New Year, new calendar

Just a quick blog from me today. As we approach the New Year I thought it would be a good idea to share with you all the World Banks 2018 water calendar.

Every year the World Bank creates a calendar about the most serious issues facing water worldwide, the 2018 calendar has a specific focus on the provision of adequate water and sanitation. Throughout the 12 cartoon pictures, the World Bank has highlighted the main issues facing water and sanitation. Below I have included my favourite. Each of the months come with a fact about water and sanitation which I have included in the caption of each figure. 

Figure 1: January 

'$114 billion per year in overall global investment is needed to meet SDG targets for water supply and sanitation'
Source: http://www.worldbank.org/en/news/feature/2017/12/14/water-cartoon-calendar-2018

Figure 2: February

2 in 5 people live in parts of the world affected by water stress
Source: http://www.worldbank.org/en/news/feature/2017/12/14/water-cartoon-calendar-2018

Figure 3: March 

2.1 billion people lack access to safe, readily available water at home.

Source: http://www.worldbank.org/en/news/feature/2017/12/14/water-cartoon-calendar-2018

Figure 4: May 

Sub-Saharan Africa loses more than 40 billion potential work hours per year collecting water.

Source: http://www.worldbank.org/en/news/feature/2017/12/14/water-cartoon-calendar-2018

Figure 5: October 

Avoidable diarrheal diseases kill one child every minute

Source: http://www.worldbank.org/en/news/feature/2017/12/14/water-cartoon-calendar-2018

I think this is a great idea by the World Bank to try and highlight the issues of water and sanitation in a 'fun' way. Unfortunately, however, I do not see the calendar being used by the masses, perhaps only those who work for the World Bank and those who are greatly interested in water and sanitation around the world. And so, I urge all of you to make the World Bank water and sanitation your calendar for 2018, you can download it here: 

http://www.worldbank.org/en/news/feature/2017/12/14/water-cartoon-calendar-2018

Great news for Lilongwe!

"Lilongwe City faces considerable water security challenges that must be addressed urgently to serve the growing population and enhance economic activities in the capital"

Greg Toulmin - World Bank Country Manager for Malawi.

Lilongwe's population of one million are currently struggling with inadequate water and sanitation facilities. Rapid urbanisation is leaving the city unable to meet growing demands, resulting in many using unsafe water supplies. 95% of Lilongwe's population is currently not connected to a sewer system, leaving many having their waste collected as illustrated in figure 1.

Figure 1: Waste collection in Lilongwe

Source: https://www.dutchwatersector.com/news-events/news/14840-vei-extends-water-operator-partnership-with-lilongwe-water-board-malawi.html

Scrolling through the news I found a very promising story for Malawi's capital city, Lilongwe. On the 20th December, the World Bank approved a US$100 million investment into the capital city's water and sanitation facilities. The World Bank is investing in a six-year-long scheme called Lilongwe Water and Sanitation Project (LWSP).

Lilongwe's existing water and sanitation systems are under great pressure as a result of rapid urbanisation into the capital city. The LWSP is not only going to improve existing infrastructure but also expand the network, which involves increasing the distribution network by 186km to parts of the city which are currently un-piped. Currently, only 5% of Lilongwe's population is served by a sewer system, consisting of a mix of latrines and septic tanks. The LWSP aims to improve sanitation facilities for 250,000 people in Lilongwe, these are just a few of the key changes being made in Lilongwe:

• Construction of four storage reservoirs with a combined capacity of 2,600m3.
• Reducing the amount of water lost due to leakages.
• Installation of 5000 new sewer connections.
• Construction of 8000 improved sanitation facilities.
• Upgrading the existing Kauma sewage system. 
• Improving sanitation facilities in 10 schools.

This investment into Lilongwe's water and sanitation is great news, however, a report created by the World Bank has highlighted that there are significant risks involved with this investment, some of the most important risks I have listed below:

• Corruption and fraud 
• Limited experience - The Lilongwe Water Board has limited experience in managing complex infrastructural projects, meaning there is a high risk involved with the deliverance of this project.
• Social risks - The project is expected to disturb settlements, however, there has been no mention as to whether these people will be re-housed, and so there are negative social implications of completing this project.
• Climatic risks - Lilongwe in recent years has been experiencing difficulties with unpredictable rainfall and droughts as a result of global warming, which has reduced the amount of water available for extraction. This creates large issues for the future of Lilongwe and Malawi as it appears that water stress conditions are likely to get worse. 

