As
discussed above, children are immersed in a world of constant threats
to their health and well being. This chapter looks at specific threats
of major importance to children, including water and sanitation, chemical
pollution, air pollution and natural resource degradation. The next
chapter looks at certain global environmental issues, such as climate
change and the impact they have on our children’s health. Lack
of Safe Water and Sanitation Water quality
and quantity
Around the world,
both biological contaminants and chemical pollutants are compromising
water quality. This section focuses on biological contaminants, as these
cause a series of deadly childhood illnesses in developing countries.
Some important chemical pollutants in water will be discussed in the
following section. Biological
contaminants of water sources, also called pathogens, include parasites,
bacteria and viruses. They get into drinking water when the water source
is contaminated by waste material, such as human or animal waste and
sewage. The most important source of water contamination in developing
countries is human faeces, due to the lack of adequate sanitation facilities.
Today, about 2.4 billion people do not have access to even a simple
latrine [1].
As a result, human waste heavily pollutes many rivers and lakes in developing
countries. For example, in Asia’s major rivers, faecal coliform
counts can be 50 times higher than the guidelines set by WHO [2].
Children face dangerous health risks when come into contact with such
water through washing, bathing or drinking. Low or non-existent
capacity in wastewater treatment is another major factor causing water
pollution in most parts of the developing world. In Latin America, only
about 14 per cent of urban wastewater receive proper treatment before
discharge. Although the level of sewage treatment is reported to be
higher among Asian cities (on average about 35 per cent), it is still
unacceptable that most of the wastewater is directly drained to various
water bodies [3].
Standard wastewater treatment is almost non-existent in many African
cities [4]. Moreover, poor water
management strategies, combined with habitat modifications (such as
land conversion and forest clearance for roads and agriculture), and
changing ecological conditions also give rise to water quality degradation
and consequent increased vector-borne disease transmissions. The construction
of dams and reservoirs, inadequate drainage in irrigation schemes or
poor urban water management creates increased quantities of standing
surface water. These stagnant water bodies provide the ideal breeding
grounds for mosquitoes, which carry various deadly or debilitating diseases,
such as malaria. The
amount of water available is as important as its quality. Already, one-third
of the world’s population lives in countries facing moderate to
high water stress and water tables are falling on every continent [5].
If present trends continue, it is estimated that two out of three people
on earth will live in water-stressed conditions by 2025 [6].
Even where water quantity is not a concern, rural and low-income population’s
access to safe drinking water poses a major challenge. Globally, 1.1
billion people are without access to clean water supply, such as groundwater
drawn from a borehole or protected dug well, rainwater, or protected
spring [7].
Too little water makes it virtually impossible to maintain the necessary
sanitary conditions in the home, which can lead to the outbreak of debilitating
or fatal diseases for children. Sanitation Poor sanitation
is common in most developing countries. Human excreta, including that
of children, contain all sorts of microorganisms from parasite eggs
to viruses (See box 7). Unsanitary conditions
and practices at the household level, such as absence of sanitary latrines,
unsafe waste disposal and unhygienic behaviour in childcare and food
preparation, create a dangerous environment with health risks to children.
A lack of sanitation facilities in schools helps transmit diseases and
keeps millions of girls out of school. Waste
dumps sit in the outskirts of almost all major cities in developing
countries, creating not only an unsightly view and unpleasant smells,
but also hazardous environmental conditions to those living nearby.
While relatively few scientific studies have been conducted regarding
adverse health effects of waste landfill sites [8],
a recent study found that living near a landfill can raise the risk
of having a child with birth defects such as Downs Syndrome by as much
as 40 per cent [9].
Selected Facts
Health
impact of unsafe water and poor sanitation
Cholera, one of
the most severe diarrhoeal diseases, is present in faecal-contaminated
water. The cholera bacteria thrives best in coastal estuaries and generally
only inhabits rivers and other freshwater sources if nutrient levels
from organic pollution, such as human faeces, are quite high. Whoever
drinks the contaminated water, without treating or boiling it, becomes
an ideal candidate for cholera infection and the ensuing fatal dehydration.
