I was introduced to the South African comic strip “Madam and Eve” by my husband, who has been hooked on it since he lived in Zimbabwe for three years as a kid. It brightens up my Google Reader feed and gives me an excuse to read about current events in the region so I can understand the context of the cartoons. But when they began their series on “toilets ‘al fresco,’” I was appalled at what the news search turned up.
With local government elections fast approaching, the African National Congress (ANC), the country’s ruling party, was quick to condemn the opposition Democratic Alliance (DA) for building 50 open-air toilets in a township outside of Cape Town. The ANC Youth League took the DA to court over the issue, arguing that they infringed on human dignity. The municipality was ordered to build enclosures for the toilets. The DA, which is the majority party in Cape Town, is struggling to shed its image as a party that caters to the white elite, and the ANC gleefully cast the fiasco as one more example of racism.
Then it was revealed that an ANC-led area has built 1,600 of the same toilets, some dating as far back as 2003.
Both area governments claimed that they did not have the funds to build the enclosures, and that the residents agreed to build them themselves. Julius Malema, the leader of the ANC Youth League, countered that officials should have known better: “They agree to it because they are desperate, they are poor people, they have no option and they agree to anything that comes.”
“Service delivery,” a term referring to the government’s (in)ability to deliver electricity, running water, and sanitation to citizens, has become a buzzword and a driving force in South African politics. While many are upset that these so-called “toilet wars” are just serving as the current political battlefield, others are optimistic that attention is being drawn to the issue. But the most disturbing aspect is perhaps that it happened in the first place, and that these government officials used a bureaucratic technicality to shirk their responsibility to the dignity of their citizens – to provide something as basic as the right to relieve themselves in private.
The Shona word murambatsvina means “to drive out trash.” This was the word used to describe the Zimbabwean government’s campaign to forcibly clear out the slum areas around the country, under the pretense of combating illegal housing and reducing the spread of infectious disease. Zimbabwe’s current president has described the “urban renewal campaign” as “a vigorous clean-up campaign to restore sanity.” UNHCR has estimated that the forced evictions have directly affected at least 700,000 people, and that approximately 2.4 million more could have been indirectly affected in some way. The campaign was condemned by the UN and was called a crime against humanity.
Five years later, the evicted slum-dwellers still remain homeless. The few houses that were built as part of the re-housing scheme were given to government employees. Obvious human rights abuses aside (like torching people’s houses and belongings) aside, the campaign had serious health consequences for the evicted populations. HIV patients were cut off from clinics and antiretroviral medications. Thousands of IDPs are still living under emergency plastic sheeting with no medical services or clean water, no schools, no sanitation, and no source of income. Amnesty International has reported a shockingly high neonatal mortality rate among babies born to evicted mothers: in five months, there were 21 newborn deaths in Hopley, a settlement 10 km south of Harare. Most of the babies died within 48 hours of birth. The women have said that they were fully aware of the importance of maternal healthcare, and they all wanted to give birth in a hospital or with a trained birth attendant, but many could not afford the $50 required to register for antenatal care. The nearest maternity clinic is 8 km away. Some thought their babies had died because of minimal access to healthcare, while others suspected they had died of cold because they live in plastic shacks.
Amnesty International and other human rights groups have called for an investigation of the newborn deaths, but there seems to be little hope of a serious inquiry. Meanwhile, there are growing concerns of another eviction campaign: residents are again being forced to leave their homes because they cannot afford a(n arbitrarily-imposed) $140 “lease renewal fee.” Zimbabwe’s government of course denies this, but it a bit difficult to argue when the evidence consists of shacks on fire. Several MEPs have called for the Zimbabwean diplomat to the EU to be sent home in response to the evictions – but will it be enough?
Imagine yourself in the day-to-day in a crowded, dirty tent camp as a refugee somewhere. You have to stand in line for bottles of clean water, your health care comes from a medical charity with a trailer, and you never know whether your next meal will come from UN trucks or your own resourcefulness to scrounge something that your neighbors have not already found. You do the best you can, though, and you look forward to the good days when you can turn a nice big bag of beans or something into a meal to divide with your family in a tent that is inevitably too small for you. On bad days, though, your water might be tainted with Vibrio cholerae, a nasty little bug with a very short incubation time. You might not feel so good a few hours after that meal – and by the same time the next day, you could be dead.
