Health Care in Sudan
Sudan is rich in natural and human resources; however, it is poverty and conflict-stricken. Agriculture is an income provider for 70 percent of the populace. Due to a lack of resources and training availability, the health care sector of the country remains underfunded and understaffed. Here are ten facts about health care in Sudan.

10 Facts About Health Care in Sudan

  1. Approximately 14 percent of Sudanese do not have access to health care. This is largely due to the fact that Sudan has a critical shortage of health care workers. According to the World Health Organization, there are 23 qualified health care workers per 10,000 members of the population.
  2. Sudan’s maternal mortality rate has improved, but it varies by region. In 2015, the maternal mortality rate was 311 per 100,000 live births. This was a significant improvement from 744 per 100,000 live births in 1990. Unfortunately, these rates are not consistent across the country. While more recent data is not available, in 2006, the maternal mortality rate in Southern Kordofan was 503 per 100,000 live births. In the Northern state, however, the rate was only 91 per 100,000 live births.
  3. Approximately 32 percent of Sudan’s population is drinking contaminated water from untreated water sources. This is a result of chemical and bacterial contamination from industrial, domestic and commercial waste that degrades the water quality. There are acts at the state and national levels to help prevent this washing and injection; however, these acts need activation. UNICEF is working with the Sudanese government to increase access to basic treated water supplies for the people of Sudan, with a focus on women and children.
  4. Sudan suffers from outbreaks of cholera, dengue fever, Rift Valley fever (RVF), chikungunya and malaria. Increased outbreaks in 2019 were, in part, a result of heavy rainfall during the rainy season. Consequently, this rainfall left behind stagnant pools which were breeding grounds for mosquitos, contributing to the spread of infection. Government authorities and their humanitarian partners worked to respond to outbreaks across the country. The Kassala and North Darfur Ministries of Health launched weekly response task force meetings and developed state-level plans to mitigate the outbreak.
  5. Sudan has widespread micronutrient deficiencies. This is partially due to insufficient levels of crop growth. Only 14 percent of 208 cultivable acres are being cultivated. Drought, pests and environmental degradation also contribute to widespread malnourishment. However, vitamin A deficiency decreased due to repeated vitamin A supplementation given during National Immunization Day campaigns.
  6. Many Sudanese women and girls lack adequate health care and resources. Women and girls living in the rebel-held areas of Southern Kordofan or the Nuba Mountains of Sudan have very limited or no access to contraception. Human Rights Watch found most of the women interviewed did not know what a condom was and was unfamiliar with other common contraceptive practices. This lack of education and the low availability of condoms are why there are high percentages of women testing positive for hepatitis B. Consequently, gonorrhea and syphilis are on the rise in Sudan.
  7. The National Expanded Program on Immunization in Sudan supports an increase in routine immunization coverage. In addition, the government’s financial investment to EPI and polio eradication program is 15 million USD. Challenges the program faces include poor service delivery and a lack of resources and skilled staff.
  8. Sudan spends 6.5 percent of its gross domestic product and 8.3 percent of government spending on health care. Before the 1990s, receiving care at public health care facilities was mostly free. However, the structural reforms of 1992 introduced user fees. Now, out-of-pocket expenses for patients hover in the 70 percent range.
  9. There are 75 degrees and diploma-granting health institutions in Sudan. About 28 of these institutions offer diplomas and 47 of these schools offer degrees. There are 14 private institutions, while the others belong to agencies such as the Federal Ministry of Health and other government agencies. In 2001, the Federal Ministers of Health and Higher Education signed a Sudan Declaration and Nursing and Allied Health Workers in 2001. The goal of the declaration was to improve nursing and other health care education. The Academy of Health Sciences was established in 2005 to help implement this goal.
  10. The Sudanese government is working to rebuild and reform the health care system. A 25-year plan spanning from 2003 to 2027 was created in the early 2000s. This plan focuses on ensuring health care services are accessible and high quality, particularly for impoverished and vulnerable populations.

These ten facts about health care in Sudan illuminate some of the struggles the nation has faced, as well as improvement efforts by the Sudanese government and other humanitarian organizations. It is imperative that these efforts continue in order for health care to continue to progress in Sudan.

Robert Forsyth
Photo: Flickr

Facts About Sanitation in Croatia
The Republic of Croatia is a country in Southeast Europe. After declaring independence from Yugoslavia, Croatia went through a period of bitter conflict. Under U.N. supervision, Croatia entered NATO in April 2009 and the E.U. in July 2013. Situated next to the Adriatic Sea, Croatia is one of the most popular tourist destinations in Europe. Croatia has abundant but unevenly distributed sources of water. Here are 10 facts about sanitation in Croatia.

