er is life’s life blood. There is not one living system, or power plant for that matter, that does not require water. Where water flows life usually flourishes. A person can survive up to a month without food. Three days without water and you’re toast!

Like other southern municipalities, Jackson, Mississippi is still reeling from the effects of a weakened, meandering polar vortex that dumped a huge mass of extremely frigid air over central United States. The resulting snow and freezing temperatures layered streets and bridges with sheets of ice that were great for bobsleds, not so much for buses. As well, as might be expected, in a city with an ancient, dilapidated, neglected sewer system, brittle water mains broke like so many politicians’ campaign promises, leaving many, including the author and his 90 year-old mother without potable water, on tap, for 7 days.

In high-income countries, in particular, we tend to take this mission-critical, albeit diminishing, resource for granted. Just turn on the faucet and out it flows, up to 2 gallons per minute, depending on the age of your plumbing fixtures. The supply seems endless. We use it liberally, to cook our food, launder our clothes, flush our toilets, wash our cars , wash our hands and faces.

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Ironically, the one purpose for which we are using tap water less and less is for drinking, opting instead for bottled water… Even so, satisfying our thirst is just a matter of a short trip, in the family, car, to the corner store. However, in low income countries, getting water is a much more time- consuming, infinitely more arduous -dangerous even- endeavor.

Walking for Water

Living in a city in which a crumbling water grid is just one of several major infrastructure issues, means being prepared for the inevitable loss of water pressure or loss of service entirely. Proactively harvesting cold water from hot water lines and later from thawing gutters, can mean that you have enough to flush toilets, and wash dishes until the infrastructure issues are resolved.

But what if there were no infrastructure at all? Imagine having to trek 2 miles, in your bare feet, regardless of the temperature, up steep, jagged hills, down into rocky ravines, to dig for water that might be teeming with dangerous, potentially life-threatening microbes. Now imagine having to make such a perilous journey twice a day, 4 miles roundtrip. Would you be able to do it with a baby strapped to your back and a precocious, preschooler at your side? Would you be able to make the second leg of the trip with the baby, the preschooler, a gallon of water in one hand, while the other hand balances a 5-gallon jerry can full of precious sky juice, weighing over 45 lbs., on your head, while contending with bees, snakes and other such botherations? That would be, dare I say, a formidable challenge, even for an iron man. Incredibly, and moreover, tragically, that is exactly what women and girls, in many low-income countries have to do to get water for themselves and their families (Reid, 2020).

Collectively, women and girls spend 200 million hours a day on these treacherous water runs (Reid, 2020). Needless to say, when she is busy getting water, she cannot get an education, get a job, or just get some relief from the pain in her neck and lower back. Here’s the thing though. Even if she is able go to school, to work, or to a health clinic, it is not only possible, but probable, especially in rural areas, that she will not find adequate hygiene facilities in these spaces either. And yet, it is not just women and girls whose health is threatened.

Clean Hands Hold Disease Down

Forty percent of the world’s population, or 3 billion people, have limited access to in-home handwashing facilities, 47% or which, or 1.4 billion, have no access at all (Handwashing/Hygiene, 2020). But that is not the end of it. As suggested above, the limited access is not limited to their homes. In 60 countries most likely to experience a health crisis, a humanitarian crisis, or both, 2 out of 3 people, including 500 million children do not have in-home handwashing facilities. Nor will they find such accommodations in schools or health clinics.

For instance, in Ivory Coast (also known as Côte d’Ivoire), a West African country, and the world’s largest exporter of cocoa beans, 76% of primary schools have no hygiene facilities (UNICEF Regional Office for Middle East and North Africa, 2020). And as an indication of the extent of the crisis in the healthcare space, consider India. With nearly 1.4 billion people, India is the world’s second most populous country. It is also a country where 24% of hospitals and 50% of non-hospital healthcare facilities have no point of care hygiene services. (UNICEF Regional Office for Middle East and North Africa, 2020).

Not surprisingly, diarrheal diseases are the 6th leading cause of death in Ivory Coast (Global Health - Côte d’Ivoire, 2020). It is the third leading cause of childhood mortality in India (Lakshminarayanan & Jayalakshmy, 2015). In fact, diarrheal disease is the 8th leading cause of death for all ages, in 195 countries around the world (Troeger, et al., 2018), claiming the lives of 800 children, under the age of five, every day. Handwashing with soap is recognized as the most effective way to reduce the transmission of not only the diarrheal diseases that plague low-income countries, clean hands also hold down respiratory disease like pneumonia, influenza and SARS-CoV-2, by 25%, 38% and up to 55% respectively (Brauer, Zhao, Binnitt, & Stanaway, 2020).

Raise Your Hand

While numerous organizations such as UNICEF, Water Equity, Water Aid and the Global Handwashing Partnership, have initiatives and have deployed resources, financial and otherwise, to meet the challenge of getting safe water to underserved communities in low and middle income countries around the world, they can always use additional support. So raise your hand! Choose one that appeals to your sensibilities and donate and/or invest. Finding a permanent, sustainable solution will require all hands on deck.

And lest you be inclined to think that access to safe water is a 3rd -World problem, be advised that the aforementioned 3 billion people with limited or no access to in-home handwashing facilities, includes four tenths of one percent of the population of high-income North America (Brauer, Zhao, Binnitt, & Stanaway, 2020). Furthermore, because of climate change-induced alterations in rainfall patterns as well as demand from the agricultural, industrial and residential sectors, aquifers around the world, including the Ogallala Aquifer, which is responsible for 30% of all irrigation in the U.S., are not being recharged or replenish quickly enough to remain viable. Similarly, and as a final note, climate change is also likely culprit responsible for the meandering polar vortex that dropped that wad of icy air over Central United Sates and has left the author and his, now, 91 year-old mother without potable water for over 30 days. The fact is that water is a dwindling resource around the world. There is a finite amount in the life-giving liquid in the water cycle. And since no one is making any more, the way we use water and how much water we use is, at least, as important as getting water.

Works Cited

Brauer, M., Zhao, J. T., Binnitt, F. B., & Stanaway, J. D. (2020). Global AccesstoHandwashing:ImplicationsforCOVID-19 Control in Low-Income Countries. Environmental Health Perspectives, 057005-1 - 057005-6.

Global Health - Côte d’Ivoire. (2020, January 10). Retrieved from

Handwashing/Hygiene. (2020). Retrieved from

Lakshminarayanan, S., & Jayalakshmy, R. (2015). Diarrheal diseases among children in India: Current scenario and future perspectives. Journal Of Natural Science, Biology and Medicine, 24-28.

Reid, K. (2020, March 19). Walk for water: Your 6K vs. theirs. Retrieved from World Vision:

Troeger, C., Blacker, B. T., Kahlil, I. A., Rao, P. C., Cao, s., Zimsen, S., & ... (2018). Estimates of the global, regional, and national morbidity,mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infectious Disease, 1211-1228.

UNICEF Regional Office for Middle East and North Africa. (2020). Hygiene Baselines pre-COVID 19. New York: WHO/UNICEF JMP.

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