The Right To Water is More Important Than Ever
Ten years ago today, United Nations finally gave formal recognition of the human right to water and sanitation
When the Universal Declaration of Human Rights was signed in 1948, it included the rights to food, clothing and housing, but inexplicably not water or sanitation.
In 1948, the United Nations had 48 members (total there are 193), only four of which — Egypt, Ethiopia, Liberia and the Union of South Africa — were from the African continent. Decades later, the office of the UN Special Rapporteur on the right to water and sanitation would write that the omissions of water and sanitation from the original Declaration “can only be explained by an assumption that water, like air, was already freely available to all.”
But clean water and adequate sanitation were far from free or readily available to all in 1948, and these grave inequalities persist to this day, with more than half the world’s population still lacking access to clean water. The COVID-19 pandemic has made access to water and sanitation more important than ever, highlighting and exacerbating the vulnerabilities of marginalized communities.
Clean water and hand hygiene are our first defense against the spread of COVID-19 and other infectious diseases. 40 percent of the world’s population does not have access to basic hand washing facilities in the home. In Africa and Asia, the poorest quintile of families spend up to 11% of their household income on water, not including the time spent collecting it.
Unequal access to water and sanitation infrastructure also impacts health systems. An estimated 896 million people use healthcare facilities without water service and another 1.5 billion people use health facilities without any sanitation services. Additional facilities are vulnerable to water shortages due to drought and high water trucking costs. For years, St. Boniface Hospital in Haiti, was able to meet its water needs from a three wells on the hospital campus. But as the hospital grew and drought worsened in Haiti, St. Boniface Hospital began to face a water shortage. The hospital’s operations team began trucking water, 3,000 gallons at a time, from two miles away and filling the hospital’s cisterns by hand, bucket by bucket. But this was expensive and inefficient.
In 2016, Build Health International began constructing a permanent solution to the hospital’s water crisis: building an extension to the pipeline that brings water from nearby Dugue Spring to the town of Fond-des-Blancs. Water now flows directly to St. Boniface Hospital and fills a 12,000 gallon tank. This investment has been particularly valuable during the COVID-19 pandemic, when the need for water is high and lock-downs restrict local travel.
For hospitals and health centers, access to a reliable, clean water supply is vital to preventing nosocomial infections (also known as hospital-acquired infections) of COVID-19 and other diseases. In these settings, disease can be spread by unwashed hands, contaminated bedding and dirty medical instruments. Water is also critical for laundering reusable personal protective equipment (PPE) required by health workers — an issue that is particularly acute in low-resource settings where disposable PPE is often not available or prohibitively expensive.
In facilities that lack water and sanitation, mothers and newborn children are among the most vulnerable. Without water and sanitation infrastructure, the risk of infection during birth can be dangerously high. More than 1 million deaths are associated with unclean births across the world, with a full 26% of neonatal deaths and 11% of maternal deaths caused by infections due to gaps in water, sanitation and hygiene infrastructure.
As COVID-19 spreads to communities without robust water and sanitation, health facilities are likely to face a two-pronged challenge: responding to a surge in cases due to high community spread infections, and caring for patients without sufficient infrastructure themselves. Swift and effective action today to invest in water and sanitation infrastructure can mitigate this crisis and prepare communities for greater health outcomes long after the pandemic.
Ela Hefler is Build Health International’s Development & Communications Specialist. She writes about the intersections of health and infrastructure, with a focus on the impact of BHI’s work on fragile health systems.
