WATER AND SANITATIONIN UNICEF 1946-1986

UNICEF HISTORY SERIESMONOGRAPH Vlll

‘75/2+/b),,

THE AUTHORMARTIN’ G. BEYER as Senior Policy Specialist (Drinking Water and Sanitation) at UNICEFNew York Headquarters is, since 1973,responsible for co-ordinating UNICEF’S activities worlti-wide in water suppl y and sanitation. In 1972-73 Beyer held the post of UNICEF Deputy RegionalDirector for the Americas in Santiago, Chile. Prior to that, he worked for twenty years as a geologistwith minerals and groundwater exploration in Alrica, the Americas and Europe. Beyer, a citizenof Sweden, is an Honorary Fellow of the Institution of Publ ic Health Engineers (London) and an

Adjunct Associate Professor at New York Medical College.

THE EDITOR

JOHN BALCWVIB worked for UNICEF for 20 years, first as feature editor in the publicinformation department at HQ and subsequently as chief of regional intbrmat ion and communica-tion services in New Delhi (1967- 1973)and Nairobi (1973- 1981). He retired in 1981and has sincelived in upstate New York.

@ Copyright United Nations Children’s Fund. (Mobcr, 19&7.

The opinions expressed in this publication we not necessarily thnsc d’ UNICEF.

CONTENTS CF/HIST/HON/87-O08

WATER AND SANITATIONIN UNICEF 1946-1986

ForewordHartin Beyer

Editor’s Note

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I. UNICEF’S ROLE IN WATER AND SANITATION

Looking back from a unique award 2UNICEF’s role’is two-fold 3Technological’tand,socialstrategies 4

:The tekhnological~background 4

:Social approaches 5:Hanagementand support 6

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II. DE~ELOPHENT

Three phases

Demonstration Projects

THROUGH THE DECADES: LEARNING FROH EXPERIENCE

1968-1980: Going to scale -- New technologies, ambitious targetsI

I

UNICEF involvementthrough emergenciesThe big push in Asia

‘:Vi’llagewater supply in India -- ‘Amodel programme:The arrival of new drilling methods:The handpump problem: The India mark-II handpump:Sanitationin India: The Gandhi legacy:Bangladesh- Sludging tubewells by hand:Pakistan- Follow-up to a flood:Burma’s dry zone:Gravity feed in Nepal and Afghanistan:Hoving away from conventional schemes elsewhere in Asia:Indonesia- An integrated approach

Africa: The challenge of drought and famine:Reinforcingjoint ventures in West Africa:East Africa:Ethiopia- Dealing with a catastrophe:Sudan and the “Donkey Pump”

The Hiddle East:Lebanon - Clearing the minefield for water pipes:A transition to modern times in Yemen

The Americas region

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1111-211112141517181919202122-262323232527-29272829-31

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CONTENTS

:The Caribbean:CentralAmerica:Hexico - Transmitting to the Tzotzils and the Tzeltals:Peru - Children in sackcloth:In Paraguay - The poetry of clean water

1980-1986. Clarification of objectives: integrationwith PHC and “Child Survival and IhSVelODSIent Revolution”.

Changing insights and new developmentsNew light on social and economic factorsFurther technologicaldevelopmentsNigeria -- Imo State: imagination and innovationIn ‘Africa- The struggle continues

l:lTheWestern SahelI :West A~rica lsouthof the Sahel

:EasternAfrica:Somalia,Uganda:Djibouti,Kenya:Tanzania and others

Middle East and North Africa - A widening scope:Egypt ~

Asia:China - remarkable development, enormous needs

I :Indochina,Burma:Pakistan - a considerable expansion:India - diversification and expansion:Sri Lanka - strong community participation

The Americas - urban urgency

111. SUNNING

Children, Water and the EnvironmentThe health factors - new insights

UP AND OUTLOOK

The remedies: a revolution in-technologiesand social awareness:Social approaches:Finance and administration

International action and UNICEF’s roleOutlook

ANNEXESAnnex I: Statistics

II: Selected bibliographyIII:Index

3030303131

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3334353637-4338394040414243-444444-48454647474849

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5253535454

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iFOREWORD

Water supply and sanitation are two of the most basic services for humanity.They are so basic that in many of the wealthier areas of the world they aretaken for granted by everyone but the administrators,engineers and plumberswho manage the treatment plants, the water distribution networks, and theaccounting.

Not so in those parts of the world where water has to be fetched from distantpools, green with algae and containing an assortment of harmful organisms andpollutants; where sanitation for women and children may be no more than acorner of the courtyard;:and for men a clump of bushes in a field just outside.

Where infants and childrlenare concerned, access to a sufficient quantity of ,water and a clean place ,todefecate, along with hygienic practices to keep I,bodyand surroundingslclean,is a major step leading from illness and miseryto health and well being. For their parents, especially their mothers, itsignifies hours of labo~ ,andenergy saved for better care of the children,better chances for education, and higher productivity.

This is why UNICEF has had these components of basic services on its agendaalmost from its inception. It is why UNICEF is today one of the world’s majoragencies supportingwater and sanitation prograrmaesin the developingcountries. UNICEF is involved in such programmed in almost 100 countries,stressing simple technologies and social strategies linked with other UNICEFactivities in the fields]of health, nutrition, and education.

A number of coincident factors have been involved in the path leading toUNICEF’s present substan~ial consnitmentto water and sanitation. A sharp jupturn in its involvemen~was initially prompted by emergencies. It was ~maintained by urgent government requests and great interest and generosity onthe part of donors, great and small. The present monograph tries in anutshell to trace this d~velopment, part planned, part spontaneous. All thatcan be said without fear’of disagreement about UNICEF’s involvement in thisfield is that there was never a dull moment.

The present monograph was evolved from a considerably larger and more detailedaccount: “The WET History - Water Supply and Environmental Sanitation inUNICEF 1946-1986”, UNICEF WET Holographs No. 2. It is a happy coincidencethat as the editor of the qresent version, John Balcomb was chosen. His ownbackground of many years w~th UNICEF in Africa and other parts of the worldhas given him a special understanding and enthusiasm, and thus greatly helpedinfuse our WET (Water and Environmental Sanitation Team) spirit into thisvolume along with keeping it more along linguistic lines preserving thedignity of the great language of Shakespeare and Hilton.

The reader is thus welcomed to a world of handpumps and VIP latrines, a worldpopulated by water well drillers, sanitarians, village-basedworkers, andchildren, children, children, whom we all wish to see clean, free fromdisease-bringingdirt, happily frolicking in splashes of clean, safe water.

Hartin G. Beyer

iiEDITOR’S NOTE

As Hartin Beyer has pointed out in his foreword, the present monograph is amuch abridged version of his “WET History” produced in 1986 -- WET being thesnappy acronym devised by him to signify the Water Supply and EnvironmentalSanitation Te,amat New York headquarters and, by extension, the wholeglobe-girdli~g UNICEF programme in that field. The “WET History” runs toabout 80,000 ~words. To fit it into the regular UNICEF history monograph’series I hav~ rather brutally cut it to about 2S,000 words, without, I hope,too greatly qiolating its spirited spirit and conversational flow. Xyllongestcuts involved statements and discussions of present policies that can easilYbe sought elsewhere in UNICEF’s documentation. I have also -- regretfully -- ihad to forego most of Hartin’s references to the very numerous individuals whoplayed variods roles in the “WET History”. His index includes more than fourhundred proped names -- a very full roll-call indeed. I hope I have notunduly hurt anyone’s feelings by leaving out so many of these personalreferences.

I had the privilege of working in UNICEF’s New Delhi Office from 1967 to 1973,the period when UNICEF’s village water supply, operations “went to scale” inIndia, launching a chapter in UNICEF assistance that was to reach almost 100countries around the world. It was, as Hartin Beyer’s account suggests, anexciting timelindeed, and I hope some of this excitement comes through in thepresent editefltext.

I

I John Balcomb ~

PART I -- UNICEF’S ROLE IN WATER AND SANITATION

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Looking back from a unique award

On June 15, 1985, UNICEF received a unique award: a huge clear drop of BelgianVal St. Lambert glass crystal, for its decades-long efforts to help put waterresources to good use by communities in the poorest areas of about a hundredcountries in the Americas, Africa, Asia and the Pacific. The occasion was theFifth InternationalWater Resources Congress in Brussels and the speaker who ‘presented the “Crystal Drop Award” to UNICEF -- the first organization toreceive it -- was Dr. Alexander King, president of the Club of Rome, thefamous association of scientists from 45 countries concerned with the futureof humanity.

UNICEF’s involvement in community water supply and sanitation had by that timebecome one of its largest and most visible activities. But it was just partof its efforts to help ensure the survival, health and well-being of childrenand -- by implication -- their mothers and the rest of their communities. Andwhatever it was achieving in water and sanitation in cooperationwith assistedgovernments would not have been possible without interaction and linking amongvarious child-relatedsectors, including health, education, food andnutrition, and social welfare.

UNICEF has now (1987) been involved in water and sanitation for more than 30years. Its really large-scale involvement in progranunestending towardnation-wide coverage goes back almost twenty years. In some countries,notably in south and south-east Asia, there is a good chance that mostinhabitantswill have access to a satisfactory if not luxurious supply offresh water for drinking, personal hygiene, and other domestic purposes.Sanitation is lagging far behind for a number of behavioral and other reasons,,but it has at least become an issue, with some countries trying to tackle it 1on a large scale.

The environmental and other problems of our globe appear quite overwhelming,particularly in view of the present, still-continuing increase in the world’spopulation. UNICEF’s inputs, as compared to those of governments,communities, and other agencies, are very modest. But actions to overcomenegative situations do stand a chance of a breakthrough when improvementsbegin to be continuous and when countries and communities begin to manage on ,their own. This is clearly visible in the field of water and sanitation.Within months of its launching, a community water supply scheme can show rapidprogress not only in the provision of safe water itself but in terms ofpeople’s awareness of its importance and usefulness. In terms of a morelasting effect on communities and governments, including proper organizationand upkeep of the installationson a nation-wide basis, things may take a gooddeal longer -- ten,to fifteen years or more.

UNICEF’s expenditure for water supply and sanitation in 1985 reached $58million. This was spent in some 95 countries. The amount of UNICEF fundsspent in water supply and sanitation programmed from 1947 through 1985 adds upto approximately 500 million dollars. Total funding for the sameUNICEF-assisted country programmed, including government and community inputs

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as well as other external contributions, are on an order of magnitude ofseveral billion dollars.

In recent years 15-20 million people per year have benefitted directly from‘theUNICEF inputs in water-supply schemes, as against 2-4 million peoplebenefiting from similar inputs in sanitation. The total number ofbeneficiaries from all the water and sanitation programmed with which UNICEFhas been involved in some way is estimated,on the oyder of 150 million. How

?much still remains to be done is suggested by the fa.t that an estimated 1.3billion people still lack adequate household water s pplies and 1.9 billionpeople lack adequate sanitation.

II I

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UNICEF’s role is two-fold

First, water and sanitation are seen as basic needs. Without water peoplecannot survive. Without sanitation people and especially children are leftmuch more vulnerable to the risk of infections through a number ofcommunicable diseases, including many forms of diarrheas and skin and eyediseases. UNICEF inputs in these fields supplement other actions for thesurvival and development of children and help demonstrate the effects andimportance of using simple, low-cost means. 1

Second, UNICEF in close coordination and cooperation with otherinternationallyactive organizations -- given the limited funding andtechnical expertise available to the group as a whole-- helps meet a major Ineed. This pertains especially to many of the poorest areas in developingcountries, where few other external organizations venture or would be allowedto work. Beginning in the 1970s, UNICEF played a distinctive role in pushinglow-cost technologies,whereas most of the others were concentrating on highertechnologies suitable primarily for urban systems.

In keeping with its general goal of improving the well-being of children andwomen, UNICEF therefore supports the development of drinking-water supply andimproved environmentalsanitation,in rural areas, urban slums, andshanty-towns of developing countries. It seeks to build national capacitiesthrough the provision of technical, financial and material support to nationalplanning and programming for water and sanitation, including communitymobilization and health education, as part of primary health care.

Water and sanitation projects tend to be capital intensive. This posedspecial problems for UNICEF with the spectacular increase in activities thattook place in the 1970s. Thus, in 1969 UNICEF expenditure on water andsanitation came to $2 million. By 1982-1984 yearly expenditure was toppingout at around $70 million. With such a demand for funds, UNICEF could notrely on its regular budget alone. This led to the necessity of meeting anincreasing part of the water and sanitation requirements through supplementaryfunding, principally through “noted “ projects which could be adopted by oneor more donors. In 1985 such special contributions accounted for 55 per centof all funding for water supply and sanitation. Fortunately, there is aninherent drama about water supply projects, and the efforts of UNICEF’s

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Programme Funding Office, at first under the leadership of a flamboyant Dutchhistorian named Victor Beerman, were notably successful in “selling “ theprojects to donors. (It was said of Beerman, that his powers of persuasioncould make stones weep.)

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Technological and social strate~ies

Part II of this history, “Development Through the Decades “, traces the growthof UNICEF’s increasing involveisentin water and sanitation and the evolutionof its policies from 1946 to 11986,a ~eri’odof 40 years. Here will be foundaccounts of the technological,

[social, and other challenges that were

encountered and, to a certain degree, over ome on a region by Iregionandcountry by country basis. The relative independence of UNICEF”S field officesand the flexibility allowed to country, area, and regional representativesencouraged the design of programmed and projects taking into account a widerange of local needs, conditions, and resources. At the same time certaincommon, overall strategic principles emerged which it may be well to stresshere at the very beginning.

:The technological background

The many hundreds of millions of people’livingunder conditions of extremepoverty in physically difficult terrains who have need of water and sanitationpresented a seemingly ihsoluble problem. The first step taken was to identifyand develop technologieswhich would allow for low-cost approaches and make itpossible for the communities themselves to undertake a part of the I

construction work and take responsibility for the use and upkeep of theinstallations, including their operation, maintenance and repairs.

Fresh water, a renewable resource in theory, is not readily availableeverywhere. Surface waters, with few exceptions, are contaminatedwithdisease-carriersand are often available only during ’therainy season.Consequently, the solution had to be sought in using groundwater occurrences,through digging or drilling wells, or, in hilly and mountainous regions byharnessing natural springs. Groundwater furthermore has the advantage ofbeing filtered by its passage through soil beds and rock formations.

During the 1960s a technical revolution took place in water well drilling withthe development of rapid compressed air drilling methods and otherimprovements, e.g. the application of hydraulic drive heads in rotary drillingand the use of new additives to the drilling media, such as polymers, forstabilizing borehole walls. With the rapid spread of water well drilling,handpumps had to be improved for continuous heavy use by hundreds of villagersfor each pump. For piped schemes, new plastic products provided longer lifeand easier handling. Old “appropriate “ technologies for water treatment wererevived, like slow sand filtration. New insights in the epidemiology ofwater-, excreta- and other dirt-related diseases, combined with developmentsin East Asia, Southern Africa and Europe, prompted new designs of excretadisposal facilities.

All these changes were incorporated in the technological approaches followedin UNICEF-assistedprogramme projects. They were made prominent parts of the

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new programme strategies towards the end of 1960s. Also, they made itpossible to attack the problem on a much larger scale than was possible before.

:SOCial auDroaches

The technologicalrevolution that would make it possible for the benefits ofwater and sanitation to reach unserved populations called for a new approachto potential users and their communities. The recognition of this need ‘coincided with what was developing in the other fields of UNICEF-related work.’

1 I (At first the introductionof new “hardware”-oriented technologies to ruralareas had tended to overlook the human dimensional Government drilling teamsrushed in with mighty machines, drilled holes in the ground in a jiffy, ~plunked in their handpumps,and then left, leaving the villagers to fend for Ithemselves. The results were often disastrous. Thousands of p~ps would soonfall into disuse, broken or idle for want of maintenance and repair.

The communities had to be stimulated into turning external assistance intoself-help. Age-old social structures, habits, attitudes and beliefs had to beredesigned for a two-way traffic of ideas and inputs. A number of majorissues had to be tackled jointly, including the need to integrate the watersupply and sanitation components with those of the other fields: healthservices, education, family food production, and nutrition.

With the need recognised for promoting community motivation and’participation(now known as “social mobilisation”), new elements such as Project SupportCommunicationwere incorporated in UNICEF’s work. Another favorable factorwas the development and application of Primary Health Care (PHC). Elements ofhealth and sanitation education and women’s advancement were added. Part ofUNICEF’s basic services approach from the outset, they were not easy to putinto practice in country programmed. One major reason for this was that ruralwater supply was usually dealt with separately from other aspects of communityand agriculturaldevelopment. UNICEF advocacy for integrated servicesforeshadowed practices now accepted by most governments.

These developments coincided with the beginning of the International DrinkingWater Supply and Sanitation Decade (1980-1990),and in the country conferencesand seminars that followed, the elements of social mobilization were stronglyemphasized.

An important developmentwas the introductionof stronger health educationcomponents in country programmed. Though the need had been perfectly obviousto anyone visiting field projects, health education, until a beginning wasmade around 1979, had been rarely linked to water and sanitation programmed.A kind of breakthroughwas achieved when a senior specialist in healtheducation was dispatched to a difficult project area in Pakistan. Theofficer, a female health educator, started a completely new trend bysuccessfully promoting sanitation teams consisting of men and women forvillages in rural Pakistan. Health education efforts have~bsequently creptinto other country programmed, though not as universally as would bedesirable. The trend is now to combine the health education elements of waterand sanitation programmedwith the promotion of other health elements, notablychild survival actions.

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Water and sanitation are basic concerns of women. They are thetraditional carriers of water, devoting a large part of their time andenergy to this arduous task. For hygiene and privacy, both for themselvesand for their families, they are dependent on adequate sanitation.Women’s participation in planning, implementation,and,maintenanceofwater and sanitation facilities can become a major factor in improvingtheir status in the community.

Women’s involvement is closely linked to human resources development,,,

which includes the training of a wide range of peo~le in’planning,management and implementationof water and sanitation-relatedwork. Theskills and capacities being developed in different countries includethose of villagers as well as government officials. Curricula includenot only technical matters but anything that helps bring water andsanitation to the people.

:Hanagementand support

A good part of UNICEF’s achievements across the board are related to itseffective management and support structure. The magnitude and strongtechnological orientation of the organization’swork in water andsanitation placed particular demands on backup along these lines. From1980 on, UNICEF developed a strong staff support structure for planningand implementationof water, sanitation, and later, hlealtheducation. By1985 this consisted of 130 specialists in 30 field offices. Backstoppingand coordination is provided by the small WET section (Water andEnvironmental Sanitation Team) in the Programme Development and PlanningDivision in New York.

