This year, World Water Day coincides with the International Year of Sanitation, challenging us to spur action on a crisis affecting more than one out of three people on the planet.

Every 20 seconds, a child dies as a result of the abysmal sanitation conditions endured by some 2.6 billion people globally. That adds up to an unconscionable 1.5 million young lives cut short by a cause we know well how to prevent.

Poor sanitation combines with a lack of safe drinking water and inadequate hygiene to contribute to the terrible global death toll. Those who survive face diminished chances of living a healthy and productive existence. Children, especially girls, are forced to stay out of school, while hygiene-related diseases keep adults from engaging in productive work.

Leaders who adopted the Millennium Development Goals in 2000 envisioned halving the proportion of people living without access to basic sanitation by the year 2015 – but we are nowhere near on pace to achieve that goal. Experts predict that by 2015, 2.1 billion people will still lack basic sanitation. At the present rate, sub-Saharan Africa will not reach the target until 2076.

While there have been advances, progress is hampered by population growth, widespread poverty, insufficient investments to address the problem and the biggest culprit: a lack of political will.

With the right resolve, there are many steps that members of the international community can take. The Commission Sustainable Development in 2005 outlined a series of measures aimed at securing meaningful progress, holding Governments of affected countries primarily responsible. It also called for international support through a conducive policy environment, financial resources and the transfer of technology to countries in need.

If we take up the challenge, the positive impact will reverberate far beyond better access to clean water. Every dollar invested in water and sanitation yields an estimated seven dollars worth of productive activity. And that comes on top of the immeasurable gains in cutting poverty, improving health and raising living standards.

World Water Day offers a chance to spotlight these issues, but this year let us go beyond raising awareness – let us press for action to make a measurable difference in people’s lives.

Although many of us know that water is a scarce resource in our world, few people know that more than 5,000 children under the age of 5 die each day due to lack of access to clean and safe drinking water.

That’s nearly 2 million children each year. On World Water Day, we need to remember these children and their families. Although I have worked in healthcare for more than 30 years, I didn’t know the depth of the crisis of poor sanitation and dangerous water. I was shocked at these statistics when I came to the US Coalition for Child Survival in 2006.

In 2005, I paid a visit to the Children’s Hospital in Kabul, Afghanistan. Afghanistan has one of the worst infant, child and maternal mortality statistics in the developing world. Although improvements have been made in the last few years, there continues to be a crisis there. When I visited Children’s Hospital of Kabul, I found that each day nearly 1,000 children come to the clinic seeking help. The hospital, at that time, didn’t have clean water or working sanitation. Babies were sharing incubators and the food was horrible. Many children showed up due to malnutrition, dehydration and illnesses related to unsafe drinking water.

The effects of climate change are already being felt in some of the world’s poorest countries. Charlotte Sterrett, Oxfam Australia Southern Africa Program Officer, recently travelled to South Africa to see the impacts first-hand.

Thandi lifts up a handful of soil and watches as it disappears through her hands. Once rich and fertile and capable of producing bountiful crops, the soil is now bone dry.

“The ground used to be soft and easy to dig by hand; water was freely available just under the surface and food was plentiful; there was a lake nearby that provided fish for us to eat,” Thandi says. “But now the land is dry and hard and there is no water under the surface; even the lake has dried up.”

Thandi sits with a group of men and women under the shade of a large tree in Hluhluwe, a small town in KwaZulu-Natal province in the north-eastern corner of South Africa. Hluhluwe is a poor community struggling to contend with eight years of drought, high unemployment, rising poverty and some of the highest malaria and HIV rates in the country. Now, after years of fighting for access to adequate health care, food, clean water and sanitation and striving to reduce the effects of HIV and AIDS and conflict, the Hhuhluwe community is facing another battle — climate change.

This is what has brought me here. Oxfam Australia works with 10 partners in UMKhanyakude to help communities with high levels of HIV grow and obtain enough food to eat. While largely unaware of the term ‘climate change’, the local communities are concerned about the effects of prolonged drought and extremely low rainfall on their crops.

Understanding climate change

Hluhluwe is one of six communities I am visiting in UMKhanyakude to get a better understanding about the effects of climate change here — what impact it is having, what communities know about it and how they are adapting to it.

Climate change is an area of work Oxfam will be placing a greater focus on in coming years. The findings from this research in Hluhluwe will be incorporated into our current projects in UMKhanyakude and be shared with partners and Oxfam affiliates across the Southern African region.

As I talk with the men and women of Hluhluwe, the conversation quickly turns to the weather and how it has changed in the past 50 years. “The weather is much hotter and drier and more humid,” says one. “We can’t tell as much difference between summer and winter anymore,” says another. “We used to talk about when the drought would end; now we are thinking that maybe it is not going to end,” says another. “I don’t see how things are going to get better.”

Although the people of Hluhluwe have experienced droughts and floods for as long as they can remember, since the mid-1990s they have noticed a gradual drying of the land.

The ground was once so lush that people could use their hands to dig for water just below the surface. But those times have long gone. Even the rainwater tanks that were installed as a solution now stand dry. The local council sends a truck to fill up the tanks, but there is no delivery schedule, nor any guarantee the truck will return. While we are there a truck comes, but is only able to half-fill one tank. This water will only last a week or so.