Clean Water and Sanitation (Africa)

Brendan O'Hara Excerpts

Thursday 21st April 2016 Westminster Hall

[Brendan O'Hara (Argyll and Bute) (SNP)]

I congratulate the hon. Gentleman on securing this incredibly important debate. Does he agree that there is nothing more important than access to clean water? It is a disgrace that, in 2016, the lack of it is the biggest killer of children in sub-Saharan Africa. They are 14 times more likely to die of things such as diarrhoea and pneumonia than children in developed parts of the world. It is time that something is done about it.

[Jim Shannon]

I thank the hon. Gentleman for bringing that to our attention. I will touch on those issues now, as they are vital. When we consider water and sanitation, we must consider disease as well. I want to underline some of the issues addressed by the all-party parliamentary group on child health and vaccine preventable diseases, which was formerly chaired by Jim Dobbin, who passed away. Those of us in this House who knew him, even for a short time, were aware of his magnificent contribution. He outlined the issues from his personal experience of visits to Africa with vaccine programmes, where he witnessed at first hand deplorable hygiene and water facilities in hospitals. People can vaccinate and do all sorts of other things, but if they do not have water and sanitation, it is not going anywhere.

The scale of the problem is massive. In 2014, the lack of access to adequate water is estimated to have killed some 3,500 children under five years of age every day. The latest figures show that every year some 600,000 children lose their lives to diarrhoeal diseases, to which the hon. Member for Argyll and Bute (Brendan O'Hara) referred. Most of those deaths are of children less than two years of age in the poorest countries of the world.

Rotavirus is the most important cause of diarrhoeal mortality in children; it is associated with 28% of the deaths from diarrhoea. Despite the advances in treating water poverty, which have saved millions of children’s lives by protecting them against diarrhoeal disease, rotavirus remains the second leading killer of children worldwide.

We have to implement a combination of health, safe water, sanitation and hygiene solutions, and then we can do what the hon. Gentleman said—save more lives. That is part of the purpose of this debate. We can save the lives of children who are still at risk with simple interventions: improved safe water; sanitation; hygiene; exclusive breastfeeding; and vaccines that prevent rotavirus.

I will pose a couple of questions at this stage to the Under-Secretary of State for International Development, the hon. Member for Ruislip, Northwood and Pinner (Mr Hurd), and to his officials who are here. The United Kingdom has a very proud history of providing expertise, resources and global leadership to improve children’s health worldwide. It continues to provide leadership and support to build upon the positive trends. Perhaps the Minister can tell us how we can build upon the success that we have had so far in order to try, with others, to close the clear gap that exists? Can the UK continue to invest in a package of life-saving tools and services, which includes the vaccines, the medicines, the water, the sanitation, the hygiene and the nutrition, too?

What priority and weighting are given to the water, sanitation and hygiene, or WASH, strategies in the upcoming bilateral aid review, which we all know about and which the Minister will hopefully speak about in his response to the debate? Where do the Government sit regarding ongoing support and commitment to the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea, which was introduced by the WHO and UNICEF? How do the Government intend to ensure that

“sustainable management of water and sanitation for all”,

as outlined in sustainable development goal 6, is achieved? What fall-back do they have if that goal is not achieved? Let us consider what happens if we do not get there. What action does the Department for International Development intend to take—I am conscious that this may cross departmental boundaries—in the Nutrition for Growth summit in Rio in August? Has DFID discussed that with stakeholder organisations? If it has, what has been the outcome? Is the Minister yet in a position to state the level of funding that will be provided through the Ross Fund for health interventions, and whether WASH will benefit from the fund? Those are the questions that I wish to pose at this early stage.

Although this issue goes back as far as we can remember, the United Kingdom’s commitment to dealing with it could be significantly better. Investment in water, sanitation and hygiene is extremely cost-effective. According to WaterAid, for every £1 spent we can get £4 in return. In fact, the World Bank has declared that hand-washing with soap is the single most cost-effective intervention. As I mentioned earlier, the Movilla church in Newtownards has sent bars of soap over to Africa, because that is one of the small ways in which we can make a difference.

The lack of sanitation services is estimated to cost the world more than US$250 million per annum. The United Kingdom currently spends some 2% of its bilateral aid budget on water and sanitation, compared with around 13% on education and 19% on health. However, we need to be careful that we are not jumping the gun on this one, as access to clean water and sanitation can often be a prerequisite for success in other development areas such as education and health, and we must acknowledge the overlap between these issues.

