Dying For Clean Water

As many as one-fifth of the world’s people lack safe water – and 6,000 children are dying every day as a result. But developed nations and companies with know-how are doing less to help.

CANDELARIA, Honduras – Struggling for the water her family needs to
live, Maria Garcia hikes five times a day from her dirt-floor shack
to a creek. The creek – cloudy from pesticides and from villagers
bathing and washing clothes – isn’t safe. Her first son, Roni, died
of hepatitis at age 3 – one of an estimated 2 million children a
year worldwide who die from diseases linked to bad water. Now her
second son, 1-year-old Jose, “is always with diarrhea, always
coughing.” Still, Garcia, 23 years old and seven months’ pregnant,
has no choice. This is the only water she can get.

She scoops the creek water into her red jug. She hoists this
40-pound load onto her back and, stretching rattan cords across her
forehead to support it, claws her way up a slippery clay slope on
the quarter-mile haul home.

“It’s hard to do without falling,” she says. “I’m going to have
to do more trips. I’m going to need the water.”

Today, nobody is moving to help Garcia and the growing numbers of
people – an estimated 1.1 billion, nearly a fifth of humanity – who
lack safe water. Twice that many lack basic sanitation.

The death toll from bad water mounts. United Nations officials say
it tops 6,000 children a day – mostly in low-income Africa, Asia
and Latin America.

Children are especially vulnerable to waterborne diseases that can
lead to fatal dehydration. Most common is diarrhea – easily
preventable in developed nations such as the United States.

But elsewhere, solutions are constrained by spreading poverty and
increasingly limited water resources.

Water shortages and deficient sanitation now are starting to
aggravate conflicts, leading to political turmoil. Three years ago
in Bolivia, slum dwellers rioted when the government tried to
install a water system that required them to pay fees they found
intolerable. International bankers would only back a for-pay

And last month, Bolivian peasants and slum dwellers, riled about
their government’s free-market policies in general, marched on
Bolivia’s capital, hurling dynamite. They forced President Gonzalo
Sanchez de Lozada to resign.

“We could have water wars – not riots, I mean wars – between
countries over control of river systems,” said Andrew Natsios,
chief of the U.S. Agency for International Development (USAID), the
nation’s main humanitarian agency. “We are very worried about

  World aid agencies doing less

In Iraq this year, a sudden collapse of water-supply networks
enraged Iraqis as U.S. troops, who had bottled water, occupied
their communities. In India, a dispute over water allocations has
led to interstate rioting. In China, an estimated 100 million
peasants unable to irrigate crops converge on ill-equipped cities.
In the Middle East, a behind-the-scenes struggle for water strains
efforts to broker Israeli-Palestinian peace.

Water shortages also are expected to spur migration from water-poor
regions to Europe and the United States, where jobs and water are

Many experts believe that a concerted effort to address global
water supply and sanitation should be a priority for the United
States and other wealthy countries. U.S. government studies have
found that installing a basic water system in a village can cut
infant mortality by up to 50 percent.

Yet the governments and corporations that could help instead are
withdrawing from the challenge instead.

Government water aid from 21 of the richest countries to poor
countries decreased by 18 percent between 1997 and 2001, according
to data compiled by the Organization of Economic Cooperation and
Development, an international group based in Paris.

The U.S. government – focusing on military priorities this year –
budgeted only $162 million for water-supply and sanitation help

USAID’s Natsios said this will change. The United States will
follow through on a presidential “Water For the Poor” initiative
to spend $970 million over three years “to deal with these
issues,” he said. That money – a third of it approved so far by
Congress – falls far short of the tens of billions U.N. leaders say
are needed.

The other key players in addressing water shortages and poor
sanitation are corporations that can design and install efficient
systems. They, too, are doing less. Private-sector spending on
water supply and sanitation decreased by 82 percent between 1997
and 2002, from $8.3 billion to $1.5 billion, according to data from
the World Bank, the main international financing agency.

