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The water and sanitation problems in Ethiopia are massive.  Access to reliable water supplies and adequate sanitation facilities in the country is among the world's lowest and the need for improvement is acute. 

Ethiopia has the second largest population in Africa, with nearly 80 million people, yet it has some of Africa's lowest figures for access to safe water and improved sanitation facilities.  The average Ethiopian survives on just 15 litres of water for all their daily needs - compared with up to 150 litres a day in the UK.  Only a third of people in Ethiopia use latrines.

Not only are coverage levels low, water quality is also a major problem.  As a result, the people of Ethiopia are vulnerable to infectious diseases and their productivity is greatly reduced, with frequent outbreaks of water-related epidemics in both rural and urban areas.

Even by Sub-Saharan African standards, this is a very low supply and coverage level.  Seventy to eighty percent of diseases in Ethiopia are preventable.  In rural areas, the incidence of water-related disease is high and is worsened by the lack of both clean and adequate water supply.

Women and children from rural communities often walk up to four hours to collect water.  Most collect water from shallow, unprotected ponds which they share with animals - others collect from shallow wells.  Both of these sources are subject to contamination as rain water washes waste from surrounding areas into the source. 

Along with limited food supply, during times of drought, water-related diseases are rampant. Surface water sources such as springs and ponds dry up.  What limited water sources remain become heavily contaminated by environmental waste, such as human and animal excreta which is washed in when the limited rains do come.  The stagnant water serves as a breeding place for mosquitoes.

In addition to the risk of contracting diseases, it is common for there not to be enough water available to bathe regularly, this is particularly acute during periods of drought.  As a result, community members, especially children, suffer from scabies and eye infections.  During these times, in an effort to conserve water, handwashing after defecation or before eating is rarely practiced.

Diarrhoeal and water-related diseases are among the principle causes of death in young children.  Pneumonia, vaccine-preventable diseases (especially measles), malaria, tuberculosis, and malnutrition are also among the top killers of this age group.

This situation costs many lives with more than 1.6 million preventable child deaths each year.  Hundreds of Ethiopian children die each day from diarrhoea and other diseases related to unclean water.  All of the top ten diseases in Ethiopia are directly or indirectly related to poor water and sanitation which, in turn, leads to problems in maternal and child health.

Rates of access to safe drinking water and adequate sanitation in urban areas have been improving in recent years, helping reduce the number of deaths due to diarrhoea which currently accounts for around 20 per cent of under-five mortality.  However, according to the WHO/UNICEF Joint Monitoring Programme (JMP), only 26 per cent of rural households have access to improved water and only 8 per cent have access to improved sanitation facilities.  In Ethiopia, it is estimated that three-quarters of communicable diseases and health problems affecting children, are as a direct result of environmental factors.

Contamination of water supplies, by both animals and humans, is frequent.  This leads to increased exposure to water-borne diseases (such as diarrhoea and dysentery), water-washed diseases (such as trachoma and scabies), water-based diseases (such as schistosomiasis), and water-related insect-borne illnesses, including malaria.

Low levels of water and sanitation coverage also have important social implications as women and children spend several hours every day fetching water.  After walking long distances to reach a water source, they then carry large clay jugs of water back to their villages.  These water jugs can weigh up to 20 kilogrammes! 

Often, young children are left home by themselves or with a slightly older sibling while their mother and older siblings collect water and their father tends animals or tries to earn money farming or with work outside the household.  Frequent trips to replenish household water supplies each day means women have less time for household chores, for child care or for income-generating activities. 

Girls, too, often collect water for their families, so clean water sources close to their homes will allow more time in school.  It is the lack of sanitary facilities in schools, combined with the task of carrying water, which often prevents girls from gaining an education, and travelling long hours to remote water sources exposes them to physical danger.

There is an urgent need for action, but all too often water and sanitation are overlooked in the global development agenda, despite being consistently cited as top priorities by communities themselves.  Total global investments in water and sanitation would need to double for the Millennium Development Goal targets, of halving the proportions of people living without water and sanitation by 2015, to be met.

Improvements in Ethiopia's water supply, sanitation and hygiene will dramatically improve the lives of rural communities, especially women and children.  The country faces enormous challenges if it is to reach the Millennium Development Goals (MDGs) by 2015.  Ethiopia will need to provide clean water for 3.6 million people, and toilets for 4.5 million, every year if it is to reach the targets.  Turning this ambition into a reality will certainly be a challenge.