MEXICO CITY, Nov 16 (IPS) - In Latin America and the Caribbean, one-third of childhood deaths are the result of diarrhoea. The problem could be resolved with clean water and appropriate sanitation systems, but millions of people, especially the indigenous and Afro-descendant populations, lack access to either.
Statistics for the region show that coverage of water and sanitation services is among the best in the world. But the figures can be misleading.
Although 91 percent of the region's population does have access to potable water, there are still 50 million people who don't, and 34 million live in rural areas. As for sanitation, coverage reaches 77 percent, but 103 million people lack access to that service.
Those shortfalls are behind the majority of diarrhoea-based illnesses, which today are the second leading cause of infant mortality in Latin America and the Caribbean, after respiratory infections.
Worldwide, 1.8 million children die each year from diarrhoea, which proves more deadly than tuberculosis, malaria or HIV/AIDS.
"For the children who don't have water and sanitation, the future is poverty and illness, and will probably follow them the rest of their lives," Liliana Carvajal, one of the authors of the 2006 Human Development Report, presented Nov. 9 by the United Nations Development Programme (UNDP), told Tierramérica.
The report states that "clean water and sanitation are among the most powerful preventative measures for child mortality." And that investment in this area "is to killer diseases like diarrhoea what immunisation is to measles -- a lifesaver."
Halving the proportion of people without access to potable water and basic sanitation is one of the eight Millennium Development Goals (MDGs) set by the United Nations, with the deadline of 2015.
Latin America and the Caribbean are well on their way to meeting that goal. But it will only be in terms of averages, because millions of people will still lack access to those services.
"We can't be shouting victory, because there are specific cases that are very complicated," said Carvajal.
"It is no longer ethically or politically acceptable to use averages as indicators of the level of compliance with the MDGs, because they hide very difficult realities," says Nils Katsberg, Latin America and Caribbean director of the United Nations Children's Fund (UNICEF).
The fact is that the people who live in rural areas and are indigenous or of African descent -- in other words, some 200 million of the approximately 523 million people in the region -- face serious obstacles in achieving the levels of development set by the MDGs, Katsberg told Tierramérica.
"There is still much to be done, especially with the children," he added.
One-third of Latin America's rural residents do not have safe sources of drinking water, and more than half do not have adequate sanitation facilities, according to UNDP studies.
In Bolivia, 95 percent of the urban population utilise potable water sources, but in the countryside the proportion is just 68 percent. As for sanitation services, access is 58 percent for the urban dwellers and 23 percent for rural residents, according to the agency's figures.
Only 54 percent of Bolivian children under age five who suffer diarrhoea receive oral rehydration treatment. In neighbouring Brazil, where there is greater coverage of both sanitation services (75 percent) and potable water services (90 percent), such treatment reaches just 28 percent of young children with diarrhoea.
In Guatemala, where 95 percent of the population has access to sources of clean or treated water, just 22 percent of children with diarrhoea receive rehydration treatment.
The reverse is true in Haiti. There, only 54 percent of the population has access to potable water and just 30 percent have sanitation services, but 41 percent of children under five with diarrhoea receive treatment.
"A child born without access to water and sanitation is going to have constant cases of diarrhoea, which will affect the immune system. The child will have anemia, which will affect schooling, and the child will learn less," said development expert Carvajal.
"It is a cycle of poverty that will follow the child for the rest of her life," she added.
The Human Development Report, which the UNDP has published annually since 1990, emphasises that investment in water and sanitation would save millions of lives, but also stresses that improved services would be of great economic benefit.
Universal access to potable water and sanitation services would reduce the financial burden of the health systems in developing countries by an estimated 1.6 billion dollars annually.
In countries like Nicaragua, clean water would cut diarrhoea cases by more than 20 percent; in Peru 15 percent; and in Guatemala nearly 40 percent, according to UNDP.
Latin America and the Caribbean "must make a much greater effort in everything related to water and sanitation in the rural sectors, and put a stop to discrimination against indigenous and Afro-descendant communities in access to those services," said UNICEF's Katsberg.
(*Originally published Nov. 11 by Latin American newspapers that are part of the Tierramérica network. Tierramérica is a specialised news service produced by IPS with the backing of the United Nations Development Programme and the United Nations Environment Programme.)