Children are most susceptible to this disease. Untreated cholera frequently results in high mortality rates. It is a recurring problem in many areas of the world and has become endemic in some regions. Indeed, the number of reported cases worldwide nearly doubled in 1998 as compared to 1997 [23]. In Africa and Latin America, several factors play a role in the dramatic rise in cholera cases: deteriorating water and sanitation systems, poor living conditions, malnutrition or the consumption of contaminated seafood, crowding, use of wastewater to irrigate crops near urban areas, and political and economic turmoil [24].
[top] Water-washed
diseases arise from insufficient water to permit regular washing of
the hands, face, body and clothes, and cause skin and eye infections.
For instance, trachoma is an infectious disease associated with dry,
arid areas and lack of accessible water supplies. Children are a major
reservoir of the trachoma-causing bacteria, but the blindness due to
trachoma most frequently occurs in women in their mid-life and beyond.
Women have a two to three times higher rate of trachoma and risk of
blindness than men, since caring for children is a risk factor for active
trachoma and for the progression to trichiasis [25]
and blindness [26].
Though the disease-causing bacteria begin in childhood, it progresses
over the years as repeated infections cause irritation and scarring
on the inside of the eyelid. This infection is easily spread as the
children then touch the faces of their mothers and other children. One
of the best interventions is surprisingly simple: increase hands and
face washing among children. Water-based diseases are transmitted through aquatic organisms such as aquatic or amphibic snails. The aquatic organisms serve as intermediate hosts to the parasites during certain stages in the life cycle of parasites. In the cases of the schistosome parasite that causes schistosomiasis and the guinea worm the intermediate hosts are small freshwater crustaceans that are ingested in drinking water. Schistosomiasis is detrimental to the growth and development of school-age children and is associated with anaemia, malnutrition and stunting [27]. Guinea worm causes a disfiguring and disabling disease. It breeds in open waters and infects people who drink contaminated water. Fortunately, with decades of concerted effort worldwide, the number of infected people has been drastically reduced, from an estimated 50 million people infected with guinea worm disease in Africa and Asia in the middle of the 20th century to only 96,000 by 1999 [28]. This success is attributable to the provision of safe water supplies, identifying and treating of infected people, and effective community monitoring in infested areas. Because of these proactive measures, it is within the realm of possibility that this disease could be completely eradicated in the near future [29].
[top] Several
water-related, vector-borne diseases are particularly dangerous to young
children, including malaria, Japanese encephalitis and dengue. Malaria
occurs in some 100 countries, causing 300 to 500 million acute cases
in people each year [30].
In 1998, 90 per cent of deaths were children under 14 [31].
In Africa, where 90 per cent of malaria cases occur, the mosquito vector
has developed insecticide resistance to one or more insecticides [32]
and the parasite’s resistance to chloroquine is also widespread.
Malarial symptoms include fever and aches, as well as more severe vomiting,
diarrhoea, liver and kidney failure, convulsions and death. Children
in infected areas can suffer an average of six bouts a year and it is
the most common cause of children missing school [33].
In Africa this disease is responsible for an estimated economic loss
of $2 billion annually [34]. Japanese encephalitis
(JE) endemic regions are mainly in Asia, where high population density
puts approximately three billion people at risk. Young children under
10 years of age are more likely to die of JE, and if they survive, they
are likely to have residual neurological deficits. The disease can have
case-fatality rates as high as 30 to 50 per cent. Although a higher
case-fatality rate is reported in the elderly, serious neurological
and psychiatric permanent effects are more frequent in the very young
[35].
The dengue haemorrhagic
fever is also a major killer of children, whose mosquito vector has
even infested all major urban centres of the American tropics [36].
