Exploring the Sustainable Development Goals
Water, Sanitation, and Hygiene for All
By Allison Kooser
Originally published in 2017. Updated in 2021.
In the first hour of your day, you might brush your teeth, take a shower, wash your face, and use the bathroom.
You may make yourself a cup of coffee or fill a bottle with water.
And if you’re anything like me, you don’t think twice about the plumbing and infrastructure that makes all of these activities possible.
Each morning when you turn on the faucet, water comes out. And the water is clean, healthy, and often temperature-controlled.
Unless you’ve traveled recently, the water you drink each day probably isn’t making you sick—and I doubt you are particularly worried about cholera, typhoid, or waterborne diarrheal diseases.
You’re able to wash your hands regularly to manage the spread of COVID-19 and other illnesses.
When you walk around your neighborhood, you probably see trees, yards, or busy traffic—not open sewage.
And at the end of the day, you can shower or wash your face again without wondering if you’ve already used up your quota of water for the day.
Each of these realities is a luxury. For billions of people around the world, clean water isn’t guaranteed. The very liquid that keeps us alive is also making millions upon millions sick because it’s contaminated or uncontrolled.
Sanitation is even rarer—compounding the health risks that unclean water creates.
While it’s hard to imagine from the comfort of our faucet-delivered clean water and in-home bathrooms, the world is facing a water and sanitation crisis.
Around the world today, “Two billion people lack access to safely managed drinking water services and 3.6 billion people lack safely managed sanitation services.”1 For these people, clean water doesn’t come out of a faucet at home, and it might not even be available within walking distance. Clean water is a precious commodity, and one that is painfully out of reach.
When water is available, it is often far away—meaning that people, usually women, have to spend large portions of their days traveling to retrieve a few gallons of water to then ration across their entire family. About 207 million people spend more than 30 minutes traveling to collect water.2 And those that can walk to a well or a water source are the lucky ones; another 144 million people still collect water directly from dangerous water sources like rivers and ponds, while 435 million draw water from unprotected wells and springs.3
Water is the driving force of all nature.Leonardo Da Vinci
Without access to clean water, nearly 1.8 billion people drink water from a source that is contaminated with feces, putting them at risk of contracting cholera, dysentery, typhoid and polio4. These health risks are severe, preventable, and made even more catastrophic when coupled with inadequate health services and medical treatment.
Simultaneously, the majority of the world doesn’t have access to safely managed sanitation, and 3.6 billion people still lack even the most basic sanitation services.5 Without toilets, latrines or any sort of sanitation system, nearly 494 million people continue to practice open defecation.6
Without sufficient access to either clean water or sufficient sanitation, more than 700 children under the age of 5 die each day from diarrhea and preventable diseases linked to poor hygiene and unsafe water.7 We simply cannot stand idly by while so many children suffer and die from illnesses that we know how to prevent.
In 2015, the World Economic Forum declared that the global water crisis is the “biggest threat facing the planet over the next decade.”8
This enormous global challenge inspired Sustainable Development Goal 6:
“Ensure availability and sustainable management of water and sanitation for all.”
This movement to address water, sanitation, and hygiene (known as WASH) is one we must all join in order to make progress on all of our development goals.
Much like peace and justice, water and sanitation are foundational elements to a flourishing society. Without clean water and sufficient sanitation, health, education, and livelihoods all suffer. When children are constantly ill because of contaminated drinking water, they cannot go to school. And the hours families spend each day walking to collect water are hours that they cannot use to work or study. As USAID noted, “Ensuring the availability of safe water to sustain natural systems and human life is integral to the success of development objectives, foreign policy goals and national security interests.”9
Water, Sanitation, and Health
Countless studies have measured the impact that water and sanitation have on health, resulting in conclusions like the one found in a 2014 report: “[This approach] confirms the important role of the provision of safe water, adequate sanitation and hygiene to protect health.”
To achieve any health initiatives, communities must first ensure that they have access to clean water and sanitation. Without these most basic needs met, people are at severe risk of waterborne illnesses and diarrheal diseases. And for those that are already hungry or undernourished, these illnesses can be devastating.
