The rapid development of so-called NBIC technologies – nanotechnology, biotechnology, information technology and cognitive science – are giving rise to possibilities that have long been the domain of science fiction. Disease, ageing and even death are all human realities that these technologies seek to end.
By Barkha Dutt
In India, even today, when you purchase sanitary pads from the neighborhood store, you can expect the (usually male) shopkeeper to evade your eye. He will wordlessly get a packet from the rear of the store and slip it into a jet-black plastic bag so that no one can see what you bought. It is like a shroud thrown over your monthly awkwardness. One of the big sanitary-napkin brands is called Whisper, a perfect metaphor for how your period should be spoken of — if you must mention it at all.
I am an unabashed, proud feminist. But the social conditioning around menstruation in India is so entrenched that, in my younger years, if I suddenly needed to ask a colleague for a sanitary pad at work, I would carry it wrapped in a newspaper or office stationery.
Our menstruation has been used against us in all sorts of ways — to shame us, embarrass us, sexually repress us and, of course, make us feel dirty. Muslim women have told me they are not allowed to offer Namaz prayers during their period. Hindu women have had to petition in court to be allowed inside temples that bar menstruating women. There are homes where girls and adult women are not allowed into the kitchen during their “impure” days.
Now comes a bizarrely paternalistic and silly proposal to further ghettoize us. A campaign in India has urged providing women a day off for the first day of their periods. I didn’t take this idea seriously when I first heard it. It seemed like the self-indulgent mumbo-jumbo of so-called post-feminists. To my shock, the issue has become a major point of discussion. One media outlet has even adopted this harebrained policy for its female employees.
“First-day period leave” may be dressed up as progressive, but it actually trivializes the feminist agenda for equal opportunity, especially in male-dominated professions. Worse, it reaffirms that there is a biological determinism to the lives of women, a construct that women of my generation have spent years challenging. Remember all those dumb jokes by male colleagues about “that time of the month” or PMS? Well, this idea only serves to emphasize that there is something spectacularly otherworldly about a bodily function.
Sure, our periods can be annoyingly uncomfortable and often painful, but this reality usually demands no more than a Tylenol or Meftal and, if needed, a hot-water bottle.
In rural India, gaps in menstruation hygiene, social stigma, lack of access to affordable sanitary napkins or toilets, and an absence of disposal mechanisms for pads all keep girls away from school. A U.N. report confirms that 20 percent of Indian girls drop out of school after reaching puberty; in sub-Saharan Africa, 1 in every 10 girls misses school during her menstrual cycle. In Nepal there are “menstrual huts” where women are isolated.
Around the world, menstruation has been a basis for barriers. (Who can forget then-candidate Donald Trump’s sexist swipe at TV host Megyn Kelly when he said she had “blood coming out of her wherever”?) Girls can be denied an education because of cultural taboos, relative poverty and lack of basic facilities during a period — and here are we, elite and spoiled women, demanding the right to stay at home. Does no one see the irony?
Female labor-force participation has declined in India despite economic growth. Only 27 percent of Indian women are in the workforce, the lowest level among the emerging BRICS nations (Brazil, Russia, India, China and South Africa); among Group of 20 countries, India’s rate is better than only Saudi Arabia’s. Instead of focusing our feminist energy on such alarming statistics, goofy ideas such as period leave create grounds for workplace discrimination or, worse, a denial of some roles completely.
Take the fight for the right of women to be allowed into military combat, fly fighter jets or be sent into space. The barriers are high enough already; now we want to add a nonsensical new one? In 1999, when war broke out between India and Pakistan in Jammu and Kashmir, I had to push hard to be allowed to report from the front lines. “There are no bathrooms, no separate beds for women,” said an initially reluctant army. I pleaded and argued my way in. But imagine if this blanket plea for period leave existed; what might the army have said to me? Incidentally, I was menstruating while reporting from the front lines.
Some women have raised the issues of endometriosis and extreme menstrual pain. I sympathize — but those are a basis for medical leave, not grounds to make such exceptions the norm as menstrual leave. Others have noted that maternity leave is also a female-specific benefit and asked me why I don’t object to that. First, I don’t think maternity and menstruation are comparable; second, I do think it’s time for the feminist framework to focus on equality at home as a key component of equality at work. I’d be much more comfortable with the idea of family leave, available to men and women, so that we finally will have crossed the final frontier of stereotypes.