Governments, international
organizations, donor agencies and other relevant civil society organizations
should strive to:
Communities should
strive to:
Chemical
Pollution and Radiation The production and
use of toxic chemicals pose a major and relatively new threat to humankind
and the environment. Synthetic chemicals were virtually unknown at the
turn of the last century, but there are now between 50,000 and 100,000
of them being produced commercially. Many of these chemicals have not
been thoroughly researched for their effects on human health [43].
Rapid industrialization, urbanization and intensified agriculture all
account for the increased chemical pollution worldwide. In certain developing
countries, vast amounts of unused pesticides have piled up in storage
– some are even stored in houses – and these can pose serious
health threats. The emissions from
cars, industrial processes, waste treatment processes, such as incinerators,
hazardous materials and the excessive use of pesticides and fertilisers
for agricultural and domestic purposes, all release toxic substances
into the air, food or water (See tables 3
and 4). Heavy metals and persistent organic
pollutants (POPs), such as polychlorinated biphenyls (PCBs), dioxins
and DDT, are of particular concern since they do not degrade in the
environment for decades and accumulate in, and are toxic to, plants,
fish, animals, and humans. These substances also can travel long distances,
easily moving from one medium to another in the environment. The following chemical
pollutants are particularly worth mentioning with regard to children’s
environmental health. Since synthetic
pesticides were first introduced in the early 1960s, their worldwide
consumption has grown markedly, with total consumption reaching 2.6
million metric tons of active ingredients in 1995, increasing at about
one per cent per year [44].
Developed countries have been the major users of pesticides, consuming
about three-quarters of the world total [45]. Pesticides are integral
to agriculture and vector-control programmes worldwide, yet children
are uniquely susceptible to the health threats that they pose. Once
released in the environment, pesticides can pollute rivers, groundwater,
air, soil, and food. Human exposure occurs from breathing, drinking,
eating, or through skin absorption. A
child’s exposure to chemicals can occur as early as the prenatal
phase, and during infancy through breast-feeding. Organochlorine pesticide
residues present in mothers’ milk may pose a potential hazard for
breast-fed children [46].
A striking example is the presence of chemicals in the breast milk of
the Inuit peoples of the Arctic region. Although the region is largely
free from polluting industries, some chemicals entered the ecosystem
and accumulate at every stage on their way up the food chain: from plants
and fish to seals, whales, polar bears and humans. However, breast milk
remains the best source of nutrition for infants and is strongly recommended
by UNICEF and WHO. Therefore, it is crucial to protect mothers from
exposure to toxic agents. Synthetic chemicals
may interfere with natural processes that regulate growth and development.
These chemicals are called endocrine disrupters. Examples of endocrine
disrupters are PCBs and DDT. Infants are particularly at risk due to
the role the endocrine system plays in young children’s growth
and development. Research on how endocrine disrupters may damage the
ability to fend off diseases, learn, integrate socially and reproduce
is steadily advancing. The impact on human health from pesticide exposure depends on a number of factors, including the kind of pesticide involved and its toxicity, the amount or dose of the exposure, the length of exposure, and the way in which the exposure occurs. Specific effects believed to be linked to pesticide exposure are outlined in box 9.
Although lead is
naturally present in the earth’s crust, human activities bring
it into air, water, food and soil in an amount up to 300 times greater
than its natural occurrence [47].
Lead is often found in:
Lead is a significant child health hazard. It can even be a threat before birth. If a pregnant woman is exposed to lead, it can be transferred to the unborn child and cause premature birth, low birth weight, or even abortion. Lead is toxic when ingested and inhaled. Encountered in the environment, it enters the bloodstream, where it reaches the kidneys and the brain and deposits in bones and teeth. Growing epidemiological
evidence suggests that lead in a child’s body, even in small amounts,
can cause disturbances in early physical and mental growth and later
in intellectual functioning and academic achievements, hindering the
child’s ability to reach full potential. Studies have concluded
that there is a direct effect of low-level lead exposure on IQ of children.