Despite the risks I have mentioned this investment is a great step forward for Lilongwe, and I hope investments like this continue throughout the whole of sub-Saharan Africa, inching the continent ever closer to good quality water and sanitation for all.

If you wish to have a more in-depth knowledge of the Lilongwe Water and Sanitation Project here is the recently published World Bank Report:
http://documents.worldbank.org/curated/en/419171513998119839/pdf/MALAWI-PAD-12012017.pdf 

The Guinea Worm Eradication Programme

Contributing to my previous blog about diseases in sub-Saharan Africa, this blog looks at the Guinea Worm Disease, a disease that can easily be eradicated by providing access to safe and protected drinking water. As the Guinea Worm Disease is mostly found in remote villages, there is often not scope for boreholes or wells, therefore changing behaviour towards water sources is the most appropriate way to provide safe water.

The Guinea Worm Disease, also known as Dracunculiasis, is a water-borne disease caused by the parasite Dracunculus medinensis.  In the 1980s the Carter Centre, a charitable organisation founded by the former US President Carter, alongside other supranational bodies, campaigned to eradicate the Guinea Worm Disease globally by 1995 (Ciantia et al, 2013). Before the eradication programme, Guinea Worm was a largely unreported disease, Nigeria estimated that it annually only had around 3000 cases in the 1980s, however, in 1989 Nigeria carried out a nationwide survey which returned with an actual figure of 650,000 cases annually (Hopkins and Ruiz-Tiben, 2011). The 1995 goal of eradication was not achieved and was therefore extended to 2009, again there were still isolated cases of Guinea Worm and the eradication date was set in line with the Millennium Development Goals (Ciantia et al, 2013).

Causes:

Eradicating the Guinea Worm Disease directly relies on the provision of safe drinking water (Hopkins, 1981). Humans can become infected with the Guinea Worm Disease by drinking stagnant surface water. This water has been infected as a result of copepods eating the young of the parasite, thus infesting the water. Figure 1 below shows an illustration of how a water source can become contaminated.

Figure 1

Source: http://edition.cnn.com/2010/WORLD/africa/10/08/guinea.worm.eradication/index.html 

Once infected the parasite remains in the body for over a year, growing up to 1 metre long. Towards the end of the year, the worm begins to slowly and painfully exit the human body through a ruptured blister on the skin, usually found on the legs or feet. The Guinea Worm Disease is not usually fatal but can have great consequences on villages, due to the painful way the worm exits the body this can result in the infected person being temporarily disabled for around 1 to 2 months, leaving the infected unable to work or attend school (Hopkins and Ruiz-Tiben, 2011). The Guinea Worm Disease commonly has no long-term effects, however, some cases report early onset arthritis, and 0.5% of cases result in permanent disability (Hopkins, 1981). 

Solutions:

There is no medical cure for the Guinea Worm Disease. Providing water from boreholes and wells would be the ideal way of preventing this parasitic disease, however, this is often a very slow and expensive approach, and often not suitable for remote villages (Hopkins and Ruiz-Tiben, 2011), and therefore other approaches are required to tackle the disease.

Through the Guinea Worm Eradication Programme (GWEP), numerous approaches were taken to make the water supply free from Guinea Worm. A vital aspect of the eradication programme involved sending village volunteers to villages impacted by Guinea Worm. The role of the village volunteers was: to educate about disease prevention, record and report cases of Guinea Worm, distribute cloth filters among villagers, and finally administer first aid to those suffering from the disease (Ciantia et al, 2013).

The programme began with educating the villages susceptible to the disease. Many did not understand that the reason behind their illness, was due to water they had drunk a year ago, many blamed bad spirits (Ciantia et al, 2013), the programme was able to change the villager's perception by magnifying a glass of the contaminated water showing the parasites inside, this was met with disgust from many villagers. This education focused on teaching the infected individuals to stay out of the water and taught the villagers how to effectively filter water, with a special emphasis on educating females, as they are the primary water collectors (Hopkins and Ruiz-Tiben, 2011).

