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Breaking the cycle

by Pierre Béland and France Hurtubise
Poor sanitation, the consumption of untreated water and the recurrence of floods would present a major health hazard in any environment. In most regions in China, they have led to a cycle of water-borne disease.

Today's China is known more for its rapidly expanding urban areas than the vast rural regions that make up most of the country. It is in these rural areas that water-borne diseases are widespread, as improper sanitation and poor health practices are endangering the health and well-being of the people living there. Government figures estimate that 59 per cent of rural households do not have any sanitation facilities. In Guangxi and Hunan provinces, where the majority of people live in agricultural communities, the incidence of typhoid fever and hepatitis A last year were respectively two to ten times higher in these regions than in the rest of China. The occurrence of tuberculosis, roundworms, and liver fluke here is also among the highest in the country.

In 2002, extensive flooding ravaged several counties in Guangxi. The resulting water contamination reached alarming levels. It was in response to this disaster that the Red Cross Society of China (RCSC) and the International Federation initiated a sanitation project, with the objective of upgrading water supply and human waste management, as well as the provision of hygiene promotion and educational programmes.

Over a two-year period, the programme will build 17,400 sanitation facilities, and run health education programmes in Guangxi and Hunan provinces. International Federation delegates work closely with the local branches of the National Society and, together, they recruit and train locally so that both construction and health education aspects of the programme are done within the beneficiary communities.

The Red Cross Society of China offers water and sanitation courses for residents in Guangxi and Hunan provinces.
©France Hurtubise / International Federation


Hope and a dream

Zhang Wang Xing and her family is one of 320 living in Nadang on an inland plateau in Guanxgi province. Until recently, it was still a scene of devastation after last year's typhoon had washed away most of the mud brick houses along with half of the crops. Villagers are now rebuilding in concrete and hard bricks through a government aid plan that covers up to half the cost.

Zhang fills a pail of water from the brand new tap in front of her house and points to her neighbour's: "There is now a tap in front of each house, though we still need to boil the water as it is not safe. We no longer have to walk hours every day to the stream." Indicating a dark area near the ruins of their old home, Zhang points to a new sanitation facility.

Zhang is also a Red Cross volunteer. "I have been a volunteer for two months," she says. "I go from house to house discussing with people about washing their hands after going to the toilet and before cooking meals. I also give out health material and instruct them on the benefits of brushing their teeth, cleaning their house, and boiling water before drinking." At the edge of the village, there is a new government-built rubbish disposal facility. In spite of last year's catastrophe, and although an early summer drought reduced this year's first harvest of rice, there are smiles again in Nadang. Hope, and a dream: to find enough money to use a spring high up in the blue mountains, to supply their new taps with a safe drinking water supply.

Local resources

The local Red Cross sanitation project in Hunan is just beginning in the village of Haoping. At the village entrance, a huge poster is nailed to a wall for all to see. It proclaims the village's determination to improve health conditions, and lists a number of simple habits and measures that everyone can apply to their daily lives. "Wash your hands after going to the toilet", "Boil water before drinking", "It is your own health that is at stake". Several people have already benefited from the programme, such as Mong Qing Tai, 65, and his wife. They have 264 square metres of rice, watermelon and vegetables. And a new sanitation facility. "The facility is built right here in the village," he explains.

In the village school's central yard, a middle-aged man mixes sand and cement. He then fills the two baskets attached to his shoulder pole, lifts them and, legs slightly bowed, takes his heavy load inside. In a temporarily modified classroom, two young villagers have finished lacing the inside of a mould with steel rods. Together, the three pour in the fresh cement. They are making the roof for a new Ecosan toilet. Through the window overlooking the yard, there are 63 of these concrete slabs with a hole to one side to receive the ventilation pipe that will send fumes outside the house. Mong adds: "All materials were obtained locally."


An envied success

Last year, the Red Cross water and sanitation programme successfully installed 3,900 sanitation facilities in 28 villages of Guangxi province. In each village, teams have been formed as Red Cross volunteers to convey basic health knowledge and encourage practices that are consistent with the new equipment. These are directly reaching 83,123 beneficiaries. In almost every participating village, residents agree that the incidence of diarrhoea, skin rash, and parasitic diseases was down. By the end of 2003, a further 13,500 facilities will have been installed in Guangxi and Hunan.

The programme has been such a success that many villages are now contacting the Red Cross to become participants. In a small village, Wuyi, near the capital of Guangxi province, Nanning, the residents are hoping to take part in the programme. Inhabited by Hans, who are the overwhelming ethnic majority in China, the village boasts a meeting hall, and the know-how to build whatever they need. The village authorities proudly show a visitor the new concrete road snaking through their community. "Before this was a muddy lane. The government donated the cement and we built it ourselves," explains one of the government officials. "This way, we can keep our village and houses clean. We are planning to upgrade our water supply system, and the new toilets and health education programme would be the final element to complete our sanitary renewal," he adds.

The Guangxi and Hunan branches of the Red Cross Society of China have proven very capable of implementing the installation of the dry hygienic toilets and providing health education. In the words of Professor Fong, president of the Guangxi branch of the RCSC: "The benefits of having a health education component based on participation are that it encourages and develops community participation and involvement in decision-making." Furthermore, this endeavour prepares a niche for local branches of the Red Cross Society of China to implement future programmes at the community level.

Hen fangbian

"Very practical." This is invariably the first answer given by beneficiaries when asked about the benefits of the new facility. In a way, this may be the key to the success of the programme. With such pragmatic people as the Chinese farmer, that may in the end be the best guarantee that the project will continue to grow. What is practical always ends up being adopted. And, in this case, the health benefits that come along with the Ecosan toilets are guaranteed to spread and have a definite impact on improving the livelihoods and health of thousands of hardworking farmers in southern China.


Pierre Béland and France Hurtubise
Pierre Béland is a freelance journalist. France Hurtubise is International Federation regional information delegate based in

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