Thank you for supporting WASHplus!

by Taj Sheriff on July 7, 2016

EOP message social media

Reposted from the 1/14 Huffington Post.

story on the high incidence of malnutrition among children in India reminded us of a curious phenomenon that for years had puzzled development and health professionals. Despite India’s growing economic power and successive governments who paid serious attention to increasing food supply, children in that country remained smaller than those in less well-off countries in sub-Saharan Africa.

It took years of research and large-scale case studies – some of which were published by UNICEF, USAID and WHO in Improving Nutrition Outcomes with Better Water, Sanitation and Hygiene - to pin it down. There is a very widespread lack of adequate and diverse food intake among young children, which needs to be addressed, in both India and poor countries in sub-Saharan Africa. However, in India there is an additional and unexpected villain in the piece: a lack of toilets.

Open defecation has been a problem for a very long time in India. So common was the practice that almost 100 years ago Mahatma Gandhi urged his compatriots to stop it. It remains widespread to this day, practiced by 44% of the population in 2015. This runs to 569 million people, the highest number of people practicing open defecation of any country in the world. In part it is due to a lack of facilities, but not entirely. Significant numbers of Indians with toilets at home still defecate in the open.

What does open defecation in India have to do with the size of its children?

There is open defecation in sub-Saharan Africa. Of the 700 million people in the region who do not have proper toilets around 230 million defecate in the open. What is different in India is the pervasiveness and the concentration of the practice.

In India, a child is surrounded by feces. It is where babies crawl; where children play; where they eat; in the water they drink and bathe. It gets into their mouths; they ingest it from their own unwashed hands as well as those of their care-givers. And when it gets inside it does some very dirty work.

Feces carry bacteria that in young children especially can lead to multiple episodes of diarrhea every year. Not only do these episodes prevent the retention of nutrients from food, we now know that they permanently alter the absorptive capacity of a child’s guts, by lessening the number of the villi on intestinal walls which are meant to trap nutrients.

Feces can also carry intestinal parasites – like hookworm, which causes anemia in pregnant women, leading to malnourished, underweight babies. These parasites rob infected children of even more nutrients.

What is the result? A stunted child.

Stunting means children are not growing as they should, they are short and small for their age, and they can have permanent cognitive damage. That has implications on a country’s economy. Stunted children grow up to be weaker and more susceptible to illness, bringing an extra burden to the public purse. They do less well in school, so they earn less as adults. The ramifications are far reaching.

In India 4 out of 10 children under 5 years old are stunted. And around the world, 159 million children are stunted.

India might have numerically the biggest problem, but unless the world wakes up and does something about sanitation, the problem could grow.

In sub-Saharan Africa the number of people who defecate in the open is growing. Countries in the region have been scrambling to keep up with a population which has very nearly doubled between 1990 and 2015. The urban population, in fact has almost tripled, and services have not kept pace.

We do know that when political will, outside intervention, and – crucially – community involvement combine, excellent results are possible.

During the prolonged Sahel drought, Mali used UNICEF’s community led approach to end open defecation in communities with high malnutrition rates. They saw vastly improved health and nutrition in children.

In conflict-affected Democratic Republic of the Congo, displaced communities were given both extra nutrition and help with improving water, sanitation and hygiene. Waterborne diseases fell dramatically in children under 5, and some 90 per cent of malnourished children returned to normal weight during a 12-month period.

It is 2016. We know what to do and we know how to do it. India’s children, and all children around the world, deserve a chance to grow tall and strong and live healthy and productive lives.

Small Intestine Bacterial Overgrowth and Environmental Enteropathy in Bangladeshi Children

February 1, 2016

A total of 165 million children worldwide are considered stunted, which is associated with increased risk of death prior to age 5 years and cognitive disability. Stunting has, in part, been attributed to the presence of environmental enteropathy. Environmental enteropathy is a poorly understood condition leading to chronic intestinal inflammation. It has been postulated that […]

Read the full article →

Improving nutrition outcomes with better water, sanitation and hygiene: Practical solutions for policy and programmes

February 1, 2016

A growing body of evidence indicates that access to safe drinking-water, sanitation, and hygiene (WASH) services has an important positive impact on nutrition. Achieving the six Global Nutrition Targets 2025, as well as global goals for WASH and health, will require greater investments in nutrition and WASH. It will also require maximizing impact through smart […]

Read the full article →

Sanitation and nutrition: Should we link them together in our development actions?

January 27, 2016

From Ideas for Development, January 7, 2016 http://ideas4development.org/en/sanitation-and-nutrition-should-we-link-them-together-in-our-development-actions-4/ The links between the lack of sanitation and hygiene and nutritional status are increasingly well documented.Yet in the field, few development actors include nutrition in their water and sanitation operations. Why do they fail to take it into account? What are the barriers? Would building stronger links […]

Read the full article →

World Bank study on WASH and Nutrition in Bangladesh: Can Building Toilets Affect Children’s Growth?

January 12, 2016

Issued early in 2016, the World Bank study provides a systematic review of the evidence on the relationship between water and sanitation and nutrition in Bangladesh. The report is intended to accomplish two things: first, to synthesize the results/evidence evolving on the pathway of WASH and undernutrition for use by practitioners working in the nutrition […]

Read the full article →

WASHplus Learning Brief on WASH and Nutrition

January 12, 2016

This first in the series of learning briefs, “WASH and Nutrition,” documents WASHplus’ WASH and nutrition integration programming efforts to stimulate the discussion and improve the evidence base as well as share experiences and approaches to integrating the two sectors at the global and country level.  WASHplus has been stimulating the discussion and improving the […]

Read the full article →

Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction

November 9, 2015

Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries. Maternal and Child Nutrition, Nov 2015. Authors: Mduduzi N.N. Mbuya and Jean H. Humphrey.  Full text: http://goo.gl/4WOXOK In 2011, one in every four (26%) children under 5 years of age worldwide was stunted. The realization that most stunting cannot be explained by poor […]

Read the full article →

Water, Sanitation, Hygiene, and Nutrition in Bangladesh” Can Building Toilets Affect Children’s Growth?

November 9, 2015

Water, Sanitation, Hygiene, and Nutrition in Bangladesh” Can Building Toilets Affect Children’s Growth? 2015. Full text Authors: Iffat Mahmud and Nkosinathi Mbuya. World Bank. This report provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition.  We also examine the potential impact […]

Read the full article →

Notes from the SuSanA WASH & Nutrition Working Group

September 8, 2015

Notes from the SuSanA WASH & Nutrition Working Group (The notes below are from Claire Gaillardou/ACF of the SuSana Working Group on WASH & Nutrition meeting at World Water Week in August 2015) Dear members/followers of WG 12, I would like firstly to thank you for your participation during the side event ACF-GWN on WWW. The […]

Read the full article →