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The Water Decalogue of Medicus Mundi Spain for Leaving No One Behind

Kids fetching water (impression, based on picture by FAMME)
Kids fetching water (impression, based on picture by FAMME)

FAMME, March 2019. 99.3% of tap water in Spain is potable, in accordance with the General Health Law 14/1986. We have to go back to 1971 to date the last time we suffered a disease because of the state of the water.

In the rest of the world this is not the case: 2.1 billion people lack access to safe water available in the home, and 6 out of 10 (4.5 billion human beings) lack safe sanitation, which means that around 1,000 children die every day due to diarrheal diseases associated with lack of hygiene as mentioned in Report 2018: Health in Development Cooperation and Humanitarian Action.

In order to make this contumacious reality visible, with women and girls among the most disadvantaged at the global level, the slogan for World Water Day is "Leave No One Behind", in an attempt to comply with Sustainable Development Goal 6 which seeks to "Ensure the availability of water and its sustainable management and sanitation for all" for the objectives of Sustainable Development.

But great progress will not be achieved without a deep and radical change that encourages the implementation of a series of measures to prevent waste, water pollution and profit through its commodification. Increasingly, water is the protagonist of numerous conflicts that can lead to violent wars.

The root causes of the current water and sanitation crisis lie in poverty, inequalities and disparity in power relations, and are compounded by social and environmental challenges, such as increasing urbanization, increasing pollution and depletion of water resources, and climate change, resulting in disasters of incalculable magnitude. To give an example that affects us, I mention Cyclone Idai, which is wreaking havoc in Mozambique, Zimbaue and Malawi, debasting and flooding entire territories. Southeast Africa's worst disaster in decades

Women and girls are the worst affected by the lack of access to safe water and sanitation.

And in order not to leave anyone behind, it is essential to redouble our efforts in favor of the women who are most affected, because in addition to being separated from decision-making, it is up to them to carry the water when it does not reach their homes. Of them and of the girls. In some parts of the world, they spend up to four hours a day walking, queuing and carrying water that is already a heavy physical activity. This task also partly explains the wide disparity in school attendance between boys and girls in many countries. Girls' right to education is affected by this assigned task, and because there are no separate toilets for them.

In many cases, the water they collect is dirty and comes from unprotected sources. Women's health (the minimum fluid requirement for a breastfeeding woman is 7.5 litres of water per day) can be profoundly affected by both the heavy burden and the illnesses they contract from contact with that water.

Another added danger when seeking water is the possibility of sexual violence both along the way and sexual favours in exchange for clean water.  Or when they have to relieve themselves outdoors without a toilet, especially at night. This is the time when many sexual abuses occur. And it is not only limited to rural areas, but also in urban areas.

Women are also excluded from decision-making on water and sanitation. As a result, their specific needs and circumstances are not taken into account in the design of water supply and sanitation programmes or in the expansion of these services.

The problem of refugees and displaced persons

Unfortunately, today the number of people displaced by armed conflict and natural causes is around 70 million. In emergencies, displaced people face particular difficulties in accessing safe water and sanitation, with potentially life-threatening consequences. Displaced persons are also particularly vulnerable to discrimination, racism and xenophobia, which can further reduce their ability to access safe water and sanitation.   Refugee and IDP camps around the world are characterized, especially when displacement is prolonged, by dilapidated and overcrowded conditions in which the provision of basic services, such as safe water and sanitation, is inadequate. Poor sanitation and lack of access to safe water in these camps often lead to the spread of waterborne diseases such as cholera. 

The fate of asylum-seekers and IDPs in urban areas is not much better. Often unable in practice or because of their legal status to obtain adequate housing, in many cases they also lack safe drinking water or sanitation facilities.

Indigenous peoples

Indigenous peoples' access to safe drinking water is closely linked to control over their ancestral lands, territories and resources. Lack of legal recognition or protection of these lands, territories or resources can have far-reaching consequences for their enjoyment of the right to water.  Natural sources of water traditionally used by indigenous peoples, such as lakes or rivers, may no longer be accessible due to expropriation or gradual appropriation of land by others. Access may also be threatened by illegal pollution or overexploitation. In addition, indigenous peoples' water sources may have been diverted to provide drinking water to urban areas. Thus, securing indigenous peoples' right to water may, in many cases, require measures to secure their rights to ancestral lands, strengthen their traditional water systems and protect their natural resources. 

Although most indigenous peoples still live in rural areas, an increasing number are migrating, voluntarily or involuntarily, to urban areas, where they often end up living in inadequate conditions, without access to safe drinking water or sanitation.

Medicusmundi's Water Decalogue

At medicusmundi (Spain) we believe that the right to health encompasses not only timely and appropriate health care, but also the main determinants of health, such as access to clean drinking water and adequate sanitary conditions. For this reason, the lines of work of medicusmundi in the right to water and sanitation. Twelve recommendations; twelve commandments... not to leave anyone behind.

  1. Contribute to local governments to increase the coverage, quality and sustainability of water and sanitation services to rural and marginal urban populations.
  2. Promote public water services and the non-privatization of water and sanitation.
  3. Promote the organization, participation and training of the population in the management of drinking water and sanitation systems in a sustainable manner.
  4. To promote the commitment of the population and the State to the rational and sustainable use of water and the fulfilment of public policies and programmes for the provision of drinking water and sanitation for populations located in rural and marginal urban areas.
  5. Plan for water and health. The health sector must be fully involved in the management of water for which networks and commitments with the Health Organisms will be favored.
  6. Contribute to the strengthening of the capacities of local personnel.
  7. Favour local markets using local materials and adequate and sustainable technology.
  8. Implement gender equity and the participation of women in the projects of their communities.
  9. Adapt the cost of the resource to the economic reality of the communities with which we work. (Promote tariff and management systems that guarantee economic accessibility to all people (rights-based approach) while penalizing abuse and excess consumption per capita).
  10. Promote the Right to Health in favor of access to water and sanitation, for which the establishment of stable Alliances and specific collaborations with specialized organizations will be promoted for the effectiveness, efficiency and sustainability of their interventions.
  11. Promote work in water and sanitation in the integral development of the communities involved, directly addressing other determinants of health and health care itself, as well as that of other conditions of development. 
  12. Participate in and encourage intervention in national and international networks where work is being done to defend the human right to water and sanitation.

This is our contribution to the process involved in fulfilling Objective 6 of the ODS Agenda for 2030: that someday, as is already the case in Spain, practically all the water from taps around the world will be drinkable and at an affordable price for everyone.

Article by Teresa Rosario, Medicus Mundi Spain, based on the Declaration of Medicusmundi on the Right to Water and Sanitation

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