Engineering, construction and utility firms aren’t motivated. As
the poor world gets poorer, the potential for profit diminishes.
Companies no longer bid on requests to install water systems even
in megacities – let alone in the villages where more than half the
world’s poor reside, said Don Evans, chief of water operations for
Denver-based CH2M Hill – one U.S. firm in a water industry
dominated by Europe- based conglomerates.

“The poor residents of these countries have no access to water.
They have incredible sanitation issues with huge health impacts,”
Evans said. “It’s a tragedy to these countries that nothing is
going to happen.”

‘It’s very hard to lose a son’

In Honduras, population 6.6 million, one of the poorest countries
in the world, water problems are chronically as severe as anywhere
in the Western Hemisphere. The struggle for clean water is constant
in villages such as Candelaria in the central highlands.

Here, amid screeching roosters and the hum of insects, Maria Garcia
enters her shack and unloads her sloshing jugs beneath rafters
where she stores maize, in the tradition of Lenca Indians,
descendants of the Mayans who once thrived across Central America.
A small fire smokes in the corner.

The only way to make the water safe – Garcia has heard from
visiting Cuban health workers – is to boil it.

But boiling water requires wood. The nearest forest lies 3 miles
away in the mountains – meaning a major chore for Reyes Gomez, 24,
her husband.

“We can’t get that much wood,” Garcia says. At the same time, she
believes that Roni died, and Jose is sick, because “we drink the
water without boiling it.”

The family tried to get help for Roni. Gomez carried the boy 13
miles down the muddy road to La Esperanza – the nearest city.
Doctors took blood and urine samples and sent Gomez and his son to
a regional hospital 60 miles across mountains in Comayagua.

There, nurses sent them back to La Esperanza. Gomez turned to a
private specialist who suggested a test for $147. Gomez sold the
family’s bull for $264 to pay for the test. The specialist
concluded Roni’s hepatitis was chronic. There was nothing to do.
Gomez carried his son home. Six nights later, on Dec. 28, as
parents and grandparents cradled him, Roni died.

“It’s very hard to lose a son,” Gomez said. “You want to kill

Doctors face similar cases every day.

More people worldwide enter hospitals with waterborne diseases than
with any other type of ailment, said Mark Brown, chief of the
United Nations Development Program. Lack of safe water ranks among
the leading causes of death. An estimated 2 million children a year
are victims of water-related diarrhea, U.N. spokesman Farhan Haq
said. Typically, the diarrhea comes from swallowing fecal

In a dimly lit emergency ward along the northern coast of Honduras,
Dr. Marta Benitez said 40 percent of her patients are children sick
from foul water. It’s a bigger killer than the mosquito-borne
malaria and hemorrhagic dengue fever that also haunt Central

During a recent night shift, Benitez and two nurses handled five
critical cases. One dehydrated boy, Daniel Ramos, 3, lay on a
gurney, eyes rolling as he drifted in and out of consciousness,
loops of white tape holding an intravenous tube on his tiny right

“He’s always sick with diarrhea,” said his mother, Esperanza
Hernandez, 27. He’d been crying that his stomach hurt, and in the
middle of the night his family hustled down a rocky trail from
their village in foggy forests above banana plantations. “I was
worried he would pass out on the way to the hospital,” Hernandez

The family drinks stream water. “We don’t boil the water,” said
Dolores Ramos, the boy’s grandmother, “because we don’t like the
taste of boiled water.”

Benitez told the parents to just wait. “With IV, I think he’ll
respond.” As they hung their heads, she added: “We could prevent

Polluted water hurts people in countless ways. Typhoid and cholera
flare regularly. Waterborne parasites cause onchocerciasis –
“river blindness.” Other parasites contribute to malnutrition.

And everywhere, girls give their lives to the chore of hauling
water for their families.

Miriam Garcia, 13, and her friends recently balanced 20-pound water
buckets on their heads along the Guaymitas River on the outskirts
of El Progresso, an industrial boomtown in northern Honduras. They
had to quit school after third grade.