10 Facts About Sanitation in Croatia

  1. Currently, 99.6 percent of people in Croatia have access to improved drinking water. The majority of the Croatians have access to public water infrastructure. The Croatian Ministry of Health monitors the country’s water infrastructure.
  2. Some Croatian islands can procure their own water supply. Croatia has over 1,000 islands as part of its territory. Croatian islanders sometimes procure their own water by building private wells, harvesting rainwater and water slimming. Some islands also have their own water infrastructure such as desalination plants or water pumping stations near a water source.
  3. The World Bank aided in improving sanitation in Croatia. In 2018, the World Bank stated that the six-year-long project, which the World Bank funded, improved sanitation in Croatia. After the conclusion of its $87.5 million project, the World Bank stated that the country eradicated the practice of discharging untreated sewage into the ocean.
  4. Coastal water contamination is an issue that needs attention. People know Croatia for its beautiful beaches. This contributes to Croatia’s booming tourism industry, which constituted about 20 percent of the country’s GDP in 2016. This makes it especially important for Croatia to maintain the swimming water quality of its coasts. Recognizing this importance the Croatian government requested project support from the World Bank. The project, which lasted from 2009 to 2015, strengthened water supply and sanitation services across 23 municipalities. The World Bank reports that this project benefited over 230,000 people.
  5. The European Union’s Cohesion Fund is further supporting the modernization of sanitation in Croatia. On March 1, 2020, the E.U. approved the investment of more than 128 million Euros (143,143,808 USD) from the Cohesion Fund to improve sanitation in Croatia. The supported project aims to give access to high-quality drinking water and wastewater treatment to more than 29,000 people.
  6. There are concerns over possible pharmaceutical pollution in the Sava River. Located 15 kilometers upstream from Zagreb, the capital city of Croatia, there are concerns over possible contamination of the city’s water source. Nikolina Udikovic Kolic, a microbiologist who raised this concern, reported that bacteria in the Sava River are possibly developing antimicrobial resistance. This is problematic since this means that there is a chance that a superbug could develop from this river which can resist anti-bacterial chemicals. Kolic suggested that a factory that Pliva owns, which is Croatia’s biggest drugmaker, might be responsible for polluting the waterways.
  7. Around 97 percent of people in Croatia have access to improved sanitation facilities. The percentage of people without basic sanitary facilities decreased since 2012. Compared to 2012, when 1.9 percent of the population lacked access to basic sanitary facilities, the conditions improved to only 1.1 percent of the population in 2018.
  8. While access to flush toilets in rural areas is nearly universal, people have limited access to sewerage services. A 2018 study found that 94 percent of rural areas had access to flush toilets. Nearly 93 percent of flush toilet users had on-site fecal sludge containment facilities. However, among the interviewed households, only 12 percent of them had access to sewerage services.
  9. People in the poorest wealth quintile are the ones who lack access to piped water access and flush toilets. The same 2018 study stated that 25 percent of the rural Croatian population relies on self-supplied water and sanitation facilities. The main reason these houses were not connected to the public system was that these houses’ were physically not able to connect to the network.
  10. Climate change poses multiple threats to sanitation in Croatia. A 2012 study that the E.U. and other organizations conducted studied the impact that climate change could bring to Croatia. Experts suggest that the potential decrease in precipitation can diminish groundwater levels, which will affect the supply of drinking water in Croatia.

These facts about sanitation in Croatia show that it maintains adequate service quality and access to service. The wide availability of sanitation facilities and water facilities is making life better for many Croatians. However, for the residents of rural communities in Croatia, the need for improvement is apparent. The Croatian government and many other international organizations are addressing this need. Organizations such as the World Bank are working with the Croatian government to improve sanitation in Croatia. With all the dangers that climate change poses, the need for sustainable development is also paramount. With all this assistance, better sanitary conditions are coming for the people of Croatia.

– YongJin Yi
Photo: Flickr

Sanitation in Kuwait
Kuwait, or the State of Kuwait, is a country between Iraq and Saudi Arabia. After obtaining its independence from Britain in 1961, Kuwait was invaded by Iraq in Aug. 1990. In Feb. 1991, a U.S.-led U.N. coalition liberated Kuwait in four days. After their liberation from Iraq, Kuwait’s many tribal groups staged protests demanding their political rights. The oppositionists, mainly composed of Sunni Islamists, tribal populists and liberals, won nearly half of the seats in the national assembly in the 2016 election. Here are 10 facts about sanitation in Kuwait.

10 Facts About Sanitation in Kuwait

  1. There are no permanent rivers or lakes in Kuwait. While there aren’t any permanent water sources in Kuwait, there are Wadis, also known as desert basins. These basins fill with water during winter rains, which occur from Dec. to March. However the low amount of rainfall, which is about 121mm per year, and the high evaporation rate of water in Kuwait’s climate make rainfall an unreliable source of water.
  2. In 2015, Kuwait was on the World Resources Institute’s (WRI) list of countries with the highest water risk by 2040. Countries such as Bahrain, Palestine, Qatar, UAE, Israel, Saudi Arabia, Oman and Lebanon were on the same list. The WRI pointed to the Middle-East’s already limited water supply and climate change as criteria for their country rankings.
  3. In Kuwait, 99 percent of people have access to improved drinking water. Kuwait also has a well-developed water infrastructure. However, the country’s rapidly growing population since 2000 is putting a toll on Kuwait’s water supply. Even as early as 1946, Kuwait was importing 80,000 gallons of fresh water per day.
  4. Kuwait’s over-reliance on groundwater led to its reliance on desalinization for drinking water. Even during the early 20th century, the shallow wells that collected rainwater were drying out. According to the 2019 U.N. report, these desalination plants produce around 93 percent of Kuwait’s drinking water.
  5. Desalination is expensive. While some might think that desalination plants are the answer to Kuwait’s water supply problem, the cost of operating desalination plants can’t be ignored. Per cubic meter, desalinated water can cost up to $1.04. Adding on to this the price of energy, which accounts for three-fourths of the cost, and transportation, it is easy to see how expensive desalination is.
  6. In 2017 and 2018, the WHO recognized the excellent water quality in Kuwait. This recognition is a testament to the Kuwait government’s commitment to water quality in its country. However, the Director of Water Resources Development Center emphasized the importance of landlords, who are responsible for the quality of water for their buildings, in keeping water storage tanks free of bacterial infection.
  7. The Water Resources Development Center (WRDC) uses real-time GIS (Geographic Information System) to monitor water quality and sanitation in Kuwait. While desalination plants produce clean water, multiple factors such as damaged water pipes or an aging water infrastructure can lead to water contamination. The GIS allows WRDC to collect and process water data from numerous sensors throughout Kuwait in real-time.
  8. The CIA estimated in 2015 that 100 percent of the Kuwait population has access to improved sanitation facilities. This reflects the Kuwait government’s commitment to public health and sanitation. In 2013, for example, Kuwait invested $5.28 billion in its water sector. Water treatment plants received the highest investment of $3.4 billion.
  9. Kuwait is expanding its sewage treatment facilities. In 2018, a German-Kuwait consortium closed a $1.6 billion contract to expand Kuwait’s Umm Al Hayman (UAH) sewage treatment plant. When the facility’s expansion finishes, experts estimate that the new plant will process 700,000 cubic meters of sewage per day, compared to the original capacity of 500,000 cubic meters.
  10. Kuwait is working on more efficient usage of water. In 2011, the Kuwait Institute for Scientific Research (KISR) stated that Kuwait had the highest water consumption in the world. UNDP’s 2019 report indicates that efficient usage of water in Kuwait rose from zero percent in 2012 to 15.1 percent in 2016. MOEW (Ministry of Electricity and Water) achieved this by conducting community awareness-raising activities or building water tanks and wells to ensure long-term water conservation.

