Clean Water and Sanitation (Africa)

Roberta Blackman-Woods Excerpts

Thursday 21st April 2016 Westminster Hall

[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.

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

It is a pleasure to serve under your chairmanship again, Mr Percy. I apologise to you and the Front Benchers for not being able to stay for the whole debate. I have a meeting in my constituency later, so I have to get the train. As Members know, my constituency is quite a way away, so it will take me a few hours to get there. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate.

The UN defines access to safe water and sanitation facilities as basic human rights. Promoting hygiene is widely regarded to be one of the most cost-effective ways of improving public health. Poor water and a lack of sanitation have a wide range of negative effects. For example, they are major causes of infectious diseases; they have knock-on effects on educational attainment, public health and economic productivity; and they exacerbate the impact of disease outbreaks, such as Ebola and the Zika virus. That is why this debate is so important, and I thank the hon. Gentleman for bringing it to the House.

Given the amount of time we spend in Parliament discussing access to healthcare and education, it is interesting that we do not spend enough time discussing access to clean water and sanitation. Those issues underpin people’s life chances, so it is extraordinary that we do not look at them in more detail and more often. I hope that today we will be able to set out a clear way forward, which will enable us to return to this issue in later months.

[Brendan O'Hara]

On that point, will the hon. Lady join me in congratulating organisations such as WaterAid on their great work? They not only educate the wider public but come directly to parliamentarians to give us knowledge about what they do. WaterAid works in 37 countries around the world. I pay tribute to the work that it and other organisations do.

[Dr Blackman-Woods]

I was going to acknowledge WaterAid’s work later in my speech, not least because Northumbrian Water, which is based in my constituency, does a lot of work with it. Northumbrian Water has been very energetic in getting MPs in our region to take note of the sort of issues that WaterAid gets involved with.

Since 2000, there have been two rounds of UN-sponsored global international development goals. The first was the millennium development goals, which ran from 2000 to 2015 and aimed to halve the number of people without access to improved drinking water and sanitation. Interestingly, the water target was met but the sanitation target was not met by a considerable amount—about 700 million people. The headline figures mask large geographical variations among countries and between rural and urban populations.

The MDGs have been replaced by the sustainable development goals. SDG 6 relates to what we are talking about this afternoon. We need to take on board the lessons learned from the MDGs, which showed that a donor-led approach on its own is not enough. Work has to be done in partnership with the recipient countries. There can be too much of a focus on short-term targets, rather than long-term viability. The hon. Member for Mid Derbyshire (Pauline Latham) touched on that point when she said that the facilities that are put in might not be appropriate or sustainable. It is really important that there is some sort of community partnership. There was a failure to exploit links with the private sector fully. The focus was on absolute numbers, so the poorest were often neglected because they were not picked out as a group for targeted intervention. I will talk more about SDG 6 in a moment, but it is interesting that it was informed by the lessons learned from the MDGs.

Globally, one in 10 people still has no access to a safe water source, and one in three has no access to proper sanitation. In parts of Africa, a third of the population does not have access to clean water. In Ethiopia alone, 42.2 million people have no access to safe water. There is still a significant problem, which is a big problem for the new SDG goal to meet in 14 years. Yet we know that it is really important. There cannot be societal transformation without proper access to clean water and sanitation. We know that from our own experience. It was only when the UK recognised, from its public health problems, that we needed properly piped water that we got the economic development that moved us on. There was a transformation in our public health, and that is what we want to see in other countries.

We are not only talking about health, because research has shown that, for every $1 spent on water and sanitation, $4 would be generated in increased economic opportunity. It has been estimated that, if everyone had universal access to water and sanitation, there would be $32 billion in economic benefits each year globally, from reductions in healthcare costs and from increased productivity as a result of reduced illness.

Interestingly, more than a quarter of the countries in sub-Saharan Africa are poorer now than they were in 1960. Therefore, foreign aid is going in, but if it is not directed in the right way, we do not necessarily get the development that we would want. The lack of access to clean water and basic sanitation is among the reasons given for the lack of economic development flowing from aid. Some of the biggest challenges are in sub-Saharan Africa: only about 30% of individuals have access to improved sanitation services; and nearly half of all people who use unimproved sources live in the region.

We have already heard this afternoon about some of the health impacts. According to the World Health Organisation, 50% of malnutrition is associated with infections caused by a lack of access to water, sanitation and hygiene. Globally, malnutrition accounts for 45% of child deaths, of which a large proportion is in Africa. A truly stark figure, also mentioned by the hon. Member for Strangford, involves children in sub-Saharan Africa, who are over 14 times more likely to die before the age of five than children in developed regions. The figures speak for themselves and are clear: there is an urgent need to improve access to clean water and good sanitation.

Another thing we have heard this afternoon is that limited access to clean water and good sanitation disproportionately affects women and girls, who are more than twice as likely as men to be responsible for water collection. On average, women and girls in developing countries walk 6 km each day to collect water—time that could be spent in school or at work. In sub-Saharan Africa alone, each day, women spend a combined total of at least 16 million hours collecting drinking water. That is a truly staggering figure.

Additionally, more than half of girls who drop out of primary school in sub-Saharan Africa do so because of a lack of separate toilets and easy access to safe water. However, the issue is to provide not any sanitation, but the right sort of sanitation. I have visited villages in Asia and Africa where money has come through for new sanitation in schools. Toilet blocks were put in, but the schools might as well not have bothered, because the toilets were communal ones, could be too easily accessed by a wide range of people, or had doors that did not close properly—people could look over the top. There was a complete lack of consideration about what actually needed to happen to make the toilets a secure, safe place, in particular for girls, enabling them to stay on at school. So, alas, despite new sanitation facilities, the girls could not continue at school anyway, because they still did not feel safe. So many girls leave education at puberty. Obviously, therefore, co-operation with the local community is necessary, and water sources should be as close as possible to the people who need them.

I will now outline some of the things for which WaterAid is calling, before finishing with a few questions for the Minister. As we know, world leaders committed to reach everyone, everywhere with safe water and sanitation by 2030. That is a wide-ranging goal, with eight objectives, and if they are met that should be a good and helpful step forward. WaterAid, however, has said that Governments must bring about a dramatic and long-term increase in public and private financing for water, sanitation and hygiene to achieve strong, national systems so that there is universal access. Private and public sectors need to co-operate effectively to achieve that universal access. An integrated approach could ensure that improving access to water, sanitation and hygiene services is embedded in plans, policies and programmes on health, nutrition, education, gender equality and employment. Last but not least, pledges made at the 2015 Paris climate summit must be implemented, because they are about the long-term sustainability of water supplies.

Are the Government using their strong voice internationally to push up the international agenda the importance of clean water and sanitation? SDG 6 should become a real priority, so how will progress towards achieving it be monitored internationally? Will the Government use the expertise of the Department for International Development, which works on some very good schemes, to inform best practice everywhere and to ensure that women and girls are prioritised for sanitation and water supply?

[Jim Shannon]

There is much talk in the press maligning DFID projects, or saying that some are not used properly. Sometimes it is good, as the hon. Lady has just done, to focus on some of the excellent work that DFID does and on the projects that are successful. It is good to remind us of such things, because everything is not negative.

[Dr Blackman-Woods]

I echo that point. I urge the Minister to use that good experience to help to roll out best practice elsewhere.