Water for Basic Needs | The Water Page

Human life, as with all animal and plant life on the planet, is dependent upon water. Not only do we need water to grow our food, generate our power and run our industries, but we need it as a basic part of our daily lives – our bodies need to ingest water every day to continue functioning. Communities and individuals can exist without many things if they have to – they can be deprived of comfort, of shelter, even of food for a period, but they cannot be deprived of water and survive for more than a few days. Because of the intimate relationship between water and life, water is woven into the fabric of all cultures, religions and societies in myriad ways.Water for basic needs (households, services) represents a relatively small amount of the total quantities withdrawn for other uses. Yet, although many fortunate people throughout the world are able to take water for granted where it is available, for an estimated 1.1 billion people – water rules their daily lives with the cruel irony that it is often both the most precious and sought after of commodities, requiring grinding daily labour to acquire.At this point in the twenty first Century we are surrounded by the marvels of modern communications, electronics and bio-mechanics; we have charted the human genome and yet we have not mustered the skills, resources and will to provide all members the global population with something as basic as safe water supply and adequate sanitation.What are basic human needs for water – how much do our bodies need? “Basic needs” go beyond what we need to drink or ingest through our food for daily survival (about 5 litres per person per day [Gleick, 1999]) – it includes the need for water to maintain a basic standard of personal and domestic hygiene sufficient to maintain health. It is not sufficient merely to have access to water in adequate quantities – the water also needs to be of adequate quality to maintain health and it must be free of harmful biological and chemical contamination. Water gathered from unprotected sources often does not meet these criteria and places the users at risk. Often water which is of a sufficiently high quality at the point of collection is contaminated before it is used because it has to be carried and stored before use or because of unhygienic practices.Water provision cannot be separated from two other inter-related factors – sanitation and health. This is because one of the primary causes of contamination of water is the inadequate or improper disposal of human (and animal) excreta. This often leads to a cycle of infection (resulting primarily in diarrhoeal diseases) and contamination which remains one of the leading cause of illness and death in the developing world.Providing for daily water needs is a burden on households with inadequate services in a number of ways, in addition to the direct health threats. Often water has to be carried long distances to the house which takes time and effort, a burden borne mainly by women and children. In urban and urban fringe areas water is often only available from vendors at a price which is usually several times more expensive than the water provided through formal services and of poor quality. Inadequate water supplies are both a cause and an effect of poverty. Invariably those without adequate and affordable water supplies are the poorest in the society. The effects of inadequate water supply – disease, time and energy expended in daily collection, high unit costs, etc. – exacerbate the poverty trap. Provision of basic daily water needs is yet to be regarded by many countries as a human right.This chapter will explore the growing awareness over the last few decades of the enormity of the problem, the development of thought and practice as we have attempted to meet the challenge, the state of affairs in the world at present and the options for the future.The minimum amount of water required to meet basic needs vary depending upon what is included as “basic needs”. The figures vary from 20 to 50 litres per person per day. Setting specific quantities as standards should be generally avoided, recognising the importance of context and the need for each country or region to set appropriate goals. Standards need to be set with great care as they can be counter productive and result in communities facing “all or nothing” alternatives rather than an interim improvement of their current services.Preferable to rigid standards are a set of development goals which allow both the possibility of monitoring progress and the opportunity for iterative improvements of current service levels towards the goals.An example where standards were shown to be counter-productive was in South Africa where insistence on both affordability and a pre-determined standard of 25 l per person per day were mutually exclu-sive resulting in some poorer communities not being serviced – policy has subsequently changed. [Rural and Peri-Urban Water Supply and Sanitation in South Africa Appropriate Practice Conference – 14 – 17 March 1999]Water, sanitation and health are closely inter-related. In wealthier communities this connection is taken for granted but in poor developing communities the connection is a stark daily reality.Water and health are related in a number of ways.Firstly, there is the direct impact of consuming contaminated water – this is known as ‘waterborne disease’ and includes