Sustainability and Poverty Alleviation : Confronting Environmental Threats in Sindh, Pakistan.

Front Cover -- Contents -- Foreword -- Acknowledgments -- About the Authors -- Abbreviations -- Chapter 1 Introduction: Responding to Sindh Province's Environmental and Climate Change Priorities -- Abstract -- Method -- Contents of This Book -- Chapter 2 Sindh Province's Priority Environmental Problems -- Abstract -- Introduction -- Ranking of Environmental Problems in Sindh Province -- Inadequate Water Supply, Sanitation, and Hygiene -- Outdoor Air Pollution in Urban Areas -- Lead Exposure -- Road Traffic Accidents -- Road Traffic Noise in Urban Areas -- Household Air Pollution -- Conclusions -- Notes -- Bibliography -- Chapter 3 Benefits and Costs of Environmental Health Interventions -- Abstract -- Introduction -- Improving Drinking Water Supply, Sanitation, and Hygiene -- Improving Outdoor Air Quality -- Controlling Household Air Pollution -- Conclusions -- Notes -- Bibliography -- Chapter 4 Natural Resource Degradation in Sindh Province -- Abstract -- Introduction -- Main Natural Resource Degradation and Natural Disaster Challenges in Sindh Province -- Loss of Productive Land Resulting from Seawater Intrusion -- Agricultural Losses Resulting from Salinity and Waterlogging -- Loss of Mangroves -- Loss of Fisheries -- Losses from Natural Disasters (Floods) -- Benefits and Costs of Interventions to Reduce Losses of Natural Resources in Sindh Province -- Sea-Level Rise in the Indus Watershed -- Prediction of Floods and Droughts in Pakistan -- Conclusions -- Notes -- Bibliography -- Chapter 5 Institutional Analysis of Sindh Province's Environmental Sector -- Abstract -- Introduction -- Institutional Framework for Environmental Regulation -- Analysis of Environmental Management Framework -- Conclusions and Recommendations -- Notes -- Bibliography -- Chapter 6 Policy Options to Strengthen Sindh Province's Environmental Management Framework.

Abstract -- Introduction -- Pakistan's Environmental Policy Framework -- Sindh Province: Environmental Policy Issues and Opportunities -- Conclusions -- Notes -- Bibliography -- Chapter 7 Conclusions and Outlook -- Abstract -- Introduction -- Sindh Province's Priority Environmental Problems -- Alternative Interventions to Address Priority Environmental Problems -- Policy Options for Strengthening Environmental Sustainability in Sindh Province -- Outlook -- Note -- Bibliography -- Chapter 8 Environmental Health Priorities for Sindh Province -- Abstract -- Health Valuation Methods -- Household Water Supply, Sanitation, and Hygiene -- Household Water Supply -- Household Treatment of Drinking Water -- Household Sanitation -- Hand Washing with Soap -- Outdoor Air Pollution -- Household Air Pollution -- Notes -- Bibliography -- Appendix A Baseline Health and Child Nutritional Status -- Appendix B Health Effects of Outdoor Particulate Matter Air Pollution -- Appendix C Health Effects of Road Traffic Noise -- Appendix D Mortality from Inadequate Water, Sanitation, and Hygiene -- Appendix E Health Effects of Household Use of Solid Fuels -- Appendix F Cardiovascular Mortality from Household Air Pollution -- Appendix G Valuation of Mortality -- Appendix H Adjusting Mortality Estimates for Multiple Risk Factors -- Appendix I Particulate Matter Emissions in Karachi -- Appendix J Particulate Matter Emission Factors -- Appendix K Benefits of Controlling Particulate Matter Emissions in Karachi -- Appendix L Natural Resource Management Priorities for Sindh Province -- Figures -- Figure 2.1 Annual Cost of Environmental Degradation in Sindh Province, Midpoint Estimate, 2009 -- Figure 2.2 Estimated Annual Deaths from Environmental Risk Factors, Sindh Province, 2009 -- Figure 2.3 DALYs Lost Because of Environmental Risk Factors, Sindh Province, 2009.