These 10 facts about sanitation in Kuwait highlight the success the nation has had in maintaining and providing sanitary water. However, Kuwait must now turn its attention toward securing stable sources of water. With the ever-looming threat of climate change, the UNDP recommends that Kuwait focus on sustainable development.

– YongJin Yi
Photo: Flickr

Malaysia’s Improvements in Water and Sanitation
Malaysia is one of many developing countries on the rise out of poverty and into wealth and prosperity. Like many developing countries, Malaysia had to make adjustments to its way of life. One of those changes was improving access to clean water and hygienic sanitation. Today, improvements to water and sanitation in Malaysia have made the country a model for other developing countries working to ensure stable and healthy livelihoods.

Improvements to Water and Sanitation in Malaysia

Malaysia’s efforts to provide access to clean water and pipe systems can be seen in data that has been collected. According to The World Health Organization/UNICEF Joint Monitoring Program, reports taken in 2015 show that approximately 92 percent of Malaysian people have access to properly managed water supplies and 82 percent have access to hygienic sanitation services. Compared to other developing countries, these numbers are better than expected.

To tackle issues in clean water and sanitation access, Malaysia joined Vision 2020 in 1991 under Prime Minister Mahathir Mohamad, setting out with a goal to reach developed country status by the year 2020. In addition to solving Malaysia’s water and sanitation issues, the agreement set out to address many other issues as well, including climate change, societal division, financial challenges and needed improvements in technological advancements.

World Water Vision

Under Vision 2020 is the World Water Vision process, which was established by the World Water Council. The World Water Council is an international water policy think-tank co-sponsored by the Food and Agriculture Organization, the World Health Organization, the World Meteorological Organization, the World Bank and several United Nations programs. The global project set out to implement extensive consultation and to incorporate innovative ideas in the creation of future technology to ensure water access for all.

On a more national level is the Malaysian Water Visioning process. Supported by the Malaysian Water Partnership and the Malaysian National Committee for Irrigation and Drainage, it carried out consultations to determine the proper distribution of water for food and rural development at the national and regional levels. It also implemented extensive water sector mapping and studies on gender disparities pertaining to water access and control.

Case Study: Orang Asli Communities

Although water and sanitation access has improved tenfold, some important groups are still in need of aid. These groups include the poor, immigrant families and people living in secluded rural areas.

To better understand the problem, a case study was done on the Orang Asli communities of indigenous people. Compared to other parts of Malaysia, their health issues are worse than average, infant mortality was double the national figure and parasitic infections were as high as up to 90 percent in certain communities. Most of these issues, if not all, were largely due to poor access to clean water and sanitation.

The Orang Asli and the Global Peace Foundation worked together to create the Communities Unite for Purewater (CUP). This came after carrying out extensive interviews, workshops and other interventions. CUP combats poor water and sanitation access through the installation of water filters and pumps.

As a result, Orang Asli people no longer have to travel miles to get clean water. The new water pumps draw water from wells and transport it into filtered water storage tanks. These are then distributed to each household through a pipe system. The Orang Asli people have stated that this significant change has made their lives much easier. There are also now less prone to diarrhea and fevers.

Moving Forward

Malaysia has come a long way to improve its water and sanitation systems, making it one of the most promising developing countries in the world today. Malaysia has used many innovative ideas and tactics to overcome its water and sanitation issues, including creating initiatives through partnerships, promoting education and doing extensive research. One thing Malaysia will have to work on while on its road to success is to pay better attention to poorer groups to ensure that they get access to clean water and sanitation as well. In order to strive for peace, there must be equal and fair treatment for everyone, regardless of social class.

– Lucia Elmi
Photo: Pixabay

Sanitation in The Bahamas
The Bahamas is still recovering from the aftermath of Hurricane Dorian, which greatly injured two of the countries’ islands in late 2019. However, the residents are facing a bigger challenge involving access to clean water and toilets, which is putting them at great risk of a major public health emergency. Here are 10 facts about sanitation in The Bahamas.

