The Link Between Sanitation and MalnutritionWorldwide, about 844 million people live without access to clean water and about 2.3 billion people lack adequate sanitation, according to WaterAid. Along with the lack of clean water access, about 155 million people worldwide experience stunting caused by acute malnutrition.

WaterAid has recognized the importance of tackling water, sanitation and health (WASH) deprivation as a tool to end chronic malnutrition. It believes that by addressing the link between sanitation and malnutrition, malnutrition will decrease in proactive countries. According to WaterAid, nearly half of all malnutrition cases are caused by WASH conflicts.

WaterAid argues that an array of diseases contribute to malnutrition, all of which are associated with a lack of clean water, sanitation and hygiene. According to the World Health Organization (WHO), those diseases include diarrhea, intestinal nematodes, trachoma, schistosomiasis and others, all of which are preventable.

According to the WHO’s report, about 50 percent of all childhood malnutrition is caused by chronic diarrhea and infectious intestinal nematodes. This results in about 860,000 children under the age of five dying each year from malnutrition directly caused by clean water, sanitation and hygiene conflicts.

“The truth is that food alone will never be enough to tackle the problem, we have to target its underlying causes too,” said Megan Wilson-Jones, WaterAid’s policy analyst on health and hygiene. “Clean water, adequate sanitation and good hygiene are also vital ingredients for good health.”

WaterAid released a “Recipe for Success” that urges governments and organizations to:

  • Implement WASH and nutrition plans in local governments
  • Increase the amount of government funding for WASH-oriented programs
  • Focus first on mothers and babies, who are most affected by sanitation and malnutrition
  • Target areas within countries (such as rural areas) that show high numbers of malnutrition
  • Promote nutritious foods and daily hand hygiene
  • Create sustainable WASH programs by educating health workers, teachers and parents on proper hygiene and nutrition

One country that illustrates the link between sanitation and malnutrition is Paraguay. According to WaterAid, access to clean water in Paraguay’s rural areas increased by about 43 percent from 2000 to 2015, causing WaterAid to declare it the most improved country. According to The Guardian, the reason for Paraguay’s success was because of the government’s improved efficiency. The sanitation and water agency was placed within the department of health, making the issue a much higher priority. This, along with many more steps taken by the government toward becoming more sustainable and efficient, is what helped Paraguay achieve success.

The results in Paraguay can be seen in the World Bank’s DataBank statistics:

  • Percentage of population with access to sanitation
    1990: 87 percent
    2015: 96 percent
  • Percentage with access to clean water
    1990: 93 percent
    2015: 99 percent
  • Percentage affected by malnutrition
    1990: 18 percent
    2012: 11 percent

By looking at Paraguay’s statistics, WaterAid’s assertion of the link between sanitation and malnutrition can be confidently supported.

WaterAid continues to voice its concern for WASH to eliminate worldwide malnutrition, but success cannot be achieved without governments also recognizing the link between sanitation and malnutrition as well as providing efficient and sustainable programs.

– Austin Stoltzfus

Photo: Flickr

Arunachalam Muruganantham is leading a sanitary pad revolution in rural India, changing women and girls’ sanitary practices. Out of 355 million females in India who menstruate, only 12 percent of them use sanitary napkins. The others use ash, newspapers, old fabric or sand. In India, women are considered untouchables at the time of their menstruation, and they face stigma and ostracism during their periods. They are banned from public places during menstruation, so they stay indoors, oftentimes reusing their dirty rags. Poor menstrual hygiene not only causes 70 percent of all reproductive diseases in India, but also can lead to maternal mortality, a lower rate of females enrolled in schools and fewer women in the workforce.

In 1998, Muruganantham discovered that his wife, Shanthi, chose to use dirty menstruation rages, rather than sanitary napkins, because sanitary napkins were too expensive. He decided to make a sanitary napkin that his wife and other women in rural India could afford to buy.

