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World Toilet Day -The relationship between clean water, sanitation and health

I couldn’t believe it when someone posted on Facebook ”Today is World Toilet Day. Who came up with that? Don’t we have enough days off the calendar already?”. Maybe it is because water and sanitation is what you would call my sector of interest. If we do not address inadequate  sanitation  especially in the developing countries, we will continue to lag behind in meeting all the other development goals. Sanitation affects health, productivity, environment, equity and education among others. The measure of a country’s development can be measured by the health of its population and sanitation plays a major role in determining the health of a population.


According to the World Health Organisation, about 1.1 billion people in the world do not have access to improved water supply sources and 2.4 billion people do not have access to any type of improved sanitation facility. A total of 3.5 billion people- half of the world’s population. The most affected people are in the developing countries particularly South Asia, East Asia, and sub-Saharan Africa. The United Nations notes that lack of access to water and adequate sanitation falls heavily on girls and women and marginalized populations such as slum dwellers, women, children and the disabled. If you are a woman and you are poor, this is a double tragedy and triple tragedy  if you live in the informal settlements.

Lack of access to clean water and adequate sanitation effects on health are hefty. Studies have shown that lack of sanitation contribute to up to 10% of the global disease burden. Water and sanitation related diseases can be categorised as follows: waterborne caused by the ingestion of water contaminated by human or animal excreta; water-based caused by parasites; water related caused by microorganisms with life cycles dependent on water sources; water collection and storage caused by contamination that occurs during or after collection; and toxin-related caused by toxic bacteria linked to eutrophication of surface-water bodies. Disease causing pathogens (disease-causing organisms) associated with lack of clean water and adequate sanitation includes: viruses, bacteria, protozoa and parasitic worms. These pathogens are responsible for the transmission of diseases such as dysentery, diarrhea, typhoid, cholera and hepatitis A.

There are over 4 billion cases of diarrhea each year resulting into 2.2 million deaths and representing 15% of all under the age of five child deaths in developing world as a result of lack of clean water and responsible. Diarrheal diseases can solely be prevented by providing clean water, adequate sewage disposal services, hygiene and health education (WHO 2011). In addition lack of clean water and inadequate sewage disposal has been associated with increased lower respiratory tract infections (LRI) among young children. Increasing provision of clean water and adequate sanitation can reduce LRI burden on the society. In addition to the diseases that are transmitted through faecal oral transmission, polluted water can also contain heavy metals such as lead and cadmium. These heavy metals can be toxic to humans depending on their concentration and duration of exposure. Therefore, clean water and adequate sanitation provision in a country can reduce child mortality, improve women’s health especially maternal health and reduce the disease burden of infectious diseases. Globally,  the economic benefits accrued from investment in water and sanitation have been estimated by the WHO as US$7 billion savings a year by  health agencies and US$340 million savings by individuals. Time savings and value of deaths averted from providing convenient drinking water and sanitation services could be used to fund other development infrastructure.

I hope next year more people will celebrate the World Toilet Day more hopeful that sanitation is not lagging so behind after the Millennium Development Goals goal on water has been reached as the current state indicates.