U.N. rights experts call for proper toilets in prisons

People held in jails and other detention centres around the world frequently have no access to clean toilets; a violation of their basic human rights, three United Nations investigators said Wednesday.

In statements marking World Toilet Day, marked on November 19 since 2001, they said states and governments had the obligation to ensure that all prisoners could enjoy safe sanitation.

“Without it, detention conditions are inhumane, and contrary to the basic human dignity that underpins all human rights,” the investigators — on torture, access to water and sanitation, and the right to the best possible health, declared jointly.

World Toilet Day is promoted by the World Toilet Organization, founded in 2001 by Singapore entrepreneur Jack Sim as a global non-profit network aiming to improve sanitation and public health policies.

“In too many places, detainees in prisons, migrant detention centres, juvenile institutions, psychiatric hospitals and other state-run institutions are forgotten,” said Manfred Nowak, special rapporteur on torture to the U.N. Human Rights Council.

Anand Grover, rapporteur on the right to the highest attainable standard of health, said unsanitary conditions “directly cause many diseases rife in places of detention.

“Access to sanitation is fundamental for a life in dignity, which all people are entitled to,” declared Catarina de Albuquerque, U.N. independent expert on human rights and access to sanitation.

“Even those convicted of heinous crimes must enjoy such basis rights,” she added.

Read the full OHCHR World Toilet Day statement.

Source: Jon Hemming, Reuters, 19 Nov 2009 [based on the UN news press release]

Gates Foundation awards $10.9 million to study impacts of sanitation on diseases

Researchers at the University of California, Berkeley, have received a five-year, $10.9 million grant from the Bill & Melinda Gates Foundation to evaluate several interventions to combat diarrheal disease in developing countries.

Dr. Jack Colford

Dr. Jack Colford, professor of epidemiology at UC Berkeley’s School of Public Health, will coordinate the project, working with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) and Innovations for Poverty Action (IPA).

An estimated 2.2 million children under the age of 5 die from diarrhoeal diseases each year, according to the World Health Organization. Most of these diseases are thought to be preventable with improvements in sanitation, water quality and hygiene.

Due to the high cost of developing and maintaining large infrastructure projects, such as networked water, there is now a movement toward simpler, alternative methods to improve health in rural areas. However, there is almost no evidence that allows direct comparison of the health benefits or cost effectiveness of these simpler interventions, such as improved latrines, household water treatment and hand washing with soap.

The goal of the new project is to determine how sanitation interventions, delivered alone or as part of combined intervention packages, impact child health and well-being. In addition to improved sanitation, the intervention packages will include drinking water improvements and hand washing solutions. The results have the potential to influence how billions of dollars are directed towards long-term improvements in health and economic outcomes for millions of children each year, said Colford.

“Increasingly, foundations, governments, the World Bank and development agencies such as the MCC (Millennium Challenge Corporation) are demanding evidence of effectiveness when awarding development funds,” said Colford. “Right now, it is unknown whether single interventions are as cost effective as combinations of these interventions. This grant will fund the first large-scale, randomized impact evaluation designed to gather rigorous evidence about this question.”

The study will test the impact of these sanitation, water and hygiene interventions using a large-scale, randomized impact evaluation in Bangladesh and Kenya. These two countries are representative of the two regions that account for the majority of the world’s gastrointestinal disease burden: Southeast Asia and sub-Saharan Africa. The researchers expect to enroll a total of 23,000 children in the trials, which will be monitored by several institutional review boards.

Of the $10.9 million, about $7.9 million will be subcontracted out to the two field sites. Dr. Stephen Luby, head of the Programme on Infectious Diseases and Vaccine Sciences with ICDDR,B, and Michael Kremer, Ph.D., a research affiliate with IPA, will lead the trials in Bangladesh and Kenya, respectively. They will be joined by a team of experts from various disciplines, including public health, economics, behavioral change, nutrition, cognitive development and tropical enteropathy.

Source: Linda Anderberg, UC Berkely News, 05 Nov 2009

Water evaporates from climate change negotiations – campaigners

Much of the talking at climate change negotiations ahead of a big gathering in Copenhagen [COP15] in December 2009 has been focusing on emissions, prompting campaigners at this week’s Barcelona meeting to point out that water is also critical to the success of any efforts to adapt to the impact of climate change.

The way that water is managed in and between countries is a vital component of future planning. Water is also crucial to many mitigation activities, including hydropower, agriculture and forestry projects.

“Let me be very clear, there is no development without water,” said Pasquale Steduto, chair of UN-Water and service chief at the Food and Agricultural Organisation.

