Interventions toward Water, Sanitation, and Hygiene in Overcoming Neglected Tropical Diseases

Neglected tropical diseases (NTDs) are a group of diseases commonly observed in developing countries affecting a majority of poor populations. There are 17 types of NTDs listed by WHO, of which are caused by lots of parasitic pathogens. NTDs significantly decrease the quality of life of the sufferers. Those diseases cause disabilities and have a negative impact on productivity and economical conditions. Furthermore, NTDs threaten the lives of millions of people worldwide, although not as enormous as those caused by HIV/AIDS, tuberculosis, or malaria. Indonesia is among those with the most cases of NTDs in the global population. Five of which are endemic in Indonesia include lymphatic filariasis (LF), leprosy, schistosomiasis, soil-transmitted helminthiasis (STH), and yaws. The United Nations (UN) showed that approximately 780 million people lack access to clean water source, and almost half of the global populations lack access to good sanitation; whereas several NTDs are very closely associated with unsafe water, bad sanitation, and poor hygiene. Examples include STH, which is transmitted through contaminated food or water, or directly by dirty hands; and trachoma, which is transmitted by direct contact or flies. Therefore, an intervention toward water, sanitation, and hygiene aspects is hugely needed. A public health institute in the United States, the Centers for Disease Control and Prevention (CDC) has actually proposed a solution called WASH Away NTDs. This project aimed to literally wash away NTDs all over the world by intervening on WASH (water, sanitation, and hygiene) aspects. Although pharmacological treatments have been found to be effective in combating NTDs, improvements in WASH-related problems could be integrated for long-term control of the diseases. Water condition is one of the most important factors in developing many NTDs. Stagnant water areas are known to be the breeding sites for insects causing the diseases. Other water areas such as contaminated lake, pool, and the like can also spread NTDs, let alone when people swim, bathe, or drink from these sources. Therefore, attention should be given in provision of safe water particularly for drinking. Sanitation can be another risk factor for NTDs. This aspect refers to the environmental health condition; eating unwashed food, doing activities barefoot outside, and open defecation system have all been linked to catching some of those diseases. Hygiene, on the other hand, refers to the individual practices of health being such as hand-washing before ingesting foods. Interventions toward those three aspects of WASH are known to prevent and control NTDs in the world. Improved WASH has been proven to reduce the cases of NTDs worldwide. An experimental study conducted by AKM Masud Rana (2009) in rural areas of Bangladesh found that the overall prevalence of waterborne diseases decreased after WASH improvements. Besides, CDC stated that improved clean water source and basic sanitation result in 29% reduction in Ascariasis (one of the STH), 78% reduction in guinea-worm disease (GWD), 27% reduction in trachoma, and 77% reduction of schistosomiasis. As a medical student, I could take a role to overcome NTDs together with the government and many organizations involved in this field. First of all, I could study and read many sources regarding NTDs and share all the knowledge to the surroundings by writing or conducting researches. In addition, being involved in many public health activities could be another great idea to spread awareness about NTDs. The activities could comprise many projects to promote hygiene-related behaviors of the societies, conferences talking about the best and most cost-effective ways in managing NTDs, and many more. By doing all this stuff, I may help combat and overcome NTDs, although in a very small portion compared to what have been done by the government or many organizations. Nonetheless, small things could result in a huge difference after all.

References1. Rana AM. Effect of water, sanitation and hygiene Intervention in reducing self-reported waterborne diseases in rural Bangladesh. Bangaldesh: BRAC. 2009.2. Daumerie D, Savioli L, Crompton DDWT, Peters P. Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases: World Health Organization; 2010.3. Freeman MC, Ogden S, Jacobson J, Abbott D, Addiss DG, Amnie AG, et al. Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration. PLoS neglected tropical diseases. 2013;7(9):e2439.