Water Advocates
Two new reports out this week by WaterAid and PATH remind us what we have shamefully forgotten: diarrhea is the second biggest killer of children worldwide. This is a wake-up call because even those of us in the international development field have pretty much neglected the fact that diarrhea is still fatal in many parts of the world. It kills 1.6 million children each year.
The WaterAid report “Fatal Neglect” reveals that diarrhea prevention and treatment programs are woefully under-funded when compared to programs for HIV/AIDS and malaria. For example, HIV/AIDS receives over $10 billion a year in global health financing, while diarrhea receives well under $2 billion. These funding levels grossly misrepresent the disease burden as both these diseases are responsible for roughly the same death toll. However, the WaterAid report also makes very clear that adequately addressing diarrheal diseases should not come at the expense of funding needed for tackling other diseases.
The PATH report “Solutions to Defeat a Global Killer” highlights that during the 1980s and 1990s incredible progress was made through a variety of interventions in preventing and treating deaths from diarrheal dehydration but the momentum ceased when the issue fell off the radar in the 2000s.
The report states:
Extraordinary improvements were made in access to safe drinking water and sanitation. In total, development efforts during the International Drinking Water Supply and Sanitation Decade (1981 to 1990) and the following decade (1991 to 2000) provided water to more than 2 billion people and sanitation to more than 1.5 billion.
A 2008 research study conducted by PATH to evaluate the global health funding and policy landscape found that diarrheal disease ranked last among a list of other global health issues.
Fortunately, two recent initiatives in Congress give some hope that political attention is shifting back to diarrhea and other sicknesses that inadequate water and sanitation trigger.
New bipartisan legislation called “The Senator Paul Simon Water for the World Act of 2009″–if passed–would be one way to increase the financing to stop fatal diarrhea and to put progress back on track. The Act would commit the U.S. government to extending safe, affordable and sustainable supplies of water and sanitation to 100 million people by 2015.
This Act–building on earlier landmark legislation (The Senator Paul Simon Water for the Poor Act of 2005)–could ratchet up interventions such as building latrines, promoting handwashing with soap, constructing water wells and providing point of use water treatment, all of which reduce fatal diarrhea.
Another bipartisan Act, “The Newborn, Child and Mother Survival Act of 2009” would also have an impact on eradicating fatal diarrhea if it were signed into law. Appropriations for this Act would fund both prevention (water and sanitation programs) and treatment (oral reyhdration therapy and zinc tablets).
Together these two pieces of legislation are an incredible opportunity for the U.S. government to take a leadership role in addressing the imbalance in priority and funding that the WaterAid and PATH reports uncover. A “Call to Action” that PATH organized has been signed so far by 80 groups from the health, corporate, environmental and water and sanitation sectors. They represent the breadth of support that is needed to push these two pieces of legislation through Congress and get them signed into law by President Obama.
-John Sauer, Water Advocates
There is a photograph that travelers inevitably take when they go to a developing country—a picture of a woman carrying a large container of water on her head. The woman’s posture is ramrod straight, the envy of runway models everywhere, and her face rarely betrays the amount of effort and strength this task involves. Most times this photo is taken because it is a stunning and moving image of a woman’s strength and beauty.
Alluring as this image may be, what it truly portrays is the economic, physical and health burden that women and girls must endure everyday of their lives to provide water for their families – this is the forgotten glass ceiling.
Whether a woman lives in Africa, South America or Asia, one of her primary tasks is to gather water for her family. There is no convenience of indoor plumbing for these women. Compare the trek you make to your bathroom or kitchen for a glass of water to the journey women in the developing world must make—3 miles a day on average—to fetch dirty water from mainly contaminated sources, such as rivers, unprotected springs and shallow wells. All this fetching for water uses up 40 billion hours annually of women’s time worldwide. It could be more productively spent on income-generating activities, education and caring for their families.
The quality of the water women gather greatly impacts their and their families’ health. Water from unsafe sources is contaminated with pathogens that cause debilitating and deadly water-borne diseases (such as cholera, typhoid and amoebic dysentery). Diarrheal diseases such as these kill more children under 5 than AIDS, Malaria and TB combined. Only with safe and accessible water will women and their families have a chance to live and to lead productive lives.
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Check out this post from John Sauer at Water Advocates honoring the memory of water champion, Mickey Sampson.
