Joseph B. Treaster: Water and The World

A Continuing Discussion on Water and People on A Warming Planet

Dec 22 2010

A Problem Worse Than Cholera

Published by Knight Center under

MIAMI—Cholera is working its way through Haiti. It is killing people and terrifying everyone.  Medical help and money has been pouring in – not enough money, the United Nations says, but a lot of money, a lot more money than has been flowing for a much worse health problem.

In the first six weeks of the cholera outbreak in Haiti, more than 2,000 people died. During the same time, many more people in poor countries around the world died from the other health problem, an estimated 210,000.  But hardly anyone noticed.

“This is a silent killer,” said David Winder, an international aid executive in Washington who has been dealing with public health for decades.

Cholera and the bigger problem are cousins. Both are forms of diarrhea. But the more common, forms of diarrhea are far more widespread and far more deadly. Cholera kills about 120,000 people a year; the more common forms of diarrhea kill 15 times more people, about 1.8 million a year, 5,000 a day.  Hard to believe when you live in the United States or Europe; but in poor countries diarrhea is a persistent killer.

Cholera gets the headlines for good reason. It can kill in hours rather than days as with other kinds of diarrhea. “It’s very dramatic,” said Dr. Gordon M. Dickinson, a University of Miami specialist on infectious diseases at the Veterans Hospital in Miami.  People become dehydrated, go into shock and die. The other forms of diarrhea kill the same way.  But there is more time to react.

Children are the main victims. More of them die of severe diarrhea than from HIV/AIDS, malaria and measles all together.   Yet the problem has not captured the imagination.

“People think of diarrhea as a temporary illness associated with something like bad food,” said Brenda McIlwraith, a spokeswoman for WaterAid, a non-profit organization in London, working to reduce diarrhea around the world.

Very little progress is being made.  In Haiti, “diarrhea is here all the time,” said Christian Lindmeier, a spokesman for the World Health Organization in Port-au-Prince. In the first wave of cholera deaths, he said by telephone, people thought “it was just another diarrhea” and they did not seek treatment.

Cholera and the other forms of diarrhea are preventable. “We know how to deal with these diseases,” said Dr. Claire-Lise Chaignat, the head of the World Health Organization’s Global Task Force on Cholera Control in Geneva. The bacteria, parasites and viruses that cause the diseases travel in drinking water. They get into the water and, sometimes, food, along with human waste, as sewage and on dirty hands. All that needs to be done to fix the problem is to provide clean drinking water, basic toilets and some tips on hygiene.

But the scale of the problem is staggering. About 1 billion people do not have clean drinking water, the United Nations estimates, and 2.6 billion, nearly 40 percent of the world’s 7 billion people, don’t have toilets.

It could take $50 billion dollars to put a big dent in the problem. No one is sure. But right now, Mr. Winder, the head of WaterAid in America, says spending “is far below what’s needed.”

The United Nations anticipates spending $164 million to tamp down a cholera epidemic that may sicken as many as 400,000 Haitians. Only about 20 percent of the money had been raised as the epidemic settled in. But it is a real spending target. And that is a lot of money in proportion to total spending in Haiti on public health.

Spending that kind of money in advance in Haiti on clean water and toilets would have saved lives. It would have made it harder for cholera to get going. It would have been the right thing to do economically, too. Half the hospital beds in the poor countries are filled with patients with severe diarrhea. That is a daily recurring cost. Improving sanitation would reduce those costs. It would also reduce days lost at work and from school.

Doctors and engineers may know how to solve the diarrhea problem, but every day there is evidence that it is not easy. Hundreds of aid agencies are working on it, but the work is piecemeal and sometimes counter-productive. In some places, Dr. Chaignat said, the people responsible for health and water “rarely talk to each other. The health sector doesn’t understand the water sector and vice versa.”

So the plague of diarrheal diseases grinds on. The people suffering most have no political clout. They are poor and they die quietly. Sometimes they make it to hospitals. But often they die in huts and shacks and out-of-the way places. One at a time. You don’t hear about it. #

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May 13 2010

On the Road In East Africa: Bang, Bump, Ouch

Published by Joseph B. Treaster under

KISUMU, Kenya—The roads in a country can tell you a lot about a place.

Some of the roads here in Kenya and in the rest of East Africa are smooth, black ribbons of asphalt. But many are pure torture. They are unpaved or once-paved washboards with crisscrossing ridges and odd-shaped craters. You start running into them just beyond the center of cities and towns.

