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Why a lack of toilets are stunting children’s heights and hopes

by Dan Jones, WaterAid | WaterAid - UK
Thursday, 28 July 2016 14:35 GMT

A group of 8-year-old children and one 9-year-old girl stand underneath a chalk mark indicating the global average height for their age at a primary school in Ooti, Karnataka State, India. Most of the children in the picture measure the same height as a healthy 5-year-old. Credit: WaterAid/Ronny Sen

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The lack of toilets and sanitation around the world is not only holding children back, it’s quite literally stunting their future

Imagine you’re a child growing up in India: living in one of the world’s fastest growing economies could mean the prospects for your future are almost endless. You have adequate food, shelter, and access to good education meaning you could become the next influential politician, teacher, doctor, Olympian, or business leader. But the one basic thing you lack is a toilet. That’s the reality facing millions of children growing up in today’s India, and it’s not only holding children back, it’s quite literally stunting their future.

A new report released by WaterAid this week reveals that India has the greatest number of children in the world suffering from stunted growth -- 48 million kids, or two children in every five under five years old. Sadly stunting doesn’t just affect a child’s height, it also limits their emotional, social and cognitive development. It’s no coincidence that India also has the greatest number of people in the world practising open defecation. Every second person in India relieves themselves outside, a centuries-old practice, but one which also spreads deadly diarrhoeal diseases and contributes to stunting.

Children are at constant risk of diarrhoea when they drink dirty water, often polluted by people going to the toilet in the open. In fact research conducted by the Lancet suggests that five or more cases of diarrhoea before two years of age can lead to stunting. This, in turn, leads to poor performance at school and stops children from being able to reach their potential.

Madagascar: 8-year-old Zara stands next to latrines that are no longer fit for use at her school in Bemanonga commune, near to Morondava, Madagascar. Children at the school have no choice but to defecate in the open, and many like Zara are suffering from stunted growth. Credit: WaterAid/ Kate Holt

Malnutrition also inflicts a big economic burden, with this year’s Global Nutrition Report concluding that the impact of malnutrition costs 11 percent of GDP annually across Africa and Asia.

The issue isn’t just confined to India. African nations are among the worst for high rates of stunting in children under five - 10.3 million children in Nigeria are stunted, the second highest in the world, while in Burundi, Eritrea and Madagascar nearly half of all children under-five suffer from stunted growth.

When WaterAid travelled to Madagascar recently, we met Zara, an eight-year-old girl who measures just 107 cm, nearly 20 cm under the global average height for her age. Left with no choice but to drink dirty water and use a bush to relieve herself, she often has bouts of diarrhoea and finds it very difficult to concentrate at school, sometimes missing lessons as a result.

The U.N. Global Goals for Sustainable Development seeks to end malnutrition by 2030, giving an opportunity for governments, donors and international agencies to invest in solutions that will improve the lives of children like Zara the world over.

But as this report highlights malnutrition is not just about food, which has for too long been the focus of most nutrition programmes. Good food will only get us halfway to the finishing line in addressing this crisis. Governments must make ambitious investments in water, sanitation and hygiene in order to end malnutrition altogether. The lives of Zara and so many other vulnerable children like her count on it.

Dan Jones is WaterAid's Advocacy Coordinator

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