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This analysis of the human rights to safe drinking water and sanitation (HRtWS) uncovers why some groups around the world are still excluded from these rights. Léo Heller, former United Nations Special Rapporteur on the human rights to water and sanitation, draws on his own research in nine countries and reviews the theoretical, legal, and political issues involved. The first part presents the origins of the HRtWS, their legal and normative meanings and the debates surrounding them. Part II discusses the drivers, mainly external to the water and sanitation sector, that shape public policies and explain why individuals and groups are included in or excluded from access to services. In Part III, public policies guided by the realization of HRtWS are addressed. Part IV highlights populations and spheres of living that have been particularly neglected in efforts to promote access to services.
This chapter imagines an ordinary day in the life of a female monastic community in twelfth-century Germany. The chapter, like the monastic day, is organized around the celebration of the monastic liturgy of the hours. Between the liturgical hours in the oratory, the nuns attend to their daily business in the cloister, chapter house, lavatory, refectory, and workshops. The flow and activities of this monastic day are based primarily on the Rule of St. Benedict, the customary of Hirsau, and Hildegard of Bingen’s own commentary on the Rule of St. Benedict, as well as on archaeological and bioarchaeological evidence that reflects medieval monastic lifeways.
We conducted a paleoparasitological study on sediment samples from two trash pits and a cesspool, collected during an archaeological assessment of a building located in the historic downtown of the city of Córdoba, Argentina. People have used these premises for residential and commercial purposes since the beginning of the seventeenth century, although the samples analyzed correspond to nineteenth-century contexts. Light microscopy examination revealed the presence of parasite eggs of whipworm (Trichuris sp.), possibly roundworm (Ascaris lumbricoides), and tapeworm (taeniid). The presence of these fecal-oral and food-borne transmitted helminths supports other lines of evidence that indicate poor sanitation and hygiene habits and inadequate food processing, which may have contributed to the high incidence and mortality of gastrointestinal diseases recorded at that time. The paleoparasitological data agree with the historical information on the health status of the populations that inhabited the city of Córdoba in the past, especially in relation to their habits and diet.
From the mid-nineteenth century, seamen were increasingly identified as vectors of epidemic diseases such as cholera. The rising acceptance of the germ theories of disease and contagion and the transition from sail to steam at this time increased the fear of the rapid spread of contagious diseases through these mobile people. This article examines how the British naval authorities, ship surgeons and the medical and municipal authorities in the Calcutta sailortown sought to improve maritime health and hygiene to prevent the spread of cholera among and by British seamen. Nineteenth century Calcutta is an ideal context for this study on account of its epidemiological notoriety as a disease entrepot and the sea route between Calcutta and British ports was one of the most closely monitored for disease in the Empire. The article argues that a study of cholera among British seamen can generate important insights into the relationship among disease, medicine and colonialism and in doing so shed light into a neglected aspect of the history of nineteenth century cholera, the British anxiety regarding disease dispersion, practice of hygiene and sanitation and British seamen’s health.
By exploring the uniquely dense urban network of the Low Countries, Janna Coomans debunks the myth of medieval cities as apathetic towards filth and disease. Based on new archival research and adopting a bio-political and spatial-material approach, Coomans traces how cities developed a broad range of practices to protect themselves and fight disease. Urban societies negotiated challenges to their collective health in the face of social, political and environmental change, transforming ideas on civic duties and the common good. Tasks were divided among different groups, including town governments, neighbours and guilds, and affected a wide range of areas, from water, fire and food, to pigs, prostitutes and plague. By studying these efforts in the round, Coomans offers new comparative insights and bolsters our understanding of the importance of population health and the physical world - infrastructures, flora and fauna - in governing medieval cities.