10 Facts About Sanitation in The Bahamas

  1. The Lack of Access to Clean Water: A lack of access to clean water often becomes a public health issue very quickly. A lot of the water in The Bahamas became contaminated with salt water right after the hurricane. Water Mission, a nonprofit organization based in North Carolina, designs, builds and implements safe water and sanitation solutions. After the Dorian hurricane, the organization tried to help sanitation in The Bahamas by implementing a process called fine-filtration, which removes salt from water through reverse osmosis.
  2. Diseases: Each day, around 6,000 children die from waterborne diseases around the world. The Grand Bahama Island experienced flooding after Hurricane Dorian, potentially increasing the transmission of waterborne diseases like diarrhea and cholera. UNICEF has provided aid by providing WASH services. Additionally, Heart to Heart International has been on the ground in the aftermath of Hurrican Dorian, administering tetanus vaccines to prevent infections from unclean water.
  3. Sewage: The Bahamas has always struggled to bring clean water to its community. The Water and Sewerage Corporation emerged in 1976 to help bring clean water to all islands and received $32 million from the World Bank. By 2014, the corporation had saved over one billion gallons of water through the reduction of water losses in New Providence.
  4. Hospitals and Housing: The Bahamas has 28 health centers, 33 main clinics and 35 satellite clinics plus two private hospitals located in the main inhabited islands. After the Hurricane hit the Islands, the International Medical Corps provided help to The Bahamas by bringing in doctors and nurses, as well as water, sanitation and hygiene specialists and 140 water kits comprising of family filters and hygiene kits.
  5. Economy: With 14 other islands in good shape in the aftermath of Hurrican Dorian, the government encouraged tourists to not cancel their vacation trips. The Minister of Tourism in The Bahamas said in an interview with The New York Times that the only means of aiding those in the north of The Bahamas was to continue tourism in the other 14 islands. This would allow the country to rebuild Abaco and Grand Bahama and help fix sewage and provide clean water. Around 4 million tourists visited The Bahamas in the six months before the hurricane, and only 20 percent of those travelers visited Abaco and Grand Bahama Island. This represented more than half of its gross domestic product.
  6. Health Care: Health Care has been one of the main priorities in The Bahamian governments’ agenda. In fact, it directed 12 percent of its budget to health. Around 47.2 percent of the general population had health insurance, and females were more likely to get insurance (47 percent) than males (45 percent). The primary care package in The Bahamas is medical services, medications and imaging and laboratory services. After the hurricane, the Pan American Health Organization (PAHO) sent professionals to assist in on-site assessments of health infrastructures and water sanitation and hygiene facilities (WASH) that had operation rooms flooded with contaminated water.
  7. Urban vs. Rural: Urban areas often bring development, better health care and living conditions. However, despite the fact that The Bahamas has a high percentage of urban areas at 83 percent in comparison to the 16.98 percent of rural areas, it still has limited water development. In fact, the country is not in the top 20 for the Caribbean.
  8. Current Poverty Rate: Sanitation in The Bahamas is always in danger because of the constant threats of new storms passing by the islands. In 2017, before hurricane Dorian, 14.8 percent of the population lived below the poverty line. That percentage grew rather than decreased leading up to 2017.
  9. Population Growth: The Bahamas had a population of 392,225 as of 2020, but has been suffering a decrease since 2007. In that year, the growth percentage was at 1.7 percent, whereas it was at 0.97 percent in 2020. With the increase in population, the National Health System Strategic Plan is aiming to educate communities to ensure optimal health and good quality of life. However, even with numbers, The Bahamas is still a country with limited basic sanitation services.
  10. Menstrual Hygiene Management: After hurricane Dorian, many women and adolescents did not have shelter or access to toilets. This presented a lack of privacy and compromised their ability to manage menstruation hygienically and with dignity. The Women’s Haven, a company distributing organic feminine hygiene products, wants to help Bahamians by switching to a better approach that will help improve their menstrual hygiene.

While Dorian impacted sanitation in The Bahamas in late 2019, the challenges for clean, accessible water continues to affect Bahamians today. With continued investment in tourism and the involvement of relief organizations, The Bahamas should hopefully recover soon.

– Merlina San Nicolás
Photo: Pixabay

10-Facts-About-Sanitation-in-Yemen
Yemen is currently going through a severe civil war. The Yemeni government’s failed political transition has led to multiple uprising since 2015. As the conflict enters its fifth year in 2020, the effects are becoming clearer. At the end of 2018, over 6,800 civilians had been killed. An additional 10,768 people were wounded and the conflict also had a significant impact on Yemen’s infrastructure. Sanitation is one aspect of Yemen’s infrastructure that has been affected the most by the ongoing conflict. Here are 10 facts about sanitation in Yemen.

