If you thought infectious diseases were big killers, think again: More children die from illnesses related to poor water and sanitation than from HIV/AIDS, malaria and tuberculosis combined. As of 2006, there were still 900 million people across the world who drank unsafe water, and 2.5 billion who did not have adequate sanitation.
In Stockholm, hundreds of professionals have gathered for the World Water Week this week, hoping to find answers to reduce millions of deaths and illnesses caused by poor water and sanitation each year, and the billions of dollars in economic losses that this causes.
One area where some answers have been found is in providing water and sanitation services for poor urban dwellers—a growing concern because of the rapid urbanization taking place in developing countries. Guidance notes on water and sanitation services for the urban poor, released by the Water and Sanitation Program at the Stockholm event, provide powerful examples of such lessons.
Photo: Manan Vatsyayana / AFP
Case studies from the guidance notes—including several from Indian cities such as Ahmedabad and Mumbai—demonstrate that the issues involved go well beyond mere investment in infrastructure. The crux of the matter often lies in the establishment of underlying systems of affordable, hygienic and sustainable service delivery.
From Mumbai’s slum sanitation project, for example, we have learnt that giving poor people the opportunity to participate in the planning and design of their water supply and sanitation systems can be the determining factor in getting the service to succeed. Under the Mumbai project, many new connections were established and water and sanitation services were improved for some 400,000 slum-dwellers between 1996 and 2005. As a result of the participatory approach adopted, community members were willing to pay fully for an upfront connection fee, for the water and sanitation services that followed, and also for routine operations and maintenance expenses.
In Karachi, too, the globally renowned Orangi pilot project has for about two decades been able to mobilize communities, secure the finances for water and sanitation services and elicit responses from the authorities to address the people’s far-reaching needs. At the heart of their approach has been the involvement of residents in identifying their needs, planning for extensions and improvements in their services and monitoring the quality of services rendered.
Sometimes, vested interests among water vendors, landlords, public officials and utility staff can prevent better services from reaching poor people. These confrontations can be avoided if new roles are assigned or suitable incentives given to informal service providers and other vested interests to bring them into the formal system. Where neighbourhoods are not served by any utility company, we have seen how legitimizing small private service providers and providing them with finance can promote the expansion of services to poor people. The Prosanear project in Brazil in the 1990s—which brought water and sewerage connections to at least one million people in low-income settlements in 17 cities and ensured safe water—involved service providers who were outside the formal system.
Public awareness campaigns that encourage politicians and others to support water and sanitation access for the poor have also proved successful. When residents of a major slum in the Manggahan Floodway in Manila struggled to buy costly water from vendors, a local non- governmental organization began an extensive campaign to make people aware of the different options available to them for water supply systems—including for bulk selling, and the provision of public taps, group taps, and individual taps. Since then (2001), these communities have taken the decision-making process into their own hands to choose the most suitable and affordable options available.
Poor people are often stymied in their efforts to obtain proper water and sanitation services because many a time they do not have formal title to the land they live on or the necessary papers to prove their tenancy. One approach that has demonstrated success is to allow poor people to use alternative documentation as proof of residence. Major progress has been made on this issue in India over the past decade; for example, in the late 1990s, the Ahmedabad Municipal Corporation gave an assurance that for the next 10 years it would not evict or remove any slum pockets that participated in a major slum upgrading project. Because this gave security without formal title, slum communities became eligible to get legally connected to networks.
In Stockholm, government officials, practitioners, private sector and aid organizations will seek out and learn from each other the approaches that have proved to work in the sector. If we harmonize our efforts through initiatives such as the Global Framework for Action, arm finance ministries with evidence needed to allocate necessary resources and foster favourable legal and regulatory frameworks, we can bridge the gaps in achieving the Millennium Development Goals on water and sanitation by 2015.
The challenge ahead is great, but there are signs of hope. Since 1990, 1.6 billion people worldwide have gained access to better drinking water and 1.2 billion to improved sanitation. By working together we can continue to make progress till 2015 and beyond. Hopefully that day will not be too far off when the lack of these basic services will become a thing of the past.
Jae So is manager of the Water and Sanitation Program (www.wsp.org), a donor-funded programme administered by the World Bank. Comments are welcome at firstname.lastname@example.org