WASH and HIV/AIDS Go Hand in Hand

This blog is re-posted with permission from the Elizabeth Glasier Pediatric AIDS Foundation.

This week is World Water Week (September 1-6, 2013), and to mark the occasion, our colleagues at WASH Advocates shared why proper water and sanitation is crucial to the global fight against HIV/AIDS.

“We shall not finally defeat AIDS, tuberculosis, malaria, or any of the other infectious diseases that plague the developing world until we have also won the battle for safe drinking water, sanitation and basic health care.” – Kofi Annan, former Secretary-General of the United Nations

Since AIDS first was discovered in 1981, more than 60 million people have been infected with the virus and more than 34 million people are living with HIV/AIDS today. It disproportionately affects the poor and those in regions where living conditions are overcrowded, unsanitary, and lack access to water, medical care, and proper nutrition.

Kofi Annan was right about the connection between AIDS and water, sanitation, and hygiene (WASH). When communities do not have adequate water or sanitation, diarrheal episodes increase, and the health of the entire community is affected. What’s more, people living with HIV/AIDS are more vulnerable to infection due to their suppressed immune systems, and are disproportionately affected by lack of access to WASH. In fact, people living with HIV/AIDS are at greater risk for developing diarrheal disease, have it more frequently, have more severe episodes, and are more likely to die from it.

Several billion dollars are spent each year to fight the HIV/AIDS epidemic, and a portion of that money is used to provide antiretroviral medication (ARVs) to HIV-positive patients to help them live long and productive lives. However, persistent diarrhea greatly reduces the efficacy of this therapy by preventing absorption of both the ARV medication and other essential nutrients. Diarrhea in people living with HIV literally flushes aid money down the toilet – that is, if they have a toilet.

Actually, a toilet could be the solution – along with safe drinking water and hygiene education. Research shows that access to WASH significantly reduces diarrheal episodes among people living with HIV/AIDS, enhancing their quality of life and allowing their ARV medications to work effectively. Furthermore, access to WASH decreases the burden on caregivers, with a labor-saving impact that allow more time for other activities, including school and income generation.

Ensuring access to WASH for people living with HIV/AIDS also makes HIV/AIDS funding and medication more efficient and effective. By integrating WASH and HIV/AIDS efforts we can improve the lives of millions around the world

World Water Week and Women

This blog is re-posted from Girls' Globe with permission.

2013 is the International Year of Water Cooperation, and during World Water Week is a perfect time to examine what water means to women around the world. Leaders in the water sector will gather in Stockholm this week, to share successes, discuss challenges, and discuss the future of water programs. We can only hope that the participants keep in mind the population most affected by water – women.

Improved access to clean water, for most, brings to mind good health and reduction of disease, but it means so much more. In the minds of those receiving a new water supply, time-saving and other social benefits are of greater importance. Women are the primary collectors of water in the developing world, spending on average six hours each day collecting water for their households, including carrying up to 40 pounds of water on their heads or backs. Women are also the primary caregiver in most households, and must spend time caring for family members and children who may get sick from contaminated water. Can you imagine a world in which women didn’t have to spend that amount of time everyday collecting water, or if they had more time because their family didn’t get sick from the water so often?

Clean water close by means time to women; it means opportunity; it means autonomy.

Often, adolescent girls must join in the effort of collecting water for their families when they are old enough. In many places, this also means missing school or dropping out altogether, due to the amount of time water collection takes. Not only does clean water mean opportunity and autonomy, it also means education for girls. A World Bank study found that a 15 minute reduction in water collection time increased girls’ school attendance by eight to twelve percent, and the provision of clean water at schools provides an incentive for girls to attend. WaterAid reports that more years of education for girls means more healthier and better educated families, and a way out of poverty.

What would our world look like if the simple act of having clean water nearby was realized?

More women would be educated, employed, leaders in their communities, and millions would be on their way out of poverty.

Watch this video from water.org, in which Jodie Foster explains that for women, water is personal.

To learn more, visit:

• Girls’ Globe Blogger Sally Pope’s blog: Women & Water
• Charity:Water’s September Campaign
• World Water Week & The Clean Water Crisis (wateronline.com)
• I wash my butt with your misfortune: On the privilege of “water”(embracetheindoguity.wordpress.com)
• Water.org
• WaterAid
• UNICEF
• WASH Advocates

For the Kids

Are you hungry? I am. I've been on a diet prescribed by my doctor which has consisted of no gluten, dairy, soy, or eggs for the past two weeks, and I like to complain about it. I can't wait until I can have pizza again (as I smell another student's slice of pizza wafting across the library..), or ice cream with my friends, or macaroni and cheese.

There are millions of children around the world who don't even have the choice.

Malnutrition and undernutrition are preventable conditions and are implicated in 50 percent of child deaths throughout the world. That's nearly 4.5 million children each year! When people, especially children, don't get enough calories or nutrients, their health deteriorates, their ability to resist infectison decreases, and children can experience developmental delays that will affect the rest of their lives, should they survive their first 5 years.

