Water, Sanitation, and Hygiene: the Basics of Our Wellbeing

By Elisa Furlan

reviewed by Amadou Barrow

Drinking water is one of our most basic needs. Alongside hygiene and sanitation, it’s fundamental for a good quality of life.
However, there are a lot of problems connected to water, sanitation, and hygiene (WASH) in some parts of the world. In fact, over 2 billion people have no running water in their house. Moreover, more than 200 million people have to walk over an hour to fetch water. This task isn’t equally distributed between the two sexes: 72% of the time it’s the woman’s task to collect the water, 8% of these women are underage girls.

Although sanitation has improved and drinking water sources have increased by around 15% in the last thirty years, there are still a lot of disparities when it comes to the different parts of the world.


The consequences of the lack of WASH

As WASH is fundamental to our wellbeing, the consequences of a lack of water, sanitation, or hygiene are catastrophic.

  • Maternal mortality: it’s defined as the death of a woman during pregnancy or within 42 days after giving birth. There are several reasons why WASH is linked to a higher risk of maternal mortality: poor sanitation increases the risk of Soil-Transmitted Helminthiasis infections, which can cause anaemia, listeria, and an associated higher risk of maternal death, as well as abortion and pre-term birth. Unsafe water management can also increase the amount of mosquitoes present in a territory, resulting in a higher risk of the transmission of diseases, such as malaria. Lastly, collecting water can also cause spinal injuries, hernias, and an increased abortion risk.


  • New-born mortality: as well as posing a threat to mothers, a lack of WASH puts new-borns at risk. Not only is neonatal mortality linked to maternal malnutrition, malaria, and influenza, but it’s also caused by infections related to childbirth and the immediate postpartum period (like birth attendant handwashing, delivery surface, hygienic cord cutting, bathing, and breastfeeding).


  • Undernutrition: this is a very serious part of the WASH problem, as almost half of all child deaths are due to undernutrition. Undernutrition is defined as “the outcome of insufficient food intake and repeated infectious diseases.” As of 2014, more than 160 million children were suffering from some form of undernutrition. WASH is closely linked to it because half of all undernutrition cases were connected to a lack of water, sanitation, or hygiene. Improving WASH could lead to the prevention of almost one million child deaths.


  • Menstrual hygiene management (MHM): this is defined as “women and adolescent girls using clean menstrual management material to absorb or collect menstrual blood.” Moreover, women need the opportunity to change in a private place and wash themselves properly. However, a lack of WASH may result in poor MHM, which could negatively affect both their mental and physical health — urogenital infections and negative feelings associated with embarrassment and anxiety are some of the consequences of poor MHM. 


  • Environmental damage: poor WASH practices result in excessive extraction of water and water pollution, due to poor management of human excreta. Heavily polluted water has a devastating impact on ecosystems, food webs, and biodiversity.


  • School absenteeism: poor health results in an increase in school absenteeism. Students may be absent from school because of difficulties with MHM or fear of assault and violence in inadequate private restrooms, as well as due to having health problems such as infections or dehydration. Moreover, girls may need to stay home to help their mother collect water. However, even if the reasons why students are absent from school in rich countries may be different from poor countries, such as the spread of infections due to not washing your hands properly, the problem remains the same. Even in one of the most advanced countries in Europe, there’s a link between WASH and school absenteeism. A study conducted in Denmark proved that if students were required to wash their hands before the first lesson, before lunch, and at the end of the school day, the rate of absenteeism significantly dropped compared to a school who didn’t promote this practice.

How can we improve the situation?

The problems related to poor WASH practices seem bigger than any of us. However, there are a couple of ways in which these problems can be tackled.

The old saying ‘prevention is better than cure’ equally applies in this case. A key to tackle WASH problems is the improvement of water infrastructures and technologies. Protecting water sources ensures clean and safe drinking water, significantly improving one’s health. Moreover, developing technical solutions to better recycle and reuse domestic wastewater — like grey water sources and rain harvesting — can also improve the situation.

However, as much as these solutions could help the current state of things, promoting behavioral change is fundamental. Rethinking the value of water and how we can use it sustainably can be the solution to present and future problems; in fact, the current water systems are highly unlikely to meet future water needs.


A link between water and spirituality.

