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Sanitation – Food for Thought

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August 21, 2014 by John Crapper

Scientists in India have noticed a disconnect between economic boom and vast numbers of children malnourished and stunted, leaving them with mental and physical deficits. Now they are hypothesizing that many of the 162 million children under the age of 5 around the world malnourished are suffering less from a lack of food than poor sanitation.

India by far has the largest number of people who defecate outdoors. As a result, children are exposed to bacteria that often sickens them, leaving them unable to attain and maintain a healthy body weight no matter how much food they eat.

“These children’s bodies divert energy and nutrients away from growth and brain development to prioritize infection-fighting survival,” said Jean Humphrey, a professor of human nutrition at Johns Hopkins Bloomberg School of Public Health. “When this happens during the first two years of life, children become stunted. What’s particularly disturbing is that the lost height and intelligence are permanent.”

Unicef, the World Health Organization and the World Bank released a report on child malnutrition two years ago that focused entirely on lack of food. Sanitation was not looked at. Now Unicef officials and many other major charitable organizations believe that poor sanitation may cause up to half of the world’s stunting problems.

“Our realization about the connection between stunting and sanitation is just emerging,” said Sue Coates, chief of water, sanitation and hygiene at Unicef India. “At this point, it is still just an hypothesis, but it is an incredibly exciting and important one because of its potential impact.”

Why is a child raised in India far more likely to be malnourished than one from the Democratic Republic of Congo, Zimbabwe, or Somalia, the planet’s poorest countries?

Stunting affects 65 million Indian children under the age of 5, including a third of children from the country’s richest families.

How do we explain this disconnect between wealth and malnutrition? Economists have concluded that economic growth has almost nothing to do with reducing malnutrition.

Half of India’s population, or at least 620 million people, defecate outdoors. And while this share has declined slightly in the past decade, an analysis of census data shows that rapid population growth has meant that most Indians are being exposed to more human waste than ever before.

“India’s stunting problem represents the largest loss of human potential in any country in history, and it affects 20 times more people in India alone than H.I.V./AIDS does around the world,” said Ramanan Laxminarayan, vice president for research and policy at the Public Health Foundation of India.

India has tried for decades to resolve it’s malnutrition problems by subsidizing and distributing vast stores of food but it has largely failed to reverse the trend.

At present India spends about $26 billion annually on food and jobs programs but less than $400 million on improving sanitation.

Studies are underway in Bangladesh, Kenya and Zimbabwe to assess the share of stunting attributable to poor sanitation. “Is it 50 percent? Ninety percent? That’s a question worth answering,” said Dr. Stephen Luby, a professor of medicine at Stanford University who is overseeing a trial in Bangladesh that is expected to report its results in 2016. “In the meantime, I think we can all agree that it’s not a good idea to raise children surrounded by poop.”

An interesting observation, little discussed, sheds light on the possible fecal/malnourished connection. Muslim children in India are 17 percent more likely to survive infancy than Hindus. The difference is explained by the fact that Muslims are far more likely to use latrines.

In September, 2013 the UN called on countries to give greater urgency to sanitation, particularly efforts to end open defecation.

“We must break taboos. As was the case for the word ‘toilets’ a few years ago, it is time to incorporate ‘open defecation’ in the political language and in the diplomatic discourse,” the deputy secretary general, Jan Eliasson, said in a keynote speech at a annual World Water Week event in Stockholm, Sweden. He has urged states to step up their efforts on sanitation, which is the subject of the seventh millennium development goals (MDGs). Meeting the target would involve reducing the proportion of people without access to sanitation from 51% to 25% by 2015. The World Health Organisation (WHO) says the objective is off track but, even if it were met, about 1.7 billion people will be without access to sanitation.

Sanitation is not a topic most politicians want to discuss. Devoting resources to it is never a priority. It is not a subject that comes up much around the dinner table. It sort of tends to spoil one’s appetite. But as is beginning to become apparent, not having access to proper sanitation can spoil a person’s ability to benefit from the food consumed at their dinner table.

The Church of the Holy Shitters is dedicated to transforming our ass-backward thought processes with regard to sanitation and ushering in a new ass-forward eco-san way of dealing with our own shit. Remember:

“If we really want to straighten out all this crap we really need to think about shit.”
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Our climate is changing. I'm humorously serious about addressing it. I'm convinced my ego is the main culprit. My religion, Holy Shitters, demands I humble myself and celebrate the fact my shit stinks.
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