Water shortages threaten the food security and incomes of rural farmers. In Chad, access to basic drinking water services is 43% and sanitation 10% (Joint Monitoring Program, 2017). Less than one in two children has access to drinking water, while only one in ten has access to improved sanitation facilities. In Cameroon, the low availability of drinking water led to an epidemic in 2022 where 3,563 people were affected by a major cholera epidemic in the South West and Littoral regions, including 783 children (48% girls), with 71 deaths reported. The South West region is shown on the map above as having 3,563 reported cholera cases, including 1,628 cases between March 21 and April 3.
Access to clean water, sanitation, and sustainable water resource management is necessary for boosting productivity and unlocking economic growth. They also significantly leverage current investments in health and education. In addition to supporting investments in physical infrastructure and institutional and regulatory arrangements for water access, use, and disaster preparedness, the natural environment, such as forests, soils, and wetlands, contributes to the management and regulation of water availability and quality. This strengthens the resilience of watersheds. While improving water management makes national economies, and the agriculture and food sectors more resilient to rainfall variability and able to meet the needs of a growing population, water shortages threaten food security and the incomes of rural farmers. Water purification and water quality standards can be ensured by preserving and restoring ecosystems related to water and their biodiversity.
Goal 6 of the Sustainable Development Agenda addresses the quality and sustainability of water resources, which are essential to human and environmental survival, and drinking water, sanitation, and hygiene.
SDG Goal 6 infographic @ UN
In Chad, access to basic drinking water services is at 43% and sanitation is at 10 per cent (Joint Monitoring Programme, 2017). Less than one in two children has access to safe drinking water, while only one in ten has access to improved sanitation and one in 17 children wash their hands with soap and water. The open defecation rate in Chad is 68%, at the national level.
Lack of access to adequate water, sanitation and hygiene services causes frequent diarrhoeal diseases and malabsorption phenomena, contributing to malnutrition, especially chronic malnutrition, in young children. In July 2017, the Government adopted the National Strategy for Sanitation in Chad (NSS), which defines its commitment to achieving the SDGs.
This strategy was completed in 2018 with the adoption of the roadmap for a Chad free from open defecation by 2030. To reach SDG 6.2.1, one million Chadians must cease this practice every year, between now and 2030. The national roadmap targets 9.5 million Chadians and will cost $160 million. By 2022 the progress of this SDG has seen mixed results. The COVID-19 pandemic and measles outbreaks are putting a lot of strain on the already vulnerable health system, which is also still susceptible to cholera and chikungunya epidemics. The need for water, sanitation and hygiene (WASH) is growing in Chad as a result of climate change15. The highest mortality rate in the world attributable to unsafe WASH is 101/100,000 in Chad. 16 Low rainfall in some areas in 2022 may have an impact on food and nutrition security. In 2021, increased rainfall in some areas reached five-year highs, resulting in floods that affected over 200, 000 people.
Children walking past hygiene information. Photo:Unicef Chad/2019/Frank Dejongh
Chad made significant strides toward creating a setting that is more favorable for community-led total sanitation (CLTS). Eight priority provinces that specifically targeted 3,000 000 people in 6 000 villages were chosen for the first phase (2018–2021). The lack of a unified strategy made progress difficult. Consequently, a district-wide strategy is now used. Demand generation and an intersecting strategy with nutrition and education are both used with CLTS. UNICEF is assisting the Directorate of Sanitation in developing a monitoring system that will provide data to aid in decision-making. By 2021, UNICEF planned to directly assist 1,400,000 more people, but the pandemic seriously hampered this plan. Efforts for recovery are underway but tellingly slow, with the political uncertainty in the country hampering collaboration and effective aid.
