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Patricia Arquette and Thorston Keifer of WASH United w DefeatDD toilet calendar
submitted by Hope Randall
02/27/2015 at 12:04

DefeatDD is a team of movie buffs. So you can imagine our excitement when we saw this photo of our pal Thorsten Kiefer of WASH United with Patricia Arquette… holding our Places We Go toilet calendar! We think the diarrhea crisis is big news, but it’s not often that we find ourselves in the middle of a trending topic. 

Earlier this week, Patricia Arquette won an Oscar for her role in Boyhood, and during her acceptance speech we learned that she is also a co-founder of GiveLove, a group working on ecological sanitation solutions in Haiti. Here’s what she has to say about her work (from the GiveLove website):

"When you work on improving sanitation, like we do in Haiti, you start to really see the big picture. Sanitation is the keystone to solving so many problems in the world-- improving public health, reducing child mortality, recycling and reducing waste, and protecting water resources -- and yet no one is really talking about the problem of untreated sewage or the fact that 40% of the world’s poorest people live without a toilet. The global community needs to commit resources to finding sustainable solutions.”

Hear, hear! And as we bask in the toilet-shaped glow of seeing our calendar in such illustrious company, we wanted to also honor four additional celebrities you may be surprised to learn aren’t afraid to talk shit. Let’s just call it the DefeatDD Oscars list, where every nominee is a winner! 

Matt Damon: You’ve just got to love a celebrity to can laugh at himself. His role as co-founder of would be enough reason to include Matt on this list, but he doesn’t stop there. Between his toilet strike, and most recently, his unique take on the ALS Ice Bucket Challenge, he is a fearless (and hilarious) advocate for safe drinking water and sanitation. His source of inspiration? His three daughters (Cue the collective “awwww”).

Our own Alfred Ochola got to hang out with PSI Ambassador Mandy Moore before speaking on a panel together about the lifesaving impact of US foreign aid.

Mandy Moore: As a PSI Ambassador, Mandy Moore has traveled to Africa, spoken with families who have benefitted from PSI’s programs, tasted water made safe to drink by purification tablets. On Capitol Hill, she speaks passionately about the simple solutions to address diarrhea. She even stood in the world’s longest toilet queue on World Water Day! Humbly, she says that her role is to observe, listen, and learn as much as she can, but don’t let her modesty fool you: she knows her shit.

Bono: Bono is responsible for perhaps the first and only mention of the “d” word in Vanity Fair: “Diarrhea may be inconvenient in our house, but it's not a death sentence.” He’s the brains behind this little group of grassroots advocates you may have heard about – the ONE Campaign – that continues to be a co-conspirator for DefeatDD awareness-raising efforts, including great coverage of rotavirus vaccine news and enthusiastic participation in our Poo Haiku Challenge (ONE’s Global Health Policy Director Erin Hohlfelder was one of our winning pooets!).

Chelsea Clinton: She’s not a movie star or singer, but she’s still a household name. This former First Daughter is anything but shy about diarrhea. Quite the opposite, in fact: she is obsessed with it! Within 30 seconds of the start of her interview at the South by Southwest Festival, she asked the moderator if she could talk about diarrhea. Now that’s the kind of urgency we like to see! She has dedicated her career to domestic and global health in her role at the Clinton Foundation. We’re not sure if she interrupts every meeting with facts and figures about the solutions to defeat diarrheal disease, but we’d like to think so.

As you can see, as a DefeatDD blog reader and advocate, you are in good company. What other celebrities would you add to this list?

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submitted by Dipika Sur
02/25/2015 at 18:37

Kolkata, on the eastern part of India, has long been a public health hub. The city boasts of the School of Tropical Medicine, All India Institute of Hygiene and Public Health, National Institute of Cholera and Enteric Diseases (NICED), and the headquarters of the Indian Public Health Association (IPHA).  As the secretary general of the IPHA, I had the chance to work on planning the recently concluded 14th World Congress on Public Health (WCPH) that was co-hosted by the World Federation of Public Health Associations and the IPHA earlier this month.

Planning for the WCPH began way back in 2013 when the IPHA Conference was hosted in Kolkata. Hectic planning and strategizing went into hosting the WCPH, with the theme of ‘Healthy People –Healthy Environment.’ For India, the timing for the WCPH aligned the Government of India’s gearing up to take up sanitation on a war footing. I have been associated with NICED for 17 years and for somebody who has conducted scientific research on enteric diseases, this was one of the most appropriate platforms to bring before the global public health fraternity the importance of the Clean India Campaign as envisaged by the Indian Government.

I was the Principal Investigator for the Indian site of the Global Enteric Multicenter Study (GEMS), which was conducted in Kolkata at NICED. GEMS was the largest study ever conducted on diarrheal diseases in developing countries, enrolling more than 20,000 children from seven sites across Asia and Africa and its results were disseminated in 2013.

