Poor sanitation, bad toilets cause deaths, misery
ASADABAD, 5 March 2008 (IRIN) - Saliha still mourns
the death of her three-year-old daughter, Halima, who
died due to severe diarrhoea at a hospital in Kunar
Province, eastern Afghanistan, on 11 January.
The child had drunk contaminated water which
Saliha's family collects from a nearby river and uses
for all purposes, including drinking, cooking and
About 200 metres away from where households in
Spinkay village, Asmar District, collect water, is a
mosque built across the river where dozens of men
gather for prayer five times a day. Men who come to
the mosque often perform their ablutions (washing
their hands, arms, face, head and feet) with river
water. Some even urinate and/or defecate near the
riverbanks, and refresh afterwards with the river
It is not always a surprise for locals to see human
faeces, sputum and even animal dung floating in the
running water. There is a consensus among some
residents in Spinkay village, and indeed many other
rural communities across Afghanistan, that "flowing
water" is always clean, unless the colour, smell and
taste is changed.
However, not only was Saliha's daughter killed by
the "flowing" river water but many other children also
suffer various water-borne diseases, according to
medical experts in Asadabad, provincial capital of
Preventable diseases such as diarrhoea, cholera,
dysentery and pneumonia kill about 600 under-five
Afghan children every day, according to the UN
Children's Fund (UNICEF).
About 25 percent of under-five children in
Afghanistan are affected annually by diseases
originating from poor and/or bad sanitation.
World's worst toilets
According to the State of the World's Toilets 2007
report, about 92 percent of Afghanistan's estimated
26.6 million population do not have access to proper
sanitation. This has placed the country at the top of
the list of "the worst places in the world for
UNICEF statistics show that 34 percent of Afghans
(urban 49 percent, rural 29 percent) are using
adequate sanitation facilities.
Others also highlight the problem: "The sanitation
status of Afghanistan, where 60 percent of the
population lives in unplanned shantytowns and where
there are growing inequalities in cities in terms of
sanitation, is not satisfactory," Bindeshwar Pathak,
founder of New Delhi-based Sulabh International, a
sanitation and social services organisation, told IRIN.
Open defecation is prevalent, causing social,
health, environmental and development problems.
In the past six years the government of Afghanistan
and the international aid community has spent a lot of
development money on projects that have improved
access to drinking water, while sanitation issues have
received little or no funding, according to the
Ministry of Rural Rehabilitation and Development.
As poor sanitation hurts communities throughout the
country, killing thousands of children, there are
hopes that the issue of sanitation will be brought
into the development process.
"UNICEF wants to pay greater attention to
sanitation and the government has also increasingly
realised the importance of sanitation," said Nadarjah
Moorthy, head of the water and environmental
sanitation unit with UNICEF in Kabul.
Poor waste management
Officials in Kabul Municipality estimate that the
over three million people living there produce at
least 1,500 cubic metres of solid waste every day.
However, due to lack of resources and a limited
capacity, the municipality does not collect more than
half of the waste from open locations in and around
"We collect 700-800 cubic metres of solid waste in
Kabul city on a daily basis, except Fridays," said
Payenda Mohammad, an official at the department of
waste management in the municipality.
Some of the remaining solid waste is either
consumed by grazing animals in some parts of the city
and/or collected by destitute children.
"When it rains a lot of waste mixes with rainwater
and often reaches drinking-water sources, which causes
different diseases," Nasrullah Habibi, a specialist on
sanitation with the UN Human Settlements Programme
(UN-HABITAT) in Kabul, told IRIN.
The traditional dry vault toilet system – a
specially-shaped dry vault that separately collects
solid and liquid waste and which is commonly used in
Afghanistan - is also considered a major health and
Septic tanks and sewerage (whereby solid and liquid
waste is collected near the home for disposal
elsewhere) are two other widely used toilet systems,
particularly in urban areas, both of which are not
"safe" or "eco-friendly", according to Pathak of
Sulabh has constructed five public toilets in Kabul
city "with biogas digesters for recycling human waste
into biogas, which can be used for lighting and
"The Sulabh two-pit-pour-flush toilet system is an
appropriate and affordable solution to the crisis of
dry vault toilets in Afghanistan," said Habibi of
Boosting public awareness
The UN General Assembly has named 2008 the Year of
Sanitation and has asked member states to improve
their citizens' access to adequate sanitation.
UNICEF, in partnership with government bodies,
plans to boost public awareness on personal hygiene
and sanitation and save thousands of lives. "We will
nominate 'model villages' to encourage communities to
improve sanitation," said Nadarjah Moorthy, UNICEF's
sanitation expert in Kabul. "It requires government,
donors and communities' support," he added.
Apart from the widespread lack of a proper toilet
system, experts such as Moorthy are concerned about
very poor personal and family hygiene practices among
"Hygiene practices need to change," said Moorthy.
Improving sanitation and hygiene practices often
requires behavioural change and takes a long time, he
A compelling reason for parents to improve their
hygiene practices and sanitation is the very safety
and well-being of their children: "I would have
protected my daughter from all unclean things and
would never have given her the river water, if I had
known that that would kill her," said Saliha, the
bereaved mother of Halima.
Integrated Regional Information Networks (IRIN), a
project the Office for the Coordination of
Humanitarian Affairs. IRIN is UN humanitarian news and
information service, but may not necessarily reflect
the views of the United Nations or its agencies.
[This report does not necessarily
reflect the views of the United Nations]