Category Archives: Sanitation and Health

Antibiotic waste is polluting India and China’s rivers; big pharma must act

Antibiotic waste is polluting India and China’s rivers; big pharma must act. The Guardian, October 25, 2016.

Pollution from drugs factories, many in India and China, is causing the spread of anti-microbial resistance. Pharma companies are under pressure to act 


A strain of the E coli bacteria. Pollution from pharmaceutical production is a factor in the rise of antibiotic-resistant bacteria. Illustration: Janice Carr/AP

Antibiotic-resistant superbugs are a fundamental threat to global health, UN secretary general Ban Ki-moon recently told a general assembly meeting. Failure to address the problem, he said, would make it “difficult if not impossible” to provide universal healthcare, “and it will put the sustainable development goals in jeopardy”.

For pharmaceutical companies the attention on antimicrobial resistance has also brought a focus on one of its key drivers: the unabated environmental pollution of drug factories in developing countries.

In India and China, where a large proportion of antibiotics are produced, the poorly regulated discharge of untreated wastewater into soils and rivers is causing the spread of antibiotic ingredients which cause bacteria to develop immunity to antibiotics, creating superbugs.

A study of wastewater factories in China found that antibiotic-resistant bacteria were not only escaping purification but also breeding. For every bacterium that entered one waste treatment plant, four or five antibiotic-resistant bacteria were released into the water system, tainting water, livestock and communities.

Read the complete article.

UNC Water Institute WASH Research Policy Digests

These useful UNC research digests discuss a key article and include literature reviews on the selected topic:

Issue #1, July 2015: Sanitation Subsidies
Our first Digest deals with the difficult issue of when and how to use subsidies for on-site sanitation.

Issue #2, October 2015: WaSH in Healthcare Facilities
Issue two of the WasH Policy Research Digest digs in to the critical issue of WaSH in health care facilities, including a detailed review of WHO and UNICEF’s 2015 report on the topic and a synthesis of literature and solutions to address its impact on infection, mortality, maternal and neonatal health.

Issue #3, March 2016: Handpump Functionality Monitoring
The third issue of the WaSH Policy Research Digest focuses on handpump functionality monitoring. This issue of the Digest explores recent literature on this topic, focusing on policy implications, recommendations, and a call for standardized functionality measurements.

Issue #4, August 2016: Sanitation and Nutrition
Our fourth digest addresses sanitation and nutrition. This issue explores recent literature and the emerging evidence base on the connection between sanitation, nutritional outcomes, and child stunting.

USAID – Celebrate Global Handwashing Day 2016!

USAID – Celebrate Global Handwashing Day 2016!

On Global Handwashing Day, we join partners around the world to celebrate the importance of handwashing with soap as an effective and affordable way to prevent diseases and save lives. Handwashing is an important part of the U.S. Agency for International Development’s (USAID’s) efforts to end preventable child and maternal deaths. ghd2016

Although many people around the world clean their hands with water, the use of soap is also necessary to prevent disease more effectively.

  • Millions of children under the age of 5 years die from diarrheal diseases and pneumonia. Handwashing with soap could prevent about 1 out of every 3 episodes of diarrheal illnesses and almost 1 out of 6 episodes of respiratory infections like pneumonia.
  • Handwashing with soap is also a key component of clean and safe birthing practices, which could save up to 40 percent of the 2.8 million infants that die during their first month of life.

USAID’s life-saving water, sanitation and hygiene (WASH) programs and other development activities promote adoption of handwashing and other hygiene practices as an important element of improved health and nutrition programs.

Learn more

Photo credit: USAID

Live Q&A: Menstruation is keeping girls out of school – what can we do?

Live Q&A: Menstruation is keeping girls out of school – what can we do? Source: The Guardian, October 7 2016 |

Starting menstruation is a major factor in girls missing school in developing countries. Join an expert panel on Thursday 13 October, 2-3.30pm BST to discuss how to work across sectors to prevent this 


Studies have shown that improved access to sanitary products increases school attendance among girls in Kenya. Photograph: George Mulala/Reuters

“I still remember the shocked silence the first time I brought up the issue of menstruation,” said Archana Patkar at Water Supply and Sanitation Collaborative Council during a recent Guardian panel discussion.

