| || |
|Post / Lyn Alweis|
|Maria Garcia and her son Jose live in Candelaria, Honduras, where Garcia has no choice but to use dirty, pesticide-laden water. Children in developing nations are especially vulnerable to waterborne diseases, and they are dying by the thousands every day. |
Sunday, November 23, 2003
Dying for clean water
As many as one-fifth of the world’s people lack safe water and 6,000 children are dying every day as a result. But developed nations and companies with know-how are doing less to help.
CANDELARIA, Honduras Struggling for the water her family needs to live, Maria Garcia hikes five times a day from her dirt-floor shack to a creek.
The creek, cloudy from pesticides and from villagers bathing and washing clothes, isn’t safe.
Her first son, Roni, died of hepatitis at age 3 one of an estimated 2 million children a year worldwide who die from diseases linked to bad water.
Now her second son, 1-year-old Jose, “is always with diarrhea, always coughing.” Still, Garcia, 23 years old and seven months’ pregnant, has no choice. This is the only water she can get.
She scoops the creek water into her red jug. She hoists this 40-pound load onto her back and, stretching rattan cords across her forehead to support it, claws her way up a slippery clay slope on the quarter-mile haul home.
“It’s hard to do without falling,” she says. “I’m going to have to do more trips. I’m going to need the water.”
Today, nobody is moving to help Garcia and the growing numbers of people an estimated 1.1 billion, nearly a fifth of humanity who lack safe water. Twice that many lack basic sanitation.
The death toll from bad water mounts. United Nations officials say it tops 6,000 children a day mostly in low-income Africa, Asia and Latin America.
Children are especially vulnerable to waterborne diseases that can lead to fatal dehydration. Most common is diarrhea easily preventable in developed nations such as the United States.
But elsewhere, solutions are constrained by spreading poverty and increasingly limited water resources.
Water shortages and deficient sanitation now are starting to aggravate conflicts, leading to political turmoil. Three years ago in Bolivia, slum dwellers rioted when the government tried to install a water system that required them to pay fees they found intolerable. International bankers would only back a for-pay system.
And last month, Bolivian peasants and slum dwellers, riled about their government’s free-market policies in general, marched on Bolivia’s capital, hurling dynamite. They forced President Gonzalo Sanchez de Lozada to resign.
“We could have water wars not riots, I mean wars between countries over control of river systems,” said Andrew Natsios, chief of the U.S. Agency for International Development (USAID), the nation’s main humanitarian agency. “We are very worried about that.”
World aid agencies doing less
In Iraq this year, a sudden collapse of water-supply networks enraged Iraqis as U.S. troops, who had bottled water, occupied their communities.
In India, a dispute over water allocations has led to interstate rioting.
In China, an estimated 100 million peasants unable to irrigate crops converge on ill-equipped cities.
In the Middle East, a behind-the-scenes struggle for water strains efforts to broker Israeli-Palestinian peace.
Water shortages also are expected to spur migration from water-poor regions to Europe and the United States, where jobs and water are plentiful.
Many experts believe that a concerted effort to address global water supply and sanitation should be a priority for the United States and other wealthy countries. U.S. government studies have found that installing a basic water system in a village can cut infant mortality by up to 50 percent.
Yet the governments and corporations that could help instead are withdrawing from the challenge instead.
Government water aid from 21 of the richest countries to poor countries decreased by 18 percent between 1997 and 2001, according to data compiled by the Organization of Economic Cooperation and Development, an international group based in Paris.
The U.S. government focusing on military priorities this year budgeted only $162 million for water-supply and sanitation help abroad.
USAID’s Natsios said this will change. The United States will follow through on a presidential “Water For the Poor” initiative to spend $970 million over three years “to deal with these issues,” he said. That money a third of it approved so far by Congress falls far short of the tens of billions U.N. leaders say are needed.
The other key players in addressing water shortages and poor sanitation are corporations that can design and install efficient systems. They, too, are doing less. Private-sector spending on water supply and sanitation decreased by 82 percent between 1997 and 2002, from $8.3 billion to $1.5 billion, according to data from the World Bank, the main international financing agency.
Engineering, construction and utility firms aren’t motivated. As the poor world gets poorer, the potential for profit diminishes. Companies no longer bid on requests to install water systems even in megacities let alone in the villages where more than half the world’s poor reside, said Don Evans, chief of water operations for Denver-based CH2M Hill one U.S. firm in a water industry dominated by Europe-based conglomerates.
“The poor residents of these countries have no access to water. They have incredible sanitation issues with huge health impacts,” Evans said. “It’s a tragedy to these countries that nothing is going to happen.”
‘It’s very hard to lose a son’
In Honduras, population 6.6 million, one of the poorest countries in the world, water problems are chronically as severe as anywhere in the Western Hemisphere. The struggle for clean water is constant in villages such as Candelaria in the central highlands.
Here, amid screeching roosters and the hum of insects, Maria Garcia enters her shack and unloads her sloshing jugs beneath rafters where she stores maize, in the tradition of Lenca Indians, descendants of the Mayans who once thrived across Central America. A small fire smokes in the corner.
