Clean Water and Sanitation (Africa)

Pauline Latham Excerpts

Thursday 21st April 2016 Westminster Hall

[Pauline Latham (Mid Derbyshire) (Con)]

It is a delight to serve under your chairmanship, Mr Percy. I did not know that you had been made a Chairman. I am delighted to see someone from our intake—you are possibly the first—become a Chairman in the House.

[Andrew Percy (in the Chair)]

Some have greatness thrust upon them.

[Pauline Latham]

Absolutely. Congratulations.

I also congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. It is a shame it happened to come on a Thursday afternoon when everyone is desperate to get home, but it is an important debate. I apologise if I repeat things that he said, but I am completely deaf in one ear and 50% deaf in the other since I had a really bad cold. I cannot clear it. Although I listened as much I could, I did not hear very much of what was said, so my apologies if I repeat anything.

[Jim Shannon]

Is it my accent?

[Pauline Latham]

Just this once, it was not the hon. Gentleman’s accent that confused me, but the fact I could not hear. That is my problem, and I apologise.

Clean water is one of the fundamental things that we expect to have. In this country, we have had it for donkey’s years. but we recently saw the problems in the north-west when water was contaminated for some time. One suddenly realised how much we take it for granted in this country that we can wash and use the washing machine and probably the dishwasher. We can have a shower or bath or clean our teeth with no worries at all. That incident showed the population of Britain that we use a huge amount of water without thinking about it.

For those in a developing country—we know that almost a third of the global population lack access to sanitation facilities and more than 660 million people lack access to clean water—it is a daily problem that they have to live with and deal with. We see so many young people dying under the age of five because they do not have access to clean water or sanitation. We and many other countries accept water as something that we can use at any time, and we should be looking to help the countries affected. Other countries have to look themselves at improving clean water facilities, but it is incredibly difficult. Where does a President or a Government start if people have no decent housing, no clean water, no or few sanitation facilities, no education and no good health facilities?

Without clean water, people cannot have access to education or decent healthcare. I have seen some hospitals where there is no running water—how can a hospital facility have no running water? How can things be kept clean? Even in the Crimean war, Florence Nightingale understood that the one thing needed in a hospital is cleanliness and sanitation. That was a very long time ago, but some countries in Africa do not have that facility, and that is totally shocking.

I am pleased to see that sustainable development goal 6 is the aim of achieving universal access to safe water and sanitation by 2030, but 2030 is not very far away—only 14 years. We have been involved in international development for many years, as have many other countries, non-governmental organisations, charities and individuals, along with diaspora communities that send money back. Why do some Governments appear to have little will to install decent water facilities? It is not difficult to do; it just needs a comprehensive plan.

As a member of the Select Committee on International Development, I have visited many countries in Africa where I have been shocked by the poor facilities that people have to live with. For instance, when we went on a visit to Burundi, we were embedded in a house right out in the sticks for 24 hours with no water and no sanitation. The only place to go to the toilet was where they had literally dug a hole specifically for me to go in. I found that rather embarrassing—not for me, but for them to have to do that. They did it, though, and the joke was that they made a wooden box for me to sit on so that I would not have to squat. They thought that as a westerner, I would not have been able to cope with that. It would not have bothered me, but they have to deal with that all the time, and I do not know that things are that much better now in Burundi. There are a lot of other problems there, but when there is conflict in an area, it makes things harder still, and not just for the people living there. How do Governments, if they are in conflict and there is a civil war, or whatever the situation is, deal with the country’s problems with water and sanitation?

I have spent a lot of my time in Uganda with a friend of mine who was a Member of Parliament there. Sadly, he lost at the last election; I do not think it was quite fair. He was very keen on helping his community have sanitation and water as well as decent health. He is a doctor, so he is very keen on health facilities, but he was struggling. I was able to go to Uganda at the beginning of this year, and I saw for myself the problems with malaria. There is no clean water. I went to a hospital that had no sheets on the bed. The parents and family members who had to go to that hospital with their children had nowhere to go to the loo. It was a state-run hospital, and I think that situation is pretty appalling. Some of the children who were in the hospitals I went to did not have malaria. They might have had dysentery or diarrhoea, which are relatively easy to cure if there is clean water and the right medication.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The hon. Lady made an interesting reference to the pit latrine that she encountered in Burundi, but does she agree that those are the least of the problem? Within memory, people in this country had to use toilets at the bottom of their garden or chamber pots. Part of the problem is that there are too many parts of the world where people are still accustomed to defecating in the open, in fields, with all the hygiene problems that that causes.

