By Elizabeth Kurylo Communications manager, International Trachoma Initiative
Every morning and every night, I turn on the hot and cold water taps, adjusting them so the temperature is just warm enough to wash my face. I take for granted that the water will flow. I would be shocked if it didn’t. This easy access to water is a luxury not enjoyed by hundreds of millions of people around the world.
As we mark World Water Day, it is worth noting that 748 million people do not have access to an improved source of drinking water and 2.5 billion do not use an improved sanitation facility. For them, the lack of water can mean poor health, disability and even death.
Water and sanitation is especially important in the prevention and control of trachoma and other neglected tropical diseases (NTDs). Trachoma is an ancient eye disease caused by a bacterial infection. Left untreated, it can lead to blindness. But we can stop it with the World Health Organization-endorsed SAFE strategy Surgery, Antibiotics, Facial cleanliness and Environmental improvement.
Water is crucial to facial cleanliness, and key to ending blinding trachoma. But in many places where trachoma is endemic, water is scarce, and rationed for uses other than hygiene, such as cooking. Face washing is not a priority.
The global trachoma community has made much progress since 1998, when Pfizer began donating the antibiotic Zithromax®, which treats and prevents trachoma. More than 444 million doses of Zithromax® have been shipped to trachoma endemic countries to date. And seven countries have reported reaching their elimination goals.
Under the leadership of WHO and the Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020), national trachoma programs have steadily scaled up implementation. In 2014, WHO’s Weekly Epidemiological Report (WER) said trichiasis surgeries and antibiotic distribution were tenfold higher in 2013 compared to 2004.
The International Coalition for Trachoma Control (ICTC) has galvanized the global trachoma community’s commitment to reaching elimination by 2020. Collaboration on game-changing initiatives with governments, health officials and trachoma endemic communities has led to the mobilization of more than 150 million dollars of new funding from DFID, USAID and the Queen Elizabeth Diamond Jubilee Trust. That is in addition to the national government domestic budget allocations and support already provided by many non-governmental development organizations as well as other donors such as the Lions Clubs International Foundation, Conrad N Hilton Foundation and the Bill & Melinda Gates Foundation. The WASH sector also is collaborating with the NTD sector to achieve shared goals of improving health and eliminating disease.
Still, there is much work to do. An estimated 232 million people in 51 countries live in trachoma endemic areas. Globally, 31 countries are implementing the SAFE strategy to eliminate trachoma, which signifies that 20 countries are still in need of help.
In 2015, ITI plans to ship 115 million doses of Zithromax®, donated by Pfizer. That is more than twice the amount approved for shipment in 2014. We are doing everything we can to accelerate access to Zithromax® needed by people who are at risk of blindness from trachoma, said Dr. Paul Emerson, Director of ITI. We are empowering national programs so that those at risk of going blind from trachoma can be treated.
Empowering people in trachoma endemic communities to prioritize water for hygiene also has lasting benefits. I saw this in Ethiopia, where I met Amarech Haluka, the mother of three young girls, one of whom had experienced the pain of trachoma. Health workers introduced the SAFE strategy to Amarech’s community, which received donated Zithromax® and education about the importance of using latrines and keeping their faces clean to avoid trachoma. Amarech and her husband got a loan to install a water pump in their back yard, and she now routinely washes her children’s faces twice a day. Even though she cannot adjust the temperature of the water that flows from her pump, her children’s faces are clean, and her family is free of trachoma.
by Liz Borkowski, cross-posted from
Today is World Water Day, when the United Nations draws attention to the importance of freshwater and advocates for sustainable water-resource management. This year, the focus is on water quality, which is declining worldwide.
According to the World Health Organization, each year 3.4 million people – most of them children – die from water-related diseases. That includes 1.4 million children dying from diarrhea annually, and 860,000 children perishing directly or indirectly from malnutrition arising from repeated diarrhea or intestinal nematodes. Many malnourished children do survive, but can suffer lifelong impairment.
Some of the most common 80 million people worldwide and has left eight million of them blind. Schistosomiasis, which spreads through water bodies contaminated with infected persons’ feces, causes progressive damage to either the bladder and kidneys or the liver, spleen, and intestines. WHO estimates that 200 million people have this preventable infection.
Because water-related diseases cause such a great reduction in quality of life and productivity, they’re a focus on the UN Millennium Development Goals. Under Goal Seven, “Ensure Environmental Sustainability,” one of the targets is “Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation.” The world has achieved substantial progress toward this goal, but it’s been uneven.
The most recent UN report on MDG progress finds that in 2006 we were ahead of schedule in meeting the 2015 drinking water target, but less than halfway toward the sanitation target. Worldwide, 884 million people still lack access to improved water sources (which include household connections, public standpipes, and protected wells), and 84% of these people are in rural areas.
Sanitation improvements must go hand-in-hand with water improvements, because human waste can contaminate water if not handled properly. The UN Food and Agriculture Organization gives this definition of improved sanitation:
Access to improved sanitation facilities refers to the percentage of the population with at least adequate excreta disposal facilities (private or shared, but not public) that can effectively prevent human, animal, and insect contact with excreta. Improved facilities range from simple but protected pit latrines to flush toilets with a sewerage connection. To be effective, facilities must be correctly constructed and properly maintained.
- connection to a public sewer
- connection to a septic system
- pour-flush latrine
- simple pit latrine
- ventilated improved pit latrine
- service or bucket latrines (where excreta are manually removed)
- shared and public latrines
- latrines with an open pit
Between 1990 and 2006 in the developing world, 1.1 billion people gained access to improved sanitation – but 1.4 billion more still need to gain access by 2015 in order to meet the target. The problem is particularly acute in Southern Asia and Sub-Saharan Africa, where progress has been notable but not equal to the substantial challenge.
While we in the developing world can and should support the achievement of the Millennium Development Goals, we also need to think about how our activities are affecting water quality. The World Water Day website has this summary of some of the top concerns:
Water quality can be affected by organic loading (e.g. sewage), pathogens including viruses in waste streams from humans and domesticated animals, agricultural runoff and human wastes loaded with nutrients (e.g. nitrates and phosphates) that give rise to eutrophication and oxygen stress in waterways, salinization from irrigation and water diversions, heavy metals, oil pollution, synthetic and persistent engineered chemicals (e.g. plastics and pesticides), medical drug residues and hormone mimetics and their by-products, radioactive pollution, and even thermal pollution from industrial cooling and reservoir operations.
If you’re interested in learning more about water pollution problems in the US, I recommend the Frontline documentary World Water Day website also has plenty of suggested reading.
On World Water Day, think about the ways you use water – and how much a clean, adequate supply means to the health of the world.