While the situation is not as severe on a large scale in Cameroon, there are also worries. The low rate of clean water availability has led to a disease outbreak in 2022 where 3,563 people were affected by a significant cholera outbreak in the South-West and Littoral regions, including 783 children (48% girls), with 71 deaths reported. The South-West region is shown on the map above as having 3,563 reported cases of cholera, including 1,628 cases between March 21 and April 3. This outbreak, which is seasonal, is brought on by inadequate water management systems, open defecation habits, and understaffed and underequipped healthcare facilities. A cholera vaccination campaign was started on April 8 even though cases have stabilized (for instance, in Limbe, where there were 400 reported cases from April 4–10 compared to 1,628 reported cases between March 21–April 3). The cholera outbreak remains critical with 26 districts across five regions (Littoral, South, South-West, Center, and North) being affected. As of 3 April, 33 districts had notified cholera cases out of which 27 still had active notified cases. The South-West region has had the highest number of reported cases (3,558 notified cases) and 71 deaths recorded, a 2.0 per cent case fatality rate. Of the total number of reported cases, 37 per cent were considered severe. Children under five represented 11 per cent of cases.
Picture from a Cholera relief centre in Cameroon. Photo: aa.com.tr
One of the first organizations to assist the Regional Delegation of Public Health (RDPH) in the management of cholera cases was UNICEF. An estimated 6,000 people will benefit from the tents, emergency health kits, and acute watery diarrhoea (AWD) kits that have been distributed. In Buea, Limbe, and Tiko, UNICEF is assisting a cholera vaccination campaign that began on April 8 by providing community sensitization, 1,000 cartons of water purification tablets (Aqua tabs), each containing 10,000 tablets, and 600 cartons of soap that are distributed directly to households. Thanks to UNICEF’s assistance, the RDPH South-West has had a sizable supply of necessary medications available since the start of the response to treat patients at no cost in the community-based therapeutic care (CTC) centres of Limbe and Tiko. Due to the ongoing risk of a cholera outbreak at the start of the rainy season, having a contingency stock is crucial.
The WHO has also sent teams of experts to assist with the response and is giving the government technical, logistical, and financial support. Aside from that;
- To assist district teams, the national incident management system holds regular coordination meetings with partners at the central and regional levels.
- The Ministry of Health created a response plan that includes response partners.
- To help with the response, cholera kits have been distributed.
- Meetings for advocacy are still held with regional and global partners.
- To assist with the response efforts and carry out investigations, response teams were sent to the main outbreak sites.
- In four health districts in the South-West region, the first round of an oral cholera vaccine (OCV) campaign was conducted from February 18 to February 23. With 85.5% administrative coverage, 204 800 people were the target of this campaign. From April 8 to April 12, 2022, the vaccination campaign was expanded to 11 additional districts in the Littoral, South, and South-West Regions, with a target population of 842 086 people and administrative coverage of 89%. Along with WASH initiatives like the distribution of water purification tablets, this was done (Aquatabs).
- In a prison area where a cholera outbreak was reported in late March, OCV was administered to all inmates as a form of mass chemoprophylaxis.
- In the affected districts, surveillance efforts have been stepped up for proactive patient referrals and case findings.
- Sites of the outbreak and the homes of confirmed cases have been decontaminated.
- Community leaders and members received training on hand washing, water filtration, and disinfecting private residences and public areas.
The journey to achieving Goal 6 of the UN SDG in Africa, especially in Chad and Cameroon is a long game and evidently would face challenges. The 2030 Agenda acknowledges the importance of water resources for sustainable development as well as the critical role that better access to drinking water, sanitation, and hygiene play in other areas of development, such as the improvement of health, education, and poverty reduction. This is why stakeholders (The UN and his Member States)) are committed to success in this area.
Goal 6 Targets
6.1 By 2030, achieve universal and equitable access to safe and affordable drinking water for all
6.2 By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations
6.3 By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing the release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally
6.4 By 2030, substantially increase water-use efficiency across all sectors and ensure sustainable withdrawals and supply of freshwater to address water scarcity and substantially reduce the number of people suffering from water scarcity
6.5 By 2030, implement integrated water resources management at all levels, including through transboundary cooperation as appropriate
6.6 By 2020, protect and restore water-related ecosystems, including mountains, forests, wetlands, rivers, aquifers and lakes
6.A By 2030, expand international cooperation and capacity-building support to developing countries in water- and sanitation-related activities and programmes, including water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse technologies
6.B Support and strengthen the participation of local communities in improving water and sanitation management