1,000 Days Partnership on Child Undernutrition
Maternal and child nutrition during the 1,000 days of pregnancy through age two shapes a child’s future.
A wide range of organizations including WaterAid have come together in the 1,000 Days partnership to support the shared purpose of improved maternal and child nutrition during the critical 1,000 day window of opportunity.
Beating under-nutrition means beating the underlying causes as well as the symptoms and this includes poor sanitation. 
Mariame Dem, WaterAid's Head of West Africa Region
How water and sanitation underpin nutrition
According
to the World Health Organisation, repeated diarrhea and nematode
infections - often caused by unsafe water and poor sanitation - are
associated with 50% of childhood malnutrition.
Repeated diarrheal episodes affect the body's ability to absorb food. But
once these diseases are reduced, this trend is reversed and there is a reduction
in malnutrition rates.
A new hypothesis1 suggests that
an even greater impact on child undernutrition is caused by a lack of
sanitation leading to the repeated ingestion of fecal bacteria by young
children.
Amin Uladi from Mozambique waters his plants every day.
Photo: WaterAid / Jon Spaull
Without an adequate water supply, there is often little to spare for crops,
vegetables or livestock. However, with water, and more time, communities can
enhance their kitchen gardens, arable fields and livestock farming activities.
Often communities will utilize the wastewater, run-off, or even their old
water sources to meet their farming needs.
Safe and hygienic latrines also impact upon crops. With a reduction in open
defecation more land can be made available for food production. Ecological
sanitation latrines enhance crops by enabling communities to create a renewable
source of fertile compost from their latrines.
Furthermore, with improved water sources many families report being able to
cook better food.
This can ultimately mean families have more food, better nutrition and, if
they are able to sell crops at market, more income. Following successful
projects, communities in Ethiopia have even reported being more resistant to
drought and famine as they are able to spend more time farming and planning for
their futures, rather than on the daily search for water.
According to Mariame Dem, WaterAid's Head of West Africa region: "Beating
under-nutrition means beating the underlying causes as well as the symptoms and
this includes poor sanitation. It rarely makes the headlines but poor
sanitation and dirty water kills thousands of children each day and is crippling
the health of billions in developing countries."
1Humphrey (2009), “Child undernutrition, tropical enteropathy, toilets, and handwashing”, Lancet, 374: 1032-35
Zambia
Water-related diseases strike repeatedly
Mother of three Mutinta Chiila from Namavwa, Zambia, tries her best to keep her children healthy and well-fed. But her efforts are constantly undermined by her community's lack of safe water and sanitation.
Even the simplest of snacks carries the risk of contracting a deadly diarrheal disease. Like most Zambian children, Mutinta's son Mike (six), and daughters Ivy (five) and Yvonne (23 months) love drinking 'zigolo' (or 'zig' for short), a simple mix of water and a spoonful of sugar. They drink it before eating boiled maize for lunch. But it's made with unboiled water from an unsafe source, and consequently her children are often ill, especially Yvonne. Mutinta told us:
"At the moment Yvonne has diarrhea. She has had it now for five days. I cook maize porridge for her which she is able to eat. Yvonne can’t talk but I can see that she is in pain because of the way that she throws herself around. She is crying a lot.
"She keeps getting diarrhea every week. She gets better and then after a few days she gets bad again.
"There is no way that I can settle down when my child is so sick. I am so worried I feel sick myself.
"Ivy is also often down with diarrhea. But she doesn’t get it as often as Yvonne. This month we haven’t been to the clinic, but most of the time we have to take Yvonne every week. We take her by bicycle, I strap her to my back. It is a long way to the clinic, at least an hour’s cycling.
"They gave her tablets and oral rehydration salts, and then some liquid which I don’t know what it is.
"Every time a child is sick we take it to the clinic, that’s what we do. But she is so sick, I don’t know whether Yvonne will ever get better.
"I think that the sickness is caused by the water. During the rainy season the water runs into the wells and makes them dirty, I think that this is what causes the sickness. The water is not clean because they are open wells, whatever blows by the wind blows into the well. We have no latrine here, we go to the bush.
"Clean water here in the village would be much better."
Photo: WaterAid / Anna Kari