The only way to make the water safe Garcia has heard from visiting Cuban health workers is to boil it.
But boiling water requires wood. The nearest forest lies 3 miles away in the mountains meaning a major chore for Reyes Gomez, 24, her husband.
“We can’t get that much wood,” Garcia says. At the same time, she believes that Roni died, and Jose is sick, because “we drink the water without boiling it.”
The family tried to get help for Roni. Gomez carried the boy 13 miles down the muddy road to La Esperanza the nearest city. Doctors took blood and urine samples and sent Gomez and his son to a regional hospital 60 miles across mountains in Comayagua.
There, nurses sent them back to La Esperanza. Gomez turned to a private specialist who suggested a test for $147. Gomez sold the family’s bull for $264 to pay for the test. The specialist concluded Roni’s hepatitis was chronic. There was nothing to do. Gomez carried his son home. Six nights later, on Dec. 28, as parents and grandparents cradled him, Roni died.
“It’s very hard to lose a son,” Gomez said. “You want to kill yourself.”
Doctors face similar cases every day.
More people worldwide enter hospitals with waterborne diseases than with any other type of ailment, said Mark Brown, chief of the United Nations Development Program. Lack of safe water ranks among the leading causes of death. An estimated 2 million children a year are victims of water-related diarrhea, U.N. spokesman Farhan Haq said. Typically, the diarrhea comes from swallowing fecal bacteria.
In a dimly lit emergency ward along the northern coast of Honduras, Dr. Marta Benitez said 40 percent of her patients are children sick from foul water. It’s a bigger killer than the mosquito-borne malaria and hemorrhagic dengue fever that also haunt Central America.
During a recent night shift, Benitez and two nurses handled five critical cases. One dehydrated boy, Daniel Ramos, 3, lay on a gurney, eyes rolling as he drifted in and out of consciousness, loops of white tape holding an intravenous tube on his tiny right wrist.
“He’s always sick with diarrhea,” said his mother, Esperanza Hernandez, 27. He’d been crying that his stomach hurt, and in the middle of the night his family hustled down a rocky trail from their village in foggy forests above banana plantations. “I was worried he would pass out on the way to the hospital,” Hernandez said.
The family drinks stream water. “We don’t boil the water,” said Dolores Ramos, the boy’s grandmother, “because we don’t like the taste of boiled water.”
Benitez told the parents to just wait. “With IV, I think he’ll respond.” As they hung their heads, she added: “We could prevent these.”
Polluted water hurts people in countless ways. Typhoid and cholera flare regularly. Waterborne parasites cause onchocerciasis “river blindness.” Other parasites contribute to malnutrition.
And everywhere, girls give their lives to the chore of hauling water for their families.
Miriam Garcia, 13, and her friends recently balanced 20-pound water buckets on their heads along the Guaymitas River on the outskirts of El Progresso, an industrial boomtown in northern Honduras. They had to quit school after third grade.
“My mother doesn’t come to get water because her hip hurts, so I am the only one who comes,” Garcia said.
The girls bathe, wash clothes and play in the river within a mile of family shanties. Diarrhea and headaches are the norm.
Doctors at public clinics “only pay attention to those who have money,” Garcia said. “We all have parasites in our stomachs.”
Population growth erases gains
For three decades, leaders of rich countries have vowed to help the world’s water have-nots.
The United Nations, which declared the 1980s “The Decade of Water,” again has put water at the top of its global agenda. After last year’s U.N. World Summit on Sustainable Development in Johannesburg, South Africa, U.N. leaders set a goal to halve the proportion of people without access to safe drinking water and sanitation by 2015.
Yet “the water situation worldwide is distressing and not improving noticeably,” said Jack Hoffbuhr, president of the Denver-based American Water Works Association, a leading group of water professionals.
Part of the challenge is that deaths caused by contaminated water unlike deaths from earthquakes or hurricanes are “a persistent, growing problem,” said John Halpern, senior water supply and sanitation adviser for the World Bank. Politically, it’s hard to get governments to focus on such problems because they don’t seem as urgent even if the consequences are huge, Halpern said.
And gains have been nullified by population growth in the most severely afflicted countries across Asia, Africa and Latin America.
Finally, lenders who could supply the billions needed for urban water systems turn away because governments in poor countries often can’t or won’t pay bills.
Meanwhile, villages like Candelaria population 1,500 are so scattered that only small-scale solutions are feasible. Grassroots nonprofit aid groups are the best hope for villagers, Halpern said.
“The rich world needs to be involved. In pure economic terms, growth in these countries is what’s going to help grow the world economy. The industrialized countries including the United States need somebody to sell goods and services to. Most of the population lives in the developing world and will live increasingly in the developing world.”
A debate among water experts also stalls action.
The issue is whether corporations should control water. In the mid-1990s, corporations backed by the World Bank began installing and operating water systems in needy countries for profit, with the view that charging for water is essential to allocate it efficiently. People in rich countries generally pay for their water, though rates often are lower than in poor countries where water is scarce. Critics argue that water essential for life shouldn’t be privately controlled.