Alongside this education, the programme provided finely woven cloths to villages to use as water filters (Hopkins and Ruiz-Tiben, 2011). The programme also provided portable 'pipe filters', a straw that could be hung around one's neck which allowed water to be filtered immediately, this meant that those who were travelling on long journeys were able to filter water effectively (Hopkins and Ruiz-Tiben, 2011).

The success of the Guinea Worm eradication programme:

The Guinea Worm Eradication Programme was an extremely successful way of combating water-borne disease through introducing behavioural changes and low-cost filtering techniques. Figure 2 illustrates the huge success of the Guinea Worm Eradication Programme, the disease which was originally found in 20 countries is now only found in four, Chad, Ethiopia, Mali and South Sudan.

Figure 2 

Source: https://www.cdc.gov/globalhealth/infographics/guinea_worm.htm

The Guinea Worm disease is the perfect example of an illness that does not need to exist, the only way one can get the disease is through drinking contaminated water. By providing the world access to a safe water source, the Guinea Worm disease would be completely eradicated and would help to further eradicate other diseases. 

The burden of disease

In 2002, it had been estimated that the disease burden, caused unnecessarily from water, sanitation and hygiene, accounted for  4% of deaths worldwide, and 5.7% of all diseases worldwide (Prüss et al, 2002). Despite these figures appearing to be low numbers in the grand scheme of things, these are all preventable deaths and diseases if the appropriate water and sanitation requirements are achieved. The World Health Organisation estimates that improvements in sanitation and water provisions could prevent 9.1% of the total burden of disease worldwide, which equates to approximately 6.3% of deaths (Clasen, 2011).

The first half of this blog will look at a few diseases caused by inadequate water and sanitation facilities. The second half will look at why these diseases are such a burden to sub-Saharan Africa.

Common diseases

This section of the blog will briefly highlight a few of the diseases affecting sub-Saharan Africa today as a result of inadequate water and sanitation facilities. Many of these diseases come with very simple interventions, such as frequent hand-washing, however, without the appropriate water and sanitation facilities, these diseases continue to plague countries in sub-Saharan Africa.

Trachoma:

Trachoma is an infectious disease which commonly ends in blindness; figure 1 illustrates the lifecycle of the disease. The incidence of trachoma can be reduced dramatically when access to water is increased. In order to reduce the incidence of trachoma, hygiene needs to be improved. Face washing and access to a latrine have been linked to reducing rates of trachoma. A study of Ethiopian households revealed that having a 'lack of access to a latrine increased the risk of having active trachoma by 4.36-fold but perhaps more important, absence of a clean face...increased the odds of having trachoma by 7.59-fold' (Cook and Mariotti, 2011:181). The International Trachoma Initiative implemented the SAFE initiative (figure 2), highlighting the steps needed to prevent trachoma, two steps involved the use of water.

'lack of access to a latrine increased the risk of having active trachoma by 4.36-fold but perhaps more important, absence of a clean face...increased the odds of having trachoma by 7.59-fold'

Figure 1: The Life Cycle of Trachoma

Source: https://healthfoxx.com/trachoma-definition-symptoms-treatment-pictures/ 

Figure 2: International Trachoma SAFE initiative

Source: http://www.globalcontagions.com/2017/02/ntds-trachoma-blindness-caused-by-chlamydia-bacteria-yes-that-chlamydia/

Hookworm:

Hookworms are the result of open defecation due to a lack of adequate sanitation. There are three ways in which the incidence of hookworm can be greatly reduced, first by providing adequate sanitation facilities to reduce open defecation. Secondly, the provision of a sufficient water source to enable the washing of food. Thirdly, behavioural changes are required, often it is children who practice open defecation, changing behaviour towards open-defecation will reduce the incidence of hookworm (Blackburn and Barry, 2011). Unfortunately, though, it is more cost effective to provide deworming treatment per person than a latrine, as proven by studies in Vietnam (Blackburn and Barry, 2011).