Lack of WASH exacerbates this problem. WASH is directly related to nutrition through diarrheal disease. When children are lucky enough to receive adequate nutrition, yet have unsafe water or unimproved sanitation, diarrhea will make them poop out the nutrients before they are absorbed. Even the best nutrition interventions can't prevent that.

We lose millions of children to diarrhea each year, in addition to the 2.6 million children who die from undernutrition. This isn't counting the millions of children who live, but with the effects of these diseases affecting their abilities in school and their development. These conditions together create a vicious cycle: diarrhea causes undernutrition, reducing a child's resistance to subsequent infections, including diarrhea. WASH alone can prevent long-term morbidity and 860,000 child deaths from malnutrition each year, through the reduction of diarrheal disease.

It is continually evident that including WASH in all development efforts can significantly increase the efficacy of programs. WASH changes everything.

What WASH Means to Girls

This has been reposted from the Girls' Globe blog.

I have the great honor of being an Auntie (they call me “TT”) to two precious children – Daniel and Lucy. I had the privilege of holding each of them when they were just hours old and being a part of their lives as they grow.

I’ve also had the privilege of meeting and getting to know children in other countries, like Honduras and Ghana. I have seen the differences in the lives of those children and of my niece and nephew. I have seen the girls skipping school to carry 40 pounds of water on their heads. I have seen them vulnerable, searching for a place to go to the bathroom because there are no toilets. I have seen the girls and women who are sick from drinking contaminated water, unable to perform the plethora of daily tasks that are left to them. I can’t imagine my niece, Lucy, living in those conditions, and therefore I must imagine a better world where these girls do not have to either.

Water, sanitation, and hygiene (WASH) impact all sectors of development, not the least those impacting women and girls. Around the world, they collectively spend 200 billion hours fetching water and finding a place to use the bathroom. What could they do with this time, if they had water and a toilet? Girls could spend time in school, instead of missing at least 3 hours each day. Women could put time into income-producing activities. It’s been shown that womenreinvest 90% of their income back into their families, contributing to overall community development.

Women and girls are continuously used as the infrastructure for electricity, plumbing, and and childcare. They are the primary collectors of water and firewood in the developing world. Girls carry 40 pounds of water on their heads each time they fetch water, increasing their risk of back and hip pan, malnutrition, and anemia. In addition to missing at least 3 hours of school each day, girls walk an average of 6 kilometers to fetch water each day. A 15-minute decrease in collection time can increase girls’ school attendance by 8-12%.

In searching for a place to use the bathroom, women and girls risk danger and sexual assault, especially because they are confined to leaving their houses in the dark to avoid shame of going in daylight. This waiting can cause serious illness like infection, chronic constipation, and mental stress. If schools don’t offer single gender sanitation facilities with ways to dispose of menstrual waste, girls miss a week of school each month or drop out altogether. The taboo of menstruation that even we in the United States feel is preventing the education of young girls throughout the world, and putting them at increased health risk. In India, 23% of girls drop out when they start menstruating and the rest miss a week of school each month. Girls who can get an education are better able to protect themselves from exploitation and illness, more likely to develop skills to contribute to society, less likely to marry before age 18, less likely to die in childbirth, and more likely to raise healthy and educated children when they become mothers.

WASH can improve not only girls’ health, but also their quality of life. It is changing the lives of girls in Honduras, Ghana, and around the world. Let’s break the taboos around menstruation and sanitation and spread the word about women and girls who don’t have access to their basic needs! To learn more visit:

http://girlsglobe.org/2012/11/19/women-water

http://www.unicef.org/wash/index_womenandgirls.html

http://womenforwater.com

http://www.wsscc.org/topics/hygiene/menstrual-hygiene-managemen

http://www.washadvocates.org/learn/wash-facts/wash-and-women-and-girls/

Gender and WASH, and Beyond

Last week I was able to attend the Philadelphia Global Water Initiative's conference on Gender and Water: Leading Beyond the Burden. I was very encouraged by all the panelists, attendees, and speakers, and the great ideas and work that is being done to integrate gender and WASH. The intersection of women and WASH is a huge aspect of both sectors and the impacts that integrating the two could make are extremely powerful. Women and girls in Sub-Saharan Africa spend 40 billion hours each year collecting water - that's the equivalent of the entire workforce of France! It is important to incorporate women into WASH because they are the most likely to know what is needed and where.

Malaika Cheney-Coker of CARE presented a theory of change in the WASH and women setting:

Secure and sustainable access to water and services

+

Gender-sensitive water and other policies, institutions and norms

x

Gender-equitable control over WASH services

=

Poor women and school-aged girls improve their lives.

That's what we're really all about - improving the lives of these women and girls, and we see how the integration of WASH and gender can do that. There is no one without the other. When we say water and gender we are also saying water and economy, water and development, water and health, water and quality of life.