diarrhoea, typhoid, viral hepatitis A, cholera, dysentery.Secondly, there is the effect of inadequate quantities of water being available for personal hygiene or the of un-hygienic practices which contaminate water and cause diseases. Without enough water, skin and eye infections (including trachoma) are easily spread, as are the faecal–oral diseases. These diseases are known as ‘water-washed diseases’.Thirdly, there are ‘water based diseases’ and “water-related vector-borne diseases” in which the aquatic environment provides an essential habitat for the mosquito vectors and intermediate snail hosts of parasites that cause human diseases. Malaria, schistosomiasis, lymphatic filariasis, onchocerciasis and Japanese encephalitis are examples of these diseases.Fourthly, there is chemically contaminated water such as water containing excessive amounts of arsenic or floride. Some contaminants are added to drinking water as a result of natural processes and some due to human activities such as industry and mining. Poor communities, especially in urban fringe areas, are particularly susceptible to dangers from polluted water from a variety of sources due to lack of or poorly enforced regulation of water pollution.The impacts on health of these factors is at a very large scale and accounts for more illness and death than any other factor in developing countries [2001, WHO]. The following impacts are the most severe:There are approximately 4 billion cases of diarrhoea each year cause 2.2 million deaths, mostly among children under the age of five. Water, sanitation, and hygiene interventions reduce diarrhoeal disease on average by between one-quarter and one-third.Intestinal worms infect about 10% of the population of the developing world. These can be controlled through better sanitation, hygiene and water supply. Intestinal parasitic infections can lead to malnutrition, anaemia and retarded growth, depending upon the severity of the infection.It is estimated that 6 million people are blind from trachoma and the population at risk from this disease is approximately 500 million.300 million people suffer from malaria – 1 million people die of malaria in sub-Saharan Africa each year.Arsenic in drinking water is a major public health threat. It is estimated that in Bangladesh, 100,000 cases of skin lesions caused by arsenic have occurred and there may be many more.Fluoride in low amounts in drinking water can be beneficial to dental health but excessive amounts can be toxic. An estimated 30 million people suffer from chronic fluorosis in China alone. Fluoride is also present in potentially toxic quantities in the groundwater throughout the Rift Valley.200 million people in the world are infected with schistosomiasis, of whom 20 million suffer severe consequences.The WHO and UNICEF promote three key hygiene behaviours as having the greatest potential health impactHand washing with soap (or ash or other aid).Safe disposal of children’s faeces.Safe water handling and storage.The WHO/UNICEF/WSSCC Global Water Supply and Sanitation Assessment 2000 Report provides information on the current status of basic water and sanitation services throughout the world. The report charts the developments since 1990. The current status is provided in Table 1 below:GlobalTotal populationPopulation servedPopulation unserved% ServedTotal populationPopulation servedPopulation unserved% ServedUrban water supply2 2922 179113952 8452 67217394Rural water supply2 9741 9611 013663 2102 28492671Total water supply5 2664 1401 126796 0554 9561 09982Urban sanitation2 2921 877415822 8452 44240386Rural sanitation2 9741 0281 946353 2101 2102 00038Total sanitation5 2662 9052 361556 0553 6522 40360Africa(72% of regional population rep)(96% of regional population rep)Urban water supply19716631842972534485Rural water supply4181832354448723125647Total water supply6153492665778448430062Urban sanitation19716730852972514684Rural sanitation4182062124948722026745Total sanitation6153732426178447131360Asia(88% of regional population rep)(94% of regional population rep)Urban water supply1 02997257941 3521 2549893Rural water supply2 1511 433718672 3311 73659575Total water supply3 1802 405775763 6832 99069381Urban sanitation1 029690339671 3521 05529778Rural sanitation2 1514961 655232 3317121 61931Total sanitation3 1801 1861 994373 6831 7671 91648Latin American & The Caribbean(77% of regional population rep)(99% of regional population rep)Urban water supply31328726923913622993Rural water supply128725656128794962Total water supply44135982825194417885Urban sanitation31326746853913405187Rural sanitation128507839128626649Total sanitation4413171247251940211778Oceania(64% of regional population rep)(85% of regional population rep)Urban water supply181801002121098Rural water supply8536296363Total water supply26233883027388Urban sanitation18180992121099Rural sanitation8718997281Total sanitation26251963028293Europe(15% of regional population rep)(44% of regional population rep)Urban water supply52252201005455423100Rural water supply20019911001841612387Total water supply72272111007297032696Urban sanitation5225220100545537899Rural sanitation20019911001841374774Total sanitation72272111007296745592Northern America(99.9% of regional population rep)(99.9% of regional population rep)Urban water supply21321301002392390100Rural water supply69 069010071710100Total water supply28228201003103100100Urban sanitation21321301002392390100Rural sanitation6969010071710100Total