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Context:
- The recent article “Can sanitation reduce stunting?” (The Hindu, February 15) touched upon many dimensions and possible reasons to explain why Water, Sanitation and Hygiene (WaSH) trials in countries like Kenya and Bangladesh ended, disappointingly, with no significant reduction in stunting among children.
More in news:
- When the effect of poor sanitation is obviously passing on from one generation to the other, it might take at least a generation to adopt WaSH interventions before their outcomes can be seen.
- Therefore, short-term trials like the ones in Kenya and Bangladesh are bound to show little or no effect.
- In addition, in India, where the baseline, unlike in those countries, is so large (over 50% of open defecation against 1% in Bangladesh) even small improvements can demonstrate significant and palpable changes.
Stunning:
- Stunting is driven by multiple factors, one of which is inflammation.
- Inflammation is normal biological responses of body tissues to stimuli such as disease-causing bacteria (pathogens), but ironically repeated exposure to high doses of bacteria that are not linked with diseases or diarrhoea also cause inflammation.
- Inflammation down regulates growth factors, and thus impairs normal growth in children.
- Mothers with inflammation in the gestation tissues had smaller babies in our study.
India needs to learn from Bangladesh:
- It is indeed true that mere building of toilets cannot prompt people to use them as there are a lot of social, cultural and behavioural aspects attached to it.
- What India needs to learn from Bangladesh is how they have managed to bring down open defecation to less than 1% by 2016, from a whopping 42%, in a little over a decade.
- A huge chunk of public and charity money was spent on building toilets, and campaign volunteers slogged to change public attitudes and habits.
- Children were used literally as whistle-blowers and agents of change while door-to-door campaigns were carried out.
- It was done in a dogged campaign in mission mode supported by 25% of the country’s overall development budget.
Way ahead:
- The very fact that over half (about 52%) of rural India still defecates in the open is still a reason why it may be too early to quash or discount Swachh Bharat Abhiyan (SBA).
- The importance SBA which accords to cleanliness, hygiene and sanitation can go a long way in India’s fight against not only stunting (low height for age) but also many other forms of malnutrition.