Even in Nairobi, the capital, lots of streets are dusty, bumpy cultural experiences – until it rains. Then they become slippery bogs and mini-lakes, channels that look like rivers and swallow cars. Open sewers run along side them, right there in the capital of what was once regarded as one of the most pleasant places in Africa – for everyone.

As in just about every country in the world, the leaders of Kenya have dreams, and they can imagine a bright future. But the country has been in decline for some time.

The roads are flat out dangerous. Kenya has one of the world’s highest road accident rates. The bad roads also stifle the economy. They make it hard for farmers and fishermen and furniture-makers and even people who make beaded jewelry for Kenya’s often substantial tourist business to get their goods to market. And they are health hazards. They make trips to clinics and hospital take longer than they should and some sick people don’t survive the journey.

According to the World Bank, Kenya has 38,400 miles of roads; 12 percent of them paved. In a place where more than 40 percent of the nearly 40 million people do not have easy access to clean drinking water, where malaria is worse than almost anywhere else, where more than 70 percent don’t have toilets, 30 percent are not getting enough to eat and perhaps 40 percent are unemployed, lousy roads do not tell the whole story. Of course the roads say nothing about Kenya’s heavy losses from HIV/AIDS.

But the roads are a pretty good metaphor. You see the roads. You feel the roads. You know this is no way to run a country. The roads look to me like very good supporting evidence for the Transparency International report that Kenya is among the most corrupt countries in the world.

With the roads in your face, it’s no big surprise to hear that another fairly simple thing like clean drinking water is not that common. People all over the developing world struggle to get safe drinking water and, in that sense, Kenya is a good example. It is also a good example of the worldwide sanitation problem, which is a cousin of the water problem.

People don’t have as much water as they need so they don’t wash their hands as often as they should. So many people live without toilets in Kenya that it is almost surprising when you find one. A farmer showed me how he digs a hole in his yard just beyond odor-range from his mud-walled, one-room house. The hole becomes the family toilet. No walls. No curtains. No seat. Not even any shrubs. At some point, he said, he covers the hole with a few shovels full of dirt and digs a new one.

In much of East Africa, especially in the slums, they use what they call flying toilets. “You do your business in a piece of paper or a plastic bag,” one health worker told me. “Then you wrap it up and throw it over your shoulder.”

The waste missile can go anywhere. Sometimes it ends up on the rusty tin roof of your neighbor’s house. Maybe it flies on to your own roof. Often it just lands on the grassless, rusty-red clay around the houses.

When it rains everything fuses together, mud, waste, garbage. And the health consequences are sure-fire. In some places, after a rain, you can barely walk the roads, they are so slippery. Diarrhea is so common that most people don’t think much about it until they start to weaken from dehydration. Often, by the time people realize they are really sick, it is too late. Small children, often malnourished, have the least resistance and are the first to die.

One morning here in Kisumu, I went to talk to fishermen at a village just outside town. I was in a bus with stiff springs and stiff seats. We turned off the paved main road and from there on to the shore of Lake Victoria we were creeping over what could have been a test track for manufacturers of off-road vehicles, or maybe army tanks. Bang. Crash. Whomp. It was a short stretch, but it took us forever.

Later, we went out to some farms north of Kisumu. It took us two hours to go 35 miles. The roads tell you a lot about a place. #

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Apr 22 2010

In An African Slum, Clean Drinking Water Gets Low Priority

Published by Joseph B. Treaster under

KIBERA , Kenya —The government clinic gets a shipment of water purification tablets every three or four months. In a week or two the tablets are gone. And then the people here in this rambling slum on the edge of Nairobi are on their own.

So how bad is that? This is one of those places around the world where the water can make you very sick. But, just like a lot of other places, it doesn’t always make you sick. Many people are convinced that the water is fine, or almost fine. People take the purification tablets because they are free. They don’t routinely use them, just like they don’t routinely boil their water. Most people in Kibera don’t have toilets and that adds to health problems.

The worn , reddish clay hills of Kibera are packed with tin-roofed shanties. The stench of sewage is strong in the air . Little clouds of smoke from charcoal cooking fires and burning garbage st ing the eyes. The slum is a microcosm of horrible conditions in much of the developing world . The United Nations estimate s that more than a billion people in places like Kibera – and places that are not nearly so extreme – don’t have consistently safe drinking water piped into their homes or within easy walking distance. Perhaps 2.5 billion people don’t have toilets. This adds up to a lot of sickness and about two million deaths every year. Over the last decade or so the situation has improved only slightly and it may very well get worse as the world population relentlessly rises.

