September 17, 2014

These are the World’s Three Biggest Killers. ~ Christopher Koury

developing nation, drinking water, polluted waterway

Water, Sanitation and Hygiene.

Where do you go to the bathroom? Where does your drinking water come from? Can you easily wash your hands with soap and water after you use the restroom?

The United Nations Development Program (UNDP) defines improved sanitation and drinking water as a “separation between human feces with human contact,” and a “drinking water source protected from outside contamination, in particular from contamination with fecal matter.”

At the end of 2013, 2.5 billion humans lacked access to an “improved sanitation facility,” and 750 million lacked access to an “improved drinking water source”.

Why is access to sanitation facilities and clean drinking water important? Diarrhea and pneumonia, the two leading causes of child death in the world today, are often caused by unimproved access to sanitation and clean drinking water. When children survive diarrheal disease, they are at higher risk of stunted growth, developmental delay, and malnutrition.

Even when sanitation and drinking water are improved, without proper handwashing with soap, very few improvements in public health are seen. This is due to fecal matter’s transmission to food and water via food handling after personal restroom use and changing of baby’s diapers.

Dr. Val Curtis and Dr. Sandy Cairncross, of the Department of Infectious and Tropical Diseases at the London School of Hygiene and Tropical Medicine, conducted intervention trials in 12 countries on the effects of washing hands with soap in communities ridden with diarrhea. Their studies found handwashing could reduce diarrhea risk by 47%. To ensure unbiased data collection, the subjects ranged from children in urban American daycares, to adults in rural Malaysian farming communities.

Historically, the global development’s focus on improving sanitation, hygiene and drinking water services has been aimed at rural areas. However, now that the global urban populations have surpassed those of rural populations (54% of the global population living in urban areas, up from 34% in 1960) aid agencies have started to focusing on low-income urban areas.

It is to no surprise that these low-income urban areas lack access to improved sanitation and hygiene services to a greater extent than regions who’s net-income places them higher on the proverbial totem pole.

Access to clean drinking water and improved sanitation directly seeds from help at the municipal and state level. Similar to poverty-stricken areas within the United States that have a weakened voice in public affairs; where there are more potholes in streets, dirtier public restrooms, and less advanced public schools: political power can result in health, prosperity and over-all improved well-being.

These low-income urban areas around the globe have less financial assistance for even the simplest of public service, fecal sludge management (FSM) (not to mention schools and roads).

For example, the wastewater treatment plant in the town of Nakura, Kenya is managed by the municipal water and sanitation utility. The community holds the facility in high regard, however due to “funding constraints” the plant has been out of service since the beginning of 2014. The staff’s only job is to direct FSM trucks where to dump their sludge. While the plant is out of service, the sludge goes through their system untreated, resulting in polluted downstream surface water sources.

Not only does this happen in Nakura, Kenya’s peri-urban areas, but all over the world—no matter the location: Brazil’s favelas, India’s slums, or Venezuela’s caseríos.

Do not give up on humanity just yet, there is hope.

For the past 14 years the thousands of aid agencies attempting to tackle these problems have been guided by the Millennium Development Goals (MDGs).

At the Millennium summit of the United Nations in 2000, 189 UN member states and 23 international organizations established eight international development goals following the adoption of the United Nations Millennium Declaration.

Here they are in the goals’ basic descriptions:

1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria, and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development

The question remains: how do these goals impact an improvement in water, sanitation and hygiene?

Target 1a of goal 1 reads “Halve, between 1990 and 2015, the proportion of people living on less than $1.25 a day,” and although the money seems insignificant to those of us who buy $5 coffees, the goal was reached five years early in 2010, and these people now have the extra money to pay for a public bathroom or buy soap for their own homes.

As aid agencies strive to achieve goal 2, they are educating children about the importance of handwashing, the presence of pathogens in their excreta, and the need to drink clean water from designated sources in their communities.

While the MDGs received criticism about not including developing and undeveloped country’s opinions, the new development goals currently being established for a 2015 release are including the input from the developing and undeveloped nations. This should help create universal credibility among countries receiving assistance.

People in developed nations live in a place where drinking fountains that produce clear and pathogen-free drinking water are plentiful and clean sanitation facilities with soap and running water are never more than five minutes away.

We must keep in mind that 2.5 billion people in the world do not have access to improved sanitation and hygiene facilities or improved drinking water sources. The UN and international development agencies are heading the assistance efforts that will hopefully eradicate these problems within the next 20 years.

Unicef. (2014, March 10). Water, Sanitation and Hygene (WASH). Retrieved from http://www.unicef.org/media/media_45481.html

Curtis, V., & Cairncross, S. (2003, May). Effect of washing hands with soap on diarrhea
risk in the community: a systematic review. The Lancet: Infectious Diseases, Vol. 3, 275-281. Retrieved from http://www.hygienecentral.org.uk/pdf/CurtisHandwashing.pdf

World Health Organization. (2014). Global Health Observatory: Urban Population Growth. Retrieved from: http://www.who.int/gho/urban_health/situation_trends/urban_population_growth_text/en/

United Nations. (2014). Millenium Development Goals and Beyond 2015. Retrieved from: http://www.un.org/millenniumgoals/bkgd.shtml




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