Ten years on: hope stuck in the mire

A newborn baby girl and her sister in Zambia where sanitation coverage is a mere 52%.

Credit: WaterAid / Anna Kari

8 September 2010

Damning new report marks signing of UN Millennium Declaration

International development organisation WaterAid today launched a damning new report to mark the ten year anniversary of the signing of the UN Millennium Declaration.

According to WaterAid, governments that signed the declaration are now presiding over populations where billions are living and dying in their own faeces for want of somewhere clean and safe to go to the toilet. 

The report - Ignored: biggest child killer – The world is neglecting sanitation ( PDF 1.4 Mb) - comes just two weeks before world leaders will meet again at the UN to review the eight Millennium Development Goals (MDGs) that were set out in 2000 to halve the proportion of people living in extreme poverty. At current rates of progress, the 2015 target to halve the proportion of people living without sanitation will not be met globally until 2049; and in Sub-Saharan Africa not until the 23rd century, some 200 years late.

The ongoing neglect of the sanitation MDG target represents a damning failure by governments and the aid community to promote an integrated approach to international development.  Policy and Campaigns Director Margaret Batty

"The hope embodied in the declaration of 2000 is mired in excrement," said WaterAid Policy and Campaigns Director Margaret Batty. "The ongoing neglect of the sanitation MDG target represents a damning failure by governments and the aid community to promote an integrated approach to international development."

Drawing on authoritative medical, academic and grassroots sources, the report argues that without sanitation in place the MDGs will not be reached across large parts of the developing world and that the health, education and prosperity of some of the world's poorest and most vulnerable people will be severely jeopardised.

Diarrhoeal diseases caused by poor sanitation and unsafe water kill more children than AIDS, malaria and measles combined, while in Africa diarrhoea is now the biggest killer of under-fives according to a recent study in The Lancet. Some 4,000 children die needlessly every single day.

The report also shows other critical health risks that arise due to a lack of sanitation, safe water and hygiene:

• Repeated diarrhoea is associated with 50% of childhood malnutrition.
• Poor sanitation and hygiene impact maternal and newborn health – a recent study shows that washing hands with soap by mothers and birth attendants can reduce the risk of neonatal deaths by 41%.
• Without sanitation, safe water and good hygiene practices, patients with already lowered immune systems have their recovery and survival chances radically reduced, particularly those living with HIV/AIDS.
• Diseases related to unsafe sanitation and water and poor hygiene place a huge burden on under-resourced health systems: at any one time half the hospital beds in developing countries are filled with people suffering from diarrhoea.

Download Ignored: biggest child killer – The world is neglecting sanitation
( PDF 1.4 Mb)

In the report health experts Dr Jamie Bartram (ex WHO, University of North Carolina), Professor Vivienne Nathanson (British Medical Association) and Professor Sandy Cairncross (London School of Hygiene and Tropical Medicine) warn of dire consequences if sanitation is not addressed at the upcoming summit.

These are avoidable deaths; we have known their cause and the means to reduce them for generations. Watching children die who we can help to flourish is unacceptable.  
Professor Vivienne Nathanson (British Medical Association) 

"The millions of premature deaths in infants will continue until safe sanitation and water is readily available and excreta is removed from the living environment," said Professor Nathanson. "These are avoidable deaths; we have known their cause and the means to reduce them for generations. Watching children die who we can help to flourish is simply unacceptable."

Beyond the direct impact on health, WaterAid reports that lack of sanitation severely impacts other areas of human development. Children sick with diarrhoea miss days on end from school, girls drop out of class because of a lack of sanitary facilities, while repeated illness stunts intellectual development. People chronically sick with diarrhoea and other diseases related to unsafe sanitation and water are unable to work, while large proportions of health budgets are spent trying to treat these preventable illnesses, diminishing the economic prosperity of developing countries.

Community members from Uganda, Zambia, Burkina Faso, Bangladesh and Timor Leste also feature in the report, providing hard-hitting testimonies where lives, health and education are in jeopardy due to a lack of sanitation.

According to Dr Eumu Silver, Head Doctor at Amuria Health Centre in Uganda, "Death from diarrhoeal diseases… can be stopped this century. We cannot afford to have our people die from illnesses which can be stopped. We don't need rocket science to prevent them."

WaterAid's Margaret Batty concluded: "The health, education, economic prosperity and lives of the world's poorest people are being threatened because of governments' and the aid community's blindspot when it comes to sanitation.  World leaders must honour their MDG promises. Let us be clear – the future success of global development efforts depend on it."

WaterAid is calling on leaders at the MDG Summit to:

• Ensure that the MDG action plan recognizes sanitation as a critical sector in human development efforts, and in the achievement of development outcomes.
• Reform the aid system, ensuring that action is integrated and coordinated.
• Evidence must inform political priorities and the necessary financial allocations for achieving the MDGs.
• Endorse the Sanitation and Water for All Partnership to raise international commitments from governments and champion pro-poor change.

Find out more about WaterAid at the MDG+10 conference in New York, and read and watch compelling case studies.

For all media enquiries, an embargoed copy of the report, high res images, footage or to speak to a spokesperson, please contact: Chloe Irvine on 07514 941577 / 020 7793 4909 chloeirvine@wateraid.org OR Ann Noon on 07787 414307 / 020 7793 4790 annnoon@wateraid.org.

Notes to editors:
A dramatic photo op symbolising the number of children who die every hour from diarrhoea (167) will take place on Wednesday 8 September, 8.30 to 10am, in London’s iconic Trafalgar Square to coincide with the launch of Ignored: the biggest child killer. The installation forms part of WaterAid's new Dig toilets Not graves campaign which highlights the fact that these deaths can be entirely prevented through simple and cost-effective measures such as building safe pit toilets. Spokespeople will be available for interview at Trafalgar Square.