—Margaret McDonnell, ONE
This past month, just before World Water Day, the water and sanitation community tragically lost Mickey Sampson, age 43, of RDI Cambodia. Mickey’s life is a portrait of success that should be recognized internationally. Through his leadership, RDI Cambodia became one of Southeast Asia’s most innovative water and sanitation organizations. It provides an array of interventions that have impacted the lives of hundreds of thousands of Cambodians.
Mickey’s philosophy was not to hand out help to Cambodians but rather to use education, incentives and social marketing to foster genuine demand for water and sanitation products. RDI Cambodia’s successes include a world-renowned ceramic water filter factory which in 2009 will provide an additional 30,000 families with safe drinking water. Mickey and his team also produced the nation’s most popular children’s television program which entertainingly teaches about water and health, including arsenic poisoning. RDI Cambodia also reaches adults with these messages through popular karaoke videos, as was highlighted by NPR and National Geographic News. Ecosan toilets, rainwater harvesting and rope pumps were other successful ways he met the country’s water needs.
Another impressive achievement was the establishment of a laboratory which tests water quality. It is the most active laboratory in Cambodia for arsenic testing. Over 10,500 wells have been tested. Mickey was constantly upgrading the laboratory and working tirelessly to get new equipment donated so that Cambodians would have safer water to drink.
Both the ceramic water filters and rope pump projects have been studied by third parties and the results show high levels of sustainability, an indication that RDI Cambodia’s approach is replicable.
Mickey, a native of Louisville, KY, was a good friend of Water Advocates and we were grateful to have known him. Thankfully, the work that Mickey started continues through the organization he founded, RDI Cambodia. He is an inspiration to many in the water and sanitation field.
Our hearts go out to Mickey’s wife, family and co-workers during this difficult time.
Learn more about RDI Cambodia’s work here:
Ceramic Water Filter Factory
Laboratory
-John Sauer, Water Advocates
This terrible irony just occurred to me at the World Water Forum this week: in the United States, we flush our toilets with drinking water, while 2.5 billion people around the world who live without access to proper sanitation literally have the toilet in their drinking water.
If you’ve ever seen a picture of a hanging toilet (a basic latrine constructed over a river or stream) you’ll understand exactly what I mean. If you haven’t, you owe it to yourself to see one. Click here.
In countries where access to sanitation is low—for example Angola, India and Yemen—the health care costs to treat sanitation-related diseases like diarrhea can eat up 20% of a household’s income, according to Jack Moss from AquaFed.
Globally, 1.5 million child deaths are attributed to the lack of access to sanitation. Most developing countries are far behind meeting their millennium development goal (MDG) targets for sanitation.
I tried to understand why more wasn’t being done to address the sanitation crisis while I listened to presentations at the World Water Forum.
One of the participants, Edmund Cain, from the Hilton Foundation pointed to the fact that people in developed countries like the U.S. fail to understand the seriousness of the problem. Another forum participant, Vandana Mehra from the World Bank’s Water and Sanitation Program, highlighted how difficult it is to change the mindset of people who are used to doing some things a certain way, such as defecating in the open. Other challenges mentioned were the lack of demand and availability for sanitation products like soap and toilets, and the low priority developing countries place on sanitation programs.
Still, some countries, like Thailand and Malaysia, have succeeded in greatly increasing their populations’ access to sanitation. John Pasch from USAID highlighted an ongoing study of what led to Thailand and Malaysia’s success in hopes that other countries can learn from their experience.
Small businesses and NGOs involved in sanitation work are growing. For example, David Kuria’s toilet business in Nairobi and Wherever the Need (directed by David Crossweller) have been successful and are now expanding.
Thankfully, “Keeping Sanitation High on the Agenda” was not only the title of a major session – it also seemed to be a major theme of the Forum. I heard journalists conducting many interviews on the issue. Author Rose George, who wrote a book last year on sanitation, presented on several panels.
As I reflect on the week, I am hopeful that many of the challenges I heard discussed can be overcome. Though I believe it will take millions more people across the globe to get involved at different levels. What will you do?
-John Sauer, Water Advocates
ONE has partners on the ground in Turkey for the 5th World Water Forum. Our partners will be providing guest blog posts throughout the week to keep us updated on the meeting’s proceedings. Stay tuned for more in this series!
