What are your thoughts on hygiene practices and the coping mechanisms for it in Bangladesh?
The Bangladesh Bureau of Statistics' 2018 National Hygiene Survey had five modules to help us understand hygiene practices for: households, schools, restaurants, street food vendors, and healthcare facilities.
Among the households surveyed, only 40% of respondents said washing hands with soap and water before eating was important. That means we have a long way to go on our track to achieving hygiene-related practices and SDG [Sustainable Development Goal] standards.
There were, however, good signs of awareness about hygiene in schools; more than 91% of students said their hands should be cleaned with soap and water after using the toilet. But only 39% of schools had an improved, clean and accessible latrine with soap and water available.
So, good hygiene practices were not in place in the rest of the schools even if students were aware of them.
Conditions for menstrual hygiene management were even poorer. Only 13% schools had separate toilets for girls with proper hygiene facilities.
What was appalling is that in restaurants, and at street food vendor stalls, 47% of the cooks did not wash their hands with soap and water after using the toilet, and more than half of them did not wash their hands before preparing food for customers. That indicates how poorly hygiene is maintained at restaurants and by street food vendors.
My last point is about health facilities. There are handwashing facilities, with soap and water, for about 77% of nurses and 81% of doctors. But what is quite interesting is that 68% doctors, 55% nurses and 73% ward boys – almost seven out of 10 – never received training on sanitation and hygiene.
Why is good hygiene important for health and livelihood?
Let me draw your attention to waterborne diseases. Globally, every two minutes, a child under five loses their life due to water-related diseases. Nearly 80% of diseases are waterborne, which means if we maintain hygiene properly, we can get rid of 80% of diseases and many lives can be saved.
And if you think of Covid-19, hygiene is the first line of defense. If you maintain good hygiene and wash hands, you can protect yourself from the disease.
We know that the Covid-19 vaccine has come but we are still not sure about its efficacy. And some people will remain out of the vaccine's coverage, as we know that children below 18, pregnant women and allergic patients will not get vaccine shots. Handwashing will act as a shield for them against Covid-19.
The absence of menstrual hygiene management is a big concern. Women and girls are shy, and their unspoken problems can be responsible for complicated diseases in the early and later stages of life. Things can get worse, leading to cancer, pregnancy-related complications and reproductive health problems.
As of livelihood, day labourers can lose days of work and income because of suffering from diarrhea and other diseases.
What should be done to keep good hygiene practices in place, especially in the time of Covid-19?
Turning hygiene practices into social norms is very important. For example, when somebody enters your home, you should first lead them to a handwashing facility and ask them to wash his or her hands with soap.
Hygiene must be part of everyday life. It should be practiced at schools, institutions, everywhere. And to make sure that the practices continue, you need to have an enabling environment. So, wherever you go, you must have handwashing facilities. A nationwide campaign on clean hands and hand hygiene for all is essential to sustain this behavior.
How is climate change putting pressure on the availability of water and what is the way out?
Impacts of climate change are now quite visible in Bangladesh. If you go to the coastal belt, you will see that water is saline; underground water, rivers all are facing salinity intrusion. It is hard to get drinking water there.
If you look at the North West region, there is water scarcity marked by desertification and drought. People are not getting water by pumping tube wells. And we are not giving much attention to these areas unlike the case of the coastal belt.
If you go to the Chittagong Hill Tracts, streams are drying up. The communities are becoming vulnerable to water crises.
Human interventions – such as irrigation through deep tube wells, shrimp cultivation and exogenous plantation – are aggravating the impacts of climate change. We need to find out how to reduce the impacts by controlling human interventions.
We should understand that water is a scarce resource and we should not overuse or waste this resource. We should use a limited amount of water and reuse it for different purposes. Moreover, we should explore alternative sources of water like rainwater harvesting.
How far are we from achieving SDG 6, that stipulates access to and proper management of water and sanitation? Do you have a recommendation for achieving the target?
According to the Sustainable Development Goals, no one should be left behind. While talking about SDG 6, or any other goal set for 2030, our attention should be on the poor and marginalised people who are more vulnerable and often are not at the center of discussion at key platforms.
Regarding water and sanitation, in particular, a pro-poor strategy is imperative. And that pro-poor strategy spells out: how to address problems facing the hardcore poor in hard-to-reach areas, how to provide them subsidies, how to identify them, how to bring them under safety net coverage, and so on. Just by implementing the strategy, we can solve the problems to a great extent.
The government and development partners must consider the strategy in their projects and intervention.
What should be the roles of the private sector and civil society organisations in the nation's journey to the SDGs?
The SDGs are designed in such a way that the government alone cannot achieve them.
There should be a concerted effort by the government, private sector, civil society organisations, and citizens. The problem we are facing now is that all are not on the same page. For example, private sector investment is a must for attaining the SDGs but how the investments will be channeled and integrated is not clearly laid out.
So, we have to figure out how to work together with a shared purpose and vision for SDGs.
Is the allocation for the water, sanitation and hygiene (WASH) sector sufficient?
The WASH budget's distribution is not equitable. It is very urban-centric. So, the allocations are not addressing the needs of hard-to-reach areas like hill-tracts, haor and char areas. Research findings indicate a gross increasing trend on WASH sector budget allocations over the years, but the challenge remains on utilisation and disparity among urban and rural [populations]. Moreover, there is no definite budget line for WASH. We have not paid much attention to these aspects. We need to focus on institutional capacity building in ensuring WASH financing – especially as we tread towards SDG targets.
Finally, I do hope the government will build the strategies and actions to address priorities in hygiene – taking into consideration the findings of the Bangladesh Bureau of Statistics' 2018 National Hygiene Survey.