Focus shifts to schools and monasteries

Diarrhoea, dysentery and worm and skin infection are among the three most common health problems affecting children in Bhutan, sometimes with tragic consequences.

Studies suggest that as many as 600 infants die from diarrhoeal diseases every year. The causes were identifed 25 years ago when the rural water and sanitation programme began dealing with unsafe drinking water supply and disposal of excreta, and poor hygiene which spreads germs and illness.

The government together with agencies such as UNICEF has steadily improved water supplies and sanitation, and the incidence of diarrhoeal diseases, worm infestations and skin infections has dropped in recent years.

Attention now rests on the more densely populated urban areas, where waterborne diseases are still a major problem. UNICEF is now focusing on the water supply and sanitation of schools and monastic institutions, which together cater to more than a sixth of Bhutan's population. There are about 114,000 students enrolled in 343 schools, and more than 9,000 monks in Bhutan.

"Although we have done a lot in the villages, we find that the school and monastic institutions lack adequate facilities and really need attention," said an engineer from the Health Department.

The national coverage for water and sanitation is 77.8 per cent and 88 per cent respectively (December 2000) but the coverage in schools is still low -- only 60 per cent for water and 57 per cent for sanitation. The situation is worse in monastic institutions which have a 23.9 per cent water coverage and 20.8 per cent sanitation coverage.

"This means that many students and young monks cannot practise the hygiene they learn in their studies while at school," said a spokesman for the public health engineering unit, responsible for water and sanitation facilities.

One of the major problems is that, as the school population continued growing, water and toilet facilities did not keep pace. Many of the facilities also need major repair.

"The school, with its large population, is a prime place for the spread of communicable diseases like diarrhoea and dysentery," said the headmaster of a primary school. "Our school numbers have been going up in recent years but we don't have the funds to repair or build more toilets and water taps."

The new UNICEF focus, therefore, comes at an opportune time. The water and sanitation programme tries to integrate the provision of hardware with education and hygiene promotion activities so that people really benefit from the facilities.

The UNICEF priority is to reach the unreached, or the more remote schools with facilities so that they become a more conducive place for learning, particularly for the girls.

The design of facilities like tap stands and toilets is being changed to be more "child-friendly" and to cater to girls and those in the middle childhood years.