Governments in many developing countries pay very little attention to clean drinking water and toilets and I could see from conversations in Kibera that there is little or no demand for improvement from many people living withiffy-water and unspeakable sanitary conditions. They don’t see a problem with their water. Some non-governmental organizations put a lot of energy into water and sanitation. But the going is tough.

In Kibera I sat on a railroad bridge with two men in their 30s who said they work from time to time as laborers in Nairobi . They said they were never sick because of the water. Just about everyone I spoke with said the same thing. Dolith Okello has set up a sports bar with four television screens in a three-room shack that she calls the Miami Inn Café. Ms. Okello, who roots for a British soccer team and speaks colloquial English, s aid the water never made her sick either.

“We don’t boil our water and we don’t get sick,” she told me. “There are diarrhea outbreaks, but they’re not related to the water . It’s because we don’t have proper latrines and we don’t have proper garbage disposal. ”

She thought a little more about water having nothing to do with diarrhea in Kibera and added: “ That’s 75 percent no and 25 percent maybe. ”

At the hot, dusty government clinic, Joyce Omune, a registered nurse who is in charge, said most of the patients are very young children. “Number one on the list” of problems,” she said, “is diarrheal diseases.” There are five other nurses, two of them registered nurses, and no doctors. There is no electricity. The paint is peeling. Each morning about 60 children are brought in with diarrhea, Ms. Omune said. One day like that would be a crisis in the United States and Europe.

Dr. Onesmo K. Ole-MoiYoi, a Kenya n graduate of Harvard University and an expert on disease in East Africa, said the problem in Kibera w as almost certainly a result of “drinking contaminated water.” Malnutrition, he said, makes children more susceptible. In turn, frequent diarrhea contributes to malnutrition, said Dr. Linda K. Ethangatta, a former United Nations nutritionist .

Some treated municipal water lines flow into Kibera , but the pipes are corroded and sewage seeps in. Middlemen routinely intercept the water and sell it. P eople end up with just enough to get by. They don’t wash their hands often en o ugh. There is garbage and filth everywhere. Flies dip into open sewers, then dance on fish and chunks of meat sizzling in open pots.

During surges of diarrhea, Ms. Omune said , people ask for purification tablets. “But when things settle down,” she said, “they go back to their old routine of just using the water the way it is.”

Ms. Omune said several non-governmental organizations had conducted campaigns to help people understand the bad things that can happen with drinking water . But there is still a lot of work to do here and around the world. And most of it is not getting done. #

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Jan 29 2010

A Drinking Water Crisis In Haiti Long Before Earthquake Destruction

Published by Joseph B. Treaster under

MIAMI—Long before the earthquake, Haiti was mired in a crisis that only a few experts noticed – a severe lack of clean drinking water.

The country’s 10 million people had drinking water from springs and rivers and wells and a broken-down municipal water system in the capital, Port-Au-Prince. But a great deal of the water was loaded with bacteria and parasites and, in some cases, chemicals and other pollutants.

The foul water undermined everything in Haiti. It caused chronic diarrhea, dysentery, hepatitis and even typhoid and cholera. The diseases filled hospital beds, kept children out of school and grown ups from work. And the water-borne diseases caused death. The Pan American Health Organization estimates that half of all the deaths in Haiti in recent years — apart from those in calamities like floods and hurricanes — have been the result of water-borne diseases. In most cases, severe diarrhea took hold. People became
dehydrated and very quickly were gone.

Many countries share Haiti’s plight. According to the World Health Organization, at least 1 billion people around the world do not have clean drinking water. Even more do not have toilets. The lack of clean water and toilets is a disaster. Each year, about two million people die from water-borne diseases. That is eight times the deaths in the Asian tsunami in 2004, and it happens every year. It is not on the radar of most Americans.

Most of the victims are young children. They die quietly, at home and in little clinics in slums and out-of-the way places in the countryside in India and Nepal, in Bolivia and Honduras. Hardly anyone notices that, according to United Nations data, more children die from simply drinking unhealthy water than from HIV/AIDS, malaria and measles combined.

These people do not have to die. All the technology for providing clean drinking water exists. It is not very complicated and it is not incredibly expensive. But almost nowhere in the developing world does clean water get high priority. Drilling wells and running pipelines and building water purification plants have never really captured the imagination of political leaders. The people who suffer most are the poorest, the hungriest, the least influential.

It is not that nothing is being done about providing clean water. Even in Haiti, many water projects were underway before the earthquake. Some had budgets in the millions of dollars. Some involved small private groups that were able to put in a few wells or a few dozen water treatment devices. One group, International Action, says it has installed 110 neighborhood water tank chlorinators in Port-au-Prince. But in Haiti and elsewhere, the efforts have scarcely made a dent.

