When Salamatu Jibrin’s daughter drank water fetched from a nearby river, she started to cry. At first, Jibrin didn’t understand what had triggered her daughter’s tears, but when the baby started passing blood in her urine and eventually experienced diarrhea, it became clear that the water she drank was contaminated. 

Jibrin, a farmer who lives in Gwako, Nigeria, is one of several people Global Citizen advocate and actress Uzo Aduba meets in the sixth episode of ACTIVATE: The Global Citizen Movement, a six-part documentary series developed by National Geographic and Procter & Gamble and co-produced by Global Citizen and RadicalMedia. You can watch the sixth episode, on clean water, in full here.

Aduba travels to Nigeria’s Edo State to see how communities access drinking water and what sanitation looks like there, before calling on leaders to take action. 

Jibrin is part of the 70% of the country’s population that does not have access to clean water and sanitation. 

“We need a quality deep well here so that we can have clean water to drink,” Jibrin asks Aduba to tell Nigerian leaders. 

Nigeria is one of the 46 countries in sub-Saharan Africa that have been most affected by the global water crisis. Of the 783 million people who are without access to clean water, 40% live in sub-Saharan Africa, and more than 320 million people lack access to safe drinking water.

Poverty is a huge barrier to access to water and sanitation, and most of the world’s poorest countries are in sub-Saharan Africa.

Natural disasters, increased pollution, and a lack of resources are all driving forces of the water crisis in sub-Saharan Africa. Learn more about these issues and more below. 

1. Access to Water Supply and Sanitation

Sanitation facilities safely separate human waste from human contact, but when people don’t have access to safe toilets, they opt to defecate in the open, and exposed human waste is transferred back into people’s food and water resources. About one-fourth of those defecating in the open in the world live in sub-Saharan Africa and they spend an average of 2.5 days per year trying to find a private location to defecate. Women spend extra time looking for a safe place to go and are put can experience gender-based violence in the process.  

The use of contaminated drinking water and poor sanitary conditions results in increased vulnerability to water-borne diseases, including diarrhea, cholera, dysentery, and typhoid. More deaths occur among children under 2 years of age living in South Asia and sub-Saharan Africa. It is reported that 115 people in Africa die every hour from diseases linked to poor sanitation, poor hygiene, and contaminated water. 

When a person doesn’t have access to clean water and sanitation, they are also at risk of decreased school attendance, missed workdays, malnutrition, and poverty. When girls and women lack access to safe sanitation and water, their education suffers because they experience period poverty and can’t afford menstrual products, clean themselves safely, or access separate bathrooms.

In Africa, especially sub-Saharan Africa, more than a quarter of the population spends more than half an hour per trip to collect water. The task of fetching water tends to fall on women, and this burden can also prevent girls from attending school. 

Read More: Poorer People Pay More for Clean Water, Report Finds

2. Sanitation Gap

The number of people living in sub-Saharan Africa has nearly doubled in the last 25 years, but access to sanitation and water has improved minimally, leaving millions behind, according to the UN. Even where improvements in access to clean water and sewage infrastructure have been made, huge numbers of Africans live without these necessities. In countries in sub-Saharan Africa with the best water coverage rates, as many as 1 in 4 people still lack adequate sanitation. Rural residents are often worse off than urban residents when it comes to lack of access to water and sanitation, and funding is uneven and insufficient in the area, according to UNICEF.

Most overseas development aid goes to countries that are already doing well, and while water and sanitation access is far behind in rural areas, both external and domestic funding goes primarily to urban systems. Underprivileged urban populations end up spending much more money on water, while wealthy people living in urban areas pay less for cleaner water and better sanitation systems.

3. Emergencies and Disasters

Floods and drought are the most dangerous water-related disasters that occur in sub-Saharan Africa. Flooding contaminates drinking water and destroys hygiene and wastewater systems, while droughts cause the most deaths by creating food insecurity that leads to malnutrition and denies communities water supplies. In sub-Saharan Africa, 66% of people –– 300 million people –– live in areas with little to no rainfall, which leads to failed crops and agricultural efforts. 

Climate change is making water availability less predictable in sub-Saharan Africa, speeding up hunger and health crises, increasing poverty, and lowering incomes for entire populations. Droughts have been drier and lasting longer in recent years, in part due to climate change. 

4. Water Resources 

Africa’s rising population is driving demand for water and decreasing the availability of water resources. If governments don’t take radical action, the urban slum population in sub-Saharan Africa is expected to reach 400 million by 2020.

Armed conflict has also increased worldwide over the last decade, displacing millions of people and presenting a challenge for host communities that need to supply basic needs, including water and sanitation. 

Two-thirds of sub-Saharan Africa rely mostly or completely on surface water –– water on the surface of continents such as in a river, lake, or wetland. Surface water is often highly polluted and not considered a reliable and safe source of drinking water. Infrastructure to pipe water from fresh clean sources in dry areas or drilling for water is too expensive and forces communities to resort to dangerous alternatives. 

What’s Being Done?

Global Goal 4 aims to ensure availability and sustainable management of water and sanitation for all by 2030. Several organizations are working to meet this goal through programs that promote behavior change and education. 

The Water Supply and Sanitation Collaborative Council (WSSCC), for example, runs the world’s first and only fund dedicated to “improving sanitation and hygiene through community-based, publicly-supported and commercially operated programs, reaching millions of people.” 

The charity United Purpose works across sub-Saharan Africa to empower women and communities to voice their rights, promote good sanitation and hygiene to reduce water-borne diseases.

ACTIVATE: THE GLOBAL CITIZEN MOVEMENT is a six-part documentary series from National Geographic and Procter & Gamble, co-produced by Global Citizen and RadicalMedia. ACTIVATE raises awareness around extreme poverty, inequality, and sustainability issues to mobilize global citizens to take action and drive meaningful and lasting change. The series will premiere globally in fall 2019 on National Geographic in 172 countries and 43 languages. You can learn more here.