The long and short of open defecation

 

DEAN SPEARS in THE HINDU

  

TOPICS

peoplechildren
social issues (general)health and hygiene
social conditions

There is statistical data to show that the height of Indian children is correlated to their and their neighbourhood’s access to toilets

You can learn a lot from measuring children’s height. How tall a child has grown by the time she is a few years old is one of the most important indicators of her well-being. This is not because height is important in itself, but because height reflects a child’s early-life health, absorbed nutrition and experience of disease.

Because health problems that prevent children from growing tall also prevent them from growing into healthy, productive, smart adults, height predicts adult mortality, economic outcomes and cognitive achievement. The first few years of life have critical life-long consequences. Physical or cognitive development that does not happen in these first years is unlikely to be made up later.

So it is entirely appropriate that news reports in India frequently mention child stunting or malnutrition. Indian children are among the shortest in the world. Such widespread stunting is both an emergency for human welfare and a puzzle.

Why are Indian children so short? Stunting is often considered an indicator of “malnutrition,” which sometimes suggests that the problem is that children don’t have enough food. Although it is surely a tragedy that so many people in India are hungry, and it is certainly the case that many families follow poor infant feeding practices, food appears to be unable to explain away the puzzle of Indian stunting.

‘ASIAN ENIGMA’

One difficult fact to explain is that children in India are shorter, on average, than children in Africa, even though people are poorer, on average, in Africa. This surprising fact has been called the “Asian enigma.” The enigma is not resolved by genetic differences between the Indian population and others. Babies adopted very early in life from India into developing countries grow much taller. Indeed, history is full of examples of populations that were deemed genetically short but eventually grew as tall as any other when the environment improved.

So, what input into child health and growth is especially poor in India? One answer that I explore in a recent research paper is widespread open defecation, without using a toilet or latrine. Faeces contain germs that, when released into the environment, make their way onto children’s fingers and feet, into their food and water, and wherever flies take them. Exposure to these germs not only gives children diarrhoea, but over the long term, also can cause changes in the tissues of their intestines that prevent the absorption and use of nutrients in food, even when the child does not seem sick.

More than half of all people in the world who defecate in the open live in India. According to the 2011 Indian census, 53 per cent of households do not use any kind of toilet or latrine. This essentially matches the 55 per cent found by the National Family Health Survey in 2005.

Open defecation is not so common elsewhere. The list of African countries with lower percentage rates of open defecation than India includes Angola, Burundi, Cameroon, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Liberia, Malawi, Rwanda, Senegal, Sierra Leone, South Africa, Tanzania, Uganda, Zambia, and more. In 2008, only 32 per cent of Nigerians defecated in the open; in 2005, only 30 per cent of people in Zimbabwe did. No country measured in the last 10 years has a higher rate of open defecation than Bihar. Twelve per cent of all people worldwide who openly defecate live in Uttar Pradesh.

So, can high rates of open defecation in India statistically account for high rates of stunting? Yes, according to data from the highly-regarded Demographic and Health Surveys, an international effort to collect comparable health data in poor and middle-income countries.

International differences in open defecation can statistically account for over half of the variation across countries in child height. Indeed, once open defecation is taken into consideration, Indian stunting is not exceptional at all: Indian children are just about exactly as short as would be expected given sanitation here and the international trend. In contrast, although it is only one example, open defecation is much less common in China, where children are much taller than in India.

Further analysis in the paper suggests that the association between child height and open defecation is not merely due to some other coincidental factor. It is not accounted for by GDP or differences in food availability, governance, female literacy, breastfeeding, immunisation, or other forms of infrastructure such as availability of water or electrification. Because changes over time within countries have an effect on height similar to the effect of differences across countries, it is safe to conclude that the effect is not a coincidental reflection of fixed genetic or cultural differences. I do not have space here to report all of the details of the study, nor to properly acknowledge the many other scholars whose work I draw upon; I hope interested readers will download the full paper at http://goo.gl/PFy43.

