Reproductive Health Package CSR PFI Section V Hygiene %26 Sanitation :: PFI Publication :: KNOWLEDGE MANAGEMENT CENTRE PORTAL, POPULATION FOUNDATION OF INDIA

Expand document

Collapse document

Reproductive Health Package CSR PFI Section V Hygiene %26 Sanitation

1 Pages 1-10

1.1 Page 1

1.2 Page 2

1.3 Page 3

1.4 Page 4

1.5 Page 5

1.6 Page 6

1.7 Page 7

1.8 Page 8

1.9 Page 9

1.10 Page 10

2 Pages 11-20

2.1 Page 11

2.2 Page 12

2.3 Page 13

2.4 Page 14

2.5 Page 15

Reproductive Health Package CSR PFI Section V Hygiene %26 Sanitation

1 Pages 1-10

▲back to top

1.1 Page 1

▲back to top

Section V

Hygiene & Sanitation

1.2 Page 2

▲back to top

Section V

HYGIENE & SANITATION

1.3 Page 3

▲back to top

chapter 15

HYGIENE AND SANITATION

Sanitation has been declared as the “greatest medical milestone since 1840” by the British Medical

Journal. But improved sanitation has yet to reach 2600 million people in the developing world, out

of whom 500 million live in India. Almost one out of five persons without toilet facility lives in

India. Even 42 per cent of India’s schools do not have toilets. Where toilets are present they are often

not functional and usable. This aggravates the dropout rates in schools; about six out of ten girls do

not complete their formal schooling in India.

Close to one thousand children die every day in India due to diarrhoea alone, that mainly occurs in

the absence of sanitation facilities. Children weakened by frequent diarrhoea episodes are also more

vulnerable to malnutrition and opportunistic infections such as pneumonia. About 46 per cent of

children in India suffer from malnutrition. All these factors contribute to high child mortality, which

is 74 child deaths per 1000 live births. A study conducted in Bangladesh showed that the post-

neonatal mortality in a household not using a latrine is more than three times higher than in

households using proper latrines.

Such implications on health result in annual loss of 18,000 million man days and economic loss of

Rs. 12,000 million. Improved sanitation has positive impacts on economic growth and poverty

reduction. According to a recent WHO study, every dollar spent on improving sanitation generates an

average economic benefit of $9.1.

Poor people are subject to the vicious cycle of poverty – ill health – reduced productivity – reduced

purchasing power to buy food for the family, resulting in malnutrition and related diseases. Poverty

relegates sanitation to last priority. This cycle can be broken by investment, economic empowerment

of the people, behaviour change communication and prevention of diseases through creation of

awareness for better hygiene and sanitation practices. The major challenges for all countries today is

to create more public demand for sanitation services, and to mobilize the community to bring about

changes for hygienic behaviour to reduce water- and excreta-related diseases.

Many illnesses are caused by eating contaminated food, bathing with or drinking contaminated water.

These form part of 5 Fs as factors of insanitation – food; fluid (drinking as well as bathing in

contaminated water); fingers (dirty hands); feet (walking barefoot); and flies.

Some of the diseases caused by unhygienic practices and unsafe drinking water are:

• gastrointestinal diseases – diarrhoea, dysentery, cholera, typhoid;

• intestinal worms – roundworm, hookworm, thread worm, tapeworm;

1.4 Page 4

▲back to top

- - - - - - - - -C-O-R-P-O- R- -A-T-E-S-O-C-I-A-L-R-E-S-P-O- -N-S-IB-I-L-IT-Y- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

• disease due to virus: hepatitis and poliomyelitis;

• disease due to mosquitoes developed in stagnant water and dark places, e.g. malaria, filaria, kala

azar, encephalitis;

• respiratory infection leading to tuberculosis.

Proper sanitation enhances dignity, privacy and safety, especially for women and girls. It improves

convenience and social status. Sanitation in schools enables children, especially girls, to remain in

the educational system. Use of toilets rather than open air defecation reduces health hazards. Toilets

provide comfort and security for women and the girl child, especially during the night.

Safe Drinking Water

Most rural households use hand-pumps for drinking

water. Less than 10 per cent of the households use

other sources such as tube-well, spring, river and

piped water supply. Many of these water sources are

not tested for safeness for drinking. While carrying

water home they dip their fingers in the water,

resulting in contamination. Also, the water vessels

are not covered at any time.

Drinking water should be clean, transparent, colourless,

and odourless. Water samples should be tested for

bacteria and harmful minerals at periodic intervals.

Any stagnant water is harmful for drinking.

