Health and hygiene situation in northern areas of Pakistan: pre and post WASEP interventions

The overarching goal of Water and Sanitation Extension programme (WASEP) is to reduce diarrhoeal morbidity by 50% in its partner communities. WASEP includes water supply, sanitation, drainage, water quality and health and hygiene education in its interventions. To calculate the possible impact of health oriented intervention, it is very important to have knowledge of existing health situation and it is always valuable to know about local beliefs and practices concerning hygiene behavior. Unfortunately, hygiene education has been an ignored subject and has not been key objective to the organizations responsible for providing rural water supply schemes and has never been an attractive option to the villagers of Northern areas and Chitral. Health should be one of the prime objectives for investing money in a water supply and Sanitation programmes. The prevailing situation requires a thorough thought to address this subject. There is a large vacuum in this field, which needs to be filed with better planning. There are many aspects of rural life in the Northern Areas and Chitral region of Pakistan where people have unhygienic traditional practices. Unfortunately, sometimes these unhygienic practices are linked with beliefs and religions. Some people for example believe that all flowing water is clean i.e. river; channels etc. regardless of its source. Also, cloths after washing with soap are not considered clean (Paak) if not dipped in water at least one meter deep. Women are main procurer and user of water and entirely responsible for sanitation and hygiene of the family at home. In many parts of northern areas, acute shortage of water, ignored sanitation and hygiene have made life difficult for women. A water and sanitation programme, should therefore involve women in the development process. The central role of women in water, sanitation and hygiene has been emphasized in throughout WASEP’s five years progamme. WASEP has been aiming to provide safe water at injection rather than at source or at tap stand. As discussed above, women shoulder responsibility of providing water to their families. Therefore, primary target group was the women who also carry out the risk practices. i.e. cleaning children, handling children’s stool and responsible for excreta disposal