Now wash your hands

Every day, 5,000 children die because of poor sanitation. Villagers in Madagascar tell Barbara Gunne

"What did we tell you last time we were here?" shouts the man with the microphone.

"Wash Your Hands!" yell back 200 children aged around 5-11. They are seated on the grass verges of the crossroads at Amparatanana, a village on Madagascar's east coast, the audience for a travelling marionette show spreading the word about hygienic use of latrines, keeping water uncontaminated and, above all, hand-washing.

As Mr Clean upbraids Mr Dirty for his bad habits, the children scold along; as Mr Dirty goes home to his wife clutching his stomach with diarrhoea pains, they giggle uncontrollably.

The puppets are part of this region's response to the international rural water, sanitation and hygiene (WASH) project that got under way in Madagascar soon after the country suffered a severe cholera outbreak early in 2000. Water Aid, the key international NGO in this field in the country, is working here with local partners, the Frères Saint-Gabriel.

Yvon, one of the FSG hygiene educators, regularly updates the puppet-show scripts to keep the children hooked on the message. His aim, he told me, is to use storylines as close to the children's home lives as possible, so that hand-washing becomes second nature. This sounds easy until you consider that, in the middle of our own culture of abundant soap and hot water, medical staff still manage to spread MRSA because they fail to wash their hands between patients.

In fact, educators like Yvon have to work miracles. The wood and thatch huts of these east-coast villages are tightly packed in to small compounds without running water. Soap is a luxury and such latrines as exist are poorly designed, badly sited and almost always a health hazard.

Yet the children do absorb the hand-washing message and the impact of the singing, dancing, 12-foot-high marionettes has been rapid in the schools. Albertine-Rosalie Clode, a teacher for 37 years, whom we met fetching water at the new water kiosk, told us that her school of 1,686 pupils aged 6-17 was already seeing improvements.

"Awareness has changed in just one year [since WaterAid and FSG came to this village], particularly among the children. When the ice-cream seller comes by, they ask him, 'What water did you use to make it?' The puppets show families as they know them. In the past we could have 20 children off sick out of a class of 44-60, particularly in the rainy season," says Mme Clode, who lives alongside the families of her pupils, and whose many grandchildren are as vulnerable to the debilitating water-borne diseases of the area as the children of poorer neighbours.

The hand-washing message - enormously effective in its own right - also underscores the urgent need to speed up provision of clean water and appropriate sanitation. The poorest villagers here still depend on river collection for some water and still manage without toilets. The few existing wells, some provided only in the past few years, are uncovered and vulnerable to impurities from the buckets of different users. And, as the area has an unusually high water table, there is considerable risk of groundwater contamination from badly designed and sited latrines.

The proportion of people with safe water and adequate sanitation in the villages of the Analanjirofo district (to which New Statesman subscri bers' contributions are directed) is estimated to be as low as 9 per cent, inflicting a heavy penalty on the local economy in hours lost to education and productive work.

Persuading officialdom of the economic good sense of developing a national sanitation strategy has been an important part of WaterAid's work in Madagascar. In 2003, its research showed that the country was losing five million working days and 3.5 million schooldays each year as a result of ill-health caused by dirty water and inadequate sanitation. To this must be added the human cost. Every day around the globe, 5,000 children die from the diarrhoeal diseases associated with contaminated water; it is the second-biggest childhood killer after tuberculosis and respiratory disease.

"Sanitation is the invisible sector," says Lucky Lowe, WaterAid's representative in Madagascar. She confirms that it is far easier to get politicians to talk about water and to promise pumps and new mains supplies than it is to get a constructive debate going about pit latrines. Clean water is a good election promise. Talking about building latrines that help make that possible isn't.

On top of the hard statistics must be added less tangible human costs: the drudgery of walking miles each day to collect contaminated water for the family, or the sheer unpleasantness and indignity of using a foul-smelling, poorly draining communal latrine day in and day out. Or, for those who have nowhere else, a patch of land that has become accepted as the local open-air toilet. We should not suppose that force of habit appreciably lessens the disgust.

Disgust was certainly written on the face of eight-year-old Sidonie when we talked to her mother before the puppet show about the field "toilet" in her village. We had gone there with Claudia Lemalade, FSG's hygiene educator for Amparatanana, to talk to a family due to receive one of the project's new latrines. We stood on a pathway that led down to a small river with the typical wooden huts on one side and lush vegetation - banana plants, coconut palms and vivid, flowering shrubs - on the other.

The path, even before the rainy season, was wet in patches and drained into the small river below, as, inevitably, would the open-air defecation site a few yards from the path.