Furthermore, undernourished children are more susceptible to the toxicity
of lead and more likely to be adversely affected by lead exposure. This
may in part reflect the competition between lead and calcium for absorption,
so that diets low in calcium allow greater lead absorption. This has
significant implications for children in poor urban communities of developing
countries where leaded gasoline is still prevalent and under-nourishment
remains a key problem. Specific effects of lead are summarised in table
3. Since the United Nations Commission for Sustainable Development in 1994 called upon Governments and international institutions to take action to phase out leaded gasoline, some progress has been made. Thirty-six countries had already phased out the use of leaded gasoline by 1999 and this will likely rise to 55 countries by 2005 [48]. Many of the countries phasing out the use of leaded gasoline are in the developing world. About 78 per cent of all gasoline sold in the world is currently unleaded and this will likely rise to more than 84 per cent by 2005 [49].
Mercury Mercury is a toxic
heavy metal normally existing in liquid or gaseous forms and found in
water, air or food, most often in freshwater fish or on coated-seeds.
Mercury occurs naturally in the environment in very small amounts in
oceans, rocks and soils, but it also enters the environment in greater
amounts through human activities such as coal-fired power generation,
waste incineration, certain manufacturing processes, mining activities
and medical and dental uses. Mercury is also used in some common household
products including fluorescent lights, thermostats, thermometers, and
even in some children’s toys. At school, mercury may be used in
science and chemistry labs, the nurse's office and electrical systems.
Methylmercury, an organic mercury compound, is more readily absorbed
by humans than elemental mercury and thus is more toxic. The
most common way of exposure to methylmercury is from eating fish from
contaminated areas. Methylmercury can be found in freshwater and saltwater
fish [50].
In January 2001, the US Environmental Protection Agency (US/EPA) and
the US Food and Drug Administration (US/FDA) issued advice to women
who are pregnant or may become pregnant, nursing mothers and young children
to limit consumption of certain fish to one meal per week because of
a concern for mercury contamination. Although fish can be an important
source of nutrition for developing children, some fish, such as shark,
swordfish, mackerel and tuna, may contain high levels of mercury [51]. Mercury is a potent
neurotoxin pollutant, which passes more easily into the brains of the
foetus and young child. The developing brain is particularly sensitive
to methylmercury. Depending on the dose and exposure level, to varying
degrees it can interfere with brain development and cause mental retardation,
cerebral palsy and seizures [52].
Mercury may cause cancer and damage the stomach, large intestine and
lung. It also may permanently harm unborn children [53]. Nitrate pollution
is now considered to be one of the most serious water quality problems
in the world [54].
Nitrogen is a basic ingredient in artificial fertilisers. The use of
fertilisers has been rapidly increasing, causing excessive nitrogen
loading of the environment on a global scale [55].
Global fertiliser use soared from less than 14 million tonnes in 1950
to 135 million tonnes in 1996 [56].
As a result, nitrogen levels have risen in surface and groundwater sources,
resulting in elevated levels in drinking water supplies [57].
Untreated wastewater discharge has also contributed to the nitrate pollution
of water resources. Nitrate absorption
is most often associated with the “blue baby syndrome” (methaemoglobinaemia).
Infants under six months of age are particularly vulnerable to high
levels of nitrates in drinking water. This is because nitrite (nitrate
reduces to nitrite once entering into a human body) interferes with
the blood’s ability to carry oxygen to the body tissues, resulting
in a bluish colour of a baby’s skin. Levels higher than 10 milligrams
of N/litre (US Standard) can have toxic effects on infants. Adults and
older children are able to withstand much higher levels with no risk
of methaemoglobinaemia [58]. Excessive nitrates
in rivers and lakes cause eutrophication in many regions of the world,
which disrupts aquatic ecosystems through oversupply of nutrients that
cause the mass growth of algae and plants. This process eventually depletes
most oxygen in the water and kills the aquatic organisms, rendering
the water body lifeless and sterile. Some dangerous chemicals
also occur naturally in groundwater, notably arsenic and fluoride. In
Bangladesh, high concentrations of arsenic have been found in tube wells
in 61 out of 64 districts [59].