This landmark study pinpointed the key causes of childhood diarrhea. In Kolkata, and in other similar GEMS sites, rotavirus was the commonest cause of moderate-to-severe diarrhea cases. Presentations at the enteric diseases sessions at WCPH emphasized the importance of proper sanitation to help countries tackle this high disease burden.

The importance of public health cannot be underscored enough. With India aligning with global leaders to work towards the eradication of polio and measles being next in line, there needs to be sharper planning around the one thing that has been pulling India back: open defecation.

In countries like India, an unhealthy environment continues to be responsible for the spread of communicable diseases. Over the past year, I worked with PATH’s Japanese Encephalitis team and I have seen first-hand the horrifying possibilities of disease outbreak – once again linked to negligible or no attention paid to the direct relation of sanitations systems breakdowns and epidemics.

Having been a life member of IPHA since 1988 and presently the secretary general of the association, I and the members of IPHA were indeed privileged to have been able to host the 14th WCPH in Kolkata at such a meaningful time for public health in India.


Photo credit: PATH.

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submitted by Jordan Teague
02/19/2015 at 12:57

Jordan hanging out with her newest source of inspiration for her work in WASH: her third niece.

Over the last few years with my four nieces and nephews, I have become intimately familiar with breastfeeding, poopy diapers, introductions to solid foods, potty training, and the process of cognitive development in young children, among many other things. All along, we’ve had running water that was safe to drink, toilets to flush, a place to dispose of diapers, and a sink with soap to wash our hands. During each of their first 1,000 days I have hardly worried that they might have too many bouts with diarrhea or other illnesses that would cause them to suffer from undernutrition. The same cannot be said for many other aunties, mothers, and families around the world. In places where WASH conditions are poor, even if there is enough food to eat, children can suffer from undernutrition due to frequent diarrhea or a condition called environmental enteropathy.

Recognition of this relationship has been gaining momentum in the WASH and nutrition sectors over the last few years. In the Lancet series on nutrition in 2013, WASH was named a nutrition-sensitive intervention. A core component of the Scaling Up Nutrition Movement’s Framework for Action is a multi-sector approach to integrating nutrition, including WASH. USAID released its Multi-Sectoral Nutrition Strategy in 2014, which includes WASH as a high-impact action for improving nutrition and has “committed to making its nutrition initiatives more effective” by integrating WASH components as essential in all its nutrition programs.

Enthralled by the impact that nutrition in the first 1,000 days has on the rest of a child’s life and even more fascinated by the effect that WASH has on nutrition, I set out in 2013 to research how WASH and nutrition were being integrated, what was working, and why. Very quickly, my research turned into why weren’t WASH and nutrition being widely integrated and what needs to be done to make that happen. I interviewed key stakeholders in both the WASH and nutrition sectors on the barriers these organizations encountered when attempting to integrate these two sectors and what solutions there might be to these challenges.

Stakeholders identified 11 common barriers to integration. The top five were:

-          Insufficient or siloed funding

-          Staff capacity and/or interest

-          Lack of knowledge of different sectors and programs

-          Lack of coordination between sectors

-          Lack of evidence of the collective impact of integration


“It takes a new way of thinking about programming”

Fourteen action items or next steps were identified as enablers for effective integration, and the five most commonly mentioned were:

-          A comprehensive strategy for integrated programs

-          Coordination and communication between sectors

-          Integrated funding and donor support for these efforts

-          Increased evidence of the collective impact of integration

-          Leadership to drive these efforts forward

These findings result in a few concrete next steps for the WASH and nutrition sectors. Operational research is needed in order to generate the evidence base of the additive or multiplicative effects of integrated programs and to formulate a standard methodology for integration. Donors need to supply flexible funding that can be used for innovation and to integrate programs in appropriate contexts. The WASH and nutrition sectors should improve knowledge sharing and increase cross-training of staff. Finally, we need to design incentives in these programs for staff to work in collaboration toward common goals and objectives. A lot of smart people are thinking about and doing these things, and I look forward to seeing where WASH and nutrition integration goes from here!

To learn more, visit the following links:

-          The full paper and presentation

-          WASHplus and their WASH & Nutrition Library

-          The 1,000 Days partnership

-          Scaling Up Nutrition

-          WASH Advocates’ fact sheet and resource guide on nutrition

-          Clean, Fed, & Nurtured

-          The WASH Benefits Study



-- Jordan Teague is the Program Associate at WASH Advocates and the proud auntie of one handsome nephew and three beautiful nieces.

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submitted by Nitya Jacob
02/13/2015 at 14:44

Sanitation is a serious challenge for India. Even though it has had sanitation programmes since the 1950s, more than half the population continues to defecate in the open because toilets are poorly made, because they do not have a toilet, or because of ‘cultural’ reasons. A third or more newly constructed toilets lie unused, as people do not understand why they should use them.