“There is no food security without water. There is most likely also no energy security without water,” Steduto added in a statement. “Water is the primary medium through which climate change influences the earth’s ecosystems and therefore people’s livelihoods and well-being. If water is not further recognized in adaptation strategies and plans, we are making a big mistake.”

To a large extent, the global climate crisis is a global water crisis. The campaigners’ warning comes against a backdrop of drought and famine as many developing countries begin to experience the devastating impact of climate change on the water cycle.

Water experts have long warned that this may lead to an increase in conflicts related to water availability and distribution.

Extreme weather events leading to drought and floods, as recently witnessed in Kenya and the Philippines, are predicted to increase in frequency and intensity, possibly as a result of climate change.

“Even with the best mitigation strategies, water related effects of climate change will come,” said Anders Berntell, executive director of the Stockholm International Water Institute. “The challenge for many nations is how to adapt. Climate change is in effect water change, since it will be through water that the changes will be realised first and foremost.”

Yet the latest draft of the negotiating text on adaptation, the so-called Non-Paper No. 31, has deleted any clear references to water and its management as a vital consideration for climate change adaptation, the campaigners say. This is despite mounting pressure from the water community for a strong outcome on water from Copenhagen.

To make sure water is at the top of the agenda, governments, UN agencies, international NGOs and civil society advocates gathered at a “Water Day” event at UN climate talks in Barcelona on 3 November to urge negotiators to consider the critical role that water plays in climate change adaptation.

They highlighted five key points in the water and climate change debate:

Climate change impacts on water resources will affect livelihoods and development .
90 percent of the 3 billion people who are expected to be added to the population by 2050 will be in developing countries, many in regions already under water stress conditions. Integrated land and water management arrangements will be critical to manage water flexibly among competing users, prioritising human needs.

Climate change adaptation is not just a national issue
More than 75 percent of the world’s nations have shared river basins within their boundaries. Regional co-operation on climate change adaptation will be vital for addressing climate change impacts on shared water resources, even as a way to prevent potential conflicts.

Investing in ecosystems can help preserve water supplies
Ecosystems build resilience to climate change. Healthy ecosystems need water and in turn help maintain a healthy water cycle. Care must be taken that climate change mitigation activities do not damage and degrade ecosystems, and that adaptation efforts prioritise their preservation. This is critical not least to food security.

Data, information and governance are key
Understanding climate change impacts on water resources will require enhanced data collection and sharing, and increased capacity for gathering and using data. However, climate change impacts are being felt now and improving water governance arrangements to respond to uncertainty and variability will be the key to good adaptation.

Climate change mitigation efforts must take water into account
The projected increase in hydropower and bio-energy to meet low-carbon energy needs will depend heavily on sustained water flows and water availability. Projected changes in the water cycle as a result of climate change must therefore be taken into account. Building dams for water storage and energy needs must be done in the context of understanding and mitigating potentially negative impacts on human populations and the environment. Bio-energy must be balanced with food security and ecosystem protection.

See also: SEAL THE DEAL: Climate change illustrates need for better water management, UN News Centre, 03 Nov 2009 and the joint Water Day press release “Water evaporates from the climate change negotiating text” by SIWI, UN-Water and Stakeholder Forum, 03 Nov 2009

Source: Astrid Zweynert, Reuters Alertnet, 03 Nov 2009

Diarrhoea kills over a million over-fives each year

Diarrhoea kills three times more over-five-year-olds in Africa and South-East Asia than previously thought, new research finds.

Some 1.15 million over-fives — thought to be mostly adolescents and the elderly — are dying in these regions each year from diarrhoeal diseases, according to the research, commissioned by the WHO. Until now the death toll estimate for these regions came to 380,000.

Preliminary results from the study — which has yet to be published — were presented at this week’s meeting of the Foodborne Disease Burden Epidemiology Reference Group (FERG) (29 October) in Switzerland.

“These estimates highlight the significant burden of diarrhoeal diseases in adolescents and adults in the developing world,” said Martyn Kirk, chair of the FERG Enteric Diseases Task Force, who presented the results.

For the study, Christa Fischer-Walker and Robert Black from Johns Hopkins School of Public Health in the US searched 25,000 journal articles for information on diarrhoea in the over-fives. Only six of the articles contained reliable figures on diarrhoeal deaths in developing countries for this age group (compared to hundreds for younger children) — and there was no data for China, Latin America, the Middle East or South Asia.

The new estimate is on a par with the global annual death toll for malaria. It is also equivalent to nearly one-third of all HIV deaths and to almost half the number of global deaths from tuberculosis, says Claudia Stein, medical officer of the WHO’s Department of Food Safety and Zoonoses.

