Hygiene Promotion - IRC International Water and Sanitation Centre

• The costs of inaction can be high. Peru’s 1991 cholera epidemic is estimated to havecost the national economy an amount equal to US$ 200 million (Bradford and Suarez,1993). It would have been cheaper to provide the clean water supplies, improvedsanitation and hygiene promotion that would have prevented the epidemic andassisted socio-economic development. There are similar examples from India.Outbreaks of plague in 1994 meant a loss of two billion dollars due to importrestrictions. On top of that came the loss from thousands of cancelled holidays andpublic health costs (De Volkskrant, 22 October 1994).• At the household level too, hygiene-related diseases bring unnecessarily highexpenditure. Suffering from diarrhoeas, eye infection and skin diseases (all threehygiene related) meant an aggregated cost of US$ 10-11 per person per year for ruralhouseholds in Uttar Pradesh, India (Verma & Srivastava, 1990). Investing in hygienepromotion to prevent such outbreaks and reduce regular disease is highly costeffective(Varley & Bendahmane, 1997). When hygiene promotion is combined withaccess to improved water supply and sanitation, the estimated cost is only US$ 3 perhousehold per year for each averted case of diarrhoea in children under five. When nowater and sanitation facilities are provided, the cost of promoting good hygiene isobviously higher. However, it costs only US$ 6 per household per year to keep a childfree from diarrhoea when hygiene is improved without the costs of hardware.Quite separately from the economic and health arguments, there is a powerful moralimperative to improve hygiene conditions in poor communities. The affront to humandignity of open defecation in squalid stinking home environments is a blight on modernsociety that shames everyone concerned. The satisfaction of being able to restore dignityand self-respect through simple interventions is an energising reward for the hygienepromoter. See: Water is life ... sanitation is dignity (Sir Richard Jolly, former chairperson ofthe Water Supply and Sanitation Collaborative Council (WSSCC),http://www.wsscc.org/about/ccnews.php?id=41. See also: Can anyone hear us? Voices ofthe poor http://www.worldbank.org/poverty/voices/index.htmSandy Cairncross and Valerie Curtis of the London School of Hygiene and TropicalMedicine (LSHTM) offer more arguments for promoting hygiene and sanitation (seeAppendix 5) in a paper presented at the World Bank Water Forum in 2001 and reprinted onthe WSSCC website.Health benefits from improved sanitation, hygiene and water supply:1. Improved sanitation;• 36% reduction in incidence of diarrhoeas from improved excreta disposal;• 30% reduction in incidence of diarrhoeas in children (3-36 months) in households withflush toilets;• 15% in incidence of diarrhoeas in children (3-36 months) in households with pitlatrines;• 40% reduction of children with stunted growth in households with flush toilets;IRC International Water and Sanitation Centre 9