The Environment for Children

Understanding and Acting on the Environmental Hazards That Threaten Children and Their Parents

David Satterthwaite, et al

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781134172856
• Edition: 1
• Topic: Medicine
• Subtopic: Public Health, Administration & Care

Each year, millions of children die of environmental causes and many more suffer serious illness or injury. Children are often the most vulnerable to the condition of their environment -and their health is an index of its quality - but their wellbeing is rarely given priority by governments or aid agencies. Ironically, the problems can be traced back to matters which can be treated straightforwardly and at relatively low cost - poor drinking water or food, or infectious diseases which can be controlled.

This book gives a multidisciplinary account of the environmental health hazards threatening children and the range of impacts they can have. It also explains what can be done, by communities as well as governments and aid workers, to provide safe and healthy environments for children. The book looks at conditions in a range of cities in the developing world, as well as pollutants and other health problems affecting children in the North.

Published in association with UNICEF, and written by some of the same authors as Environmental Problems in Third World Cities (Earthscan, 1993), this provides excellent course material, and will be useful for practitioners working on child development, infant and maternal health, environmental health and community development.

David Satterthwaite is Director of the Human Settlements Programme at the International Institute for Environment and Development, and principal author of Environmental Problems in Third World Cities (1993) and Squatter Citizen(1989).

1

The Environment for Children

THE MAIN ENVIRONMENTAL ISSUES

For more than half the world’s children, their health and often their lives are constantly threatened by environmental hazards – in their home and its surrounds, in the places where they play and socialize and, for working children, in their workplaces. The child crisis – the 40,000 child deaths that occur each day from malnutrition and disease and the 150 million children a year who survive with ill health and with their physical and mental development held back – has somehow become separated from much of the discussion about the world’s most serious environmental problems. Yet, it is pollutants or disease-causing agents (pathogens) in the child’s environment – in air, water, soils or food – and poor households’ inadequate access to natural resources (fresh water, food, fuel) which are the immediate causes of this child crisis. Given the importance of environmental factors to infant and child health (and survival), it is perhaps surprising that the relationship between children and the environment has not been given more attention. Environmental hazards also take a serious toll on the health of a high proportion of the world’s parents and this, in turn, makes it much more difficult for parents to provide their children with a safe, stable and stimulating environment.

This book describes the environmental hazards that cause or contribute to most illness, injury and premature death among children below the age of 15 and how these can be acted on.* It concentrates on those hazards to which hundreds of millions of infants and children are constantly exposed in their everyday lives in both rural and urban areas. It does not cover in detail the particular and often horrific environmental problems faced by children in what UNICEF terms ‘especially difficult circumstances’ – for instance orphans and abandoned children living on the street. Although special programmes can reduce the environmental hazards faced by children of the street – for instance through ensuring they have facilities for bathing, washing, defecation and laundry and access to health care – the problems these children face and the factors that led to their expulsion or desertion of their home need much more than this. It also does not consider the environmental problems faced by children living in hastily erected emergency camps or other places when they and their families are forced to flee from their homes, or children (and their households) living in regions in the midst of wars or civil strife when there is little or no effective civil authority and no public services. These deserve a more detailed consideration in their own right. But, perhaps more importantly, the environmental hazards these children face or the other environmental problems that such instability can generate are rarely resolvable with environmental action. This is much less the case for the environmental hazards to which children are exposed within their homes and neighbourhoods as, in most instances, these hazards or their health impacts can be eliminated, or much reduced, at relatively low cost.

This book also aims to raise the priority given to the environmental problems that underlie most illness, injury and premature death among children. These are rarely given much prominence in discussions, debates and publications about the environment – perhaps because they affect children most and because most of the illness, injury and premature death occur in the South.* The environmental concerns of the world’s wealthier inhabitants, most of whom live in Europe, North America and Japan, still dominate the discussions of ‘environmental crisis’. Here, most of the concern for the environment is related to chemical pollution in the air and water, damage to the natural environment and the scale of resource use and waste. There is also the growing concern about the loss of biodiversity, the depletion in the stratospheric ozone layer and the possible health and environmental implications of global warming.