"Women can provide [great and effective] leadership when they are not considered inconsequential receivers of charity," said one panelist. They can provide the avenues for effective services, sustainability, and huge and positive impacts. This is what we're really doing in the WASH sector, anyway. I have had multiple friends introduce me as someone who builds wells, but we do so much more and we need to start telling people about it. We need to start showing people inside and outside of the development world the impacts of what we do go so far beyond wells, even beyond health. We're impacting the livelihoods and quality of life of women, girls, children, men, old people, people with HIV, teachers, and the list goes on and on. We need to get beyond the perception of just building wells and let people know the vast amount of projects we do and impacts we have. We need to show people how integral our efforts are in their efforts, and begin such collaboration the development world has never seen before!

Mind the GAPPD: Integrating WASH with Other Sectors to End Preventable Childhood Deaths

This blog post is also posted on the WASH Advocates website.

Today’s release of the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD), developed by the World Health Organization (WHO) and UNICEF, represents the first-ever simultaneous effort to protect children from pneumonia and diarrhea, which take the lives of almost two million children a year. The Global Action Plan is based on the most recent data and evidence collected in a special series published in The Lancet today.

The goal is ambitious but achievable: to end preventable childhood deaths due to pneumonia and diarrhea by 2025. At the launch today in Washington, DC, special emphasis was placed on the fact that the interventions exist to prevent and control these diseases, but coverage of these interventions is poor, especially in the most marginalized populations and the poorest of the poor. Scale-up and collaboration of all efforts surrounding pneumonia and diarrhea is necessary to reach this goal by 2025.

Samira Aboubaker of WHO noted, “The message is clear: we do not want a new plan. We want the existing plan to reflect the priorities of [all the sectors], epidemiology, birthing, etc. Therefore, it is an opportunity to look at the existing plan and identify the missing pieces. The water and sanitation group has to be part of our plan. Clearly we’ve seen we have to protect,prevent, and treat pneumonia and diarrhea, and that needs to be reflected in this plan.”

The GAPPD strategy seeks to establish good health practice from birth, preventing children from becoming ill from pneumonia and diarrhea, and treating children who are ill from pneumonia and diarrhea with appropriate treatment. Promoting handwashing and improving water supply, sanitation, and hygiene are among the interventions that have been proven to be effective in fighting these killers of young children, in addition to exclusive breastfeeding, vaccines, disease case management, oral rehydration salts, demand creation activities for behavior change, and reduction of household air pollution.

The key messages of GAPPD are:

1. Working together, we can end preventable deaths of young children around the world from two of the leading child killers, pneumonia and diarrhea.
2. The integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) from WHO and UNICEF goes to the heart of the challenge: recognizing that prevention and control of pneumonia and diarrhea cannot be adequately dealt with separately but only through integrated programs.
3. Without these urgent accelerated and coordinated efforts, each year more than two million of the world’s most vulnerable children will continue to die from these two diseases. We must close this equity gap.
4. Successfully reducing pneumonia and diarrhea deaths requires engagement by a wide range of actors and sectors, and first and foremost, it requires national political will.
5. These diseases must be addressed if we are to move the needle significantly in achieving the Millennium Development Goal to save the lives of children under the age of five (MDG4), as well as successful implementation of the UN Global Strategy for Women’s and Children’s Health, and the Promise Renewed commitment to child survival.

We all have a role to play in ending preventable child deaths, and we must work together to achieve this ambitious and worthy goal.

April showers bring May flowers but women still have to collect water

April has now been deemed WASH and Women month! Not officially, but due to a good many various events that are focused on this very, very important topic. My post on International Women's Day explains the connection between WASH and women's health, empowerment, and life improvement, but here's the gist of it:

• Each year, women and girls around the world collectively spend 200 billion hours collecting water
• This time could be spent on other activities important to these women and girls - school, education, caring for sick loved ones, producing an income
• The health effects of collecting the water include back and hip pain, anemia, malnutrition
• Women and girls risk violence and sexual assault both when collecting the water and when finding a place to use the bathroom

Without first ensuring access to WASH, all other development efforts will be less successful because these women and girls still won't get an education, will still be subject to violence and health effects, and still won't be able to break the cycle of poverty caused by lack of access to WASH.

April has a great number of events in store, focusing on the connection between WASH and women and exploring how we can utilize that to break the cycles of poverty and the taboos on menstruation:

• The Philadelphia Global Water Institute is holding their 6th annual conference on Tuesday, April 9, in Philadelphia. The theme this year is "Gender and Water: Leading Beyond the Burden."
• The theme this year at Engineering and Humanity Week at Southern Methodist University in Texas is "Water: Ripple Effects." On Tuesday, April 9, there is a panel on Water and Women that is free and open to the public!
• On the same day, Emory University in Atlanta is hosting a World Water Day event to celebrate the importance of water in health, education, and gender equality. The event is open to the public and will be streamed live online.

If you're near any of these locations, I encourage you to attend these workshops and panels!