Nowhere in the developing world is there a plan that coordinates national or region water projects, small and large. Inevitably, some of the good work overlaps. Some of it never gets finished. Quite often maintenance is overlooked and systems collapse. For example, in Kampala, the capital of Uganda, drinking water is fine at the treatment plant. But the water mains are corroded and punctured. They lie in the same trenches as the sewer lines and filthy waste sloshes into the drinking water.

As the rebuilding of Haiti gets underway, billions of dollars are going to be spent. Some of those dollars, perhaps a billion or more, should be dedicated to cleaning up the country’s drinking water and to making sure it stays clean. It would help put Haiti on a sound footing for the future perhaps more than any other single thing. A well-orchestrated plan for providing clean drinking water to the people of Haiti could be a model for the world. #

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Dec 10 2009

Climbing Kilimanjaro Because Dirty Water Is Killing Children

MIAMIGreg Allgood will do almost anything to draw attention to the huge number of poor people – more than 1 billion – whose only drinking water is loaded with bacteria and viruses and who are often sick, sometimes so sick they die.

Now, in the name of what he calls the global crisis on drinking water, Mr. Allgood, 50 years old and in pretty good shape, is preparing to climb the biggest mountain in Africa, 19,340-foot-high Mt. Kilimanjaro. One of his drills is running up 17 flights of stairs in his office building in Cincinnati in hiking shoes with a knapsack on his back. He does that eight times— up, then down, twice a week.

Mr. Allgood, who heads a water purification program at Procter & Gamble, the big American maker of soap and many other drug store items, is going to be part of a platoon of socially-concerned glitterati that includes two pop singer-song writers, Kenna (who does not use his last name) and Lupe Fiasco, and actors Jessica Biel and Isabel Lucas. Justin Timberlake, the pop singer and Ms. Biel’s boy friend, had considered joining the expedition, the organizers said, but the date of the climb – in early January – conflicts with a movie he’s making.

Mr. Allgood and the others are climbing Mt. Kilimanjaro in Tanzania in hopes of creating a buzz that will get people around the world to focus on the stark fact that unhealthy water annually kills 1.8 million people, mostly children – about eight times the number of people who died in the Great Asian Tsunami in 2004. The worst victims of contaminated water get diarrhea, become dehydrated and die. They go quietly, one by one, at home and in little clinics. This is mostly happening in Africa, Asia and parts of Latin America. It is not on the radar of most Americans.

“Most of the world is asleep on the subject of the clean drinking water crisis,” said Kenna, who is leading the expedition.

One of the agonizing characteristics of the problem is that it does not have to exist. Dirty water was killing people long before climate change was recognized. The situation may worsen as droughts and downpours alternate more radically. But it has persisted because of neglect.

“This is a solvable problem,” said Steven Solomon, the author of a new book being published in the United States in January, “Water: The Epic Struggle For Wealth, Power and Civilization.”

“There is enough water for this,” Mr. Solomon said. “This is a logistical, political and organizational problem. It doesn’t require so much money that there are economic limits. There are no technical problems. It’s purely a problem of logistics, organization and political will.”

And that’s why Mr. Allgood is going up the mountain. He believes that once people understand the magnitude of the problem and that it is preventable, they will begin clamoring for governments “like the U.S. Government, to contribute a lot more significantly toward providing safe drinking water.”

More people die every year from diarrhea and other water-borne diseases than from HIV/AIDS, malaria and measles combined. Just about everyone seems to know about the Great Asian Tsunami. But the water problem rarely comes up.

Kenna, whose given name is Kenna Zemedkun, came to the United States from Ethiopia as a child and grew up mainly in Virginia Beach, Va. Until his dad, now a finance professor at Norfolk State University in Virginia, mentioned that he was sending money to Ethiopia to build a well, Kenna said in an interview, “I had no clue about the world water crisis.” When Kenna’s father was four years old and living in Ethiopia, his best friend, also four, died after drinking foul water. Kenna said his father, himself, “was sick from water-borne diseases for 10 years.”

After hearing his father’s account, Kenna started putting together a group of high-profile friends to tackle the mountain and looking for commercial sponsors “to do something extreme to raise awareness about an extreme social issue.” He calls his Mt. Kilimanjaro project “Summit on the Summit.”