Figure 2.4 Estimated Annual Midpoint Cost of Environmental Health Effects, 2009 -- Figure 2.5 Estimate of Annual Average PM2.5 Ambient Air Concentrations in Karachi, 2006-09 -- Figure 2.6 Suspected Blood Lead Levels in Children Younger than Five Years Old in Sindh Province -- Figure 2.7 Estimated Blood Lead Level in Children 2-5 Years Old in Relation to Lead in Drinking Water in Sindh Province, 2007-08 -- Figure 2.8 Loss of IQ Points in Early Childhood in Relation to Lower Threshold Levels in Pakistan -- Figure 2.9 Age Distribution of Road Traffic Accident Fatalities and Injuries, Karachi, September 2006 to September 2008 -- Figure 2.10 Vehicle Distribution of Road Traffic Accident Fatalities and Injuries, Karachi, September 2006 to September 2008 -- Figure 2.11 Household Fuels Used for Cooking in Sindh Province, 2008-09 -- Figure 2.12 Cooking Fuel, by Household Living Standard in Sindh Province, 2006-07 -- Figure 3.1 Benefit-Cost Ratios of Water-Supply Interventions in Sindh Province -- Figure 3.2 Benefit-Cost Ratios of Sanitation Interventions in Sindh Province -- Figure 3.3 Benefit-Cost Ratios of Point-of-Use Treatment of Drinking Water and Improved Hand Washing with Soap to Protect Young Children's Health in Sindh Province -- Figure 3.4 Benefit-Cost Ratios of Low-Sulfur Fuels in Karachi -- Figure 3.5 Benefit-Cost Ratios of Retrofitting In-Use Diesel Vehicles with DOC in Karachi -- Figure 3.6 Benefit-Cost Ratios of CNG Conversion of Diesel Vehicles, Rickshaws, and Motorcycles in Karachi -- Figure 3.7 Benefit-Cost Ratios for Use of Improved Wood/Biomass Stoves among Rural Households in Sindh Province -- Figure 3.8 Benefit-Cost Ratios for Use of LPG Stoves among Rural Households in Sindh Province -- Figure 4.1 Midpoint Estimate of Annual Cost of Natural Resources Degradation in Sindh Province, 2010.

Figure 4.2 Composition of Estimated Annual Cost of Natural Resource Degradation in Sindh Province, 2010 -- Figure 4.3 Total Catch of Major Marine Fish Types in Sindh Province, 2003-07 -- Figure 4.4 Marine Fish Catch per Unit of Effort in Sindh Province, 1999-2007 -- Figure 4.5 Distribution of Benefit-Cost Ratio for Emergency Management Intervention in Sindh Province -- Figure 4.6 Probability Distribution Function of Benefits from Capacity Building in Management of Hydrological Resources in Sindh Province -- Figure 4.7 Benefit-Cost Ratio for the Agricultural Extension Intervention in Sindh Province -- Figure 4.8 Benefit-Cost Ratio for the Water Sector Rehabilitation Intervention in Sindh Province -- Figure 4.9 Distribution of the Benefit-Cost Ratio for the Reforestation Intervention in Sindh Province -- Figure 4.10 Benefit-Cost Ratio for the Sustainable Fishery Project in Sindh Province -- Figure 4.11 Benefit-Cost Ratio Probability Distribution for the Selected Interventions to Reduce the Cost of Natural Resource Degradation, Sindh Province -- Figure 4.12 Mean Benefit-Cost Ratios for the Selected Stylized Interventions -- Figure 4.13 Climatological Distribution of Rainfall Averaged in Pakistan -- Figure 4.14 Flood Type, by Month, in Pakistan, 1990-2010 -- Figure 4.15 Number of Floods, by Type and Administrative Province of Pakistan, 1990-2010 -- Figure 4.16 Forecasts of Rainfall Using the ECMWF System in Pakistan, July-August 2010 -- Figure 4.17 Forecast Lead-Time Diagram for Floods in Pakistan and Sindh Province -- Figure 4.18 Experimental Forecasts of Stream Flow into the Tarbela Dam in Northern Pakistan, 4-, 7-, and 10-Day Forecasts, 2010 -- Figure 5.1 Environmental Sector Annual Development Plan Allocation in Sindh Province, 2007-12 -- Figure 5.2 Annual Development Plan Allocations in Sindh Province, 2011-12.

