By Anna Ortiz, MPH, International Program Director
I have frequently been asked, “what do you think is the single-most important public health issue of our day?” For a long time I struggled to answer that question without devolving into a moral argument about public health priorities. That was until I met Doña Susana. She is a feisty, 70-something matriarch who welcomed me into her home in San Isidro, Nicaragua during a hot summer morning in 2016. She opened her home to host a conversation with community members about their water needs. I wanted to know what was working and what wasn’t working with their current water system. You see, San Isidro is a very remote community in the northern part of Nicaragua and, up until a couple years ago, they did not have access to clean water. There was no such thing as a privately-owned or state-run water system. People relied on a nearby river for all their water needs- nearby being a 2 to 3 hour walk from the community.
Doña Susana was very vocal in a room full of otherwise introverted women. She spoke about how their lives had improved since the water system was built. How their children were healthier, their lives were more stable, and how some women were even able to find jobs outside the home because they no longer needed to take hours out of their day to fetch water. Eventually the rest of the women spoke up and agreed with Doña Susana’s comments. They shared stories of a time when they had to give up an entire day to do laundry because it required walking hours to the nearest river, washing everything by hand, and then walking back home with a load of wet clothes. Now, all they had to do was turn on the faucet outside their home and wash clothes in the comfort of their backyard. Another woman mentioned that having water in her home now allowed her to water her citrus trees and raise a pig, both of which were previously considered “luxuries” due to their limited access to water.
Listening to Doña Susana and her neighbors I learned something that, in retrospect, seems so simple. Access to clean water leads to not only improved health outcomes, such as reduced rates of water borne illness, but also has significant social impacts. By far, the result women spoke about most was the time they have saved that can now be spent with their children, completing other household chores or starting a small business selling baked goods. This is what impacted me most- the fact that the secondary effects of access to clean water were as important, if not more, than the primary purpose (to reduce water-borne illness).
Our partners spoke to Doña Susana recently and reported that her health continues to improve. She no longer gets that pesky annual cough and even her skin seemed clearer! Not to mention her young grandchildren have gained some healthy weight. Access to clean water is the basis on which our human right to health is built, and it has the power to transform the health profile of an entire community.