Diarrhoea:

Diarrhoea is a leading cause of death globally. Diarrhoea can be prevented by disposing of waste appropriately, improving water quality, improving personal hygiene and washing food before consumption (Zarocostas, 2008). The World Health Organisation estimates 88% of all diarrhoeal deaths are a result of inadequate water and sanitation facilities (Fitzwater et al, 2011). However, if water is to be treated at the household level, 39% of diarrhoeal cases would be reduced, further reductions would take place with the education of handwashing and appropriate waste disposal (Fitzwater et al, 2011).

The burden of disease on sub-Saharan Africa

The diseases described above and many more can easily be prevented through the provision of adequate water and sanitation, for example, piped water and latrines. However, for many, this is not reality. These diseases can have great impacts on the lives of the infected and are often blamed for restricting development, I have highlighted below the three areas which I think are the most important.

The burden on the extended family:

One perhaps overlooked impact is the strain these diseases place on the extended family. If the parents die, as a result of water-related diseases, this can leave the extended family, such as grandparents, with the role of raising the children. Taking on this role comes with a huge financial burden, with many extended families being often unable to financially assist the orphans, placing the extended family at risk of falling into poverty, or the children being at a high risk of being placed in an orphanage, all of which are poor outcomes for an easily preventable death.

Lost education:

Many children who fall ill due to these preventable diseases face missing days, weeks or even months of school. This can have detrimental impacts on their future. The less education a child receives, the less prosperous their future is likely to be, they are likely to be unable to reach their full potential in the job market and therefore maintain in the vicious cycle of poverty, increasing attendance of school drastically reduces the incidence of poverty within a country (Ayiro, 2012), and with the introduction of adequate water and sanitation facilities the issue of missed school days can be reduced.

Fall in productivity:

This can be at both the local and the national scale.  Locally families are impacted when members of the family have to take time off work due to illness, this can lead to a reduction of income leaving families finding it difficult to make ends meet, it also reduces families financial saving potential (Boutayeb, 2010). Whereas on the national scale the higher the incidence of disease, the lower the rate of development, for example, the more a person works this increases their income (something which would not happen if they are regularly ill). An increase in income leads to an increase in consumer spending, this then drives the economy leading to growth in GDP and development (World Health Organisation, 2009).

Conclusion

The diseases discussed in this blog and more can easily be eradicated, or, casualties greatly reduced if the provision of adequate sanitation and water is implemented across sub-Saharan Africa. Next week’s blog will be looking at how a successful intervention programme has almost completely eradicated the Guinea Worm Disease in sub-Saharan Africa.

Let's talk about shit

My previous impromptu blog about World Toilet Day was discussing an entire day dedicated globally to discussing the toilet. In this blog, I am going to do a complete 180 and look at reasons as to why people don’t talk about shit, and how we can get them talking. Below you will see a TEDtalk done by Rose George (figure 1), this video gave me a lot of inspiration for this blog entry and so I thought I would share it with all of you. 

Figure 1

Source: https://www.youtube.com/watch?v=ZmSF9gVz9pg

Why don't we talk about shit more?

We have all heard of the phrase 'sex sells', and it couldn't be truer. Sanitation isn't at the forefront of aid efforts, or governmental decisions; it is something we are embarrassed to talk about, something we believe should be kept private, something which isn't sexy - this needs to change. There is no universal term for shit (see figure 1). People are embarrassed or offended to use certain words making poo difficult to talk about, particularly for those who are in a position of power, whether this is a political position or the head of an NGO (Borel, 2013). There are numerous ways we try to be discreet about having a poo, for example, men in Kenyan communities will say they are 'answering the call of nature' when they need the toilet, and many find the use of the word shit extremely offensive and vulgar, preferring the term haja kubwa (David, 2011), a word which is not used universally. It is not just in the developing world where there is a shyness when it comes to sanitation, in the UK, toilet roll companies such as Andrex are not direct about their product (see figure 2), but instead show a puppy running around with toilet roll (Borel, 2013). This reluctance to talk about shit makes global sanitation issues very difficult to engage with. The Gates Foundation was one of the first organisations to start talking about shit using mediums such as competitions among universities, which has been pivotal in getting people to start talking about shit in academia and among NGOs. With The Gates Foundation as a springboard, this has allowed for numerous new approaches to appear encouraging people to talk about shit and changing their behaviour, in the last decade the approach Community-Led Total Sanitation has become increasingly popular within Sub-Saharan Africa. 

