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For more than 150 years, scientists have known that hand-washing prevents infection. Nonetheless, practical barriers to personal hygiene remain a formidable problem in places like Chunhua. According to World Bank researchers, nearly one million children worldwide die of preventable diarrheal disease each year. In a 2003 Lancet article, Dr. Valerie Curtis, a professor at the London School of Tropical Medicine and Hygiene, noted that washing hands with soap could reduce rates of diarrheal disease infection in developing nations by up to 47 percent, as well as reduce the transmission of acute respiratory infections. But in many areas where these hygiene-related deaths occur, soap, adequate water supply, and functional health care systems remain financially out of reach.
Although rural Chinese villages like Chunhua are far from the spotlight in global public health discussions, they too suffer from poor sanitation and preventable illness. But in China's case, despite massive water shortages and the collapse of a nationwide healthcare infrastructure, the country still accounts for over 30 percent of the world's annual economic growth. Some experts suggest that Communist- era investments in health care and education have contributed to China's recent success. But if the nation does not renew its commitment to health care by promoting sanitation in rural areas, its economy could suffer. Water scarcity produces poor sanitation in both human and animal communities. Already, diarrheal disease kills up to 47,000 Chinese children under age five each year. Now, health officials fear that poor sanitation could expedite a pandemic, spreading first among livestock and then mutating to infect humans. The recent scares of SARS and avian fl u serve as a reminder that epidemic illness in China could prove demographically and economically disastrous if the nation does not commit itself to promote basic practices like hand-washing.
In the struggle against diarrheal disease, many scientists and aid workers have focused on water quality. In China, however, water scarcity looms as an even greater problem. Without adequate water for drinking, how many people will be willing to use it for hand-washing? China now has a yearly supply of approximately 2,200 tons of water per capita. This figure does exceed the United Nations "threshold of concern" of 1,750 tons, but it equals only about 25 percent of the global average. As with many other resources in China, the regional distribution of water is strikingly unequal. The North China Plain, an area that stretches from the northern capital city of Beijing to the Jiangsu province, has merely 500 tons of water per capita, 50 percent below the level at which the United Nations expects consequent "economic and social disruptions." The North China Plain claims only 7.5 percent of the nation's water resources but still accounts for 40 percent of China's economic output. Tianjin, one of the driest cities in China and also a large industrial center, has a mere 110 tons of water per capita, on par with the desert nation of Saudi Arabia.
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