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Unsafe water and poor sanitation claim 4,500 lives day. What should we do about it?

On Monday, March 22, World Water Day celebrates its 17th year of publicizing water issues with the theme “Clean Water for a Healthy World.” Our Global Issues/Citizen Voices essay contest highlights this theme with hopes of prolonging the conversation. From entrants detailing first-hand accounts of how the lack of access to clean water has affected the lives of their families and communities to policy-based analyses of the issues and solutions, the participants consider a range of points, each adding a unique perspective to the dialogue.

Yet 1.1 billion people continue to live without access to reliable sources of clean water.

Imagine, for a moment, that you had to walk for miles to find clean water. Imagine again, if you lived in a country devastated by civil war and humanitarian disaster, and your only source of water was contaminated by the runoff from refugee camps—garbage, human excrement, and people bathing.

UN Secretary-General Ban Ki-Moon issued a statement today. “Water is the source of life and the link that binds all living beings on this planet,” he said. “It is connected directly to all our United Nations goals: improved maternal and child health and life expectancy, women's empowerment, food security, sustainable development and climate change adaptation and mitigation.” There is good news: there have been vast improvements in water and sanitation—so much so that 87% of the world population can now access safe drinking water, and is on-target to meet the targets identified in the Millennium Development Goals. The majority of these improvements have been in rural areas.

90% of the 1.1 billion people forced to defecate in open areas due to a lack of toilets or latrines are rural dwellers. Conditions such as these are the primary cause of the 1.5 million deaths of children under five years old due to diarrhoeal diseases, the UN reports. Such needless deaths have been called “an affront to our common humanity” by Ban Ki-Moon. In addition to faecal contamination risks, poor personal hygiene, agricultural and livestock runoff, and inadequate garbage disposal services can spread water-borne diseases.

Open defecation—humans defecating outside—is the ugly stepsister of clean water scarcity, which we commemorate on World Water Day. Two-and-half billion people lack access to even simple pit toilets, which is three times as many people as lack access to clean drinking water and results in two million preventable deaths per year, mostly of children under five from intestinal diseases.

Jack Sim, the self-described “evangelist of toilets,” from the World Toilet Organization, theorizes that’s because “every politician wants to be photographed standing next to a new well, but no one wants to be photographed standing next to a new toilet.” And without some portion of the powers that be to drive a story, coverage becomes scarce.

India has the largest number of open defecators in the world, over 600 million of them. At a certain level, this fact is inescapable. Within a hundred yards of our five star hotel in New Delhi, we could find expanses of human feces—we could find them because we could smell them. Touring Delhi slum clusters with local activists, we traversed neighborhoods where 5,000 people share 20 public toilets, which is nearly the same as having no toilets, resulting in even vaster expanses of human feces. But in urban areas, open defecation can also be invisible in the way poor people can quickly become invisible.