Every year the UN issues a Human Development Report—really a summary of the state of the world, providing a store of information on a vast number of human welfare issues, with special attention on one. This year, 2006, the focus is on access to clean water and adequate sanitation. Like hunger and malnutrition, lack of access to clean water and adequate sanitation is a silent crisis. But a silent crisis has its fallout of devastating health consequences for millions, most especially for children.
1.8 million children die each year as a result of diarrhoea. Deaths from diarrhoea in 2004, one year alone, were some six times greater than the average annual deaths from armed conflict from the whole of the 1990’s. Close to half of all people in developing countries suffer at any given time from disease, severe health problems such as cholera, typhoid, trachoma, parasitic worms. One billion people in developing countries have inadequate access to clean water. 40% of the world’s population, 2.6 billion, lack basic sanitation. Inevitably this results in large economic losses in terms of health spending and reduced productivity.
This report highlights the less well known but vital point that, in a large number of cases, the water needs have institutional and political causes, not created by scarcity. The problem is mostly man-made, either through mismanagement or political favoritism. The report notes that when it comes to water and sanitation the world suffers from a surplus of conferences and a deficit of credible action.
What would it cost to improve this situation with known and targeted action? The authors estimate that it would cost $10 billion a year to halve the percentage of people without access to safe drinking water and to provide them with simple pit latrines. But that cost is less than five days worth of global military spending and less than half of what rich countries spend each year on bottled water. It would save more than one million children’s lives over the next decade. The human development gains would be immense—economic benefits of about $38 billion annually. What a bargain!
Is there precedence for effective social action? Just over 100 years ago, infant mortality rates in Washington, DC were twice what they are today in sub-Saharan Africa. Water-borne diseases like diarrhoea, dysentery and typhoid accounted for 1 in 10 deaths in US cities in the late 19th century, with children the primary victims. In the UK and elsewhere, the industrial revolution helped people to become wealthier but not healthier. The poor moved from rural to urban areas to benefit from the boom, while overburdened cities turned into lethal open-air sewers. Epidemics of typhoid and cholera swept through cities like New Orleans and New York.
By the end of the 19th century, governments recognized that diseases associated with water and sanitation could not be isolated in the cities’ poor tenements. It was to the public’s interest to take action. In the UK and the US and elsewhere massive investments were made in effective sewage systems and purification of water supplies. No period of US history has witnessed such rapid declines in mortality rates.
The report gives examples of limited local community actions. In India and Pakistan slum dwellers associations have collaborated in innovative programs to bring sanitation to millions of people. The total sanitation campaign in Bangladesh has been scaled up from community based projects to highly effective national programs.
Cambodia, China, India and Zambia have also adopted national programs. Brazil was successful in promoting safer sewage systems, bringing sanitation to millions of people through community programs. Still, community led initiatives alone, though important, are not sufficient, and are not a substitute for government action. South Africa is an inspiring example of government action. Some 83% of the population now have access to clean water, compared to 59% at the end of apartheid in 1994. Now some 70% have access to acceptable sanitation. This is a substantial improvement compared to 48% in 1994 when access to water was used as a tool of apartheid by the white racist regime.
Governments should not be permitted to let millions die when targeted action can work. Mahatma Gandhi once commented that “the difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems.” If you would like to help, UNICEF has a program targeted for children. Others can be found by Googling clean water and sanitation programs.
Phyllis Ehrenfeld is AEU’s National Service Conference Representative to the UN. Sylvain Ehrenfeld is IHEU Representative to the UN.
