Across much of Africa, limited access to safe water and sanitation is driving a devastating cycle of disease, poverty and social inequality. Health data from the WHO highlights the scale of the crisis, with preventable infections and waterborne illnesses continuing to claim millions of lives each year, particularly among children.
Water is cheap for those who have a lot, but it costs a fortune to those who have nothing.
In the African region, the lack of clean water and adequate sanitation services is not just a matter of thirst, but a true healthcare emergency. Between rising global temperatures and the spread of devastating illnesses, the crisis of water scarcity in Africa appears dramatically linked to poverty and humanity’s inability to manage resources.
Water Contamination in Africa and the Healthcare Emergency
Freshwater is not only necessary for drinking but also for sanitation, hygiene practices, and cleanliness. The WHO counts 115 deaths every hour in the African region due to water contaminated by bacteria, viruses, parasites, and pollution. The lack of clean water increases the risk of diarrheal diseases and can also lead to eye infections that cause blindness.
According to the WHO, water scarcity in Africa affects 1 in 3 people in the region, but this average is worsening. In some areas, such as sub-Saharan Africa, purification systems do not exist. People must primarily use tropical rainwater. The latest WHO document showed that globally, 2.1 billion people still lack access to safely managed drinking water, and 3.4 billion do not have safely managed sanitation services.
The consequence is that every year across the world, 2 million people die of viral and bacterial gastroenteritis. Every year, childhood diarrhea kills nearly 443,832 children under 5 and another 50,851 children between the ages of 5 and 9. Yet, safe access to drinking water, sanitation services, and adequate hygiene practices would be enough to prevent the spread of these deadly diseases.
A fistful of sugar, a pinch of salt, a jug of water. This is the simplest remedy for oral rehydration therapy useful to contrast dehydration from diarrhea or gastroenteritis. “Then why does this disease still kill 1.9 million children under 5 every year?” Time provocatively asked already twenty years ago but no one wants to put it into practice.
River blindness and tropical diseases in neglected people
One of the most dangerous diseases is onchocerciasis, also called “river blindness.” Particularly polluted waters can indeed determine the permanence of a whole series of microorganisms.
“There are tens and tens of millions of people affected by so-called river blindness,” explains Professor Aldo Morrone, one of the world’s leading experts in migration medicine, poverty, and tropical dermatology. “Children, in particular, but also adults, through polluted waters come into contact with Onchocerca volvulus, a microorganism that determines a systemic infection, but above all, in many cases, it also determines blindness. For years, we have been trying to prove that these infections shouldm not be called Tropical Neglected Diseases, but Tropical Diseases in Neglected People. Referring to the terms chosen by the WHO, we are trying to make it officially recognized that these tropical affect poor people and not the rich.”
Another great danger to health is rainwater harvesting, a remedy that seems trivial to compensate for water scarcity but is very risky for human survival. Stagnant water represents a perfect culture medium the vector of malaria. The characteristic of malaria is that it affects pregnant women and children, who seem to fall asleep but instead fall into a coma.
Water crisis and drought
To make the situation worse, the rise in global temperatures intervenes: rainfall patterns on the African continent are becoming increasingly irregular. Projections indicate that in much of sub-Saharan Africa, average annual rainfall could decrease by 10% to 20% in the coming decades. However, water scarcity is a serious problem even in areas where rainfall is abundant. Drought is determined by man. It does not depend so much on the lack of rain but on the fact that there is no capacity to contain or safeguard rainwater, which could be reused during periods when a drought condition is actually recorded.
The water resource in Africa: the forgotten lesson of Lalibela
The story of Lalibela, a city in northern Ethiopia famous for its underground monolithic churches, is
suggestive.
“Lalibela – continues Morrone – is a medieval UNESCO heritage city where there are 11 hidden churches carved into the rock. The purpose was to hide the churches from potential invaders, covering them so no one would see them. However, during tropical rains, these churches would have filled with water. That is why underground tunnels were created to prevent the churches from flooding and to collect tropical rainwater to use it during periods of drought. We are talking about the 1200s. So, I ask myself: why can’t we do it today?”
With a water demand that is rising sharply, competition between domestic use and productive use risks generating strong tensions. The demand for water in sub-Saharan Africa is growing faster than in any other part of the planet. Across the region, water requirements for domestic use are projected to triple by 2050 compared to 2010. Water consumption by industry and the manufacturing sector is also destined to increase, up to 700%. These trends, highlighted by an analysis by the CSIS, foreshadow an increasingly intense competition for such limited resources. The problem of competition with the productive sector exacerbates the tragedy of the most remote areas where people either die of hunger and thirst or of malaria.
Protecting global health is a choice of civilization with win-win benefits
How can the mediation of these conflicts be managed to ensure that water then remains a human right and also serves to sustain food security? Is it a dream?
“No, it is a choice of civilization,” answers Morrone. “The mistake is thinking that each State, particularly Western ones, should think only of its own inhabitants. Not even the COVID disease, SARS, and Ebola managed to make us understand that any country on our planet needs to be protected. I often say that my commitment to these impoverished countries arises from the fact that I love my grandchildren. And why do I work for them? Because protecting the health of other children is fundamental for protecting the health of my grandchildren who live in Rome. This vision in which health, human dignity, and well-being are shared values is prosaic but too often the message does not get through.”
