Importance of water and sanitation in Pakistan

Every day, on the way to work, I pass a clean drinking water station, where regardless of the hour, lines of men are filling containers with water to take home, and I thank my luck that my water comes to my door, courtesy of the ubiquitous water services in Islamabad.

I am in the fortunate, privileged group of Pakistanis who have access to clean drinking water and access to in-house toilet facilities. According to a study by WaterAid,?21 million people ?in Pakistan lack access to clean water; this number includes 20 percent of Pakistan’s rural poor and 2 percent of Pakistan’s rich.?Moreover, different studies suggest that between 22 and 80 million Pakistan’s population (mostly in rural areas) lack proper toilet facilities, making?Pakistan the third-largest country where people practice open defecation.

The United Nations Educational, Scientific and Cultural Organization (UNESCO) estimates that?40 percent of all diseases ?in Pakistan are caused by unsanitary drinking water. Furthermore, according to the Pakistan Council of Research in Water Resources (PCRWR), 62 percent urban population and 84 percent rural population of Pakistan do not treat their drinking water, which also leads to waterborne diseases.

Lack of access to toilets also contributes to the spread of diseases since those unfortunate to have no toilet are forced to practice open defecation in the vicinity of their homes, which due to rains and human activity contaminates water sources and food. Water borne?and sanitation-related?diseases like?typhoid,?polio, diarrhea, jaundice,?and cholera?are some of the leading causes of death in Pakistan; 94,000 people in the country die due to the consumption of contaminated water, and?53,000 Pakistani children under the age of five die a year from?diarrhoea?due to poor water and sanitation.?

WaterAid notes that improper sanitation and food storage are some of the major sanitation issues in Pakistan.?Improper food care , such as washing food in unsanitary water sources, can transfer bacteria such as E. Coli, salmonella and other pathogens, to humans, causing severe illness.

My beloved hometown, Islamabad is one of only two cities in the country (alongside Karachi) which have biological waste facilities.?But even then, these facilities clean only about 8 percent of wastewater due to limited functioning.

I think all of us would agree that lack of access to proper sanitation facilities impacts negatively the health and wellbeing of both children and adults. However, many of us, the privileged city dwellers with access to proper water and sanitation, can’t even imagine that unsanitary conditions – like drinking and bathing in unsanitary water - cause stunted growth, which affects a staggering 44 percent of all children in Pakistan.?Equally worrisome is the fact that stunted growth can also cause cognitive development stunting. The consequences of stunting are irreversible, causing lifelong implications for the child into adulthood.

As a woman, I also find it close to my heart that due to a lack of resources and cleaning facilities, many girls and women in my country stay at home rather than partaking in normal activities, due to a lack of menstruation supplies and proper facilities.?Many of them use unsanitary methods for managing menstruation, such as homemade sanitary pads, which may lead to infections.??

Access to clean water?is also deeply linked to poverty. Water scarcity, poor water quality and inadequate sanitation negatively impact food security, livelihood choices and educational opportunities for poor families, especially for women and girls who spend endless hours fetching water over long distances.

The recent catastrophic floods have worsened the water and sanitation situation, leaving hundreds of thousands of affected people in need of emergency water and sanitation support. Unfortunately, many of the flooded areas were among the poorest in the country, with low access to clean water and sanitation even before the disaster struck. The floods have only made an already bad situation immeasurably worse.

Flood waters have invaded wells and water reservoirs, landfills and sewerage lines, car workshops and fertilizer stores – mixing it all into one huge sea of contaminated water full of chemicals and bacteria, creating fertile breeding ground for insects and diseases. Even the mighty Indus River got contaminated to the point where it’s no longer safe for humans: ARY News reported on October 11, 2022 that the Sindh Irrigation Department has declared water from Indus River as ‘unsafe for drinking’ and directed authorities to take safety precautions before supplying water. “The flood water being released from Lake Manchar is entering the Indus River,” the department stated; “human lives may be at risk”.

I shudder trying to imagine how those affected communities have survived in the immediate aftermath. Were they able to safe any clean drinking water or did they have to drink the dirty contaminated cocktail of the flood? How were they able to prepare meals? And what about those hundreds and thousands of men, women and children who had to wade through dirty water to reach safety? Many of them must be suffering from wound infections, skin rashes, gastrointestinal illnesses, and tetanus. Do they have any medical care? And even as the flood waters recede and the communities are able to return home, their water sources will remain contaminated. It will take days, weeks, months or even years to restore access to clean drinking and cooking water. Repairs or expansions take time - time that people who need them don’t have.

According to UN Office coordinating of Human Affairs, “some 20 percent of water systems are damaged in Khyber Pakhtunkhwa, around 30 percent in Baluchistan, and up to 50 percent in the hardest hit areas of Sindh and Punjab. Access to safe drinking water is a significant concern, and communities are increasingly resorting to open defecation, heightening the risk of water and sanitation-related diseases. Cases of diarrhoea and water-borne diseases, respiratory infection, and skin diseases have already been reported”.?

“Universal and equitable access to safe and affordable water” is one of the Sustainable Development Goals (SDGs) that the United Nations introduced in 2015. To meet this goal, water should be available when needed, free from contamination, and ideally located on premises; if not on premises, water should require a total collection time of less than 30 minutes.

The flood affected communities rely on the support from the government, international and non-governmental organizations to access their clean drinking water. But how long will these assistance efforts last before resources run out?

I hope that any assistance effort, regardless of the source, will help these flood affected communities to not only survive the immediate aftermath of the floods but also build long-term skills and systems to ensure that clean water and sanitation are part of daily life for every community and every citizens of the country.?To build a future for Pakistan, we need full contribution from every man, woman and child, and their ability to do so depends, in part, on access to clean water and proper sanitation.?