Clean water helps prevent stunting

Children infected as a result of a lack of access to clean water are more likely to fall behind or drop out of school

Syed Mohammad Ali August 04, 2016
The writer is a development anthropologist currently based in Fairfax, Virginia

There is growing awareness about the interplay of genes, the surrounding natural environment, and food intake, for the physical and mental development of children. However, the detrimental impact that lack of access to clean drinking water and sanitation facilities can have on children’s growth and development is often not recognised or given the attention it deserves. The need to focus on this latter issue is particularly important in countries like our own where nearly 40 per cent of our existing population is without access to adequate sanitation.

The problem of lack of access to clean water and sanitation facilities is not confined to Pakistan alone.  More than 650 million people across the world do not have access to clean water. Over 2.3 billion people globally do not have access to adequate toilet facilities. Diarrheal diseases caused by dirty water and poor sanitation are the second biggest killer of children under five. Even those children who survive severe bouts of diarrhea are at risk of having medical complications later on in life. Lack of access to adequate water and sanitation facilities also has other varied implications. For example, the time wasted from being sick with water-borne diseases or collecting water has a huge impact on education.

Moreover, there is increasing evidence to suggest that the lack of clean water, sanitation and hygiene is a major contributor to the alarming levels of malnutrition across the developing world. The World Health Organisation estimates that 50 per cent of undernutrition is associated with infections caused by unsafe water, poor sanitation and unhygienic physical conditions. Children who regularly have diarrhea or other infections caused by this lack of access are more likely to fall behind in school or even drop out altogether.

One related impact of malnutrition caused by lack of access to clean water and/or inadequate sanitation is stunting. Stunting is a form of malnutrition, caused by severe and prolonged undernutrition, which makes children shorter than normal for their age. Stunting is largely irreversible after the age of two. The implications of stunting are not only confined to hindered physical growth, it also affects emotional, social and cognitive development of children.

Pakistan is among the 10 worst countries for stunting in children, with nearly half of its child population stunted due to a lack of toilets, dirty water and poor hygiene, according to a new study, ‘Caught Short’ published by WaterAid. We are 8th out of 133 countries if we compare the percentage of total children stunted, with 45 per cent of our children stunted. As many as 9.9 million Pakistani children under the age of five are stunted. This is the third-highest population of children stunted, except for India and Nigeria.

The medical journal, Lancet, estimates that direct interventions to address malnutrition, such as nutrient supplements and exclusive breastfeeding, can only reduce stunting by 20 per cent in the worst-affected countries, even if they’re reaching 90 per cent of the population in need. By implication, the need for improving access to clean water, sanitation and hygiene, remains vital for reducing the remaining 80 per cent of stunting. These research findings, as well as the alarming levels of stunting within a country, should be a wake-up call for our current leaders who are busy diverting scarce national revenue towards mega-projects at the cost of lingering neglect of social sectors. The resulting absence of basic civic amenities, including access to clean drinking water or access to toilet facilities, linked to an adequate sewage system, not only continues to cause hardship for a major proportion of Pakistani citizens, but is also evidently stunting our future generations. 

Published in The Express Tribune, August 5th, 2016.

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