I love water.  I drink out of faucets, coolers, fountains, and my backyard hose.  I catch snowflakes on my tongue.  I love to be in rivers, streams, oceans, pools, and my pond, stomping in mud puddles.   I love to be in sailboats, kayaks, canoes, ferries, and big truck inner tubes.  And I just love to look at water and listen to it.  To me, water looks and feels and sounds like life itself: the trickle of a waterfall melting after a winter freeze or the crashing of an ocean wave on a sandy beach.  I can’t imagine my life without it.

This summer in New York was a hot one, and we all became more aware of water than usual.  People complained about the humidity while gulping from plastic bottles of designer water.  Leaving work via the streets of the Bronx, I would have to close my sun roof and nudge through the powerful spray of an open hydrant, where children and adults soaked up the blast of cold water.  Concerned about women and children traveling to our child advocacy center on subways and buses and hot sidewalks, I ordered cases of bottled water and instructed staff to make sure everybody who visited the center got water.  And yes, I worried about the plastic getting warm and releasing long-lasting toxins, but it was a matter of situational ethics.  Gotta get water into every man, woman, and child.

Sometime in late July, an e-mail popped up on my computer from an organization called End Water Poverty.  The message, advertising an open position on the project, ended with the statement, “Our ambition is massive.”  Massive ambition indeed and massively needed, for there in the opening paragraph was the statistic that to this day causes me to catch my breath every time I find myself taking water for granted:  every day 4,000 children die from drinking dirty water.  That is 1,460,000 children a year, a massive number of special, lovely, individual children who die because there is no clean water for them to drink.

I first became aware of the global tragedy due to unclean water and unethical business practices in the early 1970s as I was about to have my first baby.  Researching the benefits of breastfeeding, I came across information about the campaign against Nestle infant formula in developing countries.  With a decrease in infant formula sales in the United States and Europe as more women chose to breastfeed their babies, Nestle stepped up their marketing of “breast milk substitute” in Africa.  The marketing strategy included sending company salespersons wearing white uniforms into local hospitals in Africa and giving women samples of a month’s supply of powdered formula -- enough so that by the time they ran out, they had also stopped lactating and had to buy the formula.  But they soon learned that the formula was very expensive, a month’s worth often costing more than the family income for a month. And so the formula that was purchased was watered down and often with unclean water. The number of babies who died cannot be calculated, but WHO spent millions of dollars on a generation of sick babies.  It was my first small public health effort to demonstrate against Nestle in my local grocery stores, to raise awareness of what the company that made chocolate milk for our kids was doing to mothers and babies in Africa. That was 40 years ago but UNICEF still estimates that a non-breastfed child living is 6 to 25 times more likely to die of diarrhea and 4 times more likely to die of pneumonia than a breastfed child.  I suggest that any MCH advocate take a look at this issue online.  Maybe we still have to be in grocery stores protesting and questioning the business practices and marketing strategies that put our babies and children at risk of death and disease.  Along with End Water Poverty we all need that massive ambition to get the water of the world cleaned up so the good fresh water we do have can restore and refresh those around us. 

It is now late August in New York, and the heat has somewhat subsided, although midday is still oppressive on the sidewalks of the Bronx.  Yesterday I had to run between our medical center and my advocacy center.  I had patients and budget issues and the next meeting to go to on my mind, but most prominent in my consciousness was the aching in my sweaty wet feet as they rebelled against the cute princess heels and pointed toes of my shoes.  “Ah, when I get home I’ll dangle my feet in my pond,” I was thinking as I looked up and saw, through the shimmering heat waves, what seemed to be an apparition in the desert approaching me.  She was tall and elegant, swathed in red and orange, the scarf of white wrapped over her dark brown face.  It wasn’t until she was 10 feet away from me that I could see that she looked exhausted, beads of water on her forehead, streams running down her face, her eyelids lowered.  She reached out to me and I realized that we were both fortunate enough to be next to the front steps of a house under the shade of a maple tree.  Her name was Ann, and she was on her way to a nearby bus stop.  I asked her if she would like to come into my office for a while, but she said she had to get to the bus and home to her apartment where her grandchildren would be arriving after school.  As we shared a grandmother moment, I remembered that I had stuck a bottle of water in my briefcase, and I pulled it out and offered it to her.  She tipped her beautiful head back, closed her eyes, took a drink and smiled and then I remembered a line from The Little Prince:  “This water was indeed a different thing from ordinary nourishment. It was good for the heart, like a present.”

The gift to me from Ann was a moment of rest under a maple tree when I could slip off those shoes, two women sharing our love of our families, her smile and a reminder that we all need water to sustain us and keep us massively ambitious.

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Once again, Section member Karel Amaranth brings us her special musings on our lives in public health.   End Water Poverty opposes the global injustice that causes millions to live without access to clean water and sanitation.  For more information, click here.  Also, long-time MCH members may recall that our Section was instrumental in resolving the Nestle Boycott by lobbying APHA to pass a resolution endorsing the boycott.  The group that organized the Nestle Boycott is now called Corporate Accountability International, and their Think Outside the Bottle campaign works to promote and protect funding for public water systems.  For more information, click here.