How and Where Water is Contaminated

• polluted at source;

• defecation near the sources;

• bathing or washing clothes;

• bathing of animals;

1.5 Page 5

▲back to top

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -H-Y-G-I-E-N-E- -A-N-D- -S-A-N-IT-A-T-I-O-N- - - - - - - - -

• allowing dead animals or dead body to float in the river;

• discharge of untreated sewerage;

• effluent discharge from industries;

• unprotected well;

• drawing water with dirty ropes;

• soak pit or toilets within 20 metres of water sources;

• at storage and supply stage;

• keeping water container open and uncovered;

• taking out water directly with cup or hand;

• contamination due to leakage of water pipes which comes in contact with polluted surface

water;

• if water container is not cleaned regularly.

Elements of Pollution

• Dissolved impurities: These consist mainly of mineral salts and toxic metals. Some minerals are

essential for health. Other toxic and heavy metals like arsenic, lead, copper, fluoride, etc. can

damage the internal organs such as the liver and the kidneys and can, in the long term, also

cause damage to the arteries, etc.

• Mineral salts: At some places the water source contains various mineral salts, especially carbonates,

chlorides, phosphates, silicates, sulphides, and sulphates of calcium, iron, lithium, magnesium,

potassium, sodium, and other metals. Various gases may also be present, e.g., carbon dioxide,

hydrogen sulphide, nitrogen, and inert gases. Some of these are harmful.

• Suspended impurities: These consist of particulate matter such as sand, algae, virus, bacteria, etc.

These can cause several diseases such as diarrhoea, gastroenteritis and roundworm.

• Micro-organisms: Micro-organism, also called microbe, is an organism that can be seen only

under a microscope – algae, bacteria, fungi, protozoa, viruses, or sub-viral agents.

1.6 Page 6

▲back to top

Prevention and Treatment

• Filtration: Methods like sand separators to remove silt, sand from water, media filters to remove

organic impurities such as algae, trash, leaves, etc. can be used easily for filtration.

• Boiling is a traditional method of water treatment to prevent water-borne diseases. The water

needs to be boiled for a minimum 20 minutes at more than 100 degrees Celsius temperature

for effective elimination of disease-causing germs.

• Chlorination is the process of adding chlorine to water at a given proportion for water purification

to make it fit for human consumption. This is used mostly in supply water/well water.

• Ultraviolet sterilization, like boiling, destroys all water-borne disease-causing germs, including

viruses.

• Protection of water at its sources: Protection of water against contamination at its sources can

also diminish the risks of water contamination.

• Containers should be always cleaned and covered.

Hygienic Food

Following are the major sources of food getting contaminated:

• At sources of cultivation of raw materials:

A high proportion of inorganic manure

and spray of chemicals can poison the

plants. Unless properly washed, the food

is not fit for consumption at least in its

raw form.

• Storage: During storage, it can get

contaminated due to dust, insects, rats, etc. Some food items need special treatment during

storage. Bread and flour confectionery should be stored in special packs in a cold storage.

• Transportation: Bad handling, exposure of raw and prepared food and non-maintenance of

adequate temperature.

1.7 Page 7

▲back to top

• Sale Point: Vegetables, fruits, meat and cooked food, if kept without cover before sale can be

contaminated.

• In the Kitchen: Dirty kitchen, dirty wiping cloth, pets in the kitchen, keeping raw and cooked

food together, keeping cooked food for a long time in the ambient temperature.

• While serving food: Dirty utensils (plates, spoons), wiping cloth and dining table.

Food Safety Measures

• cleanliness of food stuffs

• maintenance of temperature for preservation of food

• hygienic process of cooking

• proper use of the refrigerator

• cleaning of raw materials and use of safe and clean water for cooking

• use of biotechnology and pasteurization

• awareness about national and international standards on food safety

• crop resistance to pests

• removal of allergy elements in food

• food with increased essential nutrients

Some Tips to Avoid Food Contamination

• Do not cough or sneeze with open mouth and nose.

• Do not touch food with fingers while cooking.

• Do not keep perishable food in the open.

• Do not put fingers in water while serving.

• Do not mix meat preparations and other food.

1.8 Page 8

▲back to top

• Keep the kitchen clean. Do not allow sick persons or pets in the kitchen.

• Use clean hands and cover your hair while cooking.

• Wash hands thoroughly with soap before cooking.

• Use spoon and spatula.

• Store raw and cooked food separately.

• Use the refrigerator for perishable food.

Liquid Waste Management

In India, one-fourth of the household wastewater is disposed in open drains. More than 50 per cent

of the households use open pits in rural areas and semi-urban areas, resulting in high risks of increase

in waterborne diseases.

Liquid waste and wastewater comes from households, industry, washing places, laundry, marketplaces,

slaughterhouses, etc.

