HOW WATER AND

SANITATION IMPACT HEALTH

BY K. KANJIRAWAYA
CONTENT
 Burden of disease due to unclean water and/or poor
sanitation and hygiene; infecting pathogens and diarrheal
diseases
 Methods for providing a supply of clean water
 Sanitation and other waste disposal methods
 Improving hygiene practices: schemes to encourage hand
washing and personal hygiene
 Future challenges in bringing safe water to all
 Improving sanitation and hygiene practices to reduce
diarrheal diseases
 The role of MDGs and SDGs related to water and sanitation,
 ‘WASH’ initiatives by UNICEF
Improving sanitation and hygiene
practices to reduce diarrheal diseases
 Diarrhoea remains a leading cause of death
globally among children under five years of
age.
 Diarrhoea contributes to nutritional

deficiencies, reduced resistance to infections

and impaired growth and development.
 Severe diarrhoea leads to fluid loss, and may

be life-threatening, particularly in young

children and people who are already
malnourished or have impaired immunity.
BURDEN OF DISEASE DUE TO
UNCLEAN WATER AND SANITATION
 Although a significant progress has been made
to increase access to water and sanitation
during the (MDG) era, more needs to be done.
 Over 663 million people still lack access to

improved drinking water.

 Some 2.4 billion people do not use improved

sanitation facilities, and almost 1 billion

practice open defecation.
 Many countries in Africa did not meet the MDG

targets for either water or sanitation.

TYPES OF DISEASES ASSOCIATED
WITH WATER
 Waterborne diseases are those caused by
ingestion of water that is contaminated by
human or animal excreta and contains
pathogenic microorganisms.
 Transmission occurs by drinking contaminated

water (faeco-oral).
 Waterborne diseases include most of the enteric

and diarrhoeal diseases caused by bacteria,

viruses, and protozoa:
Cholera, typhoid and bacillary dysentery.
Giardiasis, and amoebic dysentery.
CT………..
 Water-washed diseases are caused by poor
personal hygiene, and skin and eye contact
with contaminated water.
 They are also known as water-scarce

diseases because they occur when there is

not enough water available for adequate
personal washing.
 They include scabies, trachoma, typhus, and

other flea, lice and tick-borne diseases.

CT………….
 Water-based diseases are caused by parasites that spend
part of their lifecycle in water.
 For example, schistosomiasis and dracunculiasis are

both water-based diseases caused by helminths

(parasitic worms).
 Schistosomiasis (bilharzia) is caused by a worm that

spends part of its lifecycle in the body of a particular

species of water snail.
 People can become infected from swimming or walking

in infected water.
 Dracunculiasis (guinea worm) is transmitted by drinking

water that is contaminated the larvae of the worm.

GUINEA WORM
CT………….
 Water-related diseases are caused by insect
vectors, especially mosquitoes, that breed
or feed near water.
 They are not typically associated with lack

of access to clean drinking water or

sanitation services.
 Water-related diseases include dengue

fever, filariasis, malaria, onchocerciasis,

trypanosomiasis and yellow fever.
DIARRHOEAL DISEASES
 Diarrhoea is defined as the passage of three or more loose
or liquid stools per day (or more frequent passage than is
normal for the individual).
 Frequent passing of formed stools is not diarrhoea, nor is
the passing of loose, "pasty" stools by breastfed babies.
 Diarrhoeal disease is the second leading cause of death in
children under five years old: yet it is both preventable
and treatable.
 Each year diarrhoea kills around 525 000 children under
five.
 A significant proportion of diarrhoeal disease can be
prevented through safe drinking-water and adequate
sanitation and hygiene.
CT………….
 Diarrhoea is usually a symptom of an
infection in the intestinal tract, which can be
caused by a variety of bacterial, viral and
parasitic organisms.
 Infection is spread through contaminated

food or drinking-water, or from person-to-

person as a result of poor hygiene
CAUSES OF DIARRHOEA
 Infection: Diarrhoea is a symptom of infections
caused by a host of bacterial, viral and parasitic
organisms, most of which are spread by faeces-
contaminated water (faeco-oral route).
 Infection is more common when there is a shortage