“My mother doesn’t come to get water because her hip hurts, so I
am the only one who comes,” Garcia said.

The girls bathe, wash clothes and play in the river – within a mile
of family shanties. Diarrhea and headaches are the norm.

Doctors at public clinics “only pay attention to those who have
money,” Garcia said. “We all have parasites in our stomachs.”

Population growth erases gains

For three decades, leaders of rich countries have vowed to help the
world’s water have-nots.

The United Nations, which declared the 1980s “The Decade of
Water,” again has put water at the top of its global agenda. After
last year’s U.N. World Summit on Sustainable Development in
Johannesburg, South Africa, U.N. leaders set a goal to halve the
proportion of people without access to safe drinking water and
sanitation by 2015.

Yet “the water situation worldwide is distressing and not
improving noticeably,” said Jack Hoffbuhr, president of the
Denver-based American Water Works Association, a leading group of
water professionals.

Part of the challenge is that deaths caused by contaminated water –
unlike deaths from earthquakes or hurricanes – are “a persistent,
growing problem,” said John Halpern, senior water supply and
sanitation adviser for the World Bank. Politically, it’s hard to
get governments to focus on such problems because they don’t seem
as urgent even if the consequences are huge, Halpern said.

And gains have been nullified by population growth in the most
severely afflicted countries across Asia, Africa and Latin

Finally, lenders who could supply the billions needed for urban
water systems turn away because governments in poor countries often
can’t or won’t pay bills.

Meanwhile, villages like Candelaria – population 1,500 – are so
scattered that only small-scale solutions are feasible. Grassroots
nonprofit aid groups are the best hope for villagers, Halpern

“The rich world needs to be involved. In pure economic terms,
growth in these countries is what’s going to help grow the world
economy. The industrialized countries including the United States
need somebody to sell goods and services to. Most of the population
lives in the developing world and will live increasingly in the
developing world.”

A debate among water experts also stalls action.

The issue is whether corporations should control water. In the
mid-1990s, corporations backed by the World Bank began installing
and operating water systems in needy countries – for profit, with
the view that charging for water is essential to allocate it
efficiently. People in rich countries generally pay for their
water, though rates often are lower than in poor countries where
water is scarce. Critics argue that water essential for life
shouldn’t be privately controlled.

“There has to be strong government oversight and protection of the
public good,” said Peter Gleick, president of the Pacific
Institute, a water policy research center.

While the debate rages, children die. Anger grows.

“The U.S. response, in particular, has been inadequate. Our
contribution to water projects internationally is pathetically low.
It’s a tiny fraction of the aid we give, which itself is a tiny
fraction of what’s needed,” Gleick said.

“If this problem got the attention it deserves, we could eliminate
deaths from water-related diseases. But we seem to do better at
dealing with short-term crises. It’s more upsetting to us when a
plane crashes than when 6,000 kids died yesterday, and today, and
will die again tomorrow from preventable water-related diseases.”

For a few years, Honduras stood out among water-poor countries
because it did get some serious attention in 1998 following
Hurricane Mitch. The death and destruction – concentrated in the
north where U.S. corporations Chiquita and Dole for decades have
run banana plantations – drew more than $1 billion in emergency
aid. The United States gave more than $145 million.

Hurricane aid helped town

The aid paid for CH2M Hill, the Denver-based engineering firm, to
install $3 million worth of water supply and sanitation systems,
mostly in northern cities near the plantations and new factories.

Now in La Lima, population 70,000, healthy children play soccer
beneath red tanks that supply purified water.

The water immediately improved lives of thousands who lacked access
before, said caretaker Gilberto Nunez, 40, a father of two, who was
watering Llama del Bosque trees recently at the base of one tank.

“We don’t have the shortages we had before. People are really
satisfied,” Nunez said. “Before, they had to walk far and carry
their water. We were always working to get water.”

CH2M Hill sent engineer Leda Amador, who grew up in Honduras, to
coordinate work at the local level – including the delicate matter
of convincing low-income residents to pay for treated water piped
to their homes.

