Water, Sanitation and Hygiene (WASH)


Water is one of the most necessary elements for life, yet according to the World Health Organization (WHO)/UNICEF, 2.1 billion people lack access to safely managed drinking water. In addition, 4.5 billion people lack safely-managed sanitation facilities. Unsafe drinking water and poor hygiene can lead to diarrheal diseases that can slow the absorption of nutrients, hindering children’s development. WHO/UNICEF estimate 2,200 children die of these diseases each day.

According to the U.S. Centers for Disease Control, the situation is worsening. Water quality worldwide is declining, threatening the health of ecosystems throughout the environment. The decline may be influenced by population growth, urbanization, land use, industrial discharge of chemicals and global climate change.

Water, sanitation and hygiene (WASH) principles are of tremendous concern in everyday life, but can be heightened during an emergency or disaster. With systems potentially damaged, access to water can be quite limited. Sanitation often comes to the forefront when displaced persons live in camps—especially overcrowded ones. WASH issues are multi-faceted even in the best of times. Access to water is a consideration, but so too is the quality of the water. Sanitation challenges may be vastly different in urban and rural areas across countries. And even more developed nations are not immune from disease spread by poor hygiene practices.

The United Nation’s Sustainable Development Goals includes Goal 6: “Ensure access to water and sanitation for all.” It recognizes the important of clean and accessible water for everyone and the challenges in getting to that goal. The UN says, “Water scarcity, poor water quality and inadequate sanitation negatively impact food security, livelihood choices and educational opportunities for poor families across the world…To improve sanitation and access to drinking water, there needs to be increased investment in management of freshwater ecosystems and sanitation facilities on a local level in several developing countries within Sub-Saharan Africa, Central Asia, Southern Asia, Eastern Asia and South-Eastern Asia.”

The Goal 6 targets are:

  • 6.1 By 2030, achieve universal and equitable access to safe and affordable drinking water for all
  • 6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations
  • 6.3 By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally
  • 6.4 By 2030, substantially increase water-use efficiency across all sectors and ensure sustainable withdrawals and supply of freshwater to address water scarcity and substantially reduce the number of people suffering from water scarcity
  • 6.5 By 2030, implement integrated water resources management at all levels, including through transboundary cooperation as appropriate
  • 6.6 By 2020, protect and restore water-related ecosystems, including mountains, forests, wetlands, rivers, aquifers and lakes
  • 6.A By 2030, expand international cooperation and capacity-building support to developing countries in water- and sanitation-related activities and programs, including water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse technologies
  • 6.B Support and strengthen the participation of local communities in improving water and sanitation management

Key Facts

  • Deteriorating water quality threatens global gains made in improving access to drinking water. Between 1990 and 2000, more than 2 billion people gained access to improved water sources. Even if the water is safe at the originating source, it may be contaminated by the time it is consumed in households.
  • Poor WASH procedures are only compounded in a disaster. Communities without access to water have even less in the aftermath of a large-scale disaster. Sanitation issues can be increased by large populations living in close quarters. As more disasters hit urban areas, the demands on urban water treatment facilities may be stretched to their limits. As urban disasters are a relatively new phenomenon, there may not be the capacity or resources to deal with WASH issues in heavily populated areas. A cholera outbreak in Haiti, in the aftermath of the devastating 2010 earthquake, sickened more than 470,000 Haitians and killed 7,000. According to WHO, there are approximately three to five million cholera cases annually and 100,000 to 120,000 deaths.
  • Refugees are particularly at risk for poor WASH practices. The United Nations High Commissioner for Refugees estimates that half of the refugee camps around the world cannot provide the minimum daily requirements for water (20 liters per person per day), while nearly a third lack adequate waste and latrine facilities. In September 2012, for example, an outbreak of hepatitis E killed 16 refugees in three camps in South Sudan; the outbreak was traced to unsafe drinking water. It is important to note too that lack of private water and sanitation facilities increases children’s and women’s risk of sexual and gender-based violence.
  • Lack of access to water leads to a high educational drop-out rate for girls. In some communities, household chores such as gathering water or garbage disposal fall to the young women in the family, preventing them from attending school. Providing water closer to home frees up a girl’s time for education, improving her chances for future success. Girls and women are also more impacted than boys and men by the lack of safe and accessible
  • Lack of access to WASH impacts death rates. Diarrheal diseases are responsible for over 40 percent of deaths in the acute emergency phase of a humanitarian crisis. They are the leading cause by far (at 80 percent) of deaths in children under the age of two.
  • We are in the Water Action Decade! In Dec. 2016, the UN Member States adopted United Nations General Assembly resolution 71/222 on an International Decade for Action on ‘Water for Sustainable Development’ 2018-2028The Water Action Decade began on Mar. 22, 2018 World Water Day. The three objectives, as laid out in the Secretary-General’s Plan are: 1) advance sustainable development 2) energize implementation of existing programs and projects and 3) mobilize action to achieve the 2030 Agenda. There will be a midterm review in March 2023 in New York to coincide with World Water Day.

How to Help

  • Fund programs that develop and promote water conservation around the world. Safe and plentiful water is threatened by global climate change. Increased demand and changing climate patterns have combined to drain rivers. Pollution threatens the quality of what remains. Water shortages have become a problem even in some parts of the U.S.
  • Strengthen operations and maintenance issues related to reliable water supply. Some countries in sub-Saharan Africa have water, but about one-third of water systems there are non-operational at any given time.
  • Target water, sanitation and hygiene (WASH) programs in schools in Global South communities (formerly referred to as developing nations). Children are eager to learn and healthy hygiene habits can last a lifetime. In addition, poor sanitary conditions contribute to high rates of illness and absenteeism.
  • Undertake vulnerability assessments of community water and sanitation systems. Providing water in a disaster is vital to preventing the spread of disease and helping the community recover. In addition, the disaster itself may threaten water supplies, such as contaminants brought in by floods, or water requirements needed to combat fires as a result of earthquakes.
  • Fund unique and innovative challenges. For example, the Bill & Melinda Gates Foundation hosted “Reinvent the Toilet” challenges and expos in China and India.

What Funders Are Doing

  • The Conrad N. Hilton Foundation has been funding activities to improve access to safe drinking water in low-resource settings of Sub-Saharan Africa, Mexico and India for over 25 years. In 2011, they set a goal of providing safe drinking water to one million people—primarily among the poorest in Africa, Mexico and India–over the next five years in a $50 million initiative. In 2016, Hilton’s board approved a five-year Safe Water strategy. For example, in 2015 Hilton awarded WaterAid America $150,000 to support the provision of water, sanitation and hygiene (WASH) services for the survivors of the Nepal earthquake.
  • In 2016, the Bill & Melinda Gates Foundation provided $400,000 to CARE USA to provide critical water, sanitation and hygiene support to populations most affected by Hurricane Matthew in Haiti.
  • The National Community Lottery Fund (formerly the Big Lottery Fund) provided WaterAid with $597,321 in 2012 to respond to the need for climate resilient access to water, sanitation and hygiene (WASH) services in the Koyra Upazila of Khulna district in Bangladesh. The proposed interventions address the three key issues that have exacerbated the impacts of cyclone flooding events in Bangladesh that remain barriers to improving peoples’ long-term welfare.

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