Excessive arsenic levels in groundwater are also found in some parts
of Argentina, Cambodia, Canada, Chile, China, India, Japan, Mexico,
Philippines, Viet Nam and the United States. Arsenic can cause
severe and irreversible health effects – even in very small amounts.
Early symptoms can range from the development of dark spots on the skin
to a hardening of the skin into nodules, often on the palms and soles.
Over time, the symptoms can become more pronounced and in some cases
internal organs including the liver, kidneys and lungs can be affected
[60].
In the most severe cases, cancer can occur in the skin and internal
organs and limbs can be affected by gangrene. The damage due to arsenicosis
in humans is irreversible. There is a need to know much more about the
health impacts of chronic and relatively low levels of exposures to
arsenic. Another
problem is high levels of fluoride in some groundwater sources. Although
fluoride is found in all waters at some concentration, high fluoride
concentrations are found mostly in calcium-deficient ground waters in
certain geographical belts, such as one along the East Africa Rift and
another from Turkey through Iraq, Iran, Afghanistan, India, northern
Thailand and China [61].
With large populations in developing countries directly consuming groundwater,
excessive levels of fluoride in groundwater pose serious health concerns.
These range from dental fluorosis (discoloured, blackened or mottled
teeth) to crippling skeletal fluorosis (permanent spine, bone and joint
deformations). As with arsenicosis, the damage caused by fluorosis is
irreversible. Although the total
number of people at risk with fluoride is not known, a conservative
estimate would number in the tens of millions. In India, 16 of its 32
states have been identified as endemic for fluorosis [62].
Fluorosis is prevalent in large parts of China, and is caused not only
by drinking fluoride in groundwater, but also by breathing airborne
fluoride released from the burning of fluoride-laden coal [63].
In fluoride-affected rural areas in these countries, children with dental
fluorosis are a common sight, as are severely crippled adults, illustrating
the disabling effect of chronic exposure to excessive fluoride. Radiation Radiation
is another type of pollution that causes adverse health effects in children.
Examples of exposure to ionizing radiation include the Chernobyl nuclear
power plant accident in 1986 and the use of radioactive materials during
war. Depleted uranium, a weak radioactive material, is sometimes used
as the heads of rounds fired from aircraft. During the Kosovo conflict
in 1999, about 31,000 depleted uranium rounds were fired at targets
on the ground [64].
Fact-finding missions by UNEP
and WHO looked at the
environmental and health impacts, respectively, of the use of depleted
uranium in the conflict. Although the missions found no convincing evidence
to indicate any health impact to people in Kosovo, it was noted that
people could come into contact with depleted uranium by picking up objects
from the ground. Naturally, children may be particularly at risk from
exposure to depleted uranium because of their curiosity and lack of
knowledge about the contamination. Overexposure
to ionising radiation, such as from nuclear fuels and radioactive isotopes
used in medical facilities, can induce cancers, birth deformities and
psychiatric disorders [65].
Studies of the health impacts of Chernobyl have associated a sharp increase
in the incidences of childhood thyroid cancer with the accident [66].
The investigation of brain damage in utero found evidence suggesting
retarded mental development and deviations in behavioural and emotional
reactions in children who had been exposed [67].
Radioactive pollution
also includes radiation from non-ionising electromagnetic fields, such
as radio waves and microwaves. Knowledge of the potential health effects
of chronic and low exposure to electromagnetic fields is extremely limited.
For example, some epidemiological studies have suggested an increased
risk of leukaemia in children living near power lines. Whether this
is due to exposure to extremely low frequency magnetic fields or some
other factors in the environment has not been determined [68].
