Reasons for the high death toll:
- Lack of access to clean drinking water: Many Indian communities, especially in rural areas, do not have access to clean and safe drinking water. This leads to the consumption of contaminated water, which causes water-related diseases.
- Poor sanitation facilities: Inadequate sanitation facilities contribute to the contamination of water sources, further increasing the risk of waterborne diseases.
- Lack of awareness and education: Many individuals, especially in marginalized communities, may not be aware of the importance of clean water and proper hygiene practices to prevent water-related diseases.
- Limited healthcare resources: In many parts of India, there is a lack of sufficient healthcare resources to treat individuals suffering from water-related diseases, leading to high mortality rates, especially among young children.

Efforts to address the issue:
- Government interventions: The Indian government has implemented various programs and initiatives to improve access to clean water and sanitation facilities in rural areas.
- NGOs and nonprofit organizations: Several NGOs and nonprofit organizations are working towards providing clean water solutions and raising awareness about the importance of hygiene practices in preventing water-related diseases.
- Community participation: Engaging local communities in water management and sanitation initiatives can help ensure sustainable access to clean water and reduce the incidence of waterborne diseases.
- Health education campaigns: Conducting health education campaigns to promote proper hygiene practices and the importance of clean water can help prevent water-related diseases in vulnerable populations.
By addressing the root causes of water-related diseases and implementing effective interventions, the high death toll among Indians, especially children under five, can be significantly reduced.