Many cultures believe that water isn’t only a resource, but a living and sentient being. Indigenous people have a strong connection with water — they consider it the blood and life-stream of Mother Nature. As part of their culture, they live in community with it, both in body and spirit.

However, indigenous people suffer a great deal more than non-indigenous people: not only do they have overall shorter life expectancy, but they’re also disproportionally poorer than other communities.
Nonetheless, many of their concerns are against large-scale or commercial development projects, like dams and mining. Because of the dominance of Western interests in water management, their human right to water and sanitation isn’t respected. But as we’ve seen, they’re not the only ones suffering.

Throughout this article, we’ve highlighted the close link between us and water. Although the problems seem unbeatable, we can contribute to solving these problems by finding that connection with water we lost so long ago and thinking more sustainably when using natural resources.

Elisa Furlan
I am a positive and enthusiastic writer with an enormous passion for books. I am mostly interested in the fields of equal rights, global environment, and justice. I believe in the power of words: everything we know, we know because we read about it, heard it on the news, or someone told us – it is all connected to words. Contributing to change this world – the one and only one we will ever know – is a privilege as well as a duty: everyone can write something on the internet, especially these days; not everyone, though, can communicate effectively. It is my goal to help this world change, word by word.

Amadou Barrow

My areas of expertise center around climate change and global health; Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH); environmental and occupational health; health education and promotion; and health risk communications. I have experience as a lecturer at both university level in the area of health psychology, health education & promotion, water supply & sanitation, biostatistics, epidemiology and research methodology. I have published several scientific manuscripts in various reputable journals on maternal & child health morbidities and mortalities in LMIC settings. I am a passionate digital health enthusiast with a special focus on holistic wellbeing at all levels.

Drinking water – UNICEF DATA. (2017). UNICEF DATA. https://data.unicef.org/topic/water-and-sanitation/drinking-water/ 

Ginja, S., Gallagher, S., & Keenan, M. (2019). Water, sanitation and hygiene (WASH) behaviour change research: why an analysis of contingencies of reinforcement is needed. International Journal of Environmental Health Research, 1–14. https://doi.org/10.1080/09603123.2019.1682127

Hannah, D. M., Lynch, I., Mao, F., Miller, J. D., Young, S. L., & Krause, S. (2020). Water and sanitation for all in a pandemic. Nature Sustainability, 3(10), 773–775. https://doi.org/10.1038/s41893-020-0593-7 

Hutton, G., & Chase, C. (2016). The Knowledge Base for Achieving the Sustainable Development Goal Targets on Water Supply, Sanitation and Hygiene. International Journal of Environmental Research and Public Health, 13(6), 536. https://doi.org/10.3390/ijerph13060536 

Hygiene and Hand Washing Statistics. (n.d.). UNICEF DATA. https://data.unicef.org/topic/water-and-sanitation/hygiene/ 

Jiménez, A., Cortobius, M., & Kjellén, M. (2014). Water, sanitation and hygiene and indigenous peoples: a review of the literature. Water International, 39(3), 277–293. https://doi.org/10.1080/02508060.2014.903453 

Joshi, A., & Amadi, C. (2013). Impact of Water, Sanitation, and Hygiene Interventions on Improving Health Outcomes among School Children. Journal of Environmental and Public Health, 2013, 1–10. https://doi.org/10.1155/2013/984626 

Mills, J., & Cumming, O. (2016). THE IMPACT OF WATER, SANITATION AND HYGIENE ON KEY HEALTH AND SOCIAL OUTCOMES: REVIEW OF EVIDENCE. https://www.unicef.org/wash/files/The_Impact_of_WASH_on_Key_Social_and_Health_Outcomes_Review_of_Evidence.pdf 

Universal Access to Sanitation – UNICEF DATA. (2017). UNICEF DATA. https://data.unicef.org/topic/water-and-sanitation/sanitation/ 

Valcourt, N., Javernick-Will, A., Walters, J., & Linden, K. (2020). System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review. International Journal of Environmental Research and Public Health, 17(3), 702. https://doi.org/10.3390/ijerph17030702

Related articles

Elisa Furlan
May 11, 2021
| 6 min read
Moira Daly
April 15, 2021
| 6 min read
Robyn Albertyn
April 1, 2021
| 8 min read