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  4. Access to Safe Water, Sanitation, and Hygiene

Access to Safe Water, Sanitation, and Hygiene

    People at water well, India
    (NCEH/ATSDR is working with the Ministry of Health in
    India on several safe water and sanitation initiatives)

    In the 19th Century, industrialization and immigration caused a shift in population from rural to urban areas, which led to overcrowding and inadequate housing. Many urban residents had poor or no public water supplies and waste-disposal systems. These conditions caused repeated outbreaks of cholera, dysentery, TB, typhoid fever, influenza, yellow fever, and malaria. Such infectious diseases were controlled by local, state, and federal efforts to improve water supplies, wastewater disposal systems, and hygiene practices. Today, the same conditions exist in many developing nations, and CDC can play a major role in the transition.

    In developing countries, diseases associated with water, human excreta, chemical exposure, and poor hygiene practices use up scarce health care resources and cause preventable deaths. Worldwide, deaths from preventable waterborne diseases are estimated at 5 to 10 million per year, with 10,000 to 20,000 children dying of such diseases every day. If left unchecked, these diseases will continue to exhaust human resources and slow the progress of developing countries. Rapid population growth, urbanization, migration, poverty, economic instability, and changes in political leadership make the problem worse. Such diseases in developing countries affect the United States. For example, imported foods and visitors to the United States may reintroduce diseases from developing countries. The threat of SARS and vector-borne diseases show how the United States is susceptible to diseases that are emerging in other parts of the world.

    The World Health Organization (WHO) reports that 20% of the world’s population (1.1 billion people) don’t have enough drinking water. Ensuring an adequate supply of water is often more important than the quality of water, when it comes to directly affecting people’s health. Without enough water, personal hygiene is difficult and water-borne diseases (such as louse-borne typhus) are more prevalent. The frequent washing of hands with soap and water can reduce diarrheal disease transmission by one-third. Sanitation facilities are significantly worse: 40% of the world’s population (2.5 billion people) don’t have improved sanitation facilities. Poor water management is closely linked to many helminth (parasitic worms), protozoan, and insect-carried diseases.

    Developing countries need a basic environmental health infrastructure to prevent and control diseases related to water and sewage. CDC has the expertise to help developing countries create such an infrastructure.

    NCEH/ATSDR EXPERTISE AND EXPERIENCE

    With public health partners, CDC promotes environmental public health service programs to prevent and control diseases related to water supplies, wastewater processing, and poor hygiene practices. NCEH/ATSDR participates in international activities related to water, wastewater, and hygiene. These activities range from giving technical assistance in environmental public health assessments to conducting epidemiologic studies.