Water and Sanitation
The Issue Safe drinking water and sanitation are necessities for human survival, and a lack of them is a main cause of malnutrition, disease, and death. South Asia has dramatically increased access to improved drinking water and is on track to meet that MDG target. However, despite significant improvement, nearly a billion people in South Asia still lack basic sanitation, which remains the region’s biggest public-health threat. Some 445 million South Asians gained access to improved drinking water sources from 1990-2004 (88 per cent of them in India and Pakistan), increasing coverage to 85 per cent. The absolute number of the region’s people without safe water declined by 32 per cent, from 326 million in 1990 to 222 million in 2004. Despite the continued conflict, Afghanistan increased access to safe water from just 4 per cent in 1990 to 39 per cent in 2004. Sri Lanka has already exceeded its MDG sanitation target, achieving 91 per cent coverage by 2004. But a further 243 million people must obtain safe drinking water by 2015. Rural populations suffer more than urban ones because they rely on unprotected surface sources and sources that have faulty construction and inadequate chlorination. At any given time up to a quarter of South Asia’s public water supply systems are not operational due to breakdowns and poor management. Contamination has emerged as a significant problem, especially the naturally high levels of arsenic and fluoride in some areas of Bangladesh, India, Nepal, and Pakistan. The problem is greatest in Bangladesh, where one in five of the country’s tubewells exceeds the government limit, putting some 20 million people at risk. Although South Asia’s improvement in sanitation has actually been even greater than that in drinking water (the percentage of those with access to sanitation has more than doubled from 17 per cent in 1990 to 37 per cent in 2004), 478 million still need to gain access by 2015 to meet MDG targets, and the 921 million South Asians living without toilet facilities represent more than a third of the world’s total. Urban populations are twice as likely to have access to latrines as rural ones. In India the difference is even greater – 59 per cent compared with 22 per cent. More than 600 million people in rural India live without basic sanitation. The number of South Asian townspeople without access to sanitation rose from 139 million in 1990 to 153 million in 2004. Access to improved water and sanitation services does not, on its own, lead to improved health. It is their correct use through hygienic behaviour – including safe disposal of faeces, washing hands with soap after defecating and before eating/preparing food, and handling and storing water safely – that leads to reduced disease and healthier children.
UNICEF has learned a great deal in its 40 years of assisting developing countries in the area of water and sanitation. The need for community-managed approaches has been embraced by most stakeholders, as has the importance of making a range of low-cost appropriate technologies (backed by effective supply chains) available to service providers, communities and families. UNICEF works to ensure community participation in decision making about water supplies and to spread the message that people can stay healthy by simply washing their hands with soap and water. UNICEF lobbies governments to affirm the importance of water, sanitation and hygiene in the overall development agenda, and to ensure that adequate resources are made available. In Afghanistan, UNICEF is assisting the government on a large-scale project to develop new water technologies as part of the national reconstruction process. UNICEF has been a major force in raising community awareness about arsenic poisoning and allaying fears that it is contagious. Through its local networks it has helped communities find alternative safe water sources, monitor contaminant levels in existing wells, and mitigate the harmful cumulative effects of exposure to arsenic. UNICEF has set itself an additional target beyond those of the MDGs, which is to ensure that all schools have adequate child-friendly water and sanitation facilities, and hygiene-education programmes. Hygiene education in schools will be an important influence on the region’s long-term performance in this area.
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