Kenna, who is in his early 30s, said he hoped to get the message on water to young people who follow him and his entertainer friends. Hewlett Packard, one of the main sponsors of the project, has built a website at with a slick, high-tech video on mountain climbing. Kenna is promoting the project on Facebook, MySpace and Twitter. Hewlett Packard is producing a wireless signal on the mountain and outfitting the climbers with laptops. They plan to Twitter as they advance in the five-day journey from a rainforest base to the bare upper reaches of the mountain and, finally, to its icy crown.

“I believe we have a currency that cuts through pop culture and that people will pay attention to us because they feel they know us,” Kenna said.

Kenna and the others will be wearing jackets from Eddie Bauer and sleeping in Eddie Bauer tents. Mr. Allgood’s company, Procter & Gamble, is one of the main backers. Procter & Gamble also sells water filters. As part of its support for the Kilimanjaro project, it is donating enough of its purifying powder, PUR, to clean two and half gallons of water in poor countries for each purchase of a filter. Mr. Allgood is the director of Procter & Gamble’s Children’s Safe Drinking Water program and Kenna said he saw him as a natural climbing partner.

“He fights for this everyday,” Kenna said. “I thought we could all learn from him.”

Kenna said he expects about a dozen friends to be climbing with him, including Alexandra Cousteau, the grand daughter of Jacques Cousteau, the underwater explorer, environmentalist and star of the television series “The Undersea World of Jacques Cousteau,” and Kathleen “Kick” Kennedy, the grand daughter of Robert F. Kennedy, the assassinated brother of President John F. Kennedy. Elizabeth Gore, an executive at Ted Turner’s United Nations Foundation, and two photographers, Michael Muller, who specializes in celebrities and fashion, and Jimmy Chin, who has climbed Mt. Everest, are also in the group. A video crew will be documenting the whole thing.

Mr. Allgood said he has learned how to tell the story of the drinking water crisis so that it inspires people. “If you only give the negatives, you’re going to turn people off,” he said. The situation seems hopeless. “But if you give them the negative plus the solution – that there are practical, proven and scalable ways to prevent the deaths – they are very inspired and want to do something.” #

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Nov 26 2009

Clean Water Is Good Business; But It’s No Easy Sell

Published by Joseph B. Treaster under

MIAMI—For nearly 10 years, Greg Allgood has been working on the problem of clean drinking water for one of the biggest corporations in America – Procter & Gamble, the maker of Tide detergent, Crest toothpaste and Pampers, the disposable diapers.

Procter & Gamble also makes a powder containing chlorine and iron sulfate that people in poor countries use to purify drinking water in their homes. Mr. Allgood’s job at the company is to get the product, known as PUR, to people who routinely do not have safe drinking water. There are at least a billion people in this category.

Procter & Gamble sells PUR at cost to aid organizations. It is not a money-maker. But helping to ease one of the world’s persistent health problems has proved to be good business. The work has drawn praise from former President Bill Clinton and clean water advocates. Mr. Allgood said it has boosted morale among Procter & Gamble employees and drawn attention to the company’s other products, including water filters sold in the United States.

The problem of unsafe water around the world is enormous. Many experts say estimates of 1 billion people without consistent access to clean water are probably way low. The number, they say, could easily run to more than 2 billion.

The water these legions of people drink – mostly poor people in Africa, Asia and parts of Latin America - is loaded with bacteria and viruses. They are often sick with diarrhea. They get dehydrated. Their energy is sapped. Those with jobs sometimes don’t make it to work. The children miss school and, too often, they die before anyone realizes how much the sickness has drained them.

The product, PUR, sells for a few cents. It is one of a handful of processes and devices that have been developed in the last 15 years that enable people to disinfect drinking water in their homes. But the whole idea has been slow in getting off the ground. Only a few million of the huge number of people whose water is unsafe are using these methods.

For one thing, many people don’t associate their illness with the water they drink. “They might think diarrhea is something that is supposed to happen when a child is teething,” Mr. Allgood said. So it is hard to get them to try something new that they don’t necessarily think they need – even if it is free, which is often the case.

For another, governments and agencies like the World Bank tend to think in terms of large-scale projects like multi-million dollar water treatment plants and networks of pipes that can bring clean water into people’s homes. But these projects are often too daunting to actually get funded. So the large number of people without safe drinking water stays large.

Mr. Allgood’s product works like magic. You empty a packet into 2.5 gallons or 10 liters of really dirty water full of germs and twigs and actual dirt, stir for five minutes and let it sit a while. The solid bits and pieces drop to the bottom and the water becomes remarkably clear. Then you strain the water through a piece of cloth and in 20 minutes it’s ready to drink.