The work of the field specialists has been critical to the success ofUNICEF’s assistance. Experience has shown that once UNICEF’s inputsexceed a certain threshold (as a rule of thumb, around $500,000 per year) ‘a specialist’swork pays for itself in better planning and programmingand in increasing efficiency in the use of equipment and supplies. Forall practical purposes, these colleagues are an integral part of thefield offices where they serve.

Over the last twelve years, WET has gradually become a focal point forthe exchange of information between UNICEF, the Field Offices, otherorganizations, suppliers of equipment and materials and interestedindividuals. There has been an unending stream of documentation andmessages, especially useful in the ‘70s,when there were only a feworganizationsdealing with low-cost approaches.

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PART II -- DEVELOPMENT THROUGH THE DECADES: LEARNING FROH EXPERIENCE

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THREE PHASES “

UNICEF’s involvement in water and sanitation over the organization’s first 40years, 1946-1986, evolved through a process of trial and error.and reflectedthe major trends and shifts in UNICEF’s overall activities and policies.There were three distinct phases:

1’

I I II ANNUAL UNICEF FUNDINGPHASE PERIOD CHARACTERISTICS

(US$ dollars)

I

I. 1946-1967 Demonstration projects Less than $2 million

II. 1968-1980 Development of technologies% $2-$50 milliontargets and policies

III. 1981 through Clarification of objectives Over $S0 million1986 and links with PHC and CSDR

I )

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DEHONSTRATIONPROJECTS

Phase I (1946-1967)began with scattered efforts in the rural areas of a fewcountries, as it was increasingly realized that child health was dependenton safe water supply and;adequate sanitation. There was a closecollaborationwith WHO at the country level for technical backstopping. Thevolume’of work and the number of beneficiarieswas small. The outcomeprobably led more towards gaining technical experience for the UNICEF’fieldoffices than to providing a lead in the development of national policies andprogranmes for water!suppl’yand sanitation. It was during this period thatthe first two WHO/UNICEF Joint Committee on Health Policy (JCHP) studies onwater and sanitationwere prepared., These laid the groundwork for the jointpolicies which govern UNICEF’s actiionon a much larger scale today.

I IIn this “demonstrationproject” phase, UNICEF aid was at first restricted towater supply and sanitation in health care facilities and in schools. Someof the earliest programmed were inlCentralAmerica. The first project to beassisted through pumps and stipends for the training of sanitarians was inPanama (1954). Within five years assistance in the form of supplies andtraining stipends had been extended, with WHO technical approval, to 33projects, 18 of which were in Latin American, the others scattered overAfrica, the Hiddle East, Europe, South-East Asia and the Western Pacific.

During this period perceptions about water and sanitation were stillconditioned by the notion of large public works, into which UNICEF resourceswould have vanished liked a drop in a bucket. The idea, therefore, was thatUNICEF assistance should act as a “catalyst”,establishing a model for muchlarger’lprojectsfunded from national budgets and supported by better-endowedbilateral or multilateral resources. In some instances, this strategyworked. In Peru, for example, a WHO/UNICEF-supporteddemonstration projectin a small area led directly to government adoption of a national scheme tobring gravity-fed piped water to every village, with the help of externalloans.

But the results were not uniformly encouraging, as was revealed in a surveyundertaken at the request of the 1965 Executive Board -- a survey whichincluded on-site evaluations in eight of the 80 countries with wholsewaterauthorities UNICEF was cooperating. In West Pakistan an ambitious programmeto provide water to a thousand rural communities had overextended theresources of the public health engineering department, and much of theequipment brought in by UNICEF was lying around unused. This wasembarrassing since this was the largest water programme UNICEF had supportedup to that time,

In most cases it proved unrealistic to expect that a demonstration projecton a small scale would blossom into a national rural water grid: by andlarge the governments concerned simply did not have the resources, nor didthey attach a high priority to rural water supply and its essentialconcomitant, rural excreta disposal. Heanwhile, however, the “customers”for pipes and water -- the villagers of the developing countries -- werekeen for water, and they usually co-operated in “self-help” and “communityparticipation” schemes to cut the costs of water projects through voluntarylabor for digging wells or trenches for pipelines or carting stones forcatchment dams. But usually the village people valued these new sources of

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water as a convenience,not a health aid. This dichotomy between water asan engineering achievement and as a bringer of health haunted water supplyand sanitation schemes then and has continued to do so down through theyears.

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1968-1980: GOING TO SCALE -- NEW TECHNOLOGIES, AHBITIOUS TARGETS1

Phase II (1968 - 1980) saw UNICEF entering the village water supply field ona large scale as new t’echologiescame on the scene, as national targets wereset, and as new policies;were elaborated. This was the period during whichUNICEF took off to becomb one of the major, if not the major, externalagency in promoting the new technologies and strate~s to help the poorestareas in the world to obtain safe.water and sanitation.

A number of major trends could be noted:

* Host of the large government programmed with UNICEF input began withrelief operations in emergency situations. These were ‘rapidlyturnedinto rehabilitationof the affected areas. Finally, installationswere carried out so as to serve longer term goals. The ground waslaidfor achieving nation-wide coverage, eventually codified underthe targets of the Water Decade.

* During the latter part of the period, environmental sanitation,notably excreta disposal, began to win greater acceptance amongpeople and politicians in some major countries. Limited countryexperiences in health education linked with water and sanitationbegan to spread to other countqies.

* The feasibility and acceptability of low-cost technologies for bothwater and sanitation was established. A technical revolution inwater well drilling methods was accompanied by new concepts forhandpumps and new materials and standards. Likewise, waste andnotably excreta disposal were influenced by new ideas and newunderstanding of disease transmittal. All of this made possible amore rapid spread of water and sanitation among the millions, nay,billions of people, who urgently needed such services.

* After a number of haphazard and improvised starts, valuabletechnical, social, planning and programming experience accumulatedthrough various national progrsmmes. This body of experience wasreflected in joint UNICEF/WHO policies which could be applied tofurther programmed.

* National governments, along with international agencies --intergovermental,bilateral, and voluntary -- began to coordinatetheir efforts in an organized manner.

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UNICEF involvementthrough emergencies

The year 1968, which marked the beginning of large-scale involvement ofUNICEF in water supply, was the year when the government of India came withits first request for large-scale assistance to the then newly-conceivedIndia village water programme. It was prompted by the drought in theEast-Central India States of Bihar and Orissa in 1966-67. This catastrophewhich was accompanied by widespread famine threatened the lives of millionsof people. As in other droughts, the effects were caused by an unholycombination of the absence of rainfall for consecutive years, adeterioration of the soils and the vegetation through overworking by asteadily increasingpopulation, and the absence of technical medns andknow-how to tap the underground water resources. ,

I

The Bihar and Orissa drought was only the first of a series!of emergenciesthat, during an eight to ten-year period, would draw UNICEF willy-nilly, toa much greater extent than had been or~ginally foreseen, into assistingWater supply and later sanitation programmed. The drought.in India wasfollowed by the horrors of the liberation war in Bangladesh, which resultedin the widespread destruction of whatever infrastructurehad existed in theearlierEast Pakistan -- a catastrophe further compounded by enormous floodswhich followed,shortly thereafter. Other emergencies which acceleratedUNICEF’s involvement in water and santation inclludedthe Indus River floodsin Pakistan’s Sind province in 1972, the great S,aheldrought emergency of1972-73 in Africa, and subsequent civil strife and warfare in severalAfrican countries, including Sudan, Hozsmbique, and Angola. The emphasis tobegin with was on water supply, for inlthese emergency situations the firstconcern was survival. It was only toward the end of this period, whenprogrammed were growing to national scale, that in some important projectssanitation and health education began to receive their due consideration.

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The big push in Asia, 1968-1980

:Villagewater supply in India - A model programme

Since India was the country where UNICEF’s large-scale cooperation invillage water supply began, early developments in that country merit asomewhat detailed description. UNICEF’s input in India was the first to becarried out in cooperationwith a government that, from the outset, wasaiming to provide its poorest populations with reasonable access to safewater on a nationwide scale within a scheduled time frame. It was also inIndia that the first coherently planned programme for water well drillingalong with handpump installation took shape. The India village waterprogramme since then has served as a model, both technically and from aprogramming and strategic point of view, for developments in other countrieswith similar conditions.

Among the many problems besetting rural water supply in India are thehydrology and hydrogeology of that country. Year-around sources of surfacewater are limited to few and far-between rivers, the same rivers being usedboth for ’watersupply and as deposits for all sorts of waste. Over largeparts of the country there are small and large dams (“tanks”)which serve

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for irrigation, cattle-wateringand household purposes. These are normallyfilled during the monsoon period, but most of them are empty after a fewmonths of use, with easily another six months to go to the next rains. Foryear-around use, most of the rural people have traditionally dug openwells. Hany of those are so-called step wells, some of them very large,which could be likened to inverted pyramids. Hany are very old, someprobably pre-historic. They were excavated when the population of thesub-continentwas far less numerous, when there was much more protectivevegetation and soil cover, and when the groundwater was not being tapped atthe rate it is today. Thus, the water table lay much higher and couldreasonably be relied upon for an all-year-round supply.

With the tremendous population increase, especially during the last forty tofifty’years, the forests were largely fellbd to yield room for increasedacreage and for construction and fuel wood. Hoderm industries, large andsmall, were introduced,many of them also in the countryside. Farmers whocould afford it had deep wells drilled and power pumps installed in order toincrease their crops. All ok this contributed to drawing down the watertable catastrophicallyfor the open wells and the communities using them.

With the lowering of the water table, the open wells could not be deepenedwith the few hand-tools available to the villagers. During the early 1960s,attempts were made to develop methods with light-weight rigs (“benchdrills”) to drill horizontally through the rocks at the bottom of the openwells to open new channels for groundwater (“revitalization”). This was atemporary success but did not really improve the overall situation. Inaddition there was the problem of pollution of the water in the open wells-- especially the step-wells~ where every day hundreds of villagers climbeddown to fill their jugs and jars.

The boundary between the hard rock formations that underlie the largest partof India and their very irregular cover of softer, weathered and alluvialsoils roughly marks the old water table which was running dry. When thedrought in Bihar and Orissa hit these unfortunate states, it exacerbated asituation which already caused problems all over the country. People wouldhave to try to get to deeper occurrences of ground water. Short of blastingshafts into the underlying hard rock, an exceedingly expensive and difficultprocess, the only possibilitywas to drill water wells.

Up until about 1960, only slow drilling methods were available. One wasthe so-called “calyx”method, in which slowly rotating steel pipes wereworked into the ground with steel shot added to wear down the rock. Itcould take a year or more in one hole to reach the required depth. Theother method was cable-tool drilling, which with the old-fashionedequipmentavailable in India could take three to four months to drill a “tubewell” toa depth of 50 metres (150 feet).

:The arrival of new drilling methods

Just in the nick of time, it proved possible to alleviate some of the worsteffects of the drought in eastern India through new drilling methods. Inthe early 1960s, rigs driven by compressed air that could cut throughhard-rock with percussion hammers were used for the first time, in a fewcases, to drill water wells. Such machines had been used since the

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beginning of the century to drill blast holes for mining and engineeringconstruction. But only with new advances in metallurgy (especiallyfor thedrill bits and drill steels) and in pneumatic and hydraulic machineengineering was it possible to drill holes to the depth required foreffective well drilling. The new technology had only recently proved to bea feasible one in a few industrial countries, such as Sweden, the UnitedStates, and Canada.

In India, several non-governmentalorganizationswhich dealt with 1agricultural development such as War-on-Want, AFPRO (Action for FoodProduction), the Betul Hovement and others had imported a few of these rigsfrom different manufacturers. The first use of down-the-hole hammerequipment was introduced by the Reverend John HcLeod, a Church of Scotland;missionary,in the early 1960s. The new rigs successfully drilled wells toa depth of 50-metres in hard rock, such as gneiss or granite, within a shiftof eight hours. At the same time, some of these non-governmentalorganizationspioneered new types of handpumps that would stand up better tothe wear and tear of the hundreds of’villagers using them at each waterpoint.

During the drought in Bihar and Orissa, some of these NGOS rushed theirdrill rigs to those unfortunate States and began water well drilling. Eventhough they represented only the literal drop in the bucket, these drilledwells were an instant success. Among those who brought in drill rigs wasHalcolm Kennedy, a New Zealander who worked for one of.the NGOS, AFPRO, andwho was shortly to head UNICEF’s water section for India. In Bombay, ayoung.Indian mechanical engineer had just set up ‘hisown contracting firmwith two very small drill rigs, intending to drill relatively shallow wellsin the backyards of Bombay households. He had hardly established his:business when he was engaged by UNICEF to bring his small rigs to Bihar -along with their compressors - and to begin punching holes in the ground andinstalling handpumps in some of the worst affected areas. This was KumarJagtiani, who thus became one of the two pioneers, along with Kennedy, inUNICEF’s involvement in low-cost water supply for villages in hard rockareas.

The instant success of the new rigs was impressive, and the UNICEF regionaloffice saw and grasped tlieopportunity for a much greater breakthrough.Consultationswith the responsible authorities in India led to an officialrequest by the Government that UNICEF provide 70 or 80 air-hammer drill’’rigsfor the beginning of a nation-wide village water programme. It aimed, inthe first instance, to fill the water supply needs of the approximately125,000 villages that formed the absolutely poorest and most under-served,or totally unserved, communities in India, out of a total of 650,000villages in the entire country.

Feeling it needed a “second opinion” for what was for it a new field ofaction, UNICEF first approached WHO which was asked to set up a fact-findingmission of specialists to visit India to assess the situation and makerecommendationson the drilling progrsmme. Because of the new technologiesinvolved, it was evident, however, that it would take WHO a long time tofind the necessary specialists. With India’s urgent request on the table -which foresaw UNICEF assistance of some US $5 or $6 million over three yearsbeginning in 1970 -- UNICEF felt it could not wait so long. It turned to a

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Swedish firm, Terratest AB, consultants and contractors for minerals andgroundwater prospecting, to carry out the assessment. The report of theTerratest mission was to serve as background information to the 1970 sessionof the Executive Board for its decision approving the project - a projectthat would constitute UNICEF’s largest single programme input anywhere up tothat time. The objectives were quite clear, although the targets in thosedays seemed formidable. No one had ever been confronted with a situationthat already for’the first two or three years of the programme foresaw thedrilling of over ’8,000wells in the State of Andhra Pradesh alone, not tospeak of some vague plans for 25,000 more wells in Orissa. Nobody thencould foresee that something like 100,000 wells for handpump installationwould be drilledannually in India. The risk that UNICEF took by supportingthis first really major part of the programme, was considerable. But, as,Gordon Carter, then UNICEF’s Regional Director, recalls, “The first lot ofrigs were literally nursed onto the job by our people, and even as numbersgrew, programme and project staff kept a pretty close eye on them.” Thedrilling programme as it rapidly expanded was an outstanding success.

:The handpump Problem: the India mark-II handpump

With the exception oi a handful of master drillers to be brought in byUNICEF for several years to train national drillers, it was foreseen thatthe Government of India would handle the rest of the programme, includinginstallation of handpumps, sanitation and sanitary education, on its own.It soon developed, however, that the handpumps which were to be fitted tothe new village wells presented a considerable problem in their own right.No one in the world had had much experience in the use of deep-wellhandpumps by larger village populations on such a scale. There were a fewwater well drillers and handpump manufacturers in the world’that had come upwith relatively good solutions at a much earlier stage. Among them was theCraelius East African Drilling Company with its so-called “Uganda”handp,ump. It was made of standard hardware and had a giant mahogany handleand could be repaired and maintained locally. Host of the handpumpsavailable in India and manufactured there in those days, were cast ironpumps of the traditional type as developed in Europe and North America forsingle-farm households. They were fine for families of a few persons and atotal use of a,few minutes per day. No provision to speak of had been madefor any’organizedmaintenance and repair of such pumps. Everyone just wentoptimistically into this whole programme.

Hartin Beyer, who along with Alge Hessing, had made up the Terratest surveyteam, later joined UNICEF and in 1973 established the nucleus of the Waterand Environmental Sanitation Team (WET for short) at Headquarters in NewYork. One of his first visitors was the director of RiiddaBarnen, theSwedish Save the Children Fund, who had just returned from India with analarming report of the very high proportion of village handpumps which wereout of order in the UNICEF-aided water projects he had visited. This wasdisconcerting intelligence indeed. But in the meantime, UNICEF in India hadbeen monitoring the whole situation and were working hard on solving theproblem.

Two convergent approaches were chosen. One was to improve the materials anddesign of the handpump. The other was to secure proper operation,maintenance and repairs of the pumps, which was a matter requiring major

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,improvementsin the social approaches to the villages and the villagers.The persons who mainly contributed to the development of the India Hark-IIhandpump, which was eventually adopted as a national standard,were RupertTalbot, a young British engineer, who was to become one of UNICEF’S mostexperienced specialists in water well drilling cum handpump programmed, andan Australian rural water supply specialist, Ke~cLeod (now a consultant toUNDP/World Bank). They started with a handpump that different NGOS hadhelped develop and which had a number of innovative technical designfeatures (steel handle, ball bearings for the fulcrum, circle quadrant andchain to link the handle with the pump rods, angled spout etc.). From thelatest version of this pump, Talbot and HcLeod went on to develop thepresent standard Hark-11 design. In its later phases their work was carriedon jointly’with the Mechanical Research and Development Organization of theGovernment’of India, HERADO, and the engineers and management of thegovernment-ownedsteel manufacturing company, Richardson and Cruddas, bothin Hadras. From 1976 onwards, the India Hark-II Handpump went intoproduction on a large scale, which by 1986, amounted to 150,000 pumps peryear. The manufacture was carried out by some 40 officially recognizedmanufacturers,whoagreed to submit to the very crucial quality control.

,,That much of this development took place in the State of Tamil Nadu was nota coincidence. Tamil Nadu has one of the best state organizations for waterSupply,lthe Tamil Nadu Water and Drainage Board, with ramifications to ruraland agriculturaldevelopment. The state of Tamil Nadu was also to pioneerin innovative social approaches to the villagers to create a viablemaintenance system. This was the responsibility of Hr. Francis, the state’sAssistantDirector of Agricultural Development. In the environs of his hometown, Tirunelveli, Francis developed the so-called “three-tier system”. Itis based on village handpump.caretakersin the “tier” at village level.They are responsible for the regular maintenance and supervision of thepumps. The handpump caretakers are selected by the Block DevelopmentOfficers and given a crash course of two or three days in handpump operationand maintenance. The caretakers are reinforced by a second “tier” of rovingmechanics, each having 100 village pumps to inspect, who help the caretakerswith minor repairs. Finally, the third “tier” consists of a district-basedmaintenance team with a truck and a tripod for pulling out the rather heavyrising main.