sanitation28228201003103100100The figures indicate that the number of people who do not have any form of improved water supply facility stands at 1.1 billion globally. The number of people without basic sanitation is 2.4 billion. Most of the unserved populations are in Africa and Asia, with the highest numbers of unserved people in Asia although the proportion of unserved is higher in Africa. Although these are daunting figures (one sixth of the world’s population without water and two fifths without sanitation), it must be noted that progress has been made during the past 10 years despite an increase of 15% in the global population. The international target of reducing to a half the percentage of people not served with these services before 2015 is therefore a continuous race against increasing population. Taking population growth into account, to halve the proportion of unserved people by 2015 will require 2.2 billion additional people having access to safe sanitation (397 000 per day) and 1.5 billion to improved water services (292 000 people per day).Sanitation, Distribution of unserved populations – Source:WHO/UNICEF, 2000It is important to review the pattern of investment for new infrastructure in the water supply and sanitation sectors to gain a perspective of the magnitude of the challenges and to determine the sources of support. All the figures quoted below were taken from the 2000 Global Water Supply and Sanitation Assessment Report.There are four main sources of funds and resources available for investment – those from government (national, regional and local governments), private sector, external support largely from international donor sources, and the input of individuals, families and local communities. The value of the latter category is difficult to quantify in monetary terms. It is estimated that the total annual national and external investment in water supply and sanitation in Africa, Asia and Latin America and the Caribbean over the 90’s was about US$ 16 billion.YearWater supply and sanitation as a proportion of total co-operation (%)19863.4103419873.7132319884.2186619893.8150819903.2184419913.2183519924.2212419935.5272719945.1255219955.6303419966.62907Disparity Between Spending on Water Supply and SanitationInvestment figures indicate that a higher priority has been given over the 90’s for water supply as opposed to sanitation, both through national governments and by the international community.RegionWater supply (US$billion)%Sanitation(US$billion)rica4.09188%0.54212%Asia6.06385%1.10415%LA & C2.4162%1.50338%Total12.56480%3.14820%Comparison with Agenda 21 investment requirement estimatesThe investment estimates made by the Rio Conference Secretariat to implement Agenda 21 proposals between 1993 – 2000 were 20 US$ billion average total annual cost, twice what was being spent at the time, which included 7.4 US$ billion from the international community. The actual expenditure, in terms of the 2000 Global Water Supply and Sanitation Assessment Report was 15.6 US$ billion with an average of 2.4 US$ billion derived from international sources over the period 1990 – 1996 (as per Table 2 above). This represents a 25% shortfall in total expenditure and a 67% shortfall in international spending.RegionAfricaAsiaLA & CN. AmericaOceaniaEurope% functioning7083969793100Lack of DisinfectionMany urban water supply systems in Africa, Asia, Latin America and the Caribbean do not disinfect the water supplied to consumers. This is most likely as a result of lack of technical capacity, cost, and operation and maintenance problems.Lack of Treatment of Waste WaterThe discharge of untreated sewage presents a particular health hazard, especially to poor communities in urban contexts who have to rely on unprotected water as their main sources of supply. In developing regions, waste water is treated in only a minority of situations, but even in industrialised countries treatment is not universal. See Figure 5.The most striking trend during the past 10 years has been the comparatively rapid growth of population in urban areas. In 1990 43.5% of the world’s population lived in urban areas – by 2000 the proportion had grown to 47%. This trend is likely to continue and will present particular challenges to governments, local authorities and communities in the future. Much of the growth is in informal settlements where service provision is particularly difficult, where the population is poorest and where health is particularly vulnerable to the effects of poor services and poor shelter.A considerable problem facing many cities is that of unaccounted for water. This generally illustrates the efficiency of providers although not all of the unaccounted for water is wasted – some is utilised by consumers but not recorded as such or paid for.Over the past 30 years the problems facing developing countries in the provision of basic services has been increasingly clarified. During this period the complexity of the challenges and solutions have emerged. Successive lessons have been learned and different approaches have been taken covering a wide range of issues in the search for sustainable, replicable services provision. It is instructive to review the lessons learned. Each emerging lesson increased our understanding of the problems and our awareness that the answer did not lie in any particular avenue but rather in an integration of all the elements and a sober appreciation