An Appreciation for Abundant Clean Water
19 Apr 2025
Everyday, dozens of times, we enjoy ready and easy access to an abundance of clean water. But this is not the case for an astounding number of people around the world. An astounding 2 billion people, a quarter of the global population, lack access to safe drinking water. What’s more, nearly half of the people on the planet (46% according to the U.N. World Water Development Report 2023) do not have access to safely managed sanitation. Think about that the next time you brush your teeth or flush the toilet.
A couple weeks ago we wrote about the largely positive changes to health we have seen over many decades in Japan. This week let’s talk about Africa, where the story is far less rosy. We have both spent time in Africa, including South Africa during Apartheid. In recent years, our focus has been East Africa and work to build capacity in medicine, nursing and health sciences. During a visit last week to Kenya, Tanzania and Uganda, the water problem was evident.
There have been years when, due to a lack of rainfall, everyone suffers. The consequence was not hard to see: dead cattle at the roadside and parched earth without a blade of grass where these animals should have been grazing.
When the rains do come, it’s torrential, washing down hillsides devoid of trees, draining away the topsoil and any remaining seeds, and creating huge trenches and gullies that make the land unsuitable for animals or agriculture.
Poor water quality even in places where there is decent infrastructure is another problem. You may be aware that fluoride is often added to public water systems in North America to prevent tooth decay. But in East Africa, natural fluoride levels in water are extremely high, far exceeding the 0.5 to 1.0 mg per liter limit set by the World Health Organization. This turns teeth brown and poses problems for bones.
The human population is ballooning in East Africa. Take Uganda. In the 1960s, it was a country of less than 10 million. Today, it is 51 million. By 2050, it will exceed 100 million. To Dr. Ssali, Deputy Executive Director of the Joint Clinical Research Centre, a top-tier disease treatment facility in Kampala, a question about the population was posed, “Are you excited about the economic opportunities or worried about the burden of disease?” The initial response was, “Both.”
But we would advise a harder line. “Prevention. Prevention. Prevention.” East Africa has not turned on its economic engine despite decades of effort. Yet the region has proven time and again that it is susceptible to disease.
The HIV/AIDS epidemic was its most crushing case. While HIV is now treated effectively, the latest problem is an aging cohort of people on anti-retroviral drug treatment who are over the age of 50 and now must also manage non-communicable diseases (NCDs) like diabetes, heart disease, and kidney disease. Hypertension currently affects one in four Ugandans, but only 8% are aware of the problem. NCDs are very expensive healthcare challenges for countries still struggling to provide the basics like clean water. There’s a trainwreck coming.
Lest we forget, there remain appalling issues with the provision of safe and accessible clean water here at home. It’s a national shame that some indigenous communities in Canada must boil their water for drinking and cooking. And many industries throughout North America are guilty of water misuse and contamination, some criminally so.
Will all the prayers in the world make a difference? Not a chance. Enjoy your next glass of water with contemplation and appreciation.