Even though the organizedmaintenance of the handpumps still only reaches aminor part of all the pumps installed, it is remarkable how high apercentage of the pumps are functioning. A recent evaluation shows that theaverage number of pumps functioning at any given time in four sampled areasthroughout India amounts to about 85%. Host of the maintenance carried outseems one way or the other to be spontaneous. This is a sign that the localpopulations give a high priority to the pumps and try to keep them up, asthey would do with their trucks or bicycles.

:Sanitation in India: The Gandhi legacy

The need for proper environmental sanitation,notably excreta disposal, wasknown aRl the time, but there seemed to be no viable way to really getpeople in the communities, as well as in the government agencies and atpolitical levels, to accept the idea. Not that India was completelyunfamiliar with the concept of sanitation. It had been strongly promoted by

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Hahatma Gandhi. Somewhere in his memoirs he gives a vivid description ofhow impressed he was as a small child, when one day his father, who was thevizier, or Prime Hinister, of the Haharaja of Porbandar in Gujarat, got fedup with the filth of his own rambling house and forced the family members toall participate in a total scrubbing and cleaning up of the household. -Gandhi’s own promotionalwork may not have gone far towards nationalcoverage, but to many it did constitute a valid argument for morelarge-scale promotion of such activities.

When the UNICEF WET advisers met to discuss what could be done with theircolleagues in the WHO Regional Office for Southeast Asia in New Delhi,someone sai~, “Oh, we tried to introduce latrines in Uttar Pradesh 25 yearsago and it failed utterly. Forget about it.” Nevertheless, the discussion‘resulted in the secondment from UHO’s Regional Office of an energetic

I sanitar~ engineer from the Philippines, Alberto (Bert) Besa, who moved overto the UNICEF Regional Office. Bert Besa, with his good knowledge of thecountry and with his close links country-widewith professional engineeringand public health colleagues, was able through his insistent campaigning toencourage positive trends that were latent and to get the ball rolling.

In 1978 the Hinistry of Works and Housing, along with the Hinistry ofHea’lth,called a major conference on environmental sanitation in Patna, thecapital of Bihar. There the chief engineers and their assistants andrepresentativesof health authorities from all the states of India gatheredin order to work out a national plan for sanitation. Discussions revealed afew encouraging experiences such as those of communal latrines in Patnaitself and from Ahmedabad in Gujarat. Local NGOS had installed theselatrines, which gained rapid popularity through being equipped with showerfacilities. For a few paise anyone could go in there, relieve themselves,and then have a good shower with a small piece of soap provided by a paidattendant who would keep the place clean.

Apart from Besa’s campaigning, a major factor prompting the meeting in Patnaand the resulting national plan was the defection of the Hari.jan“scavengers” -- the caste-less people who until the end of the 1970sconstituted India’s corps of night soil collectors. As they gainedpolitical influence (again one of the Hahatma Gandhi’s major achievements),the night soil carriers got better job opportunities and defected en massefrom the defecating. The results were both inconvenient and dangerous, astheir former clients, the city and town dwellers were left almost literallyup to their necks in the muck.

Beginning with the Patna meeting’s examination of the means and modalitiesto change and improve the sanitation conditions in India, a betteratmosphere began to develop for UHICEF/WHO cooperation with the governmentin this field. It took some time for this process to take place.Nevertheless, awareness of the importance of sanitation started to spread tothe rural countryside as well as to1980s, be combined with other meanschildren.

The water and sanitation componentsgrew almost from scratch in 1970 toYet this is a small amount compared

~..

urban areas and could later, in theof combatting diarrheal diseases among

in UNICEF’s programme inputs in Indiathe present roughly $15 million (1986).with the Government of India’s present

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budget of $6S0 million for these purposes. In 1985 there were in India3,000 rapid-action drilling rigs, and thousands of engineers, water welldrillers, administrativestaff and others were involved. A correspondingbuild-up of the water and environmental sanitation support staff in theUNICEF offices had also taken place. Although the work is now being doneentirely by Indian nationals in the different states, the international andnational UNICEF specialists in India still make up one of the largestproject support sections in UNICEF anywhere. The reason for this is thecontinued need to assist in planning and training in a technical field thatis under constant development, in regard to drill rigs, water wellconstructionmethods and handpump designs. There is a continuing need forsupport to the very intricate commercial and industrial aspects of thehandpump manufacture. This also pertains to the efforts,to introduce anddevelop sanitationmethods and approaches,which has led to the build-up ofa UNICEF staff group of sanitation and health education specialists.

:Bangladesh- sludging tubewells by hand

If the advent of high-speed hard-rock drilling rigs paved the way for WETdevelopments in India in the early 1970s, it was the refinement of existinglocal technologies that led the way in neighboring Bangladesh, the scene ofthe second largest UNICEF/Governmentwater and sanitation scheme in Asia.UNICEF had already begun to support community water supply with handpumps inthat country when it was still East Pakistan, before the liberation war of1971. But it was only in the aftermath of that terrible war and the floodsoon after that UNICEF’S inputs accelerated in earnest.

Almost all of Bangladesh is underlain by the soft and relatively permeablesediments of the great Ganges and Brahmaputra rivers that come silt-ladenfrom the North India plain and the Himalayas to form the Padma River flowingto the Bay of Bengal. In the early years of the 1970s, the water table inlarge parts of the country was still only a few feet below its flatsurface. Here tubewells could be sunk through an incredibly simple method,the so-called “sludging”method. This was carried out by local contractorswith nothing more than a few bamboo poles for a derrick, a string ofstandard 1-1/2 inch galvanized pipes, and a chain to link the pipes to abamboo lever laid across a rung in the derrick. One man from the drillingcrew perched on top of the derrick and acted as a human valve, while theother members of the crew pumped up the sludge of water and sand and silt inthe drilling process. Once the drilling reached the necessary depth,normally 90 feet (30 metres), the hole remained open for the twenty minutesor half hour that is sufficient to install a string of plastic pipes with ascreen (slotted pipe) at the bottom end and a handpump attached at the top.

In coastal areas, conditions were somewhat different. Here, the groundwaterclose to the surface tended to be saline. But fortunately fresh water couldusually be found by drilling through clay strata to reach sand aquifers downto depths of 900 feet (300 meters). So soft were the sediments that even atthese depths the fresh water could be reached though simple methods of jetdrilling, and once a casing wds installed the fresh water would rise to afew feet below the surface.

In those days, for the largest part of the country, it was sufficient toinstall so-called suction pumps with the entire pump mechanism above the

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ground surface. Such pumps were manufactured throughout the country bylocal small foundries. With the need for much larger quantities of pumps,UNICEF’s water specialists had to look for possibilities to increaseproduction and improve the pump design.

Despite the seeming simplicity of a suction pump, pump design was fairlycomplicated, but after several years of development a good model was chosenas the standard one: the “Bangladesh New No. 6 Handpump”. Cast iron couldbe kept as the basic lmaterial,since in general each pump only served asmall hamlet and wear and tear was not as great as it was in India. Foundrytechnology was well established. There are very competent metallurgicalengineers in Bangladesh, and incredibly skilled foundry workers working withsimple cupola ovens in an ambiance recalling iron foundries of 18th-centuryEurope. There were no modern safety precautions, but it was impressive tosee these barefoot workers nimbly skipping over the ‘sandfloor of thefoundries, two of them each time with a stretcher load of white-hot glowingmolten iron in a heavy crucible between them, then carefully pouring themelt into the molds laid out on the sand floor. The government agencyresponsible for this handpump progrsmme, which rapidly entailed theinstallation of some 90,000 suction pumps per year, is the Public HealthEngineering Department. Their local offices throughout the country becamethe focal points for a nation-wide action, with UNICEF seconding nationalproject officers to assist with the planning and logistics of this unusualeffort. The result was a phenomenal network, supervising and directing thework of hundreds of contractor teams who now for years have “sludged” theirway down into the ground and installed the handpumps and plastic pipes andscreens provided by UNICEF.

The main UNICEF thrust in Bangladesh is the provision of household water,including drinking water supply. With the spread of both private andvillage handpumps in Bangladesh, however, a number of farmers with verysmall holdings above the high water mark were in need of means to increasetheir rice harvests. The availability of relatively low-cost (about US$ 45each) handpumps on a large scale now enabled them to irrigate their landsall year around, thus getting one or two additional rice harvests during theyear. UNICEF supported a pilot project for the spread of such handpumps byfinancing a total of 30,000 handpumps on a loan basis through the localGrameen Bank, a rural credit institute. The back-breaking task of actuatinga handpump for hours on end was in many cases made easier by the famersthemselves attaching treadles to operate them by foot.

:Pakistan -- follow-uv to a flood

After an initial handpump programme in the 1960s which never reachedfruition - probably too early an attempt - the first major effort to assistPakistan with village water supply came about as a consequence of the floodsof the Indus River in 1973, which inundated large parts of adjoiningagricultural areas in the Province of Sind, all the way down to the deltaeast of Karachi. Thousands of villages had their wells and pumps destroyedand the old pumps had to be replaced with new ones. Thus a project forrehabilitation of the wells and the installation of some 8,000 handpumps waslaunched, financed partly by UNICEF, partly by USAID. A local handpumpmanufactured in Sukkur was to be used. It was built of standard galvanizediron pipe components, and might be termed moderately successful, since itwas relatively easy to repair and replace. But somehow this firstprogramme, relatively large as it was, never made a big splash.

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Hore successful, eventually, were projects in the rugged north andnorthwest, where both government officials and the local people eagerlygrasped the opportunitiesfor UNICEF assistance in bringing water fromnewly-protectedsprings or newly-drilledwells down to the relativelyisolated valley villages.

:Burma’s dry zone

In Burma the Government solicited UNICEF’s assistance in providing cleanwater for villages in its dry zone, extending north beyond l!andalayforabout 500 km., an area with about ten million inhabitants. Here water wasfetched by women carrying jars on their heads or in wooden vats on oxcartsfrom sources up to 25 km. distant.

The government’s programme to alleviate the water needs of the most affectedvillages was ambitious, targeted to reach a population of 2.5 million over afive-year period. It was therefore necessary to provide up-to-date waterwell drilling equipment and adequate pumps. Since so many people were to beserved by each system, sometimes over 1,000 users per pump, it was necessaryto supply engine pumps. For each pump, a cistern with a number of taps wasconstructed. The villagers would then take care of the operation andmaintenance. A payment system was institutedwith payment of a few coppercoins per jar filled.

Fortunately enough, the government agency responsible for the programme, theRural Water Supply Division of the Agricultural Mechanization Department,was eagerly prepared to take on this”huge task. UNICEF after helping securethe completion of the 3,000 water wells in the Dry Zone, went on to supportlow-cost, community self-help schemes for protected, dug water wells andlatrines in the geologically easier regions closer to the coast.

:Gravity feed in Nepal and Afghanistan

New developments in low-cost, easily workable plastic pipes constituted the“technical breakthrough”that enabled UNICEF to provide cost-effectiveassistance to a variety of gravity-feed systems in mountainous areas. Amongother things, PVC (polyvinyl chloride) was in many cases superseded by HDP(high density polyethylene),which was more resistant to wear and tear onrocky surfaces.

In Nepal UNICEF assistance to water supply began with the protection ofsprings and the installation of gravity-feed pipelines to villages down themountain slopes. The distances, the very high mountains (the greatHimalayas), and the very thin roadnet -- or complete absence of roads --necessitated a-special set-up. During,the 1970s a whole network of fieldoffices was establishedby UNICEF to house its young engineers, bothexpatriates and Nepali nationals, who would locally plan and supervise theimplementationof the individual projects. Water supplyalso gradually,more so in the 1980s, would be accompanied by pilot projects for sanitation,i.e. latrine construction.

For many years, from 1973 on, this operation from UNICEF’s side was headedby Leo Goulet, a Canadian geologist. Leo’s job was to direct assistance tovillages which in extreme cases, as in Western Nepal, might be two-weeks’

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journey by foot from the nearest road-head. During the first two or threeyears, this implied helicopter transport of the heavy coils of HDP pipes andother materials. Hany villages had such difficult access that even theSherpas, who helped conquer Hount Everest and other mountain giants, simplyrefused to lend a hand in carrying these pipes.

If any project illustrateshow water supply close to home can relievewomen’s drugery, it is the one in Nepal, Women in Nepal are hardly better ‘than donkeys in terms of the loads that they are required to carry. Theseladies of small stature, under-nourished and worn out, are seen carryingcement bags of 30 kilograms or backpacking loads of firewood or watercontainers with similar weights for miles and miles on end over trailsrising and falling thousands of metres. The advent of piped water supply in’any village saves each woman hours of backbreaking work and an energyexpenditure of over a thousand calories per day.

In Afghanistan similar topography suggested widespread use of spring-fedgravity-flow systems, replacing the trek of often several miles for thewomen up and down mountain sides. But in traditional Afghan society alldecisions were made by the men, and the question of women’s drudgery wasalmost completely disregarded at first in community deliberations. (In somevillages, the entire population would run into the hills when the firstsurvey teams arrived. The villagers thought that these were tax collectors.)

Once, however, the first few installationshad been made, the convenienceand advantages of it were not only clear to the people who benefittedimmediately, but caused villagers in a wide periphery around the firstproject areas to come in with their petitions to the Government and UNICEFto obtain installationsof their own. These documents were ratherremarkable in themselves,written in Dari, the local language, and signedwith scores of thumb prints.

:Hoving away from conventional schemes elsewhere in Asia

In those instances in Asia where UNICEF’s assistance went to moreconventional schemes the results were not encouraging in terms of meetingneeds on a large scale at an affordable cost. In Sri Lanka (then Ceylon),for example, a programme launched in 1972 to bring piped chlorinated water 1to public standposts in 100 villages was phased out before it was more thanhalf completed. It was a system better suited to house connections and arecovery of costs through normal water fees and would have been betterfinanced through a loan, from the World Bank, for instance. The Philippineshad already developed a sturdy handpump built of standard fittings, namedthe Hagsaysay pump in honor of one of the country’s first presidents, but atthe Government’s request UNICEF assistance throughout most of the 1970s wentto occasional piped systems for large villages. Community participationwas lively, but toward to end of the decade it was realized that the onlyway to provide water on a larger scale basis to a considerable populationwould be through handpumps.

For some years in Thailand UNICEF provided assistance to the rehabilitationof small water treatment plants in the northeastern part of the country.These small waterworks, originally constructedwith U.S. bilateral aid, hadquickly fallen into disuse. As time went on, UNICEF assistance increasingly

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was directed to well drilling and handpump installation in this part of thecountry. Eventually the greatest efforts were directed towards rainwaterharvesting from roofs. Some three million people were provided with hugeferrocement jars to store rainwater at their households.

The only conventionalurban water project UNICEF was to assist in Asia wasthe rehabilitation of the city water systems in Haiphong and Hanoi inVietnam following the end of the Vietnam war. This was considered anemergency situation and prompted a more intensive input from UNICEF’s sidethan would otherwise have been the case. The Hanoi system had been designedin 1910 for 200,000 people. In 1977 the same system had to serve 1.2million people through its 70-year old corroding cast-iron pipes. In 1979and 1980 UNICEF delivered large tonnages of equipment and materials for thise~tensive rehabilitationjob, but never “receivedan evaluation of theoutcome, which seemed to be somewhat doubtful. Later developments woulddirect UNICEF’s assistance to the type of low-cost solutions it was becomingengaged in elsewhere, adequately supported by UNICEF project staff on thespot.

At village level in Vietnam UNICEF cooperation featured assistance to theimprovement of open wells, dug by the villagers themselves, and aid to theconstruction of safe latrines, the famous Vietnam double vault compostlatrines, allowing anaerobic fermentation of excreta into harmless,odorless, but extremely valuable fertilizer. A major UNICEF contribution toVietnam’s reconstruction in these years was construction materials,especially cement in the case of latrines. In Laos as well there wasconsiderable emphasis on safe latrines. Here, for the first time, on alarge scale, water-seal latrines were constructed with light-weight,inexpensive plastic latrine pans. The pans were imported from Halaysiawhere they were manufactured and built into platforms constructed from localmaterials.

:Indonesia - an integrated approach

In Indonesia neither a particular emergency nor a single technologicalbreakthrough sparked UNICEF’s large-scale involvement in water andsanitation. Rather, water and sanitation were brought in as a component ofintegrated basic services from the very beginning. Part of the workconsisted of the installationof handpumps in already existing or newly dugwells, which would be adequately protected. In other cases there would bespring protection and piped water supply, especially for the villages on theslopes of the volcanoes.

It was in Indonesia, where also in a few cases - as in Nepal - use was madeof hydraulic rams, a kind of self-operatingwater pump which lifts waterthrough its own pressure, an ingenious invention by the brothers ?fontgolfier(who also invented the hot air balloon) in France 200 years ago. In twopoor areas, one along the southern coast of Java and on the island ofHadura, northeast of Java, the water problem had to be tackled in adifferent way.

Both are limestone areas with a very thin soil cover. They have the kind oftopography and hydrogeologicalconditions that limestones show in moderateto warm humid climates: a rocky terrain (“karst”) pitted with caves,

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sinkholes and enlarged fissures in which water disappears for milesunderground and is very hard to locate through drilling. Furthermore, beingclose to the coast there is a great deal of infiltration of salt sea waterrendering a large part of the groundwater undrinkable. Over much of theseareas as well as in some outlying small coral islands south of Java,rainwater harvesting was the only possibility. For a cost of about $300,rainwater cisterns of ferrocement for the collection of water from the oftenlarge roofs of communal or family buildings could be installed to serve asmall group of families over the worst part of the dry season. ~his type ofproject proved so successful that a major loan was later approved by theWorld Bank for the same purpose.

UNICEF support spread to projects in other parts of Indonesia, notably theislands of Bali, Lombok and Sulawesi. A share went also to the resettlementareas on southern Sumatra for the grandiosely planned scheme for themigration of populations from overcrowded Java. A modest component ofsanitation promotion was included, but got an added push only in the 1980s.

++++

Africa: the challenge of drought and famine

The great drought catastrophe of 1972 - 1973, affecting first the Sahel andthen Ethiopia and other parts of Africa, entrained the first major UNICEFinputs for water supply in that continent. In most countries UNICEF effortswere carried out jointly or were closely co-ordinated with those of othermembers of the United Nations system, bilateral aid programmed and NGOS.

