Almost 1 billion people worldwide live without safe drinking water and more than twice that number people don’t have basic hygiene facilities. As a result, 1.8 million children die from diarrhea each year—one of the most pervasive and preventable causes of child mortality. For many households in Tanzania, diarrheal disease persists despite their having access to relatively safe sources of drinking water. Though 47 percent of the population uses improved sanitation and more than 60 percent has access to clean water, diarrhea still causes 17 percent of all deaths among children under age 5.

Though the water comes pristine from the tap, it still may be contaminated at home or not used properly to keep contamination at bay, says Jenna Davis, PhD, an assistant professor of civil and environmental engineering and a 2009-10 Clayman Institute faculty research fellow. “Having the infrastructure to deliver clean water is not enough. If water is contaminated at home by inadequate hygiene practices, there will be little improvement to family health.” Most families in Tanzania get their water from non-networked sources—a communal handpump or tap that requires several trips a day for household water needed for cooking, cleaning, and bathing. Public taps can be as far as a kilometer away, and a typical water container weighs 44 pounds when full, making those trips back and forth both time-consuming and physically demanding.

Water, women, and children’s health by Ruth Schechter on 12/06/10 at 10:00am

The job of fetching the household water goes to the women and girls of the family compound. Davis estimates that fetching water in sub-Saharan Africa takes about a half-hour per day for each adult woman. And while the United Nations’ Millennium Development Goals consider a water tap 1 kilometer from home as a safe water source, the distance may be over steep terrain, taking even more time out of a woman’s work day. The time may also affect girls’ schoolwork, although Davis says these potential impacts have not been fully researched. Though most women, when interviewed by Davis and her team, seem to understand how water gets tainted, when water is hard to come by, careful hygiene falls behind drinking and cooking needs. But hand washing is only part of the picture. For Davis, the bigger problem involves the “five Fs”—flies, food, fingers, feces, and fields (which are sometimes used as latrines). Women use sand to scrub out pots, which may harbor fecal

A woman carrying water

from a stream. Randy Plett/iStockphoto

Copyright 2010 Board of Trustees of Leland Stanford Junior University. All rights reserved.

contamination. Children may play barefoot or accidently touch fecal material. Roofless “passport” latrines are common, which allow flies to spread disease. Though many women find this style of latrine uncomfortable, men traditionally control household expenditures and are reluctant to invest in more sanitary but more costly models. “Women are largely responsible for taking care of the family and the home,” says Davis, who studied 300 families over 10 weeks and recently received a grant to expand her research to 1,200 families for a full year. “If women were in charge of finances, it’s likely that hygiene would get greater attention.”

A typical water containter weights 44 pounds when

full. Ivory Coast (Sean Warren/iStockphoto)

Davis is working to develop educational material targeted specifically to women that will help them develop daily routines that can be applied easily and consistently, using reminders that resonate on a personal level. “One in nine kids doesn’t make it to their sixth birthday. We need to trigger actions to change what’s normal and accepted,” says Davis. “If anyone has the potential to make a change, it’s the women.” You can read more about Davis and her team on their blog, News from the Poop Group.