Procter & Gamble was unable to figure out how to sell PUR directly to the people who need it most. But the company liked the idea. Now it sells PUR at cost to non-governmental organizations. The organizations either give it away or sell it to people who run grocery stores and small shops. With the middle-men involved, you have someone who has a cash incentive to get PUR into people’s homes.

Dr. Eric Mintz, a team leader working on diarrheal diseases at the Centers for Disease Control in Atlanta, is an advocate of household treatment of drinking water. Instead of waiting for treatment plants to be built, he said in an interview, “we can do something now – something simpler and less expensive.”

Nearly 2 million children die every year as a result of drinking contaminated water. A staggering number. It works out to 5,000 a day. The total is more than the annual number of children killed by HIV/AIDS and malaria combined.

“This is something that will help keep people alive,” Dr. Mintz said, “especially children, the vulnerable ones.”

The unsafe water problem gets worse in emergency situations like outbreaks of cholera. In the aftermath of the Asian tsunami, much of the drinking water was contaminated.

It is in emergency situations that Mr. Allgood has been most successful. But after the emergency, people go back to drinking their usual water and routinely living with bouts of diarrhea.

Some big international agencies like the United Nations Children’s Fund, or UNICEF, and the World Health Organization have begun supporting household water treatment, Mr. Allgood said. Population Services International, a Washington non-profit with wide experience in the developing world, also has been promoting household treatment.

Mr. Allgood has won several awards, including the strategic vision award in 2007 from CSIS, the Center for Strategic and International Studies in Washington. Procter & Gamble has gotten a lot of good press. President Clinton has been praising the company at his annual Global Initiative meetings. Popular Mechanics magazine sited PUR in 2008 as one of the top 10 World-Changing innovations of the year.

Mr. Allgood estimates that PUR is reaching four million people a year. He says the number could be 12 million four years from now. “With any new public health approach there are a series of barriers,” Mr. Allgood told me.

He talks about oral rehydration, a powder that helps people, especially children, recover from severe diarrhea. Before the advent of oral rehydration, five million children a year were dying from unsafe water. The deaths have been reduced by three million annually.

Oral rehydration, Mr. Allgood said, also had a slow start. “It took a decade for oral rehydration to start making an impact,” he said. “It hit its stride in the 1970s and 1980s. They started developing it in the 1960s.” #

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Oct 29 2009

Clean, Safe Water For Two Cents A Day; Not Bad, Not Happening

Published by Joseph B. Treaster under Uncategorized

MIAMI— Here is the problem: at least 1 billion people in the world do not have clean drinking water readily at hand—nearly one-seventh of all the people on earth. These people often burn up a lot of the work day simply lugging water. Kids get pushed into carrying the family’s water and lose time at school. The water they gather is either dirty or becomes dirty, and many of these grown-ups and kids are chronically sick. To many of them, an upset stomach is normal. Many die.

Some experts think the number of people in this miserable condition could easily be 2 billion. Maybe even more. The statistics are fuzzy and no one really knows how bad it is. They just know it is bad.

Here is the solution: put very low cost water purifiers into the homes of these people. These are poor people living on less than $2 a day. For a penny or two a day they could have safe water.

But here is the monkey wrench in the deal: To make this work someone has to go into the villages and slums where the water is unfit even for brushing your teeth and show the people that there is an alternative to being sick all the time. Someone has to hand over a water filter, or a chemical mix that you stir into the water, something like chlorine. Or show people how dirty water, put into clear plastic bottles, sealed and set out in bright sunlight, can be magically rid of bacteria in eight hours as a result of ultra-violet rays and heat.

All of this takes teams of health workers. It takes repeat visits. It costs money. The expense is a lot less than the tens of millions it might take to build a water treatment plant with pipes that can take running water into people’s homes. But it takes substantial money.

And the money is not forthcoming. In fact, a stand-off has developed: cleaning water in homes, versus building village, town and city water systems. With the big projects you’re talking big money.

When you get into the big money, national and local governments and international agencies like the World Bank and big aid providers like the United States and countries in Europe, start thinking about all the other big projects that need funding. And, historically, the water projects have been pushed to the back of the line. Somehow building a water treatment plant just doesn’t have the pizazz of a hydroelectric project that can bring power into a valley, open it up for development of one kind or another.

So the big money doesn’t come for the big projects and the people with the big money often argue that purifying water in households is a tedious process that takes forever to get established and doesn’t reach enough people to justify the effort and expense. Some water experts say that if you adopt the household approach you let the governments off the hook and they have even less incentive to do the big projects.

