INVESTMENT IN SANITATION
I recall my recent conversation with a Texan teenager born to Nepali parents who just had returned from a vacation to Nepal. I asked how much she liked the trip, her first time in Nepal. She was immensely pleased with her experiences which also included a visit to her parents’ birthplace in one Sarlahi village, but she sadly added: She saw trash everywhere, and that was an awful sight!
Her impressions may not matter much on the surface, but they hold tremendous significance for a country that depends so heavily on tourism.
Tourists visit Nepal for its history and scenic beauty, and of course, to view the Himalayas, the Mount Everest. But what we need is repeat visitors to the country, rather than one-timers—exactly the same principle that applies to, say, the restaurant business. As much as 90 percent success (or failure) of that enterprise depends on repeat customers.
The lesson then is that we must make Nepal more attractive to foreign visitors and an emerging group of new visitors—offspring of long-time migrants from Nepal who would not feel so guilty about having left the country if their children could still be lured back, for a brief visit, on business, or to settle for good. This second generation of return-migrants will open up rich opportunities for Nepal, in terms of investment, job creation, and more tourists.
We celebrated Nepal Tourism Year in 2011; more such initiatives need to be planned for coming years. This would be money well-spent on promotion and advertisement, at home and abroad. However, we should not make empty promises to would-be visitors that Nepal is an attractive, safe, and clean place to spend a vacation, do business, and consider educating their children.
What would make Nepal an attractive place to visit, live and do business? There are at least a dozen things we need to complete to improve the country’s attraction for tourists, but in my view, the single most important item that we have to focus on is public cleanliness, which includes public hygiene as well as some other items. A comprehensive acronym to highlight the generic coverage of public sanitation is called WASH—(Drinking) Water, Sanitation, and Hygiene.
The poor quality of WASH services in Nepal is catastrophic, a tragedy of public sanitation. This is so because of the near-absence of public sanitation services (trash collection, waste management and sewer treatment facilities) that not only hurts tourism and discourages foreign investors but is also injurious to the whole society. In large part, the incidence of diarrhea, tetanus, hepatitis, smallpox, malaria, tuberculosis, plague, cholera—which Chinese leader Mao Zedong once characterized as filth diseases—are all due to poor sanitation and the absence of WASH services in general.
A silent killer
Many times more Nepalis get killed each year from sanitation-related diseases than from other types of diseases. Although the incidence of cholera, smallpox, and tuberculosis has diminished over the years, a large segment of the population continues to be afflicted by water- and public sanitation-related diseases. Malaria remains a mass-killer, directly and indirectly, through multiple mosquito-borne infections, morbidity, and, generally, a life-long repeat of the malarial sicknesses. Diarrhea is another mass-killer, especially of children under five, among whom 50 percent of death is attributed to this disease. Other serious illnesses—diphtheria, tetanus, and hepatitis—claim a large number of people each year and such diseases actually never go away, leaving behind a life-time of wasting.
Aside from the impact on personal happiness and quality of life, the economic impact of these mass-diseases is enormous. This is succinctly laid out in a recent report of WaterAid, which studies public sanitation globally: “Lack of sanitation limits economic growth and cripples developing world’s economies. Workers are less healthy, and therefore, less productive, live shorter lives, save and invest less and their children are less likely to attend school.”
Looking at the public sanitation problem generally, one US agency, the Center for Disease Control and Prevention (CDCP), believes: “Global access to safe water, adequate sanitation, and proper hygiene can reduce illness and death from
[a variety of] diseases, leading to improved health, poverty reduction, and socio-economic development.”
Predictably, pay-off from investment in improving drinking water quality and public sanitation is huge. “For every US $1 invested in sanitation [and water supply], US $9 are returned to national economies in increased productivity and reduced burden of healthcare,” according to WaterAid.
There is no other development sector more dependent on government leadership than public water supply and sanitation services. This is so because almost all other public services—health and education particularly—can be turned over to the private sector, to be run as a business enterprise and for profit. However, such an option is largely unavailable in the case of waste management, water supply and sanitation services. Collection and treatment of public waste, most particularly human excreta, if unmanaged, is most damaging to public health.
This level of extreme dependence on the government for water supply and sanitation services is justifiable, since the government is more obliged to carry them out as compared to other public services. Unfortunately, this is hardly the case in Nepal.
There are at least a dozen things to do to improve the country’s attraction, but the single most important is public cleanliness. There are at least a dozen things to do to improve the country’s attraction, but the single most important is public cleanliness.
I recently asked a Nepali friend, who is not much into either economics or politics, but understands the public sanitation/water supply problems in the country well: “Suppose the government spends 100 arabs (billions) rupees each year on development projects of various kinds. How much of this should it be spending on water and sanitation services?” Her straightforward answer: “Half of it, or Rs. 50 billon.”
In a global survey of WASH spending by governments, WaterAid Nepal reports that, as a percent of GDP, this has been less than 1 percent in Nepal (the actual figure quoted is 0.7 percent) which comes to 3.3 percent of budget spending. Seemingly, this has not been a priority sector from government perspective and, actually, water and sanitation-related spending has been declining in recent years as a proportion of the budget.
At the same time spending on education has been about 4.5 percent of GDP and on health, (hospitals and medicines) about 2 percent of GDP. WaterAid recommends that WASH-related spending be increased to 3.5 percent of GDP—about Rs 45 billion annually—to match regional spending of about 10 percent of GDP on social programs.
This finding opens up another area of dispute concerning government legitimacy. If a government forces a large part of the population to live in horribly unsanitary conditions, is indifferent to public cleanliness, and supplies contaminated water that results in poor health, there is a legitimate reason to doubt its commitment to public service and, hence, its claim to legitimacy.