For example, cholera and other diarrheal diseases are responsible for some 829,000 deaths each and every year, and disproportionally affect children.10
In addition to illnesses caused by consuming contaminated water, people are also at risk of water-washed diseases—infections caused by poor personal hygiene. These illnesses—things like dysentery, scabies, trachoma, leprosy, and conjunctivitis—cause blindness, open sores, and painful skin conditions.11 Meanwhile, poor sanitation "is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma."12
In the midst of the COVID-19 pandemic, the health risks associated with a lack of clean water became even more apparent. “In the 60 countries identified as having the highest risk of health and humanitarian crisis due to COVID-19, one in two schools lacked basic water and sanitation services and three in four lacked basic hand washing services at the start of the pandemic."13 Worldwide, 20 percent of healthcare facilities do not have a water source on-site—and in sub-Saharan Africa, this number is as high as 40 percent.14
Water, Sanitation, and Education
After researching water, sanitation, and education, UNICEF noted that we could gain an estimated 1.9 billion school days if we achieved our goals related to safe water and sanitation and reduced the incidence of diarrheal illness.15 By addressing water and sanitation, we make it possible for more kids to go to school, grow, learn, and break the cycle of poverty for themselves, their families, and their communities.
In addition, accessible water and sanitation reduce the need for children to spend long hours walking for water, a task that often falls to girls. As research has noted, “Providing water closer to homes increases girls’ free time and boosts their school attendance.”16
Finally, by improving the water and sanitation facilities at schools themselves, we can make it possible for children, and especially girls, to stay in school as they grow. While “all children need a sanitary and hygienic learning environment, the lack of sanitation and hygiene facilities in schools has a stronger negative impact on girls than on boys. Girls need safe, clean, separate and private sanitation facilities in their schools, especially as they reach puberty.”17 Yet as of 2019, "698 million children lacked a basic sanitation service at their school, including 331 million whose schools had improved facilities that were not single-sex or not usable, and 367 million whose schools still had no sanitation service."18
By investing in these school improvements, we make it possible for children to go to and stay in school.
Water, Sanitation, and Livelihoods
In addition to improving health and education, access to WASH is “critical to increasing the income of individuals and households living in poverty.”19 In the same way that reducing the time spent collecting water benefits girls in school, it is also a “critical first step in the economic empowerment of poor women.”20
Research conducted in line with the Millennium Development Goals (the set of development metrics that preceded the Sustainable Development Goals) indicated that “meeting the MDG targets on water and sanitation alone would save 3.2 billion adult working days and 443 million school days annually, increasing workforce productivity and long-term earning potential.”21 There’s no doubt that as we seek to end extreme poverty and create sustainable livelihoods, water and sanitation play a crucial role.
The impact of water on all aspects of development is undeniable: a safe drinking water supply, sanitation for health, management of water resources, and improvement of water productivity can help change the lives of millions.Dr. Rajiv Shah, USAID Administrator
Achieving SDG 6, water and sanitation for all, is an expensive and challenging undertaking. Like many of our most pressing development initiatives, water and sanitation require significant investment in infrastructure, maintenance, and, importantly, ongoing training on how to use these new water and sanitation systems correctly.
WASH initiatives undertaken by organizations around the world have sought to build wells, provide toilets, dig latrines, purify water, and more. Other projects focus on training communities to use and maintain these facilities so that they do not fall into disrepair or disuse. Still other investments have gone toward hygiene awareness, encouraging healthy behaviors through creative campaigns. Clean water, sanitation, and hygiene—much like extreme poverty itself—are challenges that will require our collective, collaborative efforts. It is too big of a problem with too significant of an impact for any one person or group to be left to solve it on their own.
Water is life, and clean water means health.Audrey Hepburn
In 2017, the World Economic Forum wrote a piece on the importance of collaboration in achieving the SDGs. In it, they wrote, “We do not yet know just how things will unfold, but one thing is for sure: the scale, scope and complexity of the economic and social transformation to come will be such that no one sector—government, business, civil society or academia—will be able to manage the transformation alone. We’re going to need some surprising alliances that bring different sectors together if we are to overcome its challenges.”22
This is certainly the case for the water crisis.
