By Jane Cohen, Special to CNN
Editor’s note: Jane Cohen is a senior environmental health researcher at Human Rights Watch. The views expressed are her own.
I met Louisa, a nurse in Harare, when I asked if I could use her toilet. Louisa lives in a sprawling community on the fringe of Harare. I was in her neighborhood doing research on the city’s collapsing water and sanitation infrastructure. As Louisa led me around to the toilet at the back of her house, she apologized profusely. Without running water, the toilet didn’t flush. She gave me the water she had stored in buckets to wash down the toilet, but she often doesn’t even have that. When there is no water, she goes into the field near her house. “Going to the bathroom outdoors is humiliating,” she told me. “All these toilets used to flush, but now there’s no water and we don’t have any choice.”
In the last 30 years Zimbabwe’s water and sanitation situation has deteriorated. Over the past year I visited eight communities in and around Harare. I saw many homes that once had functioning toilets that were now out of order because of lack of water. People told me that sometimes raw sewage would back up through the toilets and spill into their homes. In some neighborhoods, burst pipes let sewage into the streets. Flies – which can carry disease from sewage into people’s homes as they hop from feces to food – were everywhere.
Many people are desperate for water, often resorting to contaminated sources like shallow wells that can become easily mixed with sewage. The water crisis has forced residents like Louisa to move from indoor plumbing and a flush toilet to squatting outdoors.
This backward slide has been devastating for people’s health. In 2008 and 2009, the county was ravaged by cholera, a disease spread by contact with feces and feces-contaminated water. More than 4,200 people died, and over 100,000 were sickened. Harare residents told us they were terrified of another epidemic, but with no clean water and no sanitation services, they did not know how to protect themselves.
Their fears are warranted.
When we first met Abigail, in 2012, she was grieving the death of her daughter from typhoid. Abigail told us that she had done everything in her power to keep her daughter healthy and provide her with clean water. She already knew the ferocity of waterborne diseases: cholera killed her mother in 2008. And yet, with no regular access to clean water, and no sanitation, there was very little Abigail could do. When she arrived at the hospital with her daughter, the doctors told her it was too late.
Access to water and sanitation are basic human rights recognized under international law. But recognizing these rights is only a start. One third of the global population does not have access to adequate sanitation, and one out of every ten people does not have access to potable water. In Zimbabwe, diarrhea is the number one killer of children under five.
In Zimbabwe, as in other places, the government says that improving access to water and sanitation requires an overwhelming investment, out of reach given the country’s economic situation. Zimbabwe’s economy is just beginning to recover from its 2008 crash, when years of economic mismanagement by Robert Mugabe’s ZANU-PF resulted in severe hyperinflation. One of the casualties of the crisis was the provision of basic services for residents.
But investing in water and sanitation pays off. According to the World Health Organization, for every $1 invested in improved access to water and sanitation, an average of $4 is returned in increased productivity. This isn’t surprising, considering that women and girls in many countries spend much of their day collecting water when they could be engaged in more productive work. Investing in low-cost sanitation measures, like improved pit latrines, would end unnecessary humiliation and risk to health. The economic costs of widespread chronic diarrhea are very real.
The collapse of Harare’s water and sanitation system requires substantial, and ongoing, investment. City officials took a step toward addressing the problem, signing a $140 million loan with the Chinese Export and Import Bank. But critics cite a lack of transparency around the terms, and whether this will be the fix that everyone is hoping for is unclear. Even if the piped network in the city is improved, there are other critical issues, like the affordability of water for millions of low-income residents that must be addressed to increase water access.
The U.N. General Assembly declared November 19 World Toilet Day. The resolution is not aimed at people like Louisa and Abigail, who have seen Harare’s decline from a modern city to one where sewage flows in the streets. Instead, it’s a message to governments and donors that water and sanitation are key elements of the global development agenda that can no longer be ignored.