10 Facts About Sanitation in Yemen

  1. Water is a scarce resource in Yemen. Before the current civil war began in 2015, experts already warned that Yemen’s capital city, Sana’a, might run out of water in 10 years. In a BBC report, they noted that this water problem is exasperated by farmers drilling underground wells without any government regulations.
  2. In 2018, an estimated 19.3 million people did not have access to clean water and sanitation. Years of aerial bombing and ground fighting destroyed Yemen’s water facilities. The power plants that supplied electricity to power water pumps and purification plants were also destroyed. This has put the quality of water and access to water in jeopardy.
  3. People in Yemen depend on private water suppliers for their water, as a result of the destruction of public water infrastructure. An estimated 56 percent of residents in the city of Sana’a and 57 percent in the city of Aden depend upon these private water distributors.
  4. This reliance on private water distribution contributes to high water prices. Private water distributors set their water prices based on the prevailing market price and the distance traveled to deliver their water. Since many of the wells close to populations are drying up, the distance these distributors need to travel is increasing. In the city of Sana’a, on average, people are paying 3.8 times more for water than if they had access to the public water supply network
  5. The weaponization of water use as a siege tactic in Yemen. The Saudi-UAE coalition and the Houthi rebels use water as a way to carry out strategic military operations. In 2016, Saudi forces carried out a strategic bombing of a reservoir that served as a source of drinking water for thirty thousand people.
  6. Access to improved latrines decreased from 71 percent in 2006 to 48 percent in 2018. Unsurprisingly, places that prioritized the rampant famine and cholera outbreak had the lowest rates of access to improved latrines. Furthermore, the majority of female respondents reported that their access to the latrines was particularly challenging because the majority of the latrines are not gender-segregated.
  7. Water in Yemen is often not sanitary. This is a result of the direct impact the civil war has on the sanitation in Yemen. Cholera remains the most significant threat to water quality, with Yemen still recovering from the cholera outbreak of 2017. As of November 2019, there were 11,531 suspected cases of cholera in Yemen.
  8. Destruction of wastewater treatment plants is contributing to poor sanitation in Yemen. Without facilities to treat wastewater, raw sewage is usually diverted to poor neighborhoods and agricultural lands. This leads to further contamination of local water wells and groundwater sources.
  9. UNICEF undertakes many restoration efforts for water treatment facilities in Yemen. For example, UNICEF restored a water treatment plant named Al Barzakh. This plant is one of the 10 water treatment centers that supplied water to Aden, Lahij and Abyan governorates. This $395,000 restoration project had a major impact. Cholera cases in the region dropped from 15,020 cholera cases in August 2017 to 164 cases in January 2018.
  10. The World Bank Group’s International Development Association is working on a 50 million-dollar project to provide electricity in Yemen. The project aims to provide solar-powered electricity to rural and peri-urban communities in Yemen. In addition to supplying powers to Yemeni schools, the project will improve sanitation in Yemen by providing power to water sanitation facilities. This is especially important for girls’ education in Yemen since the burden of water collection usually falls upon girls, often deterring girls from going to school.

These 10 facts about sanitation in Yemen highlight continuing problems as well as several efforts to address them. Water was already a scarce resource in Yemen even before the current conflict started in 2015. As the Yemeni civil war enters its fifth year, the effects of the deteriorating sanitation in Yemen are more than clear. However, efforts by groups such as UNICEF and the World Bank are working to fund, build and restore many sanitation facilities in Yemen. With the recent indirect peace talk between the combatants, many hope that conditions in Yemen will improve in the future.

– YongJin Yi
Photo: Flickr

10 Facts About Sanitation in Sudan

Sudan is the third-largest country in Africa and boasts a rich history that traces back to antiquity. Decades of unrest and civil war have crippled the economy and seriously stunted the development of domestic infrastructure, including basic sanitation. In recent years, the Sudanese government, along with the international community, has taken steps towards addressing these challenges. Here are 10 facts about sanitation in Sudan.

10 Facts About Sanitation in Sudan

  1. Open Defecation: More than 30 percent of the population practices open defecation, which is more than any other North African nation. This practice is most prevalent in rural areas where nearly 70 percent of Sudan’s population resides. Open defecation poses serious risks to clean water sources and exposes a large portion of the population to diseases like cholera, dysentery, typhoid, hepatitis and intestinal parasites.
  2. Waterborne Illnesses and Poor Sanitation: The most common result of absent clean water sources is dysentery. In Sudan, diarrhea causes around 12 percent of child deaths. Cholera outbreaks are common, the most recent being in October 2019 and infecting nearly 300 people.
  3. Menstrual Hygiene: People in Sudan treat menstruation with a lot of stigma and shame. Many women resort to unsanitary devices to conceal menstrual bleeding. Unsafe water also increases the chance of infection. Female hygiene resources and education in rural areas have been instrumental in reducing illness, infection and childhood mortality rates. UNICEF has helped develop gender-segregated bathrooms at schools to provide private space for girls to assist with menstrual management.
  4. Water Treatment Facilities: In the last 10 years, Sudan pledged $1 billion in funding for the development and maintenance of clean water sources, wells and pumping stations with the help of the international community. The use of these improved water sources has increased by 55 percent.
  5. WASH: Sudan has targeted rural areas with the WASH (water and sanitation hygiene) initiative with the help of NGOs like Near East Foundation (NEF), USAID and UNICEF. They hope to ensure clean water access to all Sudanese households by 2025 by drilling wells and developing water sanitation facilities.
  6. International Community: WHO and UNDP have been key in their funding of NGOs in Sudan, specifically UNICEF. In fact, 2.3 million Sudanese gained access to clean water between 2013 and 2015 because of their efforts.
  7. Civil Unrest: Sudan has experienced multiple civil wars and a 30-year-long military dictatorship under Omar al-Bashir. Due to these events of civil unrest, many areas of state development suffered underfunding or neglect. In April 2019, protests forced Omar al-Bashir to resign his post. This has instilled new hope and desire for social-civilian infrastructure to address public health and sanitation.
  8. Poor System Supply Chains and Limited Government Resources Diminish Clean Water Access: Sudan has worked to improve clean water access in recent decades, but while 68 percent of households have access to some form of clean water, nearly 30 percent of rural clean water treatment systems are inoperable or understaffed due to deficiencies within the government. Years of civil war and public unrest have significantly crippled supply chains and government oversight.
  9. Hygiene Education: Only 25 percent of Sudanese use soap when washing their hands, a statistic that USAID has focused on inverting. Nationwide campaigns have emerged to educate the public on hand-washing. Additionally, UNICEF issued educational resources to more than 14,000 schools and numerous mosques, ultimately reaching around 4.2 million children.
  10. Sudan National Sanitation and Hygiene Strategic Framework (SNSHSF): The SNSHSF emerged in 2016, a cohesive consulting force consisting of government and private sector individuals and committees to bring modern improvements to Sudan’s sanitation infrastructure. Funded by UNICEF and WHO, this organization has been key to developing and implementing strategies to ensure basic sanitation needs for the public.

