Background – demography
Every time our heart beats, three persons are added to the world population. By tomorrow’s time, there will be about 266, 000 more people in our homes globally. However, this was not seen when humans first appeared on Earth c.3000 BCE (Miller Jr. 1992). They lived a short life expectancy of say 30 to 40 years. This is due to the hostile environment they had lived in and were mostly ‘hunters and gathers’ as well as nomads (Yassi et al. 2001). The fact is that one billion people are added to the world population every ten years. Over the centuries commencing 1804, the billion population gradually increased, reaching approximately 1.56 to 1.71 billion by 1900. Fast forward to the year 2000, the global population had grown significantly from 6.06 to 6.15 billion. It is expected to see more than 8 billion by the end of this year (World Population Prospects, 2023). To feed the billions of people, they need food, shelter, security, and good health to live within the maximum age limits (Yassi et al, 2001). Importantly, every household needs toilets, safe water, and safe methods to dispose of solids and sullage wastes or wastewater. This will avoid the pollution of the groundwater.
Water and sanitation
An estimated 2.4 billion people still lack access to improved sanitation and 946 million still practice open defecation in less developed countries. While open defecation practice is rampant in most rural areas, it is either a voluntary choice or a compulsion (Temesgen, et al.,2021). This choice is closely linked with personal preferences, and cultural and traditional norms with special concerns for privacy for women and girls in different communities (Bhatt et al. 2019). The World Health Organization (WHO) commissioned a review to assess the impact of sanitation on coverage and use, as part of its effort to develop a set of guidelines on sanitation and health. This is due to the massive death toll from episodes of waterborne diseases. It has intervened and provided ideal support to address global issues on water, toilets, and sanitation. This is through the initiatives of Water, Sanitation, and Hygiene (WASH) to provide safe drinking water, proper sanitation facilities, and a hygienic environment and livelihood to its people. This has been widely accepted in most countries including Fiji with the Ministry of Health. Live & Learn Fiji is an organisation that works with communities throughout Asia and the Pacific to encourage ethical and sustainable attitudes, values, and actions. The priority is to support Fijian communities in sustaining their environments by improving practices.
Purpose of WASH?
In the International Year of Sanitation 2008, initiatives have been taken to review WASH interventions. Moreover, WHO has strategised a 2018-2025 plan for the improvement in the condition of sanitation and hygiene for people across the globe and to provide them with sufficient and clean water for a healthy life. The need for the WASH initiatives includes:
Improving the quality of drinking water to reduce the risk of human health; Monitoring healthcare facilities is another important aim of WASH; Improving the safety of sanitation and wastewater management; Monitor the data presented by the Global Analysis and Assessment of Sanitation and Drinking Water (GLAAS); Coordinate with multi-sectoral partners, lead or engage with global and regional platforms, and advocate for WASH and Integration of WASH with health and other programs such as Antimicrobial Resistance (AMR), cholera, climate change, emergencies, nutrition, water security to increase synergies and impacts (WHO, 2021).
Deaths and diseases
Lack of access to and use of water, sanitation, and hygiene (WASH) causes 1.6 million deaths every year, of which 1.2 million are due to gastrointestinal illnesses like diarrhoea and acute respiratory infections like pneumonia. Poor WASH access and lessen nutrition and educational attainment may cause danger and stress for vulnerable populations, especially women and girls (Chirgwin,2021). The Sustainable Development Goal (SDG) 6 calls for the end of open defecation, and universal access to safely managed water and sanitation facilities, and basic hand hygiene, by 2030. WASH access also reinforce progress in other areas such as SDG1 poverty targets, SDG3 health, and SDG4 education targets. Meeting the SDG equity agenda to “leave none behind” will require WASH providers to prioritise the hardest to reach including those living remotely and disadvantaged people. Hence ensuring everyone has access to safe water, sanitation, and hygiene facilities is one of the most fundamental of challenges to alleviate poverty.
