March 25, 2015 | By Roger Thurow

Healthy Food for a Healthy World: the Role of Water, Sanitation, and Hygiene in Improving Nutrition

Photo credit: Anne Thurow

The Chicago Council’s campaign, “Healthy Food for a Healthy World,” builds awareness about the important role food can play in promoting health and alleviating malnutrition. We publish a blog post weekly exploring these issues and the series will culminate in the release of a new Chicago Council report at the Global Food Security Symposium 2015 on April 16. Look for a new post each Wednesday, join the discussion using #GlobalAg, and tune in to the Symposium live steam on April 16.

By Roger Thurow, Senior Fellow, Global Agriculture & Food, The Chicago Council on Global Affairs

Good nutrition goes hand-in-hand with clean water, sanitation and hygiene.  Literally.  In many settings around the world, in poor neighborhoods and rich, I have seen washing hands as a central part of nutrition education programs.

Malnutrition isn’t only due to a lack of nutritious food; it can be exacerbated by parasites, bacteria, aflatoxins and pathogens found in the food, water and soil.  Bad water, poor sanitation and lousy hygiene undermine nutrition: illnesses like diarrhea and dysentery force nutrients out of the body, while parasites and worms absorb the nutrients meant for the body.

In a country like Guatemala, the toxic mixture of poor nutrition and poor sanitation leads to widespread malnutrition and stunting of children.  In the western highlands, where parasitic infection is endemic, the malnutrition and stunting rate approaches 70 percent.  And so, at a rural clinic named Primeros Pasos (First Steps), the nutrition-cleanliness lesson is taught early and often.

One morning, I followed a class of kindergartners as they came in for their annual checkup and health lesson.  After the children had been weighed and measured and examined, they gathered in a small classroom, where the walls were covered with posters of food.  They learned about the benefits of selecting fruits and vegetables for snacks rather than chips and sweets.

“You all want to be big and strong?,” asked an instructor.

“Yes!,” came the reply.

Then the instructor opened up a simple picture book and told a story about a girl named Marequita, teased by her friends as “the dirty one.”  She always played in the dirt and didn’t wash up afterwards.  She drank dirty water from the river.  She ate carrots straight out of the ground without washing off the dirt.  She didn’t wear shoes, brush her teeth or use a toilet.  Marequita gets a stomach ache and a fever.  She is sick in bed.

Marequita visits the doctor, who finds parasites in her stomach.  He gives her medicine to fight the worms.  Marequita learns to wash her hands, and to ask her parents to boil water before drinking.  She promises to wear shoes and use the toilet.  She becomes known as “the clean one.”

“So what do you need to do?,” the instructor asked.

“Wash Hands.  Use soap.”


“Before eating.  After using the toilet.”

The class walked outside to a water tap.  The pupils practiced washing their hands with soap, scrubbing top and bottom and between the fingers and up their wrists and arms as well.  With clean hands, they enjoyed a snack.  And they clutched their takeaways for the day: a toothbrush and soap, and de-worming medicine if needed.  And a new role model: Marequita the Clean.

Read previous posts in the Healthy Food for a Healthy World blog series:

Leveraging the Digital Revolution to Improve Nutrition

Hungry Cities on the Rise

Women as the Force for Improving Global Nutrition

Wasted Food, Wasted Nutrients

Food as Medicine—The Link Between Nutrition and Health

The $2 Trillion Market for Fruits and Vegetables

Economic Costs of Global Malnutrition



The Global Food and Agriculture Program aims to inform the development of US policy on global agricultural development and food security by raising awareness and providing resources, information, and policy analysis to the US Administration, Congress, and interested experts and organizations.

The Global Food and Agriculture Program is housed within the Chicago Council on Global Affairs, an independent, nonpartisan organization that provides insight – and influences the public discourse – on critical global issues. The Council on Global Affairs convenes leading global voices and conducts independent research to bring clarity and offer solutions to challenges and opportunities across the globe. The Council is committed to engaging the public and raising global awareness of issues that transcend borders and transform how people, business, and governments engage the world.

Support for the Global Food and Agriculture Program is generously provided by the Bill & Melinda Gates Foundation.


1,000 Days Blog, 1,000 Days

Africa Can End Poverty, World Bank

Agrilinks Blog

Bread Blog, Bread for the World

Can We Feed the World Blog, Agriculture for Impact

Concern Blogs, Concern Worldwide

Institute Insights, Bread for the World Institute

End Poverty in South Asia, World Bank

Global Development Blog, Center for Global Development

The Global Food Banking Network

Harvest 2050, Global Harvest Initiative

The Hunger and Undernutrition Blog, Humanitas Global Development

International Food Policy Research Institute News, IFPRI

International Maize and Wheat Improvement Center Blog, CIMMYT

ONE Blog, ONE Campaign

One Acre Fund Blog, One Acre Fund

Overseas Development Institute Blog, Overseas Development Institute

Oxfam America Blog, Oxfam America

Preventing Postharvest Loss, ADM Institute

Sense & Sustainability Blog, Sense & Sustainability

WFP USA Blog, World Food Program USA


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