Economic Growth

What can we learn from history about sanitation today?

A boy takes bath outside newly built toilets in a village on the outskirts of Nagapattinam, about 325km (202 miles) from the southern Indian city of Chennai December 24, 2005. Government and multilateral agencies have pledged more than $7.3 billion in aid for nations hit by the December 26, 2004 earthquake and tsunami in the Indian Ocean, while global private donations amount to more than $5.7 billion.

How can we learn from the past to create better sanitation systems? Image: REUTERS/Jagadeesh NV

Duncan Green
Head of Research, Oxfam GB

Ooh good, another ‘lessons of history’ research piece. Check out the excellent new WaterAid report: Achieving total sanitation and hygiene coverage within a generation – lessons from East Asia.

The paper summarizes the findings of four country case studies: Singapore, South Korea, Malaysia and Thailand, all of which produced ‘rapid and remarkable results in delivering total sanitation coverage in their formative stages as nation states’. I can certainly vouch for Singapore – I spent 3 years there as a child in the late 60s. Whenever the rains came, the main roads flooded, turning the city into an insanitary swamp. Not any longer.

The paper concludes: ‘Although their initial conditions were very different from those currently found in ‘fragile’ and ‘least-developed’ countries in Africa and South Asia, some useful conclusions can be used to inform discussions on development of strategic approaches to delivering sanitation for all:

-High-level political leadership was crucial and did not stem from community-driven demand.

-That leadership did not restrict itself to high-level exhortation, but was marked by an ongoing engagement in the implementation agenda.

-Some element of subsidy was included, but alongside demand creation, and was often indirect (e.g. through housing subsidy).

-‘Course correction’ mechanisms were devised at all levels so that obstacles to implementation were quickly identified and addressed with remedial policy reforms.

-Hygiene, cleanliness and public health aims drove sanitation improvements.

-A well-coordinated multi-sector approach was a necessary condition for rapid sanitation improvements.

-Capacity building happened alongside sanitation improvements.

-The vision of total sanitation coverage came before attainment of levels of national wealth.

-Reaching a threshold of per capita GDP was not decisive in the strategic choice to set the course to deliver total sanitation coverage.

-Monitoring was continuous and standards raised as goals were achieved.’

I would underline a couple of things emerging from the summary: firstly, stuff that you might expect to be important, but wasn’t – leaders did good things to build the nation, even though there was no bottom-up pressure. Activists who routinely say nothing happens without pressure from below please take note.

Second, lot of elements of systems thinking/how change happens here: course corrections, multi-sector approaches, ratchet mechanisms to continuously raise goals as progress was achieved.

Third, that they didn’t have to wait to get rich – you can start long before then.

But there’s a big question that the report doesn’t answer (and in that it resembles many other attempts to raid history for policy ideas): what were the politics that allowed this to happen? Here we have dirigiste one party states in Singapore and Malaysia, and military governments in the early years of take-offs in South Korea and Thailand. It’s no good just focussing on their policies while ignoring the politics – would such policies have been possible with more inclusive, democratic governments and if so, how? Need to get onto the democratic developmental state discussion if this is to be genuinely useful.

So while I applaud the attempt to oxygenate today’s policy debates with a sense of what has worked in the past, ignoring the power and politics discussion in here seems to paint a very partial picture.

My collection of useful ‘developmental lessons of history’ work now comprises

Trade and Industrial Policy (Ha-Joon Chang, Alice Amsden, Robert Wade and co.)

Agriculture (Ha-Joon again)Education and Health (Santosh Mehrotra)

Popular Campaigns (Friends of the Earth)

To which I still intend to add something on the history of successful redistribution. Any other candidates?

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