Claudia chatted with three generations of one family: Toto Suzanne, her daughter Marceline and Sidonie, Marceline's daughter. Finally the family was to get a latrine - paying around 10 per cent of the cost price (approximately £30). They had been able to pay their £3 contribution as and when they liked, in whatever instalments suited them, but the contribution had to be paid upfront before work could begin on the structure. The family had been targeted because of financial need; FSG has set families' contributions low enough to put latrines within reach of most of the poorest.

It is not hard to understand why Marceline wanted to divert her family's limited budget to pay for a latrine. "Down there is where we have to go. After dark it is really horrible for the children." Sidonie refused to discuss the matter though she had been lively enough before. As we talked, a young woman came up the hill from the river carrying a bucket. "This is to wash my baby's feet," she told us, as if to assure us that the murky water would not be used for drinking or cooking. For household use, she explained, she had limited access to a neighbour's well (itself also contaminated, according to Claudia). She understood clearly the WASH message that the puppets would later be blasting out across the village, but what, she asked us, could she do?

There is a standard image of hopeless poverty that we see on television and in poster campaigns, images usually connected with appeals for emergency aid. Yet life in these villages is far from miserable or hopeless. Men and women are visibly industrious - most have family members in work as fishermen or farmers; good-quality food is available and at this time of year the trees are laden with coconuts, lychees and jackfruit. The literacy rate of 71 per cent is reasonably high and, despite a high poverty rate of 70 per cent, when news spreads of a visit from the WaterAid people, the women come out to meet us in well-kept best clothes.

Quite small investments in sanitation could turn around that high poverty rate. But at the moment, for the vast majority of Madagascar's people, energy that could be put into education and wealth creation is being dissipated by avoidable ill-health. The Madagascan economy loses to illness around 300 times the amount the government has allocated to sanitation in its national budget, according to WaterAid.

WaterAid estimates that if Madagascar is to achieve its Millennium Development Goals (MDGs), the country has to increase the number of rural households being newly supplied with adequate sanitation, from roughly 485 households per month now to more than 12,000.

More and carefully focused international aid is, as always, one solution. Determined local politicians unafraid to champion an unpopular cause is another. Mme Clode said she intends to run as a local councillor next year and wants politicians to speak up for the Cinderella sector of sanitation.

Of Madagascar's local MDG targets, she said: "I expected things to move faster. Many things need doing. For example, there is no water in the market in Fenerive Est [the nearby town]. And we need more latrines." Against current orthodoxy, Mme Clode believes in communal latrines as a way of speeding things up, while government and international policy very much favours and directs finance towards family-based facilities, on the grounds that only families will keep them clean enough to prevent water-borne disease.

But her concern about the slippage in local millennium targets exactly mirrors WaterAid's concern about the big picture. The millennium goals included halving the proportion of those living without water and sanitation by 2015. Of all the targets (including poverty, education, health and environmental concerns), sanitation is most off-track. At the present rate of progress, the goal would be reached 61 years late. Yet hopes of eradicating extreme poverty and hunger depend more on sorting out safe sanitation than on any other intervention.

A report commissioned by WaterAid and released in October spelled out that, for every dollar spent on sanitation, the return on investment is roughly $9. Worldwide, the need is enormous, but tiny interventions and local ingenuity can still have a big impact. In Madagascar, a puppet show costing just £31 can make 200 children laugh. And possibly save their lives.

Sanitation by numbers

£15 Cost per head of hygiene education and good sanitation
£31 Cost of puppet show promoting hand-washing
£31.25 Cost of effective latrine with simple concrete pit lining
$23.4m Most expensive toilet in the world (for space shuttle)
$10bn Annual cost of achieving Millennium Goals
$20bn Global annual spending on bottled mineral water
1.1bn People worldwide without access to clean water
2.6bn People worldwide without an adequate toilet

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This article first appeared in the 03 December 2007 issue of the New Statesman, Russia’s fragile future

Photo: STEFAN BONESS/PANOS
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What Britain needs to understand about the profound and ancient divisions in Germany

As Angela Merkel campaigns for re-election, the balance of power in Europe is changing.

On 24 September, Angela Merkel will be re-elected chancellor of Germany and that, we might think, will be that. With Merkel and France’s Emmanuel Macron in control of the European project, populism will surely be vanquished and the old Franco-German core of the EU restored. Yet things are changing, and if western Europe wants Germany to keep singing “Ode to Joy” as enthusiastically as “Deutschlandlied”, it will have some work to do. Our Brexit negotiators need to see how important this is to Macron, to other European leaders and, above all, to thinking Germans.

