Residents collect water from a communal pipe, right next to an open sewer and drain

The forgotten nexus of sanitation, hygiene & water: Is this the inhibitor to progress?

Water, Sanitation and Hygiene (WASH)

In the lead-up to World Toilet Day, Oxfam’s Katie Whitehouse looks at how water, sanitation, hygiene and development are connected.

Residents collect water from a communal pipe, right next to an open sewer and drain

Residents collect water from a communal pipe, right next to an open sewer and drain. Credit: Sam Tarling

In the 1800s, towns and cities across the world, including London, were battling cholera epidemics. Before John Snow published his theory in 1849 that cholera was a waterborne disease, efforts to manage poor sanitation and hygiene were minimal. The realisation that poor sanitation contaminated drinking water sources has been heralded by many historians as a key turning point in the development of major urban centres with it the development of modern sewerage systems. In the 1800s the upgrading of London’s sewer networks was the biggest civil engineering project in the world at the time and is still in use today.

Essentially water, sanitation and hygiene are interlinked. That is why the sector is called WASH (water, sanitation and hygiene). Poor sanitation can lead to contamination of water sources. To use certain toilets and sewers you need water. In Islamic cultures you need water as part of cleansing practice. For handwashing you need water.

Rapid growth of slums underserved from formal infrastructure is leading to a ticking timebomb of disease and forcing residents to pay more for clean water with World Bank studies showing billions of dollars lost annually in healthcare costs and work days lost due to diarrheal disesase. In East Asia alone the economic losses due to poor sanitation are estimated to be USD $9.2 billion.

And yet, there is still an unprecedented focus in terms of the amount of programmes and funding on water over sanitation and hygiene despite their interdependence. There is also a distinct separation in the naming of advocacy conferences and awareness days. It felt like this at Stockholm World Water Week 2016 where the key word is water and sanitation issues had to struggle for space to be discussed during the week with the Sustainable Sanitation Alliance (SusanA) having to hold their annual meeting separately to the main seminars.

The WASH topic is heavy and complex but by separating them, are we perpetuating a non-holistic view of the sector and therefore the programmes and funding that we deliver?

Visit our World Toilet Day site.

Katie Whitehouse

Katie Whitehouse

Katie is Global Advisor Urban WASH & Markets. She works with the Oxfam Global Humanitarian Team to support the implementation of a global programme funded by OFDA to improve how we utilise market-based approaches for urban WASH in emergencies including refining the process, capacity building, knowledge sharing and programme development across key trial countries in Zimbabwe, Indonesia and Bangladesh.