Yesterday I had the chance to speak to representatives of some organisations who were keen to add their comments, to help with this debate. When we consider health, water and sanitation, we also have to consider the environment. I will just mark up one thing. Management of habitats is important; it can lead to better water access or worse water access, and to better or worse sanitation. I heard a comment yesterday about Madagascar, where people’s access to water is threatened by habitat destruction over huge areas. The destruction of the African wetlands deprives people of access to drinking water, and threatens livelihoods that depend on water, such as fishing, and the core survival of some people, including some tribes. In Madagascar, deforestation and erosion threaten almost every wetland, and as a result many thousands of people are in trouble and many species could be lost for ever.

I will just mark something else up; it is completely off the line of this debate, but is none the less important. The Wildfowl and Wetlands Trust is trying to help to save the Madagascar Pochard, or the “Mad Pochard” as it is called, which is the world’s rarest duck; I am not sure whether calling it “mad” is a compliment or not. In any case, there are only a few dozen left. The point that I am trying to make is that if something is not done about the water and wetland where that duck lives, it will not be able to provide drinking water for the local people or be used for sanitation, and it will not have any fish living in it either. Again, 6,000 people benefit from that clean water; many livelihoods go with it. That is just a reminder that conservation of nature goes hand in hand with looking after people who depend directly on the natural world.

As I have said, the United Kingdom currently spends some 2% of its bilateral aid budget on water and sanitation, compared with around 13% on education and a large percentage on health. For example, the delivery of quality healthcare in Africa has been seriously hampered by the lack of access to safely managed water. That is why I gave the example from Madagascar.

Sanitation and hygiene also affect practices in healthcare facilities. The WHO and UNICEF estimate that 42% of healthcare facilities in Africa do not have access to a safe water source within 500 metres. According to the WHO, 50% of malnutrition is associated with infections caused by a lack of access to water, sanitation and hygiene.

Globally, malnutrition accounts for some 45% of child deaths, of which a large proportion are within Africa. Children in sub-Saharan Africa are more than four times as likely to die before the age of five than children in developed regions. And after the first month of life, pneumonia and diarrhoea are the leading causes of the death of children under the age of five. Both pneumonia and diarrhoea are inextricably linked to a lack of water, sanitation and hygiene.

We have not had a debate on water aid or sanitation in this Session of Parliament. That is why we have asked for this debate today. First, we aim to raise awareness; secondly, the debate gives hon. Members a chance to participate and add their contributions; and, thirdly, we aim to highlight the issues that we feel are so very important.

Approximately 800,000 children aged between one month and five years died from pneumonia in 2013. Around 1,400 children die every day from preventable diarrhoea, and 58% of diarrhoeal deaths are caused by unsafe water, poor sanitation and poor hygiene. That is incontrovertible evidence that access to clean water and sanitation is essential if we are to see any meaningful development in other areas.

In conclusion, I will just give two examples of what I have talked about; nothing better illustrates the case I am trying to prove than case studies. The first involves child health. The name of the mother is Peggy Mpundu. She is 36 and part of the Mwasha village in Lubwe in Zambia. Peggy recently gave birth to twins, Kapya and Mpundu, in hospital. Two days later, they were discharged as healthy babies. However, one day after returning home, both babies started having problems breathing. Their parents, Peggy and her husband Sylvester, rushed them back into hospital, but tragically they both died that day. Peggy said:

“I was then told that water from shallow wells was harmful for babies.”

That was the same water that she had used for years. She continued:

“Having bathed my children using water from a shallow well just left me with a feeling of guilt and regret. I wish I knew that water could be so harmful”.

That is the true story of Peggy Mpundu.

The second case study is about opportunities for girls. The name of the girl involved is Erika Makalli, from Tanzania; I know that the hon. Member for Stafford (Jeremy Lefroy), who is here today, has particular knowledge of that country. Erika, who is 12, lives in Mbalawala village, in Tanzania. Like so many young girls, she was responsible for collecting water for her family, leaving her little time, if any, to go to school. The Tanzanian Government estimate that 58% of the country’s rural population do not have access to a safe water supply.

Discussing her old routine, Erika said that previously:

“I had to get up at 4 am and walk a long distance to find water. It took two hours and I could only collect a small amount of water to take home. That meant that Mum had to spend most of the day finding water so that we’d have enough to drink and cook with. I used to try and rush to get to school and wouldn’t be able to wash or have any breakfast beforehand. Most of the time I missed school altogether because I was sick or just exhausted. There were so many diseases in this village.”