For we may all soon miss the old, self-effacing Germany. Despite having such economic power, it always seemed to have no greater wish than to exist as part of a larger whole. Konrad Adenauer, its first postwar chancellor and founding father, made Westbindung (“binding to the West”) the heart of West German politics. Adenauer came from the deeply Catholic Rhineland, “amid the vineyards” as he put it, “where Germany’s windows are open to the West”. His instinctive cultural sympathy was with France, but he knew that West Germany’s existence depended on keeping America in Europe. France he courted out of profound conviction, the US out of clear-eyed necessity, and he was worried that after him this twin course might be abandoned. His demands for reassurance during his final year in office led to John F Kennedy’s “Ich bin ein Berliner” speech of 1963. Every West German knew about that, and about the Berlin Airlift: these became locations of national memory from which West Germany triangulated its sense of self.

There were some Germans for whom this was too much. Anti-Americanism was ingrained among West Germany’s hard left, the early Green Party and the tiny hard right. But even Germans who were suspicious of America had no fear of tying themselves closer to Europe. On the contrary, that was exactly what they wanted. The standard explanation of this is guilt. West Germans, in this argument, felt so remorseful about the horrors of the Second World War that they wanted to make amends. This idea fitted with others’ belief that Germany did indeed have much to feel guilty about.

A nuanced version of this held that the western Germans thought they had somehow “got away with it”, compared with their brethren in the east, who had felt the weight of Soviet vengeance: rape, pillage, occupation. Accordingly, Germany’s willingness to subsume itself so thoroughly, even as it footed the bills for the European Economic Community and later the European Union, was accepted with little gratitude, almost as an ongoing war debt repayment.

This guilt thesis is based on a misunderstanding of German history, especially of the experience of western Germans. The most graphic illustration of this comes from Adenauer. In 1955, he privately informed the British that while he was obliged to act in public as though he wished for reunification, he intended to devote his remaining years to blocking it. In 1961, he secretly proposed to the Americans that they offer the Russians a swap: they and he should, he said, give up West Berlin in return for Thuringia (the region containing Leipzig and Weimar). He wanted, in effect, to make the River Elbe the eastern border of Germany.

Why did Adenauer dislike the eastern Germans, think Berlin was expendable and consider the River Elbe to be the natural frontier? Simple: he knew that the Elbe was Germany’s Mason-Dixon line. Beyond it lay the flat, grim Prussian heartlands, which until 1945 stretched into present-day Russia. This vast region was known to Germans as “Ostelbien” – East Elbia. Adenauer viewed the “unification” of Germany in 1871 as East Elbia’s annexation of the west. That’s why in 1919, as mayor of Cologne, and again in 1923, he tried to get Britain and France to back a breakaway western German state. Having failed, he is said to have muttered, “Here we go, Asia again,” and closed the blinds every time his train crossed east over the Elbe.

Prussia was a different country. The victorious Allies agreed. On 25 February 1947, they declared: “The Prussian state, which from early days has been a bearer of militarism and reaction in Germany… together with its central government and all its agencies are abolished.” The name Prussia was eradicated. The Prussian hegemony of 1871-1945, an anomaly in the two millennia of German history, was over.

If we understand this, we understand what West Germany really was and why it acted as it did; why the “reunification” of 1990 – or, at least, the way it was handled – was such a mistake; why we may all have to stop taking Germany quite so much for granted now that East Elbia is back; and why our Brexit negotiators are on a hiding to nothing if they believe that the Germans have no more urgent business to consider than their car exports to us. Far more important to liberal Germans is keeping safe the western soul of Germany.

***

West Germany was anything but an artificial construct. It was the historical Germany, being almost geographically identical to what was, for almost 1,200 years, the only Germany. Julius Caesar named the land, together with its people, in 58 BC; 49 years later, Drusus, the greatest commander of the infant Roman empire, is said to have been supernaturally advised that after defeating every tribe he met in Germania, he should halt at the River Elbe. By 100 AD, Roman rule was shown by a fortified border, the Limes Germanicus. You can still walk large stretches of it; it encompasses most of the richest land in modern Germany and all of the great cities except Hamburg, Berlin and the 19th-century industrial monocultures of the Ruhr. Even these last were born as trading posts or forward bases within what archaeologists call the “market region” of Germania – the lands beyond the limes where commerce with the Roman empire defined the whole culture. Southern and western Germany’s cultural roots are almost as Roman as France’s.

