Millennium Post

Wash out this silent disaster

If I tell you that 10 times the number of children under the age of five die every day than all the people killed in the Mumbai 26/11 attacks combined, would that astonish you or outrage you? What is killing so many children? It is pneumonia and diarrhoea. In this silent disaster, children are dying all over the country- particularly those who are poor and do not have a safe environment to live in.

UNICEF estimates that 17 lakh children under the age of five died in India in 2011. Over 4,650 child deaths a day is a dubious distinction to earn. The Lancet reported that the main cause of these child deaths in India is pneumonia, responsible for 24 per cent, followed by diarrhoea (11 per cent). India tops the list in global pneumonia deaths of children with 3.97 lakh reported in 2010, and in the same year, diarrhoea was responsible for 2.12 lakh child deaths.

Almost 91 per cent of all diarrhoeal deaths and 66 per cent of all deaths due to pneumonia can be averted with simple preventive measures linked to safe water supply, sanitation, and hygiene. To prevent these deaths, India is implementing the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). The goal of the GAPPD is to reduce deaths from pneumonia to fewer than three children per 1,000 live births, and from diarrhoea to less than one in 1,000 by 2025. The four States where the India Action Plan for Pneumonia and Diarrhoea is being rolled out — Madhya Pradesh, Uttar Pradesh, Bihar, and Rajasthan — account for half of the under-five mortality in the country, which stands at 62 deaths per 1,000 live births nationally.

Immunisation against Hib, pneumococcus, measles, and whooping cough (pertussis) is the most effective way to prevent pneumonia. Adequate nutrition is integral to improving a child’s natural defences, starting with exclusive breastfeeding for the first six months. Additionally, washing hands with soap, clean drinking water, and putting an end to open defecation –which is a major cause of diarrhoea in South Asia – are easy preventative measures. Simple use of oral rehydration salts and zinc supplementation has proved to be life saving measures in children and may act as effective barriers against diarrhoea.

Evidence has shown that investments in water, sanitation, and hygiene (WASH) are essential to effectively tackle both these diseases. One of the most effective and inexpensive WASH interventions is washing hands with soap. Safe hand washing alone reduces the risk of respiratory infections like pneumonia by 25 per cent and diarrhoea by more than 50 per cent. While a majority of households in India have soap, it is mostly used for laundry and cleaning rather than hand washing.

WaterAid India, its partners and other organisations are working to promote the practice of safe hand washing. It is important for communities to understand the difference between simple hand washing and safe hand washing with soap. To enable greater awareness about the critical role of hand washing in hygiene promotion, the Madhya Pradesh government and Madhya Pradesh Technical Assistance Support Team (MPTAST) attempted to set a Guinness Book of World Record on Global Handwashing Day last year by getting the maximum number of children to wash their hands in an hour. The programme led to the simultaneous demonstration of safe hand washing to more than 13 lakh children from 20,000 schools involving 40,000 teachers, 20,000 witnesses and an equal number of videographers.  

Access to safe water and adequate sanitation infrastructure are necessary prerequisites for enabling change in behaviour and providing a safe growth environment to children. Open defecation puts at risk our drinking water sources and increases the chances of fecal-oral contamination. Inadequate environmental sanitation, such as solid and liquid waste management and poor air quality, adds up to an overall disease burden resulting in high infant mortality.

Communities in India need to have adequate knowledge about the linkages between health and safe water supply, hygienic and sanitary practices. India also needs to achieve household water security to result in a significant reduction in child mortality and morbidity. We can only defeat diarrhoea and pneumonia through concerted and integrated efforts by citizens, civil society and governments. Efforts around World Water Day (March 22) will complement the Swachh Bharat campaign which targets to have a Clean India by 2019. While that will be a fitting tribute to Mahatma Gandhi on his 150th birth anniversary – think also of all the children’s lives that would be saved.

(The author is a public health engineer and environmentalist with WaterAid)
Next Story
Share it