of the complexities of human, social, political and economic interaction.During the 1960s and 70s the prominent assumption was that the answer lay in engineering solutions. When such approaches did not lead to an appreciable impact on the problem, notwithstanding important lessons being learned regarding the need for “appropriate technology”, it began to become clear that the issue was not merely a technical problem but a complex social, economic and political problem.During the 90s, as real inroads into the backlog of services throughout the developing world remained elusive, the political importance of basic services began to be recognised in many emerging democracies. This had both positive and negative effects – the importance of political will in the allocation of resources became increasingly apparent but the politicisation of water supply and sanitation also had the effect of raising unrealistic expectations in many communities only to lead to disillusionment and further stagnation.Many of the proponents of each of these different factors were tempted to regard their area of interest as the solution to the enduring problem of sustainability. However experience now indicates that there is no single or simple solution to the complexities of service provision – there is no “silver bullet” – but rather the need for a holistic approach which incorporates all of the lessons learned. Further, the complexities of providing basic services appear to be fundamentally dependent upon factors which are not within the specific sectors of water, sanitation and hygiene, but on a number of underlying economic and political factors which are not directly related to these sectors.Reviewing targets with increasing realismOne indication of the increasing realism with which the problems of providing services have been viewed over the years is the setting of targets for the provision of universal basic water supply and sanitation services. The target set for the 1981-1990 International Drinking Water Supply and Sanitation Decade was to provide safe drinking-water and sanitation to all underserved urban and rural areas by 1990. At the World Summit for Children, in September 1990, heads of State called for both universal access to water-supply and sanitation and the eradication of guinea worm disease by 1995. Section 49 of Chapter 18 of the Rio Earth Summit’s Agenda 21 (1992) suggests that a more realistic target would be 2025.Agenda 21 also makes the important point that “specific targets should be set by each individual country.” (Section 18:49). This is echoed in Vision 21’s approach to proportional targets (see below). Recognition is increasingly being given to the reality that targets for the provision of basic services cannot be set within the water sector alone but need to be established in conjuction with a variety of other issues, chiefly poverty eradication, which involves a wide range of factors not specifically related to water supply, sanitation or public health. The persistent non-achievement of targets has resulted in a more careful approach to the setting of targets as their non-achievement is generally demoralising and leads to donor fatigue.The Global Wate Supply and Sanitation Assessment 2000 Report concludes that the recently set VISION 21 targets will not be met under the current pace of delivery without ‘dramatic’ changes.Water has multiple uses and water and land must be managed in an integrated manner,Management must be participatory and under-taken at the lowest possible level,Positive policies must be formulated to address women’s needs and to empower women, andWater should be recognised and treated as an economic good.PovertyThe single most influential factor related to the sustainable provision of basic water and sanitation services is that of poverty. The lack of availability of basic services is a primary measure of poverty and poverty is the primary obstacle in the provision of basic services. Poverty effects basic water supply and sanitation in a number of ways, ultimately being so all-pervasive that it overwhelms the application of even the very best practice incorporating all the lessons learned. It is therefore important to understand the full significance of poverty.Poverty in is not confined to the circumstances of individuals and families alone but extends to the institutions which are responsible for ensuring that services are provided, at all levels. (The characteristics of institutional and individual poverty are listed in the Box below.)Seeking to provide basic water supply and sanitation in the context of poverty requires understanding of the following factors:It is not possible to assume that services in one sector can remain functional whilst surrounded by the failure of other sectors – all sectors influence each other (health, basic services, education, transport etc.) Therefore, it must be appreciated that water supply and sanitation coverage targets for the future should also address poverty eradication.Current research indicates that there is a threshold level of disposable per capita income below which formal services are not self-sustaining on a cost-recovery basis. [Ref. World Bank – reference to be confirmed] Public subsidisation of services in such instances generally prove to be inadequate, inefficient and unsustainable.Service levels and technologies need to be developed incrementally in order to match the economic circumstances