of adequate sanitation and hygiene and safe water for

drinking, cooking and cleaning.
 Rotavirus and Escherichia coli, are the two most

common etiological agents of moderate-to-severe

diarrhoea in low-income countries.
 Other important

are cryptosporidium and shigella species.
CT…………
 Malnutrition: Children who die from diarrhoea often
suffer from underlying malnutrition, which makes
them more vulnerable to diarrhoea.
 Each diarrhoeal episode, in turn, makes their

malnutrition worse.
 Diarrhoea is a leading cause of malnutrition in

children under five years old.

 Contaminated water: water contaminated with human

faeces, for example, from sewage, septic tanks and

latrines, is a common source of diarrhoea.
 Animal faeces also contain microorganisms that can

cause diarrhoea.
 Other causes: Diarrhoeal disease can also
spread from person-to-person, aggravated
by poor personal hygiene.
 Food is another major cause of diarrhoea

when it is prepared or stored in unhygienic

conditions.
 Unsafe domestic water storage and

handling is also an important risk factor.

 Fish and seafood from polluted water may

also contribute to the disease.

TYPES OF DIARRHOEA
There are three clinical types of diarrhoea:
 Acute watery diarrhea: lasts several hours or

days, and includes cholera

 Acute bloody diarrhea: also called dysentery

 Persistent diarrhea: lasts 14 days or longer.

TREATMENT OF DIARRHOEA
Key measures to treat diarrhoea include the following:
 Rehydration: with oral rehydration salts (ORS) solution.

 ORS is a less costly mixture of clean water, salt and

sugar.
 It is absorbed in the small intestine and replaces the

water and electrolytes lost in the faeces.

 In severe dehydration or shock, rehydration is done

with intravenous fluids.

 Zinc supplements: zinc supplements reduce the

duration of a diarrhoea episode by 25% and reduces

stool volume by 30%.
CT…………..
 Nutrient-rich foods: the vicious circle of
malnutrition and diarrhoea can be broken by
continuing to give nutrient-rich foods.
 This includes breast milk (during an episode),
 Nutritious diet (including exclusive breastfeeding

for the first six months of life) – to children when

they are well.
 Consulting a health professional: in particular for:
management of persistent diarrhoea
when there is blood in stool: for antibiotic treatment
if there are signs of dehydration.
THREE TREATMENT INTERVENTIONS
 ORS
 Zinc supplementation
 Use of antibiotics for dysentery
PREVENTION OF DIARRHOEA
Key measures to prevent diarrhoea include:
 Access to safe drinking-water;
 Use of improved sanitation;
 Hand washing with soap;
 Exclusive breastfeeding for the first six months of

life;
 Improved weaning practices with hygienic foods
 Good personal and food hygiene;
 Health education about how infections spread; and
 Rotavirus vaccination.
METHODS OF SUPPLYING CLEAN
WATER
 Boiling
 Filtration
 Chlorine
 Iodine
 Purification tablets or drops
 Combination of filtering and disinfection
SANITATION AND OTHER WASTE
DISPOSAL METHODS
 Sanitation and other waste disposal methods
 Methods for dumping off waste:
 Landfill: this method involves burying off

the waste and this is the most common practice for

the disposal of waste around the Globe. ...
 Incineration:
 Methods for recycling:
 Biological reprocessing:
 Recovery of Energy:
 Reduction and Avoidance Methods:
 Waste handling and transportation
Future challenges in bringing safe water to all

Poverty
 Poverty is a major cause of public health

problems in developing countries.

 Poverty makes it difficult for people to access

safe water and find solutions for the

sanitation problems.
 Lack of resources, lack of education and

limited political, social and economic

influence all have a significant impact on the
provision of safe water.
CT……………..
 Climate change
 Rapid population growth

 Globalisation (Pathogens and vectors can

also travel around the globe.)

