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Diarrheal disease: the long-ignored killer of millions

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A Haitian girl's nanny washes her hair in a rainstorm. (Photo by: Shanley Knox) ()

Two-year-old Abel Juma died from diarrheal disease after taking healing herbs provided by his village’s traditional healer.

Too poor to buy her son a 25-cent package of oral rehydration salts, Abel's mother Evalyne waited hours to see a doctor. As she watched her son’s condition rapidly worsen, Evalyne panicked and took her son to see a village healer who provided her with the healing herbs. Her son died the next day. A water specialist's report stated that if Evalyne had understood more about the dangers of diarrhea, she would have known that the sugar-and-salt mixture was critical for rehydration and could possibly have saved her son.

Diarrheal disease dehydrates and causes malnutrition in the already fragile bodies of its victims, killing nearly 1.6 million children every year. Disease experts have made it clear that these deaths are easily avoidable.

Ninety percent of diarrheal deaths are directly related to sanitation, drinking water and hygiene, yet studies show that these water-related problems are simple to fix. The rotavirus vaccination, zinc and oral rehydration salts have been proven successful in combating even the most extreme forms of diarrhea.

In the poorest areas, however, even solutions that are affordable in developed countries are unrealistic. Instead, education has become an effective solution. Many cultures have practices, such as washing without soap, using dirty toothbrushes, drinking unfiltered water and insanitary disposal of waste, that spread diarrheal disease and bacteria.

During the two years she spent working with Haitian orphans, Angela Fairfield fought diarrhea in her children on a daily basis. She found that she was able to eliminate much of their sickness through sanitary practices most Haitians have never implemented.

Fairfield described many insanitary Haitian practices in a phone interview. “I have seen rivers with dead shells of cars in them and women gather on the sides of the rivers in the trash to wash clothes,” the former Three Angels Orphanage house manager said. “Where the people were doing their laundry was also where people were bathing, and I would see cows, pigs, dogs and goats in the water with people. Those animals were most certainly defecating. The waterway was like traffic through the filth.”

Fairfield kept her orphans healthy through buying bottled water, emphasizing the use of bleach and by educating her Haitian staff members to wash their hands.

“These kids don’t really have to die, that’s the real tragedy here,” said Water Advocates Communications Director John Sauer in a phone interview. “With simple intervention, drill holes, rain water harvesting, latrines and ceramic water filters being made available, soap being made available ... these kids don’t have to die. But they also don’t have to be sick; they don’t have to miss so much school.”

Although water-related diseases are responsible for 10 percent of the global disease burden, experts agree that those diseases have been largely ignored. They attribute the lack of attention to underfunding and weak advocacy. WaterAid Policy Officer Oliver Cumming said he believes attention turned from water-related diseases and sanitation when public healthcare became patient-centered. Politics, in turn, also began to focus on individual healthcare instead of the environmental factors behind disease.

Janie Hayes, communication officer at a water advocacy group called PATH, said she feels that more needs to be done about diarrheal disease. “Diarrhea is the second-leading cause of child death in the world today and there needs to be more attention and commitment to it,” Hayes said.

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Sonja Eberly said (9 months ago)

This article covers an extremely important health issue that affects the entire globe, and you do a good job of addressing multiple facets of the problem. The photos you include are a strong addition to the piece overall.

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SarahMarie Harman said (9 months ago)

Great article, Shanely. It's shocking that such a simple disease is responsible for so many avoidable deaths--glad to see the issue is being brought to light

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Greg said (9 months ago)

Great story

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