But for women to use the fight against menstrual taboos as an excuse for special treatment is a disservice to the seriousness of feminism. Stop this sexism. Period.
The focus on ending open defecation and ensuring a toilet in every home is a limited one. Lasting success will require a much larger focus on sanitation.
Among its many areas of focus, the Swachh Bharat Mission (SBM) promises to provide toilets for all and make the country Open Defecation Free (ODF) by October, 2019; a tribute to Mahatma Gandhi, whose 150th birth anniversary, would fall that year. The fervour engendered by this mission is truly commendable, and is revealed in the physical progress in the construction of toilets. Swachh Bharat Mission – Gramin lists an addition of 21 lakh toilets in 2014-15, and 58 lakhs in 2015-16. Swachh Bharat Urban reports 10 lakh sanctioned toilets and 3.5 lakh completed.
Not surprisingly, the agenda of ‘toilets for all’ has spurred a number of analyses and reports across various media. But these analyses on ODF India have largely excluded important narratives – around behaviour, concerning usage, financing of toilets, service delivery, and most crucially – waste management.
Sanitation is more than just toilets
A toilet, although a basic amenity, is also a merit good which creates externalities – better public health outcomes, improved infrastructure, etc. This merit can, however, be attained only when the entire value chain of sanitation, comprising the superstructure – the toilet and its substructure which includes a storage component; transport – septic tank trucks; collection; treatment and reuse, is complete. Simply put, toilets are necessary but not the only condition for good sanitation.
Policy makers are not oblivious to this. For instance the National Urban Sanitation Policy (NUSP), 2008, describing environmental sanitation, alluded to more than just toilets. It included solid and liquid waste management, storm water drainage, industrial and hazardous waste, and, water supply – all of which are elemental to the sanitation debate. The NUSP also acknowledged the fact that urban sanitation is larger than issues covered in the erstwhile scheme for Integrated Low Cost Sanitation (ILCS) which provided sanitary toilets to prevent open defecation and eliminate manual scavenging. The same goes for rural sanitation.
Insights from Data
Census 2011 shows that of the 47% households in India which have toilets in their premises, 22% are connected to septic tanks, 12% to piped sewer system, and 8% to pits with slabs. Effectively, only 42% out of the 47% of households with toilets in premises are serviced by sewered networks, septic tanks, and pits with slabs. Of the rest 58% open defecation, is 50%, and 8% are insanitary latrines.
Complementing this data is the 2010 report by the Central Pollution Control Board (CPCB) estimating that the sewerage treatment plants (STPs) in Class I and Class II towns have only 35% treatment capacity for total sewerage generated. Another study of the STPs conducted by CPCB in 2013 pointed out that of the 152 tertiary STPs (which involves chemical and/or physical treatment of the waste water making it ideal for non-potable uses like irrigation and cleaning) in the country, 9 are under construction, 30 are non-operational, and the performance of 28 is not satisfactory. And in 56 of these cases, the treated effluent exceeded the accepted levels of pollutants.
The same report also showed only 51% treatment capacity for total sewerage generated in metropolitan cities (greater than 10 lakhs population), 32% treatment capacity for class-I cities (1 lakh to 10 lakh population) and 8% treatment capacity of STPs in Class- II cities. The efficiencies of these waste treatment plants are of utmost concern when they are in the vicinity of water bodies, and more specifically if the effluents are discharged into rivers or any other drinking water sources. Incessant disposal of untreated solid or liquid waste, domestic and industrial, has worsened the pollution levels in the rivers of India.
The CPCB 2013 report furnishes information on river-basin wise sewage treatment capacities – both designed and utilised. Figure plots the designed capacity, utilised capacity and percentage of sewage receiving treatment in the STPs, based on the discharge of the effluents into different rivers or land. The treatment percentage refers to the efficiencies of these STPs, as in the percentage gap between designed and utilised capacity. For example, the STPs discharging into the Ganga actually treat only 55 percent of sewage they are designed to treat. Evidently, the effluents discharged into the rivers and agricultural lands do not receive adequate treatment. Moreover, the effluent data mentioned here are only wastes from 12 percent of the households connected to sewer system and industries.