Improving sanitation and hygiene
practices to reduce diarrheal diseases
 Diarrhoea mostly results from lack of safe
drinking-water, adequate sanitation and
hygiene.

 A number of interventions are effective in

preventing diarrhoeal diseases, thereby
positively impacting the nutritional status of
those most vulnerable.
Improving sanitation and hygiene
practices to reduce diarrheal diseases
Interventions effective in preventing diarrhoeal
diseases include:
 Improving access to safe drinking water (e.g.

water safety planning-the management of water

from the source to tap; household water
treatment and safe storage)
 Improved drinking-water sources include:
Public taps or standpipes,
tube wells or boreholes, protected dug wells,
protected springs or rainwater collection
Piped water on premises: Piped household water connection
located inside the user’s dwelling, plot or yard.
CT…………..
 Improving access to improved sanitation
facilities
 Improved sanitation facilities ensure

hygienic separation of human excreta from

human contact.
 They comprise of the following facilities:

Flush/pour flush to: piped sewer system,

septic tank, pit latrine; ventilated improved
pit (VIP) latrine, pit latrine with slab,
composting toilet.
CT……………
 Hand washing with soap at critical times
(e.g. after toilet use and before the
preparation of food)
 Hygiene promotion, along with access to

safe drinking water and adequate sanitation

should be accessible by all.
WASH INITIATIVES BY UNICEF
 UNICEF's water, sanitation and hygiene (WASH) team works
in over 100 countries worldwide to improve water
and sanitation services, as well as basic hygiene practices.
  Clean water, basic toilets and good hygiene practices are
essential for the survival and development of children.
 Around 2.4 billion people do not use improved sanitation,
and 663 million have no access to improved water
sources.
 Without these basic needs, the lives of millions of children
are at risk.
 For children under five, water- and sanitation-related
diseases are one of the leading causes of death.
WASH
 WASH is the collective term for Water,
Sanitation and Hygiene.
 Due to their interdependent nature, these

three core issues are grouped together to

represent a growing sector.
 While each a separate field of work, each is

dependent on the presence of the other.

 For example, without toilets, water sources

become contaminated; without clean water,

basic hygiene practices are not possible.
Water
 UNICEF’s work in water focuses on the ability

for children to access safe water, the quality

of the water they can access and the journey
they must take to collect it.
 UNICEF is at the forefront of exploring

innovative ways to access water, and building

climate resistant infrastructure
Water
 UNICEF’s work in water focuses on the:
ability for children to access safe water,
quality of the water they can access
journey they must take to collect it.

 UNICEF is at the forefront of exploring

innovative ways to access water, and building
climate resistant infrastructure. 
Sanitation
 UNICEF works to ensure access and use of

basic toilets and ways to separate human

waste from contact with people.
 One important area of work for sanitation is

to end the practice of “open defecation,” and

 facilitate community-led initiatives to build,

maintain and use basic toilets. 

Hygiene
 UNICEF’s work in hygiene is aimed at

nurturing good hygiene practices, especially

hand washing with soap.
 Although it sounds simple, this act is

essential to prevent disease and the health of

children. 
 All three areas in WASH support and

strengthen one another.

 If one is missing, the others cannot progress.
HYGIENE PROMOTION
 Hygiene promotion is not simply a matter of
providing information.
 It is more of a dialogue with communities

about hygiene and related health problems,

to encourage improved hygiene practices.
THE ROLE OF SDGs
 Goal 6 of the SDGs aims to “ensure
availability and sustainable management of
water and sanitation for all.”
 This goal is more ambitious than previous

development goals because it addresses the

entire water cycle:
 It outlines targets to manage water under

scarce conditions, maintain water for

ecosystems and improve management of
wastewater.
 While all the goals are integrated and support
one another, access to water and sanitation is
essential for the attainment of the other 16
goals
 For example, Goal 11, on urbanization, includes

a target aimed at reducing the number of

deaths attributable to water-related disasters.
 Goal 13, on climate change, calls for urgent

action to reduce the impacts of climate change

risks.
THE END