The international development charity WaterAid in early October rolled out a first-of-a-kind ‘virtual reality’ documentary that allows viewers to follow a Nepalese plumber in point-of-view perspective as he scrambles to restore his the water supply of his village in the wake of a double earthquake last year. Earlier, in August, the UN finally fessed up to its central role in sparking a deadly cholera outbreak in the small Caribbean nation of Haiti in 2010. What is the connection?
UN peacekeepers have been deployed in Haiti since 2004 to prevent a political crisis from snowballing into a bloody civil war. Their role was expanded to recovery and reconstruction following a catastrophic earthquake in early 2010 and their numbers enlarged. Nepal, in keeping with its international commitments, dispatched a contingent to help with the UN mandate. This noble gesture brought hell to the Haitians. Cholera, a disease unknown to their immune systems for over 150 years, quickly ravaged an unsuspecting population and the death toll climbed to 10,000.
To the UN’s then firm denials, locals squarely blamed raw sewage seeping downriver from the Nepalese encampment for the outbreak. Nepal, coincidentally, has some of the worst water, sanitation and hygiene (WASH) indices in the world, and open defecation in rural areas is common even today. Unlike the Haitians, thus, snap flare-ups of cholera and other waterborne diseases in summer are a way of life for many Nepalese, and most adults have acquired a degree of immunity to them from contracting mild cases in childhood. And despite a surfeit of government initiatives in cooperation with international agencies, over half of Nepal’s population still has no access to adequate sanitation.
Stonewalling Nepal’s path to WASH progress is its unique confluence of structural and social realities. Nepal is one of the poorest countries in the world with a GDP per capita that peaked at $690 in 2015, but has generally hovered below $400. It is landlocked and relies heavily on India for trade — a state of affairs that triggered mass shortages of everyday staples last year when the Madhesi blockade tacitly endorsed by New Delhi was in full swing. Without foreign handouts and a tourism industry built around the Himalayan peaks, Nepal would be in dire fiscal straits.
A Nepal Multiple Indicator Cluster Survey (NMICS) in 2014 found that 37 percent of Nepalese children under the age of five are “moderately or severely malnourished.” And on its website, WaterAid cites grim data claiming two million Nepalese have no access to safe drinking water and over 600 children under five perish every year to diarrhea from contaminated water and poor hygiene. Also thwarting a speedy solution to Nepal’s WASH dilemma is the ramshackle state of the country’s water supply system, with approximately 75 percent of core infrastructure in need of repair.
The year 2016 has not fared any better. Environment & Public Health Organisation (EPHO), a national NGO, reported the return of cholera to the Kathmandu Valley this summer, confirming news stories of fecal matter floating in its water supply. By EPHO estimates, at least half of the water consumed by residents of the Kathmandu and Lalitpur municipalities is contaminated with pathogenic bacteria and industrial pollutants. Kathmandu has thus far struggled to design a water supply system insulated from sewage. Some 60 tons of household wastewater flows into the valley’s rivers everyday, eventually moving downstream to lakes that make up its primary water source. It is a vicious cycle ripe for contagion.
Moreover, the communities most vulnerable to hazards wrought by unsafe water live in scattered settlements across forbidding terrain. They are also loath to adopt better sanitation and hygiene practices. The high cost per capita of WASH programmes in such regions coupled with Nepal’s economic woes often translates to such communities getting pushed down the priority list. Also confounding a unified strategy is the absence of elected local governments, which often leads to murky jurisdiction and duplication of effort.
Mother Nature has not been kind to Nepal either. The 7.8 magnitude Gorkha earthquake in May last year not only laid waste 8,000 lives, it also threatened to violently shake the country back to the Stone Age. Nepal’s National Planning Commission puts the cost of post-disaster rebuilding at close to seven billion dollars, an impossible amount without sustained foreign aid. The World Bank, meanwhile, predicts Nepal’s GDP will plummet to below two percent this year from its near five percent average in the 2010s, while UNICEF warns close to a million Nepalese may have been shoved into poverty after the earthquake.
Impeding the rebuilding effort is bureaucratic lethargy inherent to Nepalese governments. Although more than four billion dollars have poured in from international donors, the National Recovery Authority instituted to roadmap and direct these efforts has trudged along at a glacial pace. Political instability arising from the Madhesi blockade, and premier K P Sharma Oli’s sudden resignation in July has further set back the timeline to substantive progress.
That said, it would be unfair to insinuate that successive Nepalese governments have deliberately skirted the issue. Before the Gorkha earthquake, Kathmandu in cooperation with UNICEF and other international partners was steadily tipping these indicators towards the positive, hoping to achieve nationwide access to improved water supply and sanitation by 2017. Noteworthy achievements between 1990 and 2014 include raising the share of Nepalese households with access to drinking water from 46 percent to 84 percent today, and reducing the rural open defecation rate by over half to 45 percent. Employing female health workers to teach basic hygiene and sanitation practices is also credited with cutting childhood deaths from diarrhea by 50 percent between 2000 and 2010.
Besides the strong focus on public-private partnerships to cover the gaps in infrastructure financing, surveillance and reporting activities on water quality need to be localised, so hitherto voiceless residents feel empowered to effect change. Nepal, lest we forget, is blessed with a superabundance of water resources. When coupled with the right mix of capital and strategy, it has the potential to perform a quantum leap in WASH indices over the next decade.
The writer is an Islamabad-based freelance journalist