Report shows impact of poor sanitation on world’s health

By Barry Mason
18 April 2002

A report entitled “The Human Waste”, issued by the British charity Water Aid and Tearfund, a British relief and development agency, details the horrific consequences of poor sanitation and lack of clean drinking water.

Lack of sanitation now affects about 40 percent (2.4 billion) of the world’s population and is expected to rise to 50 percent by 2025.

Diarrhoea caused by bad sanitation kills nearly 6,000 children a day—an annual toll of two million deaths. People suffering from waterborne diseases occupy half the world’s hospital beds.

Already half of Asia’s population lacks adequate sanitation and in China, India and Indonesia twice as many people die from diarrhoeal diseases as from HIV/Aids.

In Africa in 1998, 308,000 died as a result of war, yet nearly two million died of the effects of diarrhoeal disease.

In developing countries 80 percent of all disease results from a combination of poor hygiene, contaminated water and poor sanitation. Parasitic infections are also exacerbated by poor sanitation—the report estimates that 1.5 billion people have parasitic worm infections. Such worms, whilst they may not cause death, lead to stunted growth and general debilitation. Among the diseases resulting from poor sanitation, unclean water and poor waste disposal are dysentery, cholera, typhus fever, typhoid, schistosomiasis and trachoma.

The increasing urbanisation of populations throughout the world is exacerbating poor sanitation. The report estimates that 160,000 people move from the country to live in cities every single day. It states that in Africa, Asia and Latin America there are 600 million people living in squatter settlements around conurbations that lack any sanitation infrastructure. These settlements are expanding faster than any attempt to provide such infrastructure. Dhaka, the capital of Bangladesh, is growing at an exponential rate. Its population at the beginning of the 1970s was a quarter of a million, whereas it is now 10 million.

A recent United Nations (UN) Habitat report similarly warns of the impact of rapid urbanisation. It details the rate of urbanisation of African countries, forecasting that the numbers living in cities will rise from the 1990 figure of 138 million to 500 million by 2020, with 200 million people living in cities with populations of more than a million. The report explained that a 1990 survey showed eight out of 29 sub-Saharan countries “were suffering from water stress or water scarcity.” This is expected to increase to 20 countries by the year 2025.

The “Human Waste” report explains that the answer to the vast numbers of preventable deaths and illness is a simple one. For a very small amount of money, a person in the developing world could be provided with safe water and adequate sanitation—£11 (US$16) billion a year would halve the number of people living with no sanitation and save millions of lives.

The report calls for increased aid from Western countries, and for the British Labour government to give a lead in this by increasing its spending on overseas aid to 0.7 percent of GNP. However, this offers no solution for this rapidly expanding human catastrophe.

Following the pledges made by Western governments to increase aid flows to governments carrying out “sound” policies at the Monterrey conference on poverty held in March, the World Bank issued the report “African Development Indicators 2002”. It suggests that it was time Western governments “deliver on their promises of more generous aid.” It explains that despite African governments adopting the policies demanded of them by the West, aid flows are still declining. Mozambique, for example, a country that has carried out the pro-market economic reforms demanded, saw aid fall from $1 billion in 1990 to $804 million in 1999.

Even if aid donations were increased by tiny amounts, there can be no reasonable expectation that it will be spent on issues such as poor sanitation. The true meaning behind the Western commitment to “halving poverty by 2015”, as the United Nations declaration of 2000 put it, was made clear in a recent speech by British development minister Clare Short in Johannesburg. She said, “in these globalised times, a surplus of capital [is] constantly looking for investment opportunities... it can earn higher rates of return from emerging markets than it can in OECD countries.” The precondition for this investment was “good governance”, explained Short, citing the example of China where there has been “considerable progress” over the last ten years. Despite Short’s rhetoric about “political rights”, the reference to China leads to the obvious conclusion that only countries that discipline their population to accept the demands for ruthless levels of exploitation by the multinational companies can expect increased aid and investment.

Aid in the past “has too often been used for political reasons”, said Short. Although she made perfunctory references to promoting trade interests of donor countries and propping up “corrupt rulers”, it is clear that “politically” motivated projects include direct public spending on areas such as sanitation and health. Stressing the importance of the “private sector” several times and “public and private partnerships”, Short made clear that aid would now only be used to “back reformers” who opened up their economies, including the former state sectors, to the market.