Basic Sanitation: A major healthcare woe

It is the quality of the immediate physical ecosystem…which can make or break civilizations today.

Basic Sanitation

Basic Sanitation The UN initiative – ‘Millennium Development Goals’ involves a set of guidelines aimed towards working for the needs of the poorest as agreed upon by all countries and leading developmental institutions. Though the target for 2015 included halving poverty rates, stalling the spread of HIV/AIDS, and making provisions for universal primary education, one of the goals concerns improvising basic sanitation to ensure environmental sustainability. Despite awareness programs organized by numerous organizations and development bodies, inadequate basic sanitation crops up to be a continuous concern, which includes efficient sewage/waste treatment, provision of clean domestic water, and many others which carry the potential threat of affecting the quality of human lives.

Sanitation is a layman’s term involves a provision that facilitates the safe disposal of human urine and feces. It also involves the maintenance of garbage, wastewater, and the implementation of provisions to make the environment clean and hygienic. Sanitation thus is an important and crucial aspect that helps in establishing and maintaining a clean and disease-free environment. Therefore, it becomes the foremost requisite for living a healthy life. But, are we taking this crucial facet seriously? Do we implement or practice proper sanitation norms? Does poor sanitation contribute to be anguish towards maintaining proper healthcare? In this article, let’s understand the importance of this simple basic concept, yet a pivot in affecting the quality of life.

What involves basic sanitation?

Before we try to list down the various criteria that fall under basic sanitation, it is important to understand and define ‘sanitation’ accurately. The definition of sanitation is dynamic and is often defined based on priority issues and problems being faced about sanitation.

  • A safe and logical collection of human waste, their proper treatment, and disposal, or recycling (recycling would majorly involve human urine and feces)
  • Management/recycling/reuse of solid waste and sullage from human settlements
  • Collection and proper management of industrial waste products
  • Disposal, reuse/recycling of sewage effluents
  • Management and proper disposal of hazardous wastes generated by hospitals, chemical and radioactive wastes, etc.


Needless to say, wherever humans are, the amount of waste generated will be huge. Though a lot of progress is being made in meeting efficient sanitation, many areas and people lack to find proper means to dispose of wastes. Non-effective management strategies of wastes, especially in heavily populated areas eventually lead to an increase in risk towards many infectious diseases and epidemics. Such conditions majorly end up targeting the young, elderly generations, or individuals with low resistance power towards fighting diseases. Again, poor management of waste to contributes making the surroundings unpleasant eventually putting even other species at risk affecting the ecological balance.

The major paths that are directly affected due to poor sanitation include:

  • Drinking water
  • Food chain which majorly involves sites used for growing fruits, vegetables and breeding of animals for their meat and fishes
  • Recreational sites, etc.

How big is the problem?

The numbers of people who are at risk of preventable health due to poor sanitation are huge in comparison to those affected by other modes of man-made sources of physical damage and destruction due to wars, weapons, etc. Close to only 60% of the world’s population has access to improved sanitation and the rest are forced to defecate in either open places or use unsanitary provisions for the same.

Indian statistics about sanitation present a very glum picture. Of the 1 billion people the world over who lack access to the basic necessity of a toilet, India alone harbors a burden of 600m. 130m households are pointed to lack toilets and more than 72% of the rural community resort to open defecation. This poses a greater societal threat to women and children especially those who apart from being exposed to stalkers, are also subjected to verbal and physical assault due to open defecation. Sanitation is also important among young girls, because of menstruation and statistics point out to girls dropping out of school due to the same (almost 23%) as many schools even lack functional toilets (roughly 40%). With slums mushrooming in every metro city in this country, providing appropriate sanitation facilities become a burden on the local municipality.

Reality bites!