While these 10 facts about sanitation in Sudan show the country’s challenges regarding open defecation, handwashing and water treatment, it is clearly making efforts to improve. With continued efforts from Sudan’s government, the international community and NGOs, the country should eventually be able to grant basic sanitation to all.

Tiernán Gordon
Photo: USAID

Sanitation in Pakistan
Pakistan had a population of 210 million people as of 2017 and is the world’s fifth-most populous country. Further, it is surprising that Pakistan’s GDP has grown 3.3 percent in a single year considering that 24 percent of its population lives below the national poverty line. Poverty has contributed to citizens’ ongoing struggle with inadequate sanitation. Here are 10 facts about sanitation in Pakistan.

10 Facts About Sanitation in Pakistan

  1. Pakistan is among the top 10 countries in the world that lack access to clean water. The nonprofit organization WaterAid conducted a study revealing that 21 million people out of the country’s total population lack access to clean water. Out of Pakistan’s total population, 79.2 percent of the rural poor have access to clean water. On the other hand, 98 percent of Pakistan’s rich have access to clean water. 
  2. Seventy-nine million people in Pakistan do not have access to a proper toilet. According to WaterAid.org, every two out of five people, or the majority of people living in poor rural areas, do not have access to a toilet. The lack of adequate facilities can create additional problems for citizens, such as bacterial infection or diarrhea. In fact, 16,800 children under the age of 5 die from diarrhea each year. WaterAid is currently working to combat the sanitation issue in Pakistan by working with government and local officials to provide proper toilet facilities throughout disadvantaged communities.
  3. Pakistan’s women and young girls often stay at home rather than partaking in normal activities, due to a lack of menstruation supplies and proper facilities. According to the United Nations International Children’s Emergency Fund (UNICEF), 75 percent of women stay at home during menstruation. Due to a lack of resources and cleaning facilities, many girls have no choice but to use unsanitary methods for managing menstruation, such as homemade sanitary pads. Further, these methods are prone to cause vaginal infections as a result of reuse. 
  4. Improper sanitation and food storage are some of the major sanitation issues in Pakistan. The National Center for Biotechnology Information (NCBI) reveals the prevalence of illness from improper food care. Contamination of food due to washing it in unsanitary water sources can cause bacteria like E. Coli, salmonella and other pathogens to enter the human body, causing severe illness.
  5. Waterborne diseases are prevalent as a result of untreated drinking water. According to the Pakistan Council of Research in Water Resources (PCRWR), 62 percent of the urban population and 84 percent of the rural population of Pakistan do not treat their drinking water to prevent waterborne diseases. The United Nations Educational, Scientific and Cultural Organization (UNESCO) estimates that 40 percent of all diseases in Pakistan are due to unsanitary drinking water.
  6. Stunted growth due to unsanitary conditions affects 38 percent of children in Pakistan. The United Nations International Children’s Emergency Fund (UNICEF) found that unsanitary conditions like drinking and bathing in unsanitary water stunt growth. In the state of Sindh, stunted growth affects 50 percent of children, which can also cause cognitive development stunting. The consequences of stunting are irreversible, causing lifelong implications for the child into adulthood. Working with these communities, the United States Agency for International Development (USAID) has begun a stunting reduction program to work with families to provide children with clean water and facilities to fight against poor sanitation in Pakistan.
  7. The misuse of pesticides in Pakistan’s agricultural fields results in an annual death rate of 10,000 people per year from agrochemical poisoning. Around 500,000 people fall ill annually as a result, although most are fortunate to recover. When people do not properly use pesticides, they can persist through rain and flooding, eventually entering water sources. People drink these water sources, in turn causing illness. Training is crucial for agricultural workers to properly prevent water contamination.
  8. The population growth rate has been climbing since the late 1900s. According to the United Nations, the total population of the country will reach 220 million people by mid-2020. A researcher with the Sustainable Development Policy Institute (SDPI) stresses that millions of people still live without access to clean drinking water, which includes large metropolitan cities where drinking water is scarce. The Sustainable Development Policy Institute (SDPI) recommendation for government intervention to bring clean water to overpopulated areas should help improve sanitation in Pakistan.
  9. The lack of proper toilet facilities is a part of 41 million people’s lives in Pakistan. According to The United Nations International Emergency Children’s Fund (UNICEF), the lack of toilets leaves people with no choice but to practice open defecation, which can lead to the spread of diseases among communities. Pakistan is the third-largest country where people practice open defecation. UNICEF is working with the government to help build toilet facilities for communities that need them to ultimately improve sanitation in Pakistan. These facilities are especially important for girls to protect them against assault, which happens often during open defecation.
  10. Only two cities in Pakistan — Islamabad and Karachi — have biological waste facilities. These facilities clean only about 8 percent of wastewater due to limited functioning, even with the already limited number of facilities to filter wastewater. Industrial waste also pollutes water in Pakistan. Out of 6,000 of the country’s registered businesses, 1,228 have “highly polluted” water sources. Government officials are working towards improving water treatment centers. Pakistan established the National Water Policy (NWP) to ensure that the country applies 10 percent of national funding to the development and repair of water infrastructure.

