World Water Day 2004: Water and disasters
The role of the World Health Organization
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Access to a safe water supply and adequate sanitation are both essential to a healthy life, and they enable the poor and unserved to develop socioeconomically. And yet approximately 1.1 billion (1100 million) people worldwide lack access to improved water sources, and 2.4 billion people lack access to any type of improved sanitation. This lack of access comes with a heavy burden. Some 1.7 million deaths a year worldwide are attributable to unsafe water and to poor sanitation and hygiene, mainly through infectious diarrhoea. Most of the deaths (90%) occur in children, and virtually all occur in developing countries. Every year, over one million people die of malaria, a disease closely linked to the poor management of water resources, and about 6% of the global burden of disease is water related. Much of the morbidity and mortality could be mitigated by providing adequate sanitation services, a safe water supply, and hygiene education. These are effective interventions that studies suggest could reduce mortality from diarrhoeal disease by an average of 65% and related morbidity by 26%.
The burden of disease associated with inadequate or poorly-managed water resources is increased when natural or man-made disasters occur, and this can directly impact the livelihood of a population. Almost two billion people – one-third of humanity – were affected by natural disasters in the last decade of the 20th century, 86% of them by floods and droughts. There are high rates of suffering and death in populations affected by natural and man-made disasters, mainly due to common illnesses made life-threatening by crisis conditions. Vulnerable groups, such as women, children and the elderly suffer disproportionately in disasters and have high death rates.
Each disaster can pose its unique set of health threats. Floods are the second most-frequent cause of natural disaster after windstorms, but they affect more regions and more people than any other phenomenon. Flooding increases the ever-present health threat from inadequate drinking-water and sanitation systems. Water supplies can become contaminated with industrial waste and by refuse dumps. Drowning, which is closely linked to flooding, adds considerably to the burden of disease attributable to flooding disasters. People who have lost everything in a flood – their homes, their food, their livelihood – are also more vulnerable to disease.
Droughts cause the most ill-health and death because they often trigger and exacerbate malnutrition and famine, and deny access to adequate water supplies. Accurate statistics for mortality caused by droughts are not available, because deaths are attributed mainly to lack of food and exacerbation of pre-existing malnutrition. Deaths are also attributed to migration, homelessness, lack of (or damage to) public health infrastructure, and to poor health care. In hot countries, or during heatwaves, deaths may be caused by a combination of heat and a shortage of water.
To reduce the vulnerability of water and sanitation systems in a disaster, they should be maintained to acceptable standards. Water-supply systems may become overwhelmed, either because their capacity cannot meet an ever-growing demand from users, or because the systems are not sustainable (e.g. frequent system breakdowns). Poorly maintained systems are unlikely to be sustainable, and will be especially vulnerable in an emergency and unable to meet the basic needs of the population. It will be costly for the health sector to be institutionally unprepared for emergencies, not only in terms of lives lost, but also technically and politically.
The World Health Organization (WHO) is the United Nations agency responsible for health. WHO works at country, regional and global levels for disaster mitigation, emergency preparedness and response, and is an advocate for health and humanitarian action. WHO cooperates with Member States through the following entities:
- the Water, Sanitation and Health Programme, and the Department for Health Action in Crisis, at WHO Headquarters, Geneva;
- six WHO Regional Offices;
- over 150 WHO country offices, responsible for directly interacting with governments through the ministries of health and other ministries dealing with water and sanitation;
- three WHO Regional Environmental Health Centres: Centre for Environmental Health Activities (CEHA) in Amman; Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS) in Lima; and European Centre for Environment and Health (ECEH) in Rome.
More specifically, WHO focuses on strengthening the preparedness of health systems, as well as their ability to respond to all types of disasters. WHO prepares and promotes guidelines, publications and audiovisual materials that are based on best public-health practices. WHO also trains staff from ministries of health in preparedness and response, as well as in the development of emergency contingency plans. WHO collaborates in the development of human resources and institutions, and in the elaboration of response plans, and donates equipment, medicines and emergency supplies of chlorine.
The WHO Health Action in Crisis (HAC) department aims at increasing the capacity of countries to: prevent disasters, become more self-reliant, prepare for emergencies, mitigate the health consequences of a disaster, and create a synergy between emergency action and sustainable development. The HAC web site provides situational information, including baseline statistics, health situation reports and epidemiological surveillance data (http://www.who.int/disasters/).
In addition to HAC, which is responsible for coordinating the health aspects of disaster management within WHO, the Water, Sanitation and Health Programme (WSH) prepares tools (norms and practice manuals), and provides training and technical advice on how to respond to an emergency or disaster, and on how to reduce vulnerability. Material is available as downloadable files from the WSH web site (www.who.int/health_topics/water/en/).
To establish priorities in a disaster response plan, it is essential that the health sector and other groups involved in the framework for emergency preparedness cooperate. For this reason, WHO has several collaborating centres around the world that consult and collaborate with its different offices, to provide effective support for countries affected by man-made and natural disasters.
For further information please contact:
World Health Organization
20 Avenue Appia, Geneva, Switzerland
Water, Sanitation and Health Programme, or
Department for Health Action in Crises
Tel. 0041 22 7912111
Fax. 0041 22 7913111
www.who.int/disasters
www.who.int/water-_sanitation_health