Research suggests India has the highest rates of morbidity and mortality at all ages from water-borne diseases caused by faecal pathogens and high rates of malnutrition. The absence of toilets at home forces women to ‘hold on’ the whole day making them susceptible to urinary tract infections. When they go to defecate in the open, they are vulnerable to harassment or assault.

Last year, Prime Minister Narendra Modi launched his high profile ‘Swachh Bharat’ (Clean India) campaign to eliminate open defecation by 2019. This clearly shows the eagerness of the government to deal with the crisis, but the problem at hand is too big to be dealt with just good intent. Early indications are the programme is going the way of earlier ones with single-minded emphasis on hardware.

As per the 2014 Millennium Development Goals Report, 66% of rural India still defecates in the open. Research by RICE Institute has suggested that most rural Indians can afford a toilet but don’t want one because they are comfortable with the idea of defecating in the open. Thus, the new Prime Minister will only meet his goal if he can create a social movement that changes people's attitudes, and builds demand for toilet use by making people aware of the health and environmental risks attached to open defecation.

The positives attached with the ‘Swachh Bharat’ campaign is that it ensures funds and support from the government, but realising the fundamental need to change people’s attitudes about sanitation and channeling the funds into the right direction will be its true test. Thus, the government should learn from past failures, and recognise that policies to address open defecation should be tailored to Indians' attitudes towards sanitation.

Sanitation policy needs a radical restructuring in India. What India needs is a concerted effort to change the attitudes and behaviours of its citizens to get them out of the fields and into toilets!

WaterAid believes this is an unprecedented opportunity not only to really raise the issue of sanitation and the safe disposal of human waste, but also for all those involved in the campaign to ensure that we work together and learn from our previous experiences, successes, and failures.

With decades of experience in India and around the world in managing and scaling up programmes, providing technical assistance, and testing new solutions, WaterAid looks forward to supporting the government in its ambitious agenda to solve the sanitation crisis in India.

To achieve this, WaterAid, along with the Ministry of Drinking Water & Sanitation and the Ministry of Urban Development, are organising a three-day ‘India WASH Summit’ from 16-18 February 2015 in New Delhi. The first event of its kind, it will bring together the government, private sector, and the civil society working to make clean India a reality by 2019. Participants at the Summit will discuss and deliberate on the sanitation crisis facing India and ways to solve it through the Swachh Bharat Mission and beyond.

More information regarding the Summit can be accessed at:


-- Nitya Jacob is the Head of Policy with WaterAid in India

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submitted by Erin Sosne
02/03/2015 at 11:06

A full circle moment: My son receives his rotavirus vaccine.

With the measles outbreak dominating the US vaccine-related news (and jeopardizing a trip my two-month old baby and I planned to take to visit family in southern California), I wanted to share some positive news.

Last week, I joined mothers (and fathers) around the world and took my baby boy to receive his first series of childhood vaccines, including the vaccine against rotavirus.  As a person working on vaccine-related policy issues, I awoke with a number of emotions and thoughts running through my head:

Admiration – for the mothers who walk miles and wait hours to receive the same vaccines for which my husband and I carried our baby four city blocks and waited ten minutes; for the science that made it possible to prevent these diseases; and for the complex systems that bring the vaccines safely from their point of manufacture to their place of delivery (a much more complex challenge than one might realize).

Disbelief – How is it that far too many American parents could make the choice (and have the choice!) not to vaccinate their children, and in turn, leave mine and many others young and immunocompromised children unprotected from diseases that had almost been erased from the US? What so many families in developing countries would give to have the privilege of easy access to these lifesaving tools, yet these parents refuse without scientific basis!

Pride – to live in a country whose scientists, including those at PATH, helped develop and manufacture many of these vaccines with the support of the US Government. These decision makers and citizens have prioritized making vaccines affordable and accessible to people living in low-resource settings around the world through financial contributions to organizations such as Gavi, the Vaccine Alliance, and through the programs of federal agencies, including the US Agency for International Development (USAID) and the Centers for Disease Control (CDC). Americans know that protecting the world against vaccine-preventable illness protects Americans at home and abroad, and is the right thing to do.


I am grateful that my son joined the millions of children who will be vaccinated this year.  I am glad that the unfortunate news of the vaccine refusers has stimulated discussion about the value of vaccines among American families, and hope that we can all learn from this tragic outbreak the importance of immunizing ourselves and continuing to make existing and to-be-developed vaccines available to families around the world. While it was hard to watch the jabs go into my son’s tiny little thighs, when I swaddled him in my arms I felt content.


For more information:

-- PHOTOS: Rotavirus vaccines make their steady march across the African continent. 

-- Visit PATH's Vaccine Resource Library for scientific documents and specific diseases and topics in immunization addressed by PATH's work. 

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