22 MAR, 2013
Water and sanitation are two of the most fundamental factors in health yet we still don’t know how best to tackle these in Africa due to the lack of evidence-based research. Today on World Water Day, Samira Abd Elrahman introduces a collaboration aiming to put this right.
The African SNOWS (Scientists Networked for Outcomes from Water and Sanitation) Consortium takes its inspiration from Dr John Snow, who not only founded the science of epidemiology but was also the father of evidence-based interventions for environmental health. He famously halted an outbreak of cholera in 19th century in London, by removing a water pump’s handle to prevent its use, as he lacked the funds to provide something like a better water supply.
Ever since then, environmental health has lacked its fair share of resources, and environmental health practitioners have had to use all their creativity and innovation to achieve challenging goals, such as behaviour change, as cheaply as possible. Environmental health research has also suffered, particularly in Africa where resources are scarce. At the start of 2008, the International Year of Sanitation, nearly two-thirds of the population of sub-Saharan Africa are still without a toilet.
Diarrhoeal disease kills as many children globally as AIDS, malaria and TB combined. One third of these children are in Africa. For those who survive, repeated episodes of diarrhoea contribute to malnutrition, which in turn causes impaired cognitive performance, late entry to schooling and ultimately to the work force, which according to a recent study (World Bank 2008) robs a typical African country of some 8 per cent of its potential GDP. This loss of life, productivity and wellbeing is preventable, chiefly by improved water supply, sanitation and domestic hygiene.
Indeed, hygiene promotion is the most cost-effective of all interventions against the high-burden diseases of the developing world, yet, little research is conducted to determine how to implement such interventions to the best effect.
Vast amounts of resources are spent and key decisions (on policies and strategies) are taken by governments, aid agencies and NGOs, but most of them are not based on evidence from research. We still don’t know, for example, the extent to which diarrhoea in Africa is transmitted by food, or by drinking water. We still don’t know how best to get people to wash their hands with soap; the best toilet technologies to address the needs of male, female or disabled poor people; or when public latrines will be a health hazard or a benefit. We still also don’t know the best technologies to help protect our water sources, especially in rural areas; the most feasible appropriate technologies for water purification in areas where safe water is scarce; the best approaches to enhance healthy behaviours in water storage, transportation and utilisation; the best mechanisms to prevent water-related diseases linked to development projects (agricultural, industrial etc); or the extent of, and best mechanisms to prevent illness due to improper disposal of clinical waste. That such problems of hygiene, sanitation and environmental health have not yet been solved in the 21st century is a scandal.
This is where the SNOWS Consortium aims to make a difference. SNOWS aims to build a critical mass of sustainable local research and capacity across Africa, through strengthening African universities and research institutions in water supply, sanitation and environmental health. The issues of water, sanitation and hygiene promotion addresses and benefits from, knowledge and technology related to many disciplines: engineering, sociology, medicine, psychology, economics, toxicology and many others. So SNOWS encourages multidisciplinary teams, bringing together academic institutions with government policy and strategic planning. We build the capacity of African universities to conduct research on sanitation, water and hygiene, by training African trainers in research management, writing grant proposals and the supervision of graduate students, so that they can in turn train others. And we are organising the first SNOWS science conference in South Africa for young African researchers from the consortium to present their research and exchange ideas and experiences with other senior African and Northern researchers.
This is a just a small part of our activities. SNOWS has presented a model of research and collaboration for African universities, encouraging and supporting multidisciplinary research groups, linked with related government sectors and civil society and community. Our vision is to provide internally excellent Africa-based research that will enable all African children to realise their maximum potential through sustainable water supply, sanitation and hygiene delivery.
Samira H. Abd Elrahman
Samira H. Abd Elrahman is a Professor of Community Medicine, Faculty of Medicine and Dean of The Blue Nile National Institute for Communicable Diseases, University of Gezira, Sudan.
The SNOWS Consortium is supported by the Wellcome Trust.