CHAPTER TWO
CHALLENGES AND
CONSEQUENCES OF POOR
SANITATION
LECTURE 2
SESSION ONE
UNIVERSITY OF BOOSAASO (GAROWE, SOMALIA)
Introduction
❑Sanitation refers to the safe collection,
transportation, treatment and disposal
of human wastes. In developing countries,
improvements in practices of disposing of
human excreta are crucial to raising levels
of public health.
❖Poor sanitation is linked to transmission
of diarrheal diseases such as cholera
and dysentery, as well as typhoid,
intestinal worm infections and polio.
It exacerbates stunting and contributes to
the spread of antimicrobial resistance.
Challenges Faced by the Sanitation Sector
•The major global challenges faced by the sanitation sector
are the following:
People without sanitation:
•An often quoted figure is that the total number of unserved
is about 40% of all people in the world. If present
trends continue, the number of unserved is going to
increase.
Health effects of poor sanitation:
•Approximately 6000 children die every day from
diarrheal diseases related to inadequate sanitation
and hygiene. About 1 billion people worldwide,
mostly children, are infested with intestinal worms and
as a result suffer nutritional deficiencies and
poor growth.
Water shortage:
•Already today many areas are suffering from chronic
fresh water shortages and the demand for
freshwater has tripled in the past 50 years. By 2030
more than half the world's population will face
a shortage of water.
Water pollution:
•Sewage discharges from centralized,
water-borne collection systems are a
major component of water pollution all
over the world.
•Only about 300 million people in the
world today have end-of-pipe
treatment of sewage to a secondary
level before the sewage is discharged
into open bodies of water.
Food insecurity:
•In today's urban societies the flow of
plant nutrient is linear: nutrients are
taken up from the soil by the crop,
transported to the market, eaten,
excrete and discharged.
•In a sustainable society the
production of food must be
based on returning the plant
nutrients to the soil.
Urban growth:
•Rates of urban growth of greater than 5%
per year have produced concentrations of
poor people in city- centre slums and in
squatter areas on the periphery of
towns and cities.
•Health risks are high in these areas.
High-density living promotes the
spread of airborne respiratory
infections and hygiene-related
diseases such as diarrhea.
Inadequacy of current options:
•The sanitation practices promoted today are
either based on hiding human excreta in deep
pits (“drop- and-store”) or on flushing
them away and diluting them in rivers,
lakes and the sea (“flush-and-
discharge”).
Consequences of Poor
Sanitation
1. Health impacts
✔The lack of safe sanitation systems leads to a range of
adverse health impacts, including:
• Diarrhoea, a major public health concern and a leading cause of
disease and death among children under five years of age in low
and middle-income countries. This includes cholera, an acute
diarrhoeal disease that can kill within hours if left
untreated.
•Neglected tropical diseases such as
soil-transmitted helminth infections,
schistosomiasis and trachoma, which account for
a significant burden of disease globally.
•Vector-borne diseases such as West Nile virus or
lymphatic filariasis (through poor sanitation
facilitating the proliferation of Culex mosquitos).
• Stunting, which affects almost one quarter of
children under five years of age globally through
several mechanisms, including repeated diarrhoea,
helminth infections and environmental enteric
dysfunction related to unsanitary conditions, and
leads to poor physical and cognitive
development.
• Antimicrobial resistance, by increasing
the risk of preventable infections that
are treated with antibiotics and by
spreading excreted resistant
organisms in the environment though
untreated wastewater and sludge.
•Anemia and spontaneous
abortion and pre-term birth
associated with soil-transmitted
helminth infections (worms).
2. Economic costs
•Significant financial costs can result
from sickness and death related to poor
sanitation: out-of-pocket payments and
travel costs for households seeking
health care;
•government subsidies implicit in
public health care provision;
income losses associated
with sickness;
3. Social impacts
•In addition to the economic costs, lack of sanitation
has negative impacts that cannot easily be quantified.
Impacts on dignity, poverty, disability, safety,
gender and education represent unrealized human
potential and are disproportionately borne by the most
vulnerable and disadvantaged.
✔Dignity: The ability to manage bodily
functions, including urination, defecation
and menstruation, is at the core of dignity.
A complete lack of service, forcing people
to resort to open defecation, presents
the greatest indignity.
✔Poverty: The poor are less likely to
benefit from public investments in
sanitation, and their health is
disproportionately impacted by lack of
sanitation.
❑Sanitation rates are lower in rural
areas, and only a small minority of
countries are on track to eliminate
open defecation among the poorest
rural dwellers.
✔Education: Poor sanitation has
been shown to act as a barrier to
school attendance and
enrolment in many countries.
❑This affects girls in particular,
especially after puberty, when their
need for menstrual hygiene
management may not be
addressed.
THANK YOU
