World Water Day and infectious diseases

In honor of World Water Day, which was March 22, I thought I’d spend a little bit of time today discussing the important role of water in transmitting infectious diseases around the world.

There are lots of diseases that are transmitted via water and a lot of that transmission can be interrupted with better sanitation practices. Some of the diseases directly transmitted via water that you might have heard of include diarrhea, cholera, trachoma, typhoid, and schistosomiasis. Other diseases, like malaria or dengue, are indirectly transmitted via water when water is involved in the life cycle of the vector or parasite. Because fecal-oral transmission is common in a lot of waterborne diseases, improving sanitation practices can decrease the occurrence of some of these infectious diseases.

A common global health term pertaining to water/sanitation is WASH, which stands for Water Sanitation & Hygiene. This term encompasses work being done to improve access to clean water and proper sanitation for the world’s people.

Now for a few stats to put this WASH effort into perspective:

  • 748 million people don’t have access to safe drinking water
  • 2.5 billion people (more than 35% of the world’s population) don’t have access to proper sanitation facilities
  • 2,200 children are dying every day due to diarrheal disease
  • People may have access to clean water but lack proper supplies in their home like soap for handwashing to help prevent disease
  • 1 in 5 primary-school aged girls are not in school due to lack of sanitation facilities needed for puberty and the fact that girls are frequently responsible for collecting water for their family (which can take up a significant amount of time depending on how far the water source is from the home)
  • WASH activities have the potential to prevent 9.1% of the global disease burden
  • Return on investment on WASH activities ranges from US $5 to US $46 per every US $1 invested


So now that we understand how important WASH activities are and how better sanitation can lead to decreasing incidence of infectious diseases, what WASH activities are happening around the world? The CDC and PAHO (Pan American Health Organization) developed something called the Safe Water System (SWS) which protect communities through household water treatment, safe storage of treated water, and behavior change to improve WASH and food handling procedures. UNICEF is working toward sanitation practices in many countries by focusing on eliminating open defecation instead of latrine construction. UNICEF is encouraging communities to evaluate current open defecation patterns and focus on building latrines in the right areas to eliminate the health threat. UNICEF is also promoting handwashing, water quality monitoring, and water supply preservation.

I can personally attest to the hardship of living in an area without adequate sanitation. I spent 2 months working in Ghana back in 2009 and I quickly learned that I needed to be conservative with my eating and drinking during the day as the only place I had access to adequate sanitation was at my living quarters with a host family. While I only made a slight sacrifice to adapt to my living conditions, I witnessed many people performing open defecation or urination because of the lack of adequate facilities. I know that behavior change can be hard as can ensuring simple things like adequate water supply for toilets or handwashing, which is why I have such deep respect for the work being done by WASH specialists around the world to come up with innovative ways to address the water and sanitation challenges of communities.

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