However, there are two, more serious, environmental crises that are forgotten or their importance is downplayed. They are more serious because of their immediate impact on human health – and especially on the health of children. The first is the ill health and premature death caused by pathogens in the human environment – in water, food, air and soil. Each year, these contribute to the premature death of millions of people (mostly infants and children) and to the ill health or disability of hundreds of millions more. As the World Health Organization (WHO) points out,¹ this includes:

• the three million infants or children who die each year from diarrhoeal diseases and the hundreds of millions whose physical and mental development is impaired by repeated attacks of diarrhoea – largely as a result of contaminated food or water.

• the two million people who die from malaria each year, three quarters of whom are children under five; in Africa alone, an estimated 800,000 children died from malaria in 1991;² tens of millions of people suffer prolonged or repeated bouts of malaria each year.

• the hundreds of millions of people of all ages who suffer from debilitating intestinal parasitic infestations caused by pathogens in the soil, water or food, and from respiratory and other diseases caused or exacerbated by pathogens in the air, both indoors and outdoors.

There are very large differences between the disease burdens suffered by those living in the wealthiest and the poorest countries from pathogens such as these. For instance, the disease burden per person from diarrhoeal diseases acquired in 1990 in sub-Saharan Africa was around 200 times larger than in West Europe, North America, Japan, Australia and New Zealand³* – and virtually all this disease burden is preventable or curable at a modest cost. In this same year, the disease burden per 5 to 14 year old child in sub-Saharan Africa from infectious and parasitic diseases and maternal causes was nearly 100 times higher than that for 5 to 14 year olds in the world’s wealthier countries.

The proportion of infants who die from infectious and parasitic diseases among households living in the poorest quality housing in Africa, Asia and Latin America is several hundred times higher than for households in West Europe or North America; all such diseases are transmitted by airborne, waterborne or foodborne pathogens or by disease vectors such as insects or snails. Of the 12.2 million children under the age of five who die each year in the South, 97 per cent of these deaths would not have occurred if these children had been born and lived in the countries with the best health and social conditions.⁴

The second ‘environmental crisis’ is the hundreds of millions of people who lack access to natural resources on which their health and/or their livelihood depend. The most common is no safe and convenient supply of water for drinking and domestic use. (Official statistics on water supply provision greatly overstate the proportion of the world’s population with safe and convenient supplies; see Chapter 2 for more details.) But there are also hundreds of millions of households who depend for part or all of their livelihood on raising crops or livestock – and their poverty (and the malnutrition and ill health that generally accompanies it) is the result of inadequate access to water and fertile land. This lack of access to land and water for crop cultivation or livestock underlies the poverty of around a fifth of the world’s population (see Chapter 4).

Although these two environmental crises – the life threatening pathogens in the human environment and the lack of access to natural resources needed for health and/or livelihoods – are often forgotten in the North, less than a century ago, diarrhoeal diseases, acute respiratory infections and other diseases spread by biological pathogens in the air, food or water were still the major causes of ill health and premature death in Europe, North America and Japan.⁵ Large sections of the population in these countries or regions also lacked access to fresh water while many of their rural populations also had too little land to support themselves adequately. This can be seen in the infant mortality rates that existed only 100 years ago in what were then the world’s most prosperous countries. Today, infant mortality rates (the number of infants who die between their birth and their first birthday per 1000 live births) in healthy, prosperous societies should be less than ten and can be as low as five. In such societies, it is very rare for an infant or child to die from an infectious or parasitic disease. Yet only 100 years ago, most prosperous European cities still had infant mortality rates similar to those in the poorest countries today, exceeding 100 per 1000 live births; in many, including Vienna, Berlin, Leipzig, Naples, St Petersburg and many of the large industrial towns in England, the figure exceeded 200.⁶

The fact that these two environmental crises have been tackled in the North in little more than a century shows the extent to which purposive human action can solve them. This is especially so for the pathogens in air, food, soil and water – either through environmental modification (for instance much improved housing and living conditions, including adequate provision for water supply and sanitation) or through protecting people from them or their health impacts. There are also many examples of countries in the South or particular states or regions within countries that have successfully tackled these environmental crises – and some have done so in a few decades. Most countries have made some progress in this, over the last 20 to 30 years. But much more could be done.

