Sanitation a pre-requisite for health

Our interest in food may not to stop once the residue leaves the colon into the outside world.
In Asia, Africa and Latin America more than two and half billion people ( 40% of the worlds population) have no toilets with a proper waste removal system. In India the figure is 700 million. In Afghanistan less than 10% have access to toilets. Which is a major source of disease, as the free expression leads to contamination of drinking water and the spread of highly lethal diseases e.g. cholera with faecal contamination ( in 2006 over 230,000 reported cases ) and hepatitis from faecal and urinary contamination. When there is a serious sanitation programme then the death rate particularly in children falls . There are cultural problems and the need or education, to use toilets and for them to be kept clean and healthy. My wife and I have a league of the worst toilet we have seen , one in South Mexico is a slender winner.
It also must be said what a remarkable system the urban sewage system is. The pioneering London scheme in the Victorian era and the development of similar systems in the cities, town, villages has transformed life and health.
Leader Lancet 2007 Access to toilet for all Lancet vol 370, p 1590
Durrheim 2007, A clarion call for greater investment in global sanitation Lancet vo370, 1592-3
Barreta et al 2007 Effect of city-wide sanitation programme on education in rate of childhood diarrhoea in northeast Brazil : assessment by two cohort studies Lancet ; vol 370, 1622-28

Martin Eastwood
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