聯合國兒童基金會:兒童沒有廁所 營養不良風險更大

 

聯合國兒童基金會:兒童沒有廁所 營養不良風險更大

On 6 December, children stand outside portable toilets, in the Astrodome evacuation centre in Tacloban City – among the areas worst affected by Typhoon Haiyan – in Leyte Province, Eastern Visayas Region. The toilets bear the UNICEF logo. From 5 to 7 December in the Philippines, Government-led emergency relief and recovery operations continued in the wake of the destruction caused by Typhoon Haiyan (known locally as Yolanda), which hit the Philippines on 8 November. Casualties have reached 5,759, and 1,779 people remain missing. Some 15 million people, including 6.7 million children, have been affected. Some 4 million people, including 1.6 million children, have been displaced. The storm, one of the strongest ever to make landfall, also destroyed homes, schools, hospitals, roads, communications and other basic infrastructure, and damaged power and water supply systems. Though main roads were passable as of mid-November, debris continues to hamper access to remote areas. To date, UNICEF response has ensured that 360,500 people in affected areas have access to clean water. Hygiene kits have been provided to 100,000 people, and toilet slabs and portable toilets are serving 25,000 people. Other support includes screenings for malnutrition in children under age 5; efforts to reunify unaccompanied and separated children with their families; the establishment of temporary learning spaces that have benefitted over 10,000 children; and the assessment of damage to the cold chain in affected areas. UNICEF has appealed for US$61.5 million to cover its response to Typhoon Haiyan through May 2014.

© UNICEF/NYHQ2013-1219/Maitem

紐約/香港,2015年11月19日—聯合國兒童基金會今天表示,全球數百萬名極端貧窮的兒童,正因為缺乏廁所設施,而受到威脅。愈來愈多證據顯示,衞生程度偏低與營養不良的有密切關係

全球有24億人口還未有廁所可上,而世上每8個人中,就有1人須隨地便溺(即合共9.46億人)。與此同時,全球估計有1.59億名5歲以下兒童生長遲緩,另有5,000萬兒童體重並未及同齡兒童的正常水平。

由聯合國兒童基金會、聯合國愛滋病規劃署及世界衞生組織共同發佈的報告《從食水及環境衞生改善營養情況》,首次引述多年的個案及其他研究,顯示衞生情况惡劣與營養不良息息相關。重要的是報告會成為日後行動的指引。

衞生情况惡劣、特別是隨地便溺的環境,令患上腹瀉的機會增加,而腸道寄生蟲亦容易傳播,這會導致當地的人營養不良。

聯合國兒童基金會食水及環境衞生計劃負責人桑杰‧書杰塞克若(Sanjay Wijesekera)說:「我們要以切實和創新的方法,解決居民可以到哪裏上廁所的問題,否則我們將無法挽救數以百萬計最貧窮和最弱勢的兒童。研究證實了營養不良及衞生的關係,正正是另一個促使我們改善衞生的原因,因為這樣我們才能成功。」

每年,有9%五歲以下兒童死於腹瀉,患者透過與受感染的糞便接觸、攝入微生物(即糞口途徑)感染。當廁所使用率偏低,患上腹瀉的機會便會增加。

每年全球約錄得17億5歲以下兒童患上腹瀉個案,其中以低收入國家情況最為嚴峻,年均有3次爆發。而最脆弱的兩歲以下兒童患上腹瀉的頻率最高。多次腹瀉發作會永久地改變他們的腸道健康,讓兒童無法吸收重要的營養素,導致生長遲緩,甚至死亡。

每年有300,000名(即平均每日超過800名)5歲以下兒童因欠缺食水與衞生設施,而死於腹瀉相關疾病。當中,以居住在撒哈拉以南非洲及南亞地區的貧窮兒童最受威脅。

在部分流行隨地便溺的地區,腸道寄生蟲如蛔蟲、鞭蟲及鉤蟲都會經受污染的土壤傳播。鉤蟲是孕婦貧血的主因,並使孕婦誕下營養不良、體重不足的嬰兒。

A girl washes her hands at a basic hand-washing station after using the latrine, in a small village located between Gabú and Bafatá Regions. The village has achieved open-defecation-free (ODF) status, indicating that the entire village has committed to building and using latrines and has renounced open-air defecation, thereby also protecting its water supply from contamination by human excreta. Latrines, one for each extended family, as well as hand-washing stations, have been built by residents with UNICEF support. [#2 IN SEQUENCE OF TWO] In November/December 2012 in Guinea-Bissau, a vaccination campaign against measles was held as part of an effort by the Government and the Measles & Rubella Initiative, a multi-partner effort led by the American Red Cross, the United Nations Foundation, the United States Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and UNICEF. In Guinea-Bissau, political instability and deep poverty continue to contribute to limiting economic and social development. The country has the seventh-highest under-five mortality rate in the world, despite a decline (from 210 to 161 deaths per 1,000 live births) from 1990 to 2011, and maternal mortality is also high. One-third of the population and half of all rural inhabitants lack access to safe water. More than 80 per cent of the population have no access to sanitation. Cholera continues to be endemic, and HIV prevalence is 5.3 per cent among adults, with women disproportionately affected. Wide economic, gender and other disparities persist. Working with the Government, NGOs and others, UNICEF supports health; nutrition; water, sanitation and hygiene (WASH); education; and child protection interventions, including the Measles & Rubella Initiative. Worldwide, measles remains a leading cause of death among the youngest children: In 2011, some 158,000 people – mainly children under the age of 5 – died from the disease. Nevertheless, thanks to the Initiativ

© UNICEF/NYHQ2012-2155/LeMoyne
部分國家已經在改善衞生及兒童營養狀況方面取得很大進步。透過聯合國兒童基金會「社區主導的整體衞生」方法,受影響人口以自己的方法去解決隨地便溺的問題。
– 巴基斯坦達成2015年《千禧發展目標》,將1990年沒有衞生設施的人口減半。透過「社區主導的整體衞生」計劃,整個社會不再隨地便溺,令下一代有更好的衞生及營養水平。
 
埃塞俄比亞動員社區工作人員推動計劃,並在減少隨地便溺人口中錄得全球最大跌幅。雖然人口繼續增長,但隨地便溺人口比例已從1990年92%(4,400萬人)減至2015年的29%(2,800萬人)。
– 在馬里,撒哈拉地區的社區受旱災問題纏繞,本來高企的營養不良率更趨惡化。當地人推行「社區主導的整體衞生」計劃,改善衞生,讓居民得到和使用坑廁,並改善兒童的健康與營養。

– 剛果民主共和國因爆發衝突而需要緊急救援,聯合國兒童基金會為流離失所的居民提供營養改善及食水、個人及環境衞生(WASH)的介入措施。五歲以下兒童營養不良及水媒疾病個案明顯減少。近六成人口建坑廁,並有90%營養不良兒童在一年間回復正常體重。桑杰‧書杰塞克若說:「即使是在最貧窮的國家,抑或緊急時期,我們都沒有任何理由不去改善衞生問題。另一方面,我們有許許多多理由——要拯救每名生長遲緩或體重低於正常水平的兒童,甚至是病重或死亡的——難道這樣的問題不逼切嗎?」

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