1. Water, Sanitation and Hygiene (WASH) and waterborne disease
Richard Gelting, Ph.D., P.E.
Center for Global Health
Centers for Disease Control and Prevention
Center for Global Health,
Division of Global Health Protection

2. Diarrhea = 2nd largest cause of <5 mortality
Importance of WASH
Diarrhea = 2nd largest cause of <5 mortality
88% of deaths from diarrheal diseases attributable to unsafe WASH conditions
Poor WASH also contributes to:
respiratory diseases (handwashing)
Neglected tropical diseases (e.g., trachoma)
Malnutrition
Vector-borne diseases (poor drainage forming mosquito breeding habitat)
So the question arises as to why Haiti’s infrastructure is so divergent from the rest of the region.

4. At least basic access to Drinking Water Sources1
Access to Water and Sanitation in Haiti Based on WHO/UNICEF Joint Monitoring Program 2015
At least basic access to Drinking Water Sources1
Urban 81% (99% regional average LAC)
Rural 40% (86%)
Overall 64% (96%)
Access to Improved Sanitation Facilities2
Urban 37% (90%)
Rural 22% (68%)
Overall 31% (86%)
1 Either safely managed source or improved drinking water source within 30 min (improved = piped water into dwelling or yard, public standpipe, tubewell or borehole, protected spring, rainwater)
2 Either safely managed facility or improved sanitation facility not shared (improved = facility that hygienically separates human excreta from human contact)
Reference: WHO/UNICEF Joint Monitoring Programme (JMP) for Water and Sanitation

8. WASH Interventions We know WASH works:
Improved water sources can lead to ~21% reduction in diarrhea illness
Improved sanitation can lead to a ~37% reduction in diarrhea illness
Handwashing can reduce the number of diarrhea cases by 35%
Improved drinking water quality can lead to a ~45% reduction in diarrheal episodes

9. Typhoid Fever Trend (Mortality per 100,000) and
Lessons from History
Typhoid Fever Trend (Mortality per 100,000) and
Sanitary Interventions, 1900–1936
Cutler D, Miller G. Demography. 2005;42(1):1-22.

10. Increase coverage of sustainable WASH facilities and services
Objectives
Increase coverage of sustainable WASH facilities and services
Aligned with Sustainable Development Goals (SDGs)
Including health care facilities, schools, markets
Strengthen capacity to sustain facilities and services
Technical and administrative
Improving the situation will require long term effort

11. Increasing coverage for Sanitation takes time

12. THANK YOU FOR YOUR ATTENTION!
Center for Global Health
Division of Global Health Protection