“There has to be strong government oversight and protection of the public good,” said Peter Gleick, president of the Pacific Institute, a water policy research center.
While the debate rages, children die. Anger grows.
“The U.S. response, in particular, has been inadequate. Our contribution to water projects internationally is pathetically low. It’s a tiny fraction of the aid we give, which itself is a tiny fraction of what’s needed,” Gleick said.
“If this problem got the attention it deserves, we could eliminate deaths from water-related diseases. But we seem to do better at dealing with short-term crises. It’s more upsetting to us when a plane crashes than when 6,000 kids died yesterday, and today, and will die again tomorrow from preventable water-related diseases.”
For a few years, Honduras stood out among water-poor countries because it did get some serious attention in 1998 following Hurricane Mitch. The death and destruction concentrated in the north where U.S. corporations Chiquita and Dole for decades have run banana plantations drew more than $1 billion in emergency aid. The United States gave more than $145 million.
Hurricane aid helped town
The aid paid for CH2M Hill, the Denver-based engineering firm, to install $3 million worth of water supply and sanitation systems, mostly in northern cities near the plantations and new factories.
Now in La Lima, population 70,000, healthy children play soccer beneath red tanks that supply purified water.
The water immediately improved lives of thousands who lacked access before, said caretaker Gilberto Nunez, 40, a father of two, who was watering Llama del Bosque trees recently at the base of one tank.
“We don’t have the shortages we had before. People are really satisfied,” Nunez said. “Before, they had to walk far and carry their water. We were always working to get water.”
CH2M Hill sent engineer Leda Amador, who grew up in Honduras, to coordinate work at the local level including the delicate matter of convincing low-income residents to pay for treated water piped to their homes.
Incomes here, as across much of the world, are generally less than $500 a year. And newcomers flocking from rural areas for factory work often bristle at the notion of paying for water. Sometimes they refuse.
“The question is whether the poor can pay,” Amador said. “I think they can. If you figure what their other options are what they pay to buy water from private water trucks or to buy water in bottles it’s more than what they would pay for (municipal) water service.”
Amador teamed with leaders of neighborhood “patronata” self-help associations to explain plans. City officials backed her up, cutting off service when people didn’t pay. Rates were set on a sliding scale to help the poor. A typical family pays $7 a month.
But now Honduras’ hurricane money has run out. CH2M Hill is closing its office. And, as in other poor countries, hundreds of thousands of Hondurans the population is growing by 3.2 percent a year still lack access to safe water.
The United States “must continue helping, because in poor countries, we don’t have the capability to build up our water systems because it’s too expensive,” said Mayor Nelly Soliman of El Progresso, population 200,000. “Always, the policy has been, the richer countries should help the poorer countries. This is a severe problem for us.”
U.S. officials say the most children die in rural areas, where 36 percent of Hondurans lack water. “I’d like to put more in. It is needed,” said Paul Tuebner, USAID’s director in Honduras.
“Have you ever hauled water daily for 2 miles on your head up and down mountains? ...We have studies that show, once we put in a water system, infant mortality goes down.”
The anger that has led to riots over water has erupted here, too. Last March, 1,500 protesters riled about water targeted roads in a northern industrial area where they knew they might get attention. They blocked traffic around new “maquila” factories where, for about $50 a month, workers make Fruit of the Loom, Wrangler, Tommy Hilfiger and other garments for U.S. consumers. But Honduras’ rural poor traditionally are peaceful. And in Candelaria, villagers preferred a practical approach.
They’ve designed a water system that would pipe water from a spring to spigots at family compounds.
A few years ago, they bought pipes and laid them, with dozens of men contributing free labor. But the pipes burst. Local engineers had failed to allow for pressure changes as water whooshed up and down hills. Now, with help from different engineers, village leaders have modified their plan and are looking for a better kind of pipe.
Some villagers are hopeful. Maria Garcia and Reyes Gomez are impatient after their son’s death.
Gomez now plans to emigrate to the United States. Friends who have managed to sneak into the country send home money that lets their families live comfortably in La Esperanza.
Working abroad “would be harder. This is my father’s land. I learned to grow crops from my father. This is the natural way for me to earn my living,” Gomez said. But potato and banana crops don’t pay. His wife, Maria, is too busy hauling water to work in a sewing cooperative.
So Gomez talks of borrowing $1,300 to hire a smuggler to guide him north. There are alligators in the river along the U.S.-Mexico border, he said. “That’s what I’m scared of, and maybe somebody will kill me.”
If he gets through, his first earnings will pay off his lender, he said. “Then I could help my family.”
Median age: 18.8 years
Population growth rate: 3.2 percent
Infant mortality rate: 29.96 deaths per 1,000 live births
Life expectancy at birth: 66.65 years
Fertility rate: 4.07 children born per woman (2003 estimate)
Literacy rate: 76.2 percent (those 15 and over who can read and write)
Population below poverty line: 53 percent (1993 estimate)
Unemployment rate: 28 percent (2002 estimate)
Sources: Denver Post research,
© Denver Post