We Need to Rethink What Safe Water Means

We Need to Rethink What Safe Water Means

We Need to Rethink What Safe Water Means. Statistics from reliable sources tell us that in India in 2010, 97 percent of urban and 90percent of the...

Statistics from reliable sources tell us that in India in 2010, 97 percent of urban and 90percent of the rural population in India had access to improved sources of water.

When I walk around in the area in urban Tamil Nadu, where I have been working in the community for over two decades, and I wonder what ‘improved’ water means—to the government, to me and to the households in Ramanaickanpalayam, Kasba and Chinnallapuram and Vellore Old Town? Of course, things are better than they were 20years ago: the government has put in a system that provides both ‘salt water’ for daily use, has put 500L tanks on every street to store water and does the best it can to provide an equitable distribution of drinking water.

But the woman on the street who is washing her dishes using ash to scrub and re-using the same water for every dish, also has to manage her household’s need with the limited number of plastic kodams (containers) that she can collect and store when water is pumped to the stand pipe in the street every two weeks.

It is not surprising to me or to the doctors in our clinic that she frequently brings her children in with illnesses, diarrhea, colds, coughs and fevers, which are so frequent that the family does not even realize, as our research team does, that her two children have each been ill for over three months of their first year of life. The children are now four and two years old and the older daughter has had 30respiratory infections, diarrhea 10 times and fever for more than three days without other symptoms six times.

Her family of four lives in one room, and uses the verandah outside to cook and the street to bathe the children and wash dishes, with all adults in the building where each family rents a room sharing a common toilet and bathing facility. Although the research team that looks after this community is proud of the fact that we have a much lower rate of death in children than in surrounding areas, because we look after their illnesses and make sure that they get the care they need, there is actually very little that we can do to decrease the level of illness that children in the community experience.

The microbes that cause respiratory infections and diarrhoea come to us from the environment that we live and work in. We acquire them through food, through water and through touching people and objects that have been contaminated by these agents. Prevention of infection requires safe food and water, a clean environment and clean people. How can this be achieved without clean and safe water? Or without enough clean, safe water?

Water for drinking is treated, and it is, in most places, tested to ensure that there are no microbes.But water from an ‘improved’ source, and that water at the time when it is drunk, or used for cooking and cleaning, can vary quite considerably depending on how it reached and how it was stored when it reached the household. Re-contamination during transport and during storage are unfortunately common. When this contaminated water is used for cleaning, or when cleaning is not done because of limitations of water availability, the level of microbial contamination in the environment builds up over time.

While adults with good immunity may not be affected, children are more vulnerable and become sick when exposed because of the relatively larger exposure given their smaller bodies and their less developed immune systems. Safe, clean and enough water is essential for human health.

The role of water in terms of infectious diseases alone can be classified into three major areas. Waterborne diseases are those that can be transmitted through water and include cholera and hepatitis. Making sure that drinking water has no bacteria, viruses or parasites addresses the transmission of these diseases, but is easier said than done, as multiple reports of outbreaks that follow the breakdown of facilities in municipal water systems have shown.

Water-related diseases include dengue and malaria where vectors breed in water. Other infectious diseases where water plays an important role are all kinds of diseases where the role of water is crucial for a hygienic environment or for people to improve personal hygiene. These include the viruses that cause respiratory infections or diarrhoeal diseases or the dangerous multi-drug resistant bacteria in hospitals that can be transmitted by unwashed hands.

In his book ‘Water: The Epic Struggle for Wealth, Power and Civilization’, journalist Steven Solomon argues that water is surpassing oil as the world's scarcest critical resource.Safe water is a critical environmental and public health issue, but it requires integration of water and sanitation programmes into larger strategies than align with the government’s development agenda. The Swachh Bharat Abhiyan addresses sanitation, but building toilets alone is not a solution when safe and sufficient water are not factored into the equation.

High-level coordination, firm political will and support from state authorities and communities that implement programmes on the ground are needed to build and maintain systems that have the ability to make a difference to the health of our people and especially our most vulnerable, the children.

The author is Professor, Department of Gastrointestinal Sciences, ChristianMedical College, India

By Dr Gagandeep Kang

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