The chapter provides a broader comparative view of the League’s environmental concerns. The main aim of the discussion in this chapter it to weave these different initiatives (which are described separately in each chapter) into a coherent and broad regime, ones that has a common ground, continuity, and certain dynamics. As each chapter explains the role played by central theories, ideas, conflicting interests, environmental challenges, and scientific or professional concerns, this chapter puts them together and explain some of the differences and common patterns. Moreover, this analysis also revises the League’s different endeavors from contemporary environmental perspectives, and assesses their relevance to current dilemmas where nature protection conflicts with human needs.
Each of the chapters explores a different dimension of the League’s environmental policy. They focus on the environmental impacts of pollution of the sea by oil, the growing whaling industry and endangered whales, rural hygiene and sanitation problems in the periphery, and timber production and fears of spreading deforestation. There may well be other interwar concerns that also involved environmental perspectives. However, I present a sweeping legal-historical overview of several of the central environmental challenges that the interwar world faced, in order to understand the notions behind the League’s leadership and to explain its shortcomings and achievements.
The chapter explores the League’s “rural hygiene” campaign. During its work on different reflections of sanitary problems that put local, national, and global public health at risk, the League invested substantial scientific, comparative, and professional effort while it was considering possible policies with which these dangers could be faced. These suggested policies, articulated in terms of international law, focused on the eradication of a variety of environmental-sanitary risks and spreading diseases, which the League believed to be plaguing the countryside in Eastern Europe and across the “Far East”. Among the international community’s concerns were the need to protect water resources from human and nonhuman pollution, to treat refuse, to fight spreading diseases in rural areas, to limit fly breeding, to control rats and pests, and more. Citing these concerns as threats to local and international communities, the League conceptualized agricultural peripheries as a rural frontier from which humanity could better protect itself, using various means of sanitary engineering, special medical services, and political awareness.
This chapter tracks two main events that took up much of the League’s attention. First, it assembled the European Conference on Rural Hygiene (1931) and, later, parallel to its main agenda, the Intergovernmental Conference of Far Eastern Countries on Rural Hygiene, held at Bandoeng, Java in August 1937.
In the history of how the law has dealt with environmental issues over the last century or so, the 1920s and 30s and the key role of the League of Nations in particular remain underexplored by scholars. By delving into the League's archives, Omer Aloni uncovers the story of how the interwar world expressed similar concerns to those of our own time in relation to nature, environmental challenges and human development, and reveals a missing link in understanding the roots of our ecological crisis. Charting the environmental regime of the League, he sheds new light on its role as a centre of surprising environmental dilemmas, initiatives, and solutions. Through a number of fascinating case studies, the hidden interests, perceptions, motivations, hopes, agendas and concerns of the League are revealed for the first time. Combining legal thought, historical archival research and environmental studies, a fascinating period in legal-environmental history is brought to life.
Metam potassium (metam-K) is a soil fumigant used commonly in Florida at the end of the tomato and pepper production season. The fumigant essentially cleans a field by killing the established weeds and crops after harvest. The goal of this project was to determine the optimal rate of metam-K for the effective termination of tomato, pepper, and established weeds such as purple nutsedge, goosegrass, and dogfennel. Tomato, pepper, and purple nutsedge at bed center were effectively terminated with the metam-K rate of 65 kg ha−1. Optimal rates required for the termination of goosegrass and dogfennel were 91 and 156 kg ha−1, respectively. In contrast, metam-K at 500 to 680 kg ha−1 was required to terminate purple nutsedge on bed edges. The reduced efficacy of metam-K at bed edge might be related to the limited movement of metam-K in soil.
Information on safe water, sanitation and hand washing obtained in large scale surveys are used to validate its responsiveness to childhood ailments. Definition of these variables are uniform to enable comparison within and across countries and devoid of the context and circumstance. Associating these variables with prevalence of diarrhoea overlooking the context seem to distort the relationship and lead to spurious results. An empirical verification of such an association in an Indian context based on the most recently conducted NFHS-4 data set brings to the fore apparent contradictions that cautions on the use of these variables as they are obtained. It calls for a redefinition of these variables prior to verifying their responsiveness to childhood diarrhoea as illustrated here.
