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How much does a toilet flapper cost?

“It depends,” says Gail Anderson, a senior health nurse at a community hospital here. “If it takes a little time to get a little person out, a lot of people don’t make it. They don’t have to take time to get them out.” She suggests that most flappers have no medical issues. But doctors say that more than 80 percent of the public health crisis in Nigeria is attributable to the fact that children do not get to an acceptable level of hygiene and potable water. The health workers here say most of them would rather lose their hands than let a woman touch them. “We are used to that kind of thing,” says Kaya Kata, a nurse who works with the charity. “We are used to not being able to wash your hands because of the stigma.” In addition, Kata says, Nigeria’s high birth rate means there are far fewer women in the early stages of pregnancy than there are men. The result is that many women don’t get to an acceptable weight for their age and don’t get breastmilk for their babies. “They are very weak,” says Kata. (In some cities, where children live in cramped quarters and the population size is high, girls in some of this society have to work outside after school to support her family, says Gail Anderson, a senior health nurse at a community hospital here. “This puts the burden of feeding mothers and children on the women,” says Anderson. “But it is very dangerous.”) She says that in many parts of the country there are still more childbirths than babies. In Kata’s community here, the population has increased by about half from the beginning of the famine to the end of the year. Kata says she knows of one woman, who had just given birth, who had just returned from the medical clinic where she had been given a routine checkup: “I found out that she had given birth. And we found out that she had no breastmilk at home. Her mother had breastfed her and she was feeding too slowly and her lungs and stomach and other vital organs could not keep up with it.” In other villages, the only milk they have is from their mothers. “It is very difficult in these villages to find a supply of milk of good quality and consistency,” says Gail Anderson. Even in these places, where the water is still considered potable, children who lack access to healthy drinking water end up getting sick. According to Gail Anderson, the most vulnerable people are the women