As I was quoted in the Associated Press the other day,“In America, diarrhea is bad takeout, in Chad, it’s the difference between life and death.”
I’m here at the 5th World Water Forum in Istanbul to help coordinate a journalist workshop on the health aspects of water, sanitation and hygiene. Journalists have come from as far away as Indonesia, Laos and Peru to learn about this massive, but surmountable, challenge.
We want to bring attention to this under-reported issue, as more children die of diarrhea and other water and sanitation related diseases than die of HIV/AIDS, tuberculosis and malaria combined. Meanwhile, 80% of research and development funding for diseases that disproportionately affect the poor is spent on these “big three” diseases. We aim to point out this disparity, not to take away funding from the more well-known diseases, but to see that more resources go to solving the water and sanitation crisis.
What is also unique about preventing and treating diarrhea is that affordable solutions are available now. Ceramic water filters, rope pumps, and ecosan toilets are all effective and sustainable solutions.
Sessions this week at the World Water Forum are going to focus on vast array of topics, such as new technologies, entrepreneurship and child health. The issue of poor water and sanitation in schools will also be discussed by UNICEF. An astounding 50% of schools in the developing world do not have access to water and sanitation.
PATH, WSSCC (Water Supply & Sanitation Collaborative Council), and Water Advocates are a few of the organizers of the journalist forum. We hope that the workshop and forum will increase attention on the health aspects of the water and sanitation crisis. With 5,000 people dying each day due to dirty water, and poor sanitation and hygiene, this cannot wait.
-John Sauer, Water Advocates
Check out this great post from our friends at Water Advocates!
Image by Kimberly Cadena
A few days ago at a DC-style networking session for public health folks, I introduced myself as the Communications Director for Water Advocates.
I am used to receiving surprised- even shocked- expressions when people learn that poor sanitation and unsafe water cause the illnesses that fill half of the hospital beds in the developing world and 10 percent of the entire global disease burden, even if I am amidst the public health folks of the world.
Yet, without missing a beat, the doctor who organized the event spoke up: “You must know that plumbing was the biggest contribution to improving public health in history.”
Yes!! I exclaimed, overjoyed to finally meet a medical doctor who understands that plumbing is the best way to save lives.
He was referring to the fact that when developed countries like the US, Japan, and England installed water and sanitation systems, they eradicated diseases like cholera and typhoid that caused death by diarrhea. Plumbing has saved millions of lives- our lives.
Still, billions of people in the world don’t have access to safe drinking water or a place to dispose their feces. 1.5 million children subsequently die every year.
We hear public outcries–in national news headlines, through savvy leadership, and championed by celebrity spokespeople–on many poverty-related diseases that are more costly to prevent, cannot yet be treated, or kill fewer people.
When such a simple, cheap, tried-and-true public health intervention is so present in our lives–and could prevent the astronomical death toll–why am I still surprised when people know about it?
Blame it on the name.
There are over 25 diseases (deadly and debilitating) that (more…)
Last week, we wrote about World Toilet Day. John Sauer from Water Advocates passed along this great post about raising awareness for better sanitation practices, and what we can do to help:
Public indifference to the HIVAIDS epidemic was chronicled in 1987 in And the Band Played On: Politics, People, and the AIDS Epidemic. As the author Randy Shilts lamented, “Everyone responded with an ordinary pace to an extraordinary situation.” Thankfully now there is attention to this deadly disease, but it wasn’t always the case.
Another pandemic—namely more than two dozen diseases associated with poor sanitation—now faces the same kind of unresponsiveness. Every 20 seconds a child dies of sanitation-related diseases, which kill five times as many children as HIVAIDS. As an article in the New England Journal of Medicine documents, pathogens that cause diarrheal diseases, tracoma, and guinea-worm are among the culprits. You didn’t think you can die of diarrhea did you? Well you probably can’t but those living where open defecation is the norm can. Human excrement: it is the last taboo.
Pushback on this topic is very real. A TIME Magazine review of Rose George’s new book on sanitation suggested that “a series of articles was plenty on this topic.” One US government official refused to release a statement on World Toilet Day because of objection to the word “toilet.” Progress towards the Millennium Development Goal (MDG) target of halving the proportion of people without basic sanitation by 2015 will not be met, at current rates, until 2115. In fact, the original version of the MDGs didn’t have a sanitation target.
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