DOUBLE THREAT

Of course, poor sanitation is not the only threat to Indian children’s health, nor the only cause of stunting. Sadly, height reflects many dimensions of inequality within India: caste, birth order, women’s status. But evidence suggests that socially privileged and disadvantaged children alike are shorter than they would be in the absence of open defecation.

Indeed, the situation is even worse for Indian children than the simple percentage rate of open defecation suggests. Living near neighbours who defecate outside is more threatening than living in the same country as people who openly defecate but live far away. This means that height is even more strongly associated with the density of open defecation: the average number of people per square kilometre who do not use latrines. Thus, stunting among Indian children is no surprise: they face a double threat of widespread open defecation and high population density.

The importance of population density demonstrates a simple fact: Open defecation is everybody’s problem. It is the quintessential “public bad” with negative spillover effects even on households that do not practise it. Even the richest 2.5 per cent of children — all in urban households with educated mothers and indoor toilets — are shorter, on average, than healthy norms recommend. They do not openly defecate, but some of their neighbours do. These privileged children are almost exactly as short as children in other countries who are exposed to a similar amount of nearby open defecation.

If open defecation indeed causes stunting in India, then sanitation reflects an emergency not only for health, but also for the economy. After all, stunted children grow into less productive adults.

It is time for communities, leaders, and organisations throughout India to make eliminating open defecation a top priority. This means much more than merely building latrines; it means achieving widespread latrine use. Latrines only make people healthier if they are used for defecation. They do not if they are used to store tools or grain, or provide homes for the family goats, or are taken apart for their building materials. Any response to open defecation must take seriously the thousands of publicly funded latrines that sit unused (at least as toilets) in rural India. Perhaps surprisingly, giving people latrines is not enough.

Ending a behaviour as widespread as open defecation is an immense task. To its considerable credit, the Indian government has committed itself to the work, and has been increasing funding for sanitation. Such a big job will depend on the collaboration of many people, and the solutions that work in different places may prove complex. The assistant responsible for rural sanitation at your local Block Development Office may well have one of the most important jobs in India. Any progress he makes could be a step towards taller children — who become healthier adults and a more productive workforce.

The Ten Biggest Lies of B-School

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I went to B-School about 10 years ago.  I remember the good times, the parties, the camaraderie.  I also remember the long hours in the library, working on team projects with other keen classmates, and the sense of accomplishment at graduation.

However, 10 years later, Business School missed out on a lot in terms of teaching me the skills needed to succeed in my career and life.

Here are the ten biggest lies of B-School you should protect yourself against:

1. You will be rich. My experience (and from talking to others) is that it will take you 2 or 3 times as long as you think it will take to succeed after Business School.  So take it easy running up your student loans and credit card debts expecting you’re going to be a rock star later.

 

 

2. You are smarter than people without an MBA. You were smart enough to get in to Business School.  That doesn’t mean you are smarter than other people without an MBA.  Stay humble.

3. There’s always a right answer. B-School students are usually very analytical and achievement-oriented. They like to think there’s always a “best” answer. There’s not.  The perfect answer is always the enemy of the good enough one.  You make decisions you can with the best information available.  Life and business today doesn’t let you count how many angels can fit on the head of a pin.

4. If you’ve made it this far (to B-School), you’re destined to succeed. In my B-School, there were always amazingly talented executives coming in to give talks on business and life. They’d always compliment us on what a great school we attended and why we had our future by the tail.  It made us all feel invincible — destined to succeed once we set out on our various career paths.  It doesn’t work that way. I know B-School classmates who’ve failed miserably, under-achieved, gotten divorced, gotten severely depressed, etc.  B-School is a great educational opportunity in life, but you still have to go out there and succeed. Nothing is given to you as a birthright.

5. You know how to “fix” the first few companies you join after school. You’ve probably worked at companies were people who’ve been there for 2 decades roll their eyes telling you about the new hotshot MBA who just started and is now telling everyone how to do their jobs.  It’s so clear to him, yet others find it deeply offensive that he would think he knows how the company works when they’ve spent countless years there and are still trying to figure it out.  All hotshot MBAs should wear tape over their mouths for the first 3 months on the job and not be allowed to “fix” anything.