Figure 2 

Source: https://www.youtube.com/watch?v=yx6gZAKWLHk

Community-led total sanitation (CLTS)

CLTS is a method of making sanitation issues important within communities by making them talk and work together to reduce open-defecation (OD) and improve toilet facilities. CLTS comes with many challenges, often people are reluctant to talk about shit due to embarrassment, there are also many cultural taboos that need to be addressed. If cultural taboos are not addressed, regardless of whether latrines are available they will not be used, below I have bullet-pointed a few common taboos and superstitions regarding shit in SSA:

• Pooing over someone else's poo is considered to be bad luck (Zombo, 2010).
• It is a taboo for a father-in-law and his daughter-in-law's poo to mix (Bwire, 2010).
• In Kenya, it is believed a person's poo can be used to bewitch them, this stops people using communal latrines and continue to practice OD due to fear of witchcraft (Bwire, 2010).
• In Ethiopia it is considered a taboo for both men and women to share the same latrine, also the sight of faeces is unacceptable resulting in continuing OD (Chambers and Myers, 2016).

CLTS has a variety of techniques to overcome these embarrassments and taboos. CLTS believe that rather than sitting communities down and lecturing them over the importance of good sanitation and hygiene, the most effective outcomes come from generating disgust through demonstrations. Typical demonstrations include putting a pile of food next to a pile of poo and getting the villagers to watch the flies jump back and forth between the two, people were mostly disgusted by the thought of ingesting someone else’s shit (George, 2012), you have to shock people to change their behaviour (Zombo, 2010). Shocking people is the easy part, getting them to talk shit is difficult. CLTS gets people talking by introducing them to shit through songs, proverbs, stories and laughter (Zombo, 2010). CLTS has found laughter to be the most effective tool, in Sierra Leone CLTS has created a lighthearted song to highlight how easily poo can spread:

"Kaka na kaka, big wan, small wan, na the same foot den get for waka go na chop or water."

(A shit is a shit, big shit or small shit, they all have legs and feet that move them to food and water.)

(Zombo, 2010).

In Sierra Leone alone the CLTS approach has helped 300 villages become OD free (Zombo, 2010). The successes of CLTS are very important, OD and unsafe sanitation facilities can be deadly or cause serious illness amongst communities, and so it is of utmost importance we talk about shit. 

Why is it important to talk about shit?

Every day 4000 children die from diarrhoea, a number that is higher than HIV/AIDS, tuberculosis and measles combined (Borel, 2013), however, it receives far less attention. A single gram of poo can contain upwards of 50 diseases, many of which can be fatal (Borel, 2013). Contracting one of these many diseases can have several negative multiplier effects, such as a lack of productivity in the economy, death, embarrassment, and social isolation; it is estimated that each year $260 billion is lost as a result of inadequate sanitation globally (Borel, 2013). This leads me to next week's blog which will be focusing on water and sanitation related diseases, and the cost they have on many lives. 

World Toilet Day 2017

As some of you may know yesterday (19th November) was World Toilet Day. This will be a quick blog looking at the importance of World Toilet Day, and how it is helping to improve sanitation around the globe.

What is it?

The purpose of World Toilet Day is to raise awareness for the global sanitation crisis. The UN day is helping to work towards meeting the Sustainable Development Goal 'Ensure access to water and sanitation for all by 2030'.

Why is it important?

For many people, especially in the western world, going to the toilet isn't an issue. For many there is a clean toilet within their home, allowing them to safely and cleanly go about their lives. However, for many owning a toilet in one's home is seen as a luxury, something to aspire for. With people defecating in the streets, in the open and in rivers, there is a desperate need to build more toilets. Without safe access to a toilet, or a sanitary way to go to the loo, a number of issues can arise:

• Globally 1.8 billion people drink water contaminated by faeces, which has resulted in large health implications. 
• Around 80% of wastewater in the world flows straight back into the ecosystem without being treated.
• It is believed that improved sanitation facilities could reduce the number of deaths a year by 842,000.
• It is estimated that 10% of the world's population consumes food that has been irrigated by waste water - this creates significant health risks, including diarrhea which kills an estimate 280,000 a year due to poor sanitation. 

