Why basic hygiene and sanitation practices are key to fighting Covid-19 and other pandemics.
The world is reeling under an unprecedented pandemic that has not been experienced by people of many generations. It is, perhaps, the most lethal peacetime calamity causing an unimaginable health and economic crisis.
The power of the virus to destabilise the entire world and to unleash death and horror in a staggering pace – even in most advanced countries – has left all governments bewildered.
Such has been the potent force of the virus that it has effectively rendered useless humanity’s remarkable and epoch-making advancements in science and technology.
Questions are being raised how the world was unprepared to handle a pandemic of such a scale – why did we not see it coming? It is true that with the collective commitment of medical fraternity, political will and scientific innovation like a vaccine, we will – sooner than later – successfully control and finally defeat the virus.
However, the pandemic has brought into spotlight the basic importance of access to water, sanitation and hygiene (WASH) facilities, which is increasingly been seen as frontline barrier in protecting human lives from Covid-19.
Handwashing with soap is now the most critical step in the fight against the novel coronavirus disease (Covid-19), and there has been a holistic global campaign led by World Health Organization (WHO), the United Nations and developmental agencies and national governments appealing to populations to wash their hands in the right manner.
It has been proven repeatedly in the past by a number of baselines studies around the world that handwashing and hygiene information and practices play a critical role in preventing disease.
During the Ebola outbreak, effective coordination amongst the WASH partners and making provisions for handwashing and access to water were key measures in defeating the virus and it is now equally playing an important role along with social distancing in our battle against Covid-19.
As we deal with this pandemic, we must be reminded that millions of people have no access to a place to wash their hands. According to the latest data released by WHO and UNICEF joint monitoring group only three out of five people worldwide have basic handwashing facilities.
In absolute terms, it is estimated that, globally 2.2 billion people lack safe drinking water facilities 4.2 billion people live without access to adequate sanitation facilities.
In India, 20 per cent of urban citizens or 91 million lack basic handwashing facilities at home. In the last few years, though some strides have been made in providing WASH services, the outbreak of the novel coronavirus has brought into forefront the urgency of the issue.
It is clear that access to clean water and sanitation will be key in protecting populations from future pandemics as well for other recurring diseases like diarrhoea and cholera, especially in the low-income countries.
Before novel coronavirus emerged, India became one of the large economies to address the issues related to WASH seriously. Five years back, it was estimated that over 600 million people in India did not even have access to toilets.
In 2014, Prime Minister Narendra Modi made sanitation one of the priority policies of his government and launched an ambitious Swachh Bharat Abhiyan.
Over the last five years, under the programme, India built more than 100 million toilets thus bringing more population under the ambit of WASH activities in some way or the other. These measures are now proving to be vital as the nation gears up to fight the pandemic.
The Swachh Bharat Abhiyan has laid the infrastructure from which future interventions can be designed to step up and enhance water and sanitation services post the Covid-19 crisis.
It is evident that there will be an urgent need to create long-term sustainable solutions that prevent the spread of Covid-19 and other pathogens especially among India’s vulnerable and marginalised communities.
The government of India has a plan in place to provide clean drinking water to all by 2024. The plan must have comprehensive WASH initiatives so that in years to come health gains can be made through behaviourial change and adoption of hygienic health practices in communities and schools across the country.
India’ swift and timely response in tackling the Covid-19 has been one the largest medical-driven logistical exercise, which has been hailed by the WHO.
However, once the lockdown is lifted, India must use this opportunity to create a robust health system that penetrates deep across the country. By all measures, the pandemic will generate huge data that will further help in mapping India’s teeming population and their health needs.
The response to the pandemic has also highlighted the merits of coordination between agencies at all levels from the Centre to panchayat and to block levels; such momentum must be maintained in creating systems capable of delivering basic health care and information systems coupled with machine learning techniques so that future pandemics can be controlled.
India has got a very dedicated and well-trained healthcare force involving doctors, nurses, paramedics and sanitation workers, and this capability must be strengthen manifold.
The vocational and skill development programmes will have to focus on creating well-defined medical and sanitation sentinels. A significant amount of resources have to be mobilised for cutting edge research in the fields of virology, biotech and microbiology at district levels.
Within India, experiences of states like Kerala can be emulated. Kerala has largely modelled its Covid-19 response from its experiences of dealing with the Nipah virus. Kerala’s effective tackling of the virus was based on two things — surveillance and information sharing.
The Nipah virus was controlled in less than three months and the battle was won because of dedication of frontline health workers.
At Sulabh International, the organisation that I founded 50 years ago, WASH has been an integral part of our sanitation delivery models. As an implementing agency, we have used significant resources in training and educating masses across India and aboard about handwashing and hygiene practices.
Additionally, Sulabh has always stressed in promoting WASH campaigns in its intervention programmes with a specific focus on girl students. It has set up school sanitation clubs, which is a child-centred and girls-led global movement of children and young people engaged in bringing about positive social transformation in schools by empowering girls.
So far, 64 clubs in 12 states of India, six in Nepal and Bhutan and one in South Africa have been set up. About 6,500 schoolchildren in more than 200 schools have been trained in school sanitation and hygiene education and menstrual health.
I strongly believe that along with sanitation, safe water should also be provided to the community so that gain to the public health becomes comprehensive. It has been established in many studies that for comprehensive and lasting impact on community health need an integrated approach on sanitation and safe water.
Sulabh has undertaken a number of projects on water supply to the rural communities in West Bengal and Bihar.
A significant number of the villagers in these districts suffer from arsenic related diseases due to contamination of ground water. These treatment plants installed with support from Sulabh takes water from traditional ponds and rivers, which is arsenic free.
The objective is to create decentralised, people-friendly approach aimed at empowering communities by building capacity in them so that villagers by training can run the plant effectively.
It must be noted that due to years of training the communities here understand the importance of handwashing and hygiene and in turn they raise awareness to slow the spread of the virus by maximising access to safe water and sanitation services.
These projects are fundamental to fighting the virus, creating a more sustainable future and preserving the health and well-being of thousands.
It is evident that a robust WASH sector is important in mitigating the longer-term consequences of the pandemic.
Likewise, besides mobilising the financial resources needed to address the pandemic in the current emergency, work will be needed to make financing instruments available for strengthening preparedness and response to future pandemics.