“What makes the tragedy even greater is that many of these diseases are clearly preventable,” said Jørgen Schlundt, director of FOS. Schlundt calls for policymakers to be alerted to cheap strategies known to prevent diarrhoea.

Improvements in food safety, sanitation and hygiene are critical, says Kirk. He told the meeting that nearly half (48.9 per cent) of diarrhoeal deaths in the developing world are caused by the bacteria Enterotoxigenic Escherichia coli and Vibrio cholerae, both of which are associated with poor sanitation and are common in resource-poor countries.

Stein says major gaps remain in scientists’ understanding of diarrhoeal deaths. Research focusing on older people attracts little funding, as a result of which the problem has never been thoroughly assessed in this group.

But it is expected that some of these gaps will be filled next year, when results emerge from studies in China and India. The FERG is also planning country-level studies across the world, the results of which should begin to emerge in 2010.

Source: Sian Lewis, SciDev.net, 30 Oct 2009

Tackling global health risks prevents premature deaths

Global life expectancy could be increased by nearly five years by addressing five factors affecting health – childhood underweight, unsafe sex, alcohol use, lack of safe water, sanitation and hygiene, and high blood pressure, according to a new WHO report.

These are responsible for one-quarter of the 60 million deaths estimated to occur annually.

Global health risks describes 24 factors affecting health. These are mixture of environmental, behavioural and physiological factors, such as air pollution, tobacco use and poor nutrition.

The report also draws attention to the combined effect of multiple risk factors. Many deaths and diseases are caused by more than one risk factor and may be prevented by reducing any of the risk factors responsible for them.

Read the full press release: WHO, 27 Oct 2009

Read the full report

The report mentions that unsafe water, sanitation and hygiene is one of the the leading global risks for burden of disease, accounting for 4% of disability-adjusted life years (DALYs), The others are childhood underweight (6% of global DALYs), unsafe sex (5%) and alcohol use (5%) [see fig. 7].

In developing countries, unsafe water, sanitation and hygiene comes second behind childhood underweight as the highest risk for burden of disease [see tab 2.].

In the annexes of the report there are more detailed tables on health risk factors by WHO region (Africa, Southeast Asia, the Americas, Eastern Mediterranean, Europe and Western Pacific).

Source: WHO, 2009. Global health risks

Source: WHO, 2009, Global health risks

World Water Council: UN agencies join board despite activist lobby

Three UN agencies, UNESCO, FAO and UN-HABITAT, have been elected on the new Board of Governors of the World Water Council (WWC), organisers of the World Water Forum (WWF). Activists see the election as a reaction to their own lobby to get the United Nations to organise the next World Water Forum instead of the WWC. The activists say that 26 countries’ governments had endorsed their call for a UN-led forum after the 5th WWF in Istanbul in March 2009.

After it became known that the WWC was lobbying to get the UN on board, activist groups started a counter-lobbying offensive with a petition directed at the UN’s Secretary General to prevent UN agencies from joining. The petition, which attracted nearly 700 signatories, was an initiative of the Blue Planet Project of the Council of Canadians.

Reacting to the news of the UN agency sign-on to the WWC, Anil Naidoo of the Blue Plant Project said “it was not unexpected, but is a disappointment. The reality is that these UN agencies have been under severe pressure for some time. I can tell you that there are many good people within the UN who are disturbed by the degree of corporate influence within their agencies”.

The WWC’s new Board of Governors will oversee and guide the Council’s work for the coming three years. The elections took place during the triennial General Assembly for which more than 280 members had gathered in Marseille, France. Through majority rule voting, the members elected the 36 Governors from 74 candidatures and appointed Loic Fauchon to continue to serve as President of the World Water Council.

The rector of UNESCO-IHE Institue for Water Education Andras Szollosi-Nagy was elected as one of the four WWC Bureau Members. UN-HABITAT Executive Director Anna Tibaijuka and the Service Chief of FAO’s Water Development and Management Unit (NRLW) Pasquale Steduto are the two other UN representatives on WWC’s board.

Several other UN agencies are WWC members. In the June 2009 membership list we find the UN Environment Programme (UNEP), the World Bank and the World Meterological Organisation (WMO).

UNICEF/WHO – Diarrhoea: Why children are still dying and what can be done

Despite the existence of inexpensive and efficient means of treatment, diarrhoea kills more children than AIDS, malaria and measles combined, according to a report issued today by UNICEF and the World Health Organization (WHO).

