Introduction
The 650 million people who live without safe water and the 2.3 billion that do not have access to adequate sanitation, are highly susceptible to suffer from vector-borne and water-related diseases or die from diarrheal diseases. Access to safe water is essential for people in both rural and urban areas to save them time and energy to fetch water as well as to protect them against the negative health impacts of dirty water. Once they suffer from disease, clean water is needed for treatment, wound care/self-care and prevention of disabilities.
Safe water is required for face washing to remove eye discharges in people affected by trachoma as well as for wound care to reduce disability or prevent secondary infections in Guinea worm, Buruli ulcer, lymphatic filariasis, leprosy and cutaneous leishmaniasis. Two things are critical for access to safe water: good quality, well managed water resources and effective water supply services. Water resources cannot be easily accessed without pumps, pipes, taps, tanks and skilled people to manage them as part of a service. Similarly, water supply services alone are of little use without water resources. If either is unavailable or unreliable, people will not be water secure.
Improved sanitation is a primary prevention strategy for soil-transmitted helminthiases and schistosomiasis. It prevents faecal pathogens such as intestinal worm eggs from contaminating the environment and infecting people through contaminated food, water, dirty hands and direct skin contact with the soil or water. Improved sanitation by using latrines therefore halts defecation in the open and subsequently prevents disease transmission via water and soil pollution. To ensure that the improvements are sustainable, promoting behaviour change, for example staying out of open infested water sources, and working with communities to review various sanitation options is important. In this the entire sanitation chain will be addressed to make sure human waste is safely managed, including transportation or storage, treatment, and disposal or re-use.