By creating World Toilet Day there is a hope to raise awareness about the sanitary crisis, and getting people to start talking about poo!


This year's theme: Waste management.

Every World Toilet Day has a different theme, this year the theme is on Waste management. World Toilet Day has proposed a four-point scheme to effectively manage waste (Figure 1), which they believe will help the world meet the Sustainable Development Goals for water and sanitation:

Figure 1: The 4-step journey of safely treated poo

Source: http://www.worldtoiletday.info/where-does-our-poo-go/ 

This year's theme, wastewater, is very important as it helps highlight the issues that many people face around the world. Billions of people are without effective sanitation systems, which can lead to a large number of issues such as child stunting. This year's World Toilet Day is hoping to improve or put in place these sanitation systems to reduce the amount of poo in the environment, making the world a safer place for all.


To find out more information about World Toilet Day: http://www.worldtoiletday.info/

Millennium Development Goals - part 2

What went wrong?

My previous blog on the MDGs gave a few figures surrounding water and sanitation for Sub-Saharan Africa (SSA), but these figures do not represent the regional difference. Below figure 1 and figure 2 show a breakdown of country populations with access to improved water sources and sanitation sources respectively.

Figure 1 - Percentage of population with improved drinking water source, 1990-2008.

Source: http://www.undp.org/content/undp/en/home/librarypage/mdg/mdg-reports/africa-

collection.html

Figure 2 - Percentage of population with improved sanitation, 1990-2008.

Source: http://www.undp.org/content/undp/en/home/librarypage/mdg/mdg-reports/africa-collection.html

Figure 2 portrays how SSA made very little progress towards achieving the sanitation goal. However, many SSA countries made great improvements in their percentage of the population with access to an improved water source (figure 1). Despite increases in access to improved water sources, water still remains inaccessible to much of the population.

The two figures also show how regional differences need to be highlighted, and SSA should not be generalised. Not all SSA countries missed the targets greatly, for some countries there have been great successes. In 1990, only 43% of Ghana's rural population had access to an improved drinking water source, by 2006 this had almost doubled to 80% of the rural population. Also, 93% of the Senegalese population living in cities had access to improved water in 2006. As you can see it was not all doom and gloom for SSA countries, however, for the many countries who did not meet the targets, there are a variety of potential reasons.

Why did it go wrong?

There is a multitude of reasons as to why SSA did not meet the MDGs for both water and sanitation, below I have addressed the reasons I felt were crucial in SSA being unable to meet the MDGs.

Urban-rural divide.

The MDGs did a great job in reducing urban and rural disparities, however, the difference between the urban and rural is still great across access to both improved water and sanitation sources. In some rural areas of SSA, 40% of the population still relies on surface water, they have very little access to stand posts and water facilities, something which has barely improved over the last fifteen years. Conditions for sanitation in rural areas within SSA is in a far worse condition, as sanitation is deemed not as important as access to safe drinking water, meaning that the rural areas have lagged greatly behind urban areas. With still more than one-third of the population, mostly in rural areas, continuing to defecate in the open, rural SSA has a long way to go to catch up with the urban.

The cost of water. 

Implementing infrastructure and water provisions is a costly business, so much so that spending on the water sector in SSA is currently $3.6 billion a year, which is only one-fourth of what is required. For low-income countries, this high cost for improving water and sanitation sources seems even greater. SSA countries have received donations from many countries and NGOs, which has helped fund capital costs, however, many countries are still faced with maintenance costs, which can be upwards of 2% of GDP, which may not sound like a lot, but when coupled with other issues that require a great deal of spending and weaknesses in budgeting processes, it is a large expenditure for low-income countries.