[Pauline Latham]

I was going to mention that problem. I well remember living in Lincolnshire as a child and having to go down the garden to the toilet. There was a large seat for the adults and a small seat for the children. I did not mind doing that, because I had not known anything different. Of course, at night we had a chamber pot, and when it was freezing cold it was frozen in the morning. That is not that many years ago; I know I am old, but I am not as old as the Queen, although I suspect she never went down the garden to the loo. Nevertheless, I remember doing that, and it was something that one lived with. I remember having a tin bath in front of the fire with everybody around me—there was no hot water upstairs. I was tiny, but I do remember it. It has not been that many years since we solved the problem, but we have solved it.

As the hon. Lady says, one problem is open defecation. I described the hole in the ground in Burundi, and it was a tiny hole just for me, not for anyone else. The problem with open defecation is that people have to go into the bushes to get some privacy, so they are at risk of rape and all sorts of violence. Of course, when the rains come, all the sewage is washed through the villages, which is one of the biggest problems in many places. When the Select Committee went to South Sudan, we saw that was happening. The people in the refugee camp who had been told to leave Sudan and go to South Sudan—although they and previous generations had never lived there, they were considered South Sudanese, so they had to go and had walked there—had no toilet facilities and no water. People can go to collect water, but toilet facilities are a basic human right and everybody should have them. It is a huge problem.

[Dr Roberta Blackman-Woods (City of Durham) (Lab)]

The hon. Lady is making a number of interesting points. Interesting though this trip down memory lane is, for most of us these are memories, either distant or otherwise, because we recognise the need for proper sanitation facilities. Is it not right that the focus of the debate is on how we can work with others to ensure that everyone has access to those same facilities?

[Pauline Latham]

Yes, they should have access to those facilities.

The WHO and UNICEF joint monitoring programme has drawn up a ladder of WASH—water, sanitation and hygiene—facilities, ranked according to their degree of safety. The facilities fall into the following categories, from the most to the least safe. The safest are “safely managed” facilities, which include

“drinking water sources that are located on premises, and are free of faecal and chemical contamination. Private sanitation facilities where excreta are safely disposed are also included.”

That was what I had, because the night soil men used to come once a week to clear it out. That was absolutely safe, but it was still pretty basic, and people would not want to be doing it now. “Basic” facilities include

“piped water sources, protected groundwater sources (such as standpipes, hand-pumps and protected dug wells) within a 30 minute round trip of a household. ‘Basic’ sanitation facilities include flush, or pour-based toilet systems connected to a piped sewer or septic tank and contained pit latrines. Hand washing facilities with both soap and water are counted as basic”—

but without them, how can there be any sort of hygiene?

“Unimproved” facilities include

“unprotected groundwater sources, water provided by tankers, or water sources that are greater than 30 minutes-walk from a household. Shared sanitation facilities, uncontained pit latrines and handwashing facilities with no soap are also included.”

“Open defecation”, which is the worst and the least safe, is where

“human faeces are disposed of directly into the open environment”,

as the hon. Member for Hackney North and Stoke Newington (Ms Abbott) mentioned earlier.

When there is a move towards proper, contained pit latrines—not open pit latrines—that are emptied regularly, it is important that girls and boys at schools have separate facilities, because many girls say they cannot go to school because they are in danger of being raped in the toilets. If they cannot go to the toilet in private, that is horrific. Not only that, but if they have to share the facilities, they cannot go when they are menstruating because they find it embarrassing and are likely to be made fun of, so they need better facilities than most schools, particularly those in rural areas, currently have. They need that protection so that they feel safe and have privacy and can go to the toilet during menstruation and at other times without feeling threatened. That is not the only reason why girls do not go to school, but it is quite a large one.

Diarrhoea kills many under-fives, so there should be better testing and better, quicker medication. Mothers often think it is malaria when it is not. There are rapid diagnostic tests, but we all know that in some places in some African countries, the rapid diagnostic tests and medication do not get to pharmacies or health facilities. Better access would help many children to live much longer.

