African Water Development Report 2006 - United Nations Economic ...

African Water Development Report 2006Water Management for HealthMore than 300 million people in Africa stilllack access to sufficient safe water and a largernumber to adequate sanitation (UNDP 1996).In sub-Saharan Africa, only about 51 percentof the people have access to safe water, and 45percent to sanitation (UNDP 1997). However,the proportions vary widely throughout the continent.In Libya and Mauritius, almost the entirepopulation has access to safe water and sanitation,as opposed to only about a quarter in Chad,Ethiopia and Madagascar (UNDP 1997). Urbanresidents generally have better access to safe waterand sanitation than those living in rural areas.For example, in 1994, only 30 per cent of therural people in Uganda had access to safe water,as against 60 per cent in urban centres (Ministryof Natural Resources, Uganda, 1995). Withrecurring droughts and chronic water shortagesin many areas, most countries and people pay anincreasingly high price for water and lack of it.The poor, especially women and children, usuallypay the highest price, in cash terms, to buy smallamounts of water. They also expend more in caloriesby carrying water from distant sources, suffermore in impaired health from contaminated orinsufficient water, and lose more in diminishedlivelihoods and lives.The 2000 Assessment Report gives a breakdownof some water-related diseases by means of provision,in addition to estimated overall coverage,as follows:(a)Approximately 4 billion cases of diarrhoeaeach year cause 2.2 million deaths, mostlyamong children under the age of five. This isequivalent to one child dying every 15 seconds,or 20 jumbo jets crashing every day.These deaths represent approximately 15 percent of all deaths of children under the ageof five in developing countries. Taking stepsto solve water, sanitation and hygiene problemsreduce diarrhoeal diseases by about onequarter and one third on average;(b) Intestinal worms infect about 10 per centof the people in the developing world.These can be controlled through better sanitation,hygiene and water supply. Intestinalparasitic infections can lead to malnutrition,anaemia and retarded growth, dependingon the severity of the infection;(c)It is estimated that 6 million people areblind from trachoma and the number ofpeople at risk from this disease is approximately500 million. In analysing rigorousepidemiological studies linking water to trachoma.Esrey et al. (1991) found that providingadequate quantities of water reducedthe median infection rate by 25 percent;(d) About 200 million people in the world areinfected with schistosomiasis. Of these20 million suffer severe consequences. Thedisease is still found in 74 countries of theworld. Esrey et al., in reviewing epidemiologicalstudies, found that well-designedwater and sanitation measures reduced thedisease by about 77 per cent;(e) Cholera is a worldwide problem that canbe prevented by ensuring that everyone hasaccess to safe drinking water, adequate excretadisposal systems and maintains goodhygiene behaviours.Major health risks arise where there are largeconcentrations of people and hygiene is poor.These conditions often occur in refugee camps,and special vigilance is needed to avoid outbreaksof disease. Most of the 58,057 cases of cholerareported in Zaire in 1994 occurred in refugeecamps near the Rwandan border. A decrease to553 cases in Zaire in 1995 reflected the stabilizationof refugee movement. A cholera epidemicthat began in Peru in 1990 spread to 16 othercountries in Latin America. A total of 378 488cases were reported in Latin America in 1991.Ten years later, cholera remains endemic, after ithad disappeared from the continent for nearly acentury (WHO/UNICEF, 2001)94