A key reason for the abbreviation of those lives was the lack of safe water and sanitation, and providing these services was a decisive turning point in reducing infant death rates. Epidemiologists studying historical records realize that there has been a tendency to underestimate the impact of water and sanitation on people s health. Considering the state of the infrastructure in the developing world, it is no surprise that diarrhoea still holds sway in the 1990s. As population has increased, so too has the number of people lacking access to sanitation. Just since 1990, an additional 300 million individuals are making do without decent sanitation, an ominous indication that the world community is failing in its efforts to provide services where they are most needed.
Many large cities are still without central sewage systems for their millions of residents.
In New Delhi, for example, less than 40 per cent of households are connected to sewers. Though latrines are available to some city dwellers in developing countries, more than a third lack adequate sanitation. In such conditions, many of these residents, particularly the very poor, are forced to defecate in open spaces or to dispose of their waste in nearby gullies and streams. Such de facto latrines become breeding grounds for bacteria, ripe to contaminate the children who play in these open spaces and the families who wash and fetch drinking water from streams near them. These sites also encourage the growth of virulent strains of typhoid, typhus and dysentery and infestation by disease-ridden carriers such as insects and vermin.