of those served.In isolated situations, given adequate local leadership and commitment, some communities are able to rise above the constraints of poverty and provide viable services. Health gains can be enormous through the use of simple measures such as water storage, in-house water disinfection, better hygiene.The harsh realities of poverty should not lead to the despondent notion that all efforts are in vein until poverty is eradicated – the provision of services forms part of poverty eradication.Factors Which Constrain the Water Supply and Sanitation SectorInsufficient financial resourcesInadequate institutional arrangementsInadequate human resourcesLack of sector coordinationLack of political commitmentInsufficient community involvementInadequate operation and maintenancePoor hygiene educationPoor water qualityInsufficient information and communicationCharacteristics of Institutional and Individual PovertyInstitutional poverty has the following characteristics:Public institutions are not able, because of the poverty of individuals and the corporate private environment, to raise funds from taxes and revenues.Public sector conditions of service are therefore very poor with extremely low salaries and inadequate working conditions,Public spending on basic necessities such as education and health care are very low,It is difficult to attract and keep good calibre public servants and capacity building programs are often means to leave public service for more attractive opportunities,The capacity and experience of officials is consequently often inadequate,Fertile grounds are laid for corruption and graft,Patronage systems result in the avoidance of accountability,Authorities at all levels are unable to provide the institutional framework necessary for sustainability,Authorities are unable to regulate the sector adequately which undermines the engagement of the private sector.Individual poverty is characterised by:Very low levels of formal employment, particularly in rural areas and poor urban fringes.Access to basic services is very difficult and even minimal costs for basic services represent a large proportion of disposable income.For the vast numbers of people surviving below the poverty line each day requires enormous skill and creativity in order to survive.Disease and poor health are constant realities.Education, if available, is of a very low standard and literacy levels are very lowPolitical focusThe provision of basic services is a “people” affair. At this stage in the 21st Century there is little that cannot be achieved technically. Providing services requires the interaction of many people in all spheres of life. Such interaction is governed by politics – the politics of the allocation of resources, the establishment of priorities, the interaction between institutions and the engagement of those most directly effected.Because of the history of the sector and its perceived technical nature, those working in the water supply and sanitation sector have not been adept and skilled in the language and techniques necessary to manage the politics of service provision. This has begun to be recognised during the 1990s with the identification of the need for political will and commitment but, having identified the need, the sector has generally been unable to effectively generate the required will and commitment. The need for effective political engagement is increasingly being recognised however, as can be seen in the recent adoption by the Water Supply and Sanitation Collaborative Council of advocacy as one of its emerging primary areas of activity.It is politically naïve to attempt to avoid the ‘politicisation’ of service provision – what is important is to raise the political profile of the issue and to increase the pressure for politicians to be accountable and for good governance, and to achieve this using all the tools and practices available in the politicians’ and activists’ toolboxes.Human RightsWhilst politics is the process of ensuring the prioritisation and allocation of resources, legislation creates legal obligation and leverage. At present basic water supply and sanitation do not enjoy the status of explicit statutory rights either in the international community nor at national level in all but a handful of countries. However it is argued (The Human Right to Water, Peter Gleick, July 1999) that there is sufficient implicit content in existing conventions and international agreements to amount to a recognisable right of all to a basic level of service. Implicit rights, however, are not sufficient to create the obligations required to adequately address the issue and to highlight the entirely unacceptable current global coverage situation where billions of people remain unserved resulting in greater human suffering and death than the violation of any other explicit human right.The amount of human energy, foresight, leadership and political astuteness required to bring the issue of basic services as an explicit human right to centre stage of the international community and to have such a right incorporated into domestic legislation will be enormous. Some would argue that such energy and resources would be better employed in the business of actually providing services to the poor but both are urgently needed. Having the right to basic services recognised as a human right will not in itself provide a single drop of water but it establishes obligation