He surveyed female medical students, studied used sanitary napkins, and fashioned a fake uterus from a soccer ball filled with goat’s blood. Tucking the soccer ball under his clothing with a tube feeding the blood into his underwear, he ran and walked around to experience having a period. During his mission to create a low cost sanitary napkin, his wife, his mother and his village would abandon him. Due to his unique experiments, he was labeled a mad pervert, but Muruganatham did not give up.

By contacting multiple large sanitary pad manufacturing companies, he discovered what sanitary napkins were made of: cellulose from tree bark. However, the machines needed to break the cellulose down and make the cellulose into sanitary pads were extremely expensive.

After years of hard work, Muruganatham invented a low-cost wooden machine that could break down the hard cellulose to make sanitary napkins, increase sanitary napkin use and create thousands of jobs for rural women. One of his manual machines costs 75,000 rupees, and provides employment for approximately 10 individuals. They can produce 200-250 pads a day, selling for around 2.5 rupees each. Although his invention could have brought him enormous profits, he chose not to sell the machines to big companies. He continues to sell the machines mainly to NGOs and women’s self-help groups.

Muruganatham’s family and community are now supporting his endeavors. He is currently expanding his machines to 106 other countries such as Kenya, Nigeria, and the Philippines. His low cost, locally produced sanitary napkins are empowering women and girls in developing countries while giving them the opportunity to contribute to their local economy. These sanitary napkins reduce unsanitary menstruation practices and are beginning to chip away at the cultural taboo of menstruation that forces women to feel unclean and untouchable because of a completely natural bodily function.

Sarah Yan

Sources: Business Week, BBC
Photo: The Globe And Mail

Sanitation and Poverty
Two and a half billion people – over a third of the entire world’s population – have no access to adequate sanitation facilities, which leads to the rapid spread of disease and heightened child mortality rates. Most commonly, poor sanitation practices lead to diarrhea: little more than an annoying byproduct of bad hygiene practices for first-world residents, it is often fatal in developing countries. In fact, it is estimated that 5,000 children die daily from complications related to the ailment. Consequently, one person dies every minute due to the lack of basic sanitation.

Why is the lack of well-formulated means of sanitation such a large problem in modern times, when technology has reached such an advanced stage? One reason is the negative stigma associated with it: the discussion of toilets simply feels dirty or inappropriate and is not as popular nor does it appear at first glance as urgent as, for example, the issue of access to drinking water. However, the two are related and equally pressing; disease control is an impossible goal without proper sanitation adjustments. In many places around the third world, toilet stalls are completely nonexistent. Essentially, this means that people are forced to defecate in public, populated areas, leaving waste behind which will remain on the ground spreading disease. Just a gram of human feces may contain as much as ten million viruses and a hundred parasite eggs.

Besides the obvious health benefits, according to the World Health Organization (WHO,) improved sanitation in developing countries would provide $9 economic benefit per $1 spent. The year of 2008 was dubbed by WHO as the International Year of Sanitation. Through various conferences and seminars, five key principles of sanitation were determined: 1. Sanitation is vital for human health. 2. It generates economic benefits. 3. It contributes to dignity and social development. 4. It helps the environment, and most importantly. 5. It IS achievable. South-East Asia and Sub-Saharan Africa are two regions most affected by poor sanitation practices. Coincidentally, they are also the two areas with the highest death rates from various diseases. It is especially prevalent in rural areas, where open defecation is six times more likely and use of unimproved sanitation is four times higher than in urban areas. Being one of the 2015 Millennium Goals, improved sanitation should not be taken for granted. To heighten the quality of sanitation is to improve the quality of life as well as economic efficiency for millions of individuals worldwide. In this day and age, no one should have to defecate publicly; not only for reasons of dignity and civility, but also due to personal awareness and dedication towards reducing of the spread of deadly disease.

– Natalia Isaeva


Sources: The Global Poverty Project, World Health Organization: International Year of Sanitation, UNICEF: Progress on Drinking Water and Sanitation