A recent study has suggested that exposure to radio frequency fields
increases the incidence of lymphomas in genetically manipulated mice,
but until at least two more large studies are conducted, the issues
raised by that study cannot be fully answered [69].
Most known adverse health effects related to electromagnetic fields
occur from exposure to radio frequency fields between one MHz and 10
GHz inducing heating in the body. Induced heating may adversely affect
the development of a foetus [70].
Taking action
Examples of
what works
[top] Indoor
and Outdoor Air Pollution Air pollution – both indoor and outdoor – is a major environment-related health threat, causing a range of respiratory and cardiovascular ailments. Unhealthy air is breathed by an estimated 1.1 billion people and claims 3 million lives a year [81].
Indoor air
pollution Indoor air pollution
occurs when fossil or biomass fuels are used for cooking and heating
in crowded and poorly ventilated settings. Of all forms of air pollution
worldwide, indoor air pollution from open fires or inefficient stoves
is the single greatest cause of ill-health [82].
About 2.5 billion
people are dependant on biomass fuel for cooking and heating, of whom
75 per cent are in developing countries [83].
Of this 2.5 billion population, approximately 800 million depend on
agricultural residues and animal dung as sources of fuel due to severe
fuel wood shortage [84].
These
people often use low-efficiency, smoky cooking stoves. For example,
the efficiency of the three-stone fire traditionally used in many developing
countries is only about 10 to 15 per cent. The cooking stoves produce
heavy smoke with fine particles, carbon monoxide and carcinogenic compounds
such as polycyclic aromatic hydrocarbons (PAHs) [85].
Measurements of indoor particle concentration in rural households of
developing countries greatly exceeded the 1987 WHO recognized guideline
values and air quality standards used in the United States and Europe
[86],
typically by some 20 times higher [87].
Indoor air contamination
is also caused by biological particles, such as pollen, mould, the droppings
of mites, insects, microorganisms, as well as the non-biological particles,
such as lead, carbon monoxide, asbestos and synthetic chemicals. Women
and children, who spend the most time indoors, are the prime victims
of the resulting indoor air pollution. These dust particles contain
irritants and infectious agents that can cause or worsen ARI. Another
very important source of indoor air pollution is tobacco smoke. Outdoor air
pollution
Cities
in developing countries have much higher average pollutant concentrations
than cities in industrialized countries (See figure
6). In the late 1990s, the average annual concentration of PM10
(small particles with diameters less than 10 microns) in North American,
Western European and Japanese cities ranged from 30 to 45 micrograms
per cubic metre. Chinese and Indian cities, on the other hand, had averages
of nearly 200 micrograms per cubic metre of PM10 [88]. In addition, forest
fires, whether accidental or started to clear forestland for agricultural
purposes, have been the cause of severe smoke haze pollution in Asia,
Latin America and North America – causing serious health concerns
for children and the elderly. In addition, dust storms in many regions
of the world (especially in Central Asia), the magnitude of which is
aggravated by desertification and deforestation, represent another significant
source of outdoor air pollution. Impact of
air pollution on children Children
are most susceptible to air pollutants in the first month of life [89],
particularly during episodes of severe pollution. Although the risk
declines with each passing month, air pollutants remain a risk to children.
The health effects of air pollution depend in large measure on the types
of pollutants inhaled and the exposure level (i.e., frequency, concentration,
etc.) of the child. Estimates suggest that up to 60 per cent of the
global ARI burden of disease is associated with indoor air pollution
and other environmental factors such as ambient air pollution and housing
conditions [90].
Infants and young children, particularly girls, who are often requested
to help their mothers in household chores, are most at risk. Infants are exposed
to pollutants while resting on the backs of their mothers as they tend
fires. Girls are exposed as they assume their share of household cooking.
In India, respiratory infections linked to solid fuel use are estimated
to cause 290,000-440,000 premature deaths a year in children under five
years of age [91].