The Department for International Development is providing funding to the SHINE—sanitation, hygiene and infant nutrition efficacy—trial. People will have poor nutrition if they do not have clean water for mixing bottles or whatever. Mothers without clean water will also have problems before they have children. Many children either die before birth—stillbirths or spontaneous abortions—or have low birth weights or stunting. Children who have been stunted never catch up, so access to clean water is needed. I am pleased that DFID is providing £7.2 million of funding to support the SHINE trial that is currently under way in Zimbabwe, because that is another problem that children without clean water face—they seem to have one thing piled on top of another.

As I said earlier, I have worked very closely with a friend who was a Member of Parliament and a medical doctor. In his former constituency is a place that I know only as a landing site. It is on the lake between Kampala and Jinja. The people there spend their whole lives on the lake, because they are fishermen, fisherwomen and indeed fisherchildren—many of the children have to go out fishing and are exploited by their employers. They have water, but because it is not clean there is a lot of disease and stunting. They have very poor livelihoods. They drown in the water because they cannot swim—they are not allowed to, because the water is too heavily contaminated. They need their own borehole, because they have to walk miles to get to one, so of course they do not bother. More places should have at least a simple borehole so that people can access clean water.

I know about the importance of boreholes from my experience with a charity called Free The Children, which the Minister will know. I went out to Kenya with Free The Children staff to see what they were doing there. They are building health facilities and schools in communities, and they put a borehole next to schools so that the children—particularly the girls—can go to school and take water home in the evening. That saves an awful lot of worry for the parents, because they know that the water is clean and that their children are in school, so they are safe and getting an education. There are health facilities nearby to which the mothers can go for pre-natal classes and monitoring, so they are helped too.

There was something that I did not appreciate until I did it for myself. We walked a kilometre with the yellow cans that people put on their heads, although we had them on a rope band around our heads. I could not lift the large, 20-litre ones; I could not even get them off the ground. I managed to get a 10-litre one off the ground, but I could not physically manage to get it all the way back, so somebody had to help me. That was a lesson for me. I have been to countries where women and children walk miles to collect their water, but I had never thought of the weight. Not only is it not good for people to have it on their head, because it affects their neck muscles—although they are obviously more used to it—but the sheer weight of the can means that getting it home is problematic. Sometimes people have to do that 10 times a day to get clean water for their family. A big lesson for me was not just the distances that people have to walk but the weight that they have to carry. We have to encourage children to go to school; that has to be done better. If they have to have a water facility that requires them to carry the water like that, it is incredibly important that it is close to a school and/or a health facility. I am very pleased that DFID is doing a lot of work in that area.

We have to concentrate on water facilities and work with the charities that do such a good job of providing them, but we have to monitor them to ensure that they are being used and that people have access to spare parts. In some parts of the world, a facility can be put in, but unless the spare parts are easily available and simple to install, it will go into disuse. I have seen that happen in Africa. The International Development Committee went somewhere where there was a borehole and a pump, but the pump was broken so the people could not use it and had to go to the next one.

There are many things that can be done to help people in sub-Saharan Africa and the rest of the world to access water, but we need to act fast. If we are serious about giving everybody access to water by 2030, we have got only 14 years left, which is not very long at all. I thank the hon. Member for Strangford for securing this debate on this important subject. I am delighted that I have been able to take part in it.

--- Later in debate ---

[Alan Brown (Kilmarnock and Loudoun) (SNP)]

It is a pleasure to serve under your chairmanship for the first time, Mr Percy. Although I am responding for the Scottish National party from the Front Bench, I would like to put on record the apologies of the SNP’s international spokesperson, my hon. Friend the Member for Glasgow North (Patrick Grady). He has important constituency work today, otherwise he would have been here; this is a cause he is very passionate about.

I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate, which has been really good. I have a feeling that because he covered the issue so comprehensively, a lot of my comments will be prefaced by, “As the hon. Member for Strangford said earlier”. The two cases he mentioned at the end of his speech were very powerful and illustrated the need for further action on water and sanitation in Africa.