Figure 7.1 Annual Cost of Environmental Degradation and Natural Disasters in Sindh Province, Midpoint Estimate, 2009 -- Figure 7.2 Benefit-Cost Ratios of Water-Supply Interventions in Sindh Province -- Figure 7.3 Benefit-Cost Ratios of Low-Sulfur Fuels in Karachi -- Figure 7.4 Benefit-Cost Ratios for Use of Improved Wood/Biomass Stoves among Rural Households in Sindh Province -- Figure 7.5 Benefit-Cost Ratio Probability Distribution for the Selected Interventions to Reduce the Cost of Natural Resource Degradation in Sindh Province -- Figure 7.6 Mean Benefit-Cost Ratios for Selected Stylized Interventions to Reduce Natural Resource Degradation in Sindh Province -- Figure 8.1 Benefit-Cost Ratios of 500-ppm and 50-ppm Sulfur Diesel in Karachi -- Figure 8.2 European Union Diesel Vehicle Emission Standards for PM -- Figure 8.3 European Union Heavy-Duty Diesel Engines Emission Standards for PM -- Figure 8.4 Benefit-Cost Ratios of Retrofitting In-Use Diesel Vehicles with DOC in Sindh Province -- Figure 8.5 Benefit-Cost Ratios of Converting In-Use Diesel-Fueled Minibuses and Vans to CNG -- Figure A.1 Estimates of Cause-Specific Mortality among Children under Five Years of Age in Pakistan, 2008 -- Figure I.1 Fossil Fuel Primary Energy Consumption in Sindh Province, 2008-09 -- Figure I.2 Registered Motor Vehicles in Sindh Province ('000), 2001-10 -- Figure I.3 Transport Sector Fuel Mix in South and East Asia (% of Total Transport Fuel), 2009 -- Figure L.1 Subsidy for Operation and Maintenance of Irrigation Systems in Sindh Province, 1993-2003 -- Figure L.2 Wheat and Rice Yield and Total Irrigated Area in Sindh Province, 1987-2008 -- Figure L.3 Distribution of Annual Precipitation of Three Cities in Sindh Province, 1961-2004 -- Figure L.4 Overlapping Cumulative Probability Function of Droughts for Three Selected Cities in Sindh Province.

Figure L.5 Economic Damage per Flood Event in Sindh Province, 1976-2011.

In 2009, more than 40,000 people died prematurely in Sindh, Pakistan because of an illness associated with an environmental health risk. This means that almost one of every five deaths that occurred that year was caused by environmental factors. Loss of natural resources and impacts from natural disasters also represent development challenges. Increased salinity and waterlogging result in loss of agricultural crops. In addition, hydro-meteorological hazards recurrently affect Sindh, as illustrated by the devastating effects of the 2010 and 2011 floods. For Sindh's population, these problems mean pain and suffering, and reduced opportunities for economic advancement. The costs of all these phenomena are equivalent to 10% of Sindh's Gross Domestic Product. Climate change may exacerbate these challenges. Sindh's environmental and climate change problems call for urgent responses. A number of feasible interventions could be carried out to address the categories of environmental degradation that have the highest impacts on Sindh's population. Many of those interventions have positive benefit-cost ratios, meaning that every rupee invested in them would result in health and social benefits worth more than one rupee. Addressing these challenges also calls for targeted institutional strengthening and policy improvements, particularly after the 18th Constitutional Amendment devolved environmental management responsibilities to provincial governments. The underlying goal of this book is to facilitate and stimulate sharing of information on these phenomena, and to provide an interdisciplinary framework for bringing about improved environmental conditions in Sindh. It includes a methodology that enables the identification of environmental and climate change priority problems; the analysis of interventions to address such problems; the establishment of a

social learning mechanism to continuously improve Sindh's responses and build resilience in the face of climate variability and change; and opportunities for the potential involvement of different stakeholder groups to decisively tackle climate change and deteriorating environmental conditions.

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