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 on 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 pizzazz 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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