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1.1.2
Inadequate Appreciation of the Full Benefits of Sanitary Provision |
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Sanitation can be considered primarily as the safe removal of excreta, possibly with the inclusion of a partial treatment stage. There is a huge need for such sanitation, and associated hygiene practices, which can only begin to be met if they are accorded greater priority than hitherto. |
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Studies have indicated that, while improvement of water quality may lead to a 16 per cent reduction of infant diarrhoea, improved removal of excreta can lead to a 22% reduction (Esrey et al., 1985). A 1990 review by USAID's Water and Sanitation for Health Programme of studies on the health effects of water and sanitation found that safe excreta disposal was the most effective intervention for reducing the incidence and severity of the six diseases studied (WASH, 1993). |
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Survey data from Guatemala indicate that children who lived in urban communities with poor sanitation were twice as likely to suffer from stunted growth due to bouts of diarrhoea as those who lived in communities with high levels of sanitation. In 'insanitary' areas of Bangladesh, the infant mortality rate is reported to be twice as high as that in the most affluent areas (WASH, 1993). These and similar findings are well documented, but their significance to planners and politicians is not yet universally accepted. |
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In western Europe during the nineteenth century the main effort to design and construct appropriate sanitation systems occurred in the wake of cholera, although in England the stench from the River Thames alongside the Houses of Parliament also had a significant influence upon politicians. In the words of one contemporary non-governmental organization (NGO) campaigner: 'Will we again have to wait until cholera epidemics in Latin America and elsewhere strike terror into cities and continents?' (Black, 1994). The author considers that 'in many rapidly urbanising countries, where life-threatening diarrhoeal disease is still endemic and erupts in periodic outbreaks, the urban sanitary crisis is a crisis simply waiting to happen'. |
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Notwithstanding this impassioned plea for rapidly expanded sanitation, the reality is that some communities are still likely to prefer water supply over sanitation and may be reluctant to pay for a facility where direct benefits are unclear. The demand for |
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