Septic tanks serve as treatment systems for 22% of the total toilets – the highest form of connectivity to toilets. But their upkeep which requires timely emptying, is hardly up to mark given the dearth of resources (financial, human and technical) with the local governments. Furthermore, the septage, effluent from the septic tanks, receive no treatment. About 3% of total households account for insanitary latrines, 8% account for pit latrines. Thus, the lack of treatment solutions for effluents from different types of toilets and collection networks has inadvertently sustained the practice manual scavenging, reported or unreported.
Efforts for Waste Management in India
Some schemes have given due importance to waste management and other elements of the sanitation value chain. The Jawaharlal Nehru Urban Renewal Mission (JnNURM) under its components of Urban Infrastructure and Governance (UIG) and Urban Infrastructure Development Scheme for Small and Medium Towns (UIDSSMT) allocated funds for water supply, sewerage, drainage, preservation of water bodies, and, solid waste management. The UIG targeted 65 cities and the projects approved under UIDSSMT covered 904 cities.
The JnNURM website reports the status of projects undertaken in different sectors under UIG and UIDSSMT. Water supply ranked highest in the priority list of sectors, with largest number of such projects undertaken in both UIG and UIDSSMT, but waste management – sewerage, solid waste management and preservation of water bodies, with the low number of projects, have received lesser importance. For solid and liquid waste management infrastructure, only 28 percent of the UIG projects approved have been completed and 16 percent of the UIDSSMT approved projects have been accomplished. There may be gaps between the number of approved and completed projects but the resolve for environmental sanitation and recognition of the waste management instil hope.
While a project approach to ensure basic infrastructure for water and sanitation services relating to water supply, sewerage, septage management, and storm water drains appears in the press release on Smart Cities mission and AMRUT – whether it has learned anything from JnNURM is yet to be explored.
One of the dominant narratives around developing the sanitation sector in India has been prioritising behaviour change strategies. Many contend that behaviour change strategies will catalyse the development of the sanitation sector by initiating demand for sanitation services. The SBM too has a component on imparting Information Education and Communications Programme and Behaviour Changing Strategies in its endeavour to improve sanitation.
To this effect, the 69th NSSO survey reports that non-usage of toilets have been because of no superstructure, no clean/insufficient water, malfunctioning toilet, personal preference, and unaffordability. Another survey conducted by Research Institute for Compassionate Economics ( R.I.C.E) in 4 states points to non-usage of latrines, and reports that 23 per cent of surveyed people practise open defecation despite having a toilet in the house and that 43 percent of households has at least one member defecating in the open in spite of a toilet. The findings of the survey also reports averseness to government provided toilets and general preference for open defecation of people despite access to toilets.
The stories and plight of sanitation workers in our local bodies is another thing missing from the focus. The enactment of Prohibition of Employment as Manual Scavengers and their Rehabilitation Act (PEMSRA), 2013 and the subsequent outlawing of manual scavenging has had a tremendous impact on changing the perception of sanitation. As noted in my field work from Odisha; local bodies are increasingly procuring sanitation equipment at the directives of the state governments in efforts to prohibit employment of manual scavengers.
While this is part of larger plan of “technology advancement” or “smart cities” dialogue, what is contradictory is the fact that local bodies are not spending money on technology and equipment including hygiene and safety gear that would make our sanitation workers more efficient and safe. Secondly, this means that the conditions of sanitation workers and sweepers remain the same or have even worsened – recent events of non-disposal of garbage in Delhi and a report that out of the 1,300 safai karmacharis, employed by Chandigarh Municipal Corporation, more than 200 workers have died since 2009 bear testimony to this argument.
Some Insights from Field Work
Certain other insights from my field work in Odisha also support the need to invigorate behaviour changes for sanitation and address the entire value chain. First, in the absence of technology and poor provisions for sanitation workers the safai karamcharis have formed unions and favour only a few councillors. This has resulted in the regular waste collection in a few wards of the city. Second, municipality owned tippers for solid waste collection are gathering rust in the municipal office compound given the inability of the municipality to train and hire personnel to operate them. This has resulted in the waste being dumped within the municipal area near informal settlements sans treatment by private contractors.