The 1972 Lome Conference, arranged by UNICEF to promote planning forchildren and mothers in West Africa, put water high on its list ofpriorities. This was the beginning of awareness of the drought, which had,so to speak sneaked up on everyone. In those days the means for droughtmonitoring were much less developed than they are now. This is one of thereasons the more recent emergency in 1984-85 was detected earlier and wassomewhat better contained, along with increased overall alertness to theproblem and the use of such technical innovations as satellite imagery.

In the years 1972-1973 the Sahel countries presented a bleak picture. Finesand and dust, eroded by the winds from the Sahara in the north and from theovergrazed Sahelian plains, covered the ground over hundreds of thousands ofsquare kilometres which once had been cultivated fields and reasonably greenpastures. Overpopulation and overgrazing together with the long absence ofrain contributed to the catastrophe.

The ensuing sudden migration by large numbers of nomads and semi-nomads fromthe north - starving, emaciated and dying people by the hundreds ofthousands -- was a terrifying phenomenon. In many areas it increased thepressure on the sedentary populations further south, who under normalconditions eked out a marginal existence and now also felt the effects ofthe drought.

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:Reinforcingjoint ventures in West Africa

In West Africa, fortunately, there already existed an infrastructure in theform of specialists from UNTCD (the United Nations Department of TechnicalCooperation for Development) whose work was funded by UNDP. For many yearsthey had assisted a number of countries with water resources studies in theSahelian drought belt and in the regions to the east and south of it. A inumber of hydrological studies had been made of the highly seasonal river, ~flows in the great rivers, such as the Senegalland the Niger. Ratherextensive groundwater studies also had been carried out. With the onsetofthe drought these specialists directed their efforts to water well drillingand the immediate installation of handpumps fo’rthe drought-stricken ‘ ,communities.

The first countries slated for immediate assistance were Sene~al, Hali,Upper Volta (in 1984 renamed Burkina Faso) and Niger. ~here had notpreviously been any major UNCEF-supportedwater projects in any of thesecountries. It was therefore logical for UNICEF to provide additionalequipment and materials, reinforcing the DTCD-managed projects. (Only muchlater, in the 1980s did UNICEF begin to set up its own posts for water andsanitation project staff in the Sahel countries, when the work had developedinto a long-term concern.)

Hajor support went into reinforcing the national well drillirigorganizationssuch as HER (HydrauliqueEquipment Rural) in Upper Volta or OFEDES (Officepour L’Exploitation des Eaux Souterraines) in Niger. The selection of wellsites to be equipped with handpumps aimed at maintaining fresh water supplyin areas where people were still staying - of~en women, children and theelderly - who had been left behind while the men went further south withtheir cattle in search of greener pastures. These most vulnerable remaininggroups had to be helped to survive and then to create a base for better.andmore secure living conditions.

In the same years of the drought, during the first half of the 1970s, otherjoint UNDTCD/UNICEFventures were begun in some of the countries south ofthe Sahel. They are in the wooded savanna and rainforest belts, with ahigher rainfall but with equally difficult water resource problems. Hostwater resources traditionally available in the villages, were surface watercourses or shallow unprotected dug wells. Therefore, again, drilled waterwells and spring protection would be the only ways to provide reasonablysafe water the year round. Elsewhere in West Africa in those days, anduntil the early 1980s, UNICEF had only small inputs.

:East Africa

The 1972-73 drought was not confined to the westrepercussions clear across Africa to the Red Seatwo large countries of East Africa, Ethiopia andcarry out very large-scalewater supply projects

but had the most severeand the Indian Ocean. InSudan, UNICEF was to helpin the 1970s which would be

expanded and continued into the next decade as well.

:Ethiopia - dealing with a catastrophe

In Ethiopia, the combination of drought, malnutrition, internal strife

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(Eritrea,Wollo, Tigrai, etc.) and complete neglect from the side of theImperial Government had catastrophic effects. In the words of a seniorUNICEF colleague, “The government would not disclose the conditions thatwould spell famine, misery and death to millions of its people, to the outerworld. The internationalorganizations dared not speak up forfear ofprejudicing the Ethiopian government against them and thus make any actionimpossible. Thus, when the first>disclosureto the exterior was made of thereal state of affairs by a young UNICEF ProgrsmsneOfficer, Stephen Green,the drought and its effects were already in an advanced stage. StephenGreen’s courageous stance cost him His post forraison d’etat ,buttriggereda massive internationalrelief campaign.” The rest is history now. EmperorHaile Selassie was deposed and replaced by a military government, the “Derg”under Colonel Haile Harism Hengistu.

Among the direct relief actions, water supply was a prime one. Relief interms of water supply at the same time became a first step towardsrehabilitation and strengthening of the national infrastructureon a longerterm basis. In spite of the miserable condition of Ethiopia and its people,two government-linkedorganizations stood out as effectively managed. Onewas Ethiopian Airlines whose good services greatly facilitated transport ofpeople, equipment and other supplies from UNICEF. The other one was theEthiopian Water Resources Authority (EWRA), now,called the National WatecResources Commission, responsible for water supply and water resourcesmanagement throughout the country. It was staffe~ by competent andmotivated nationals such as Ato Birru Itissa, one of the Directors, andstrongly assisted by a United Nations team (TAB/DTCD) headed by a Dutchhydraulic engineer, Gerry Dekker.

This provided a stable base for thk UNICEF-assisted activities, which weredeveloped successivelyduring the years 1973-197S and-which have beenmaintained since. For many years, UNICEF remained highly operational, withdirect inputs in the most difficult areas of drought, strife and warfare.Only by early 1984 was UNICEF’s role somewhat toned down to advisoryservices and supplies, although a direct training component continued.

Beginning in 1973-1974, UNICEF’s assistance concentrated on some of theworst hit drought areas in Wollo and Tigrai to the north and northeast ofthe central, rainier highlands. I!ateron it spread to Hararge and to theOgaden, the hotly disputed border areas with Somalia. To this were thenadded a series of provinces in the southern part of the country borderingKenya and Sudan: Bale, Sidamo and Gemmu-Goffa.

For Wollo and Tigrai with their extension into that geologically interestingbut climatic hell-hole of the Danakil Depression, inhabited by the tribes ofthe Afar and the Issas, drilling of water wells was the only solution.Engine-driven pumps were installed to serve people, cattle and camelsinasmuch as they had survived, A high priority was given to camps for therefugees from the drought and - later, especially in the Ogaden - from theborder war with Somalia.

For larger camps and communities, and wherever conditions so allowed,perennial natural springs were harnessed and pipelines laid to camps,villages, even small towns. Where the technologies could be kept simpleenough, the self-help element was encouraged. This was the case

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particularlywith the digging (manual excavation) of water wells in thesouth. One of the mast important features of the UNICEF assistance was thetraining of water well drillers and engineers.

The work was never easy. Adverse geological conditions with tough basaltrocks, with an overburden boulders and loose gravel, and with highlymineralized, hot groundwater proved to be problems for drilling crews andwater consumers. Add to this the long distances, few and bumpy roads, aformidable terrain and all sorts of logistics and supply difficulties. Inthe ports of Djibouti and Assab, imported equipment would be delayed, vyingfor clearance with hundreds of thousands of tons of grain and other relief,items.

Political pressure, the severity of transport and outright danger to lifeIand limb made the work difficult for the Ethiopian drillers and the fewUNICEF watermen who were their instructors. UNICEF’S Vlado Zakula oneSunday afternoon in Wollo literally came under crossfire between governmenttroops and rebel forces. He had to dive for shelter from his car into aditch, spending some very uncomfortable hours there. Normally, however,UNICEF-assistedwater supply constructionwould never be hampered by eitherside in the conflict. The sanctity of water transcended any short-termconsiderationsand UNICEF, with its staff, was’too well-known and popular towarrant hostile action.

:Sudan and the “Donkey PumP”

When the drought struck across Africa south of the Sahara, the Sudan wasjust emerging from a state of protracted and bloody civil war, in which forseventeen years the partly Christian population of the south -- theprovinces of Bahr-el-Ghazal,Upper Nile, and Equatoria -- had been fightingthe Arab-speaking Sudanese of the North, including the central government inKhartoum.

When the war ended, the South was left with hundreds of thousands dead,villages that had been burned and wells that had been destroyed. Some ofthe wells were choked with corpses. In the centres of Juba, Wau, andHalakal, a new regional semi-autonomousgovernment strove to introduce asemblance of order.

Such was the situationwhen the Norwegian Government agreed to channel $2million in special assistance to UNICEF for water supply in southern Sudan.Initial discussions led to the assignment of the Norwegian consultant,Per-Fredrik Tr6ften to the project. (Tr6ften, among other things, hadinvented a method of horizontal drilling for the “revitalization”of wellsin India.) Troften’s recommendationsled to the drafting of a progrsmme forUpper Nile province, centred on Juba, which was to be carried out incooperationwith Norwegian Church Aid, long active in rural development workin Upper Nile.

Just before the beginning of implementation,however, the Sudanesegovernment requested UNICEF to leave Juba aside and concentrate onBahr-el-Ghazal,working out of its capital, Wau. Here the first UNICEFproject manager, the Norwegian drilling engineer Per Engebak and his team,faced an unusual challenge. The nearest port was.Port Sudan, connected to

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Wau via Khartoum and El Obeid through a rickety railroad. It could take amonth or more to get the goods through - a distance of over 2,500kilometres. The other port was Hombasa in Kenya - which meant trucktransport over about the same distance and running through Uganda$ thenunder the unpredictablerule of Idi Amin.

Undaunted, Engebak and his companions from UNICEF, set to their task in1976, While waiting for the trucks to arrive, they had maintenanceworkshops, offices, and laboratories constructed on the outskirts of Wau.The drilling equipment eventually arrived and so did the handpumps. 2hepriority was given to the hardrock areas in the southern part ofBahr-el-Ghazal. Later these activities spread to adjoining parts ofEquatoria. Drilling methods and equipment were the same as those used inIndia - compressed air rigs with down-the-hole hammers. The handpumps werestandard India Hark II, which the workshop at Wau assembled.

For the local population, predominantlymembers of the Dinka tribe, thehandpumps were completely new and rapidly gained popularity, being referredto as the “donkey pump”. The Dinkas are stately, tall people. The men -very appropriately in the hot climate - walk about practically naked. Allmen at any given moment carry three or four short iron-tipped spears forhunting and for fighting. A visit to the government hospital in Gogriel,100 kms. north of Wau in 1976 revealed that 90 out of the 100 hospital bedswere occupied by men with bad cuts and gashes from fights, mainly overwater. With the introduction of handpumps village by village, this epidemicof spear wounds diminished and the hospital beds could be used for thetreatment of more “legitimate” sick cases.

An even greater innovationwas the function of handpump caretakers selectedfrom every village with a new pump. The caretakers-electwere assembled atcentral locations in their own districts and given a crash course inhandpump mechanics and repairs along with a considerable amount of healtheducation. All this was bestowed by the WHO sanitary engineer - for manyyears Mr. Singh - from Juba. The ambiance of the training courses wascongenial and they often culminated in meals of dik-dik (a small antelope)and baboon, washed down by home-brewed beer.

A major feature of the entire programme was the development of humanresources at all levels. On the managerial and technical side, onedifficulty was in getting the trainees to stay on once they had learnedtheir jobs. Either they were siphoned off by the government for highpositions elsewhere or, if they were drillers or mechanics, they wouldsuccumb to the lure of the Arab Gulf States, hungry for skilled labour.Those who did stay on, however, did a fine job. They included the Sudanesemanager of the project, Joseph Haker (pronouncedHakkair) and thehydrogeologist Hohammed El Fatih.

Around 1978 UNICEF-assistedwater supply activities spread to an area abouthalfway between Wau and Khartoum: Southern Kordofan, centered on the townof Kadugli. This is an extensive dry savannah, home to semi-nomadicherdsmen who subsist on herds of cattle, goats, and occasional camels. Thefirst task there was to rehabilitate the large rainwater collection basins,situated in shallow valleys, which during the brief rains would be filledwith water. These basins or “hafirs” measure several hundred meters across

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and serve the needs of humans and their animals. In order to desilt the“hafirs”, UNICEF had to enter into the procurement of earthmovingmachinerysuch as bulldozers and draglines - a far cry from the bedpans and babyscales of more conventional UNICEF supply lists. Somewhat later the firstlightweight drill rigs arrived in Southern Kordofan. The “donkey pump” madeits inroads there, too, and made it possible for the benefits of safe watersupply to reach far-off villages in this desolate landscape.

As in Ethiopia, the national agdncy responsible for rural water supply, theNational Water Bokrd, Provided a solid base for the work. It maynot havebeen very strong in numbers, but was headed and staffed by purposefulnational professionals. The drilling crews in the UNICEF-ass,istedprojectsin the South were reinforced by~experiencedengineers and drillers from theWater Board. 1:

I ++++I

The Hiddle East I

:Lebanon - clearing the minefield for water pipes

UNICEF’s largest water supply operation in the Hiddle East, like those inAsia and Africa, was occasioned by an efiergency- the brutal civil war whichcontinues to this day. In this beautiful and relatively developed country,once regarded as an’oasis of peace in a troubled region, there were atvarious times in the hostilities as many as 40 different warring factions.Bombs, gunfights, mortar and artillery fire became an everyday fact oflife. Amid the general destruction of homes, hospitals, schools and publicutilities, water supply and sanitation facilities of all kinds were badlydamaged and entire villages and towns were threatened by epidemics.

UNICEF’s task was to assist the immense job of rehabilitation, concentratingin particular on institutions serving children, notably schools andhospitals. As the only major external aid agency with access to all partsof southern Lebanon, the part of the country most divided, UNICEF wassaddled with responsibilitiesbeyond its usual ones. Realizing this,funding sources such as the United States and Saudi,Arabia provided majorspecial contributionsto enable UNICEF to go on with the work. ‘

This involved water well drilling, carried out by local Lebanesecontractors, the installationof entire pumping stations, repair of watertreatment facilities and the laying of pipelines and connections tohospitals and schools. On occasion, help had to be relied upon from the UNpeace-keepingforces in order to clear stretches of terrain of landmines forthe laying of pipelines.

Somehow, UNICEF’s work evoked a certain restraint on the part of differentwarring groups. Although violently opposed to one another, they would notinterfere with the continued functioning of those water supply systems.A piped water supply system across southern-mostLebanon is one example. Itoriginates at wells drilled close to the foot of Ht. Hermon and goeswestward towards the coast, branching out to a number of villages along theway. The water would thus pass through and serve areas held byorganizations as diverse as the PFLP, the PLO, the UN Forces and the

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.,

Christian militia that had been set up by the Lebanese army major Haddad.Any would have had opportunities to cut off the water supply of another.Yet the feeling of the sacredness of water, as enunciated in the Holy Koran,prevailed. Sometimes, repairs had to be made after heavy tanks passed overpipelines. By and large, though, there were no acts of hostility towardsUNICEF and its water engineers.

One ‘waterengineer remained in his home city Beirut where he now has takenover the responsibilitylfor all of UNICEF’s activities., Raymond Naimy madean internationalname for himself when in early 1983$ I@raeli troops had cutoff East Bei’rutfrom the rest of the country and from its normal watersupply. In order to prevent a major water famine among the city dwellersand their large ch~ldlpopulation, Naimy launched “Operation Water Jug”,providing at least mi#imum quantities of drinking water to the beleagueredcitizens. 1He used water from privatk borewells add brought it by truck tohastily erected water tanks until after some precarious months conditionswere more or less restored to normal.

:A transition to modern times in Yemen

Elsewhere in the Middle East and North Africa, including Algeria, Jordan andMorocco, UNICEF assisted a variety of water and sanitationschemes in the 1970’s, but all on a fairly small scale. UNICEF’scooperation with the Yemen Arab Republic (North Yemen) was moreconsiderable, however, and is an interestingexample of water supply workbeing integrated,intoone country’s hasty transition to modern times.

A five-year civil war had ended in 1967 with the ouster of the old ruler,the Imam, who had been both secular and religious head of this mountainouscountry in the southwestern part of the Arabian peninsula. The Imam hadruled in purely medieval fashion over his people, not allowing anymodernities except for a DC-3 airplane for himself and one car operatingover the only few miles of road existing in the whole country. Zhe newgovernment devoted itself to intensive efforts to develop the rudiments of amodern country, with considerable help from abroad in which the major worldpowers peacefully competed. Water supply was one of the immediatepriorities, and in 1972 the Federal Republic of Germany allocated $890,000to UNICEF as a “noted project” for the express purpose of water supply inthe Yeman Arab Republic.

Bilateral funding was taking care of assistance to water supplies in thecities and larger towns, but in the rural areas UNICEF was the first majorinternationaldonor to be tapped for help. Some limited beginnings weremade in the first year or two, including a simple piped water scheme withpublic standposts in the sleepy little town of Al ?lukha,the ancient Hochaof coffee fame. But by 1974 the Government of the German Federal Republicbegan to get concerned over the fact that its special contributionwas stillunspent and threatened to ask for its money back -- plus interest! Thisprompted a rapid survey of the situation by Martin Beyer from HQ along withthe local country representative,Toni Beruti. They found that theGovernment’s Rural Water Supply Agency was more than willing to do its partin putting the proffered assistance to good use but was so badlyunderstaffed it could hardly function.

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UNICEF accordinglyembarked on a crash programme to help train localcraftsmen, and a burst of activity soon got underway. With seriousness and ‘energy, the trenches were dug, pipes laid and pumps installed with theirengines. Hany of the systems installedwere in the form of engine-poweredpumps forcing water up from springs and other sources in the valleys to thevillages, usually located on hill and mountain tops, a reminder of thousandsof years of warfare against marauding neighbors. Consequently, in manyplaces, water had to be lifted for many hundreds of meters. This entailedrelatively high costs for the installation,operation and maintenance. Itwas a somewhat mitigating circumstance that Yemen at least was a neighbourof Saudi Arabia with access to the plentiful oil and gasoline produced there.

With the upswing of the economy of the oil-rich Arab countries in themid-1970’s, more funds, equipment and materials flowed in from differentdonors. This allowed for a widening of the scope of the governments workin the proud Yemeni tradition of water supply engineering, symbolized by theancient ?faribdam said to date from the reign of the Queen Sheba.

++++

The Americas region

UNICEF assistance to water supply and sanitation in the Americas Regionfocussed on relatively few countries and within these on the poorest areas.UNICEF’s overall assistance ceilings in the Americas were lower than theywere in Asia and Africa, and the countries of Latin America as a rulealready had higher water and sanitation coverage.

