Clean water should be our next global accomplishment

The Harvard Business Review studied 15 social movements it says “defied the odds and achieved life-changing results to uncover lessons for today’s ambitious donors.” It’s an impressive list that includes CPR, hospice, car seats, public libraries, 911 services, Anti-Apartheid and global health victories — oral rehydration and the eradication of polio.

These “inconceivable moon shots of their day,” as the Harvard Business Review calls them, got us thinking about a 16th “social movement”. 

{mosads}Consider that the poliovirus is spread through untreated sewage and deadly dehydration starts with bad water; then consider that the U.S. Department of State and USAID released the first-ever U.S. Global Water Strategy to coordinate 16 government agencies that all touch on water issues to better address the growing set of global water challenges. The 16th “inevitable success story in retrospect” is clear: Universal access to safe water and sanitation.

Perhaps the most inconceivable water challenge is the absence of WASH — water/sanitation/hygiene — in of all places: healthcare facilities. When the World Health Organization (WHO), and the University of North Carolina’s Water Institute reviewed 66,000 healthcare facilities in 54 countries after the deadly Ebola outbreak, which was escalated in part by the lack of access to clean water, they found:

●      Almost 40 percent of healthcare facilities did not have access to safe water;

●      Almost 20 percent did not have basic sanitation;

●      35 percent did not have soap and water for hand washing.

The links between dirty hands, dirty water and mortality have been known for centuries. This situation is waiting not for answers, but action. Far too many health workers in low- and middle-income countries lack the most basic means to keep patients safe.

An American doctor tells the story of the time she found herself in a packed labor and delivery ward in East Africa. An unexpected twin was born not breathing and, with almost no protective gear, two nurses she’d brought with her jumped in and saved the baby. “All they could do was hope no mother or child we came in contact with that day was infected with HIV, hepatitis,” says Dr. Migs Muldrow. “We had no way to clean up because this massive, overcrowded hospital that serves 2.5 million people, had had no water in six weeks.”

Dr. Muldrow founded Village Health Partnership, which helps build sustainable health systems in some of the poorest, remote corners of the globe. When she was asked to review WASH in 13 rural healthcare facilities this past year, without exception, every hospital and clinic went through periods of having no water.

At one health center serving some 53,000 people, there is just one latrine, no shower, and two donkeys that make 20 trips a day to transport water from a river 1.5 miles away. Another facility has one pit latrine that spills sewage onto the healthcare compound during the rainy season. At a main hospital, mothers give birth side-by-side, sometimes three at a time. When it’s busy, they attempt to clean up their blood and bodily fluids with their own clothes and rags to make way for the next women about to give birth. Mothers are afraid to deliver here but they are also afraid to die in labor at home.

Tragically, one in five babies dies in the first month of life in the developing world, even though just being washed in clean water and cared for in a clean environment by people who have washed their hands could prevent these deaths. WHO estimates that 50 percent of undernutrition is linked to chronic diarrhea, intestinal worms and other infections caused by unsafe water, inadequate sanitation or poor hygiene. Simply handwashing with soap can reduce diarrheal episodes, a leading cause of death in children, by about 45 percent.

Mary Mwape, a midwife in Zambia, told WaterAid, “We know that we are supposed to wash our hands thoroughly before attending to another patient, but what do you do in a situation where there is no running water?”

WaterAid launched Healthy Start, a four-year campaign focused on improving the health and nutrition of newborns and children through safe WASH integrated into health policy and delivery. 

Dramatic, cost-effective results can be achieved, simply by adding WASH. For example, when WaterAid provided WASH services to a hospital in Tanzania, neonatal deaths reduced by 75 percent and the number of mothers who chose to give birth at the hospital more than doubled. When WaterAid partnered with WHO and the Centers for Disease Control to develop minimum standards for WASH in healthcare facilities, Mali’s Ministry of Health adopted these standards, opening the way for WaterAid to help provide 23 healthcare facilities with sustainable access to water, sanitation kits and incinerators to properly manage medical waste.

More such efforts are needed. What we have here is a solvable problem. But as medicine travels in the high-tech lane, low cost prevention is too often overlooked. Some 50 different diseases and illnesses still trace back to unsafe water, and half the developing world’s hospital beds are still filled with people suffering from one of them. As Dr. Muldrow succinctly puts it, “We’re learning that local commitment is vital to creating sustainable health systems. But it seems to me that we shouldn’t have to learn water is, too.”

The new U.S. Global Water Strategy is an important American commitment, maybe even the start of a 16th social movement that transforms water from the burden that it is for so many, into the source of life it is meant to be — even the next “inevitable success story in retrospect.”

Sarina Prabasi is the U.S. chief executive of WaterAid, the world’s largest international non-profit dedicated exclusively to helping the world’s poorest people gain long-term access to clean water, decent toilets and good hygiene. Susan Barnett, a former award-winning network news journalist, is a strategic media, communications and advocacy consultant for nonprofits. She is founder of Faiths for Safe Water and Cause Communications