"The good things with dreams put into action is that they come true" (Michael LeBoeuf)

"Not very much happens without a dream. And for something great to happen, there must be a great dream ... much more than a dreamer is required ... but the dream must be there first" (Robert K. Greenleaf).

Saving 4 000 000 lives per year is a great dream, but that is only a part of what is possible. Effects of improved sanitation are also: reduced malnutrition, better resistance to other diseases, increased productivity, better economy, more education, etc., not to speak about the happiness of being healthy.

Success at our fingertips

Imagineering: The good thing with dreams put into action is that they come true. Michael LeBoeuf

Imagine a new disease

Imagine that a new disease like AIDS or Ebola killed all the people in Norway in one year, and in the following year the population of Denmark. The population in the Nordic countries were all eradicated in a 6 years , and the disease was spreading down the European continent. Imagine the panic! And imagine the media attention and resources which would be allocated to stop the epidemic.

4 million people dead by toxin produced by faecal germs in one year. The produced toxin leads to severe loss of fluids and dehydration. In one year the disease have killed 4 million people (corresponding to the total population of Norway) disabling approximately an other 10 million. In the coming years time population corresponding to all people in Northern Europe can be expected to perish unless preventive measures are applied.

4 million deaths per year

The disease is real. Faecal matter is the single largest cause of disease in the world and is killing over 4 million people each year in diarrhoeas and intestinal parasite infections. It is disabling many more through secondary malnutrition and reducing resistance to other diseases like malaria, respiratory diseases and tuberculosis, causing poverty and considerable economic stagnation in a vicious circle. It can be prevented with water, sanitation and personal hygiene.

Can be stopped

Recent research show that children's faeces are up to 20 times more dangerous than the faecal matter of an adult person, and that improvement of water supply and personal hygiene have no health impact if not accompanied by safe disposal of the human faeces (use of latrines). Over 80% of all human faeces in developing countries are not disposed in a latrine and approximately 70% of the people do not even have one.

Environmental protection

We are seriously concerned about environment and forget that people are poisoned to death by toxins produced by faecal borne germs in the domestic environment. Mothers with hands contaminated by the children's faeces infect food and domestic utensils, including containers for water and food. 4 million deaths per year, severe disabling, unnecessary malnutrition and disease and poverty could be avoided.

Technology

Almost any person in a developing country knows how to build a traditional latrine using local materials, and almost any traditional latrine can be improved with a SanPlat to the cost of about two US dollars (less than 50 cent per person). Wealthier families can build themselves VIP and Pour-Flush latrines if they prefer a higher standard.

Behavioural change

People will not start using latrines until they have one. Personal hygiene is a confused but well accepted concept in all cultures but will have little or no effect until people get rid of the faecal matter (in a latrine) which otherwise will recontaminate water, food and recently washed hands.

Social marketing

Improving sanitation depend critically on selling ideas, concepts and behaviour, and consequently a question of marketing skills. Social marketing requires the skills of commercial marketing and a bit more. Commercial marketing satisfies felt needs. Social marketing creates the awareness of the needs. Through advocacy, ideas and visions can be sold to key personalities including presidents and prime ministers, ministers of any involved ministry, top religious leaders, politicians and other influential personalities. Through social mobilisation, supported by advocacy achievements, partnerships can be forged with key ministries and local authorities, local leaders, health committees, traditional healers and birth attendants, schools, religious institutions and community groups, etc, which can be assisted with training and required material. Through the forged partnerships a massive marketing machinery can be mobilised to move people with competence and commitment, eventually making people and find their own practical solutions.

The potential success

The possible health impact can be estimated by comparing the burden of faecal borne diseases in for example Africa with industrialised countries where the water and sanitation problem is solved and where personal hygiene is more adequate. The relation is 1:41.6 which means that the rate of faecal borne disease can be reduced to 2.4% of the present level.

The missing step

The world has decided to solve the problem of water. Governments and agencies are focused on water. People settle where there is water and move from places where water is scarce. Commitment at all levels is there and resources are in the process of being allocated. Opinions about faecal matter are still confused, but knowledge about the danger is spreading. The information explosion makes that important knowledge spread fast and correctly. And the concept of cleanliness and personal hygiene is appreciated in all cultures. Who is committed to sanitation? Everybody in the third world knows how to build a latrine and it is still easier to use one, but something is missing between practice and what is obviously right to do.

Imagineering success

More and more studies have proven the strength of imagination. Football players around the world are trained to imagine the ball in the net to feel the triumph before it has happened. No successful boxer would step into the ring without being convinced about his victory. Without being convinced he would had lost before the match began. Water and sanitation engineers are enthusiastically sinking wells and training pump mechanics, but few feel encouraged setting up a community managed sanitation programme. Politicians know that they can get more votes on promising free water than encouraging people to build latrines, all imagineering success.

Do we want sanitation?

Are we afraid of the population explosion? Sanitation is a powerful tool to save lives. Many people fear that if too many lives are saved, that the world's poorest population should be growing too fast and create more poverty. The answer is that faecal borne diseases create more poverty and that populations grow faster under uncertainty: "If children may die, it is better to have many." Countries with low population growth are the ones where children survive. Improved sanitation is a human way to control population growth. Improved sanitation is a global need.

Imagineering sanitation

Improved sanitation deserves top priority on the word development agenda. Waiting for the demand to develop is cynical as we know that the people who need it most don't even know the benefit of it, but the awareness can be created. The question of hindering taboos is a ridiculous excuse as long as most "western" families have "bathrooms", which rather look like hygienic laboratories than shit houses, still they talk less confortably about faecal matter than people in rural Africa. Technically and economically the sanitation problem can be easier solved than for example the water and hygiene education problem. We need a mental switch now, commitment, positive thinking and imagineering success in the same way as any foot ballplayer or boxer would do. Imagine if each major development agency had a senior level sanitation manager to pep up his economists, engineers and administrators before each budgeting session and hearing providing progress data, encouraging prognoses and reports.

Success is at our fingertips if we are able to believe in it.