The Punta del Este Conference of 1961 in Uruguay among American heads ofstate had set a target for water supply and sanitation coverage for all ofLatin America and the Caribbean of 50 per cent by 1970. In the event, only25 per cent coverage was attained by that date. Given the circumstances, ,this was not a bad result, though far from ideal, proving that regionalplans could be established and at least partly carried through. Thefollow-up to the conference had brought internationalfinancing, private and,public,into play on an unprecedented scale, one of’the key lenders beingthe Inter-AmericanDevelopment Bank. The IDB loans benefitted not only thebig cities but helped to finance water systems for small towns and villages,with active promotion of community participation. Hajor technical supportcame from the Pan-American Sanitary Bureau’s strong network ofrepresentatives.

Under the circumstances,piped water schemes with household or patioconnections for each family could be implemented on a wider scale in theAmericas than in most other parts of the developing world. The need forlow-cost approaches -- handpumps, simple gravity feed schemes, latrines etc-- definitely existed, but to a somewhat lesser degree than in the otherUNICEF regions. The main target populations for UNICEF assistance in theAmericas in the 1970’s were found in the Caribbean, in southeasternMexico,Central America, Peru, Bolivia and Paraguay. In these areas water andsanitation goals were pursued not as separate programs but within theframework of “integratedservices for children.” .

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:The Caribbean

In the Caribbean, UNICEF contributed materials to piped water schemes forcommunities of various sizes in Jamaica, St. Vincent, and the DominicanRepublic, while in Surinam it supplied pumps and pipes to some moreelaborate schemes based on large diameter deep wells. In Haiti, the poorestcountry in the Hemisphere, pipes and construction materials went to projectsin some communities on the south coast. But with the then government payingscant attention to the needs of its citizens, the Rural Water Supply Agencyin the later 1970’s consisted of only of one engineer and one draftsman.Bilateral aid people, notably US AID, and a number of NGO’S did their bestto fill the worst gaps, but in an uncoordinatedway.1980’s that conditions were right for sizable UNICEFappropriate.

:CentralAmerica

It was not until theinputs to be

UNICEF provided materials and equipment to rural water supply projects inPanama, Costa Rica, and Guatemala. The catastrophic Guatemala earthquake of1976 necessitated the total reconstruction of villages along the denselypopulated earthquake zone in the highlands. With the government sooverburdenedwith other rehabilitation tasks, remarkable work was done bysmall voluntary agencies, working with UNICEF and a group of dedicatedGuatemala engineers, to help villagers in rural areas rebuild their housesand install water systems. UNICEF’s senior drilling supervisor,AlejandroAmoretti, originally from Cuba, played an important role for years indirecting the right kind of assistance for village water supply to Guatemalaand neighboring Honduras and El Salvador.

:Hexico -- transmitting to the Tzotzils and the Tzeltals

A.special integratedproject was carried out in Hexico in the 1970’s inwhich UNICEF played a part. This was the Programa para el Desarrollo de 10SAltos de Chiapas (PRODESCH) -- the Programme for the Development of theHighlands of Chiapas. The population to be assisted in economic and’socialdevelopment, 90 per cent based on self help, were 600,000 Indians in theforested and humid highlands of Chiapas, near the Guatemala border. NO

roads or modern amenities existed in the ‘projectzone, inhabited byTzotzils, Tzeltals and other tribes,’each with its own language andcustoms. On their list of priorities, village access roads stood as numberone, followed by a long enumeration of other needs. The PRODESCHadministrationfrom the outset put its emphasis on agriculturaldevelopment. In this it was aided by an unusually effective cooperationamong UNICEF, FAO and WFP (World Food Programmed). Water was an importantpart of the agricultural aspects of the programme.

The water for the small terraced plots of cultivation came from protectedsprings, which fed the villages with drinkable water through pipelines.Since a constant flow of water was assured through the regular and highrainfall, there was plenty of excess water for diversion to the fields. Atthe same time, health education campaigns supported the newly establishedsystem of local health care centres and helped spread the understanding ofproper water use, sanitation and hygiene. A most original feature was theinstallationby UNICEF of a powerful radio tran~mitter at the PRODESCH

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headquarters. It broadcast round-the-clockwith news, popular music andagriculture-extensionand educational messages to the local people in theirown languages. It was the first time ever in Mexico that such broadcastswere made in local languages other than Spanish. Radio PRODESCH gainedinstant popularity. In 1979 there was a daily influx of 250 letters fromlisteners. One interesting and successful use of this radio station was toalert parents in remote areas to impending visits of immunization teams sothat they could bring tiieirchildren to designated health centres in timefor the teams’ arrival. 1

:Peru -- children in Sackcloth

There were few parts of the world where the need for action on behalf ofI children appeared so compelling as among the Quechua and Aymara Indians of

Peru’s high Altiplano villages. The children of these descendants of theIncas, barefoot and literally clad in sackcloth, spent their nights insub-freezing temperatures, sleeping on reed mats on dirt floors in stonehuts, without any form of heating. Daytimes, they were largely on theirown, neglected by parents who struggled hard for survival in one of theworld’s least hospitable environments.

A,remarkable project assisted by UNICEF in the 1970’s was the systematicbuildup of village pre-school centers, or wawa huasis, in Puno and Cuzcodistricts,. Operated by trained volunteers, these centers reportedly workedwonders with the small Inca tots, who on entering primary school foundthemselves with an excellent cognitive and emotional headstart over theother children. One aspect of UNICEF’s assistance was to help provide thesewawa huasis with safe water, since the seemingly clear streams of theAltiplano are heavily contaminatedwith human and animal fecal matter.UNICEF provided cable-tool drilling rigs, handpumps, and constructionmaterials for protected springs. Unfortunately, technical support from thegovernment was weak, and it was not until the 1980’s that UNICEF was able toprovide consultants of its own to help get things going on the spot.

In adjacent Bolivia UNICEF concentrated on aid to spring-fed systems in theAltiplano and handpumps fitted to dug wells in the resettlement areas of theeastern lowlands. Some drilling rigs were also provided to Bolivia. One ofthese rigs suffered a’curious fate. It was highjacked at gunpoint from theSaneamiento Ambiental warehouse in Sucre by a highly intoxicated gentleman,who some kilometers further away promptly-capsizedthe 18-ton outfit in aditch and disappeared.

:In Paraguay -- the poetry of clean water

In landlocked Paraguay, UNICEF joined up with the World Bank to assist anambitious water supply program carried out by the National Health Service.UNICEF concentrated on assistance to small settlements, while the Bankfinanced projects for agglomerations of 2,000 or more inhabitants. The.introductionof water supply to the rural Paraguayan communitieswasaccompanied by impressive health and sanitation education campaigns., Thesewere all-out teach-ins in primary and secondary schools, normally scheduledfor a whole month. Day in and day out, the school children would bebrainwashed with matters concerning water, sanitation and hygiene. In

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mathematics, they would count buckets. In biology, they would study all thebugs in a drop of untreated water. In Spanish, they would write poetryabout the beauty of clean water.

++++

1980-1986. CLARIFICATION OF OBJECTIVES: INTEGRATION WITH PHC AND“CHILD SURVIVAL AND DEVELOP?SENTREVOLUTION”.

The period 1980-86 was the first and crucial half of the InternationalDrinking-Watdr Supply and Sanitation Decade, with increasingly fruitfulco-ordination among all parties concerned. Within UNICEF, the drive toward

I .-. ..,

WATER AND SANITATION

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infant and child health within the framework of CSDR accelerated theintegration of water supply and sanitation with other health measures. Newscientific insights into the nature of diarrheal and other water andsanitation related diseases contributed to improved programme and technicaldesigns.

At the suggestion of the UN Water Conference which was held in Har delPlata, Argentina, in 1977, the UN General Assembly in 1980 declared1981-1990 to be the International Drinking Water Supply and SanitationDecade. Its professed goal was perhaps visionary, to provide everybody withadequate water supply and sanitation by 1990, but it did establish aneffective rallying point for internationalcooperation. The beginning ofthis decade happened to coincide with a clarification and sharpening ofUNICEF’s policies, linkingithem directly with the objective of reducinginfant and child mortalitylandmorbidity rates. ~he acronym GOBI --standing for growth monitoring, oral dehydration therapy, breast feeding,and immunization -- symbolized the practical and very direct measures UNICEFwas now emphasizing, shortly to be incorporated into the concept of aworldwide Child Survival and Development Revolution (CSDR) with massimmunization campaigns as the spearhead.

Changing insights and new developments

There were at first fears among some UNICEF colleagues that WET would bedropped from UNICEF’s repertoire of leading activities in favor of measures,like those symbolized by GOBI, which were thought by some to be more costeffective. Apart from this, questions about the value of water andsanitation investmentshad been raised for some time by specialists andeconomists at the internationallevel. The debate still goes on, withneither proponents nor opponents having the last word, but with a number ofnewly discovered considerations to be taken into account.

From the health point of view, for one thing, it was becoming clear that theeffects of water and sanitation are not so clear cut as had at first beensupposed, since there is such a close interdependenceamong these andnutrition, other health interventions,education, and a host of otherfactors. New research had revealed that the “water-borne” diseases of oldwere not exclusivelywater-borne. For example, it had been shown thatrotaviruses, an important agent of diarrheal diseases, in addition to beingspread by the oral-fecal route could be transmitted through the air bycoughing.

It was becoming evident that for the evaluation of the impact of watersupply and sanitation on health, clear indicators were not as easy to findas had at first been supposed. Thus, measures of diarrhoea incidence arefraught with many uncertainties. The present best bet seems to be to usethe same anthropometricmeasures as those used to appraise the nutritionalstatus of infants and young children and to monitor their growth. But hereagain, the causes for changes and deviations from the normal range are somanifold and intricate that the conclusion up to now is that water andsanitation cannot be singled out for impact evaluations. Indeed, healthimpact cannot be measured in absolute terms for any single type ofintervention. This was the conclusion of the first internationalseminar onthe subject of health impact of water and sanitation, held in 1983 at Cox’s

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Bazaar, Bangladesh. The results of the research and studies presented thereas well as derived from other institutions in the world are constantly beingevaluated by UNICEF. Xhe water supply and sanitation programme in Imostate, Nigeria, which was launched in the early 1980s was the firstUNICEF-assistedprogramme designed from the beginning so that the effects ofwater and sanitation would be measured in combination with those of primaryhealth care (PHC) and other CSDR measures. (See below, P.36).

++++

New light on social and economic factors

The social and economic aspects of water and sanitation programmed of thetype supported by UNICEF became clearer through a number of studies. Astudy conducted‘inBahr-el Ghazal province, Sudan, in 1980, for exampleshowed an enormous difference in women’s use of their time before and after “the installation of a handpump. A study on body energy expenditure clearlyindicated the beneficial effects of the “convenience factor” of water supplyprograms in reducing the drudgery of pregnant and lactating women.

In 1982 the World Bank began a study of the economy of handpump systems, andits preliminary findings were presented in draft form in late 198S,confirming, generally, the pragmatic estimates which had guided most of thehandpump programmed. Such studies, along with considerable documentation onmonitoring and evaluation methodologies, began to provide, for the firsttime, what could be described as an authoritative body of professional“literature” on low-cost water and sanitation in the developing countries.

A major bottleneck to reaching the goals of the Water Decade was thetremendous investment in “human resources development” required. If theoriginal target was to be met -- adequate water and sanitation for everyoneby 1990 -- it would mean adding water supply installations to serve half amillion people every day. In the event, the rate of constructionwasconsiderably lower. Still, it would require the skills and motivation ofmillions of people -- engineers, administrators,public health specialists,,handpumpcaretakers, teachers, mothers and children. Not only does thiscarry with it a tremendous need for training. It implies the need for manyprofessionals to adapt their skills and attitudes to local requirements.Some of the more “high-fallutin’”engineers, sociologists and others mayhave to modify their concepts of technology and people considerably. Humanresources development for the Decade has been taken up by a special taskforce of the Decade Steering Committee. UNICEF’s hopes are that this willlead to a coordinated and well-publicized effort to support the necessarytraining programmed all over the world. At present, training inwell-drilling, handpump installation,latrine construction, sanitation andhealth education is a primary task of UNICEF’s 130-odd water, sanitation andhealth education specialists -- but their efforts can only meet a very smallpart of the need.

As concepts wax and wane in any human endeavour, so do buzzwords in theinternationalworld. The “grassroots” of the 1970s were replaced --hopefully for the duration -- by “communityPanticipation”. “ProjectSupport Consnunication(PSC)” in UNICEF parlance, was turned into “ProgrammeCommunication” to stimulate and support “Social Mobilization”.

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Behinclthe buzzwords lay the realization that it was vital to secure notjust the villagers’ voluntary labor in digging wells and trenches but theirinvolvement in the whole process of decision-making, planning andimplementation. It aimed at making the users in the communities aware thatthe water supply and sanitation facilities were theirs, theirs to use andtheir responsibility to operate, maintain and repair. The participation ofwomen, in particular,was increasingly emphasized, improved water supply andsanitation being such an important element in their advancement.

Realization of the need for active community participation in water andsanitation coincided with a growing realization of its importance in othersocial development fields, including child health, education, andnutrition. Consequently, community participation figured to an increasingdegree in UNICEF’S country pi?ogrammesas a whole as the decade of the 1980”sunfolded.

Health education became mandatory in all programming, strongly supported bythe creation of the post of a health education specialist at New Yorkheadquarters. An unofficial aim was to widen the scope of the healtheducation element in the water and sanitation programmed to support primaryhealth care, the Child Survival and Development Revolution, and theUniversal Child Immunization efforts.

++++

Further technologicaldevelopments

Technologies continued to ’develop. Hajor advances were made in equipmentand materials for water supply. Highspeed drill-rigs were made even moreefficient, compact and easier to handle. Compressed air was partly replacedby hydraulics. New polymers began to be used for drilling fluids underdifficult conditions. UNICEF continued its co-operation with drill-rigmanufacturers to develop lighter and less expensive rigs. Some of the bigmonsters used in certain areas, as with difficult rock conditions in India,cost up to half a million dollars! They were immensely powerful andefficient, but every cent counted and the rigs had to be kept down in sizefor transport over narrow and difficult roads and bridges as well as forlower operation and maintenance costs.

Extremely valuable work was done by the UNDP-funded water and sanitationgroup at the World Bank, including TAG, its Technical Advisory Group, indeveloping low-cost water-lifting and waste-disposal techniques. The Bank’sadviser on these matters was John Kalbermatten, a Swiss-Americanengineer,who deserves special mention as a veritable pillar of the Water Decade. Theimportance of the Bank’s work in this field to UNICEF cannot beoverestimated. The project for developing and testing low-cost latrinedesigns, for example, laid the technical groundwork for UNICEF’s ownadvocacy (in countries like Botswana, India, Lesotho and Tanzania), the factthat a new design had been tested and recommended by the World Bank givingit considerable prestige.

One success story was that of the VIP latrine, the ventilated improved pitlatrine developed at the Blair Research Institute in Harare, Zimbabwe. Its

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inventor is an entomologist, Dr. Peter llorgan,whose insights into thepsychology of flies led to its ingenious design: flies, attracted by theodors from the pit, fly into it, do whatever flies do, and then, onceproperly satisfied, fly up the vent pipe on the outside of the outhouse, nowattracted by the daylight through the vent. Only -- this is where the flystops. The flies cannot get out, for a mosquito net covers the open top.The flies have too short a memory to remember where they came from, getconfused, buzz around, starve, get weak, fall down and die, not necessarilyin beauty. The VIP latrine is an example of a low-cost, “appropriate”technical development that has been used on an increasing scale by UNl!CEF.

A related UNDP/World Bank project deals with the development and testing ofhandpumps -- those seemingly simple implements that so often go wrong.UNICEF, which is possibly the world’s largest single handpump buyer, has agreat stake in this project. The potential world-wide market, Chinaincluded, is estimated to be one million handpumps a year, benefiting some150 million new users. Design, quality, cost and ease of operation andmaintenance are important considerations. UNICEF, along with severalbilateral agencies, actively participates in the project, above all in thefield testing of improved designs. By 1986 a huge field testing scheme wasunderway, involving 2500 pumps of 70 different makes in project areas in 16countries.

Alternative energy sources for power pumps also began to enter the picturein the 1980s, as solar voltaic cells went down in cost from US $30 per wattin 1980 to about $7 in 1985. Consequently, there was a surge in theprocurement of solar-powered equipment, especially in West Africa.

++++

Nigeria -- Imo State: imagination and innovation

The planned introductionof all.these elements into WET programmed -- theconcepts of the health and social approaches, the complementarilyof thevarious measures -- began to take shape in the first years of the new decade.

One programme in which all these factors were planned for from its veryinception was the PHC/water-supply/sanitationprogramme in Imo State insoutheastern Nigeria. It was conceived by the UNICEF Representative,Richard Reid, who rapidly picked out the essential ingredients of GOBI,water supply and sanitation technologies, added a solid build-up of a PHCsystem with a backbone of Village-Based Workers (the “VBWS”), shook themixture vigorously and applied it to some of the poorest districts of ImoState. This judicious blend of components and the enthusiasm that Reidinfused into the local health teams and water supply technicians, along withthe establishment of a good UNICEF support team, made the project a successand a model.

At first, the entire idea of solving the problem of rural water supply with

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drilled wells and handpumps met with considerable resistance at both Federalgovernment and State levels. While oil prices were still high, Nigeriacould afford to plan for infrastructure improvements at much highertechnical levels than it could have afforded before the great oildiscoveries in the Niger Delta. For water and sanitation this meant water ‘treatment plants, urban distribution systems and sewerage -- at least wherethere was water around in some abundance, i.e. mainly in the areas close tothe Niger river system. However, the largest part of Imo State, and forthat matter most other states of Nigeria, have little or no access tosurface waters. Groundwater is therefore the only source that can betapped. Also the small size of the individual villages and the limitedreserves and recharge of groundwater would be prohibitive for majorwaterworks and piped network systems.

Once the original objections had been overcome, Reid with his colleagues ofthe UNICEF office in Lagos and with the Imo State health authorities,designed an approach based on the drilling of wells and installation ofhandpumps, accompaniedby the training of VBWS: An interesting feature wasthe mandatory installationof latrines in half of households of each villagebefore their handpumps would be installed. This laudable but difficultapproach eventually had to be modified. The programme, nevertheless, was agreat success.. In 1985, the Federal government of Nigeria, at theinsistence of the other state governments, decided to spread the handpumpcum PHC strategy over the whole nation, with UNICEF-supported beginnings=e in three states, Gongola, Kwara, and River Cross.

An outstanding feature of the Imo scheme was that the emerging art of “WETevaluation” was built into the project from its inception. The LondonSchool of Tropical Hedicine and Hygiene seconded an epidemiologist,Dr.Deborah Blum, to UNICEF, Nigeria, on a long-term basis to carry out afull-scale health impact study as the Imo project proceeded. It wasexpected that this study would be a major step in understanding andevaluating the effects of similar projects elsewhere.

