Tuesday, February 26, 2013

Sanitation: basic need or a luxurious lifestyle?

By: Ris Sukarma
(Dari tulisan yang tersimpan dalam laci beberapa tahun yang lalu, rasanya masih relevan untuk saat ini), selamat membaca!

For human beings, sanitation is a basic need. Without proper sanitation, we will be exposed to communicable diseases, such as diarrhea. In many developing countries, proper sanitation is sometimes ignored, not only in the government’s development agenda, but also in the people’s mind. In East Asian region, 415 million were noted to have no access to improved water supplies, and 800 million have no access to improved sanitation. Meeting the MDGs still leaves 630 million (1/3 of population) without improved sanitation.
People’s awareness on proper sanitation and personal hygiene is still low, and Indonesia is no exception. Jakarta, the country’s capital, has very low (only about 2%) coverage on piped sewerage. The households in Jakarta have to rely on septic tanks which are mostly not functioning. Nation-wide, only less than a dozen of cities that has sewerage system which serves only parts of the city. The systems were mostly built during the Dutch colonial era, with a modest extension after independence.
As a matter of fact, demand for sanitation services is significant and growing rapidly.  For example, in Jakarta alone there are approximately one million septic tanks, mostly serving urban households and small commercial establishments. Large majority of these have been fully owner-financed.  The poor functioning and management of most of these tanks notwithstanding, the private investment indicates a significant demand for sanitation improvement at the household, and to a lesser extent at the neighborhood level.  
Yet, to most of those living in suburban or slum urban areas, sanitation facilities are still considered as a luxurious lifestyle. For Nata (30) toilet is not something that important. He lives in Desa Kramat, Kecamatan Pakuhaji, Tangerang one of satellite towns of Jakarta. For him, and even for his ancestor as he recalled, toilet is something that should not necessarily exist. He just smiled when he was asked if he owns a toilet in his house. “Don’t even ask me to build a toilet, for everyday meal I am still struggling (to get)”, as he replied to the press who interviewed him. For him, and for the majority of the people in his village, toilet is something luxury. 

Yes, for some of wealthy people living in a modern compound, sanitation facilities indicate a luxury lifestyle. Fully automatic toilet and fancy bath-tube are expensive and they can afford. But for Nata and his neighbor, a simple toilet they do not even think of.  They are defecating almost everywhere: in the river, above the pond, in yard, or around the house. Simple toilet should not be considered as a luxury. For this basic facility, the economic status of people like Nata should not be a reason for not having a proper defecating facility

Nata represents one among 35% of Indonesian people who do not have access to proper sanitation facility. Nata and his family usually defecate in the river in from of his house, where everybody else does the same. They also do washing and bathing there, in the same river, in a distance of less than 10 meters that he usually defecates. The case of diarrhea hit this village for several months recently, but the ‘rituals’ were again practiced after the diseases over. “People are already used to it” Nata said. The local health office recorded that in the same year, the diseases due to lack of proper sanitation has caused sickness to more than one thousand, 19 of them died.

The combination of poverty, low social status, lack of clean water supply and the absence of proper sanitation facility is the cause of the spread of the diseases. Improper understanding of the main cause of the diseases is also lacking. Chairul, a father of one child in Pakuhaji village for instance, does not believe that the spread of the diseases has something to do with improper sanitation. He thinks there is no correlation between the diseases and the people’s habit of defecating in the open space. He thinks diarrhea occurs just instantaneously. 

In its presentation in the second National Sanitation Conference in Jakarta, 2009, Sanitation Donor Group led by the World Bank mentioned three success factors for sanitation development in developing countries, particularly in Asia: (i) political priorities, (ii) increasing budget allocations over time, and (iii) sustained implementation. Sustained implementation may lead to increased access to sanitation. To make this happens, sanitation has to be linked to national development plans, and demand-based sanitation policy needs to be implemented by the agreed strategies. 

Success stories from other Asian countries may be worth noted. In Thailand, from 0.17% household latrine coverage in 1960 it has increased to above 90% by mid 1990s and 99% in 2005. These occurred after the following steps were subsequently taken: (i) systematic inclusion of sanitation program in National Economic and Social Development Plans; (ii) comprehensive vision – water supply, excreta disposal, refuse disposal – implemented on a step-by-step approach; and (iii) increased participation by key actors. 

Vietnam has invested substantial national investment since 1990s in urban sewerage and treatment systems using loan funding with grant elements for community involvement and software support to households. It also integrates urban sanitation and sewerage project. In addition to investing more on sanitation by national government, key lessons learned from other countries are on choosing the right financing approach for household involvement which will increase cost effectiveness, equity, impact and scale. In Vietnam, subsidy is given on interest rate for low income people and poor households. The real challenge is to change the people’s mind that sanitation is not a luxurious lifestyle, but a basic need!

Reading materials:

  1. Indonesia – Overview of Sanitation and Sewerage Experience and Policy Options by R. Sukarma and R. Pollard, 2001
  2. Kompas Newspaper – “Makan saja susah, apalagi bikin WC”, by Nila Kirana, circa 2003
  3. National Policy and Financing for Sanitation, examples from Asian Countries, presented at the Second National Sanitation Conference, 2009 by Sanitation Donor Group.  

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