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“Gerald Grob points out in “The Deadly Truth: A History of Disease in America,” the first sewage systems made the transmission of fecal-borne diseases worse. Lacking an understanding of germs, people thought that dilution was the best solution and just piped their sewage into nearby waterways. Unfortunately, the sewage outlets were often near the water system inlets. Finally understanding that sewage and drinking water need to be completely separated, Chicago built a drainage canal that in 1900 reversed the flow of the Chicago River. The city thus sent its sewage into the greater Mississippi watershed and continued taking its drinking water from Lake Michigan.”–Laura Helmuth, Slate Magazine

Unfortunately, in many communities in Latin America, sewage is still dumped directly into waterways used for drinking, washing and bathing.

 118 million people in Latin America and the Caribbean do not use improved sanitation facilities and 36 million still practice open-air defecation.

 The improvement of basic sanitation and the proper disposal of excrement are highly effective in reducing the morbidity and mortality caused by diarrhea.

 Women have different privacy requirements from men. When the absence of latrines forces them to use public spaces, they can do so only in the shelter of darkness, during early morning and late evening hours, putting their safety at risk. One response is urine retention, which leads to health problems, such as urinary tract infections.

 From the community perspective, the adequacy of drainage plays a large role in health outcomes. Where drains don’t exist or are blocked, and wastewater stands in the streets, children are particularly vulnerable to disease transmission through direct contact. The standing water may also serve to host other disease vectors, such as mosquitoes transmitting malaria and other diseases.

 In Latin America and the Caribbean treatment plants treat only 14% of human waste.