Today is World Toilet Day but there is not much to celebrate.
Diarrhea kills at least two million people per year, according to experts from the World Health Organisation (WHO). It can be prevented and treated, but we are not doing enough to address this critical global health problem.
UNICEF’s 2012 Progress Report, released last month, showed that diarrhea is the second leading cause of young child deaths worldwide (responsible for 11% of deaths, following pneumonia which causes 18% of deaths). Although diarrhea’s death toll has dropped by a third in the last decade, this progress is insufficient for a disease with simple, proven, cost-effective interventions.
As the causes of and conditions for diarrhea are inextricably linked to desperate poverty, many interventions require meeting the most fundamental human needs. Deaths can be easily averted through practices such as breastfeeding; providing adequate nutrition, safe drinking water and vaccinations; and maintaining basic sanitation such as hand washing with soap.
Open defecation, which is practiced by over a billion people worldwide, remains a major contributing factor to diarrheal disease. I have seen children in the poorest slums of Kenya, India and Central America run barefoot in streets where feces flow freely. They play in garbage and draw pictures in the dirt, running their little fingers through sewage then have no water or soap to wash up.
The United Nations has committed to reduce the number of people without access to safe water by half, and many of our big-hitters in global health are working to address this, but expenses are considerable. The Gates Foundation recently launched a “Reinvent the Toilet” competition, challenging researchers to leverage new technologies to design models that function without sewage output, water or electricity, yet the cost of winning prototypes may initially be as high as $5,000 (though this drops with commercial production). In many ways, meeting critical needs and implementing infrastructural changes presents a far a greater challenge than other intervention techniques to treat the symptoms of this illness.
First and foremost, talk about it. The Community-Led Total Sanitation (CLTS) method, used by the World Bank, Plan International , UNICEF and The Gates Foundation among others, begins with communication. If we can raise awareness for the potentially deadly problems caused by open defecation, we can actually stigmatize it and encourage people to change their common behaviors. According to the CLTS approach, this awareness is a critical first step to trigger a community’s desire for change, propel them into action and encourage innovation, mutual support and appropriate local solutions, thus leading to increased ownership and sustainability.
Next, we must keep talking. The dialogue must extend beyond the impoverished communities where children are dying from diarrhea. There is an incredible dearth of private donor-driven funding for this cause; by talking about it here, in the U.S., we can spread the awareness, so people will understand the gravity of the issue and support the treatment of the disease. Here, we must remove the stigma associated with diarrhea, so that people will be willing and wanting to publicly help prevent it.
Diarrhea kills at least two million people per year, according to experts from the World Health Organisation (WHO). It can be prevented and treated, but we are not doing enough to address this critical global health problem.
UNICEF’s 2012 Progress Report, released last month, showed that diarrhea is the second leading cause of young child deaths worldwide (responsible for 11% of deaths, following pneumonia which causes 18% of deaths). Although diarrhea’s death toll has dropped by a third in the last decade, this progress is insufficient for a disease with simple, proven, cost-effective interventions.
As the causes of and conditions for diarrhea are inextricably linked to desperate poverty, many interventions require meeting the most fundamental human needs. Deaths can be easily averted through practices such as breastfeeding; providing adequate nutrition, safe drinking water and vaccinations; and maintaining basic sanitation such as hand washing with soap.
Open defecation, which is practiced by over a billion people worldwide, remains a major contributing factor to diarrheal disease. I have seen children in the poorest slums of Kenya, India and Central America run barefoot in streets where feces flow freely. They play in garbage and draw pictures in the dirt, running their little fingers through sewage then have no water or soap to wash up.
The United Nations has committed to reduce the number of people without access to safe water by half, and many of our big-hitters in global health are working to address this, but expenses are considerable. The Gates Foundation recently launched a “Reinvent the Toilet” competition, challenging researchers to leverage new technologies to design models that function without sewage output, water or electricity, yet the cost of winning prototypes may initially be as high as $5,000 (though this drops with commercial production). In many ways, meeting critical needs and implementing infrastructural changes presents a far a greater challenge than other intervention techniques to treat the symptoms of this illness.
So what can we do to stop this shit?
First and foremost, talk about it. The Community-Led Total Sanitation (CLTS) method, used by the World Bank, Plan International , UNICEF and The Gates Foundation among others, begins with communication. If we can raise awareness for the potentially deadly problems caused by open defecation, we can actually stigmatize it and encourage people to change their common behaviors. According to the CLTS approach, this awareness is a critical first step to trigger a community’s desire for change, propel them into action and encourage innovation, mutual support and appropriate local solutions, thus leading to increased ownership and sustainability.
Next, we must keep talking. The dialogue must extend beyond the impoverished communities where children are dying from diarrhea. There is an incredible dearth of private donor-driven funding for this cause; by talking about it here, in the U.S., we can spread the awareness, so people will understand the gravity of the issue and support the treatment of the disease. Here, we must remove the stigma associated with diarrhea, so that people will be willing and wanting to publicly help prevent it.
Three key interventions can successfully treat diarrheal disease: administration of oral rehydration salt (ORS) solutions to prevent life-threatening dehydration (the main culprit of diarrheal deaths); continued feeding; and zinc supplementation. These low-cost treatments remain inaccessible for the vast majority of the world’s most vulnerable people. Oral Rehydration Salts alone could prevent about 90% of child deaths from diarrheal dehydration, yet less than one third of diarrhea- infected children receive ORS, and there has been only a 2% increase in this access over the last decade. ORSs have been criticized as a “Band-Aid” in places where safe water and sewage systems do not exist—only providing the most superficial treatment rather than addressing the underlying causes of the disease. But the fact of the matter is that they save children’s lives, and it’s better to bandage a wound then let it bleed dry.
Oral Rehydration Salts cost about 10 cents each. They can even be substituted with a homemade mixture of sugar, salt and water. If only more mothers were aware of this treatment and the treatment was more widely accessible, many, many lives would be saved.
The technology is here; the effect is proven; the cost is negligible; and the services are available.
So let’s all be potty mouths. The time has come to start talking about diarrhea, why it matters, and what we can do to stop it.
So let’s all be potty mouths. The time has come to start talking about diarrhea, why it matters, and what we can do to stop it.
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