Speaking at the Lord’s Mayor’s Coffee Colloquy: a reflection

I was honoured to be asked to take part in the Lord Mayor’s Coffee Colloquy, and was impressed by the depth and breadth of knowledge and expertise of the other speakers, which the two Livery companies, the Water Conservators and Plumbers had brought together, with insight on what is needed to achieve UN SDG6 goals: “the availability and sustainable management of water and sanitation for all” by 2030.

My background is in public health, especially associated with the adverse health consequences of unsafe water. I thought I would concentrate on some of the wider public health issues and challenges around achieving the UN SDG6. The challenge was how choose the points I could do justice to in just four minutes (!) and as I was number nine out of ten speakers, how I could do this and ensure that all the points I wanted to make were not covered by the eight other speakers before me.

I decided to concentrate on some of the public health challenges of achieving SDG6. Quite rightly, whilst we tend to concentrate on the consequences of unsafe water and sanitation in developing countries, there are many issues around the achievement of SDG6 goals which apply to developed countries too, including the ongoing public health implications around the inadequacy of sewage infrastructure and wastewater management, which lead to large scale pollution of coastal and inland waterways. Flash flooding also has implications for food and drinking water safety, not just from microbiological hazards but also chemical hazards, including heavy metals and endocrine disruptors, for example. There is also an increased risk of antibiotic resistant bacteria entering drinking water supplies threatening the ongoing effectiveness of antibiotics, and identified as a global priority by WHO.

Warmer water entering building distribution systems as a result of climate change also increases the risk of waterborne pathogens, e.g. Legionella entering buildings already in an active growth phase and with increased ability to cause infection. This poses a significant and increasing threat of serious illness and death, especially to susceptible groups in healthcare and the elderly. It is essential that design and build water systems are safe for the most vulnerable users.

My final point was on the impact of poor water availability and sanitation facilities, especially in developing countries, causing serious gender and health inequalities. This particularly affects women and girls, especially those who are menstruating. No water or safe sanitary spaces for personal hygiene means that women and girls are at risk from attack, and from serious urinary tract and vaginal infections as they delay relieving themselves until after dark. The task of providing water for drinking, cooking and family hygiene also falls predominantly on women and girls who may have to walk on average 3 ½ miles in unsafe terrain carrying between 15 and 20 kg of water on their heads, resulting in long term health consequences from back and neck injury. This also negatively affects their education meaning that girls, more than boys, are likely to be illiterate. The water sources themselves, they walk to, are often not safe, with incidents of drowning reported, particularly for children collecting water.

Whatever is done to achieve SDG6, it needs a holistic and risk assessed approach to addressing the wider public health issues in both developed and developing countries.

Liveryman Susanne Surman-Lee

The full text is available from susannelee@leegionella.co.uk on request.