So you get a lot of debate, and very little happens. It has been that way for ages. Experts estimate that no more than five million of the perhaps two billion people with unhealthy water are using household water treatment devices or processes.

Dr. Stephen Luby is an advocate of disinfecting water in homes. He is in charge of the infectious diseases program at the International Centre for Diarrhoeal Disease Research in one of the world’s most beleaguered places in terms of water, Bangladesh. He was in the United States recently to receive an award for his work from Oklahoma University.

“Do I think household water treatment is a panacea, a silver bullet,” he asked in an interview. “No. But it’s something we can do.”

Dr. Luby said he was not opposed to building water treatment plants. “But those kinds of solutions,” he said, “are decades away for the populations at the highest risk for death from water-borne diseases.”

He and other water experts say there has been little or no progress in reducing the total of one billion or two billion people without regular access to clean water.

Perhaps three million people a year are getting deathly ill as a result of drinking contaminated water. That was true 10 years ago. It is true today.

But the annual number of these people dying has declined to perhaps 1.8 million- still a staggering number - because of the introduction of an inexpensive medicine that enables grown-ups and children who have been dehydrated by diarrhea to recover the balance of fluids in their bodies. It’s called oral rehydration. It saves lives. But it saves lives that would not even be threatened if the water were cleaned up. #

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Sep 24 2009

A Fixable Problem Remains Unresolved And Kids Keep Dying

Published by Joseph B. Treaster under Uncategorized

WASHINGTON—Dirty water is killing kids–lots of kids. The magnitude of the deaths is staggering, perhaps 5,000 a day, 1.8 million a year – more deaths annually than the combined total from malaria, measles and HIV/AIDS.

And who’s talking about it? Who is outraged? Practically no one. It is a problem that is virtually unknown in the United States and Europe. The victims are poor children in poor families throughout most of Africa and in remote parts of Asia.

Specialists in water and health are working on the problem and spending lots of money. But some experts say that progress has been meager and that the situation could be getting even worse.

The deaths come quickly and simply. Kids drink the only water they can get. It is loaded with bacteria. They get diarrhea, which is a manifestation of many diseases, including cholera. They get dehydrated and before their parents realize how bad things have gotten the kids are gone. Some grownups die, too. But mostly the 1.8 million victims annually are children, five years old and younger. Millions of kids don’t die from diarrhea. But their illnesses strain already strained hospitals and clinics. By some estimates kids sick with diarrhea miss nearly 300 million school days a year.

This has been going on for decades, almost unbelievable rates of death and sickness among millions of kids. They and their families cannot solve the problem on their own. And they are not getting enough help to break the pattern. They are stuck in a vast pool of nearly 1 billion people around the world who do not have dependable access to clean water every day. Most of them are also among the 2.5 billion people who do not have even the most basic toilets. Without a good supply of clean water and without toilets, disease, sickness and death are almost guaranteed.

The International Federation of Red Cross and Red Crescent Societies, which works in the most awful places and is not given to hysteria, said earlier this year that it had been seeing an increase in cases of water-related diseases that cause diarrhea, including cholera. Uli Jaspers, the head of water and sanitation for the federation at its headquarters in Geneva, said in a statement that “data suggests we may be losing the battle.”

Hundreds if not thousands of people in government and private agencies are devoting their energies to stopping the silent epidemic. Often times the work is one person, one-village, one school at a time. Paul Faeth, the president of Global Water Challenge, a group of organizations here in Washington committed to working against water-related diseases, is getting soap and water to schools in Africa. Sally Cowal, a water expert at Population Services International, also in Washington, provides several low-cost ways of purifying water. They are both having successes, they said at a conference here presented by, the Internet incarnation of a former news agency that competed with the Associated Press and Reuters. But they also acknowledge that what they are doing is not enough.

Katherine Bliss, a deputy director at the Center for Strategic and International Studies in Washington, said at the UPI conference that about $18 billion a year is needed to meet the United Nations’ goal of deeply reducing the problem of water and disease or about three times more than is now being spent worldwide.

But the barrier to a solution is not just money. Often people with the best intentions are working at cross purposes. According to a recent report by several environmental groups, including units of the United Nations and the Nature Conservancy, efforts around the world to provide clean water and sanitation are “plagued by institutional fragmentation that may result in governmental agencies working against each other” in pursuit of their own strategic objectives.

