Miranda Newsom, www.theaccidentalecomaniac.com

Dying for the loo: how sanitation can save lives

Genet Weldegerite, Mahilet Solomon, and Seliman Mehamed Suhar, all age 7

Sh*t, poo, caca, faeces, wee, pee, piss. Now can we all stop tittering and blushing, and speak sensibly about sanitation? In reality, it isn’t a dirty word – the real shame is the silence surrounding the crisis.

Over 5000 children under five die every day due to inadequate sanitation and hygiene, but now children like Genet, Mahilet and Seliman (pictured above) are learning how to protect themselves.

"After we go to the toilet, we wash our hands," they sing with other children at Hiwane Elementary School in Ethiopia. The education of these children is part of a WaterAid project to improve access to clean water, sanitation and hygiene in the east African country.

When water is scarce it’s rationed, and cleaning and washing hands come way down the list

"The project builds latrines, but education and training are a vital part of the solution," says Sadie Ramm of Ecover, who are helping WaterAid with the project. "When water is scarce it’s rationed, and cleaning and washing hands come way down the list."

Now safe water is more plentiful and school clubs encourage children to take the message home, helping overcome cultural sensitivities and traditions to improve hygiene. The benefits are clear: UNICEF says washing hands with soap prevents the transfer of bacteria, viruses and parasites from human excreta, reducing diarrhoeal cases by more than 40%.

In fact, last year British Medical Journal readers voted The Sanitary Revolution (clean water and sewage disposal) the greatest medical milestone since 1840, ahead of vaccines or anaesthesia. "Sanitation is a cornerstone of public health," says World Health Organization Director-General Dr Margaret Chan.

Washing hands with soap prevents the transfer of bacteria, viruses and parasites from human excreta

The world's crisis

This year marks the 150th anniversary of ‘The Great Stink’ of 1858, when the Thames had become a festering sewer, and cholera and diarrhoea plagued Londoners. The stench that summer led Parliament to fund a complex sewerage system, which dramatically improved health.

Today, a century and a half later, 2.5 billion people around the world still don’t have access to sanitation, including over 70% of the population of sub-Saharan Africa and nearly half the population of South Asia. To combat this “hidden global scandal” the UN’s General Assembly declared 2008 the International Year of Sanitation.

Sanitation is such a serious issue it was included in the eight Millennium Development Goals (MDGs), with a target of halving the number of people living without basic sanitation by 2015.

Sanitation actually affects several MDGs: reducing child mortality, making primary education universal, empowering women, eradicating extreme poverty and helping the environment.
Improved sewage disposal and washing hands can save lives.

In schools, private latrines increase girls’ enrolment up to 11%, and with every 1% rise in female literacy a country’s economy grows significantly. In fact, a WHO study showed that every $1 invested in sanitation leads to a $3-34 gain, including time saved, more days at work or school, averted illness and death and reduced medical expenses.

Sanitation also helps the environment, with less contamination of water and soil and increased biodiversity.

Despite all these benefits, we’re unlikely to meet the 2015 target. "It’s astonishing that in 2008 we still have this problem," says Cecilia Martinsen of the Stockholm International Water Institute.

"We can go to the moon, but millions of people don’t have a proper place to pee and poo." The taboo is a huge factor. "Everyone sugar-coats the problem: it’s not ‛water-related’ disease, it’s sh*t-related disease," says Cecilia.

She draws a parallel with the HIV/AIDS crisis, which forced us to speak frankly about sex and condoms and insists politicians must be braver. "If they can’t talk about sanitation, they won’t plan for it or budget for it," she says. "We must break down the taboo if we want economic and social development."

The International Year of Sanitation is raising awareness of the global crisis.

How you can help

What can you do to help? Potty talk may not seem like polite dinner conversation, but don’t be ashamed to raise awareness among your friends and family. Sanitation doesn’t get as much press as cute baby seals or cuddly pandas, but it saves human lives.

Could you help the world reach its MDG sanitation target? To do so, 173 million people need to gain access to sanitation each year, costing $10 billion per annum.

It seems a huge amount, but actually it’s less than 1% of the world’s yearly military budget. If your own budget’s crunched, think of it this way: $10 billion is one-third the amount the world spends on bottled water, and what Europeans pay every year for ice cream.

Why not pledge to cut back on those two items, and set up a direct debit supporting a sanitation project? Take a closer look at the worthy causes listed here:

WaterAid is an international charity working to overcome poverty by enabling the world’s poorest people to gain access to safe water, sanitation and hygiene education.

The British Red Cross works on sanitation projects in Zambia, Zimbabwe and Cambodia and its Mass Sanitation Unit helps areas hit by disasters such as floods.

The International Year of Sanitation is raising awareness of the global crisis.

The World Toilet Organization is a global non- profit improving sanitation worldwide.

UNICEF’s ‘Don’t Wash Your Hands of Children’ campaign is helping to raise awareness and accessing progress on meeting the MDG drinking water and sanitation target.

Further Reading

WaterAid: international charity

The WaterAid/Ecover project

Special report: world water crisis

Graphic: world water facts

Video: Where has the water gone?