide, the UN on Tuesday launched a major push to accelerate progress toward the goal of halving the proportion of the population lacking access to basic sanitation by 2015.

The resolution called for an end to open defecation, the most dangerous sanitation practice for public health and practiced by over 1.1 billion people who have no access to facilities.

Secretary-General Ban Ki-moon said at the launch that sanitation is a sensitive issue and unpopular subject and that is perhaps why the sanitation crisis has not been met with the expected kind of response.

"It is time to put sanitation and access to proper toilets at the center of our development discussions," he said, calling for strong political commitment, a focused policy framework and reliable supply chains for both building and maintaining affordable latrines to end open defecation.

"Most important of all, we need effective public education so people understand the hazards of open defecation," he said. "We must convince people to change these unhealthy practices."

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