We must work collaboratively—as organizations, business, governments, academics, and individuals—to solve this massive health, wellness, environmental, and economic challenge.
In this spirit of collaboration, Opportunity International has sought intentional partnerships in the last few years to address WASH around the world. As an organization that specializes in financial services and training, we recognized that we were not well suited to provide technical implementation of water and sanitation services—but we were well suited to help finance these programs and train our clients on their use. So in 2013, we began building a WASH portfolio in partnership with technical experts around the world.
Water and Sanitation in Ghana
In 2013, we began working with partners in Ghana to assess the market and explore potential opportunities to expand access to WASH through financial services. We chose to develop sanitation financing for landlords, equipping them to improve and install facilities in their buildings, and facilitate household water connections in homes. The test showed that a financially minded organization can have an important role to play in improving access to both sanitation and water.
In addition, we are working with WASH businesses such as pit-emptying businesses and water distributors to improve not only personal access to water and sanitation, but the supply side of WASH as well.
For a country like Ghana, where 79 percent of people lack access to improved sanitation, these programs can be revolutionary.23
Water and Sanitation in India
In the Indian region of Bihar, water and sanitation present a severe crisis. Baseline data collected in 2012 found that 79% of surveyed households were practicing open defecation, and 74% of households were dependent on unreliable and often unsafe tube-wells and hand pumps as their water source.
Still today, despite the progress that has been made in the last decade, less than half of the rural population in India uses safe drinking water.24
In partnership with a local NGO, Healing Fields, and an on-the-ground microfinance partner, CASHPOR, we disbursed over 17,000 loans for toilets and an additional 16,000 loans for water connection or purification since 2013. In addition, we have focused our attention on training and education by working with Healing Fields to train Community Health Facilitators. These local women have, in turn, provided more than one million people with health education that encourages hygienic and healthy behaviors. As a result, hand washing has increased, women are seeing a decrease in preventable infections, and the communities are experiencing fewer illnesses.
Water and Sanitation in the Philippines
We also began providing WASH loans to our clients in the Philippines in partnership with local technicians. These loans empower those who rely on unsafe water sources and lack improved sanitation to purchase toilets and install clean water sources. We have worked with technical experts to equip our field partners with education on implementing WASH loan products, staff training, and assistance to execute a pilot program. In addition, we have built financial relationships with supply-side WASH businesses to improve their ability to serve local communities. To date, we have administered over 20,000 WASH loans in the Philippines so that families can access clean water and healthy sanitation.
Water and Sanitation in Schools
As part of our EduFinance program, Opportunity provides School Improvement Loans to school proprietors around the world. These loans empower school owners to make key improvements to their facilities, which often include building additional bathrooms or improving access to water. School proprietors may use their loans to purchase toilets, build new structures, or improve existing, low-quality infrastructure. As we have already seen, when these facilities are available at school, they make education more accessible to children, especially girls.
What’s more, when schools bring in clean water, they often spark a ripple effect for the whole community. We have seen entire neighborhoods benefit from one school’s decision to improve its infrastructure.
Opportunity has found a role to play in addressing WASH around the world, and we are proud to collaborate with other thought leaders and technicians to end this global crisis. We believe that everyone deserves clean water and sanitation, and we know what access to these resources can make possible.
We also know that we cannot do it alone. We are grateful for our partners who spend their lives developing the most innovative and sustainable solutions for clean water and sanitation, just as we spend our lives developing financial tools and partnerships that allow us to tackle some of the world’s most pressing challenges. Together, our work is helping to provide clean water, improve sanitation, and ultimately, end extreme poverty.
Allison is a professional storyteller, freelance writer, and avid traveler. She spent the last year backpacking around the world meeting and interviewing incredible people with remarkable stories, eating amazing food, and climbing very scary mountains. Now, she lives in Chicago where she runs a small business helping nonprofit organizations identify, create, and share their stories, equipping them to better do the work they were born to do. When she's not working, you can usually find her reading a book, planning her next trip, or baking the best cookies on the planet.
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