++++

In Africa -- the struggle continues

UNICEF had in the mid ’70s established two regional advisers’ posts forwater and sanitation in Africa, one for Eastern Africa in Nairobi, one forWest Africa in Abidjan. With a few exceptions, Africa’s wide-flung array ofcountries, with their problems of exploding populations, environmentaldegradation, droughts, poverty, and weak administrations,required not onlymaterial assistance but help in programsneplanning, monitoring andevaluation from UNICEF and other external organizations. Moreover, while in .other parts of the world, UNICEF’s cooperation could be carried out in theframework of regular long-term programmed, in.the case of Africa many of thecountries, in 1984 and 1985, had to put all their energy anew intocombatting the effects of a resurging drought.

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When the internationalcommunity rallied in 1985 to help alleviate the newemergency, it was confronted with many of the same problems faced twelve orthirteen years earlier, for the great plans drawn up by the Sahel countrieswith UN backing after the 1972-73 drought had only been partly realized.The building of access roads, the expansion of transport facilities, theimprovement of range management, the development of better grain and foodstorage remained largely unattended to. Yet there was more experienceavailable; there were more specialists and equipment. The odds werefavorable that whatever funds UNICEF could avail itself of for water andsanitation would be well spent.

Certain projects, in addition to providing potable water for households,involved micro-irrigationfor family food production. Projects in Senegal,Mauritania and Hali featuring the cultivation of tomatoes and onions notonly contribute= better nutrition but helped keep the local populationsfrom migrating away from their villages. In Sudan the UNICEF/WNO JointNutrition Support Programme includes.the use of water from sub-surface damsfor small-scale cultivation.

In many cases in Africa, the post-1980 programmed tended to include morehealth and nutrition components. A certain strengthening of UNICEF’stechnical backstopping is taking place gradually in the Sahel region, andthe co-operation between UNICEF and UNTCD {Technical Cooperation ForDevelopment) continues. The concepts of sanitary excreta disposal and othersanitation measures began to spread in many project areas.

:The Western Sahel

In the Sahelian countries of West Africa UNICEF generally concentrated onwell-drilling and handpump installation,continuing efforts that had slowlygotten underway in the 1970s. It also became involved to an increasingextent with micro-irrigation, as just mentioned. UNICEF also graduallybuilt up its own support staff: in Burkina-Faso, for example, it posted aFrench hydrogeologistand a Swiss master driller to direct activities in thenorthern, drier portions of the country. In the Central African Republicand in Chad activitieswere hampered by the political situation, but from1984 an=85 on it was possible to carry our fairly substantialwell-drilling activities.

An interesting case is that of Cape Verde, a republic consisting of a groupof small islands in the Atlantic, about 700 km due west of Dakar. Theislands were not so much granted independenceas abandoned by the Portugesein 1975, and the continued effects of the drought at that latitude causedgreat hardship. During the ’70s and early ’80s Cape Verdean engineers drovelong “galleries” or tunnels into the flanks of some of the islands’ extinctvolcanoes, piercing lava barriers to tap the groundwater dammed up againstthem. Some of this water is so abundant that it is used for small-scaleirrigation as well as household use. On some of the mountain topsexperimental installationswere made of large screens. Hoisture frompassing clouds condenses on these screens and the resulting drip-off iscollected for drinking water. (Further experiments with this method havemore recently been conducted in the coastal desert of Peru).

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:WestAfrica south of the Sahel

In West Africa south of the Sahel, the wooded-savanna and rain-forest zonesdid not suffer to the same degree fro~ the drought. Nevertheless, many ofthese areas experience an annual dry season of up to six months -- a periodknown in some countries as “the hungry season”. Add to this the highincidence of all sorts of diseases caused by lack of water, contaminatedsurface water, dirt, faeces, lack of health awareness, and -- on top ofeverything -- the presence of disease vectors breeding in water, such as theanopheles mosquito and the tsetse fly: this all goes to show that UNICEF’sassistance in regard to water and sanitation was amply justified in thesecountries, too. I

‘ Some of the countries that were worst affected by these conditions were theformer Portugese colonies of Guinea-Bissau, Sao Tom6 and Principe, andAngola, along with Hozambigue to the east. So was the former Spanishpossession of Guinea Equatorial. All these gained their independence around1975 and were left completely on their own with a minimum of basic servicesintact.

Guinea-Bissau, to cite one example, had no safe rural water supplies of anydescription on an appreciable scale. After independence a good beginningwas made through a UNTCD-managed water-well project headed by a USSRhydrogeologist. UNICEF contributed to this project, including theprocurement of a number of the ingenious, though not quite perfect, Vergnetfoot pumps, which had been invented by a pair of French engineers working inOuagadougou.

The second phase of the water supply programme in Guinea Bissau, which beganin 1982, was more community oriented. It involved the digging of wells bycommunities themselves, under the supervision of specially trained localwell-diggers, or “puisatiers”. The entire project was funded through UNICEFby a special contribution from DANIDA, the Danish overseas developmentagency. The results were encouraging: there is now a cadre of some 50well-trained and motivated puisatiers, who are able to work independently.

In some West African countries there was just a trickle of assistance towell-drilling and the like, the pace accelerating around 1985. A favorableexception was Benin, where a solid programme for wells and handpumps hadbeen going on since the mid ‘70s. Originally a straight-forwarddrillingprogramme of the type carried out in India, with India Hark-II handpumps ofHalian manufacture being installed, the project broadened in 1985 to includemore attention to sanitation and a linkage with primary health care. Arecent salute to the effectiveness of the Benin programme was USAID’sdecision to channel considerable funds through UNICEF for handpump andsanitation activities, and also to link the programme to a majorUSAID-funded health education effort.

In Zaire during the 1970s UNICEF had cooperated in the planning and supplyof materials to some rather sizable spring-protectioncum gravity-feedschemes in the eastern part of the country. For a while these activities

-,40 -

waned. The formation of a National Water Supply Commission in 1985 and thedrafting of the country’s first water resources management and supply planpromised a resurgence of water and sanitation activities. Several externaldonors were being lined up to assist different parts of the country. UNICEFwas scheduled to support well drilling in artesian formations of thecentrally-locatedBandundu region and spring-protection/gravity-feedschemesin Kasai Occidental and Kivu.

In strife-tornAngola, the first projects were the rehabilitation of watersupply systems in the fundas (former Portugese plantations) which were toserve as resettlement areas #or refugees and displaced persons. WNO’ssanitary engineer designed small water treatment units of concrete whichcould be prefabricated in Luanda, the capital, and trucked to the projectsites. It was soon evident, however, that a different approach was neededto’meet Itheneeds of ru~al people in general. Two rather largedown-the-hole hammer rigs were procured by UNICEF with funding from Sweden’soverseas assistance agency, SIDA, and brought to Angola. Here they operatedunder very dangerous circumstances due to the constant state of activewarfare in the south of the country, where the roads were often strewn withlandmines and there was a constant threat of ambushes.

:Eastern Africa

In the eastern Sahel, the new drought hit Sudan in 1984/85 at the same timeas a massive influx of refugees from Ethiopia took place. The transportsituation was extremelyweak, and the normal logistic difficulties werecomplicated by a new rebel movement in the south, despite the Government’sattempts to smooth things over by providing the southerners a considerabledegree of autonomy. The onslaught of relief workers from variousorganizations, all of them motivated by compassionate considerations,was attimes as difficult to regulate as the movement of displaced persons.

The UNICEF-assistedwater supply and sanitation project in Bahr-el-Ghazal inthe south was kept going. By 1985, 800 India Hark-11 handpumps had beeninstalled in that province and in Equatoria province; but in late 1985 andin 1986 rebel action to some degree curtailed operations. Increasedassistance was directed to the arid Red Sea province in the northeast and tothe areas to the immediate south which included a number of large refugeecamps. Already, before the drought hit, a series of sub-surface dams hadbeen planned for Red Sea Province. The very dry areas of the northwest werealso slated for increased assistance.

In Ethiopia the UNICEF co-operation with the National Water ResourcesCommission gradually moved from the Provinces of Wollo and Tigre to the morecentrally located province of Shea, around Addis Ababa. The UNICEFRepresentatives during the 1980s oriented the UNICEF assistancemore towardssanitation and the links with child health and other basic services.

:Somalia, Uganda

There was a steady improvement and widening of activities in Somalia. Sincethe late ’70s Somalia had been subject to more or less permanent drought andto warfare with Ethiopia over the disputed expanses of the Ogaden. Refugeessettled en masse in camps around the Wabi Shebele and other river beds that

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Iay dry for the greater part of the year.at the best with calabashes as their onlyof the riverbeds to collect the few dropsaccumulated.

Raoid action was called for. but with the

Their women would dig by hand, ortools, pitiful holes in the sandsof muddied ground water that

slowness of the understaffedgo~ernment organizations,the difficulties encountered by UNICEF, and a hostof other constraints, there were delays upon delays. These were aggravatedby the long lead-time for the supply of equipment and materials, such asdrill rigs, casing and pumps. Few shipping companies cared to route theirships to Hogadishu, and the goods frequently were shortshipped, dotting thequaysides of Aden or Hombasa. A careful selection of well sites wasrequired to avoid the large areas underlain with waters with,high salinity(chlorides and sulphates). Despite these constraintsconsiderable progresswas eventually made. From the refugee areas in the central-southernpartsof the country, the emphasis of the UNICEF-assistedwater activities wasshifted to the even drier north, to the region around Hargeisa, where astrong health and sanitation component was added.

Further south, in Uganda, innnediatelyafter the fall of Idi Amin in 1982, amajor operation began for the rehabilitationof water wells. Uganda, alongwith Kenya and Tanzania, had been one of the few colonies, where rural watersupply through drilled wells and handpumps had been instituted on a largesystematic scale from the 1930s on. Two contracting firms, based inNairobi, in those years did the drilling and construction work, one theaffiliate of a Swedish company, the other the affiliate of a major Britishengineering group.

Both companies trained local water-well drillers. The Swedish drillingsupervisors came up with the design of one of the first appropriatevillage-level handpumps in the world, the “Uganda” pump, built from standardpipes and fittings with a heavy handle of local mahogany. If the handlebroke, the villagers could just go to the nearest forest and cut themselvesa new one. At the accession to power of the dictator Idi Amin, in thebeginning of the 1970s, some 10,000 wells with handpumps were serving largeparts of the rural populations. During a decade and a half of politicalrepression and with the ensuing mismanagement and neglect,’a large number ofthese wells fell into disuse or were wantonly destroyed outright through waror vandalism.

A huge task therefore awaited the UNICEF team, when in spite of continuedrebellions and marauding bands of soldiers and tribesmen, the programme forthe rehabilitationof these 5,000 wells was formulated. It included thedrilling of additionalwells, an incipient drive for sanitation with excretadisposal and integrationwith the PHC programme and the CSDR campaignspearheaded by immunization. Huch of the work concentrated on the dryKaramoja region, with a base, workshops and all, in Soroti.

:Djibouti,Kenya

The small republic of Djibouti, nestled around the southwestern corner of

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the Red Sea, is part of the hot Danakil Depression, characterized by barrenbasalts and other former ocean-bottom features on dry land. With UNICEF’sassistance, the first effective campaign for rural water supply was launchedin 1980. A young water well driller from the American-French coastline ofAcadia in the State of Maine, with a background in business administration,in that year plunged right into the water problems of small, scattered andextremely poor settlements. this campaign during the years won high acclaimfrom the Djiboutians. Even the President of the country himself came toinaugurate some of the well sites.

For a number of reasons, Kenya since its independence in the 1950s had beenalmost overrun by bilateral aid. UNICEF’s water and sanitation inputs inthis country never were very large. The most interesting part of work doneby any UN organization is the development of programmed of the last fewyears involving women’s advancement as connected with water and sanitation.This is managed by UNDP with substantial funding from the Norwegiangovernment and with UNICEF participating.

:Tanzania and others

Tanzania has been the recipient of massive bilateral aid for many years, butthe country is so large and the problems of providing services for itswidespread population so difficult that many years of work still lie ahead.This is abundantly true in regard to water supply and sanitation. When inthe late 1970s the Hinistry of Water submitted its requests for externalassistance to various donors, it asked UNICEF to concentrate on theWanging’ombe Project in Iringa District. The project area lies in thesouth-centralpart of the Tanzanian high plateau. No groundwater resourcesexist in the unusually dense rocks of this area. The water for the schemecomes from a group of productive wells at some distance from the villages tobe supplied. It is fed to these communities by a network of pipelinestotalling more than 250 km. Community participation in digging trenches andlaying the pipes has been particularly strong, backed by the politicalspirit fostered by the country’s “Ujamaa”movement. In the mid 1980’s thework was combined with concerted efforts to improve rural sanitation.

In Rwanda and Burundi, two small but populous countries on the eastern rimof the Great Rift Valley, water is easily available in the form of naturalsprings, and it is usually feasible to pipe water to the villages by gravityflow. Here a large part of the assistance is dedicated to training localcraftsmen for the protective masonry and plumbing work.

In Halawi, also, at the southern continuation of the Rift Valley, naturalsprings can often be used to supply water to villages. The largest part ofrural water supply, however, depends on groundwater, with drilled or dugwells and pumps. The government’s campaigns for improving agriculture andwater and sanitation through its excellent extension services have beenquite successful, partly due to favorable traditional village structures,knowledge, and practices. UNICEF support was concentrated on the poorerparts of the lower Livulezi Valley, with strong support to self-helpschemes. In the 1980s Halawi pursued intense efforts to improve its primaryhealth care system, with a strong emphasis on health education -- thusassuring good backup for community water and sanitation efforts.

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In Zimbabwe, following its independence in 1980, UNICEF helped thegovernment promote water and sanitation as an integrated part of its healthprogramme and provided technical assistance in the search for water in thedrier, rockier parts of the country.

In Swaziland, the first attempts to assist rural water supply on the part ofa UN organization came from the United Nations Environment Programme, whichhelped launch a pilot scheme in a small area to eradicate schistosomiasis (aparasitic disease transmitted by freshwater snails) through improved latersupply and sanitation facilities. Heasures were to include shower stallsand laundry facilities for the farm households -- the so-called “homesteads”-- so that the farm people and their children could avoid bathing andwashing in the contaminated,watercourses. Through UNEP, UNICEF was includedas one of the donors, and gradually the responsibility for supporting theproject went over to UNICEF.

In most of the remaining countries of UNICEF’s Eastern Africa region,UNICEF’s inputs for water and sanitation remained quite limited. InBotswana the lion’s share of assistance came from Sweden, with UNICEFcontributing only some supplies for piped water to the larger villages.Lesotho’s sanitation program, involving the construction of pit latrines,was under the supervision of the UNDP/World”BankGlobal Project for Low-CostSanitation. In Madagascar and the Comoros there was a potential for furtherassistance, but inputs were low.

Among the southern-mostcountries of the region, Mozambique received themost considerableUNICEF support for water and sanitation. Assistance wasto a large extent directed to the Hakonde Plateau, bordering on Tanzania inthe north. Its inhabitants,famous for their wooden sculptures, live on topof the plateau, away from the vector-infestedriver banks and creeks. HereUNICEF helped to provide water from safe sources down in the valleys bypumping it up to the plateau and distributing it to village taps through aseries of piped systems.

At a later stage, simple water and sanitation systems around the capital,Haputo, are planned. Large areas in central Mozambique have not beenaccessible in the more than ten years that have elapsed since independencebecause of guerrilla action. Once more peaceful conditions arrive --hopefully soon -- UNICEF will face these even greater challenges.

+ ++ +

Hiddle East and North Africa -- a widening scope

In this part of the world a wider scope for both funding and policypromotion was opened up in the 1980s, partly through the UN system’spromotion of the Water Decade, partly through the initiative of UNICEF’sExecutive Director and his personal connectionswith a number of funding andfund-raising organizations in the Hiddle East. His Royal Highness, PrincePrince Talal Bin Abdul Aziz, of Saudi Arabia played a major role inobtaining funding for UNICEF assistance to water supply and otheractivities. Among the contributors were AGFUND, the organization that

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Prince Talal himself set up to obtain development funds from the Arab GulfStates; the Arab Fund for Economic Social Development (AFESD); and the OPECFund. Lebanon received a major share of the additional funding for thecontinued rehabilitation of southern Lebanon, a uromam that was bhased outin 1985. All the other programs which benefitte~ w&e of anature.

:XEL

Hajor cooperation with Egypt began in 1981, featuring waterto large villages all the way up the Nile valley to Aswan.

supply projectsThese consisted

of wells drilled to groundwater~ electric pumps; small overhead tanks, andpiped systems to standposts, with house connections possible. For smallervillages and outlying settlements India Hark-11 handpumps were installed. Awell-drilling program in northern Sinai was also launched on thegovernment’s insistence. Here the depths to groundwater were so great (upto 1000 meters and more) as to require the procurement of heavy oil-fieldtype drilling equipment.

Environmental sanitation, and in particular excreta disposal, took a longertime to get established as part of the government/UNICEFprogram. Thedifficultieswere the usual ones:“the problem of influencing the beliefs andhabits of the villagers and the need for long-range preparation of publicawareness. Around 1979 UNICEF assistance was requested for tackling thedrainage problem in large villages and towns in the Nile delta. Thedifficulties of getting rid of excreta and other wastes in these verylow-lying areas, subject to flooding, can well be imagined, and in the eventUNICEF was able to do little about it. in some parts of the delta,particularly around Alexandria, there were World Bank-funded drainageprojects, and in later years USAID made major contributions to urban watersupply projects in Egypt.

Horocco accelerated its rural water supply work with UNICEF-assistance. Anexperienced sanitary engineer joined this strongly community-orientedprogramme in the early ’80s and was able to contribute significantly.

++++

Asia

In Asia as the new decade unfolded, population increase continued and withit problems of food and nutrition, shelter, environment and water andsanitation. At the same time, some Asian nations emerged as industrializedhigher-income countries,with a definite improvement in their quality oflife. Japanese trucks, machinery and supplies became a factor to reckonwith in water and sanitation around the world. Japan also became a majoraid-donor country, emphasizing assistance to family planning but with waterand sanitation as a strong component of its community-healthassistance.

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Singapore, Korea and Hongkong, came to play a prominent role as centers forsupplies and entrep~ts for logistic support. In the rapidly industrializingRepublic of Korea, UNICEF had by 1980 phased out its assistance to asuccessful rural sanitation programme, all support having been completelytaken over by the government itself.