The small particles in polluted air enter deep into the lungs and respiratory
organs, causing viral and bacterial ARI, the most severe being pneumonia.
ARI account for 67 per cent of deaths in the world’s children from
birth to 14 years [92].
Irritation that would not significantly affect adults may result in
more severe obstruction and damage in a child’s lungs since they
are still forming and are more vulnerable. Childhood ARI-related death
rates are high even in nations where the infant mortality rates are
low. In high-income countries, ARI is the third leading cause of death
in children under four. In developing countries over 64 million cases
of ARI are reported per year [93]. Indoor
air pollution is not only linked to ARI. Studies in developing countries
have linked exposure to indoor air pollution with chronic respiratory
diseases such as asthma (See box 10), chronic
obstructive pulmonary disease, lung cancer, stillbirths and low-birth
weight [94].
Lung cancer has been found to result from long-term exposure to cooking
with coal in China [95].
Outdoor air contamination can also cause pulmonary irritation, interfere
with foetal growth and infant development, impair lung functions, exacerbate
viral infections, bronchitis and pneumonia and worsen heart problems,
asthma and emphysema. Adults who smoke can also put children at risk for tobacco-related illnesses. Environmental tobacco smoke (ETS) has been linked to a number of serious health problems in children, including upper respiratory infections, chronic coughs, asthma, chronic ear infections and sudden infant death syndrome [96]. A 1997 study also connected ETS to abnormal cholesterol levels in children. It found that children who were exposed to environmental tobacco smoke at home had high-density lipoprotein cholesterol levels – the so called “good” cholesterol - as much as 10 per cent lower than the levels of children who came from non smoking households [97].
Taking action
[top] Currently, there
is enough food to feed the world; yet, 149 million children are still
malnourished [108].
A nutritionally adequate diet for the world's rapidly growing population
will necessitate tripling food production over the next 50 years [109].
This task will be an enormous challenge in the face of growing environmental
degradation and contamination – two factors that often compromise
household food security and health, especially for children. Land degradation
The distribution
of fertile soils and favourable growing conditions does not match that
of the world’s population. Global projections for food supplies
by region suggest that future problems will be mainly concentrated in
sub-Saharan Africa and South Asia [110].
The worldwide loss of arable land is exacerbated by land and natural
resource degradation caused by a series of processes and human activities,
such as deforestation, desertification, soil erosion, over grazing,
over-use of fertilisers and pesticides, lack of watershed management,
excessive withdrawal of groundwater, pollution, poor land-use planning
and uncontrolled dumping of wastes. Moreover, the rising demand for
meat, fish, poultry and dairy products encourages farmers to raise livestock,
displacing subsistence food crops for growing fodder and feed crops
for animals, hence, making less efficient use of the land [111].
Selected facts
Impacts
of natural resource degradation Millions of children
under five die each year in developing countries mainly from preventable
diseases. It is estimated that half of these deaths are either directly
or indirectly attributable to malnutrition [117].
Foetal development also hinges on the mother's nutritional status. Under-nutrition
during pregnancy and in early childhood can adversely affect physical
and behavioural development, with short- and long-term consequences
(See figure 8). Maternal anaemia (iron deficiency),
which is often linked to protein energy deficiency, renders the mother
more vulnerable to diseases and increases her chances of giving birth
to lower birth-weight babies. Low birth-weight babies are vulnerable
and more likely to die at an early age or face severe physical and developmental
problems during infancy and beyond. Land degradation and natural resource
depletion can contribute to malnutrition. Malnourished children
can be listless and have slow social and cognitive development, which
can lead to poor school performance and disadvantages in later adult
life. Furthermore, childhood micronutrient deficiency (vitamin A, iron)
can retard child growth, increase the duration and severity of illness
and render children more sensitive to toxic agents at lower levels.