The hon. Member for Mid Derbyshire (Pauline Latham) certainly added to the debate, giving examples from Burundi, Uganda and South Sudan. She talked about open defecation in the fields and witnessing the sewage traversing towards villages, and that underpins the need for more action. I must say, I have learned more today about Members’ childhood toilet activities than I thought I would.

The hon. Member for City of Durham (Dr Blackman-Woods) made some important points about the millennium development goals and learning lessons for the sustainable development goals. She made a powerful point about sub-Saharan countries being poorer now than in the 1960s.

The hon. Member for Stafford (Jeremy Lefroy) presented some excellent examples from his personal knowledge of and involvement in projects. Importantly, he touched on the fact that small programmes and smart working are the way forward. There does not have to be big money. We hear about expenditure on headline projects and the overseas aid budget, but the way forward is to work smart and invest in small, sustainable projects so that communities can take ownership of them.

I am a civil engineer, and prior to being elected to this place, I spent my career in the water industry. I have always known the importance of clean water and sanitation in this country, let alone in the developing world. I used to do presentations in schools, and to try to capture the children’s imagination I used the example that the water infrastructure in this country saves more lives than the NHS. That is backed up by the fact that the World Bank has declared that hand-washing with soap is the single most cost-effective health intervention.

Hon. Members have touched on the fact that because we have a successful water and sanitation infrastructure in this country, many people it for granted. Some people complain about the taste of water if there is a slight change and do not realise that it is still perfectly healthy and provides great health benefits. They complain if they lose their water supply for three hours and cannot put their kettle or have a bath or shower, without realising that some people without water and sanitation face personal challenges every day.

It was when I worked for Scottish Water and its predecessor that I became aware of WaterAid and WaterAid Scotland, and I pay tribute to them. What struck me when I first went to a WaterAid presentation was the sustainability aspect of the projects it invests in, which struck a chord with me. That touches on the point the hon. Member for Stafford made about smart investment in sustainable projects. I am also impressed by the wider education that WaterAid is involved in. As my hon. Friend the Member for Argyll and Bute (Brendan O'Hara) said, it is fantastic at engaging MPs and widening their education, but it goes further than that in its education programme.

I was pleased that earlier this year a school in my constituency, James Hamilton Academy, won WaterAid’s star supporters competition as a result of its innovative learning programme about water collection and sustainability. The project challenged pupils to think differently about water usage and to compare their usage with that of a child in the developing world. We can safely say that the pupils will no longer take their water supply for granted.

Another example of education was in October 2015 when a group of Scottish Water staff headed out to Zambia to visit WaterAid projects. They visited communities with and without access to safe water, which helped them to gain a real understanding of the challenges facing communities. Since their return, the Zambia team have delivered numerous presentations to their colleagues at Scottish Water. That became an ongoing education programme to spread the word.

Statistics highlight the importance of this debate. It is a basic fact that unclean water and the lack of basic sanitation prevents the eradication of poverty and disease globally, and particularly in Africa. It is well documented that water and sanitation are necessary for success in many other development areas, such as improving health, education and the prospects of women and girls.

In sub-Saharan Africa, only 68% of people have access to clean water and 30% to adequate sanitation. That means children in sub-Saharan Africa are more than 14 times more likely to die before the age of five than children in developed regions. In Uganda, 80% of the population does not have a safe place to go to the toilet. Every year, 500,000 children, most of whom live in Africa, die from diarrhoea caused by unsafe water and poor sanitation. That is more than one child every minute.

[Pauline Latham]

Does the hon. Gentleman agree that that is not a proud record for a President who has been in power in Uganda for more than 30 years? What progress has been made over the past 30-odd years? The President plans to carry on for ever. Does the hon. Gentleman agree that the situation in that country is desperate?

[Alan Brown]

I agree with the hon. Lady. She obviously has a good understanding of Uganda, and I thank her for her intervention.

More than 9,000 children die every year in Ethiopia alone from diarrhoea caused by unsafe water and poor sanitation. Approximately 800,000 children aged between one month and five years died from pneumonia in 2013, and about 1,400 children die every day from preventable diarrhoea. Some 58% of diarrhoeal deaths are caused by unsafe water and poor sanitation and hygiene.