  • One gram of faeces can contain 10,000,000 bacteria; 1,000,000 viruses, 1,000 parasites and 100 parasite eggs – WHO report
  • Water is the major medium through which the adverse effects of poor sanitation gain a bigger picture in appearance
  • Inadequate sanitation is known to hurt water quality, health, access time, and even tourism
  • Premature mortality to a high extent is contributed due to poor sanitation

Communicable Vs Non-communicable

Communicable ailments include infectious conditions which if not controlled have the potential to become epidemics posing a major threat to human life and a colossal burden to the healthcare system. The one fundamental threat to the aforementioned calamity is sanitation conditions. Non-communicable ailments though have risen to epidemic proportions in our country today, majorly caused due to lifestyle habits and genetics; it is the communicable ones that can be completely eradicated with appropriate and monitored sanitation measures in place.

Poor sanitation = Healthcare in distress (needlessly though!)

Poor or no sanitation in human settlements is an ideal opportunity for the spread of many infections. In fact, human excreta alone have been involved in infectious disease transmission which involves typhoid, cholera, hepatitis, ascariasis, etc., and even encephalitis. Estimates by WHO prove that diarrheal diseases alone caused due to poor sanitation is a major responsible factor for deaths among children belonging to the age group of fewer than 5 years.

Among parasitic diseases, malaria holds the first rank with the affected regions showing poor or no sanitation and is majorly a concern in tropical and subtropical regions of the world. Conditions like ascariasis are found almost worldwide having greatest frequency again in tropical and subtropical regions affecting more of the areas with less sanitation. Ascariasis also contributes to being the major chunk of intestinal worms’ infection in the developing regions of the world.

Yet another parasitic infection prevalent in many developing areas more precisely in Asian countries is that of Trematodes. Flatworm infections mostly spread through fecal contamination, as the larvae are present in the feces of an infected individual. Trematode infections enter the food chain through fish, shellfish, and finally into humans. Global estimations of WHO prove almost 10% of the population to be at risk.

Another leading cause of preventable blindness – trachoma infection is again linked to poor sanitation! Again to add to the misery, it is the sole reason for making almost 6 million people around the globe permanently blind. This contribution of trachoma infections in causing preventable blindness is majorly supported by poor sanitation, substandard hygiene related to drinking water, etc.

Lack of proper management, disposal/reuse/recycling of heavy metals, inorganic and toxic wastes have been on rising in most developing countries including ours. Contamination of water bodies with industrial effluents and toxic elements eventually cause their entry into the food chain causing severe damage to human health.

Many of these also harbor the property for bioaccumulation bearing the potential to affect generations. The damages caused include organ dysfunctions, inflammation, irritation, damage to the nervous system, congenital malformations to even cancer. An increase in nitrate content through industrial wastes causes its deposition in groundwater eventually leading to its entry into the food chain; wherein it can cause fetal complications like methemoglobinemia (blue baby syndrome) in infants exposed to the same. Also, a rise in inorganic compounds in groundwater can cause eutrophication which becomes breeding grounds for algae and many toxic compounds producing cyanobacteria.

Proper sanitation – Need of the hour!

Looking at the predicament that arises due to lack of adequate sanitation, the health communities and welfare institutions need to be the first ones in taking measures to tackle the menace caused by the same. Considering the ever-increasing rate of population, meeting the requirements of proper sanitation becomes imperative. Most of the poor and developing countries who lack to keep stride with the increasing population growth should be the first ones to implement and incorporate strategies in meeting the requirements of proper sanitation.

Because sanitation poses a great burden on public health. Good sanitation is the basic need for a society and to develop a healthy country. Simple measures taken can compound healthy benefits at large. Sustainable growth and expansion will only become a possibility when sanitation measures become considered as the foremost pedestal to tackle.

Adequate sanitation – A social necessity as well as a need to safeguard the sentiments of the entire human community! As the Prime Minister has aptly put – Building Toilets over Temples is a need!

  1. Cited by Centers for Disease Control and Prevention (2015). Global Water, Sanitation, & Hygiene (WASH) Fast Facts. Retrieved from:
wo(Retrieved on 5th Jan. 2016).
  1. World Health Organisation and UNICEF Joint Monitoring Programme for Water Supply and Sanitation Report (2012). Progress on Drinking Water and Sanitation:2012 Update. Retrieved from: (Retrieved on 5th 2016).