She was describing working with colleagues in education looking at reasons for the dropout of girls from school at around ages 11-13. “[There were] a lot of discussions on teacher quality, classrooms, inadequacy of material, inappropriateness of curricular, but nobody was talking about what happens to girls at that point,” said Patkar.

Now there is recognition that starting their periods, and inadequate toilets and sanitation supplies, is a huge factor in girls missing out on their education. The United Nations Children’s Fund found that one in 10 African girls skip school during menstruation, and some drop out entirely. Not having access or money to buy supplies even leads to girls feeling that they must engage in transactional sex.

So how can the education and the public health and water, sanitation and hygiene (Wash) sectors work together so that more girls complete secondary school? How can schools provide better sanitation facilities so girls aren’t afraid to go to school when they have their period? And how can girls get easier access to healthy sanitation products?

Join an expert panel on Thursday 13 October, 2-3.30pm BST, to discuss these questions and more.

No evidence that current sanitation interventions stop faecal exposure

A systematic review [1] of 29 studies found “little to no effect from sanitation interventions” on “faecal-oral transmission of enteric and other pathogens”. The transmission pathways reviewed included “faecal pathogens or indicator bacteria in drinking water, hand contamination, sentinel toys, food, household and latrine surfaces and soil, as well as flies and observations of human faeces”.

There was some evidence showing the association of sanitation “with reductions in flies and a small effect on observations of faeces”. There was also evidence showing “an inverse relationship between the distance of a water supply from a latrine and level of faecal contamination of such water supply”.

The authors of the review conclude that current sanitation efforts in low-income countries are ineffective and unable to prevent contamination along well-known pathways. This may be because “interventions often fail to achieve universal coverage or use”, which is the subject of another forthcoming systematic review [2].

As expected from researchers, they are also recommend that more rigorous studies are required to investigate the impact of sanitation interventions on multiple transmission pathways.

Unfortunately this important study is not available as an open access article.

[1] Sclar GD, Penakalapati G, Amato HK, Garn JV, Alexander K, Freeman MC, Clasen T. Assessing the impact of sanitation on indicators of fecal exposure along principal transmission pathways : a systematic review. International Journal of Hygiene and Environmental Health. 2016 Oct 1.DOI:10.1016/j.ijheh.2016.09.021

[2] Garn, J.V., Sclar, G.D., Freeman, M.C., Alexander, K.T., Penakalapati, G., Brooks, P.,Rehfuess, E.A., Clasen, T.F., submitted. The impact of sanitation interventions on latrine coverage and latrine use : a systematic review and meta-analysis.

Women waste pickers: living conditions, work, and health

Women waste pickers: living conditions, work, and healthRev. Gaúcha Enferm. vol.37 no.3 Porto Alegre Sept 2016.

Objective – To know the elements of work, health, and living conditions of women who pick recyclable waste and are members of a waste cooperative in a town of the state of Rio Grande do Sul, Brazil.

Method – This is a qualitative, exploratory and descriptive study with seven subjects. Data were collected through participative observation, semi structured interview, and a focus group from July to August of 2013. The data were subjected to content analysis.

Results – The following thematic categories emerged: Women’s work, informality and precariousness; Experiences of job satisfaction; and Working conditions and health: experiences with accidents, illness and health services.

Conclusion – It was concluded that the women who collect recyclable material are exposed to precarious work conditions and potential health risks, such as work overload, accidents, illness, and social insecurity, and that nurses are responsible for promoting actions that ensure the health and inclusion of these workers.

Superbugs 1, the world 0

Superbugs 1, the world 0 | Source: The Conversation, Oct 5 2016 |

World leaders have committed US$790m to fighting superbugs. These are infectious diseases that don’t respond to treatment using antibiotics – an essential defence against infections after surgery.

They are also essential in complex treatment programmes, such as chemotherapy. But antibiotics are being misused. They are often wrongly prescribed for viral diseases, such as the flu, and they are increasingly used in livestock to encourage growth. This abuse of antibiotics is leading to strains of bacteria that are resistant to all antibiotics. Without urgent action, it is estimated that antimicrobial resistance will result in 10m deaths annually by 2050.

Read the complete article.