Toilets for health
When human wastes are not managed well, they pollute water, food, and soil with germs and lead to diarrhoea and other serious health infections. For a toilet to be safe, it must be well-built and in a safe place. It must be close to the premises and not isolated, women may not feel safe using it. A well-built toilet will give respect to the owner of the house. This is why people wish to spend money and effort to build one. Over centuries, there have been many designs and models of toilets manufactured and patented by companies. There are numerous models of toilets worldwide such as dry and flush toilets. The discovery of the toilet by John Harrington in 1596, in England led to a decrease in the number of water-borne and other infectious diseases. His design was water-borne which was a gift to Queen Elizabeth 1. The goal of good toilet hygiene is minimising the potential for pathogen transmission. Control of odours is also socially important and believed to be a societal measure of cleanliness. On the other hand, the World Toilet Day is observed on November 19 every year. It highlights, that the benefits of access to toilets and safe sanitation for all are many and must be harnessed to maximum effect. It’s a global initiative aimed at raising awareness of sanitation issues worldwide and promoting better sanitation practices. Today, 2.4 billion people are struggling to stay healthy, keep their children alive, and work their way to a better future – all for the want of a toilet. Let’s change that. Open defecation (the practice whereby people go out in fields, bushes, forests, open bodies of water, or other open spaces rather than using the toilet to defecate) is a leading cause of diarrheal death, (WHO, 2012). The diarrhoea death toll stands at around 6000 a day, mostly young children. “Life without a toilet is dirty, dangerous, and undignified,” mentioned by the UN Secretary-General Antonio Guterres while urgent and massive investment, as well as innovation, along the entire “sanitation chain”, from toilets to the transport, collection, and treatment of human waste. He alluded that delivering on the basic human right to water and sanitation is not only good for people but also good for business and the planet. For every dollar invested in toilets and sanitation, up to five dollars are returned in saved medical costs, better health, increased productivity, education, and jobs. Hand-washing with soap after using the toilet is one of the most effective and inexpensive ways to prevent diarrheal diseases and pneumonia. This simple behaviour can reduce the risk of diarrheal disease by up to 47 per cent, but only if it’s done consistently. Research shows that globally less than one-fifth of people currently wash their hands properly at critical times, and only 19 per cent of people wash their hands after using the toilet or changing a child’s diaper. Diarrhoea and pneumonia, two major illnesses that are transmitted this way, together kill an estimated 1.7 million children every year. To wash your hands properly, make sure you scrub your hands with soap for 20 seconds, or the time it takes to sing “Happy Birthday” twice. The day draws attention to the 3.5 billion people who still lack access to safely managed sanitation facilities. This year, the theme for World Toilet Day in November is “Leveraging Water for Peace”. There are over 20 different extra disposal systems that offer varying degrees of convenience and protection to people from poor to rich or from rural, peri-urban, and urban (Yassi et al. 2001). The overall purpose of good sanitation is to provide a healthy living environment for everyone, protect natural resources such as surface water, groundwater, and soil, and provide safety, security, and dignity for people when they defecate or urinate. There is an urgent and massive investment, as well as innovation, along the entire “sanitation chain”, from toilets to the transport, collection, and treatment of human waste. Water and sanitation are not only good for people but also good for business and the planet (Guterres, 2020). For every dollar invested in toilets and sanitation, up to five dollars is returned in saved medical costs, better health, increased productivity, education, and jobs, the UN chief said. According to Target 2 of Sustainable Development Goal No. 6 on sanitation, by 2030 we should achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women, girls, and the elderly.
Climate change (sanitation and environment)
Many anthropogenic activities have, including the use of fossil fuels, increased population growth urbanization and changes to the geomorphology for developmental purposes and increased carbon foot print which have added impacts on our climate changes. To safeguard our physical environment, it is essentially important to ensure the wastewater or the effluents from sanitary wares such as toilets, hand basins, showers, kitchen sinks, and ablution devices, are safely treated by way of septic tanks, sewerage systems, or other approved methods. The leachates are the main cause of chemical and physical pollution to creeks, streams, and rivers. The pollutants from these sources enrich the quality of water from various chemicals and include, nitrogen, sulfates, potassium, lead, carbon, and other heavy metals. Nutrient data for Suva Lagoon over the last 25 years indicate that nitrate concentrations in nearshore waters are usually present at significant levels. Moreover, data for metals in shellfish collected from Laucala Bay indicate no significant levels of concern, the mercury and lead levels in shellfish at Lami dump were particularly high (Morrison et al. 2005). For metals in sediments, high concentrations of metals of health concern (Pb, Hg, Cd, Sn) are found only at “hot spots” such as former Lami Dump, Wailada, and Walu Bay industrial areas (Morrison et al. 2005). Levels of faecal coliforms in mangrove oysters were found to be above the internal safety standard for consumption and potential health hazards, particularly if eaten raw (Naidu and Morrison 1988). High levels of fecal coliforms have also been found in kaikoso clams in inshore environments (Tawake 2004). Humans are affected in many ways such as by way of resources such as; fisheries, drinking water, recreation, and contamination by infiltration to adjacent spring water by underground sources or aquifers. On the other hand, climate change threatens people with increased flooding, extreme heat, food and water scarcity, disease, and economic loss. Cattaneo (2019), agrees communities and ecosystems will experience more severe risks without action to limit warming. Adapting to climate change through flood control measures or drought-resistant crops partially may reduce climate change risks, although some limits to adaptation have already been reached. Poorer communities are responsible for a small share of global emissions, yet have the least ability to adapt to most changes. Some of the tangible impacts of disasters are invariably attributed to human atrocities such as wars and genocides, few natural calamities are described below.
