The New York Times, October 2015
"What if there were a remedy that could save more children...
A young girl in Haiti carries water.
What if we lost 32 school buses full of children today? That’s 2,195 children—the number who die daily of diarrhea around the world. That’s more than die from AIDS, malaria, and measles combined.
As World Water Day approaches on March 22, we should consider water’s role in those deaths—and what we can do to prevent them. About 88% of diarrhea-associated deaths are attributable to unsafe water, inadequate sanitation, and insufficient hygiene. Yet most diarrheal deaths are preventable using simple, low-cost interventions.
Diarrhea: common illness, global killer
Diarrheal diseases account for 1 in 9 child deaths worldwide, making diarrhea the second leading cause of death among children under the age of 5. For children with HIV, diarrhea is even more deadly; the death rate for these children is 11 times higher than the rate for children without HIV.
Despite these sobering statistics, strides made over the last 20 years have shown that, in addition to rotavirus vaccination and breastfeeding, diarrhea prevention focused on safe water and improved hygiene and sanitation is not only possible, but cost effective: every $1 invested yields an average return of $25.50.
We know what works
A young girl drinks water from a safe storage vessel in her home.
I have learned through my work on the etiology, control, and prevention of enteric diseases in the developing world that most water sources in these countries are contaminated. If we were to test water sources where families draw their water for drinking and cooking, we would find many colonies of bacteria, such as E.coli, which is a sign of fecal contamination. And where there are feces, there’s the potential for disease, because that’s one way germs spread from one person to another. Yet, despite the enormity of the problem, there are proven ways to tackle diarrhea. They include:
· Vaccinate for rotavirus
· Provide safe water and adequate sanitation and human waste disposal
· Promote handwashing with soap and breastfeeding to reduce exposure to contaminated water
· Treat diarrhea appropriately with oral rehydration therapy and antibiotics
· Train health care providers and community health workers on diarrhea treatment
· Educate mothers and caretakers about caring for ill children and when to seek medical assistance
· Build laboratory diagnostic capability and identify the causes of diarrhea
Partnerships for action
To prevent diarrhea around the world, we must work together at all levels, using effective interventions and proven treatments. One example is the Safe Water System, which addresses household water treatment and safe water storage. It is a simple technology, but, setting up effective safe water programs in developing countries can be complex. We rely heavily on our partners at home and in the field. We work with local partners to determine appropriate packaging for the system, translate educational materials, and develop plans for distribution and use of the product.
Rob Quick (CDC) and Greg Allgood (Director, Children’s Safe Drinking Water Program, Proctor & Gamble) in Kisumu, Kenya. From blog: With a Little Help from My Friends: CARE, CDC, and SWAP Kenya.
Resources must be available to produce the locally branded diluted bleach solution and safe water storage containers, and, once the project is underway, we also must have the capacity to work with local partners to conduct research on usage rates of the system and its effectiveness in preventing disease and death.
From government investments in safe water infrastructure to individuals treating their household water and promoting handwashing in their communities, we can all do our part to prevent diarrhea and save lives.
-- Robert E. Quick MD, MPH, Medical Epidemiologist with the Waterborne Disease Prevention Branch, US Centers for Disease Control and Prevention, in Atlanta, Georgia.
Photo credits: 1 to 3 – CDC; 4 – Proctor & Gamble