6. Discounted Cash Flow (DCF) will always tell you what a company is worth. MBAs love DCF. They think the true answer to what a company is worth is always a DCF away.  Just crank it out on a spreadsheet or whiteboard, show the boss, and move on to the next problem.  Unless you’re going to be a sell-side analyst, you’ll never do a DCF after B-School.  And even the sell-side analysts get their underlings to do them.  And no one reading your reports will read them anyway.

7. The “soft” courses (leadership and people management) are least important. I remember talking to the professors from theManagement Department at my school who had to teach the courses on leadership and people management.  They used to lament that the MBAs never paid attention to them in class.  Yet, the Executive MBAs (usually in their 40s or 50s) always told them that these courses were the most important of all the B-School classes they took.  You learn after B-School that the perfect answer or strategy means nothing if you can’t get people around you to buy in to it and help you achieve it.  To do that, you need to motivate them, listen to them, connect with them, and support them when they need it.

8. You are going to be more creative and entrepreneurial after Business School than before. In my experience, B-School makes you less creative, the longer you’re in it.  They teach courses on entrepreneurship but it’s kind of an oxymoron the idea of the analysis paralysis B-School Students being entrepreneurial.  You will learn a lot of tools and frameworks in B-School, but you won’t learn how to start a company.  You just need to start a company.

9. Your peers will give you lots of tips and insights that will help you succeed in your career. In my experience, the majority of B-School students are lemmings.  They don’t know what they want to do afterwards, so they just do what their peers say they should do (maybe that’s why they applied to B-School in the first place).  Ten years ago, everyone at my school wanted to be a dot com entrepreneur.  That didn’t work out so well and most students later went back to being investment bankers or management consultants.  Your peers don’t know what you want to do with your career.  You need to start listening to that voice inside your head.

10. The Ivy League MBAs will be even more successful. An Ivy League credential will be a big plus for you on your resume – no question.  However, you have to realize that if you’re getting an Ivy League MBA, you’re probably 10x more susceptible to the previous 9 lies than other MBAs.  Don’t let yourself be the next Jeff Skilling, the smart Harvard MBA, who worked at McKinsey and then went to Enron and drove the company off a cliff.  He had a golden resume – and where did it get him?

If you treat B-School like an amazing educational experience, chances are you’ll get a lot out of it.  Just keep your attitude and sense of entitlement in check.As Casey Kasam used to say, “Keep your feet on the ground, and keep reaching for the stars.”

Motherhood, the career that dare not speak its name

By Cristina Odone Politics Last updated: March 13th, 2013 

Claire Perry MP: motherhood is a career

Claire Perry, Tory MP for Devizes and childhood guru to David Cameron, says she's had three careers: she's been a banker, a mother and a politician. It is brave of her – and not because bankers and politicians are the most despised professions around. Ms Perry is brave because she makes claims for motherhood that has too many feminists and members of the Coalition sneering: it is a full-time, unpaid job.

Perry is promoting "Mothers at Home Matter", a group that wants the Coalition to recognise the contribution of stay-at-home mothers. Their message is urgent: when the state has to step in to care for children, the tax payers end up paying millions in creches and programmes like SureStart – now recognised as a hugely expensive Labour failure.

Worse, psychologists are now worrying that being raised outside their home environment by a succession of "professionals" can scar children for life. In Sweden, where this is a matter of routine, school records show the highest truancy and "worst classroom disorder" in western Europe. The star witness for MAHM was Jonas Himmlestrand, expert in Swedish family policy, who reported that his homeland, where 90 per cent of children are in subsidised child care, has seen a serious decline in adolescent mental health, between 1986 -2002 declined faster than in 10 comparable European countries.