I am very pleased that two officials from WaterAid are here in Westminster Hall today; they have helped me in preparing for this debate. WaterAid started working in the Mbalawala village two years ago and now there is a tapstand 15 minutes’ walk from Erika’s house and in her school. Erika now attends schools with her friends. Get the water right, get the health right, get the education, give them opportunities—those things follow on from each other. She is a prefect. Discussing the transformation in her life, she said:

“If I still had dirty water I wouldn’t be going to school anymore. I probably wouldn’t have had any real education at all. Also, most of my friends would probably also have died from the diseases we used to get. Life would be miserable. I feel I can at last look forward to a brighter future. Perhaps I will be a health and hygiene teacher when I leave school.”

WaterAid, this House, our Government and all the many other organisations—whoever they may be, and whether they are Churches, individuals or groups—have enabled that to happen.

Dr Lee Jong-wook, the former director general of the World Health Organisation, said:

“Water and Sanitation is one of the primary drivers of public health. I often refer to it as ‘Health 101’, which means that once we can secure access to clean water and to adequate sanitation facilities for all people, irrespective of the difference in their living conditions, a huge battle against all kinds of diseases will be won.”

I conclude with a question for the Minister. I am convinced that his response will be positive and helpful; I have no doubt about that. The contributions we all make show how united the House is on the issue. I will say it again: in this House, we are fortunate to have access to water for all purposes, whether that is washing, cleaning, sanitation or regular showers. Many of us have a shower every morning, but many people elsewhere would just love to have that water. We have it every day. We have to be the voice for the voiceless. We have to speak here on behalf of those who need help, wherever they may be in the world. Can the Minister give us some idea of the Government’s bilateral and multilateral aid reviews? Will he set out and prioritise water and sanitation in the reviews? We need to be ever mindful of the fact that if we start with water and sanitation, then health, education and opportunity follow.

--- Later in debate ---

[Dr Roberta Blackman-Woods (City of Durham) (Lab)]

It is a pleasure to serve under your chairmanship again, Mr Percy. I apologise to you and the Front Benchers for not being able to stay for the whole debate. I have a meeting in my constituency later, so I have to get the train. As Members know, my constituency is quite a way away, so it will take me a few hours to get there. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate.

The UN defines access to safe water and sanitation facilities as basic human rights. Promoting hygiene is widely regarded to be one of the most cost-effective ways of improving public health. Poor water and a lack of sanitation have a wide range of negative effects. For example, they are major causes of infectious diseases; they have knock-on effects on educational attainment, public health and economic productivity; and they exacerbate the impact of disease outbreaks, such as Ebola and the Zika virus. That is why this debate is so important, and I thank the hon. Gentleman for bringing it to the House.

Given the amount of time we spend in Parliament discussing access to healthcare and education, it is interesting that we do not spend enough time discussing access to clean water and sanitation. Those issues underpin people’s life chances, so it is extraordinary that we do not look at them in more detail and more often. I hope that today we will be able to set out a clear way forward, which will enable us to return to this issue in later months.

[Brendan O'Hara]

On that point, will the hon. Lady join me in congratulating organisations such as WaterAid on their great work? They not only educate the wider public but come directly to parliamentarians to give us knowledge about what they do. WaterAid works in 37 countries around the world. I pay tribute to the work that it and other organisations do.

[Dr Blackman-Woods]

I was going to acknowledge WaterAid’s work later in my speech, not least because Northumbrian Water, which is based in my constituency, does a lot of work with it. Northumbrian Water has been very energetic in getting MPs in our region to take note of the sort of issues that WaterAid gets involved with.

Since 2000, there have been two rounds of UN-sponsored global international development goals. The first was the millennium development goals, which ran from 2000 to 2015 and aimed to halve the number of people without access to improved drinking water and sanitation. Interestingly, the water target was met but the sanitation target was not met by a considerable amount—about 700 million people. The headline figures mask large geographical variations among countries and between rural and urban populations.

The MDGs have been replaced by the sustainable development goals. SDG 6 relates to what we are talking about this afternoon. We need to take on board the lessons learned from the MDGs, which showed that a donor-led approach on its own is not enough. Work has to be done in partnership with the recipient countries. There can be too much of a focus on short-term targets, rather than long-term viability. The hon. Member for Mid Derbyshire (Pauline Latham) touched on that point when she said that the facilities that are put in might not be appropriate or sustainable. It is really important that there is some sort of community partnership. There was a failure to exploit links with the private sector fully. The focus was on absolute numbers, so the poorest were often neglected because they were not picked out as a group for targeted intervention. I will talk more about SDG 6 in a moment, but it is interesting that it was informed by the lessons learned from the MDGs.