Third, the lack of coordination between different state departments responsible for different aspects of sanitation has led to a situation where households cannot connect to newly laid sewer lines because they are obstructed by storm water drains. The sad outcome of this has been household waste water being discharged into the storm water drains. Fourth, a municipal official when asked about the level of engagement of the ULB in drafting the City Sanitation Plan(CSP) responded, “We had only one or two meetings of the City Sanitation Task Force for the orientation of CSP, but we were never involved in the subsequent planning exercises”. This depicts the minimal involvement of ULBs in the planning process.
Such lessons from ground work are essential to understanding the dire situation of sanitation in India. They also help find the missing pieces of the sanitation value chain.
The way forward
In May this year, the cabinet approved the flagship Namami Gange programme to clean and preserve the Ganga. The targets of this programme are far-reaching with components on rehabilitation and up-gradation of existing STPs along Ganga, 100 percent sewerage infrastructure in towns in the Ganga basin and in-situ sewage treatment in open drains. Similarly, other schemes like Smart Cities and AMRUT, also assure infrastructure for waste management in select beneficiary cities.
ILCS (1993), TSC (1999), NUSP (2008), JnNURM (2005) are some of the key policies and programmes for the development of sanitation sector in India. Clearly, there has not been a scarcity of schemes in the past, yet, we have made only inches of progress in the development of sanitation. Consequentially, new policies and schemes have been designed and rolled out. However, without adequate change in behaviour and perception of sanitation, ten years on we would still be pondering the same issues.
Recently, a letter issued by the Ministry of Drinking Water and Sanitation to all state secretaries for rural sanitation broadens the definition of ODF to include safe technology option for proper disposal of faeces. This is a welcome move towards addressing the bigger issues of sanitation by duly incorporating waste management. Guidelines and targets set on such broad definitions can have far-reaching effects on improving access figures and securing safe working conditions for the sanitation workers. In our endeavour for Swachh Bharat, it is only coherent to transition the debates and actions from toilets to waste management and address sanitation in a holistic way.
By Khalid Omani / Muscat
In the first week of May, members of the Majlis Al Shura, the lower house of Oman’s Parliament, urged the minister of manpower to replace all the expatriates occupying the top five positions in the private sector, including the post of chief executive officers (CEOs), with the country’s own citizens. “We are unanimously supporting the Omanisation move at the top positions in the private sector,” Tawfiq Al Lawati, a Shura member, was quoted as saying.
News of the proposal sent the nearly 7-lakh strong Indian community into a tizzy. If enforced, the move directly affects not only about 7,000 Indians in Oman, it could also have wider ramifications for Indian managers and workers in the entire Gulf, where unemployment is fast becoming a raging issue. The proposal by the Shura surprised few, though. Oman has long been plagued by high level of unemployment.
More than 1,45,000 Omanis are looking for jobs. The country has been hobbled by a substantial reduction in oil revenue due to the sharp fall in the global crude oil prices. Stacked against this grim backdrop, the nudge by the Shura is seen as a caustic warning to the private sector, which has long been reluctant to recruit Omanis despite a 25-year-old localisation drive.
As recently as last February, there was a proposal to reduce the expat workforce by 6% to 5,86,272 to ‘balance’ the labour market, in which expats vastly outnumber Omani nationals. Of the 15,33,679 private sector employees, Omanis constitute only 2,24,698. The number of expat employees rose to 13,08,981 as of 2013, according to the ministry of manpower. Prior to the Shura’s proposal, there was a move to replace 1,00,000 expats with Omanis, but that did not make much headway. Human resources managers were accused of resisting the drive.
A Burning Issue
The Oman government also recently launched a programme to identify and develop a community of competent Omani CEOs partnering IMD, a prominent international business school, and McKinsey & Co. Called the National CEO Program, the first batch drew 30 Omani senior managers from select private companies.
James AE said although the Oman government initiated the localisation programme several decades ago, most of the job reservations happened in the lower rung. “The private firms were deliberately inducting mostly semi-skilled Omani professionals like drivers, in an apparent move to achieve their ‘Omanisation percentage’,” he said. Business houses don’t have much confidence in employing locals at the top, according to him.
In other words, traditional Omani business houses and even governmentowned companies are packed with expat managers, mainly those from the West and India. The Shura’s suggestion is to turn this setting on its head, but reactions are mixed. Philiph K Philiph, CEO of Muscat National Holding Company SAOG, a public limited company, said only time will prove whether the move will be practical.