Chapter 4 discusses the evolution of the urban space of Jeddah in the late nineteenth and early twentieth century on the basis of maps, photographs, and documents. It shows the impact of the Ottoman modernisation efforts regarding the urban fabric. Thus, the economic lifelines of the city, such as the ports and markets, were regularly cleaned and expanded. New buildings also reflected the increase of the state functions of administration and health. The latter issue was given particular attention in the light of concerns over epidemics, most notably cholera. Another major and related concern was the provision of sufficient and clean drinking water. Urban growth is also seen in the evolution and growth of suburbs which were closely linked to the city.
Chapter six investigates the economic bases of Jeddah, trade and pilgrimage. A brief overview of major trends in trade and transport is followed by a more detailed discussion of the merchants of Jeddah and their internal organisation. The political role of the merchants and their relation to the respective ruling powers forms another topic. The chapter then turns to the pilgrimage, starting by investigating the pilgrims’ guides and the way in which they organised reception, accommodation and transport for pilgrims. Given the attempts of Western powers to limit what were perceived health and political threats emanating from the pilgrimage, the ways in which such organisation played out locally through the consulates is touched upon, notably in as far it affected local water and health provision. Finally, the chapter turns to the Bedouin, a population usually residing outside of the city walls but indispensable to trade and pilgrimage and constituting a vital link between the city, its suburbs and surroundings.
Diarrhoeal disease is one of the major causes of morbidity and mortality in children and is usually measured at individual level. Shared household attributes, such as improved water supply and sanitation, expose those living in the same household to these same risk factors for diarrhoea. The occurrence of diarrhoea in two or more children in the same household is termed ‘diarrhoea clustering’. The aim of this study was to examine the role of improved water supply and sanitation in the occurrence of diarrhoea, and the clustering of diarrhoea in households, among under-five children in India. Data were taken from the fourth round of the National Family and Health Survey (NFHS-4), a nationally representative survey which interviewed 699,686 women from 601,509 households in the country. If any child was reported to have diarrhoea in a household in the 2 weeks preceding the survey, the household was designated a diarrhoeal household. Household clustering of diarrhoea was defined the occurrence of diarrhoea in more than one child in households with two or more children. The analysis was done at the household level separately for diarrhoeal households and clustering of diarrhoea in households. The presence of clustering was tested using a chi-squared test. The overall prevalences of diarrhoea and clustering of diarrhoea were examined using exogenous variables. Odds ratios, standardized to allow comparison across categories, were computed. The household prevalence of diarrhoea was 12% and that of clustering of diarrhoea was 2.4%. About 6.5% of households contributed 12.6% of the total diarrhoeal cases. Access to safe water and sanitation was shown to have a great impact on reducing diarrhoeal prevalence and clustering across different household groups. Safe water alone had a greater impact on reducing the prevalence in the absence of improved sanitation when compared with the presence of improved sanitation. It may be possible to reduce the prevalence of diarrhoea in households by targeting those households with more than one child in the under-five age group with the provision of safe water and improved sanitation.
Existing histories of public health in Iran often center on elite or urban narratives. This paper shifts the focus to Iran’s villages by examining the twentieth century public health history of rural northern Khuzestan. It argues that Khuzestani villagers desired, rather than resisted, modern medical services. However, vertical decision-making and the prioritization given by public health planners to economic concerns over social well-being led to the uneven distribution of services and failure to fulfill the expectations of Khuzestan’s villagers. This paper uses memoirs, official reports, correspondence, and other records from the Development & Resources Corporation, along with reports from Iran’s Ministry of Education and Ministry of Health, to bring a richer picture of Iranian villagers’ twentieth century history into focus.