Globally, one in 10 people still has no access to a safe water source, and one in three has no access to proper sanitation. In parts of Africa, a third of the population does not have access to clean water. In Ethiopia alone, 42.2 million people have no access to safe water. There is still a significant problem, which is a big problem for the new SDG goal to meet in 14 years. Yet we know that it is really important. There cannot be societal transformation without proper access to clean water and sanitation. We know that from our own experience. It was only when the UK recognised, from its public health problems, that we needed properly piped water that we got the economic development that moved us on. There was a transformation in our public health, and that is what we want to see in other countries.

We are not only talking about health, because research has shown that, for every $1 spent on water and sanitation, $4 would be generated in increased economic opportunity. It has been estimated that, if everyone had universal access to water and sanitation, there would be $32 billion in economic benefits each year globally, from reductions in healthcare costs and from increased productivity as a result of reduced illness.

Interestingly, more than a quarter of the countries in sub-Saharan Africa are poorer now than they were in 1960. Therefore, foreign aid is going in, but if it is not directed in the right way, we do not necessarily get the development that we would want. The lack of access to clean water and basic sanitation is among the reasons given for the lack of economic development flowing from aid. Some of the biggest challenges are in sub-Saharan Africa: only about 30% of individuals have access to improved sanitation services; and nearly half of all people who use unimproved sources live in the region.

We have already heard this afternoon about some of the health impacts. According to the World Health Organisation, 50% of malnutrition is associated with infections caused by a lack of access to water, sanitation and hygiene. Globally, malnutrition accounts for 45% of child deaths, of which a large proportion is in Africa. A truly stark figure, also mentioned by the hon. Member for Strangford, involves children in sub-Saharan Africa, who are over 14 times more likely to die before the age of five than children in developed regions. The figures speak for themselves and are clear: there is an urgent need to improve access to clean water and good sanitation.

Another thing we have heard this afternoon is that limited access to clean water and good sanitation disproportionately affects women and girls, who are more than twice as likely as men to be responsible for water collection. On average, women and girls in developing countries walk 6 km each day to collect water—time that could be spent in school or at work. In sub-Saharan Africa alone, each day, women spend a combined total of at least 16 million hours collecting drinking water. That is a truly staggering figure.

Additionally, more than half of girls who drop out of primary school in sub-Saharan Africa do so because of a lack of separate toilets and easy access to safe water. However, the issue is to provide not any sanitation, but the right sort of sanitation. I have visited villages in Asia and Africa where money has come through for new sanitation in schools. Toilet blocks were put in, but the schools might as well not have bothered, because the toilets were communal ones, could be too easily accessed by a wide range of people, or had doors that did not close properly—people could look over the top. There was a complete lack of consideration about what actually needed to happen to make the toilets a secure, safe place, in particular for girls, enabling them to stay on at school. So, alas, despite new sanitation facilities, the girls could not continue at school anyway, because they still did not feel safe. So many girls leave education at puberty. Obviously, therefore, co-operation with the local community is necessary, and water sources should be as close as possible to the people who need them.

I will now outline some of the things for which WaterAid is calling, before finishing with a few questions for the Minister. As we know, world leaders committed to reach everyone, everywhere with safe water and sanitation by 2030. That is a wide-ranging goal, with eight objectives, and if they are met that should be a good and helpful step forward. WaterAid, however, has said that Governments must bring about a dramatic and long-term increase in public and private financing for water, sanitation and hygiene to achieve strong, national systems so that there is universal access. Private and public sectors need to co-operate effectively to achieve that universal access. An integrated approach could ensure that improving access to water, sanitation and hygiene services is embedded in plans, policies and programmes on health, nutrition, education, gender equality and employment. Last but not least, pledges made at the 2015 Paris climate summit must be implemented, because they are about the long-term sustainability of water supplies.

Are the Government using their strong voice internationally to push up the international agenda the importance of clean water and sanitation? SDG 6 should become a real priority, so how will progress towards achieving it be monitored internationally? Will the Government use the expertise of the Department for International Development, which works on some very good schemes, to inform best practice everywhere and to ensure that women and girls are prioritised for sanitation and water supply?