No-Plumbing Disease

A few days ago at a DC-style networking session for public health folks, I introduced myself as the Communications Director for Water Advocates.

I am used to receiving surprised -- even shocked -- expressions when people learn that poor sanitation and unsafe water cause the illnesses that fill half of the hospital beds in the developing world and 10 percent of the entire global disease burden, even if I am amidst the public health folks of the world.

Yet, without missing a beat, the doctor who organized the event spoke up: "You must know that plumbing was the biggest contribution to improving public health in history."

"Yes!!" I exclaimed, overjoyed to finally meet a medical doctor who understands that plumbing is the best way to save lives.

He was referring to the fact that when developed countries like the U.S., Japan, and England installed water and sanitation systems, they eradicated diseases like cholera and typhoid that caused death by diarrhea. Plumbing has saved millions of lives -- our lives.

Still, billions of people in the world don't have access to safe drinking water or a place to dispose their feces. Subsequently, 1.5 million children die every year.

We hear public outcries -- in national news headlines, through savvy leadership, and championed by celebrity spokespeople -- on many poverty-related diseases that are more costly to prevent, cannot yet be treated, or kill fewer people.

When such a simple, cheap, tried-and-true public health intervention is so present in our lives -- and could prevent the astronomical death toll -- why am I still surprised when people know about it?

Blame it on the name.

There are over 25 diseases (deadly and debilitating) that are the result of poor sanitation and unsafe water. These include cholera, typhoid, amoebic dysentery, campylobacter enteritis, giardia, Guinea worm, schistosomiasis, bacillary dysentery (shigellosis), Escherichia Coli diarrhea. And there are at least 10 lesser known ones.

Perhaps if we considered these as one disease it would garner the public outcry it deserves. Let's call it No-Plumbing Disease.

We would then see that No-Plumbing Disease kills more children than HIV/AIDS, malaria, and TB combined. We would see the truth of this ugly situation; the relentless outbreaks of diarrhea that, when they don't kill kids, weaken them month after month -- the instances of a single child, for example, suffering a dozen bouts of it per year, the ensuing malnutrition, the family's economic burden of curing the child, the impact this constant sickness has on a child's education.

The most practical investment we can make in global public health is plumbing.

Of course, plumbing is an oversimplified way of talking about solutions for improving water and sanitation. Many of the existing solutions are simple basic infrastructure, such as a ceramic water filter or a pit latrine. And we need to be more environmentally minded as we develop these systems.

But the main point remains: dirty water and lack of sanitation cause No-Plumbing Disease. The solutions exist right now to solve this crisis. Call it what it is, and give it the attention it rightfully deserves. We will save millions of lives each year.

---

Katryn Bowe from Water Advocates co-authored this blog

Comments

[minkaboo]

Very interesting post! I thought most of the world's diseases and sufferings were caused by civil wars. It makes total sense that if we can create sanitation in these countries, alot of diseases will be eliminated. I can't imagine my own world without clean water and modern toilets. I can't imagine not being able to clean my foods with clean water and wash away all the dirt, bacterias, and bugs on them. It brings a sense of hope that if we invest in the right stuffs, poor countries can significantly improve their lives, and also save costs in future aid money.

[LaineSylvan]

I would rather you re-branded the nasty team of water-borne diseases with a phrase
that doesn't immediately paint a picture of a flushing toilet. Toilets aren't impeccable. (No pun intended.)

Our current practice of plumbing isn't a long-term solution for anywhere.
Untreated sewage is a toxic mix that severely impacts waterways and therefore threatens public health.
Treating sewage demands huge infrastructure cost layouts.

I like what you say at the bottom of this piece,
"Many of the existing solutions are simple basic infrastructure, such as a ceramic water filter or a pit latrine. And we need to be more environmentally minded as we develop these systems."

I would like to add that homemade compost toilets are an excellent way to go --
(no pun intended) -- they use air flow to dry out the waste and turn it into compost. The toilets can be built with bricks.

It costs $18,000 to dig a deep well in the developing world:
http://donate.worldvision.org/OA_HTML/xxwv2ibeCCtpItmDspRte.jsp?section=10373&item=154

With clean water sources, and sanitary, sustainable sewage treatment (composting), imagine how many lives would be graced with better health.

[awalling]

Great article John. "No-plumbing disease" - I love it! The phrase definitely paints a clear picture of the need for increased focus on the basics - safe water and sanitation infrastructure. In my experience, I would have to add a related phrase - "bad-plumbing disease". I work for a non-profit called Healing Waters International (www.healingwatersintl.org) and we focus on areas that have a water infrastructure, but still have unsafe drinking water. This is primarily due to either a lack of proper treatment at the central plant, or most commonly a broken down infrastructure of pipes that lets groundwater contamination and sewage mix into the drinking water. While not as large of a population as those who lack any sort of infrastructure, there are still hundreds of millions of people around the world who get sick from drinking water from their city's "plumbing". So, needles to say, we have a lot of work to do - both in communities with and without a water infrastructure.

[MerhabaAbi]

Indoor plumbing, electricity on demand and a heated home in the Winter are 3 of the things for whcih I am most grateful.