This chapter delineates the long-term factors that predisposed Harare’s townships to a diarrhoeal disease outbreak and the short-term factors that precipitated the 2008–09 cholera epidemic. Foundational to my argument is the claim that urban order in the city has always been bound up with strategies of political control and social inequality. Under colonial rule, historically produced segregation and social inequality laid down the underlying physical conditions in the high-density townships – namely poor sanitation facilities, inadequate clean water provision and overcrowded housing – for the potential spread of an epidemic in the high-density areas of the city. These conditions can be traced as far back as the late nineteenth century when Harare was founded as an administrative centre for the white settler regime. They have persisted through the twentieth century and were never adequately rectified by the post-colonial government despite its ostensible attempts to transform urban spaces in the 1980s and 1990s. Finally, the chapter examines how the post-2000 political and economic meltdown triggered an urban crisis that ultimately precipitated the cholera outbreak.
Many developing countries lack universal sanitation services for residents. Years of inappropriate disposal of solid waste and wastewater have increased the potential for devastating environmental and health issues. An economic valuation of sanitation services may help in planning investment projects by demonstrating the benefits that households derive from having access to improved sanitation. We examine Guatemala as a case study and employ a series of hedonic models to estimate the value that households in Guatemala assign to the sanitation services of solid waste collection and connections to sewer infrastructure. Findings indicate that residents are willing to pay higher rents for both wastewater and solid waste removal. Policy implications are discussed.
According to the World Heath Organization's (WHO) EMT initiative, teams must meet an agreed set of standards, both clinically and logistically. EMTs must be self-sustainable and not create a burden on the already stretched resources of a host nation.
The technical demands of field hospitals require logistical personnel with specialist skills, which ensures a field hospital can continue to function when all around them has been destroyed. They must be multiskilled to fulfill multiple roles within the team.
A collection of tents does not constitute a field hospital: methodical planning around safety and security, patient flow, and overall functionality is a necessity. Field hospitals require large volumes of clean water that meets or exceeds the WHO standards of potable water; consequently, EMTs must understand the requirements of self sustainability, water quality, and quantities for the delivery of services they are offering. WASH requires an expertise and the capacity and capability to deliver high levels of WASH irrespective of the circumstances. Leading by example in health care to other health-care personnel and facilities is a essential criteria of an EMT: technical logistics is key to achieving this.
The seventh chapter, “An Era of Optimism,” analyzes the new culture of sanitation practices that helped to define modernity. In the late nineteenth and early twentieth centuries, those living in the developed world became accustomed to wearing shoes, using toilet paper, bathing regularly with soap, and utilizing refrigeration systems to extend the life of foods. In the mid-twentieth century, populations in the Global North benefited from population-wide vaccination programs against poliomyelitis, the prevalence of which seemed to have increased as a result of the implementation of better sanitation systems. Based on the "hygiene hypothesis," many specialists believed that poliomyelitis was rare in regions without modern sanitation. This was not the case. Regrettably, polio vaccination did not begin in the developing world until the 1970s. Oral rehydration therapy, a major breakthrough in the treatment of diarrheal disease, saved millions of lives.
The conclusion summarizes the major themes and findings of the book. The first major advance in the control of infectious intestinal disease in the modern era was in the treatment of water supplies. In the first half of the twentieth century, the combined package of underground sewerage and purified water won broad cultural acceptance. Modern sanitation conveyed enormous population-level benefits, even as it produced some unanticipated vulnerabilities and contrary health outcomes. Oral rehydration therapy and childhood immunizations have dramatically improved childhood survival rates, contributing to soaring population growth and deepening environmental challenges.
The second chapter, “Early Change,” explores what is known about environments in which intestinal disease transmission emerged. It marshals research in the biological sciences to discuss the settings in which early communities were able to transmit some intestinal pathogens and parasites, long before the agricultural revolution. It suggests that the construct of the “first epidemiological transition” needs to be revised. It explores the patterns of vulnerability to infectious intestinal disease associated with hunting, gathering, and fishing in an early era and those associated with early farming practices, settlements, and pastoral nomadism. It provides a historical overview of the evolution of zones of infectious intestinal disease, the various Eurasian attitudes toward human waste, regional patterns in the use or non-use of human excreta in early agriculture, and early urban sanitation.