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联合国儿童基金会:儿童沒有厕所 营养不良风险更大

2015-11-19

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, deis 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

纽约/香港,2015年11月19日—联合国儿童基金会今天表示,全球数百万名极端贫穷的儿童,正因为缺乏厕所设施,而受到威胁。愈来愈多证据显示,衞生程度偏低与营养不良的有密切关係

全球有24亿人口还未有厕所可上,而世上每8个人中,就有1人须随地便溺(即合共9.46亿人)。与此同时,全球估计有1.59亿名5岁以下儿童生长迟缓,另有5,000万儿童体重並未及同龄儿童的正常水平。

由联合国儿童基金会、联合国爱滋病规划署及世界衞生组织共同发佈的报告《从食水及环境衞生改善营养情况》,首次引述多年的个案及其他研究,显示衞生情况恶劣与营养不良息息相关。重要的是报告会成为日后行动的指引。

衞生情况恶劣、特別是随地便溺的环境,令患上腹泻的机会增加,而肠道寄生虫亦容易传播,这会导致当地的人营养不良。

联合国儿童基金会食水及环境衞生计划负责人桑杰‧书杰塞克若(Sanjay Wijesekera)说:「我们要以切实和创新的方法,解决居民可以到哪裏上厕所的问题,否则我们将无法挽救数以百万计最贫穷和最弱势的儿童。研究证实了营养不良及衞生的关係,正正是另一个促使我们改善衞生的原因,因为这样我们才能成功。」

每年,有9%五岁以下儿童死于腹泻,患者透过与受感染的粪便接触、摄入微生物(即粪口途径)感染。当厕所使用率偏低,患上腹泻的机会便会增加。

每年全球约录得17亿5岁以下儿童患上腹泻个案,其中以低收入国家情况最为严峻,年均有3次爆发。而最脆弱的两岁以下儿童患上腹泻的频率最高。多次腹泻发作会永久地改变他们的肠道健康,让儿童无法吸收重要的营养素,导致生长迟缓,甚至死亡。

每年有300,000名(即平均每日超过800名)5岁以下儿童因欠缺食水与衞生设施,而死于腹泻相关疾病。当中,以居住在撒哈拉以南非洲及南亚地区的贫穷儿童最受威胁。

在部分流行随地便溺的地区,肠道寄生虫如蛔虫、鞭虫及钩虫都会经受污染的土壤传播。钩虫是孕妇贫血的主因,並使孕妇诞下营养不良、体重不足的婴儿。

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
部分国家已经在改善衞生及儿童营养状况方面取得很大进步。透过联合国儿童基金会「社区主导的整体衞生」方法,受影响人口以自己的方法去解决随地便溺的问题。
- 巴基斯坦达成2015年《千禧发展目标》,将1990年沒有衞生设施的人口减半。透过「社区主导的整体衞生」计划,整个社会不再随地便溺,令下一代有更好的衞生及营养水平。
 
- 埃塞俄比亚动员社区工作人员推动计划,並在减少随地便溺人口中录得全球最大跌幅。虽然人口继续增长,但随地便溺人口比例已从1990年92%(4,400万人)减至2015年的29%(2,800万人)。
- 在马里,撒哈拉地区的社区受旱灾问题缠绕,本来高企的营养不良率更趋恶化。当地人推行「社区主导的整体衞生」计划,改善衞生,让居民得到和使用坑厕,並改善儿童的健康与营养。

- 刚果民主共和国因爆发冲突而需要紧急救援,联合国儿童基金会为流离失所的居民提供营养改善及食水、个人及环境衞生(WASH)的介入措施。五岁以下儿童营养不良及水媒疾病个案明显减少。近六成人口建坑厕,並有90%营养不良儿童在一年间回復正常体重。桑杰‧书杰塞克若说:「即使是在最贫穷的国家,抑或紧急时期,我们都沒有任何理由不去改善衞生问题。另一方面,我们有许许多多理由——要拯救每名生长迟缓或体重低于正常水平的儿童,甚至是病重或死亡的——难道这样的问题不逼切吗?」

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