Research suggests
that child growth can be harmed in unhygienic surroundings even before
acute infections occur. It is believed that early childhood nutritional
deficits coupled with an unsanitary environment lead to impaired growth
and a failure to maximize genetic potential. Even if a child is not
obviously sick, an unclean environment poses a constant threat to the
immune system. Nutrients from food that should help a child to grow
are instead used by the body to support its immune system, thus impairing
growth. A
hungry child is a weak child. A weak child is a sick child. Frequent
illness will almost surely result in physical weakness and nutritional
deficiency. Consequently, poor nutritional status further weakens a
child’s immune system, making the child all the more susceptible
to diseases and pollutants. For example, frequent and prolonged diarrhoea
episodes are important contributors to malnutrition and malnutrition
increases susceptibility to more severe diarrhoea, and, in turn, increases
the likelihood of death due to this ailment [118].
The cycle of “malnutrition ‘ infection ‘ malnutrition”
(See figure 9) pushes children down the spiral
of poor growth and early death. This vicious spiral can, to a large
extent, be prevented. Environmental management strategies can have an
important contribution to make in this regard. Moreover, the amount
of energy and time spent by women and children, especially girls, collecting
water, fuel and fodder is proportional to the abundance of natural resources.
Often, girls will be forced to abandon school in order to meet their
family’s needs for these resources. All in all, environmental degradation
intensifies the drudgery of women and children, further undermining
their health and nutritional status.
The contamination
of land and vegetables along with poor sanitation and hygiene is associated
with another important problem for children – helminth diseases.
Hundreds of millions of school-age children throughout the developing
world are currently infected by roundworm, whipworm and/or hookworm,
which cause helminth infections. Coming into contact with soil or vegetables
that contain the eggs or young worms of these parasites infects children.
The highest rates of roundworm and whipworm infections are found in
the groups five to nine and 10 to 14 years old [119]. Worms consume the
nutrients from the children they infect. Hence, the infected children
are robbed of nutrients needed for their young bodies to grow, which,
in turn, triggers or aggravates malnutrition, retards physical development,
and stunts growth. These parasites destroy the tissues and organs they
live in, causing pain and various health problems. Roundworms cause
structural problems in the small intestine in children and also cause
serious pulmonary disease in children. Severe whipworm infections are
associated with high incidence of dysentery, chronic colitis, anaemia
and growth retardation. Hookworm infections cause iron deficiency anaemia
and may result in minor infections developing into severe anaemia in
children and adolescent girls [120].
Taking action
|
Water
is life. It is essential for sustaining basic human functions, health
and food production, as well as for preserving the integrity of the
world’s ecosystems. Access to safe drinking water is a basic right
for all human beings. A child’s well-being is highly dependent
on both the quality and the availability of water and how well we manage
this precious resource.
Contaminated
water causes a range of diseases which are often life threatening (
In
developing countries, a lack of water often forces people – usually
women and young girls – to spend a lot of time fetching water,
often at great distances from the home, or to extract water from alternative,
unsafe sources. Lack of access to safe water and sanitation facilities
has important implications for the education of children, especially
girls since they bear the major burden of carrying the water home from
distant sources, preventing them from attending school. In developing
countries, lack of sanitation facilities is a major reason for girls
dropping out of school. Finally, poor people are more likely required
to purchase water at highly elevated costs. When their dwellings are
not connected to municipal sources, they are often forced to buy water
of doubtful quality from vendors.
Outdoor
air pollution is a particularly serious threat to the swelling populations
of the world’s cities. With the increased combustion of fossil
fuels, industrial processes and growing car use, urban populations are
exposed to a long list of pollutants that include sulphur dioxide, nitrogen
oxide, nitrogen dioxide, carbon monoxide, ozone, lead, dioxins, suspended
particulate matter and a host of volatile organic compounds. Open burning
of urban waste with high components of plastics like polyvinyl chloride
(PVC) is also a significant source of dioxins, furans and heavy metals
in many communities. People who are poor often live close to these sites
or work in them. 
Nearly
one billion people depend on fish as their primary source of protein
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