Following are the hazards due to liquid waste:

• contamination of drinking water

• formation of stagnant water pools, which provides a breeding ground for flies, mosquitoes and

insects

• environmental contamination

The following measures should be taken for effective liquid waste management:

• Dispose of liquid waste properly.

• Clean drains regularly.

• Do not put garbage in drains.

• Put disinfectant liquid in drains.

• Develop/construct soak pit.

1.9 Page 9

▲back to top

Human Waste Disposal

Unsafe disposal of excreta is a principal cause in the transmission of pathogens within the environment.

Improvement in excreta management, especially fluid, through safe toilets can avoid health hazards

to a great extent. An estimate by the Planning Commission shows that hardly 20 per cent of the urban

population has access to flushing system connected to the toilets; 40 per cent have access to toilets

connected to septic tanks; 33 per cent have buckets or dry latrines and the remaining 33 per cent do

not have access to any facilities whatsoever.

The following diseases are caused by open-air defecation:

• bacterial diseases such as diarrhoea, cholera and typhoid;

• viral diseases such as polio and hepatitis;

• roundworm, hookworm, thread worm, tapeworm are spread when people walk barefoot for

open-air defecation.

These health hazards can be minimized if we:

• do not walk barefoot;

• use two-pit toilets;

• construct toilets and urinals separately for boys and girls in the schools;

• construct toilet complex with biogas plant in the local market, at railway stations, Panchayat

Bhawan, etc.

In order to make effective human waste disposal, an effective system such as total sanitation programme

has to be launched. Use of closed-door toilets has to be inculcated among the people through

behavioural change communication.

Solid Waste Management

Solid waste consists of biodegradable and non-biodegradable wastes, generated from homes, shops,

commercial buildings, industries, and other institutions. By segregating the biodegradable waste and

further recycling it, it can be reused as organic compost.

1.10 Page 10

▲back to top

Only a small proportion of the rural households have a system for safe disposal of solid and liquid

waste. More than half of the rural households throw their kitchen and household waste in the open.

Most rural households dump their cow dung in open pits to make compost.

The following are the hazards of improperly disposed solid waste:

• Improper solid waste management can create breeding places for flies and mosquitoes and spread

vector-borne diseases.

• Foul odour can cause air pollution.

• Poor solid waste management also increases the probability of fire hazards.

The following basic measures can improve the solid waste management system:

• Use covered dustbin.

• Households should have compost pit for biodegradable waste. Construct compost pit and vermin

compost unit.

• Collect non-biodegradable waste and deposit it in the collection centres for further disposal.

• Take the help of the municipality for proper disposal of waste.

• Do not throw solid waste and plastic bags in drains.

Method of Disposal

• Composting of biodegradable waste: Biodegradable waste is waste typically originating from

plant or animal sources, which may be broken down by other living organisms. Biodegradable

waste, therefore, can be recycled for production of vermin compost/organic compost.

• Compost pit: A compost pit, 3 ft in diameter, is dug at a cool and shaded corner of the garden

or the school compound. This depth is convenient for aerobic composting as the compost has

to be turned at regular intervals in this process. Preferably, the pit should be lined with granite

or brick to prevent nitrite pollution of the subsoil water, which is known to be highly toxic.

Each time organic matter is added to the pit it should be covered with a layer of dried leaves

or a thin layer of soil, which allows air to enter the pit thereby preventing bad odour. At the

end of 45 days, the rich pure organic matter is ready to be used.

2 Pages 11-20

▲back to top

2.1 Page 11

▲back to top

• Vermin compost: In vermin-composting, worms are added to the compost. These help to break

the waste and the added excreta of the worms makes the compost very rich in nutrients. It is

now being used widely as an organic fertilizer.

• Composting by NADEP method: This requires construction of a tank measuring 3m x 1.8 m or

3.6 m x 1.5m internally with 25 cm thick perforated brick wall all around plastered with mud

or cement to a height of 0.9 m above the ground level. This structure facilitates passage of air

for aerobic decomposition. The floor of the tank is laid with bricks. A thatched roof is erected

above the tank. This prevents loss of nutrients by seepage or evaporation and the contents are

not exposed to sun and rain. The ingredients for making compost are agro-wastes, animal dung

and soil in the ratio of 45:5:50 by weight. The ingredients are added in layers, starting with

vegetable matter followed by dung and next soil. Each layer can be about 45 kg vegetable matter,

5 kg of dung mixed in 70 litres of water and 50 kg of soil so that 30 layers will fill the tank.

Tree-lopping and green manure crops can also be used to fill up the tank if sufficient farm wastes

are not available at any time. The nutrients produced in the manure are absorbed by the soil

layers, thus preventing their loss. The compost can be stored for future use, preferably in a

thatched shed after air drying and maintaining it at about 20 per cent moisture level by sprinkling

water whenever needed.

