[Two weeks have passed
since a magnitude 7.8 earthquake
devastated large swaths of this mountainous country, killing
more than 7,900 people and injuring more than 17,000. Nepal’s government and
charitable organizations are racing to beat monsoon season, which begins in
about six weeks, to get tents and food to as many as 800,000 Nepalis whose
homes are uninhabitable. But they say an equally urgent task is to provide
clean water and toilets before the rains make the poor sanitary environment in
these devastated areas far worse by carrying contamination into water supplies
and making direct contact with fecal bacteria almost inevitable.]
 |
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Saili,
25, from Selang, said that her 2-year-old son died in the earthquake
and
that her home was destroyed. She and her two surviving children are
now
living in a shelter with four other families.
|
PAUWATHOK, Nepal — After years of intense
effort, officials here in rural Sindhupalchok district had persuaded almost all
of the nearly 61,000 households to each build a toilet. Then the earthquake
struck, destroying most houses — and the very toilets that could have helped
stave off the diseases that can run rampant after natural disasters.
Now, instead of
celebrating a public health triumph, residents are holding services for their
dead and digging through the rubble to find more bodies. And relief workers are
pouring into the district, hoping to salvage the remarkable progress in
improving hygiene made here in recent years.
“There will be outbreaks
of cholera and other diseases,” said Antti Rautavaara, chief of water,
sanitation and hygiene for Unicef in Nepal.
“It is a battle we cannot win. We can only try to minimize the pain and death.”
Two weeks have passed
since a magnitude 7.8 earthquake
devastated large swaths of this mountainous country, killing
more than 7,900 people and injuring more than 17,000. Nepal’s government and
charitable organizations are racing to beat monsoon season, which begins in
about six weeks, to get tents and food to as many as 800,000 Nepalis whose
homes are uninhabitable. But they say an equally urgent task is to provide
clean water and toilets before the rains make the poor sanitary environment in
these devastated areas far worse by carrying contamination into water supplies
and making direct contact with fecal bacteria almost inevitable.
Small outbreaks of
diarrhea have been reported across Nepal since the earthquake, and although
such outbreaks are routine here, they have raised worries that the quake’s
aftermath is at least partly to blame. But getting residents to consider
building more toilets amid the devastation has not been easy.
About every fourth house
in Chautara, among the district’s largest villages, is rubble. Most of those
still standing are leaning precariously or have slid down the hill. The road
through town is a narrow pathway choked with the red dust of pulverized bricks.
A sign still standing at
one end of town declares, “To Defecate In Open Areas Is To Commit A Crime.” But
in interviews, many residents said the destruction had forced them to return to
that now-criminalized practice.
Chameli Giri, 45, is one.
Standing on a pile of rubble and wood that was once her house in the nearby
village of Pauwathok, an eye-watering stench from the family’s crushed goats
rising around her, Ms. Giri made it clear that her worries were more immediate.
She and her seven children were all living in a jury-rigged lean-to next to the
family’s surviving livestock; the night before, she had heard a tiger. She
feared thieves.
For the moment, she said
gesturing toward the hillside, the family would have to make do with the
outdoors.
“What else can we do?”
she said.
More than 80 charities
and government agencies have poured into Nepal since the quake to work on its
well-documented water and sanitation problems. Nepal’s water ministry has held
routine meetings with them in its biggest conference room, which is still not
large enough to accommodate the scores of people who show up in T-shirts and
vests emblazoned with the bright-colored logos of their organizations.
They are coming to a
country that was already among the world’s most unsanitary, with a 2011
government survey finding that 45 percent of Nepalis did not use toilets, one
reason 82 percent of drinking water supplies are contaminated with fecal bacteria.
A study found that about 11 percent of
Nepali children have diarrhea at any given moment, which contributes to the stunting
that affects more than a third of the nation’s children, according to
government figures.
“The risk is that an
already bad situation gets much worse,” said Mr. Rautavaara of Unicef. “But at
the same time, this is a massive opportunity for the sanitation movement.”
Before the earthquake,
Unicef had intended to spend $25 million over four years aiding the government
in its sanitation efforts. Now, the United
Nations intends to dole out $63 million in water and sanitation
grants for work that must be completed within three months, if international
donations meet hopes.
Some of the money will be
spent on providing and constructing temporary pit latrines — each a hole in the
ground with a small booth above it. Stacks of the materials for the latrines
have been appearing in district headquarters across Nepal, courtesy of aid
organizations like Oxfam. The government’s goal is to quickly build one such
latrine for every 50 male residents and another for every 30 females.
While the aid is
considered necessary, it has raised at least some fears that handouts will
backfire. Many Nepalis have shown over the years that they prefer using open
fields to using smelly pit latrines. In fact, giving away or having the
government construct toilets has been a singularly unsuccessful strategy in
much of South Asia, where people often turn government toilets into storage
rooms or simply abandon them altogether.
So Nepal began a series
of initiatives to persuade and sometimes shame residents into spending their
own money to build toilets, figuring the expenditure would give the people more
of an investment in the modern convenience. Most areas lack running water, and
the toilets are usually outhouses with pour-flush systems. The strategy was
especially successful in the country’s hilly and mountainous districts —
precisely the ones most affected by the earthquake.
Arun Simkhad, the
district water and sanitation chief, said the area had been tantalizingly close
to having all its residents use toilets when the quake undid the progress. “We
only had about 300 households out of 60,600 in the district that still didn’t have
toilets,” said Mr. Simkhad, sitting in a thatch pagoda outside his destroyed
district office. He has not given up, though.
“People are going to
rebuild their homes,” Mr. Simkhad said. “And when they do, we are asking them
to build a toilet as well.”
Sanitation experts said
they were uncertain whether Sindhupalchok’s residents, with jobs now scarce,
would be able to afford to rebuild toilets without financial or construction
assistance. And while some worried that would lead people not to value the toilets,
others suggest that will no longer be a problem.
“They’ve already built
toilets once. I’m sure the habits are ingrained now,” said Payden, a regional
water and sanitation adviser for the World Health Organization who, like many
South Asians, uses only one name. “So I don’t think they’ll abandon facilities
built by external donors or governments.”
But getting residents to
even discuss toilets has been difficult in recent days, she said. “If you’re
not bringing tents or food, people in these hard-hit areas can get angry and
even aggressive,” Ms. Payden said. “Some water and sanitation assessors have
had to leave villages.”
In interviews, many
residents of Sindhupalchok also said that getting a toilet was the least of
their worries.
Saili, 25, of Selang, said
that her 2-year-old son had died and that she had been buried up to her waist
when her home, like every other in her village, collapsed. Now, she and her two
surviving children live in a makeshift shelter of branches along with four
other families.
“We really need a tent
and some food,” she said. “A toilet? I don’t know. Not really.”