Inefficiency

The third reason why SSA was unable to meet MDG 7 is due to and the cost of inefficiencies. It was reported that in 2010 approximately $2.7 billion was being wasted as a result of inefficient practice.  One of the greatest inefficiencies faced in SSA is the under-pricing of water services. In order for SSA countries to reach the cost-recovery threshold, they need to price a cubic meter of water at $1.00, however, average water tariffs are around $0.67 per cubic meter, resulting in an annual $1.8 billion loss in revenues. This loss has resulted in a reduction of investment in maintenance and enhancement of sanitation facilities in SSA. It is estimated that if all inefficient practices in SSA's water and sanitation sectors are eliminated, there would still be an annual $7.8 billion (1.2% of GDP) gap in finance.

Were the MDGs too ambitious?

Some believe SSA was set up to fail, the MDGs were made based on 1990s data. SSA had weak initial conditions in 1990, coupled with the unprecedented urbanisation and high population growth, which was far greater than anywhere else in the world, challenged SSA to meet the MDG targets.

Achieving the MDG for water and sanitation in SSA required an additional funding of $16.5 billion annually, which is around 2.6% of Africa's GDP - this level of funding often wasn't achievable for many of the SSA nations. 

In order for every country in the world to have met all 8 MDGs, it would have required an increase in global aid levels by $50 billion per year. Scholars have argued that this was a toxic way of looking at the MDGs, as it placed a heavy focus and reliance on aid, rather than countries being able to achieve the goals on their own accord, and frequently use the view that 'no amount of aid will make Africa grow at 7%' (Clemens and Moss, 2005:2). It is seen that the MDGs were too ambitious for many countries to financially achieve.

Future

SSA failing to meet the MDGs for water and sanitation was not because they failed, or there was a lack of effort, nor was that aid wasted, but perhaps because SSA is missing sustained support, 'development is a marathon, not a sprint' (Clemens and Moss, 2005:4). Perhaps the MDGs were designed not to be precisely met, but maybe a tool to improve conditions in some of the world’s poorest countries, which has happened.

The Sustainable Development Goals (SDGs) are the future in reducing poverty. Having learnt from the success and failures of the MDGs, the SDGs are far more scientific, specific and measurable than the MDGs. The SDGs will be addressed in further detail later on in this blog series.

Millennium Development Goals - part 1

The Millennium Development Goals (MDGs) came to an end in 2015. There was a hope globally that poverty and other issues would be alleviated. Despite the MDG's achieving many of its aims it fell short on water and sanitation, especially in sub-Saharan Africa. As the Millennium Development Goals is a large topic, I will divide my discussion across two blog posts. This week's blog will be focusing on what the MDGs aimed to do with water and sanitation, and why. Next week's blog will focus on what happened. I will then also begin to discuss possible reasons as to why advances in water and sanitation were unsuccessful in Sub-Saharan Africa. 

The United Nations Millennium Development Goals consisted of 8 goals which were designed to be achieved by all countries worldwide. Figure 1 below illustrates the 8 goals. 

Figure 1

Source:

http://un.dk/about-the-un/the-mdgs 

In 2015 the United Nations summarised all that the Millennium Development Goals had achieved in a report. Below I have bullet-pointed a handful of the Millennium Development Goal's greatest successes:

• The number of people living in extreme poverty declined more than half, from 1.9 billion in 1990 to 836 million in 2015.
• Worldwide maternal mortality has fallen by 45% since 1990.
• Gender parity in a majority of countries has been achieved at primary school level. 
• 2.1 billion people worldwide gained access to improved sanitation 
• And finally, 147 countries met the MDG target for the drinking water target, 95 countries met the target for improved sanitation, and 77 countries were able to meet both targets. 

Whilst I could dedicate an entire blog to the Millennium Development Goals, this blog is focusing on water and sanitation in Africa. Therefore, the Millennium Development Goal which is of most use to this blog is MDG 7, 'Ensure Environmental Sustainability'. 

MDG 7, Ensure Environmental Sustainability, was governed by four main targets:

• Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources.
• Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss.
• Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation.
• By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers.