The effects of a lack of water and sanitation go much further than just disease, as other hon. Members have said. It affects all aspects of life and has a profound impact on women and girls in Africa. As we have heard, they are typically responsible for collecting water for their family, and girls spend as many as six hours a day collecting water, leaving them little time to go to school. In many places, schools are not located within villages or close to where people work, so if girls must travel for hours to collect water, they face the problem of having to travel for hours to go to school as well, so attendance is difficult.

Without a safe and private place to go to the toilet, many girls are forced to drop out of school when they start to menstruate. Many women and girls also have to wait until night to relieve themselves in the open, which causes further health problems and strips them of dignity. Many are harassed or even assaulted. A former work colleague of mine who went to India on a fact-finding mission gave harrowing accounts of women being raped as they went out at night to open fields to use as a toilet. Clearly, the same can happen in Africa.

A lack of clean water also makes it extremely difficult to give birth safely, and mother and child often do not survive. I would like to illustrate that point with one case. Aisha Mkude, who is 38, lives in Lugono village in Tanzania. Last year, she gave birth to her first son, who was born healthy. Aisha says she left the hospital feeling joyful, but just two days later her son got a high fever and started discharging smelly water from his belly button, so she returned to the clinic with him. She says:

“There wasn’t enough water at the health centre when I gave birth, resulting in him catching an infection.”

That was because after the birth, she had washed herself and her baby in water that her brother’s wife had fetched for her from the nearby river. It was the dry season, so she had to dig out part of the river to get water. Unfortunately Aisha’s son lived for only seven days, but if there had been regular availability of safe water at the health centre, that situation would have been prevented. She says:

“I feel so bad because I never expected this but because it has happened I will just accept it.”

She should not have to accept it, and that is the thrust of today’s debate. That example highlights the importance of WaterAid’s Healthy Start campaign, which brings into sharp focus the importance of water, sanitation and hygiene in improving the health and nutrition of newborns and children.

That example also illustrates why global action and co-operation are required in a wider context. To that end, we welcome the UN members signing up to the sustainable development goals, particularly goal 6—access to water and sanitation for all by 2030. It is vital that the UK Government set an ambitious and realistic agenda to help ensure that that framework of goals is achieved.

Other hon. Members have touched on this point, but investment in water, sanitation and hygiene is an extremely cost-effective way to spend the UK’s aid budget. We have heard about the 1:4 ratio—for every £1 spent on improving access to water and sanitation, an estimated £4 is returned. We also need to consider that according to the World Bank, total global economic losses due to inadequate water supply and sanitation services have been estimated at $260 billion a year. That illustrates the fact that it is imperative that suitable money be committed. At present, only 2% of UK bilateral aid goes to water, sanitation and hygiene. I put my name to a letter issued in the name of the hon. Member for Stone (Sir William Cash) calling on the Government to increase that percentage. It would be good if the Minister could give his thoughts on that.

The hon. Member for Strangford touched on the fact that the House is generally united on this subject, but I will make one criticism of the Government. Their overseas development aid needs to be concentrated on programmes relating to water and sanitation projects throughout Africa and elsewhere, instead of on defence. I am concerned that there is increasing double-counting of defence expenditure towards both the NATO targets and official development assistance, through mechanisms such as the conflict, security and stability fund. We should not blur the lines between aid and defence spending. The Government need to realign their moral compass and redirect aid towards those who need it most. The £1 billion conflict, security and stability fund, which the UK Government lists as overseas development aid, is not an appropriate use of UK aid spend. Indeed, in February 2016, Oxfam, Global Citizen and ONE called on Governments across Europe to ensure that aid budgets are used only for poverty eradication and sustainable development.

On a more positive note, I welcome the Government’s commitment to reach a further 60 million people with access to clean water and sanitation by 2020. I look forward to seeing how that will be advanced when the bilateral aid review is published. I suggest, however, that the Government could be even more ambitious.

In Scotland, the SNP-led Government are also committed to boosting water and sanitation projects in Africa, through their climate justice fund. In December 2015, Nicola Sturgeon announced £12 million of funding to help mitigate the effects of climate change on the world’s most vulnerable populations. That was a doubling of the climate justice fund. The head of Oxfam Scotland, Jamie Livingstone, said that

“the Scottish Government’s enhanced commitment to climate justice is very welcome—it increases the funding promised and creates much needed predictability.”