There is no coordinating body or global clearing house for work related to water, Ms. Bliss said, no one seeing that the work of governments and non-governmental organizations complement each other, don’t duplicate, don’t cancel out some other effort. For HIV/AIDS there is the United Nations organization, UNAIDS. Tuberculosis, malaria and HIV/AIDS come under the aegis of the Global Fund to Fight Aids. Water has no similar counterpart.

“Within the United Nations,” Ms. Bliss said, “water and sanitation activities are managed across 26 different technical agencies.” And no one is in charge. The work of the agencies is officially coordinated by the United Nations Water Office. But it does not have enough clout to have much impact.

For now, this is a problem that looks like it can be fixed. But it is a problem that is not getting the attention, the money and the coordination it needs. #

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Jul 30 2009

A Promising Solution To Clean Water Problem Fails To Win Support

Published by Joseph B. Treaster under Uncategorized

ZURICH — When Martin Wegelin worked in Tanzania his three-year-old daughter’s playmate fell ill one morning. By afternoon the playmate, a boy who lived next door, was dead.

The boy routinely had been drinking water loaded with bacteria. He was stricken with diarrhea, became dehydrated and was gone before his parents realized how sick he was.

In Africa and other developing countries, diarrhea is at the top of the list of child-killers. Around the world, the World Health Organization says, 5,000 children die as a result of diarrhea every day; 1.8 million a year. Most of the children die because of drinking water that often looks clean but contains all kinds of bugs.

The boy’s death put Mr. Wegelin, a Swiss engineer who specializes in water and sanitation, on a mission. He determined that he would find a simple, low-cost way to purify drinking water. He developed a method that, in most cases, costs absolutely nothing. But 30 years later, only a few million of the nearly 1 billion people around the world who lack clean drinking water – and are often sick - are using his process called SODIS or Solar Water Disinfection.

Mr. Wegelin says the problem has to do with perception. “It is too simple,” he said in an interview in his government laboratory in the Zurich suburb of Duebendorf. “People think it can’t work.”

The only ingredients in Mr. Wegelin’s process are water, a discarded plastic bottle – the kind used everywhere for soft drinks and commercially packaged water – and sunlight. After six hours in bright sunlight the water is healthy to drink.

“It’s magical,” said Sally G. Cowal, a vice president and water specialist at PSI or Population Services International, a non-profit aid organization in Washington.

But water experts say there are several reasons that the process has never taken off, all fairly frustrating. For one thing, no one has been able to figure out how to make money with it. No big companies have gotten involved, as they have in producing chlorine tablets, liquid and powder that cost about a penny a day to purify water for a family of six. Not big money, but money.

Then there is the matter of the plastic bottle. Environmental groups hate the bottles. They are made from petroleum, their manufacture adds to global warming and they never go away: garbage dumps are filled with them and they are all over the oceans and the waterways. No one has a good word for them and at a time when some cities are banning plastic bottles from municipal vending machines, no government wants to back a program that depends on them.

Ten years ago, Ms. Cowal started a project on household treatment of water in developing countries and decided to go with the chlorine process. The water did not taste as good as sunshine cleaned water. But by using a product that could be sold, Population Services International could do good and continue to do good. They sell the chlorine at a shade above cost, Ms. Cowal said, and put their sliver of profit “into promotion and advertising.” A perpetual motion machine. The sunshine machine gets a nod of approval from the United Nations, but no big allocation of money.

The sunshine method is not without its problems. For one thing, if it’s cloudy the process takes longer, and it is often hard for families to gauge how long. More importantly, making the process work requires a change of behavior for people who have routinely just been drinking water as it has come to them. “We come along,” Mr. Wegelin said, “and tell people, ‘You have another activity. You have to treat the water.’ That requires a change of habit. And changing habits takes time.”

Educating people about water treatment and disease requires aid organizations to invest time and energy and the lessons don’t always stick. It is less complicated to just pump in clean water. But the worldwide problem is so great, that billions of dollars are needed. And, so far, that money has not been forthcoming.

The big government aid agencies and big private aid organizations have strategic problems with the sunshine purification system, the chlorine process and low-cost filters, all designed to be used by individuals and families. They want high impact. They don’t want to do their work one family at a time. They prefer to install networks of standpipes and dig new wells that serve lots of people. Their way provides water to people who might have previously had to walk long distances to get water. It doesn’t always provide clean water. Or water that stays clean. But it works on a large scale. A lot of people get some improvement and aid managers get credit for the accomplishment. If the water quality is not perfect, people can boil it when they get home – or not. The water providers and the health service agencies are not always on the same page, which is one of the many reasons that deaths from water-borne diseases have declined very little in the last decade. #

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