Pakistan’s impoverished citizens experience sanitation issues the most. The solutions are fairly simple but Pakistan’s acceptance of outside support will be a substantial step. If one considers the progress that Pakistan is already making to change the lives of people facing sanitation challenges in Pakistan, it is clear that the country should be able to implement real change and help communities thrive for years to come.

– Amelia Sharma
Photo: Flickr

Sanitation in Sierra LeoneSierra Leone is a country on the west coast of Africa with a population of more than 7.5 million people and is perhaps most widely known for its turbulent diamond trade. The country’s heart resides in its lively capital, Freetown and it attracts many visitors with its beautiful beaches and vibrant rainforests. Despite its rich natural resources, the country struggles when it comes to providing adequate sanitation services for its citizens. Here are 10 facts about sanitation in Sierra Leone.

10 Facts About Sanitation in Sierra Leone

  1. A decade-long civil war severely impacted the country’s infrastructure. Ensuring access to safe water and sanitation services has been a top priority during Sierra Leone’s post-conflict governance reform. However, there is still much work to be done to restore services that halted during the war in the 1990s.
  2. Waste management is a major challenge. The Minister of the State, Office of the Vice President, Mohamed Alie Bah said in 2017 that the increasing amounts of solid waste need to be addressed, as the problem will only worsen with expected population growth. The Ministry of Health and Sanitation in Sierra Leone is troubleshooting the most effective and sustainable ways to address the problem with the hopes of improving overall health and wellness in their communities.
  3. Nearly 3 million people lack access to clean water. As a result, millions drink from freestanding water such as ponds and unprotected wells, which increases the likeliness of exposure to infections and parasites. According to a 2017 report, risks associated with poor water, sanitation and health facilities are the second largest cause of death and disability. The Water Project is an example of one nonprofit working to improve clean water access in Sierra Leone. To date, the group has built wells that have benefited 7,000 Sierra Leoneans to date.
  4. Diarrheal disease is a leading cause of child death. Drinking unclean water that contains bacteria or parasites can lead to an infection in the intestinal tract. Diarrheal disease usually results in malnutrition and dehydration, which can become fatal. In Sierra Leone, more than 1,400 children die from diarrheal diseases each year.
  5. Sierra Leone is trying to improve water quality and availability. Officials in Sierra Leone are aware of the importance of providing adequate drinking water and are currently taking steps to conceptualize, budget and fundraise for systems that would hopefully improve the country’s water supply. Due to a lack of funding, it appears that the project will be a collaborative effort between several sectors and organizations. An anticipated $164 million annual investment is needed to create and maintain rural and urban water supply facilities. Even with donations from organizations such as the World Bank and UNICEF, the monetary goal is expected to be missed by a large margin, around $130 million.
  6. Sierra Leone has one of the world’s highest maternal mortality rates. While a majority of maternal deaths are caused by severe bleeding, 11 percent of the deaths are caused by sepsis. Most maternal deaths are treatable and preventable, and this statistic is another indicator of the changes that still need to be made. Over recent years, the Ministry of Health and Sanitation in Sierra Leone has partnered with the World Health Organization to implement several health initiatives, including the Emergency Obstetric and Newborn Care training program, which aims to ensure health care professionals have the knowledge needed to manage child-birth related complications.
  7. Hand-washing facilities are often lacking. According to a report published by the Government of Sierra Leone in 2017, 27 percent of people in urban areas have access to hand-washing facilities with soap and water, and only 15 percent of people in rural communities have the same access.
  8. Household toilet facilities are often inadequate. Nationally, only 16 percent of households have an improved toilet facility, which is defined as “a non-shared facility constructed to prevent contact with human waste.” These facilities reduce the spread of diseases such as cholera and typhoid. Conversely, 18 percent of households nationwide do not have access to any toilet facilities, and instead, must defecate outdoors.
  9. Poor menstruation hygiene management affects girls’ education in Sierra Leone. Girls in Sierra Leone can face several challenges while menstruating, especially while attending school. The quality of restroom facilities can vary at schools, but oftentimes there are not bathrooms with running water or separate facilities for girls. This leads to girls having difficulty disposing of pads and managing their periods, which can leave them feeling embarrassed or distracted during classes. Others miss school altogether during their periods.
  10. Training is being offered to prepare Sierra Leone for future disasters or outbreaks. The CDC offers water, sanitation and hygiene (WASH) training to help at-risk countries strengthen their infrastructure and workforce to ensure they are prepared to prevent, detect and respond to infectious disease threats. There are several facets to the training, such as Outbreak Investigation Training, which trains public health staff to detect and respond to waterborne diseases, and training to teach students how to test water samples for contamination.