“In the insurance sector, we have a lot of trained and experienced Omani employees, but not enough Omani manpower. We need to check whether there are enough number of qualified and experienced Omani professionals who can replace all the top managerial positions.”
Y Sudhir Kumar Shetty, president, UAE Exchange, said his organisation has been supporting the Omanisation programme since inception. “Our organisation has 65% Omanis who are spread across various verticals.”
Even so, enforcing a quota for Omanis in the private sector could not have come at a worse time for Indians. Many senior Indian managers are already facing difficulties in Oman. After the government began to crack down on graft in February 2014, Omani employers were quick to pass on the buck to Indians.
P Mohammed Ali, an Indian entrepreneur and formerly managing director of Galfar Engineering, a company he helped develop, was sentenced to 15 years in jail for allegedly bribing officials to get contracts for the company. Ali was for many years the most successful Indian businessman in the Gulf and his imprisonment shocked many Indian CEOs and managers in Oman. Since then, eight other Indian CEOs or senior managers have been put behind bars.
Political observers say the government embraced these measures to pacify agitators who participated in massive rallies and anti-corruption protests in the wake of the Arab Spring. The government also announced plans to create 50,000 new jobs for Omanis and started an unemployment benefit scheme. An amnesty scheme has also been launched to send back 50,000-plus illegal expat workers to their countries.
But the most shocking proposal yet has been the one to replace expats in senior positions with Omanis. Indian managers are understandably worried. “It is a very strange proposal for smalland medium-sized companies like ours.
We cannot afford to hire an Omani in a senior position at the company that I have built from scratch. I need efficient and loyal staff to run the business. Our experience is that the Omani staff leave the positions quite often and do not report for duty,” said the owner of an Indian business group with interests in furniture retail, hospitals and telecom in Oman. “I am planning to shift my business to Dubai or other cities which offer a better business environment,” he said, requesting anonymity.
Sajith Kumar PK, CEO of the Dubai-based JRG International, said during the last recession, many private companies in the Gulf appointed Indian CEOs and senior managers to replace expensive expatriates from the West. “This approach helped them return to profitability,” he said. Viewed from that perspective, replacing efficient managers with local staff will not help companies, he said.
The only solace for Indian managers is that the plan by the Shura has received an underwhelming response from other sections of the Omani society, including trade unions, investors, and economists. They have all said the move should be enforced cautiously. Oman is not exactly a favourite destination in the Gulf for expats in terms of payment and perks. The Shura plan has just taken the sheen further from the country.
Loneliness may be a greater public health hazard than obesity, according to a study which found that social isolation may put people at an increased risk of early death. “Being connected to others socially is widely considered a fundamental human need -crucial to both well-being and survival,” said Julianne Holt-Lunstad, professor at Brigham Young University in the United States.
“Extreme examples show infants in custodial care who lack human contact fail to thrive and often die, and indeed, social isolation or solitary confinement has been used as a form of punishment,” said Holt-Lunstad. “Yet an increasing portion of the American population now experiences isolation regularly,” she said.
Loneliness and social isolation have both been associated with poor health. One study reported by Medical News Today last year, for example, suggested that loneliness may be linked to Alzheimer’s disease, while other research linked social isolation to reduced survival for breast cancer patients.
To illustrate the influence of social isolation and loneliness on the risk for premature mortality, Holt-Lunstad presented data from two research reviews.
The first involved 148 studies, representing more than 300,000 participants, and found that greater social connection is associated with a 50% reduced risk of early death.The second study, involving 70 studies representing more than 3.4 million individuals from North America, Europe, Asia and Australia, examined the role that social isolation, loneliness or living alone might have on mortality. Researchers found that all three had a significant and equal effect on the risk of premature death, one that was equal to or exceeded the effect of other well-accepted risk factors such as obesity .
“There is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators,” said Holt-Lunstad.
Wouldn’t it be great if something as simple and pleasurable as international travel could help end something as grinding and enduring as global poverty?
In 2016, over 1.3 billion international tourists spent an estimated US$1.4 trillion. That’s the equivalent of Australia’s gross domestic product, dispersed around the world.