Droughts
The International Red Cross stated that more damages have been done due to droughts than any other disasters, in addition, one-fifth of the world area is severely gripped by droughts (Miller, 1992). Therefore, the lack of safe water for daily human needs is a big challenge to see at least basic sanitation and hygiene being practiced apart from severe human suffering and deaths from severe dehydration, and contagious diseases. The worsening droughts compromise added burdens to scanty water supplies, females will be required to harness water for domestic needs from distant places. Others need to purchase water with huge costs. Hence the poor will suffer further. “Rich may survive while the poor may perish” (Chamber, 1991).
Flooding
Excessive precipitation or rainfall causes much damage to landforms and causes soil erosion, inundation of houses, contaminating drinking water, loss of lives, and numerous other damages to the properties and infrastructure. The worsening droughts compromise water supplies to ration water supply with huge costs. The unsurmountable damages are observed to food crops and the fertility of the soil. The remaining loss of crops will be attributed to destruction by the pests after the floods. The infrastructure damages to the water main and sewerage will be hard to fix due to added costs among the poor countries. Most of the sewerage treatment plants are located along the coastal areas. The risks of contamination from sewage plants will further damage vast ecosystems. Dangerous wastes from industries, and leachates from landfills, will further add woes to the health and safety of people.
Seal level rise
The rise of the sea level is a serious issue that we need to address urgently. Our planet is facing the consequences of global warming, which is causing the melting of ice sheets and glaciers, increasing the height of the ocean’s surface. This phenomenon not only causes flooding and erosion in coastal regions but also leads to the loss of habitats and displacement of people and animals. The actual impact will vary regionally due to changes in both land and ocean height. As the sea level rises, saltwater moves into freshwater areas. This may force water managers to seek other freshwater sources or increase the need for desalination (or removal of salt) for some coastal freshwater aquifers used as drinking water supply (USGCRP, 2014). In addition, as more freshwater is removed from rivers for human use, saltwater will move farther upstream. Drought can cause coastal water resources to become more saline as freshwater supplies from rivers are reduced. Water infrastructure in coastal cities, including sewer systems and wastewater treatment facilities, faces risks from rising sea levels and the damaging impacts of storm surges.
Earthquakes
An earthquake is any sudden shaking of the ground caused by the passage of seismic waves through Earth’s rocks. Most earthquakes occur due to the movement of tectonic plates. These massive plates that makeup Earth’s crust are constantly shifting. When they collide, pull apart, or slide past each other, stress builds up along fault lines (narrow zones where rock masses move about one another). Earthquakes can inflict severe damage to buildings, infrastructure, and landforms. Insurmountable damages to bridges and roads pose risks to human life. Cause injury and loss of life, hurt by falling debris, collapsing structures, or being trapped. Earthquakes can also lead to loss of life. It may also trigger fires, rupture gas lines, damage to sewer pipes and water mains. It can also generate a tsunami (Britannica, 2024).
Public Health Law of Fiji
Public Health Act 1936, Cap 111, under this Act, health inspectors have the power to abate nuisances and to inspect and ascertain a nuisance (the deposit of any material which is offensive to the public or injurious to health, (Section 56 (e) (Watling and Chape 1992). It is limited in terms of environmental protection and provides few remedies for compelling the abatement of nuisances that may affect human health such as pollution of waterways. It is not meant to regulate pollution, although in limited situations may provide a means for intervening in the absence of other means (Evans 2006). The strength of the Act lies in its institutional organisation; specifically, the Central Board of Health (CBH), which has over 100 Environmental Health Inspectors around the country (Watling 2005). Section 56 of the Act provides wide-ranging powers for environmental health officers to enter premises to carry out their duties. These powers could assist with inspecting trade waste discharges into sewerage systems and enforcing ecological regulations related to waste discharge into the environment (Kirkwood and Hughes 2005).
Conclusion
There is a wide range of challenges faced by the global community to address issues affecting health, water supply, and sanitation. The variations in weather patterns, climate change, and increased urban drift of people tend to change the landforms that impact precipitation. Natural disasters have increased many folds causing huge loss of lives and increased poverty due to food shortages, starvation and deaths. The chances of many infectious/contagious diseases, deaths due to inadequate supplies of safe drinking water, and lack of sanitation will tend to escalate beyond any optimistic expectations in 2030 and beyond. This also means achieving many areas of Sustainable Development Goals (SDGs) enhanced in 2015 by the United Nations. To address all these areas, innovative approaches have to be made with many stakeholders and developing partners. Fiji is also at a crossroads despite having 98.4 per cent of the urban population having a piped water supply yet the cases of infectious diseases are overwhelmingly on the rise (Gov. of Fiji, 2012). A lot more work has to be done to make Fiji’s population healthy by adopting WASH concepts to protect the health of all people. We must prioritise the preservation of our planet for future generations.
- KESHWA NAND is a regular contributor to this column. The views expressed in this article are his and do not necessarily reflect those of this newspaper.