The work enabled by that fund has focused on clean water provision and is aimed at mapping pollution sources, which are very often sanitation facilities. The Scottish Government are working to position water and sanitation assets to maximise access and minimise cross-contamination.

A lot of good work is ongoing, and there is the ambitious aim to supply water and sanitation to all by 2030. As the hon. Member for Mid Derbyshire said, that is not far away, but I remind the House that even if we achieve that goal by 2030, there will still be millions of deaths before then, and that is why urgent action is needed.

--- Later in debate ---

[Mr Hurd]

My hon. Friend adds another texture—another layer of relevance that has not yet been mentioned in this debate—so he has added value.

Like the hon. Member for Hackney North and Stoke Newington, I will not go over the statistics again, because they have been given a good airing. However numb we have become in this House to the horror of much of what is happening around the world, it is still staggering that by the end of the day another 1,000 children under five will have died from a lack of clean water and basic sanitation, which is just not acceptable. Such deaths are utterly preventable. The drinking water of at least a quarter of the world’s population is contaminated with faeces, and more than 650 million people do not have access to a water supply close to their home. Those numbers are shaming, given what we take for granted. That ground was well covered in the debate.

I was also extremely encouraged to hear how many Members wanted to emphasise the particularly heavy burden that falls on women and girls, which matters a great deal to the Department. My hon. Friend the Member for Mid Derbyshire spoke powerfully about the huge physical burden on them. I lifted a water container in Goma, in the Democratic Republic of the Congo, and I was staggered by how heavy it was. I asked the ladies how far they had walked with it, and their answer was extraordinary. I also asked them about the risks they take in queuing and walking. The situation they face is genuinely shocking and unacceptable.

The human dimension has come through powerfully in the debate, but the economic dimension has not come up. Some clever people have attributed an economic cost to the lack of good water and sanitation at about $1.8 billion a year in Nigeria alone. Whether that is right or wrong, the human and financial cost is massively significant. So this issue matters, and I genuinely congratulate hon. Members on throwing a spotlight on it today. The good news is that we can do something about it. We have done something, but not enough. I will return to that, but it is worth noting that human endeavour has moved the needle in important ways.

The world met the millennium development goal for drinking water in 2010, and although the sanitation target was missed—I will return to that—2 billion more people had a toilet in 2015 than in 1990. Some countries have shown outstanding leadership in that context. For example, Ethiopia has reduced open defecation by 64% over the MDG period.

I am genuinely proud of the role that the UK has played over many years. It predates me and this Government, so I claim no credit for it. Between 2011 and 2015, we helped more than 60 million people to get access to water and sanitation, exceeding the coalition Government target. That has made a real difference to poor people’s lives in countries such as Ethiopia, Tanzania, Mozambique and Nigeria. Many Members have seen that for themselves in their visits and know how powerful and important it is.

In Ethiopia, we are working hard to support the Government to reach 31 million people with sustainable water and sanitation services. That includes ensuring that the services are resilient to future threats from climate change, because as many Members will know, the sustainability of such services is critical.

[Pauline Latham]

Does my hon. Friend agree that the money that DFID is putting into Sierra Leone post-Ebola will be incredibly important to it in moving forward? The fight against Ebola required a lot of water, and water is crucial for many countries to stop disease. Sierra Leone had many problems before Ebola, and obviously during the outbreak it had more. In Freetown, in the slum area, pigs, chickens and people can be seen sharing the same dribble of water along the main street. Until that situation is solved, Ebola could occur again.

[Mr Hurd]

This is freaky; my hon. Friend has obviously seen my speech, because my next point is on Sierra Leone.

In Sierra Leone our support has been crucial in a country that was so cruelly affected by Ebola. I look forward to seeing our support on the ground there in a forthcoming visit. Our support for solid waste management in Bo will create more than 300 new jobs. There are many dimensions to the support being provided that we need to understand and appreciate. We have been leading innovation in how to deliver water and sanitation programmes. Through the WASH programme we have reached nearly 5 million people, but we have paid the NGOs undertaking the projects only once we have independently confirmed that the services are in place. Of course, we are working in a context of extreme and quite understandable scrutiny of the value for money of what we do, so as we contract services we have to be more innovative in how we push to make sure that we pay for results and get value for money for the British taxpayer.