So, forget the Swedish model. MAHM believes the key to happy families is to change the tax system that right now forces women to work. The UK is almost alone amongst developed countries in not recognising family and spousal responsibilities in its tax system. The burden on the single earner has more than doubled in the last 50 years. Many single earner families are in the poorest third of the population. MAHM want families taxed on the basis of household rather than individual income. They call "for a debate about income-splitting, transferable tax allowances and protecting child benefit for parents with dependent children."

Politicians should pay attention: the number of mothers who stay at home is down to a third — but, as I found out when I researched "What Women Really Want" for the Centre for Policy Studies, the majority of mothers would like to stay at home to look after their children. That's quite a constituency, Messrs Cameron et al. Ignore it (and your pledge to introduce family tax credits) at your peril.

Cambridge University medicine admissions show race gap

Applicants with three A*s at A-level are 20% more likely to get offer if they are white than if they are from ethnic minority

• James Ball and Kurien Parel
• guardian.co.uk, Wednesday 13 March 2013 12.56 GMT

Cambridge University released the detailed admissions data, covering 2010 to 2012, for medicine only in response to a freedom of information request. Photograph: Brian Harris/Alamy

People applying to study medicine at Cambridge University with three A*s at A-level are more than 20% more likely to be given an offer if they are white than if they are from an ethnic minority, according to new data released by the institution.

Cambridge University released the detailed admissions data, covering 2010 to 2012, for medicine only in response to a freedom of information request. The university refused a similar request a few weeks before, which covered more subject areas, on the grounds of cost.

The data, which covers applications from within the UK by people who declare their ethnicity, shows that 329 out of 586 white applicants for medicine who went on to achieve three A*s were given an offer of a place, versus 190 of 412 applicants from ethnic minorities – representing success rates of 56% and 46% respectively. The difference between the two groups is statistically significant.

Both Oxford and Cambridge have been challenged by MPs and campaigners to do more to get students from ethnic minorities into their institutions, particularly as the headline admissions figures for the two institutions show a substantial gap in success rates between students of different ethnicities.

The universities have said this gap is explained in large part by students from ethnic minorities disproportionately applying for the most competitive subjects, such as medicine – but these new figures show that even within the competitive subjects, white students are more likely to receive offers.

Cambridge's race gap for medical applicants is substantially smaller than that of its rival, Oxford University. Figures released to the Guardian under the Freedom of Information Act, published last month, show white students applying for medicine who went on to achieve three A*s were 94% more likely to be offered a place than those from ethnic minorities.

A-levels are only one of several factors taken into account by admissions tutors for medicine at both universities. Applicants are also required to take a specific entrance exam, the bioMedical admissions test, while work experience and performance at interview are also factored in to whether to make an offer. Those handling applications may also be unaware of the ethnicity of prospective applicants rejected prior to interview.

A spokeswoman for Cambridge University said analysis of applications based on A-level grades "ignores a significant number of relevant variables" and is therefore "superficial".

"Admissions decisions are based on students' ability, commitment and their potential to achieve," she said. "Our commitment to improving access to the university is longstanding and unwavering … [and] we aim to ensure that anyone with the ability, passion and commitment to apply to Cambridge receives all the support necessary for them to best demonstrate their potential."

She added that Cambridge had run initiatives to encourage gifted students from minority backgrounds to apply to Cambridge since 1989.

Oxford University declined to comment on the difference in size of the medical race gap of applicants between itself and Cambridge University, but said in an earlier statement it constantly reviewed the race gap of its applicants.

"Oxford University is committed to selecting the very best students, regardless of race, ethnicity, or any other factor," a spokeswoman said.

"This is not only the right thing to do but it is in our own interests. Differences in success rates between ethnic groups are therefore something we are continuing to examine carefully for possible explanations."

The Oxford spokeswoman also noted Cambridge made more use of students' grades at AS-level than does Oxford, and said ethnic minorities were well represented at the university, making up 22% of all students and 13% of UK undergraduates.

The justice and security bill will have a corrosive impact on individual rights.

