Hospitals & Asylums    

World Water Day HA-22-3-06

Goal 7 of the UN Millennium Development Goals: 7. Integrate the principles of sustainable development into country policies and programs to reverse loss of environmental resources.  To reduce by half the proportion of people without sustainable access to drinking water.  Achieve significant improvements in the lives of at least 100-million slum dwellers worldwide by 2020.  In 1992, the UN General Assembly designated March 22 as “World Water Day” after the United Nations Conference on Environment and Development (UNCED) in Rio de Janeiro to draw international attention to the critical lack of clean, safe drinking water worldwide. Eighty percent of our bodies are formed of water, and two thirds of the planet's surface is covered by water: water is our culture, our life. The theme 'Water and Culture' of World Water Day 2006 draws attention to the fact that there are as many ways of viewing, using, and celebrating water as there are cultural traditions across the world. Sacred, water is at the heart of many religions and is used in different rites and ceremonies. Fascinating and ephemeral, water has been represented in art for centuries - in music, painting, writing, cinema - and it is an essential factor in many scientific endeavours as well.  The critical importance of water, in particular freshwater, for all aspects on sustainable development, including poverty and hunger eradication, water related disaster reduction, health, agricultural and rural development, hydropower, food security, gender equality as well as the achievement of environmental sustainability and protection was underlined at the 4th World Water Forum in Mexico City from 16-22 March where the need to include water and sanitation were marked as priorities in national processes, in particular national sustainable development and poverty reduction strategies.


Nearly 1.1 billion people (roughly 20% of the world’s population) lack access to clean safe drinking water. The lack of clean, safe drinking water is estimated to kill almost 4,500 children per day. In fact, out of the 2.2 million unsafe drinking water deaths in 2004, 90% were children under the age of five, mostly from infectious diarrhea. Water is essential to the treatment of diseases, something especially critical for children.  This problem isn’t just confined to a particular region of the planet – it’s a world-wide public health issue. A third of the Earth’s population lives in “water stressed” countries and that number is expected to rise dramatically over the next two decades. The crisis is worst in developing nations, especially in Sub-Saharan Africa and South Asia.  The world water crisis is created by a confluence of factors including climate and geography, lack of water systems and infrastructure, and inadequate sanitation, something that 2.6 billion people (40% of the world’s population) lack access to although this number is more sympathetic to nature estimated at 600 million. Some of these countries have additional problems, including high levels of arsenic and fluoride in drinking water.   Even with these unsanitary conditions, many women and young girls in rural areas in Sub-Saharan African and other parts of the world must trek as much as six miles everyday to retrieve water for their families. Due to this manual labor, such women and children are prevented from pursuing an education, maintaining their households or earning additional income.  Thus, the lack of clean water, coupled with the lack of basic sanitation and a dearth of hygiene education, is one of the largest obstacles to progress and development in these regions and across the world. The UN has prioritized water access among its Millennium Development Goals because it contributes to such widespread suffering, including increased poverty, high child mortality rates, depressed education levels, and political instability. Without question, the world water crisis condemns billions of people to a perpetual struggle to survive at the subsistence level.  The world water crisis is one of the largest public health issues of our time.


Access to clean water and sanitation services has become a critical problem throughout Latin America and the Caribbean, but nowhere more urgently than in the region’s cities. Already under pressure from decades of accelerated population growth, water systems in cities from Mexico to Argentina are reaching the breaking point. Aging treatment plants, old and leaky water mains, depleted aquifers and polluted sources make it ever more difficult to keep up with the growing demand. Meanwhile, tens of millions of people in marginal urban areas still lack even basic water and sewer services. A recent IDB study estimated that in Mexico and Central America alone, governments will need to invest US$23 billion in the coming decade if they are to meet the United Nations Millennium Development Goal of halving the portion of their populations without water and sanitation services by the year 2015. In South America, tens of billions of additional dollars will need to be invested.  San Pedro Sula is Honduras’ second largest city and its industrial nerve center. Between 1999 and 2003, the number of homes with residential water service in San Pedro Sula increased from 84 percent to 93 percent, thanks to the installation of 13,600 new connections. The proportion of tap water receiving proper sanitary treatment rose from 22 percent to 80 percent. Water pressure and continuity increased throughout the system. These gains took place during a period when the city’s population grew at a daunting pace—from 444,200 to an estimated 526,000 people. Most notably, they were achieved without using a single lempira (Honduras’ currency) from the municipal budget. Instead, the necessary infrastructure improvements were paid by a private firm, Aguas de San Pedro, S.A. de C.V. (ASP), which holds a 30-year concession to provide the service.  At first everything went well but then the prices went up and water meters were installed in every home.