Incomes here, as across much of the world, are generally less than
$500 a year. And newcomers flocking from rural areas for factory
work often bristle at the notion of paying for water. Sometimes
they refuse.

“The question is whether the poor can pay,” Amador said. “I
think they can. If you figure what their other options are – what
they pay to buy water from private water trucks or to buy water in
bottles – it’s more than what they would pay for (municipal) water

Amador teamed with leaders of neighborhood “patronata” self-help
associations to explain plans. City officials backed her up,
cutting off service when people didn’t pay. Rates were set on a
sliding scale to help the poor. A typical family pays $7 a month.

But now Honduras’ hurricane money has run out. CH2M Hill is closing
its office. And, as in other poor countries, hundreds of thousands
of Hondurans – the population is growing by 3.2 percent a year –
still lack access to safe water.

The United States “must continue helping, because in poor
countries, we don’t have the capability to build up our water
systems because it’s too expensive,” said Mayor Nelly Soliman of
El Progresso, population 200,000. “Always, the policy has been,
the richer countries should help the poorer countries. This is a
severe problem for us.”

U.S. officials say the most children die in rural areas, where 36
percent of Hondurans lack water. “I’d like to put more in. It is
needed,” said Paul Tuebner, USAID’s director in Honduras.

“Have you ever hauled water daily for 2 miles on your head up and
down mountains? … We have studies that show, once we put in a water
system, infant mortality goes down.”

The anger that has led to riots over water has erupted here, too.
Last March, 1,500 protesters riled about water targeted roads in a
northern industrial area where they knew they might get attention.
They blocked traffic around new “maquila” factories where, for
about $50 a month, workers make Fruit of the Loom, Wrangler, Tommy
Hilfiger and other garments for U.S. consumers.But Honduras’ rural
poor traditionally are peaceful. And in Candelaria, villagers
preferred a practical approach.

They’ve designed a water system that would pipe water from a spring
to spigots at family compounds.

A few years ago, they bought pipes and laid them, with dozens of
men contributing free labor. But the pipes burst. Local engineers
had failed to allow for pressure changes as water whooshed up and
down hills. Now, with help from different engineers, village
leaders have modified their plan and are looking for a better kind
of pipe.

Some villagers are hopeful. Maria Garcia and Reyes Gomez are
impatient after their son’s death.

Gomez now plans to emigrate to the United States. Friends who have
managed to sneak into the country send home money that lets their
families live comfortably in La Esperanza.

Working abroad “would be harder. This is my father’s land. I
learned to grow crops from my father. This is the natural way for
me to earn my living,” Gomez said. But potato and banana crops
don’t pay. His wife, Maria, is too busy hauling water to work in a
sewing cooperative.

So Gomez talks of borrowing $1,300 to hire a smuggler to guide him
north. There are alligators in the river along the U.S.-Mexico
border, he said. “That’s what I’m scared of, and maybe somebody
will kill me.”

If he gets through, his first earnings will pay off his lender, he
said. “Then I could help my family.”


American Water Works Association (Based in Denver):

….www.awwa.org; 303-734-3410

….www.water4people.org; 303-734-3476; ….303-734-3494

World Vision, aid contacts in La Esperanza, Honduras:




Pacific Institute, an Oakland, Calif.- based water research center
that publishes the biennial survey “The World’s Water”:

USAID, a government humanitarian agency: www.usaid.gov

World Bank, an international finance organization:


Population: 6,669,789

Median age: 18.8 years

Population growth rate: 3.2 percent

Infant mortality rate: 29.96 deaths per 1,000 live births

Life expectancy at birth: 66.65 years

Fertility rate: 4.07 children born per woman (2003 estimate)

Literacy rate: 76.2 percent (those 15 and over who can read and

Population below poverty line: 53 percent (1993 estimate)

Unemployment rate: 28 percent (2002 estimate)

Sources: Denver Post research,

CIA Factbook