In low and middle-income countries (LMIC) like Pakistan, development of healthcare infrastructure is not the sole requirement for creating a healthy environment.  Most of the neonatal deaths and mortality rate for children under-5 are because of diarrheal disease. Cholera and diarrhea claimed innumerable lives and poor hygiene continue to cause these fatal diseases among children in villages. The role that a hospital can play for prevention of such diseases is too little to mention, because problem is not with the cure but the challenge is to hamper its spread by establishing disease barriers. In pursuit of the same, what Pakistan needed to invest in is “Behaviour Change”, which was earlier neglected. Similarly, when governments plan and execute mega initiatives for provision of safe drinking water or improved sanitation system, it’s not the filtration plant that saves the community from waterborne diseases but it’s the pull-strategy created by Behaviour Change that convinces the community to come out of their homes and get filtered water. Children would continue to get infected if they are not told how important is to wash hands with soap. The problem doesn’t lie with the availability of resources only but it’s more about sensitizing the marginalized communities to use safe water or to use better sanitation mechanism. This untapped area of focus has finally been addressed with the Clean & Green Program of Chief Minister Sardar Usman Buzdar.

CM Buzdar has launched an initiative under Clean & Green Punjab program, which emphasizes on provision of potable water, waste water management, solid waste management, sanitation & hygiene, tree plantation and beautification of cities along with community participation. Apart from sensitizing the administrative wings, deputy commissioners, the program is aimed at a healthy competition of 319 local governments which shall work for creating a healthy environment within their respective jurisdictions across Punjab. Under Clean & Green Pakistan Program, 12 cities of Punjab and 7 from Khyber Pakhtunkhwa are participating in the competition. The Chief Minister Punjab not only tasked the Deputy Commissioners to pioneer the concept of this service delivery system, but also motivated them to be the role models for people’s representatives who are going to be elected after upcoming local bodies election with the enforcement of Punjab Local Government Act 2019. With this legislation, PTI led Punjab government has not only strengthened local governments but the system is more answerable and productive than the previous system in which power delegation was not adequate to run local bodies effectively.

The true essence of this Clean & Green Punjab program lies in sharing the burden and owning community development as a collective task. Chief Minister set an example by registering himself on Clean and Green online portal for Clean Green Champion program. He emphasized on the role of community participation in ensuring provision of improved and adequate water supply and sanitation management. Now, Clean & Green Pakistan program has over 10,000 registered champions. This has laid the foundation stone of community engagement and behavior change which was earlier handled solely by Public Health & Engineering Dept. On the directions of Chief Minister Punjab, Housing, Urban Development & Public Health Engineering Dept has successfully operationalised and revamped divisional water quality labs in addition to providing mobile water laboratories. This mechanism is as scientific and innovative as it needed to be, for instance water contamination varies from village to village, it’s not only a water filtration plant that is required for disinfecting the contaminated water always. Some contaminations need treatment for brackish water and other’s simply need certain amount of heat, which you can even try at home by filling glass bottles with water and exposing them to sun. Therefore, the operationalization of these water laboratories is going to play a key role in identification and rectification of safe water problems. The department in collaboration with WASH program by UNICEF is working in marginalized communities and villages to develop open defecation free zones. With effective communication strategy, the department is sensitizing rural population about use of toilet, handwashing with soap, proper disposal of garbage including liquid and solid wastes.

The political will behind the entire system matters the most, the way Usman Buzdar has expanded its role from one department to two departments, alongwith international collaborations, Punjab would eliminate waterborne and other diseases caused by poor hygiene. With the help of Chief Minister’s idea behind engaging youth and locals of these villages and cities, the government of Punjab can make substantial progress towards cleaner and greener Punjab. Other provinces must follow in the footsteps of CM Buzdar, because this collaborative effort can yield results that previous government failed to achieve. Punjab has taken the lead, let’s see how other provinces take lessons!