and contributes to political pressure. Such a quest faces many hurdles, not least of which is a sense of global and national fatigue in the face of decades of activity with only very slow progress.”All peoples, whatever their stage of development and their social and economic conditions, have the right to have access to drinking water in quantities and of a quality equal to their basic needs”.”To emphasize the human right of access to drinking water does more than emphasize its importance. It grounds the priority on the bedrock of social and economic rights, it emphasizes the obligations of states parties to ensure access, and it identifies the obligations of states parties to provide support inter-nationally as well as nationally”PopulationWith population growth, demand for the world’s finite supply of fresh water is rising, putting strains even on the industrialized countries. Global population projections suggest that the world population of over 6 billion people in 2000 will increase 20% to over 7 billion by 2015, and to 7.8 billion by 2025, a 30% rise. Enormous strains will be put on existing services, and substantial increases in the provision of water and sanitation will be needed to meet the needs of the ever-growing population. As populations grow and demands for water and other services expand, pollution levels will rise, which will then reduce the availability of water for human consumption.There are a number of significant current activities in the international arena which are contributing to the goals of universal basic services coverage.Poverty reduction strategiesThe current emphasis on poverty reduction which has been widely adopted by many international and bilateral development agencies, resulting in the formulation and adoption of broad, multi-sectoral country level poverty reduction strategies by many countries. It is vitally important that the issues of basic water and sanitation services be highlighted in such strategies, with specific attention being given to the different needs of the rural and urban poor.Debt reliefDebt relief programs have released much needed funds for redirection into the provision of a range of basic health, education and infrastructure services in many of the least developed countries of the world in recent years. In some instances this has produced a hitherto unfamiliar pressure to spend funds rapidly within national fiscal time-frames without the necessary technical and administrative capacity. This often leads to a relaxation of hard learned lessons such as the critical importance of ensuring stakeholder participation. The need to fast-track expenditure also increases the rationale for the engagement of the private sector which brings with it greater capacity. It is of vital importance that extra available capital from factors such as debt relief is used to maximum benefit in the development of sustainable basic services.Vision 21″A clean and healthy world: A world in which every person has safe and adequate water and sanitation and lives in a hygienic environment.”Vision 21, a unique initiative to address the needs of the unserved populations of the world compiled and published by the Water Supply and Sanitation Collaborative Council in March 2000, provides the principle current framework for action in the sector. Compiled out of a rigorous participatory process involving institutions, communities and individual experts from around the Globe, Vision 21 identifies four determining components and eleven core points.Four components of the Vision are:Building on people’s energy and creativity at all levels, requiring empowerment and building the capacity of people in households and communities to take action, and applying technologies that respond to actual needs.Holistic approach, acknowledging hygiene, water and sanitation as a human right, and relating it to human development, the elimination of poverty, environmental sustainability and the integrated management of water resources.Committed and compassionate leadership and good governance, changing long-accustomed roles, leading to new responsibilities of authorities and institutions to support households and communities in the management of their hygiene, water and sanitation, and in being accountable to users as clients.Synergy among all partners, encouraging shared commitment among users, politicians and professionals; requiring professionals within the water and sanitation sector to combine technical expertise with an ability to work with users and politicians and with the sectors of health, education, environment, community development and food.The targets set by Vision 21 are:By 2015universal public awareness of hygienepercentage of people who lack adequate sanitation halved (target endorsed by the Second World Water Forum, The Hague, March 2000)percentage of people who lack safe water halved (endorsed in the United Nations Millenium Declaration)80% of primary school children educated about hygieneall schools equipped with facilities for sanitation and hand washingdiarrhoeal disease incidence reduced by 50%By 2025good hygiene practices universally appliedadequate sanitation for everyonesafe water for everyoneall primary school children educated about hygiene,diarrhoeal disease incidence reduced by 80%.The key factors which will determine the development of the water supply and sector include:IntegrationIntegration is needed in two main forms:The integratio