The report, titled Diarrhoea: Why Children Are Still Dying and What Can Be Done (PDF),  includes information on the causes of diarrhoea, data on access to means of prevention and treatment, and a seven-point plan to reduce diarrhoea deaths.  “It is a tragedy that diarrhoea, which is little more than an inconvenience in the developed world, kills an estimated 1.5 million children each year,” said UNICEF Executive Director, Ann M. Veneman.

“Inexpensive and effective treatments for diarrhoea exist, but in developing countries only 39 per cent of children with diarrhoea receive the recommended treatment.” Dr Margaret Chan, Director-General of WHO, said:  “We know where children are dying of diarrhoea. We know what must be done to prevent those deaths.  We must work with governments and partners to put this seven-point plan into action.”  Diarrhoea is a common symptom of gastrointestinal infection, which can have a variety of sources.

However just a handful of organisms are responsible for most acute cases of diarrhoea and one,  Rotavirus, is responsible for more than 40 per cent of all diarrhoea-related hospital admissions of children under five. A new vaccine for Rotavirus has been found to be safe and effective but is still largely unavailable in most developing countries. Though most episodes of childhood diarrhoea are mild, acute cases can lead to significant fluid loss and dehydration. This dehydration can lead to death unless fluids are quickly replaced. Oral rehydration therapy is the cornerstone of fluid replacement and the new low-osmolarity formula of oral rehydration salts (ORS) is a simple, inexpensive and life-saving remedy that prevents dehydration in children suffering diarrhoea.

Some 88 percent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene. As of 2006, an estimated 2.5 billion people around the world were not using adequate sanitation facilities, and about 1 in 4 people in developing countries practiced open defecation.  Access to clean water and good hygiene practices are extremely effective in preventing childhood diarrhoea.  Hand washing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent, making it one of the most cost-effective interventions for reducing child deaths caused by this neglected killer.

October 15 is annual Global Handwashing Day when millions of children and adults in over 80 countries will take part in activities to highlight this key intervention.  The overall health and nutrition of children is also critical to their susceptibility to diarrhoea and the damage it can cause.  Undernourished children are at higher risk of suffering more frequent, severe and prolonged episodes of diarrhoea, and repeated bouts of diarrhoea also place children at greater risk of worsening nutritional status.

The seven point plan to save the lives of children stricken by diarrhoea includes two treatment and five prevention elements.

The two treatment elements are:

1. fluid replacement to prevent dehydration; and
2. zinc treatments, which decrease the severity and duration of the attack.

The five prevention elements are:

1. immunization against rotavirus and measles;
2. early and exclusive breastfeeding and vitamin A supplementation;
3. handwashing with soap;
4. improved water supply quantity and quality; and
5. promoting community-wide sanitation.

Campaigns targeting childhood diarrhoea in the 1970s and 1980s achieved success by educating caregivers and scaling up oral rehydration therapy to prevent dehydration. The campaigns delivered promising results but following that success, focus shifted to other health problems. There is now an urgent need to shift attention and resources back to treating and preventing diarrhoea.

Johansson, E.M. … [et al.] (2009). Diarrhoea : why children are still dying and what can be done. New York, NY, USA, UNICEF and Geneva, Switzerland, World Health Organization. v, 58 p. ISBN 978-92-806-4462-3 (UNICEF). ISBN 978-92-4-159841-5 (WHO). Full report

Related web sites:

• WHO – Diarrhoea
• Rehydration Project

UNICEF TV Video: Diarrhoea is the second leading killer of children

Source: UNICEF, 14 Oct 2009

Geneva Raindrops Award 2009 contest for video films

The International Rainwater Harvesting Alliance (IRHA) will be awarding three prizes for the best videos on the advantages of the use of rainwater. The duration of the videos should be from 10 seconds to 6 minutes. The prizes will be awarded in December 2009.

The prizes are:

• 1st winner – CHF 500.00 (US$ 500)
• 2nd winner – CHF 300.00 (US$ 300)
• 3rd winner – CHF 200.00 (US$ 200)

Competition deadline: 17 November 2009

For full details of the competition go to the IRHA web site

UN investigator tells of horrors and insanitary conditions of world prisons

Inmates at a prison in Uruguay can spend years in “las latas” (tin cans) — small metal boxes where temperatures rise to 60 degrees Celcius. They had to use the water in the toilets for drinking and defecate in plastic bags which they later threw outside their cells.

Those were among the abuses chronicled in a report released by Manfred Nowak, an Austrian human rights lawyer and U.N. special rapporteur on torture and other forms of cruel and inhuman treatment and punishment. Nowak’s report focused on “forgotten prisons” and the treatment of children in the dozens of countries he visited. He said roughly 1 million of the world’s 10 million detainees were children, some as young as 9 or 10 years old.

