How does the health situation of a population interact with its level of education? Is there a direct link between water, sanitation and hygiene (WASH) services and the education rate/school attendance? And more specifically, does access to safe drinking water have an impact on these indicators? A recent study, published in March 2014 by PLOS ONE (an international, peer-reviewed, open-access, online publication on science and medicine) suggests that it does. The study, entitled “Impact of the Provision of Safe Drinking Water on School Absence Rates in Cambodia: A Quasi-Experimental Study” shows “strong association between the provision of free safe drinking water and reduced absenteeism” in Cambodian schools.
Led by Professor Paul Hunter from East Anglia University (UK), the observational study followed 3,000 children aged 6 to 12 in eight Cambodian schools, during the six months of the dry season. Half the children attended schools where safe drinking water was delivered free by the NGO 1001 Fountains (supported by danone.communities – read our report in the field here); the other half drank either what they brought from home or water from a pump.It was observed that “absenteeism was less than half in the intervention schools compared to those who did not receive 1001 Fountains water,” wrote the authors of the study.
A clue that health, and more particularly health through hydration, has a direct impact on school presence rates and therefore helps to improve a country’s education rate.
Hydration and school attendance
The study was carried out during the dry period, a time where absenteeism is usually low – it increases during the wet season, when roads are flooded and children are often kept at home to help on the fields. Week after week, for 26 weeks, the study consistently showed that the absenteeism rate of the children who had access to safe drinking water was between 55% and 75% lower than that of the children who did not. “The mechanism for this association is not clear but may in part be due to improved hydration, leading to an improved school experience for the children,” wrote the authors. “Given the fact that the association was between absenteeism rates and water delivery in the same week and not the previous week, we are not suggesting that this association was primarily due to a reduction in waterborne infectious disease. A possible explanation in our view may be that by providing readily available palatable, safe water in the classroom, children are more likely to drink during the school day, and thus not become dehydrated. (…) Consequently they are more likely to attend school the following day if they had felt good at school the previous day.” Cautious as they were, the authors still stressed that it would not be acceptable to provide the children with water of inferior quality, even if it increases their level of hydration, since it would also put them at risk of waterborne diseases.
Safe drinking water and waterborne diseases
In fact, there exists a link between access to safe drinking water and the likelihood of developing these diseases. As Louis Pasteur used to say, “we drink 90% of our diseases.” 1001 Fountains, in a press release issued after the publication of the study in PLOS ONE, related it to the results of another study, also led by Prof. Paul Hunter in Cambodia during the same six months, and entitled “Water source and diarrhoeal disease risk in children under 5 years old in Cambodia: a prospective diary based study.” This second study, published in January 2014 by BioMed Central, an open-access publisher of scientific studies, observed 350 families with children under 5 years old. It was established that there is a link between the type of water consumed by the household and the frequency of diarrhoea suffered by children. The children who drink surface water are 35% more likely to develop waterborne diseases than those who drink bottled or rainwater; the rate rises to 65% for those who drink water from the well. Given these results, 1001 Fountains called on health organisms, institutions and foundations to open a new research field to fine-tune the initial findings on the link between completely safe and healthy drinking water and the improvement of general health. The organisation also emphasised that providing drinking water is not enough, and that the quality and taste of the water are crucial to help improve health, increase school attendance rates and consequently alleviate poverty. In view of these first results, let us hope that research keeps advancing on these subjects, and that more concrete actions like 1001 Fountains will soon be implemented.
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