The Other I

March 26, 2018

A Happy Easter story

Filed under: Just Stuff,Survival Strategies — theotheri @ 12:11 pm

In 1990, 54% more children under the age of five in Bangladesh died compared to the world average.  Diarrhoea is the biggest killer.

Today 16% fewer under-five Bangladeshi children die than the world average.  That is a huge difference.   How did it happen?

The surprising answer is that the solutions need not always be hugely expensive, and are not totally dependent on government-sponsored mega-structural changes that provide clean, chlorinated water, and sewage systems with pipes to treatment plants.  Yes, such changes are certainly desirable.  Various bacteria causing diarrhoea, including cholera and dysentery, typically are a result of contaminated food and water, or contact with the feces of an infected person, which is most often a result of defecating in the open.  India’s strategy of building more latrines seems like an utterly sensible, even necessary, first step.

But a comparison between Bangladesh and India suggests that even this seemingly-essential solution requires other changes that are simple and inexpensive.

Image result for pit latrine images

Like India, Bangladesh has also built latrines, often small-pit latrines with separate tubewells for water, both near people’s houses.  But Bangladesh has done a great deal more to stigmatize open defecation.  They have subsidized latrines for the poor and then prod the better off to do the same for themselves.  It’s working better than a strategy that encourages the poor to emulate the better off.

Critically Bangladesh has also shown that simple basic hygiene is absolutely essential.  Flush toilets and access to chlorinated water cannot take the place of teaching mothers to wash their hands before preparing food and to reheat it if necessary, two simple practices that can wipe out most bugs causing deadly diarrhoea.

Were you told as often as I was when I was growing up to wash my hands after using the toilet?    It might have felt rather like being bossed around by a fussy mother figure.  But it very well might have been a life-saver.

As the Economist puts it:  “The training is cheap.  The benefits, in disease avoided and lives saved, are enormous.”




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