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Water, sanitation and hygiene

Thousands of children die every day as a result of diarrhoea and other
illnesses transmitted by water or caused by a lack of sanitation and hygiene.

Antananarivo, 19 November, 2010 – November 19 is World Toilet Day, highlighting the
importance of adequate sanitation to prevent disease – especially among children – and
raising awareness of the 2.6 billion people worldwide who lack adequate sanitation, living
without access to a toilet or latrine that provides safe disposal of human urine and faeces.
Among these people, 1.2 billion have no facilities at all.

For children, the impact of such poor sanitation is profound. Inadequate sanitation is linked
to diarrhoea, an illness estimated to be responsible for the deaths of around 1.5 million
children under five years old every year. Worldwide, 88 percent of cases of diarrhoea are
attributable to unsafe water, inadequate sanitation and insufficient hygiene. Among children
under five, diarrhoea continues to be one of the biggest causes of mortality.

“Despite being preventable, disease related to poor water and sanitation is still one of the
most significant child health problems worldwide, with diarrhoea causing the deaths of an
estimated 4,000 children under five every day,” said UNICEF Madagascar acting
representative, Valerie Taton.

“Access to adequate sanitation underpins many aspects of child development; and
children’s rights to an adequate standard of living and to the highest attainable standard of
health are enshrined in the Convention on the Rights of the Child. Through our water,
sanitation and hygiene programmes, UNICEF is working towards realising these rights by
improving access to sanitation facilities for children, at home and at school.”

In Madagascar, access to adequate sanitation is low. According to the latest World Health
Organisation/UNICEF Joint Monitoring Program (JMP 2010) report, only 15% of the
population in urban areas has access to improved sanitation, while in rural areas the figure
is just 10%. Across the country, only 11% of people are now able to use improved
sanitation facilities. Where communities have no access to sanitation, they are most often
forced to defecate in communal open areas near their homes.

As part of its strategy to improve the situation, UNICEF Madagascar is working with local
communities to enable them to analyse their environmental sanitation conditions and
collectively draw the link between public health and poor sanitation practices, particularly
open defecation. Known as community-led total sanitation (CLTS), this method allows
communities to identify their own sanitation needs, and formulate their own action plans to
end open defecation and begin the construction of latrines.
Working with local partners, UNICEF has initiated the CLTS process in over 350 villages
across Madagascar.

For more information on Global Latrine Day please visit:

                          Fast Facts on Sanitation
       1.5 million children under five years old die each year from diarrhea,
        according to the World Health Organisation WHO), equivalent to around
        4,000 deaths each day.

       Around half the world’s population lives a life without a clean, private place
        to defecate and urinate. Instead they use fields, streams, rivers, railway
        lines, canal banks, roadsides, plastic bags, waste-paper, or buckets and
        insanitary latrines.

       The regions with the lowest sanitation coverage are sub-Saharan Africa
        (37%), southern Asia (38%) and eastern Asia (45%). Underlying issues that
        add to the challenge in many countries include weak infrastructure and
        scarce resources to improve the situation (WHO).

       Only 11% of the population of Madagascar has access to improved
        sanitation; 15% access in urban areas and 10% access in rural areas
        (UNICEF/WHO Joint Monitoring Progamme, 2010).

       Lack of sanitation facilities forces people to defecate in the open, in rivers or
        near areas where children play or food is prepared. This increases the risk
        of transmitting disease. The Ganges river in India has 1.1 million litres of
        raw sewage dumped into it every minute, a startling figure considering that
        one gram of faeces in untreated water may contain 10 million viruses, one
        million bacteria, 1000 parasite cysts and 100 worm eggs (WHO).

       The majority of the illness in the world is caused by fecal matter .Examples
        of diseases transmitted through water contaminated by human waste
        include diarrhoea, cholera, dysentery, typhoid, and hepatitis A. In Africa, 115
        people die every hour from diseases linked to poor sanitation, poor hygiene
        and contaminated water (WHO & Water Supply and Sanitation Collaborative
       Eighty-eight percent of cases of diarrhea worldwide are attributable to
        unsafe water, inadequate sanitation or insufficient hygiene (WHO).

       Adequate sanitation encourages children to be at school, particularly girls.
        Access to latrines raises school attendance rates for children: an increase
        in girls’ enrolment can be attributed to the provision of separate, sanitary
        facilities (WHO).

       Hygiene education and promotion of hand washing are simple, cost-
        effective measures that can reduce diarrhoea cases by up to 45%. Even
        when ideal sanitation is not available, instituting good hygiene practices in
        communities will lead to better health. Proper hygiene goes hand-in-hand
        with the use of improved facilities to prevent disease (WHO).


   1. Water Supply and Sanitation Collaborative Council [WSSCC]. 2008. A Guide to Investigating
      One of the Biggest Scandals of the Last 50 Years.
   2. UNDP(2006 United Nations Human Development Report)
   3. (WHO 2008. Safer Water, Better Health: Costs, benefits, and sustainability of interventions
      to protect and promote health.)
   4. JMP, 2010

Press contact :

Maurice Apted
Chief of Communications
+261 (0)33 15 411 38
UNICEF Madagascar

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