But what about 9 AD and the destruction of three Roman legions by the German tribes under Arminius? There is a popular myth that this kept all Germany free and different. We owe this idea to Martin Luther and his supporters: Luther claimed from 1520 onwards to be a German, anti-Roman hero and identified himself with the newly rediscovered tale of Arminius. More decisively, the events of 9 AD were an obsession of later Prussian historians, who had an interest in claiming that the real Germany was one that was pure and un-Romanised. Yet the reverse is true. Under the Romans, then the Merovingians, then the Franks, the Rhine/Danube super-region of Germany remained politically and culturally a part of western Europe. After Charlemagne, a Rhineland German, “restored the Roman empire” (as his seals put it) in 800 AD, western Germany was the very centre of things. It was never a nation state, but always the key part of a greater whole, the Holy Roman empire.

Along the Elbe, things were different. Charlemagne extracted tribute from the pagan Slavs across the river, and his successors tried to build on this, but the German conquest and settlement of East Elbia only really began with the Wendish Crusade of 1147, the northern arm of the Second Crusade. Three centuries later, the entire region was still hotly disputed by Balts and Slavs, with German supremacy threatened by major defeats at Tannenberg (1410) and in the Hussite Wars (1419-34).

Long-contested frontier lands breed a special kind of society. The German incomers cowed the natives, such as the pagan Pruscie from whom they ultimately borrowed their name, through brute force. Where they couldn’t, they had to make armed deals with local elites. In this new sort-of-Germany, the Junkers, an aggressive landowning caste, lorded it over the Slavs and Balts – as well as poorer Germans, who knew that the locals would cut their throats if the Junker castles fell, so were loyal and subservient to their masters. East Prussia remained like this within living memory.

In 1525, Prussia named itself and declared itself the first Protestant state. From then on, it had absolute rulers, the Hohenzollern dynasty, backed by a quiescent Lutheran state church. The Junkers swore loyalty in return for exclusive access to all officer-level jobs in the army and the administration. By the mid-18th century, Voltaire quipped that while other states had armies, the Prussian army had a state. The overriding strategic concern of Prussia was always with the east. In his 1758-59 campaigns, Frederick the Great was shocked to find the Russians extremely hard to beat. He bequeathed to his successors a policy of keeping the tsars onside. Partitioning Poland between them was the sticking plaster that masked this Russian-Prussian rivalry, right until 1941.

This thoroughly east-facing power was, by the normal standards of European statehood – history, social structures, religion, geography – a different country from the Rhineland, Swabia or Bavaria. It defeated them all in 1866, laying the ground for the “unification” of 1871. The Prussian empire (for that is what it was) could now enlist the wealth, industry and manpower of Germany in pursuit of its ancient goal: hegemony over north-eastern Europe. By 1887, the future imperial chancellor Bernhard von Bülow was already musing on how to destroy Russia “for a generation”, cleanse Prussia of its Poles, set up a puppet Ukrainian state and take the Prussian armies to the banks of the Volga. This is the bloody Prussian – not German – thread that leads directly to the Nazi onslaught of 1941. In 1945, that centuries-long struggle was settled, in almost inconceivable violence. Half of East Elbia was ruthlessly stripped of Germans and handed over to Poles or Russians; the rump became the German Democratic Republic (GDR), a mere satrap of the Red Army.

So while it is easy and comfortable to say that the otherness of eastern Germany today is the result of that 40-year Soviet occupation, history says otherwise. East Elbia has always been different. Take the voting patterns: from 1871 to 1933, East Elbia outside Berlin (always a left-liberal political island) was the main electoral reservoir for the authoritarian right. The Prussian Conservative Party under the empire, the Deutschnationale Volkspartei until 1928 and the Nazis from 1930 depended on rural and small-town East Elbian voters. It was they who (just) swung things in 1933, by going 50-60 per cent for the “Hitler coalition”. Had all Germany voted like the Rhineland or Bavaria, Hitler and his Junker allies would have got nowhere close to a majority. Small wonder that Adenauer didn’t want East Elbia back and was secretly delighted to have it safely fenced off behind the Iron Curtain.

***

West Germany (1949-90) – Germany shorn of Prussia – was, then, no historical fluke, and nor was the supra­national way it acted. This was the real Germany. But the hasty reunification of 1990 (there was no referendum or election on the issue) changed things. Why should the inhabitants of the former GDR, rather than Poles and Czechs, get immediate access to the wealth and benefits of the West? Because they were Germans. With that, the chancellor Helmut Kohl embraced the notion that being German overrode all considerations of social, economic or historical difference. He also subliminally revived the idea, common to the Second Empire and the Third Reich, that East Elbia was special and needed subsidising by the rich west of Germany. The director of the Bundesbank, Germany’s central bank, resigned in 1991 over this abandoning of economic sanity for political nationalism.