:China - remarkable development, enormous needs

I

The People’s Republic of China, which has seen remarkable development,especially since 1976, still faces enormous needs for improved water supplyand sanitation in different parts of the country, including the largecities. For many areas handpumps are the only solution. In the early ’80s ;the government began co-operation with the UNDP/World Bank Handp~p 1!Development and Testing Project and built two handpump testing laboratories,one in Beijing and one in Changsha.

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UNICEF does not plan to go into assistance to low-cost water supplyprogrammed in China on any appreciable scale; the magnitude of China’sneeds are simply beyond any capacity that UNICEF could muster. (If theproblems of rural and peri-urban water supply were approached on thescale, say, of the India programme, a total investment of $10 billionwould not seem unrealistic for an initial five-year period.) In theautumn of 1985, however, UNICEF did begin to plan for support, in theform of materials, to a water supply project in Lunan county, Yunnanprovince, where 70,000 people would be provided with water from existingdams through pipelines. Related sanitation problems will be taken up inthis context. The UNICEF input in this casewould serve to illustrate anessential public health point in an “Experience Exchange Project” of highvisibility.

:Indochina,Burma

The Indochina Peninsula again attracted world attention when in 1979 theKhmer Rouge were driven out of central Kampuchea (Cambodia) by nationaland Vietnamese troops. The extent of the Khmer Rouge’s mass killings anddestruction shocked the world and triggered one of the most concertedrelief efforts in history, effectively co-ordinated by UNICEF from 1979to 1981. The emergency action was then phased over into more regularprogramme support.

Water and sanitation would have to wait until 1982, since food, health,transport and other more immediate aid had to be taken care of first.The first programming for water supply was limited to repairing theindividual systems for hospitals, schools, orphanages, and teachers’ andhealth workers’ training centres in the capital and in the districtcapitals. Two small cable-tool rigs were brought into the country asgenerous gifts from the workers of a U.K. manufacturer of drill rigs,Duke and Ockenden, for the first drilling of wells for handpumpinstallation in the countryside.

In Vietnam the sanitation activities continued with the construction ofthe double-vault latrines. Water supply progressed from the urbaninterventions of the 1970s to a more country-wide approach, emphasizingwell drilling and the installation of handpumps in rural areas, with anextension of these services to southern Vietnam. A number of systemswere created which were less costly and easier to operate and maintainfor the villagers than many of the piped schemes. Drilling operationswere concentrated on areas where it was difficult to dig water wells inthe traditional way.

To the west, Burma had had a spectacular increase in its rural watersupply activities through the Dry-Zone programme, with over 5,000 deepwells sunk from 1976 through 1985. After delivering 11 large drill rigsand ancillary equipment and other supplies for these operations, UNICEFphased out of this programme during 1985 and moved on to a majorco-operationwith the Hinistry of Health in another part of the country,principally the three provinces in the south: Rangoon, Irrawaddy andPegu. In the soft soils there, with the water tables close to thesurface, it was easier to promote wells constructed by the communities

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themselves as well as sanitary latrines. This work was closely linkedwith the existing political and administrativestructures and the variousother components.ofa major health development effort.

:Pakistan - a considerable expansion

In Pakistan water and sanitation activitieswere considerably expanded indifferent parts of the country. The provision of water supply andsanitation to a number of large villages in a very dry setting was aprominent feature of the Baluchistan Integrated Area DevelopmentProgramme in the southwest. In Northwest Frontier Province, theaccommodation of refugees from Afghanistan posed a major problem, as anestimated two-and-one-halfmillion settled in the border zone. In manycases water had to be trucked in to them in tankers; thirty of these wereprovided as a gift from AGFUND through UNICEF. As-this was a veryexpensive solution, attempts were launched to provide water by othermeans such as drilled wells and pipelines.

In the mainstream of villagewater and sanitation development, one of themost spectacular successes to which UNICEF contributed was the trainingand deployment of young women as local water, sanitation and health“promoters”. The training program was carried out over four years,1982-86, for 400 young women at the “government’sschool for CommunityManagement at Lala Husa, between Islsmabad and Lahore. This was thefirst time women in Pakistan had been trained for such work and therewere many constraints For one thing, women were not supposed to worktogether with men, whereas the ideal system was foreseen as having aman-women team working in each village. Some of the young femalestudents in these courses at first csme to the Lala Xusa schoolaccompanied by their parents for safe measure. Also, the matter ofexcreta was not supposed to be talked about in the Pakistani villages.The results, after the first years of these courses, were spectacular,not to say startling. The sudden self-assuranceof the young, once verytimid ladies was highly encouraging, and the potential of the wholedevelopment was clearly visible. The problem was to prepare thegovernment to take over the costs for the salaries of these promoters.By the end of 1985, this was still somewhat uncertain, although it seemedthat the provincial and federal governments were’very positive to theidea.

:India - diversificationand expansion

In India, with the 1980s, there came diversification and expansion ofUNICEF’s work in the realms of sanitation,health education and communitymotivation. The Government of India continued and increased its fundingand, with the state governments, the management of the water-well andhandpump installationoperations. By the mid-1980s, the Government ofIndia budget for the rural water supply programme amounted to about $650million. Presently there are a total of some 3,000 high speed drill rigsin the country, not counting machinery of other types, and thousands ofengineers and drillers involved. The handpump industry, with themanufacture of the standardized India Hark-II handpump, has over 40manufacturers authorized to deliver their products to the differentstates. It means that these manufacturers have agreed-to follow the

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standards and submit to regular control of the deliveries. This industryis reputed to employ more than 8,000 people in different parts of thecountry. Every state is now keen to have some manufacturing capacity ofits own.

UNICEF inputs in the early ’80s shifted away from the large-scaledelivery of spare parts, with much of its funding going to “software” asopposed to hardware. Particularly, it was directed toward the trainingof handpump caretakers,who have the principal role in the maintenanceand minor repair of the pumps. In spite of brave UNICEF efforts to aidand encourage the individual State organizations to take over fullresponsibility for the training of these caretakers and to expand it tothe required extent, things have not progressed along these lines as wellas was hoped. in Andhra Pradesh, for example, in 1984’,86,000 IndiaHark-II pumps had been installed, but only 6,000 caretakers were trained.

Nepal is not all mountains; it includes a low-lying section in theGangetic plains known as the Terai. In the ‘80s, UNICEF’s waterprogramme in that country was expanded to include support for shallowtube wells in the Terai fitted with suction handpumps of the type used inBangladesh. Sanitation became a more prominent part of the Nepal programas a whole, promoted by the construction of demonstration latrines aspart of all the water supply programs, whether in the higher reaches ofthe Himalayas or in the lowlands. Special attempts were made in a pilotproject in a small town near Kathmandu to clean up the whole town’senvironment and stimulate the town dwellers to better hygiene.

:Sri Lanka - strong community participation

A pilot programme for water well drilling in the hardrock areas coveringmost of Sri Lanka was started up around Hambantota in the south in 1980.It was intended to show the feasibility of the India-type of handpumpprogramme. Although there were problems with the high salinity in someof borewells, the programme was deemed successful enough to warrant itscontinuation on a larger scale. This was carried out in the north,around Anuradhapura, and later in the Kalutara District southeast ofColombo. Eventually wells were also drilled in parts of the area for theHahaveli Ganga irrigation scheme.

There was a great need to improve the water and sanitation situation ofthe extremely poor tea plantation workers living in company housing (the“lines”) in the granite hill country around Kandy. This was done throughgravity feed schemes from natural springs. One brave attempt was made toexperiment with horizontal drilling, but the equipment available reachedonly 20-30 metres into the cliffs, which was too little.

Some of the work in Kalutara was hampered by the high iron content inmany of the wells. Although not detrimental to health, the iron cloggedpipes and discolored laundry. Very simple aeration and filtrationplants were devised in the form of fibreglass boxes filled with graveland sand. These would retain the worst iron contamination and were usedwith some success.

.

-49-

A notable feature of the Sri Lanka activitieswas the very strong elementof community participation, along with enthusiastic support from thelocal district governments. This greatly facilitated integratedprogramming, with PHC and CSDR measures high on the list of priorities.Integrated programming likewise characterizedthe UNICEF-assistedsanitation project in some of the low-income areas of Colombo, its firstventure into the vast problems of the poor urban areas in Sri Lanka.

++ ‘+ :+ ,

The Americas:urban urgency

,A salient feature of life in the Americlas~Regionin the early 1980s wasthe continued accelerat~on in the growth of cities’,illustrated by theoft-quoted figures for Hexico City, which grew from 4 million inhabitantsin 1960 to 20 million in the Distrito Federal in 1985. The Americas inabsolute terms continued to receive the smallest share of UNICEF’sassistance in this decade, but through carefully programmed inputs UNICEFwas able to make meaningful contributions to a number of self-helpprojects in poor urban areas.

In four coastal cities in Mexico, campaigns were launched to help slumdwellers build latrines, not an easy task,as the location of theirdwellings had been forcibly restricted to low-lying marshlands close toestuaries, which frequently flooded homes ,andstreets. In the programmefor the “Pueblos Jovenes” of the “Barriadas”of Lima, Peru, aid was givenwith designs, tools and materials to construct simple water supply,shower and laundry facilities, along with lat’rines. Special problemscould arise -- how to overcome the opposition of private water vendors,for example, whose profitable monopolies were threatened by theintroduction of piped water. This problem arose while planning forUNICEF support in the poor urban,areas of Guayaquil, Ecuador, and ispresently being studied.

The rural water supply activities with UNICEF assistance continued in theCaribbean. Haiti managed to give a major boost to a new water well cumhandpump programme, introducing the India Hark-II pump to the region-Previously cast-iron pumps of traditional designs had been predominant.During the last years in Haiti, this task was greatly helped though thededicated professionalmanagement of the Director of the National Societyfor Drinking Water, engineer Pierre Sajous. The recent political changeswith the end of the 28 years of rule by the Duvalier family, may bringabout a further and much-needed increase in activities.

In Central America, after some years of low-key but continuous support to “Guatemala, Honduras, El Salvador and Nicaragua, a marked increase ofplanning for UNICEF-fundedwater and sanitation activities took place.An entirely new programme for well drilling and handpumps began in 1985in Belize. By the beginning of 1986 the establishment of an area postfor Central America of a joint Pan American Health Organization/UNICEFwater supply and sanitation adviser was seriously being considered.

++++

-50-

1!’

PART III -- SUHHING OUTLOOK

-51-

Children, water, and the environment

Children, as the most vulnerable group of human populations, are the onesmost dependent on their environment. In the parts of the world wheremost of UNICEF’s inputs are applied, the deterioration of the environmentis progressing at an accelerating rate. The resulting loss ofagricultural production and other means to sustain a reasonable qualityof life, including the supply of water and household fuel, tend tosustain high infant and child mortality and morbidity rates.

This degradation of the environment can take dramatic forms. Entirevillages on the slopes of the Himalayas in Pakistan, Nepal and northernIndia are carried down into the valleys, forcing thousands of people tosettle in the already over-populatedlowlands. In Hexico, a drying up ofsoil and groundwater resources along with damaging agricultural practicesare destroying entire landscapes. Some of the UNICEF-assisted projectsin Chiapas risk being laid waste in a few years because of thesephenomena, causing wholesale migration of entire communities to thecities, especially to the environs of Hexico City, already perhaps theworld’s largest urban conglomeration.

The impact of these negative environmental developments on children’slives and well-being is evident and has to be taken into account inplanning for the improvement of their condition. At the same time, therehave been encouraging technical developments over the past forty years insuch environmentalmatters as water, sanitation, and vector control, andboth governments and aid organizations have given greater priority tothese environmentalconsiderations.

The rehabilitation of damaged water and sanitation systems immediatelyfollowing World War II primarily dealt with municipal systems in the moreindustrializedcountries, and the requisite skills and experiences werereadily available. This was not the case in the countries comprising theso-called Third World, most of which at that time still consisted ofcolonies. The independenceof the ‘formercolonies, the gradualimprovement of administrationsand human capabilities combined with thedevelopment of external sources of cooperation and assistance, slowly ledto a recognition of the needs for basic services on a nation-wide scaleand the possibility of providing them on a economically feasible basis.Although still incomplete and in some parts of the world interrupted bynew bouts of human conflict, this development process, helped by greatscientific, technical and industrial advances, seems to be spreading withpositive benefits. The problem now, especially in the fields of watersupply and sanitation,which require a global awareness and majorinvestments along with participation by the communities concerned, ishelp promote the coverage of entire populations in spite of the rapidincrease in their numbers.

The health factors -- new insights

to

It becsme evident over the past four decades that determining the effectsof water supply, sanitation and other environmental factors on health,and consequently the social and economic conditions of communities -- andin particular.on children -- was a much more complex matter than had at

-52-

first been realized. Biomedical, epidemiological, immunological,nutritional and other research, combined with technical developments anddevelopments in the social sciences, have provided insights which nowmake it possible to plan more purposefully for remedial action.

This in its turn has greatly stimulated the present integrated approachesto improvements in the health conditions of children and the communitiesthey live in. It has helped in a better combination of preventive andcurative measures, including improved vector control, immunization,newdrugs (e.g. against schistosomiasis) in combination with the provision ofsafe water and sanitation facilities. Zhe need for water supply inadequate quantities -- not only better quality -- has been furtherrecognized in its effects on personal hygiene, with a direct impact onother categories of diseases, notably skin and eye infections. Equallyimportant, easier access to household water directly benefits women andolder children by reducing the energy they waste on long hauls of waterfrom distant sources, leaving them time and energy for more productivework. Yet another health spin-off lies in the use of excess water from -pumps or gravity-feed schemes for micro-irrigation. This can be appliedto raising nutritious vegetables and fruits, improving both childnutrition and the family economy.

++++

The remedies: a revolution in technologies and social awareness

The past forty years have witnessed great changes in the awareness of thebasic needs of the poorest populations and in the approaches to solve theconnected problems. These changes are the result of a trial and errorprocess in terms of concepts, technologies,planning and programming.The need to assist the poorest areas, both rural and peri-urban, prompteda departure from the conventional, strongly urban-oriented approaches.

Thus, in water and sanitation, the overall trend, especially during thelast fifteen to twenty years, has led to lower-cost technologies and thedevelopment of projects and their implementationon a community basis.Some of the lowest cost handpump installations,e.g. in Bangladesh, canIbe carried out for as low as $2 per capita. US $25 per capita is anormal figure for deeper handpump installations in borewells or for pipedgravity feed schemes with public standposts. This compares with costsfor high-technologywater installationsranging from $300 to thousands ofdollars per capita.

The use of high-speed water-well drill rigs has made it possible to sink50-metre wells (150 feet) in hard rocks in one eight-hour shift, asagainst one to four months with traditional equipment. The handpumptypes of yesteryear had to be redesigned radically in order for each pumpto effectively serve hundreds of villagers daily. The combination ofsuch technologies is now bringing water supply to another estimated 45million people in India each year. New sophisticated filter media withstrong germicidal properties promise to further improve water quality.The lowering of costs for solar energy will contribute to an easier flowof groundwater to remote communities. Subsurface dams are increasingly

>

-53-

coming into use in tropical and subtropical regions, where the waters inopen dams disappear too rapidly through extreme evaporation rates.

Similarly, sanitation technologies have moved towards low-cost optionswith the use of local materials and locally acceptable designs. Thispertains especially to excreta disposal. Installations such as the “VIP”(VentilatedImproved Pit) latrine are coming into wider use and helplower the risk of infections via the fecal-oral route. Recycling of~astes and the comporting of fecal matter for the producti~n offertilizer and biogas may not have won universal acceptance but are~racticed ina number of countries with direct economic benefits for thelocal populations. ;I

:kocial approaches I II

The old “top-down” type of programming and project implementationleft inits wake thousands of unusable costly installations in the form ofderelict water treatment plants and broken handpumps, leaving thecommunities in the same or worse health conditions as before. The samepertained to the scant efforts to promote environmental sanitation, asubject even less enticing to the conununities.A full realization of theneed for community participation, combined with the appropriatemotivation and education, came about generally,onlyduring $he 1970s.This concerns any type of activity, but is particularly relevant to thevery basic services of water supply and sanitation, which r“quireconcerted agreement and action on the part of the people wh~ stand tobenefit.

~In this context, the particular importance of women’s role ~s worth, )

noting. Not only are women the traditional providers of water or“managers” of their own households, but they are the educators of infantsand young children as well as of the older girls. So far, however, inrelation to project planning and participation, they constitute a littleor poorly used resource. In parts of rural Pakistan, the training anduse of women as village sanitation workers has made for a kind ofbreakthrough in traditionallymale strongholds. In Ethiopia thesurprising strength of the village women’s associations is fu~ther -supported through easier access to water.

The recently intensifiedaction in the field of human resourcesdevelopment is an important factor in strengthening the social basis ofwater and sanitation programmed. This includes training of people at alllevels -- government, technical support staff, social workers, and aboveall community workers themselves. Insufficient skills and their unevendistribution are still the principal bottlenecks that have to beovercome. Health and sanitation at v“illagelevel, a good part of itdirected toward the children, is the final and most important step inhuman resources development.

:Finance and administration

A vast investment in funding and administrativecapacity is clearlyneeded to bring about the equally vast improvements that adequate waterand sanitation would bring to the children and families who still lack

-54-

these necessities. Less than half of the needs have been covered todate, Yet there is reason for encouragement. Communities seem morewilling and interested in contributing their share to the financing andupkeep of facilities. Governments in the developing countries now havenational plans and corresponding budget lines where there were nonebefore. Administrations in many countries are better geared to supportthe work.

New insights, increased levels of activity, and Icorrespondingplanningand management complexities have led to the inc~eased use of evaluationsfor more efficient monitoring and administration. The systematicdevelopment of new evaluation techniques and ~thodologies is still underway, and the ultimate effects of the various water and sanitation

: progrsmmes on the ‘healthand lives of childre~ will probably take a longtime properly to estimate and evaluate. ~ I

++++

International action and UNICEF’s role

Action in the fields of water supply and sanitation has advanced overpast ten years more than anybody might have anticipated even around

the

i970. This development is being facilitated by unusually concerted andpolitically non-controversialactions among the ifferent countries in

!the world, thanks in part to the influence of th International DrinkingWater Supply and Sanitation Decade 1981-1990. A considerable part of thepresent trend towards improvement in this field in the majority ofdeveloping countries would seem to be due to thel’’Decade’s”promotionalimpact. The Decade does not constitute a progrsmme in itself, and itsgoal of adequate water supply and sanitation for everybody by the year1990 will undoubtedly remain unfulfilled in many countries, but at leasta beginning has been made. UNICEF’s role is impossible to assessproperly, since it involves such close cooperation and coordination withothers: governments, international agencies, and other agencies --hundreds of them. It is difficult to state where the work of one agencybegins and another ends. Yet UNICEF’s concern for khe poorest segmentsof rural and peri-urban populations has certainly contributed to a morerapid coverage of these groups on a national scale in many countries.Its effective cooperationwith a number of major internationalorganizations,notably WNO, UNDP, UNDTCD and the World Bank, hasdeveloped into what is probably one of the best United Nations supportactions at any time in a specialized field.