Nowak notes that in many countries the “police and prison authorities simply do not regard it as their responsibility to provide detainees with the most basic services necessary for survival, let alone for a dignified existence or what human rights instruments call an “adequate standard of living”, i.e., food, water, clothing, a toilet and a proper place to sleep.”

The living conditions of prisoners in Equatorial Guinea and Uruguay were shocking.

“”In Equatorial Guinea, detainees spend several weeks or even months in overcrowded, often dark and filthy police cells with virtually nothing but a concrete floor where they are kept for 24 hours a day. It is the task of their families to bring them water in plastic bottles and food in plastic bags. Since there are no toilets, they must use the same bottles to urinate and the plastic bags to defecate. In most police stations, including the police headquarters in Malabo, plenty of filled and stinking plastic bottles and bags had been thrown through the bars to the corridors and open yards.’

“In Uruguay the situation of accused and convicted children who were held in extremely poor conditions was alarming. The system of detention was based on a punitive approach. Children had no opportunities for education, work or any other rehabilitative activity, and the boys were locked up for up to 22 hours a day in their cells. The sanitary conditions were very poor. There were no toilets in the cells, which sometimes forced detainees to wait for hours for a guard to let them go to the toilet. At the Piedras Home, the detainees had to relieve themselves in bottles and plastic bags, which they threw out of the window, resulting in a repulsive smell around the building.”

Under the International Covenant on Economic, Social and Cultural Rights, detainees have a right to an
adequate standard of living. This includes cells with sanitary installations “adequate to enable every prisoner to comply with the needs of nature” (rule 12), with “adequate bathing and shower installations” (rule 13) and “with water and with such toilet articles as are necessary for health and cleanliness” (rule 15).

In 2005, the International Committee of the Red Cross (ICRC) published a handbook on “Water, sanitation, hygiene and habitat in prisons“.

Nowak said that Iran and most Arab countries, except for Jordan, had denied him access to their prisons.

Watch Manfred Nowak outline the main points of his report.

Source: Louis Charbonneau, Reuters, 20 Oct 2009 ; UN, 20 Oct 2009

Global Handwashing Day 2009: Spread the word, not the germs

Next Thursday, 15 October 2009, marks the second annual Global Handwashing Day, which millions of children and adults will celebrate with special activities in over 80 countries.

Handwashing with soap and water is one of the most affordable and effective interventions to prevent needless deaths of children under the age of five. It helps reduces diarrhoea-related deaths by more than 40 per cent and cases of acute respiratory disease by about 25 per cent.

The promotion of handwashing with soap is also a key strategy for controlling the spread of the H1N1 virus – another major focus of the planned events in many countries on 15 October.

‘Clean hands save lives’

Meanwhile, the popular Australian children’s entertainers, The Wiggles, have once again partnered with UNICEF to raise awareness about the importance of handwashing with soap.

And children themselves play a central role in spreading the word instead of the germs. Under the slogan ‘Clean hands save lives,’ Global Handwashing Day 2009 will honour schoolchildren as effective communicators and agents of change, who learn good hygiene practices at school and take them back into their homes and communities.

Events around the world

In 2008 over 80 countries participated in handwashing day activities, with about 200 million children washing their hands with soap and water at public events. Activities ranged from school assemblies and contests to government outreach programmes, SMS text messaging campaigns, photo exhibits and celebrity appearances.

Global Handwashing Day 2009 is being celebrated with renewed enthusiasm. Japan, Guatemala and Mali are preparing educational programmes, demonstrations and performances. Nepal is promoting a handwashing song to be played during its annual Teej Festival. Côte d’Ivoire is training restaurant workers on handwashing techniques and prevention of H1N1. See an updated list on the official Global Handwashing Day web site.

The annual observance was launched in 2008 as an initiative of the Global Public-Private Partnership for Handwashing with Soap. It is endorsed by a wide array of governments, international institutions, civil society organizations, non-governmental organizations, private companies and individuals worldwide.

As a contribution to Global Handwashing Day, the IRC/USAID Sanitation Updates news feed is having a Handwashing Slogan Contest.

In a related development, UNICEF and the World Health Organization will release a new report on 14 October focusing on the prevention and treatment of diarrhoeal diseases as a central factor in improving child survival.

Watch the public service announcement starring the popular Australian children’s entertainers, The Wiggles, promoting Global Handwashing Day 2009, below

Source: UNICEF, 09 Oct 2009