Since 1990, the former East Germany has received more than €2trn from the old West Germany, for a fast-ageing, shrinking and disproportionately male population of only 16 million, including Berlin. That’s the equivalent of a Greek bailout every year since 1990, and as a straight gift, not a loan. This represents a huge shift in financial priorities, overshadowing Germany’s annual net EU budget contribution (currently €15.5bn). In 1990, Kohl promised that western German aid would soon turn the new states into “blooming” areas, but they have become, instead, proof that age-old differences resist even the most gigantic subsidies.

Between 30 and 40 per cent of voters in East Elbia have declared over the past two years that at the general election, they intend to support either Alternative für Deutschland (Germany’s Ukip), Die Linke (heirs to the old East German Communist Party) or the all but openly neo-Nazi National Democratic Party (the NPD, currently represented in the Mecklenburg-Vorpommern state parliament). Though theoretical enemies, these three parties are united by cultural affinities: all despise economic liberalism, oppose Nato and the EU and want closer relations with Russia.

East Elbia no longer has the population to swing the entire German electorate of more than 61 million but many liberal western Germans are nervous. They recoil at the sight of anti-asylum-seeker attacks, which are proportionally far more common in East Elbia than in the west, or when they see Merkel heckled by right-wingers. They call East Elbia Dunkeldeutschland (“Dark Germany”) and joke bitterly that if Britain can have a Brexit, why can’t the old East Germans, whom they lump together under the name of Saxons, have a “Säxit”? But it’s no laughing matter. They know there are those only too aware of any anti-western drift in Germany and eager to give succour to it.

Alexander Saldostanov, the rabid leader of Russia’s “Night Wolves” bikers and a public friend of Vladimir Putin, recently told Germany’s bestselling daily, Bild, that he dreams of a grand union between Germany and Russia: “We have so much in common. You simply have to free yourself at last from America, that scourge of humanity. Together, we can, should and must take power.”

There’s no danger of that, but there is a sense in which eastern Europe is, to Germans, no longer “the other”. It’s the place whence natural gas flows from Russia, where labour is cheap but skilled and where the people are keen to work with Germany on setting up new sites of joint national memory. From Kaliningrad to Prague, museums and projects are springing up in which the horrors of the past are neither denied nor used as ammunition in today’s negotiations. In eastern Europe, perhaps because Russia is so close, the Germans are rarely made to feel guilty for their grandfathers’ sins. Meanwhile in the west, from Greece to Britain, people can’t resist mentioning the war whenever the Germans don’t act as desired.

***

Germany’s resources are not infinite. Nor is the patience of the 40 per cent of Germans who “have net worths of essentially zero”, as Die Welt reported last year – largely because German home ownership rates are the lowest in the EU. They are disproportionately concentrated in the old east, the region that never had supranational, western European connections. From them come ever-louder voices saying that Germany’s EU contribution is too high. And with Britain out, the maths will look even worse to such voters. If south-western Germany’s taxes have to keep bailing out the country’s east, while also helping out the old and new EU lands, what is left for, say, the post-industrial Ruhr, which has financial and social problems of its own? There are tough choices ahead, and it’s not hard to imagine a day when Germany decides to aim its subsidies and investments where they seem most welcome. The old idea of Mitteleuropa – a multi-ethnic, German-centred Middle Europe, neither of the West nor of the East – no longer seems so antiquarian. Nothing would gladden Putin’s heart more.

So, yes, Merkel will win the election and will have a chance to revive the EU’s Franco-­German core. Yet the relative strengths of France and Germany are different now. As for their leaders, while Adenauer was a devoted Catholic Rhinelander, Merkel is a Lutheran vicar’s daughter from the east. Bonn was physically close to Paris, Brussels, The Hague, even London; Berlin is closer to Prague and Warsaw.

With Donald Trump’s wavering on Nato and his noisy anti-German protectionism, along with Brexit, the West may no longer seem vital to Germany’s future. During Merkel’s election debate with her main challenger, Martin Schulz, on 3 September, Brexit was not even mentioned. The old EU core will have to work to keep Germany anchored, resisting any new call from the east. Macron and German liberals know that; that’s why there will be no Franco-German split over Brexit just to sell us a few more Audis. The sooner David Davis and Liam Fox realise that the Germans have far bigger issues to deal with, the better.

James Hawes is the author of “The Shortest History of Germany” (Old Street Publishing)

This article first appeared in the 03 December 2007 issue of the New Statesman, Russia’s fragile future