Photo above: Girls washing their hands outside the school toilet block. Kalmunai, Ampara district. Sri Lanka ©Tom Pietrasik

This photograph was taken in eastern Sri Lanka a month ago. The four students had all been on a hygiene awareness course and had emerged enthusiastic advocates of handwashing.

India celebrates Global Handwashing Day on October 27th. I will be following activities in the east Indian state of Jharkand on that day. In the meantime, I’m in West Bengal photographing the build up to the event and looking at attempts to improve the sanitary conditions of those people most vulnerable to water-borne infection.

I’ve been doing a little background reading on the shocking statistics that demonstrate the urgency of the situation. According to UNICEF more than 5,000 children under the age of 5 years die every day from diarrheal diseases. And acute respiratory infections account for the the deaths of 1.8 million children a year.

According to a report in the Lancet, the incidence of both diarrhea and acute respiratory infections can be significantly reduced by handwashing. The report estimates, for instance, that handwashing with soap could cut the rate of diarrheal infections by almost 50 percent. It is clear that we need to increase awareness of the importance of handwashing. This doesn’t mean that other issues can be ignored. Inadequate clean-water supplies, overcrowded living conditions, a lack of education, poor nutrition and insufficient investment in public healthcare all contribute to the deaths of millions of people every year.

But if the enthusiastic splashing of the students I met in Sri Lanka could be replicated elsewhere, we might have achieved a significant step towards reducing the appalling rate of child mortality.