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Across many countries of the world mostly developing countries, diarrheal still remains one of the prevailing cause of infant mortality responsible for the death of children under 5 years old. This has plagued world for too long yet it is very preventable if we can focus on addressing the issues of access to clean water and sanitation mostly open defecation.

In most communities and even urban areas, i still feel the requisite information about hygiene is still not distilling or sinking properly. Mother are still not grounded thoroughly in hygiene in maternal care, simple washing of hands before we feed our children we go a long way, washing of hands after using the toilet will just be a very strong key but how much of these have we thought these mothers in which ever local language they understand?

Open defecation and the use of pit toilets popularly known as latrines are still in use in most communities. This is an offshoot of poverty which impacts greatly on health. In most areas, there are not infrastructures for people to use a decent toilet system, no water for flushing and even if they are able to sink boreholes, poor electricity supply will not allow them pump water to overhead storage for use.  Where there are open pit toilets, flies go into those toilets and come back and perch on people’s food. What about cockroaches and rodents, they go into this toilets and they come back to touch our food, plates and spoons.

People should not be allowed to defecate into the same water that people rely on as only source of water. This practice has not also helped in any way in reducing diarrhea induced child mortality. Nothing exists in isolation, Government political will will go a long way in addressing some of these issues, we need more precise public policies that can drive the health and well being of our people through effective hygiene practice and equal access to clean water.

“Water is life”, said UN Secretary-General Ban Ki-moon, at the opening session of the high-level meeting on sanitation and water for all, in Washington, DC, on April 11, 2014. Yet lack of access to safe drinking water, and poor sanitation and hygiene in many parts of the world, often leads to death. The Lancet Series on childhood pneumonia and diarrhea estimated that in 2011 around 700 000 child deaths occurred from diarrhea disease alone.

The Millennium Development Goal (MDG) 7c target to halve the proportion of people without sustainable access to safe water by 2015 has been declared on track, yet 768 million people globally are still without access to safe drinking water. In a letter in today’s Lancet, Mira Johri and colleagues argue that the indicator does not consider water quality, and should be reconsidered. Progress for sanitation is alarmingly off track.

An estimated 2•5 billion people lack access to basic sanitation (functioning toilets and safe means to dispose of human faeces). A shocking 1 billion people practice open defecation, with one in nine living in rural areas. The high-level meeting gathered ministers and representatives of finance, health, and water and sanitation from 46 countries, donors, international organisations, and civil society to discuss how to reach water and sanitation targets. Margaret Chan and Jim Kim were both in attendance. The UN-Water Global Analysis and Assessment of Sanitation and Drinking—Water (GLAAS) project, led by WHO, simultaneously released a preliminary report Investing in Water and Sanitation: Increasing Access, Reducing Inequalities. Special Report for the Sanitation and Water for All (SWA) High-Level Meeting (HLM). The report comprehensively analysed whether an enabling environment (governance, monitoring and evaluation, financing) for reaching water and sanitation targets exists for each country. The full report will be released in September, 2014, with data from 90 countries.

The good news is that there is progress. Cambodia for example, has increased access to safe water and sanitation in urban areas for all quintiles by implementing pro-poor policies. 7% of the population in urban areas practice open defecation, reduced from 28% in 2005. 75% of countries analysed have pro-poor universal access to water and sanitation policies, and three-quarters of countries have constitutions or legislation recognising the human right to water and sanitation. The alarming news is that although many countries have established policies for disadvantaged groups (poor individuals, populations with disabilities, urban slums, and remote communities), only 30% have financed implementation plans, and household contributions range from 6—97% of water, sanitation, and hygiene financing. More than 50% of the unserved population for water and sanitation live in middle-income countries .

Access to safe water and sanitation is essential to all development outcomes across the life course. It ensures healthy growth and prevention of water-borne and food-borne diseases causing diarrhea, which contributes to stunting in children. Contaminated and stagnant water also contribute to the global burden of trachoma, and vector-borne diseases. 165 million children worldwide with stunted growth risk compromised cognitive development, physical capabilities, and future school performance; resulting in a less productive generation, with unfulfilled potential to contribute to the workforce and the economy.

Beyond direct health outcomes, investing in water and sanitation is essential to achievement of post—2015 sustainable development goals. The Lancet highlights four areas going forward. First, the poor must remain central to all planning, because they pay the highest individual cost in health and finances in efforts to access safe drinking water and sanitation. Donors and governments must target and urgently address open defecation in particular. Second, girls and women must be prioritised. They travel long distances to fetch water, and the lack of private sanitation facilities at schools to ensure their dignity and safety risks absenteeism and drop out. Third, in fragile states and situations, access to health services, clean water, and sanitation must be secured, rapidly and without question. The supply of clean drinking water and sanitation facilities can be the difference between life and death, not to mention risks to personal security. Fourth, and finally, with the rapid and uncontrolled growth of urban slums, climate change, conflict over water resources, and growing global demand for products and food that require water for production, all sectors beyond health must develop governance mechanisms to ensure that access to safe water, sanitation, and hygiene, is a right for all. Only then can the global community return to the notion of water as life.

An article published by The Lancet


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