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Hygiene in the Industrial World:
An Unhealthy Obsession with Cleanliness?

(Released June 2011)

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  by Kathryn Mori & Carolyn Scearce  


Key Citations





Hygiene in the 3rd World


In developed countries, cholera is no longer a prevalent disease. However, the disease is much more common in less affluent countries, and in 2010, there was a fresh outbreak of cholera in Haiti following the earthquake that devastated the country at the beginning of the year. After the earthquake, Haitians had less access to clean water and many hospitals were destroyed. The lack of clean water lead to the cholera outbreak, and lack of access to adequate medical treatment further exacerbated the situation. 

Chart showing deaths from the cholera outbreak in Haiti.
Chart showing deaths from the cholera outbreak in Haiti.

Cholera is only one of a number of diarrheal diseases caused by contaminated water. Many of these diseases are prevalent in undeveloped or developing countries. Cholera, typhoid, dysentery and other diarrheal diseases are caused by ingestion of water contaminated by human waste. Dracunculiasis, schistosomiasis, and some other helminths are parasites found in intermediate organisms living in water (Montgomery and Elimelech 2007).

In developing countries, four fifths of all illnesses are caused by water-borne diseases. Worldwide, 1.1 billion live without improved drinking water. Nearly 2.6 billion live without improved sanitation. The situation is the worst in sub-Saharan Africa where 42% of the population lives without improved water and 64% lives without improved sanitation. Deaths due to diarrheal diseases are higher than any other region. The most hard-hit section of the population is children under one year of age; the mortality rates among that group are much higher than any other region (Montgomery and Elimelech).

Nearly 60% of all infant mortality is related to infectious diseases most of which are water-, sanitation-, or hygiene-related. The third leading cause of morbidity worldwide and the sixth leading cause of death are diarrheal diseases. In developing countries, diarrheal diseases are the leading cause of childhood death. Morbidity is caused by diarrheal diseases in an estimated one billion people per year leading to an estimated 2.2 million deaths. Intestinal helminths is estimated to cause morbidity in 1.5 billion and deaths of 100,000 yearly, while schistosomiasis causes morbidity in 200 million and death in 200,000 yearly. Trachoma, an excreta-related infection, causes 150 million illnesses yearly (Montgomery and Elimelech). Sometimes, while these infections do not lead directly to death they cause malnutrition which greatly weakens individuals leading them to succumb to other problems.

Efforts have been made to improve water quality, sanitation and hygiene worldwide. However, these efforts have only met with limited success as yet. Even when technology is put in place to treat water, money, or political will is often insufficient to maintain the technology. Individuals may travel some distance from the water source to their homes causing the water to be susceptible to contamination through transportation. Also, water stored within the home may be exposed to pathogens or toxic substances (Wright et al.). In many cases, improved hygiene practices in the home would contribute significantly to the heath of young children, however education is often lacking or not well suited to the needs of the population. Sufficient amounts of water are often unavailable. In circumstances where individuals spend hours of each day trying to obtain enough water for the household, sufficient hand washing seems impractical (van Wijk and Murre). Greater effort is being made to tailor solutions to the specific regions most affected, and some improvements have been made. Clearly there is still a good deal of room for better sanitation and hygiene practices to improve the living standards of many people in developing countries.

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