The UN has even declared 2017 the International Year of Sustainable Tourism for Development, heralding the role of international travel in reducing poverty. But how much global tourism money really makes its way to poor countries?
That big tourism pie
Researchers from Griffith University and University of Surrey provide a mechanism to get find out – Global Sustainable Tourism Dashboard. And, spoiler alert, it’s not inspiring.
The dashboard was launched in January 2017 to measure tourism’s impacts and contribution to the UN’s 2015-2030 Sustainable Development Goals. Among other sustainability-related indicators, it can determine whether tourism is really redistributing wealth by tracking how much travel money arrives in the world’s least developed countries (LDCs) and small island developing states (SIDS).
Some 14% of the global population lives in LDCs (which includes Cambodia and Senegal, among others) and SIDS, like Vanuatu and the Dominican Republic.
Yet in 2016 these countries saw just 5.6% of global international tourism expenditure. If we take Singapore (a small island developing state in name only) out of the mix, it falls to 4.4% – just US$62 billion out of the US$1.4 trillion spent worldwide on travel in 2016.
Mainly, the dashboard shows, global tourism is an economic exchange between rich countries. Citizens of ten nations, most of them in Europe and North America, make about half of all international travel. China, which in 1995 was not a member of this frequent flyer club, broke into the top ten in 2000.
Money can’t buy everything
If the share isn’t great, the total amount of traveller money spent in these countries is still substantial – US$79 billion in 2016 alone. This is as much as the foreign aid budget of the US, Germany, UK and France combined, based on figures from the World Economic Forum.
But money alone doesn’t reduce poverty. If it did, Thailand, the world’s fourth most popular tourism destination, would be rich (it earned US$54 billion from international tourism in 2016).
Whether a cash injection turns into development depends on many well-studied factors. For example, less developed countries lack the critical goods and services that tourists require, including airports, accommodation, key attractions, tour guides and telecommunications, to name just a few.
This leads to what economists call “leakage”. When a country must import everything from generators and solar panels to certain kinds of food, it spends a considerable proportion of tourist dollars before they can multiply in the local economy.
In developing countries, leakage ranges from 40% in India to 80% in Mauritius, according to researcher Lea Lange who wrote a 2011 paper for the German development agency GIZ, depending also on the factors that are included in the analysis.
Part of the broader leakage problem is that tourism investors are often foreign, so the profits are expatriated. Cruise lines are notorious for this. Ships may well visit a dozen small island developing states on any given marine jaunt, but most of the profit goes back to headquarters, which are typically located in Western countries.
Don’t let that dollar go
Governments can reduce leakage by thinking strategically about procurement, emphasising local business development, integrating supply chains and investing in education and training to prepare workers for tourism jobs.
Such changes helped Samoa, where tourism is one of the economy’s main pillars, develop a more diversified and lucrative portfolio. Tourism income has grown from US$73 million in 2005 to US$141 million in 2015 (at current prices), when the industry contributed 20% of the country’s GDP. It welcomes about 134,000 international visitors annually.
Among other innovations launched jointly by donors, government and community groups, Samoa increased locals’ share of traveller resources by reinventing its fales – simple, sometimes open-air beach huts that often attract backpacker-types – to appeal to luxury travellers.
Out of the 2,000 hotel rooms in Samoa, about 340 are now fales, which are typically owned and operated by local families. The Samoa Tourism Authority assists them in business planning, marketing and service delivery.
Samoan tourism was given a boost by a lucrative 2009 contract with the Body Shop to produce and sell coconut-based beauty products. With the Samoan Women In Business Development Initiative securing continuity and scale, this deal is likely to create positive domestic tourism spin-offs like greater entrepreneurial capacity among Samoan women, business confidence, and brand enhancement of Samoa with luxury connotations.
By 2014, Samoa was no longer classified as a least-developed country.
Making sure that visitor dollars benefit local people also depends on the commitment of foreign-owned companies, particularly hotel groups, to partner with and invest in local communities.
The Global Sustainable Tourism Dashboard provides an insight into how the sector is contributing to key sustainability goals. The Tourism Dashboard, Author provided
The Marriott in Port au Prince, for example, has been feted not just for setting up shop in earthquake-shattered Haiti (one of the world’s least-developed countries) in 2015 but for hiring local, paying well and focusing on professional development. This has proven to be a good business strategy, too. With happy workers, the hotel has very low turnover.