Cholera is an aggressive water-borne disease that is currently running rampant through the world, the news, and the global health blogosphere. An outbreak reared its ugly head in Haiti last week when five cases were detected in Port-au-Prince. The disease has since spread through the population: 284 people have died so far, and over 3,600 people have been infected. Despite so many people living in high-density refugee camps with little to no sanitation, many are still surprised: it is the first time the island has seen cholera in 100 years, and after nine months I guess people were beginning to entertain the optimistic notion that the earthquake-ravaged nation might be able to avoid it. The debate over whether or not the outbreak (which some are already calling an epidemic) is contained rages on. Meanwhile, a much larger epidemic is running rampant through Nigeria (though I suppose having eleven times as many cases and five times as many deaths will still not make you more noteworthy than Haiti – after all, Nigeria sees cholera every year). It has already appeared in flood-affected areas of Pakistan and in the aftermath of the mostly-ignored floods in West Africa. Basically, where there are floods, natural disasters, and/or refugee camps, there is cholera.
This year’s floods are the worst Benin has seen since 1964. Photo taken by Salako Valentin/AP.
The extremely rapid spread of the disease through disaster areas underscores the extreme importance of prevention planning and education. In Haiti, for example, you would think that a nine-month lag would have allowed for ample time to have systems in place to deal with this kind of outbreak, but that unfortunately does not appear to be the case: Melinda Miles, director of Let Haiti Live, told UN Dispatch last week that “it is absolutely stunning that so little was in place to prepare for [the outbreak]…It is certain that many unnecessary deaths will be the result of poor planning and slow response.” On the other hand, Care has held hygiene awareness sessions for more than 10,000 people affected by the flooding in Benin. Even if cholera never appears, preparations for it are never in vain: having clean water, proper sanitation, and stocks of oral rehydration salts are always a good idea.
“This is the world’s most precious natural resource. We need to control as much of it as we can.” –Dominic Greene, Quantum of Solace
I think it is safe to assume that everyone who wanted to watch it has seen Quantum of Solace, the latest James Bond installment (but if you have not, be advised – there are spoilers ahead). The film’s villain is Dominic Greene, environmental philanthropist and major player in “Quantum,” the mysterious global terrorist network. Greene’s plot for world domination involves funding a coup in Bolivia in exchange for a large tract of desert. Both the CIA and MI6 believe he is after oil, and the film leads the audience in the same direction until Mr. Bond and Camille stumble across a massive dam built by Greene’s organization, whose purpose is to control access to, and charge exorbitant amounts of money for, water – “the world’s most precious natural resource.” [End spoilers.]
While the premise, as with all Bond movies, is far-fetched, Mr. Greene is definitely onto something. Water is indeed one of the most precious resources we have, too often taken for granted by those of us who have it in abundance. No clean water means no sanitation, which reduces people to living in illness and squalor – unsafe water and lack of basic sanitation cause approximately 80% of all diseases in the developing world and kill more people than all forms of violence.1 The cholera outbreak in Zimbabwe was the worst in Africa in 15 years, infecting nearly 100,000 people and killing over 4,000. The search for safe water in Bangladesh has led to people depending on arsenic-contaminated wells. In the slums of Nairobi, which have recently attracted attention as destinations for “slum tourism” (whatever that means), residents extort each other by selling water for inflated prices, and excrement crowds the streets.2 Progress on MDG 7 (the “sanitation goal”) has been slow, with many global health experts lamenting that the world will be nowhere close to reaching it by 2015. The concept of not having a toilet can barely be grasped by most people in the developed world, but millions suffer that reality each day.
The UN recognized this critical need by declaring access to clean water to be a human right this summer.3 While this is a good symbolic step, it accomplishes little without concrete action. Attacking this issue is arguably more difficult than some of the other global health issues that attract more attention: digging wells and building toilets is more involved and more expensive than, say, providing mosquito nets for malaria or designing cell phone apps to promote maternal health and prenatal screening. We cannot afford to turn our backs on those who simply do not have what all life on this earth requires. No one deserves to live a life where not having clean water is just another way to die.
This entry was contributed on behalf of Blog Action Day, an annual effort by Change.org to unite bloggers in drawing attention to and promoting discussion on an issue that is globally relevant.
With the explosive growth of social media, these days it seems that every non-profit and NGO has its own blog, Twitter handle, YouTube account, and Facebook page, with some even venturing into Tumblr, MySpace, and Flickr (if you have never heard of these, don’t worry – I barely even know what Flickr is). One organization has done something pretty nifty (at least, I think so) with their YouTube account, though: Save the Children, which works in the U.S. and 41 other countries providing humanitarian relief, education, and other services to children, features a weekly video series called “Dirty Words.” These videos, narrated by its Director of School Health and Nutrition, Seung Lee, are 2-5 minutes long and highlight the water, sanitation and hygiene conditions at schools in developing countries, with simple solutions to address them. This week’s “dirty word” is worms – the video below shows a school in Nepal which has begun a program to provide de-worming medicines and iron to improve the health of the students.