Water is rarely the first thought that pops into my head when I hear about illnesses in general. I have mostly thought about water borne illness in reference to Ebola or bacterial infections; but never on a large scale. I have heard about diarrhea being such a massive problem before, but I have never actually looked at how it became such. The idea that so many illnesses develop because of fecal to oral transmission is very gross to me, and learning the statistics of how many people live in conditions where it is common to ingest contaminated matter, made me realize my privilege having grown up in an environment where I didn’t really have to worry about that stuff. Growing up, I would play in rivers and ponds, drink water from the hose, and play in puddles for hours at a time. I never had to worry about what was in this water, or whether there was human waste in it. This chapter made me realize how the things in life that I deem as normal, are the same things that others deem as a luxury. In other words, it made me realize how much I take advantage of.
WASH (water, sanitation, and hygiene), are noted as the forgotten foundations of health. Many individuals believe that funds should be allocated more towards reactive care, i.e hospitals, medicine, etc, than preventative care, i.e clean drinking water, safe plumbing, etc. The public media often reports on matters surrounding “the big three,” HIV/AIDS, Malaria, and Tuberculosis, but fails to provide enough awareness surrounding water borne illnesses, such as diarrhea, which kills more people than all of the big three combined (Boschi-Pinto, et al, 2008). One possible reason for the gap in funding for preventative care, in my opinion is that because of the media, donors do not hear as much about the impact that their donations could have on health. Additionally, reactive care provides a much more cut and dry emotional pay off. Donors are able to see that their funds helped heal someone. Whereas with preventative care, donors are not able to see that effect for a while, since their funds are going towards making sure no one gets sick, they can’t see that they helped them heal.
As I read about the effects that WASH has on global health, I was surprised to see how many people do not have access to safe indoor plumbing and clean drinking water. My idea of “improved sanitation” has always been having access to clean water, a flushing toilet, and safe drinking water. Upon learning the actual definition of improved sanitation, I realized that a lot more people than I expected live without what I, as a person who grew up in America, would deem close to the bear minimum. I have traveled to over thirty countries, and I have visited some areas that likely suffer from water insecurity. But every time I have visited these areas, my mind went mostly to their poor housing conditions, limited access to food, or inability to access health care. Water to me has always been sort of a given, and it was eye opening to see how many people go without safe plumbing and clean water.
In the reading, it was mentioned that water and sanitation are top priorities for the poor. I completely agree with this statement, for the simple fact that these are basic necessities for humans to survive. By having access to clean water and sanitation, the rates of water borne illnesses could plummet. This brings me back to a book I read when I was a kid. It took place when the Mayflower came to America, and it was a diary of a teenage girl. I remember that a lot of people died because of starvation, unclean water, bad weather, etc. But one part that I remember very well was that her mother got very sick with stomach problems and diarrhea. They were trying to rehydrate her, but the only waters they had access to were either dirty fecal contaminated ponds, or the salty ocean. Her mother ended up dying, and I have always wondered if she could have been saved if she had access to clean water. Though this is a very different situation to what the textbook was referring to, it goes back to access to safe water. This happened hundreds of years ago in America, and was considered an awful time to be alive. But what they don’t talk about in school prior to college, is that it still happens in so much of the world. By helping people gain access to safe water and sanitation, illnesses, disabilities, and deaths could be prevented in large amounts.
I believe that governments should invest more into preventative care such as sanitation, clean water, safe housing, education, etc, rather than pooling all of their resources into reactive care. I keep going back to the bodies in the river example from earlier in the textbook. To put the same analogy in different words, consider a broken train track. If there is a section of train track in a city that broke, and the train travels off the track, it will wreck many buildings and cars, and likely kill many people. You can run after the train and try to hop on and pull the emergency break, but by the time you succeed, the train will have caused tons of damage. A much more effective method would have been to make sure the track was built correctly and was safe to use before the train started. By identifying the break in the track and repairing it before any damage was caused, millions of dollars and hundreds of lives could be saved. It’s the same with global health. By implementing measures to prevent illness, governments could save millions of dollars in medical costs every year. Aside from the mere financial aspect of global health, by ensuring their citizens have the tools they need to stay healthy, they will likely see an increase in productivity, since their citizens will be alive and well. Conversely, the return on investment for water supply interventions shows that $1 U.S brings a return on investment between $5-$46 U.S depending on the intervention. This comes not only from money saved from medical costs, but time saved retrieving water as well (Hutton, et al, 2007). Overall, preventative measures, in my opinion, should be a high priority for every country.
As can be seen, access to clean water and proper sanitation play a vital role in global health. By ensuring that people have access to these basic necessities, years of life lost (YLL) and disability adjusted life years (DALYs) could be prevented in large amounts. It has always astounded me that so much of the earth is made of water, yet so little of it is safe to consume. By investing in low cost preventative measures such as water filtration straws, sand dams, building new wells, etc, the rates of water borne illnesses will see a drastic decrease. This decrease will provide less of a financial strain on governments by limiting the amount of medical care and hospitalizations needed. Not only would investing in preventive measures provide a more cost effective method for governments, but most importantly, it could save thousands of lives. For example, South Africa experiences 115 deaths every hour that are linked to poor hygiene, sub par sanitation, and unsafe water (The Last Well, 2020). That is 1,007,400 preventable deaths per year in South Africa alone. Once this number is expanded to include all areas affected by water insecurity and bad sanitation, we are looking at a massive part of the world population that was killed due to something that was easily preventable. There are many benefits to investing in preventative measures, ranging from fiscal to humanitarian, and each reason goes further and further into showing that more funds should be invested into this area.
References
Boschi-Pinto C, Velebit L, Shibuya K (2008) Estimating child mortality due to diarrhoea in developing countries. Bull World Health Organ 86: 710–717
Hutton G, Haller L, Bartram J (2007) Global CostBenefit Analysis of Water Supply and Sanitation Interventions. J Water Health 5: 481–502.
The Last Well. (2020, January 21). Ways to Get Clean Water in Africa. The Last Well. https://thelastwell.org/ways-to-get-clean-water-in-africa/.
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