The Calgary Herald (Alberta)
Bob Dickson and Blaise Salmon
Almost half the world's population, 2.6 billion people, lack access to basic sanitation. One insix people, 1.1 billion, do not have safe drinking water. The lack of access to these basicrequirements of healthy living is the world's most horrific and least reported humanitariandisaster.OK, let's be truthful -- it's not attractive dinner conversation, nor is it high on the politicalagenda. However, the most recent United Nations Human Development Report tells it like it is:"In the case of sanitation, millions of people are paying every day for the failure to confrontthe problem, many of them with their lives."According to the World Health Organization, 4,500 children die daily from the consequences ofunsafe water and sanitation and about 3.4 million children and adults perish annually.A century ago in Canada, similar conditions were common. Life expectancy was less than 50years, similar to many African countries today. Now, ours is over 80. The principal reason forthe dramatic leap in average lifespan was the ability to tame the spread of infectious disease,in large part through the creation and proliferation of water purification and sewage systems.Where there are no toilets, people defecate in ditches, in plastic bags dumped into ditches or,at best, in dumpsites. In many of the world's largest urban slums, such as Kibera in Kenya,raw sewage is everywhere and, when it rains, noxious black liquid flows into the streets,through people's homes and into the local water supply.The health problems caused by poor sanitation are ubiquitous. It is responsible for a broadrange of disorders such as diarrhea (one of the world's most insidious killers of children),cholera, typhoid, hepatitis A, dysentery and worm diseases.Intestinal worms lead to malnutrition, anemia and retarded growth, both mental and physical.Trachoma, an eye infection that thrives where sanitation is lacking, is a leading cause ofblindness.Bilharzia, a debilitating illness for tens of millions of people each year, caused by a parasiticworm, would essentially disappear with even basic sanitation. And the lack of adequatesanitation at schools throughout the developing world keeps many children, especially girls,from completing basic education.There is less than a decade left until the target date of 2015 for the Millennium DevelopmentGoals, the international targets for global poverty reduction signed by 191 countries in 2000.The sanitation goal, which is to halve the proportion of people without basic sanitation, is theleast likely of all MDGs to be achieved. This is in marked contrast to the steady progress beingmade in providing clean water. The goal of halving the proportion of people without access toclean water by 2015 is on track to be achieved.Therefore, the most urgent need is for a rapid increase in the scale and effectiveness ofsanitation programs. Achieving this will require bringing improved sanitation to 120 millionpeople every year between now and 2015. Even if that were accomplished, 1.9 billion peoplewould still be without access.The $10 billion US price tag for reaching the MDG sanitation target is based on access to thefirst rung of the sanitation ladder -- simple pit latrines. These latrines cost as little as $10each. As with most contagious diseases, the whole community benefits from improvements.When a household installs a latrine, it not only protects members of that family from contactwith their own excreta, it also protects their neighbours.Hygiene education is a second essential element of the sanitation campaign. Programs inschools, microcredit facilities and clinics can promote simple hand washing with soap andwater, and awareness of how disease is transmitted.This transition to simple, basic sanitation and hygiene improvements is accompanied by amore than 30 per cent reduction in child mortality, according to the United NationsDevelopment Program.In November, the annual UN Human Development Report was released, with the focus on theglobal water and sanitation crisis. Due to the magnitude of this crisis, the report issued anurgent call for a global action plan to be led by the G-8 group of the world's wealthiestcountries -- the U.S., Japan, Germany, U.K., France, Italy, Russia and Canada.Among its many recommendations, the report called for a "virtual mechanism" to ramp up theattack on the global crisis. This would have a small secretariat and minimal bureaucracy -- theGlobal Fund to fight AIDS, Tuberculosis and Malaria was cited as an example.The estimated cost of $10 billion a year to reach the MDG target would be money well spentas the financial returns in increased productivity and reduced health costs are estimated at $8for each $1 invested.Canada could be the ideal country to initiate and champion G-8 discussions of a GlobalSanitation Fund. History shows what is possible.Several years ago, Canada took the lead by initiating a series of meetings, known as theOttawa Initiative, which sought buy-in from larger countries for a plan to scale up efforts toaddress the global AIDS crisis.This process ultimately led to the creation of the Global Fund to fight AIDS, TB and Malaria,now one of the world's most effective development mechanisms.The coming G-8 conference in Heiligendamm, Germany in June 2007 is the next opportunityfor the world's most powerful countries to take on our planet's most urgent developmentcrisis. Canada must ensure that sanitation is high on the agenda.As unsavoury as this topic may be to us in our protected and hygienic world, the bang for thebuck is in the toilet.Dr. Bob Dickson is a physician in Calgary, Alberta, and a partner with RESULTS CANADAwww.resultscanada.ca, a volunteer organization fighting poverty, hunger and debilitatingdiseases. Blaise Salmon is the national president of RESULTS and is based in Victoria, B.C.LOAD-DATE: February 28, 2007Copyright 2007 The Calgary Herald, a division of Canwest MediaWorks Publication Inc.
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