The news out of Cofradía, a low-income district near San Pedro Sula, was shocking. Residents claimed that water coming out of their taps was causing an epidemic of skin diseases and stomach problems.  Experts agree that Latin America’s governments do not have the financial resources necessary to adequately expand water and sanitation services in the future. There are simply too many other competing priorities. As a result, some kind of private participation in the water sector—either through concessions, privatizations, or operating agreements under public control—will be increasingly crucial for cities that want to improve water service.  Now entering the fourth year of a 30-year concession to operate and expand water and sanitation services that it awarded to a private consortium known as Aguas de San Pedro, the Honduran city of San Pedro Sula has learned some valuable lessons about the benefits and liabilities of this type of arrangement. Asked what they would do differently if they could start all over, here’s what some of the city’s water experts suggested.

  1. Create a strong, independent regulator. Both municipal officials and ASP executives lament that plans to create an effective regulatory body to oversee the concession were not properly carried out. This has made it difficult for both sides to resolve disputes over tariffs and other issues. However, a new law for the water and sanitation services that was promulgated last year has now created an independent national regulator for the sector. The concession contract provides for regulation by this new organization, once it is operating, and this should help to settle pending disagreements.
  2. Manage public perceptions proactively. Consumers are much less likely to protest changes if they understand why, when and how their water service will be affected or their water bill will increase. These types of questions can be addressed through effective public information campaigns. City officials and the water company must coordinate these campaigns in order to prevent finger-pointing over controversial decisions.
  3. Ensure land-use issues can be quickly resolved. In San Pedro Sula, municipal authorities vastly underestimated how long it would take for the city to purchase or exercise eminent domain on land that ASP needs for new wells, pumping stations and other infrastructure. As a result, the city has yet to deliver key properties to ASP, and the company is consequently unable to meet some of its obligations.
  4. Negotiate flexible implementation plans with community leaders. In low-income areas with a history of poor or nonexistent water service, it is best to broker customized implementation plans with pledges of support by local leaders. In San Pedro Sula, a lack of flexibility in deciding issues such as when water meters should be installed has ultimately complicated ASP’s work by inviting political interference.
  5. Use carrots instead of sticks. Consumers are much more likely to accept increases in their water bill if they see a noticeable improvement in service quality first. Water companies that start by sending out rate increases and only later try to solve service problems risk permanently alienating consumers.


1 World Water Day. 22 March 2006., www.worldwaterday2006.htm,

2 World Water Forum 16-22 March 2006 Mexico City. ,

3 UNICEF/WHO Water for Life, Making it Happen, 2005

4 Department of International Development, Water Action Plan, March 2004

5 UNESCO/ International Year of Fresh Water 2003

6 UNICEF/WHO Water for Life, Making it Happen, 2005

7 Constance, Paul. Thirsty Cities. Magazine of the Inter-American Development Bank. Thursday 23 March 2006

8 Constance, Paul. Glass Half Full: San Pedro Sula’s Water Service is Improving.   Magazine of the Inter-American Development Bank. Thursday 23 March 2006.

9 Constance, Paul. Don’t Drink the Water. Magainze of the Inter-American Development Bank. Thursday 23 March 2006

10 The Lessons of San Pedro Sula. Magazine of the Inter-American Development Bank.  Thursday 23 March 2006