Making tourism work
Ecuador, Fiji and South Africa are among other countries illustrating that tourism can contribute to development and alleviate poverty. The English travel agency Responsible Travel, which holds annual World Responsible Tourism Awards, showcases more great examples.
International organisations such as the UN can help countries find this balance by financing transport connectivity, for example, and facilitating infrastructure investment that’s mindful of potential tourism uses.
Capacity-building among domestic stakeholders is also critical. Only when a destination’s tourism offices, luxury hotels and ecoparks are run and staffed by well-trained locals can the benefits of tourism be equitably distributed, its costs effectively managed and its growth sustainable.
Individuals have a role to play, too, by making ethical travel choices. Tourists visiting developing countries can maximise the community benefits of their trip by “going local” on everything from food and tour companies to craft purchases.
Opting for certified “responsible” companies and simply by asking the right questions may also send an important signal over time that tourists care about their impacts.
Tourism will never end poverty. But if governments, industries and consumers start paying attention, they can make it a force for change.
Contraception empowers women to plan the number of children they will have.
Family planning improves child survival and reduces maternal deaths. But the uptake of family planning in Africa is only 33%, nearly half the world average of 64%. The contraceptive prevalence rate in African countries is considerably low despite an increase in demand.
Niger has one of the highest fertility rates globally. Women of reproductive age have, on average, eight children. Niger has a maternal mortality ratio of 553 per 100,000 live births and an under five mortality rate of 104 per 1000 live births. Mauritius has the lowest child mortality rate in Africa at 12 per 1,000 live births.
In Niger 13% of children under five years die from various illnesses. The country is one of the top five that account for half of these deaths in the world.
The low provision of family planning across sub-Saharan Africa is cited as one of the main reasons for the region’s high maternal mortality rates. A lack of family planning leads to unintended pregnancies and often means that women deliver their babies with very low skilled assistance. This in turn pushes up the rate of newborn deaths.
Access to family planning services, particularly in developing countries, should be improved.
Research shows that increasing contraceptive use averts maternal mortality. Investing USD$8.4 per person each year in developing regions would result in 224,000 fewer maternal deaths in sub-Saharan Africa.
There are now a range of contraceptive methods that can be offered to women. These range from medical procedures like sterilisation and implants in men and women to condoms, injectables and emergency contraceptive pills.
Family planning interventions should focus on passing this message to people living in remote rural areas.
Malawi, Ethiopia and Rwanda have achieved dramatic strides in ensuring access to family planning as well as uptake. Strong political support, community engagement, effective strategies and systems and good partnerships are the backbones of successful programmes.
Ethiopia’s success has been driven by health extension workers taking family planning services to rural households. The country expanded access to quality primary health care that was promotive, preventive and curative.
In Rwanda, family planning champions were trained and actively involved in advocacy at a community level.
But success can’t be achieved without addressing the root causes of low rates of contraceptive use.
Studies have shown that low contraceptive use is usually due to a combination factors. These include:
– low female literacy rates
– cultural values on misconceptions of family planning
– lack of spousal or partner approval
– lack of women autonomy in decision making on reproductive health, and
– inaccessibility of health services.
Targeted and sustained public health awareness campaigns on the benefits of contraception should be rolled out at village level to all people of reproductive age.
The campaigns should also encourage male involvement. Studies have shown that the uptake of contraception improves when men are involved in family planning. And encouraging women to speak about their fertility preferences with their partners makes a significant difference.
Governments need to strengthen family planning programmes by understanding and using data on unmet needs to establish community based strategies. Funding for these initiatives should be prioritised.
The global organisation, Family Planning, has proposed a target of getting 120 million women and girls – particularly from sub Saharan Africa – to use contraceptives by 2020.
Robust family planning policies also have the added advantage of changing a country’s age profile by reducing the number of young people dependent on the productive population for their livelihood. This is known as the demographic window, which in turn allows countries to take advantage of reaping demographic dividend.
Family planning can affect the demographic profile of countries in positive ways too – for example by increasing the life expectancy and well-being of women and couples.
But none of this can be achieved unless African countries pay more attention to family planning, put proper policies in place with the necessary resources behind them.