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E
very day without fail, Jamna Kolhi waits for the sun to set so that she can go to the nearby jungle to relieve herself. With her face hidden behind a veil, the 29-year-old mother of four looks down before saying hesitantly, “I am not the only one who follows this daily practice. Every woman in my village has to do this because we don’t have latrines in our homes. In the daylight and due to the presence of our male fellow villagers all around it becomes very difficult for us to go to the jungle to relieve ourselves.”
For a while she becomes silent and then points to the north, saying, “So we choose darkness to go there. The wilderness is just a few steps away from our huts in that direction and if any woman misses her daily turn of going to the jungle she has to wait till the next day.”
Her daughter Pooja, 10, chimes in, “I also go to the jungle along with my mother and a sister. It really haunts us at night but we have no other option.”
Jamna and her family live in the village Harchand Kolhi, a settlement of more than 150 Kolhi-caste households. The village is some 25 kms southwest of Badin city in Pakistan’s Sindh province. As stories from Pakistan go, the latrine woes of Jamna’s family are far too familiar and commonplace. But since the floods last year, the country’s sanitation problems have gone from bad to worse. In Sindh, where nearly 88 percent of the 1.5 million houses damaged by the floods were located, the few previous efforts to provide people in the rural areas with sanitation facilities have been wiped out. In fact, the one and only latrine in Jamna’s village was destroyed by the floodwaters.
“I built an open pit latrine near my house with a structure of mixed mud, wooden walls, and a slab in 2021 for my fellow villagers,” says Chowthram Kolhi, who is the only one in Harchand Kolhi to have completed 10th grade. “The recent heavy rains washed it away and my dream is broken.”
According to the humanitarian-information portal Reliefweb, Pakistan is among the top 10 countries in the world with the worst sanitation, with 79 million of its 232 million people (34 percent) with no access to a “proper toilet.” That means not only heightened health risks for millions of the country’s people, but also problems with security, especially among the women and girls.
Chowthram agrees with the view that everyone is affected by the lack of toilets. But like many others, he thinks that women and girls suffer more than the males because they usually go to the jungle to get away from prying eyes while they relieve themselves.
He says that when his latrine was still standing, “nobody used it except some elderly people because it was in the center of the village so females felt insecure.”
“About two years ago, my daughter-in-law Radha died due to a snake bite as she was going to the jungle barefoot at night,” says Chowthram. “The social security of our women is also at risk because they leave their houses in the darkness. Some four years ago, a 16-year-old newlywed girl was kidnapped and raped in nearby fields when she was going to the forest at night. There are many such incidents happening year after year but all go unnoticed.”
An unhealthy practice
In truth, UNICEF says that although Pakistan has made “significant progress in improving access to sanitation…25 million people still practice open defecation.”
The UN agency also says that “53,000 Pakistani children die annually of diarrhea due to poor water and sanitation.” Repeated bouts of diarrhea can lead to stunting, it adds, and notes that this is already happening to some 44 percent of Pakistani children.
According to the provincial health department of Sindh, 891,915 cases of diarrhea were reported there last year – the highest number recorded in the country so far. For September 2022 alone, Sindh official records show 219,707 cases of diarrhea and eight children’s deaths due to the illness. Majority of these cases occurred in districts badly hit by the catastrophic floods, among them Badin, where Harchand Kohli is located.
“In 2022, 91,966 diarrhea cases in children under five years of age, 134,231 diarrhea cases in children above five years of age and 10,235 dysentery cases in below five years children were reported in District Badin,” says Dr. Wasim Abbas of the Badin District Health Department. “And more than 85 percent of these cases belonged to rural areas of the district where latrine facility is almost next to nil and people are forced to drink contaminated water, which is caused by the open defecation.”
“Shockingly, the number of cases recorded last year were a lot more than the same being reported during previous years,” he says. “And the reason behind such a rapid rise in such cases is because of the number of people practicing open defecation has increased due to devastation caused by recent floods which destroyed shelters, latrines and other infrastructure at villages’ level all over southern Sindh. It’s a catastrophe in making.”
According to Abbas, more than 78 percent of Badin District’s population live in rural areas where open defecation is common. He says that this practice has been causing several waterborne diseases – such as diarrhea, dysentery, cholera, hepatitis A, and typhoid — and that the prime victims of these are children, followed by women.
Shahid Quraishi, who has worked with multiple nongovernmental agencies on WASH (Water Sanitation and Hygiene) projects throughout southern Sindh, confirms that hardly five percent of the population residing in Badin’s rural areas have access to any form of latrines. He says that some villages had been provided with pit latrines by different NGOs, “but that too are almost negligible and a lick and a promise to their issue, while majority of those pit latrines became tumbledown because of the recent floods.”
Adds Quraishi: “There are hundreds of densely populated villages [both of the Muslims and Hindus] in district Badin where not even a single household has a latrine facility and that is due to extreme poverty.”
No money to build toilets
About 37 percent of Sindh’s rural population lives below the poverty line – “higher than the Pakistan average,” according to the World Bank. It also says, “Poverty rates are much higher in some flood-affected districts, reaching 53.4 percent in Badin district.”
Ironically, many households have been driven into more poverty because of medical bills due to waterborne diseases. Says Shanti Kolhi, a mother of five: “My husband works as a laborer in Karachi and he often remains out of the village while we all are confronting abdominal diseases. We are mired in debt as every month we spend more money on buying medicines than on everything else.”
Shanti lives in Alu Kolhi village, also in Badin district, where almost every child is suffering from a waterborne disease. Village head Saroopo Kolhi says that practically everyone in this remote part of Sindh practice open defecation adjacent to a water source. Many people also wash their body parts in that water after relieving themselves, he says.
“We further use that water for drinking and cooking purposes, which makes everyone sick,” he says. “The nearest government health facility is situated around 20 kilometers away from our village and for some time we have been sending a rickshaw filled with sick children and women to the hospital on a daily basis.”
Quraishi thinks that the provision of latrines to the people who lives below the poverty line is the prime responsibility of the state, but it has been relying on NGOs instead of implementing projects on bettering infrastructure in rural areas.
“The government should need to develop a proper drainage system on villages’ level first and then work on providing those villages with latrines with proper sanitation facilities,” he says. “Such a step will not only help rural communities to be healthy but financially sound, too.”
Pakistan has actually had at least two plans to improve sanitation facilities nationwide. In 2011, the Pakistan Approach to Total Sanitation (PATS) was launched, but it never quite got off the ground due to differences among the political parties. In 2018, the Imran Khan administration launched ‘Clean Green Pakistan,’ but it, too, couldn’t be properly handled by the central government due to political biases among the provincial governments.
Asked about the problems the people of Harchand Kolhi are currently facing, village head Genu Kolhi replies in near tears, “This village was established in 1953 by my father and since that time we have not been provided with electricity, education or school, healthcare, safe drinking water, and washrooms. More than 1,000 people of this village have been suffering due to lack of amenities. But the people in power keep turning a blind eye to our issues.”◉
