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Great Lakes Article:

Lack of Clean Water Linked with Stunted Growth
By Alison McCook
Reuters
01/09/04

NEW YORK - Poor access to clean water and good sanitation is associated with poor growth in children, researchers said Friday.

Among children living in a poor community in Peru, those who had the poorest access to clean water and sanitation were 1 centimeter shorter and had 54 percent more episodes of diarrhea than children who grew up in the cleanest conditions.

In an interview, study author Dr. William Checkley of Johns Hopkins University in Maryland said that the conditions that cause early childhood stunting may have long-term effects on children's lives.

Specifically, he said that previous research has shown that kids with stunted growth in early childhood often do not reach normal height, and tend to score worse in tests of overall intelligence years later.

Consequently, early childhood hygiene could have effects on the brain power of the future adult population, and the productivity of the nations in which they reside, Checkley told Reuters Health.

Providing the world's population with access to clean water and good sanitation remains "a huge public health challenge, and will remain so unless governments make it a top priority," he said.

As an initial step in this process, both developing nations and the developed countries that can assist them need to realize that "access to safe water and sanitation is not a privilege, but a basic human right," Checkley stated.

During the study, Checkley and his colleagues followed 230 children, who lived in a community in Lima, from birth to age 35 months. The researchers noted the quality of their water and sanitation, height and frequency of diarrhea.

The families included in the study obtained their water from indoor taps, a cistern truck or community standpipe, or bought it from a neighbor. Water was stored in containers ranging from small pots and pans to large covered cement cisterns.

Although water stored in small containers is recycled more often than water stored in larger vessels, small pots are usually kept indoors and uncovered, making them more at risk of contamination than are large containers, which are generally kept outside and covered.

Children living in houses with the worst access to clean water and sanitation, which included houses that lacked indoor taps and plumbing, and stored water in small containers, were shorter and had more episodes of diarrhea by age 24 months than children raised in the cleanest conditions.

Simply improving water quality did not change children's height; children raised in households with an indoor water source but no sewage or large storage containers remained significantly shorter than others.

Checkley explained that stunting is a sign of malnutrition, which may result if drinking unclean water transmits diseases that use up the body's resources that are normally used for brain and body development.

He added that the solution may also involve educating people about safe practices, such as opting for larger water storage containers that are kept outside.

In an accompanying editorial, Drs. Richard L. Guerrant and Rebecca Dillingham of the University of Virginia in Charlottesville noted that 2.9 billion people currently live without adequate access to clean water, and another 4.2 billion have no sanitation.

Given the scope of the problem, "we must not delay investing in measures known to alleviate the devastating long-term societal costs of inadequate water, poor sanitation, and early childhood diarrhea," they write.

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