The MDG's recognised the importance of clean and safe water as a vital component of health care, considering it to be one of the most critical instruments in saving lives (Mabugu, 2008). MDG 7 highlighted that water is a fundamental part of human life, a basic human right, this resulted in the MDGs working to increase the number of people with access to an improved water supply and an improved sanitation supply (Mabugu, 2008). This involved creating guidelines on what was suitable water for safe consumption and also resulted in the creation of information networks, which spread knowledge about how people can treat and store water safely and effectively (World Health Organisation, 2013). The Millennium Development Goals helped put water and sanitation on the development agenda (Anand, 2008).

In 1990 the percentage of the population with access to an improved drinking water source was 76%, by 2015 it had increased to 91%, this was above the MDG target, which was reached in 2010 (Figure 2). The MDGs was a great success in ensuring the provision of improved water sources globally, unfortunately, these statistics only represent a worldwide scale, there are still significant geographical differences in results (Anand, 2008). In 1990, 48% of the Sub-Saharan African population had access to improved drinking water sources, and by 2015 this had risen to 68%, falling under the MDG target of 75% for the region (Figure 2). Unfortunately, sanitation globally and in Sub-Saharan Africa has performed worse. 

Figure 2 

Source:  http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf 

In 1990 the percentage of the population with access to an improved sanitation facility was 54%, this later increased to 68% in 2015 (Figure 3). However, there were still 2.4 billion people worldwide without adequate sanitation, meaning the world did not meet the MDG target for sanitation (United Nations, 2015). When looking at statistics for Sub-Saharan Africa the reality becomes bleaker. In 1990 only 24% of Sub-Saharan Africans had access to an improved sanitation source, and by 2015 this had only increased to a measly 30%, well below the 2015 target of 65% (Figure 3). 

Figure 3 

Source:

http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf 

The Millennium Development Goals were supposed to help reduce global poverty, but have been very poor in providing results for water and sanitation in Sub-Saharan Africa. Next week's blog will be looking at what went wrong, and why Sub-Saharan Africa lagged behind so many other regions.

Water and Sanitation Introduction

Water, it is arguably one of the most valuable resources on planet earth, not only does it contribute heavily to agricultural and industrial processes, it sustains human life and improves our health. In nineteenth-century London, it was John Snow who discovered the correlation between contaminated water and disease in the city (Caincross, 2003). Following this discovery, great advances have been made in the UK to improve domestic sanitation which has reduced the risk of disease. Unfortunately, there are still countries today who have not been able to make these same advances in water supply and sanitation, and so this blog will be focusing on those, specifically those countries within Africa.

Globally there are many initiatives to address the problem of inadequate sanitation, through improving sanitation facilities. An improved sanitation facility is one which separates faeces from human contact (UNICEF and World Health Organisation, 2015). Globally today, there are approximately 2.4 billion people who do not have access to an improved sanitation facility (UNICEF, n.d.). The map below (figure 1) shows the percentage of the population using improved sanitation facilities in 2015; it is clear to see that Sub-Saharan Africa is facing great issues regarding its sanitation facilities.

Figure 1 - A map illustrating the progress made towards sanitation globally

 Source: https://public.tableau.com/views/WASHDASHBOARDSanitationv4/SanitationDashboard?:showVizHome=no

This is an interactive map, providing information on a time scale of 1990-2015, I strongly recommend clicking on the link and watching how the rest of the world has changed over time, whilst Sub-Saharan Africa has lagged behind.

The issue in Africa surrounding water and sanitation is not widely a volume problem, in many African countries there is enough water. Rather there are issues with managing the water sources they have and preventing the water from being contaminated. It is reported that in a majority of African cities (apart from Northern and South Africa), 50% of water supply is wasted (Kauffmann, 2007).Many Sub-Saharan African countries are also plagued by financial issues, if there is an increased access to financial resources, there is a potential to both increase water supply and reduce the risk of contamination. 

Sub-Saharan Africa is slowly making achievements towards improving their water and sanitation crisis, for example, annually between 1990 and 2004, 10 million people have gained access to improved drinking water (Kauffmann, 2007). Despite these advances, the continent of Africa still has a long way to go in improving water and sanitation and faces further challenges in the future as population sizes continue to grow. In this blog, I will discuss the issues surrounding water sanitation in Africa and also examine different approaches in alleviating the sanitation problem.