Water Cut-Offs: A Public Health Issue

By Mary Ellen Howard, RSM

Water is essential to humans for drinking and sanitation.  Research by the World Health Organization (WHO), Centers for Disease Control (CDC), and National Institute of Medicine (NIM), focuses primarily on water contamination and water shortage—the latter resulting from contamination or drought.  I could find nothing in public health literature about situations like Detroit where there is an adequate supply of clean water—which is being denied to poor people because they can’t afford to pay for it.  Last week the United Ways of Michigan released a major report, “ALICE,” which shows that 67 percent of the residents of Detroit cannot afford to meet their basic needs, including water. If we care about public health and the right to life, we need to find a way to provide affordable clean water everyone.

WHO says that water has a profound influence on human health.  At a very basic level, we have to take in a minimum amount of water daily for survival.  Water is essential for life. The quantity and quality of the water available to the community are important determinants of public health.  But so is the cost, and the ability to pay.

I would like to share three stories on how this water issue has touched my life in Detroit.  I am on the board of a school-based health center in a Detroit Public School.  The social worker reported that the biggest public health problem the staff was dealing with was hygiene of the children.  These middle school kids have dirty clothes and body odor.  She put together hygiene kits and was handing them out to the kids when she discovered that the real problem was no water in the home.  Another board I serve on reported that they had held a baby shower for new Moms in the community.  When asked to name challenges in their lives, several reported that they had no water to make formula for their babies.  A family down the street from us had their water turned off and for more than a year they got their water in buckets from the tap at the side of our house.  Once a week they dropped off their laundry and we did it for them.  This is not in Afghanistan or the South Sudan; this is on my block on the east side of Detroit.  I don’t know how these families survive, but I do know that they are at risk for disease.

The NIM says that developing countries that do not have adequate supplies of fresh water and basic sanitation carry the highest burdens of disease which disproportionately impact children under five years of age, and cause 20 percent of deaths below age 14.  Lack of access to clean water also influences the work burden, safety, education, and equity of women.  This is true also for the women and children of Detroit.

So what happens when you don’t have water to drink, when you can’t flush your toilet, or bathe, or do laundry, or rinse off fruits and vegetables before eating them, or keep your household clean of solid waste?  We know that hand-washing is one of the most effective ways to prevent the spread of communicable disease, in hospitals, restaurants, and everywhere.  Where there is no water and no hand-washing, disease will spread.

What are the diseases related to the availability of water for cleaning, sanitation, or hygiene?  It’s a nasty list: dysentery, enteroviral diarrhea, paratyphoid fever, pinworm, scabies, skin sepsis, lice, typhus, trachoma, conjunctivitis, and hookworm.

Water is a human right, necessary for human life and for public health.  Water must not only be clean; it must also be available and affordable. We have no excuse here in Detroit.  We have the water and we have the means to make it affordable and available.  We must also have the will to make sure no one goes without water.  Our humanity and our lives depend on it.

Mary Ellen Howard, RSM, is a public policy advocate with the St. Frances Cabrini of Most Holy Trinity Church, Detroit. She delivered this statement at a news conference opposing water shut-offs in the city. Sr. Mary Ellen is also a member of the Detroit Wayne County Health Authority Board of Directors.