• STAC Method developed by Sulabh: Sulabh International Institute of Technical Research and

Training has developed a new technology under the guidance of Dr. P.K. Jha, Adviser Technical,

which requires only 5–6 days to make compost from any biodegradable wastes without manual

handling during composting. It is also widely used by different municipalities.

Kitchen Smoke

More than 98 per cent of rural households do not have chimney for the exhaust of kitchen smoke,

resulting in respiratory diseases, including tuberculosis.

Personal Hygiene

Many among the rural and slum dwelling population take bath along with animals in highly contaminated

stagnant water, leading to skin and related diseases. Most rural females do not adopt hygienic practices

during menstruation, on account of social myths and misconceptions. Some useful tips for personal

cleanliness are:

• Clean your hands with soap after visiting the toilet.

2.2 Page 12

▲back to top

• Wash your hands before and after eating.

• Wash your mouth after eating.

• Brush your teeth regularly.

• Do not spit.

• Use handkerchief when sneezing or coughing.

• Avoid picking the nose.

• Keep your hair clean.

• Trim your nails.

• Have regular bath.

• Wash your eyes.

• Do not use eyeliner/pencil shared by others.

Factors Conducive to Sanitation

• Change in attitude: There is an age-old belief that toilets, especially close to the dwelling unit,

are not healthy and open-air defecation is a more healthy practice. This perception has to be

changed through appropriate behavioural change communication. Lack of finances also prevents

families investing in sanitation facilities.

• Change in belief: Most people believe that age-old practices, even if unhygienic, do not affect

their health. This belief needs to be changed.

• Change in habit: Habits like open-air defecation, improper handling of water, etc., need to be

changed.

• Change of practice: Going barefoot, open-air defecation, practices such as using mud for cleaning

hands after defecation and improper washing of hand before meals are a few of the practices

which need to be changed.

• Value addition to disposable waste: Human excreta contain more methane than cow dung.

Hence sanitation should be so designed that the methane gas can be channelized for lighting

as well as cooking. This may motivate the rural community to go for closed-door toilets.

2.3 Page 13

▲back to top

Corporate Involvement

The United Nations declared 2008 as the International Year of Sanitation.

Hygiene and sanitation has evolved as one of the potential sectors for growth, particularly in view of

the growing demand for clean and green environment. It also offers improved scope for developing

business models that can be profitable too. Sanitation has multipurpose uses, such as production of

biogas for lighting and cooking, manure, etc.

Particularly in solid waste management, there is huge business potential in terms of waste collection,

segregation, composting and recycling with revenue models emerging in collection charges from

household, sale of compost, sale of inorganic segregated waste for recycling, biogas energy generated

during composting, carbon credits for saving greenhouse gas emission, etc. Such profitable solid waste

management practice has already been demonstrated in Vellore, Tamil Nadu.

Moreover, in the allied sectors such as tourism, hotel industries, healthcare, etc., the need for good

sanitation and quality housekeeping promise more revenue and employment opportunities. Many

companies are already working in the sanitation sector directly or indirectly as part of CSR activities

that includes GMR, Mahindra & Mahindra, Bajaj Auto, Tata, Suzlone, TVS Electronics Ltd and Sulabh

International.

Corporate houses can support innovative models which have proven an impact in the community on

a larger scale. They can also invest a portion of their social fund towards sanitation and sustainability

aspects.

Technology Option

• Village masons to be trained on design and construction aspects of low-cost toilets. The

materials for mass construction can be made available by the government in bulk so that it is

economical.

• All schools must have toilets, separately for boys and girls.

Legal Actions

All legal actions are to be enforced.

2.4 Page 14

▲back to top

Developing Modern Technology for Waste Management

Corporate houses and NGOs can take the help of research institutes to produce user-friendly low-cost

devices for solid waste management.

Awareness on Hygiene and Sanitation Issues

Behavioural change communication can be addressed through street plays, puppet shows, songs and

posters based on hygiene and sanitation issues.

Women as Change Agents

Women play an important role in bringing attitudinal changes among family members on health,

hygiene and sanitation issues. Government, NGOs and corporate houses must pool their resources for

capacity building of women, who can act as change agents to motivate the community and generate

awareness about the beneficial effect of proper hygiene and sanitation on health.

Reference

Adapted and Compiled from Training Material Developed by Sulabh International.

2.5 Page 15

▲back to top

POPULATION FOUNDATION OF INDIA

B-28, Qutab Institutional Area, Tara Crescent, New Delhi 110 016

Tel. No : 42899770, Fax : 42899795

Website : www.popfound.org, E-mail : popfound@sify.com