I'm leaving the Liberal Democrats too

The justice and security bill will have a corrosive impact on individual rights. The party's support for it is a coalition compromise too far

• 
• • Philippe Sands
  • The Guardian, Monday 11 March 2013 20.30 GMT

Liberal Democrat parliamentary candidate Jo Shaw announces her resignation during a speech at the party's spring conference. Photograph: Matthew Lloyd/Getty Images

I have worked closely with the Liberal Democrats since the attacks of 11 September; it has been the only party to adopt a principled and consistent position favouring the rule of law and the protection of individual rights. In difficult times, and in the face of blanket claims invoking risks to national security, the Liberal Democrats have resisted policies embracing torture, rendition and the indefinite detention of alleged terrorists without charge, as well as war under conditions of patent illegality.

After the London attacks of July 2005 the Lib Dems stood firm against the idea that the "rules of the game" had changed, committed to respect of human rights for all. They opposed executive authority, secrecy and the rise of the "security state". In government, on many issues, that position has been maintained. But to my great regret, last week the parliamentary group was whipped to vote in favour of the introduction of secret court hearings in part 2 of the justice and security bill. If adopted, the bill will put British judges in the invidious position of adjudging certain civil claims under conditions in which one party will not be entitled to see the evidence on which the opposing party relies. Last year Lib Dem members voted overwhelmingly against this. They did so again at their conference on Sunday. Their approach was informed, reasonable, principled and correct. Why was it ignored?

This part of the bill is a messy and unhappy compromise. It is said to have been demanded by the US (which itself has stopped more or less any case that raises 'national security' issues from reaching court), on the basis that it won't share as much sensitive intelligence information if the UK doesn't rein in its courts. Important decisions on intelligence taken at the instigation of others are inherently unreliable. We remember Iraq, which broke a bond of trust between government and citizen.

There is no floodgate of cases, nothing in the coalition agreement, nor any widely supported call for such a draconian change. There is every chance that, if the bill is adopted, this and future governments will spend years defending the legislation in UK courts and Strasbourg. There will be claims that it violates rights of fair trial under the Human Rights Act and the European convention (no doubt giving rise to ever-more strident calls from Theresa May and Chris Grayling that both should be scrapped). Other countries with a less robust legal tradition favouring the rule of law and an independent judiciary will take their lead from the UK, as they did with torture and rendition.

I accept that there may be times when the country faces a threat of such gravity and imminence that the exceptional measure of closed material proceedings might be needed. This is not such a time, and the bill is not such a measure. Under conditions prevailing today, this part of the bill is not pragmatic or proportionate. It is wrong in principle, and will not deliver justice. It will be used to shield governmental wrongdoing from public and judicial scrutiny under conditions that are fair and just. The bill threatens greater corrosion of the rights of the individual in the UK, in the name of "national security".

It smells too of political compromise in the name of coalition politics. Being a party of government does not mean such compromise is inevitable. This is particularly important now, as Conservative forces ratchet up their attacks on rights for all and against the European convention. At this moment the need for the Liberal Democrats to stand firm on issues of principle – for individual rights and open justice, against the security state – is greater than ever.

Secrecy begets secrecy. I have listened to all the arguments, and concluded this is a compromise too far, neither necessary nor fair at this time. The point has been made eloquently in recent days by Dinah Rose QC and Jo Shaw. Their principled arguments have long had my full support and so I have joined them in resigning from the Liberal Democrats. I have done so with regret, given the courageous positions adopted on these issues by Charles Kennedy, Menzies Campbell and Nick Clegg in the past. I still hope that the views of the membership might yet prevail, before the bill passes into law. If not, the Liberal Democrats will have lost integrity on one issue that has truly distinguished them from other parties, and on which they can rightly claim to have made a real difference.

Vicky pays the Pryce

What makes Chris Huhne and Vicky Pryce so compelling is that we all live on the brink of disaster

Chris Huhne was sent to prison today. But if his fall from grace seems remote from anything that might happen in our own lives, we should think again.

In my experience all of us, at any stage, are potentially just a few steps from disaster. It takes no more than a handful of bad decisions to reach the point that events are out of our control and disaster overtakes us.

