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World Health Day: Health inequality in East Africa, and our humanitarian response

World Health Day prods us to explore lesser-known health facts of unfamiliar realities. Although our society advances, globally there is a need for better health situations.

As MERCY PARTNERS, we are motivated to provide healthcare because our envisioned future is for all to know the grace of God. Our safe water initiative, PROJECT JACOB, has balanced the scales of health inequality by providing safe water and addressing contamination issues. Our WASH (Water Access, Sanitation, and Hygiene) instruction assures those rural communities can sustain their safe water needs, even in times of political turmoil.

WASH exemplifies the practical mercy of Jesus' ministry — caring for the poor in spirit and their health. WASH is also the foundation of society, as, without it, communities would not exist — good health and mental well-being flourish through safe water. Safe water is essential and creates tremendous evangelistic opportunities.

Consider the below realities and estimations of health among some East African nations:

Life expectancy and healthy life expectancy:

In South Sudan, age expectancy is 57 for women and only 55 for men. Uganda and Sudan's population enjoys an additional year or two.

Health inequalities:

East Africans face a complex blend of interconnected threats to their health and well-being. Many of these threats are rooted in social, political, economic, and gender inequalities beyond the regional health perils.

For instance, certain degraded conditions impede appropriately targeted interventions, such as overcrowded housing. By world health standards, an extremely crowded home is defined as more than five people per room used for sleeping in the house. MERCY PARTNERS have known up to 20 to live in one home in South Sudan, with as few as two rooms.

Many in East Africa house five members in one room with the kitchen to the side. Indeed, COVID-19 has shone a harsh spotlight on housing inequalities and the importance of using WASH to address them. Irrespective of the pandemic, infectious diseases have ravaged East Africa's populations, whose habitations are densely populated.

The burden of disease and inadequate sanitation and hygiene


  • There are 1.7 billion cases of diarrhea among children younger than five years old.

  • An estimated 446,000 children younger than five years old die from diarrhea, mostly in developing countries. This amounts to 9% of the deaths of children younger than 5.

  • There are 3 million cases of cholera and an estimated 95,000 cholera deaths.

  • There are 11 million cases of typhoid fever and an estimated 129,000 typhoid fever deaths.

  • Parasitic worms found in contaminated soil infect 1,723 thousand people worldwide. Many of these infections are associated with inadequate or non-existent sanitation facilities.

  • Worldwide, millions of people suffer from neglected tropical diseases (NTDs); many are water-borne illnesses and pathogens often correlated to poor hygiene. These diseases are often in places with unsafe drinking water, poor sanitation, and insufficient hygiene practices.

MERCY PARTNERS mitigates Cholera, Malaria, diarrhea, and Typhoid regularly. In addition to providing access to over 4400 medical treatments related to such diseases and illnesses, we have added nutritional supplements, supplies, and instruction to create Oral Rehydration Solution (ORS) to free a community to care for themselves long after the clinics move away.

Furthermore, sanitation and hygiene outreach is administered by local hands connected to loving hearts because we have empowered the church. Instead of far-off strangers rendering aid, the empowered church enters the camps of the displaced to remove each parasite that had already developed into the larvae stage and sanitize trash homes of the slums.

Progress in preventing and treating diseases like Cholera, Malaria, Dysentry, and Typhoid (especially those that tend to kill children under five), has seen them decline significantly below some notable noncommunicable diseases and injuries.

Access to essential health services and safe water:

The pace of progress in essential health services has slowed since 2010, and African countries in conflict generally lag furthest behind. According to the latest available data from 2014 to 2019, the reach of health workers is the lowest in our service region, with just three doctors per 10,000 population with only ten nursing/midwifery personnel per 10,000 population. In addition, 700 million used unimproved facilities, and 673 million continued practicing open defecation.

Assessment of our sanitation and safe-water reports signaled significant underinvestment in hand-washing facilities, improved lavatory systems, and safe water among those in and near refugee settlements and rural communities. As a result, unsafe drinking water contributed to most diarrheal deaths, while unsafe sanitation contributed to more than half of deaths from similar diseases. These two realities contribute to the need for our PROJECT JACOB and WASH program throughout all the regions we operate.

Ethiopia, Uganda, Kenya, and Tanzania have the largest number of people in the region with no access to basic sanitation services. Meanwhile, the most considerable proportions and numbers of people practicing open defecation are in countries like Eritrea, South Sudan, and Ethiopia. It is why we make our WASH program the basis of each medical outreach in East Africa. Sanitation and hygiene classes are held alongside medical outreaches, and the treatment of preventable ailments is never overlooked but immediately addressed. In addition, the local disciples pray over each soul cared for as they speak about a loving heavenly Father and His Son who died and was resurrected.

Our providing safe water access during or right after medical outreach increases the sustainability of health care and furthers prevention. Globally, more than 785 million people have access to at least basic water (improved drinking water sources, including rusty piped connections), and more than 884 million people do not have safe water. Unsafe drinking water contributed to 72% of diarrheal deaths, while unsafe sanitation contributed to about 56% of deaths from diarrheal diseases.

Water and sanitation interventions are cost-effective across all world regions:

Water, sanitation, and hygiene have the potential to prevent at least 9% of the global disease burden and 6% of global deaths. In addition, the impact of clean water technologies on public health has had a return rate of over 2000%. Improved sanitation contributed to a 15% decrease in diarrheal deaths in Southeast Asia, East Asia, and Oceania, and more than a 10% decrease globally.

While efforts to eliminate open defecation in many countries are on course, too many households are too low on the sanitation service ladder, with every risk of being stuck there. MERCY PARTNERS is standing in the gap, reversing disease deaths in rural areas where access to an adequate toilet essentially equates to good sanitation.

Global water and sanitation interventions have demonstrated economic benefits ranging from $5 to $46 per $1 invested. MERCY PARTNERS have seen the complete transformation of villages and hundreds coming to Christ from our medical and water initiatives.

Overcoming the challenges in reporting data:

Current data is inadequate in many countries to monitor health inequalities and assess the situation of vulnerable populations. Traditionally, these data blind spots masked the struggles of vulnerable groups and people living in specific areas misleading humanitarian efforts to allocate resources effectively and prioritize interventions properly. However, MERCY PARTNERS has decreased and even nullified the margin of misallocation by empowering locals to be the caretakers. Locals intimately know what is needed for the success of their villages' sanitation.

• • •

MERCY PARTNERS works with the empowered local church to achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying particular attention to the needs of those in vulnerable situations.


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Thomas, Communications Director for Mercy Partners


Thomas Kilian III, as Communications Director, has personal relationships with our Global Partners having traveled to most of our mission points. He is degreed with a Bachelors of Science, with high honor, and is a candidate for Masters of Theology from NationsUniversity. He's an Ordained Minister and is the author of the book, Start being, Stop Doing (



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