In a 2007 poll, BMJ readers voted the introduction of clean water and sewage disposal as the most significant medical advance since the journal first appeared in 1840.
The so-called “sanitary revolution”, pioneered by Chadwick, Snow and others in the mid-19th century, delivered piped water to people’s homes and sewers rinsed by water. It signalled the end for cesspits, privies, and cholera epidemics, and laid the foundations for the cleaner, healthier and longer life which we enjoy today.
Except, that is, if you happen to live in the developing world, where 884 million people are without clean water and where 40% of the world’s population suffer without a safe toilet: a total of 2.5 billion people living in 19th century squalor.
The impact on health is devastating. Over half of all hospital beds in Sub Saharan Africa are occupied by patients suffering from sanitation and water-related diseases. Four thousand children die from these diseases every day, making them the biggest killer of young children, killing over five times more than HIV/AIDS and twice as many as malaria.
The political will and money needed to address this crisis have not been forthcoming. The medical profession, however, has joined the call for world leaders to step up to the plate. The BMA is working with End Water Poverty, an international campaign calling for governments to sign up to a global action plan which will provide clean water and sanitation for the world’s poor and to ensure developing countries have enough money to make it sustainable.
A key moment for the campaign came on 23 April when the first annual high level meeting on water and sanitation was held in Washington DC. Politicians (including finance ministers) from developing and developed countries, multilateral agencies and other civil society organisations were brought together. It has resulted in a new global partnership to accelerate efforts to bring clean water and safe sanitation to millions more people across the globe.
The BMA urges all doctors to join the End Water Poverty campaign and also to blog , tweet and digg about the need for decisive action. The global sanitary revolution starts here.