It's not unusual

Mr Huhne’s decisions to speed and to cover up his offence, were not unusual. Up to 300,000 of us may have persuaded others to take our penalty points for speeding, according to a survey for the AA in 2011. However, once Mr Huhne rejected his wife and forfeited her loyalty, his ability to control events passed out of his hands. The disaster that followed was entirely predictable.

As a lawyer specialising in criminal law, the point that strikes me over and over again is how close we all are to the disaster of a criminal investigation and trial, whatever our background or circumstances.  We are all capable of committing crimes. It takes very little - a moment of temptation, a rush of anger, a reckless impulse - to commit many crimes.  Then all that stands between us and a criminal conviction is discovery, investigation and trial. 

Goethe once said that there was no crime of which he did not deem himself capable.  Most of us will understand the sense of what he was saying even if we cannot sign up to the entire proposition.  In identifying with his thought, we do not condone acts of violence or dishonesty, we simply recognise our own capacity to fail.

So why do people who have every advantage in life – a happy family background, a decent education, a good job - commit crimes? Few of us with such a background set out to commit a crime. There is too much stopping us: we have grown up believing in, obeying, and benefiting from rules, and we have prospered. The fear of losing all we have is a strong motivator to obey the law. We spent much of our lives controlling our behaviour. 

It is when an event or set of circumstances occurs which causes us to lose control, or when we think that the risks are minimal, that the danger surfaces. People convicted of stealing from their employers often do so because the pressure of debt in their personal lives overwhelms them. They begin with a genuine intention to repay the money that they “borrow” when circumstances allow, but somehow this moment never arrives.

Losing control

Often people convicted of downloading indecent images commit their crimes because they cannot control their behaviour but they also convince themselves that they will never be caught. These cases rarely involve a single instance of criminality. Instead they begin with a single bad decision (to take from petty cash or look at an image), followed by a further decision which commits the individual to the path that they choose.

Then there are other factors in the mix that are particular to ourselves: our appetite for risk and the extent to which we think we can control events.

When Dominique Strauss Kahn approached the maid in his New York hotel room; when Jonathan Aitken announced he would begin a libel action to “cut out the cancer of bent and twisted journalism in our country”; when Lord Archer sued the Daily Star for libel over allegations (subsequently proved to be true) that he had slept with a prostitute – they were spinning the dice but also, I suspect, taking the gamblers pleasure in doing so. They thought they could win.

It may be that the biggest risk-takers are also those most likely to take the bad decisions that lead to disaster. But we have all done things we regret which through happenchance never become known, or have compounded an error by our subsequent decisions. The Huhne case illustrates the additional danger of entrusting a secret to others.

Once that step has been taken, then all depends on their ability or willingness to continue the deception.

Primary school maths whiz kids are set up for life

Hamish McRae in The Independent

An important, if troubling, bit of research has just been published by the Institute for Fiscal Studies, backed with some government money.

It shows that 10-year-olds who are good at mathematics earn significantly more once they reach their thirties than those who are not. The IFS took a large group of children born in April 1970, then looked at their maths and English scores 10 years later. Then, they looked at their earnings at the ages of 30, 34 and 38.

The findings showed that those who were in the top 15 per cent of maths scores at age 10, earned on average 7.3 per cent more at 30 – equivalent to £2,100 a year – than the child who scored the average in that class, even adjusting for all other factors. Those who did similarly well in English earned 1.9 per cent – or £550 – more than the middle-ranker. So, being good at English is helpful, but being good at maths is even better.

The IFS says this suggests that employers value maths skills and are prepared to bid for people who have them, and it therefore concludes that we need to invest more in lifting children's performance in maths.

This makes sense, but also carries the worry that if 10-year-olds happen to be bad at maths, they are disadvantaged through life. It would thus follow that having a bad maths teacher at primary school can really damage people's chances, while a great one can lift children up for the rest of their lives.

The task for educators is huge, and clear objectives are a help. But, if numeracy is more important in the job market than literacy, what conclusions should we draw?