Africa faces huge challenges with multiple issues that adversely affect public health. One major challenge is the ability for both rural and urban Africans to access a clean water supply. According to the WHO (2006), only 59% of the world's population had access to adequate sanitation systems, and efforts to achieve the Millennium Development Goal, which is aiming for 75% by the year 2015, will fall short by nearly half a billion people.
The situation of access to clean water and sanitation in rural Africa is even more dismal than the previous statistics imply. The WHO (2006) stated that, in 2004, only 16% of people in sub-Saharan Africa had access to drinking water through a household connection (an indoor tap or a tap in the yard). Not only is there poor access to readily accessible drinking water, even when water is available in these small towns, there are risks of contamination due to several factors. When wells are built and water sanitation facilities are developed, they are improperly maintained to due to limited financial resources. Water quality testing is not performed as often as is necessary, and lack of education among the people utilizing the water source leads them to believe that as long as they are getting water from a well, it is safe. Once a source of water has been provided, quantity of water is often given more attention than quality of water (Awuah, Nyarko, Owusu, & Osei-Bonsu, 2009).
There are limited sources of water available to provide clean drinking water to the entire population of Africa. Surface water sources are often highly polluted, and infrastructure to pipe water from fresh, clean sources to arid areas is too costly of an endeavor. Groundwater is the best resource to tap to provide clean water to the majority of areas in Africa, especially rural Africa, and groundwater has the benefit of being naturally protected from bacterial contamination and is a reliable source during droughts. However, the high costs associated with drilling for water, and the technical challenges in finding sources that are large enough to serve the population in need, present challenges that limit tapping the resource. Groundwater is not a fail-safe resource, either, when it comes to providing clean water. There may be contamination of the water with heavy metals, and bacteria may be introduced by leaking septic systems or contaminated wells. For these reasons, it is important that groundwater be monitored frequently, which is costly and requires technical abilities that may not be present in rural areas (Awuah, et al., 2009).
The implications of lack of clean water and access to adequate sanitation are widespread. Young children die from dehydration and malnutrition, results of suffering from diarrheal illnesses that could be prevented by clean water and good hygiene (Metwally, Ibrahim, Saad, & Abu El-Ela, 2006). Diseases such as cholera are spread rampantly during the wet season. Women and young girls, who are the major role-players in accessing and carrying water, are prevented from doing income-generating work or attending school, as the majority of their day is often spent walking miles for their daily water needs. They are also at an increased risk for violence since they travel such great distances from their villages on a daily basis, and are even at risk when they must go to the edge of the village to find a private place to relieve themselves.
Urban areas face a whole different host of challenges to providing clean water and sanitation. Rapid growth of urban areas, especially in sub-Saharan Africa, has lead to large volumes of water being extracted from existing sources. The influx of water, in addition to the influx in human waste, has outpaced the development of wastewater management systems, which has lead to pollution of natural water bodies, unintentional use of wastewater in irrigated agriculture, irregular water supply, and environmental concerns for aquatic life due to the high concentration of pollutants flowing into water bodies (Van Rooijen, Biggs, Smout, & Drechsel, 2009).
Overcrowding in urban slums makes it even more difficult to control sanitation issues and disease outbreaks associated with exposure to raw sewage. It has been reported that underprivileged urban populations pay exorbitant amounts of money for water, which is often not even suitable for consumption, while resources allocated to those living in the wealthy urban areas are heavily subsidized, meaning the wealthy pay less for cleaner water and better sanitation systems (Fotso, Ezeh, Madise, & Ciera, 2007).
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