Improving sanitation in Sierra Leone has been a priority for the nations’ leaders for decades. While finances continue to be a challenge, improvements have been made thanks to the efforts of organizations within the country, such as the Ministry of Health and Sanitation, as well as organizations outside of the country, such as the World Health Organization.

– Lindsey Shinkle
Photo: Flickr

Sanitation in Peru
Thanks to the government and various international organizations, Peru has made noticeable progress in regards to sanitation and clean water. However, there is still a large amount of room for improvement in the country. Here are 10 facts about sanitation in Peru.

10 Facts About Sanitation in Peru

  1. Access to Running Water: The water crisis in the suburbs of Peru is complex. Even in more urban areas, running water is still a rare commodity. In middle-class homes just outside of Lima, 3 million people still lack running water. Hand-dug wells are common sources of water in these areas and local citizens may travel miles in order to use the restroom. The country has made progress in the hopes of expanding access to running water. In 2014, the International Secretariat for Water Solidarity established a sustainable source of water in Cuchoquesera and followed this with a similar development in the town of Waripercca. Both communities now have running water.
  2. Sanitation in Schools: The Peruvian water crisis has heavily affected schools. Almost no rural schools have clean bathrooms or working sinks. A lack of proper restrooms and facilities can prevent academic progress. Luckily, sanitation officials in Peru have identified this issue and created a plan to increase infrastructure. This plan should provide suitable and sanitary bathrooms to Peruvian schools by 2030 and educate younger children on hygienic practices, however, donations and investments could speed up the process.
  3. Sanitation in Hospitals: In 2016, 18 percent of health care facilities reported having to operate without running water, leading to problems in water disposal, waste management and an overall inability to perform tasks as simple as cleansing the hands. According to a report from UNICEF and WHO, this can easily lead to life-threatening illnesses, especially for newborns that may be born in these facilities.
  4. Plumbing Systems: Even homes in the suburbs of Lima do not always have toilets. In Peru’s urban areas, about 5 million people do not have a working toilet in their homes. In places where these facilities do exist, the plumbing system is so fragile that flushing toilet paper could do serious damage to the system, or at the very least cause the toilet to clog or flood. The best solution to this less-than-perfect system is to invest more money in plumbing infrastructure or to utilize the “dry toilet” designs that are popping up around the world.
  5. Open Defecation: Despite having dropped since 2000, the percentage of the rural population practicing open defecation still measured around 19 percent in 2017. Experts cannot understate the negative health and sanitation effects of citizens experiencing exposure to human waste. The good news is that the portion of the urban population practicing open defecation is as low as 3 percent and both rates are in a steady decline.
  6. Untreated Drinking Water: Lima’s source of water and the surrounding areas is the Rio Rimac, a river heavily polluted by harmful microorganisms. One of these microorganisms is Helicobacter pylori, a dangerous bacteria that can affect the gastrointestinal tract of those unlucky enough to experience an infection. The good news is that water treatment is seeing a slow uptick in Peru, especially in urban areas. The number of people consuming untreated water has decreased by the thousands since 2000. Public health intervention has begun to focus on treating the water before distribution, partnering with organizations like the International Secretariat for Water Solidarity.
  7. Unsafe Water Affects More Than Drinking: While drinking unsafe tap water is a prominent issue, the problem becomes monumental when one considers everything else that people use water for. Fruit and vegetables that individuals wash in tap water may be dangerous for consumption, as well as drinks with ice and any foods kept on ice.
  8. Unsanitary Practices: While many of the sanitation problems in Peru come from lack of funding or infrastructure, another big problem comes in the form of unsanitary practices. This involves hand-fecal transmission and infection, which may lead to transmission to the face or other individuals in the community. During observation in 2014, 64 percent of those researchers observed potentially contaminated their face, hands or food within one hour of hand contamination. This can be detrimental to the health of Peruvians, as contamination can cause an array of enteric pathogens including salmonella and Escherichia coli. These practices are simply a result of the lack of running water in many parts of the country and lack of awareness of the diseases that fecal transmission can cause. Peru can eliminate this issue by educating Peruvians as children about sanitation and hygiene and by improving the running water system in Peru. There have been attempts to address these issues, including observation and correction of some of these behaviors.
  9. WaterCredit Program: Water.org’s WaterCredit program is quite possibly the jumpstart the nation needs in order to provide running water and sanitary conditions to all of its citizens. The WaterCredit program works with various donating partners to provide plumbing and similar infrastructure to countries that need it. Through this program, Water.org has been trying to reach people in urban areas, like Lima, and provide them with improved indoor bathrooms, sewage collection infrastructure and safe running water. It has reached an estimated 2.5 million people and hopes to reach more within the country in the future.
  10. Stray Dogs: One problem affecting sanitary conditions in Peru is the fact that stray animals, especially dogs, run rampant in cities like Cusco and Mancora. Sadly, due to lack of proper care, these animals can carry various infections that they can spread to humans through direct contact. These infections include rabies, norovirus, salmonella and brucella among others. These infections can have detrimental health effects on humans if contracted and the infected animals may show little to no symptoms.

While the conditions of sanitation in Peru are not yet acceptable, the country has made significant progress in the last decade. It is not an overestimation to say that Peru will continue this forward progress with the help of its citizens and various donating partners. With continued aid from international organizations, the sanitary conditions in Peru could see a significant increase in quality in the next few years.

Tyler Hall
Photo: Flickr