++++

Outlook

The dependence of children on their physical environment andenvironmentally-relatedbasic services has been brutally, tragicallyillustrated during the past fifteen to twenty years through enormousecological catastrophes:on a large scale in Africa; on only somewhatsmaller and slower scales in parts of Asia and the Americas. The

-55-

question of water and sanitation for child health and welfare has to beseen in this wider environmental context.

Up until now there seem to have been positive advances in children’simmediate environment in most developing countries -- although theseadvances are in danger of being outbalanced by the still rapid populationincrease in large parts of the world. The greatest uncertainty is in thethreat of the deterioration of the environment at large, caught in thecycle of overpopulation,deforestation, overgrazing, overcultivation,erosion, dessication and desertification.

The next great step to take will be increasing the awareness of theenvironment. For this, a motivational and educational effort ofunprecedented dimensions is overdue. It will have to be directed toadults and children alike and will have to be accompanied by practicalmeasures, involving agricultural extension and all phases of communitydevelopment. After all, the children of today face an environmentalheritage in many respects more depleted than it was forty years ago.

-S6-

ANNEX I

Unicef Total income 1947-85RedsndNominslTerms

M “

300”

“ 2so-g~ ~.

J IlcQ -

/A! LIA o“>-’-~\/,--

-4-Expenditure ,

------+0- ....................

for

I90 1952 1%0 1970 19s0 !98?ndwater supplysanitation

Years

— Nominal ---- Real(l%5=100)

Expenditure on Programmed by Sector1947-85

Nutrition Inotincluded in

wother WC!(VSI

Social wvicesfor children M

Formnt andnonformul &3educo[ion

probctsuppnrl ‘*Pfwrninu and

Emergency relief A

mI-1 \

/ S507m” \ I /

( 1;%\‘+)

coAl I m

//.,

v 15%

=%s229m

\

&

A04Rm

“+-Y“ Expendi{urc forwuter supply inuurred prmrto 1970 isincludedinh;tsic heulth,

-57-

ANNEX I

Unicef expenditure from inception through 1986($ million)

1947-50 1951-59 1960-69 1970-79 1980-86 1947-86

Long-range aid: I I

Health services 8.0 26.0 97.7 313.8 481.4 92?.9 $Mass disease control

campaigns I I 12.3 56.7 82.2 * % 151.2Water and sanit tion

P* * * 156.3 409.0 565.3

;,Child nutrition’ 5.4 19.1 47.3 87.0 124.8 283.6Social welfare servicesfor children ‘k * 9.1 49.3. 111.1 169.5

Formal education ‘ -- -- 30.3 170.9 158.7 359.9Nonformal education -- -- 2.4 27.7 71.3 101.4General** -- -- 6.3 62.3 212.7 281.3

Total long-range aid 25.7 101.8 275.3 867.3 1569.0 2839.1Emergency relief**~ 82.3 34.8 11.1 42.7 209.3 380.2

Total programme aih 108.0 136.6 286.4 910.0 1978.3’ 3219.3Programme supportservices I

1’0.3 14.1 42.4 158.1 359.9 574.8

Total assistance 1’ 108.3 150.7 328.8 1068.1 2138.2 3794.1Administration costs 6.6 10.6 25.5 97.9 261.2 401.8

Total expenditures 114.9 161.3 354.3 1166.0 2399.4 4195.9

* Included in health services.** This assistancelcannot be broken down into the above categories. It

includes mainly’planning and project preparation, project supportservices and project support communication.

*** Not including expenditure for rehabilitation of facilities damaged ordestroyed in emergency situations which is distributed into appropriatecategories of assistance.

-58-

ANNEX I

One Year of UNICEF Co-operation

.

COUNTRY

for Water Supply and Sanitation: 1986

EXPENDITURES(in US $)

BENEFICIARIESWater Supply Sanitation

West Africa

Ango~a, 1,169,000 30.500 2!000Benin 402,000Bur~in~ Faso 688,000Came!rooh 213,000Cape Verde 166,000Central African Rep. 494,000ChadGambiaGhanaGuineaGuinea-BissauLiberial,Hali 1,HauritahiaNiger iNigerialSenegal

LSierra coneTogoZaire

East Africa

BotswanaBurundi ~ComorosDjiboutiEthiopiaKenyaLesothoMadagascarHalawiMozambiqueRwandaSomaliaUganda

11,000163,000303,000216,000307,00025,000669,0002,000

189,0002,214,0001s7,00080,0002,000

393,000

106,000. 401,000

104,00047,000

2,656,00058,000

203,000114,00031,000

419,000

198,000479,000

2,878,000United Rep. Tanzania 454,000Zimbabwe 193,000

27,000

161,00075,000

100,000

174,000

621,00017,900

19,000123,40020,00051,000190,000

11,400

1

29,00025,000

1,200

3,000

20,00015,800

13,400

--

1,500

3,600

-59-

ANNEX I

COUNTRY

Hiddle East andNorth Africa

Democratic Yemen

EgyptJordanLebanonHoroccoOmanSudanTunisiaYemen Arab Republic

Americas

ArgentinaBelizeBoliviaColombiaCosta RicaCubaDominicaDominican RepublicEl SalvadorGuatemalaGuayanaHaitiHondurasJamaicaHexicoNicaraguaPanamaParaguayPeruOther CaribbeanRegional UrbanEastern Caribbean

One Year of UNICEF Co-operation

for Water Supply and Sanitation: 1986

EXPENDITURE BENEFICIARIES(in US $) Water Supply Sanitation

108,000

1,118,0002,000

3.,906,000285,0007,000

1,S16,000692,000351,000

109,000138,000412,000

-o-90,00025,00027,000

-o-20,000199,00035,000700,000

-o-26,000188,00082,00017,00043,000

148,000

249,000

N/A

77,000

3,200,000

N/A112,500215,00050,000

135,000N/A

60,500N/A

4,000N/AN/AN/AN/A

39,2002,800

122,000

N/A

0,6007,70045,000

N/A

12,000

10,000N/A

3,2003,8008,000

1,100

12,0004,700N/A

N/AN/A

38,40030,000

10,900N/A

-60-

ANNRX I

COUNXRY

South Central Asia

AfghanistanBhutanIndiaHaldivesNepalSri Lanka

East Asia & Pacific

BangladeshBurmaIndonesiaKampucheaLao P.D.R.PakistanPapua New GuineaPhilippinesSolomon and otherPacific IslandsThailandVietnam

One Year of UNICEF Co-oDeration

for Water Supply and Sanitation: 1986

EXPENDITURES(in US $)

57,000107,000

12,239,00066,000

1,434,0001,162,000

1,360,0002,558,0001,117,0001,327,000287,000

2,619,000.34,000

77,000802,0002,205

BENEFICIARIESWater SupPly Sanitation

115,00014,800

3,256,00012,000107,500241,600

61,000N/A

469,0003,000

24,50090,600

6,778,000 103,800325,500 1,406,900382,800 9,500

NIA90,000 N/A309,300 42,000

N/A N/A

WA1,257,000

71,50032,0000,300

-61-

ANNEX II -- SELECTED BIBLIOGRAPHY

ARLOSOROFF, Shaul et. al.: Community water supply: The handpump option.The World Bank, Washington, D.C. 1987.

BEYER, Hartin G.: The WET histor~. Water and sanitation in UNICEF 1946-1986.UNICEF WET Honograph No. 2, UNICEF, New York 1987 (unabridged).

BLACK, Haggie: The children and the nations. UNICEF, New York 1986.

BRADLEY, David, WHITE, Gilbert and WHITE, Anne: Drawers of water: Domesticwater use in East Africa. University of Chicago Press, Chicago, 1972.

I

BRISCOE, John, FEACHEH, Richard G. and RAHAHAN, Hujibur H.:Evaluating health impact. Water supplj, s nitation and hygiene education.

?IDRC, Ottawa, Ontario, 1986. (Co-publishe with UNICEF and IC DR,B.)

?

GLASGOW, Huriel (Edit.):Promoting health behaviour in water and sanitationprogrammed. Report of a Working Group, UNICEF, New York, 25-29 Harch 198S.

GLENNIE, Colin: Village water supply in the Decade: Lessons from fieldexperience. Wiley, London, 1983.

JORDAN, Tom: A handbook of gravity-flow systems. Intermediate TechnologyPublications, London, 1984.

HA Yansheng and ELHENDORF, Hary: Insights from field practice: How women havebeen and could be involved in water supply and sanitation at the communitylevel. Inter-AgencyTask Force on Women and Water for the UN SteeringCommittee for Co-opera~ive Action on the IDWSSD, November 1984, New Y,ork.

SAUNDERS, R.J. and WARFORD, J.: Village water supply: Economics and policy inthe developing world. Published for the World Bank by the Johns HopkinsUniversity Press, Baltimore, 1976 (A World Bapk Research Publication).

SPIEGELHAN, Judith H. and UNICEF: We are the children. A celebration ofUNICEF’s first forty years. The Atlantic Honthly Press, Boston/New York,1986.

TATA Economic Consultancy Service (Bombay):Semi-industrial projects assistedby UNICEF in India. (Part on India Hk-11 handrmxm.) UNCEF Regional Officefor South-CentralAsia, New Delhi, Dec. 1984.

UNICEF: Water supply and sanitation. PrograxmneField Guidelines, Book E.Draft, UliICEF$New York 1987.

UNICEF: From the UNICEF waterfront. Newsletter, issues 1 - 34, UNICEF, NewYork, 1975-1986.

UNICEF/WHO: Joint study on water SUPDIY and sanitation components of Primar~Health Care. UNICEF Document E/ICEF/L.1386,New York, 15 December 1978.

UNICEF: Guidelist AQUA (Equipment and materials for water supply andsanitation). Under preparation for publication 1988. UNICEF, New York. “

UNICEF/WHO: Joint study on water supply and sanitation components of PrimaryHealth Care. UNICEF Document E/ICEF/L.1386,New York, 15 December 1978.

ANNEX III - INDEX

AdministrationAFESD see Arab Fund for Economic and Social

&elopmentAFPROAfghanistanAfricaAGFUNDAlternative energy sourcesAltiplanoAmericas RegionAmin, IdiAndhra PradeshAngolaAnuradhapuraArab Fund for Economic and Social DevelopmentArab Gulf States Fund (see AGFUND)Artesian aquifersAsiaBaleBaliBaluchistanBangladeshBangladesh New No. 6.HandpumpBasic servicesBeerm&nn, VictorBeijing“Bench drills”BelizeBeninBeruti, TonyBeyer, MartinBilateralBilharzia (see Schistosomiasis)BiogasBlock Development OfficersBotswanaBreast-feedingBurkina FasoBurmaBurundiComorosCape VerdeCaretakersCaribbeanCarter, GordonCentral African RepublicCentral AmericaChadChiapasChild Survival and Development Revolution(see also CSDR)

53

131922-26, 37-4343363129-32, 49 I40 I

14, 4811, 39, 4048 ,,44 I

1!40 :11-21, 44-4824224711, 17, 52 I185444

49392814, 2811, 28

5315433223, 3819, 464243382630, 49143830, 493830, 5132

. ,,,~,, ,..,, . ,, ..,

-62-

ChildrenChina, People’s Republic ofClub of RomeCommunity participationComportingCompressed airCosta RicaCraelius East African Drilling CompanyCSDRCuzcoDANIDADanakil DepressionDemonstration projectsDiarrhoeaDjiboutiDocumentationDominican Republic“Donkey pump”Drill rigsDrought monitoring“Dry Central Zone”East AfricaEast PakistanEgyptEl Fatih, ?IohammedEl SalvadorEmergency situationsEngebek, PerEnvironmentEnvironmental sanitation

EquatoriaEthiopiaEthiopian AirlinesEthiopian Water Resources AuthorityEvaluationsExcreta disposalFAOFertilizerFilter mediaFinanceFloods, Indus RiverFrancis, Hr.FundingGandhi, MahatmaGemmu-GoffaGoalsGOBIGoulet, LeoGrameen BankGravity Feed SchemesGreen, StephenGroundwater

3, 51, 544525, 9, 20, 34, 35, 49, 53534, 26301433, 34, 35, 41,,4831 I3924, 4293, 16, 33 ‘ ,2s, 41 1!630254, 12, 26, 35, 522219, 4623, 471144264911, 22-26, 272538, 51, 5415, 16, 21, 33, 35, 37,44, 46, 472523, 402424, 4033, 37, 5416, 21, 37, 44, 473021525318152, 3, 27, 28, 531524336191839, 20, 48244, 12, 17, 37

-63-

Growth monitoringGuatemalaGuayaquilGuineaGuinea BissauGujaratHaiphongHaitiHandpump caretakersHandpump installationHandpumps

testing and developmentHhno~

iHarar eHarijhnsHealthHealth educationHealth effectsHealth factorsHealth impactHigh Density PolyethyleneHonduras’Hongkong, I

Horizontal drillingHI@ see Human Resources DevelopmentHuman Resources DevelopmentHydraulic ramsHygieneImmunization I

IndiaAhmedabadAndhra PradeshBiharGujaratOrissa I

PatnaTsmil NaduTirunelviBihar/Orissa droughtGovernment of India budget

India Hark II handpumpIndia village water programmeIndochina PeninsulaIndonesiaInformation exchangeInter-AmericanDevelopment BankInternationalDrinking Water SupplySanitation Decade

Iringa DistrictJagtiani, KumarJamaicaJapan

3330, 49493939162130, 4926, 4814, 5214-15, 18, 25, 26, 39, 4736, 452124163, 33, 37s, 3533513319494438

6, 26, 34, 5321633, 5211-17, 47-48, 5216 s14, 48161614161515134715, 26, 39, 4711, 474521629

and5, 33, 5442 -133044

-64-

Japanese assistance to family planning andcompmnity health

JCHP see Joint WHO/UNICEF Committee onHea= Policies

Joint WHO/UNICEF Committee on Health PoliciesJubaKalutaraDsmpucheaKaramoja regionKennedy, MalcolmKenyaKhmer RougeKing, Dr. Alexander~~a, Republiy of

Latrine constructionLatrine pansLatrines: communalLebanonLesothoLimaLivulezi ValleyLom6 conferenceLondon School of Tropical Hedicine and HygieneLow-interest loansMadagascarHagsaysay pumpHahaveli Ganga irrigation schemeMaker, JosephHakonde PlateauHalawiHaliMalnutritionManagementHanua!llyoperated shallow tubewell irrigationMaputoEar del PlataMauritaniaHexicoMexico CityHcLeod, KenHicro-irrigationHiddle EastHochaHoroccoMozambiqueHt. HermonNaimy, RaymondNepalKathmanduTerai

New No, 6 Handpump

44

9254846 ‘411341462452121, 35, 46211627, 44

I

434942223718432048 I26 I

434223, 38236, 261843333849, 51491538, 5227-29, 43-44284443272819, 48484818

-65-

NicaraguaNigerNigeriaImo State

Nile DeltaNon-governmentalorganizationsNorsk Kirkehjhelp see Norwegian Church AidNorth Africa —North YemenNorthern Sinai

II

Northwest Frontier ProvinceNorwegian Church AidNorwegian governmentNutritionOgaden 1OPECOpen Wells“Operation Water Jug”Oral dehydrationPAHO see Pan American Health OrganizationPakis= IPan American Health OrganizationPan American Sanitary Bureau IPanamaParaguayPatna conferencePercussion hammersPeri-urban areasPeruPHC see Primary Health CarePhil~inesPiped waterPol PotPrimary Health CarePrince Talal Bin Abdul AzizPRODESCHti-Programapara el Desarrollode 10S Altos de Chiapas

Programme CommunicationProgramme Funding OfficeProject Support Communication“Puisatiers”Punta del Este ConferencePVC pipes #

QuechuaQueen of ShebaRainwater collection basinsRainwater harvestingRecycling of wasteRefugees

49233636-374410, 13

432844

47

254233, 372444212833

5, 11, 18, 4749293031162848, 499, 31, 49

2019-21, 24, 27, 29465, 34, 35, 36, 4949

303445, 3439291931282721, 225310, 40

-66-

RehabilitationRelief operationsReid, Richard“Revitalization”RwandaSahel“Scavengers”SchistosomiasisSelassie, Haile“Self-help” (see also Co~unity Participation)Seminar: Cox’s BazaarSenegalSierra Hadre de ChiapasSindSingapore I 1““Sludging’”Social approachesSocial mobilizationSolar energySomaliaSouth KoreaSri LankaSt. VincentStaffStandardizationSubsurface damsSuction pumpsSudanSurinamSwazilandTAG see Technical Advisory GroupTalb~ RupertTamil Nadu Water and Drainage BoardTanzaniaTechnical Advisory GroupTechnologiesTeraiTerratestThailand“Three-tier system”TigraiTr6ften, Per-FredrikU(X see Universal Child ImmunizationUgan=“Uganda” pumpUjamaa MovementUN forces

10, 271036254211, 22, 23, 38, 401643, 52249’33, 34233011, 1845175, 34, 535, 345240-414520, 4830615, 4740, 531811, 25, 403043

151542354, 10, 12, 35, 524814201524, 4025

4114$ 414227 ‘

-67-

UNDPUNDP/World Bank Global Project for Low Cost Waterand Sanitation

UNTCDUNICEFadvocacyobjectivespoliciesrolescope ofstaffing structure

United Nations Development Progrsmme see UNDPUnited Nations Environment Programme —United Nations Department of Technical Co-operationfor Development see UNTCD (

United States Agen~for International 1Development see USAID

Universal Chil~mmunizationUpper Volta I

UrbanUrban water supplyUSAIDVector controlVentilated Improved Pit latrines (see VIP latrines“Vergnet” foot pumpViet Nam Double Vault Compost LatrineVietnamVillage Health WorkersVillage Level Operation and Hain~enanceVillage promotorsVIP latrinesWater and EnvironmentalSanitation Teem see WETWater DecadeWater treatmentWater well diggingWest AfricaWET 6, 14WHoWolloWomenWomen’s advancementWomen’s drudgeryWorld BankWorld Health Organization see WHOYemen Arab Republic —ZaireZaluka, VladoZimbabwe

35, 4523, 24, 38, 39, S4

35233, 5436

33, 35234921, 4918, 4452

392121, 46364, 364735-36, 53

3321, 272423, 39

9, 13, 26, 5424, 406, 47, 536, 47, 5320, 3420, 35

2839-402543

Fi!!L