THE NEED FOR A SAFE ENVIRONMENT

The built environment in which an infant or child lives and the natural environment in which all settlements are located should be a safe environment. Environmental factors should not figure as major causes of infant and child deaths. The role of environmental factors in causing or contributing to ill health or injuries can be minimized. Indeed, the human environment should have a very positive role in promoting and supporting children’s physical and mental development. It is this book’s contention that governments and aid agencies can do far more to improve the environment for children and greatly reduce the toll that environmental factors take on child health and development – and on the health of their parents or carers. The cost of doing so is also, generally, not very high.

Many of the interventions to do this have not only very high social returns relative to costs but also high economic returns – for instance through the increased productivity of a healthy workforce and decreased expenditures on medicines and health care. Obviously, the greatest difficulties in funding such interventions come in the nations with the lowest incomes and the least prosperous economies and in the villages or urban districts with the lowest-income inhabitants who have the least possibility of repaying the cost of the needed interventions. But there are many examples of successful interventions to reduce environmental hazards for children which required modest levels of external funding – including numerous examples of community-based initiatives which received some support from local non-governmental organizations (NGOs) or foundations (and sometimes from municipalities, government agencies or international agencies). Many also recovered most of their costs. These are considered in more detail in Chapter 6. There is also the fact, much stressed by UNICEF in its annual The State of The World’s Children, that much child illness and death is preventable at low cost as in the vaccine preventable diseases and in addressing micronutrient deficiencies such as iodine, vitamin A, iron and zinc (for more details see Chapter 2). The cost of curing or controlling many of the infectious and parasitic diseases associated with poor quality living environments is also very low.⁷

This first chapter sets the context for the rest of the book by considering the environmental components of ‘development’, especially those that concern children, and the great variety of environmental and non-environmental factors that influence child health. It also locates this discussion of the environmental problems that children face in their homes and neighbourhoods within the social, economic and political context in which they occur – especially why it is almost always the children (and adults) in the households with the lowest incomes and least assets that suffer most ill health, injury and premature death from environmental problems. Chapter 2 describes the different kinds of environmental hazards that affect child health and development while Chapter 3 describes how and in what way these hazards affect the health of infants and children and how the scale and nature of environmental hazards change the older the child. Chapter 4 describes the links between children and renewable resources, although the main concern is how and under what conditions households obtain those natural resources on which their children’s survival or development depends. It concentrates on rural and urban households whose livelihood depends in part or wholly on access to natural resources.

Chapter 5 discusses the meaning of ‘sustainable development’, especially for children, and how a concern for sustainable development fits within the concerns outlined in previous chapters. It also considers current patterns of consumption for non-renewable resources and the wastes arising from production and consumption, and what these imply for the achievement of sustainable development. It also questions the much published assertion that ‘the poor’ are a significant contributor to the depletion of the world’s environmental capital. Chapter 6 describes a community-based approach to addressing environmental problems, termed ‘primary environmental care’, that can serve as the means through which groups of people (including children) can better manage their own environment while also addressing their own livelihood and health needs. Chapter 7 discusses the involvement of children in primary environmental care and in other environmental concerns.

LINKS BETWEEN THE ENVIRONMENT AND CHILD HEALTH

The early chapters in this book concentrate on describing the range of physical, chemical and biological hazards to which infants and chi...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of Acronyms and Abbreviations
• List of Figures, Tables and Boxes
• About the Authors
• Preface
• 1. The Environment for Children
• 2. The Links between Environment and Health
• 3. The Vulnerability of the Infant and Child to Environmental Hazards
• 4. Children and Renewable Resources
• 5. Sustaining Environment and Development
• 6. Primary Environmental Care
• 7. Children as a Bridge to Sustainable Development
• Bibliography
• Index