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Global Water Sanitation and Health: What this Course is about

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Title: Lack of Sanitation Access: The Flying Toilet Author: Mark Sobsey Last modified by: Lisa Casanova Created Date: 3/18/2005 8:10:05 AM Document presentation ... – PowerPoint PPT presentation

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Title: Global Water Sanitation and Health: What this Course is about


1
Global Water Sanitation and Health What this
Course is about
  • Mark D. Sobsey
  • University of North Carolina
  • Department of Environmental Sciences and
    Engineering
  • Sobsey_at_email.unc.edu

2
Kofi Annan United Nations Secretary-General
  • We shall not finally defeat AIDS, tuberculosis,
    malaria, or any of the other infectious diseases
    that plague the developing world until we have
    also won the battle for safe drinking-water,
    sanitation and basic health care.

3
Global Burden of Disease Attributable to Selected
Major Risk Factors
Underweight
Tobacco
Unsafe sex
Alcohol
Overweight
Water, sanitation and hygiene (5.5)
5 -
Percent of total burden (within region)
Indoor air (3.7 )
Physical inactivity
Zinc deficiency
Tobacco
Alcohol
Occupational risks
1 -
Overweight
Unsafe sex
Ambient air
Lead
Occupational injuries
Ambient air
Water, sanitation and hygiene
Climate change
Lead
Developed countries
Developing countries (high mortality)
More recent estimate even higher!
4
Global Burden of Poor Water, Sanitation and
Hygiene (WSH)
  • 1.1 billion people (17 of the population) lack
    access to improved water
  • tap water in house/yard from public distribution
    systems,
  • protected wells springs
  • public stand posts
  • rain water collection
  • 2.6 billion (42 of population) lack access to
    basic sanitation
  • sewerage, on-site septic waste treatment system,
    latrine

5
Global Burden of Poor Water, Sanitation and
Hygiene (WSH)
  • 1.8 million people die every year from diarrheal
    diseases (including cholera)
  • 90 are children under 5
  • mostly in developing countries.
  • 80 of the population without access to
    drinking-water are rural dwellers, but future
    populations will be mainly urban
  • Peri-urban slums are among the most underserved
    and unsanitary places on earth!

6
The Older Conventional View
Lack of WSH Disease and Poverty
  • Inadequate water supply
  • Unsafe water resources
  • Inequitable access
  • Time, financial cost
  • Disease burden
  • Health care costs

POVERTY
7
The Newer Optimistic View!
WSH An Engine for Development and Productivity
  • Improved water supply
  • Safe water resources
  • Universal access
  • Time, financial savings
  • Averted disease costs
  • Healthy populations

Development
8
Millennium Development Goals
  • Goal 1 Eradicate extreme poverty and hunger
  • Goal 2 Achieve universal primary education
  • Goal 3 Promote gender equality and empower women
  • Goal 4 Reduce child mortality
  • Goal 5 Improve maternal health
  • Goal 6 Combat HIV/AIDS, malaria, and other
    diseases
  • Goal 7 Ensure environmental sustainability
  • Target 9 Integrate the principles of sustainable
    development into country policies reverse loss
    of environmental resources.
  • Target 10 Halve by 2015 the proportion of people
    without sustainable access to safe drinking water
    and basic sanitation
  • Target 11 improve the lives of at least 100
    million slum dwellers
  • Goal 8 Develop a global partnership for
    development

9
What a lot of this course will be aboutThe Fs
of WSH
  • Feces
  • Fingers
  • Flies
  • Fields/Food
  • Fluids
  • Fomites

Water Treatment
10
A Lot of What Else this Course is About
  • Air pollution
  • Solid waste management
  • Vectors vector-borne diseases
  • Disasters and emergencies
  • Climate change health effects

11
Human SanitationFundamental but Often Lacking
  • Excreta management and disposal
  • Hygiene behaviors
  • Handwashing
  • Safe water

12
Sanitation Our Biggest Failure
  • Our sanitation systems dont work well and result
    in pathogen release
  • Whether community or on-site, they all fail or
    have serious deficiencies
  • Sanitation is one of the biggest technological
    gaps we have globally
  • Pathogens go everywhere as a result

Roman latrine
VIP latrine
Latrine
13
Inferior/Absent Community Wastewater Treatment
Systems
Rx.
No Rx.
Rx. Often Absent!
Untreated/poorly treated wastewater is discharged
to land or natural waters
14
Water, Disease and Health
  • Water-borne
  • Exposure mainly by ingestion of contaminated
    water
  • Primarily enteric diseases transmitted by the
    fecal-oral route
  • Water-washed
  • exposure is reduced by water use for personal and
    domestic hygiene washing (clothes, floors, other
    household chores), bathing other personal
    hygiene
  • Water contact and water vector-borne
  • Exposure by skin contact with infested water
  • Ex schistosomiasis
  • Exposure to water habitat "insect vector"
    diseases

15
The Microbial World Types and Sizes of Microbes
SOME BAD ONES!
Amebic dysentery Giardiasis
Cholera Diarrhea Dysentery Typhoid fever
Norovirus Hepatitis AE Rotaviruses Polio-/enterov
iruses
BACTERIUM 1 µM
Helminth (Worm) (eggs shed in feces)
gt30 microns
(Ascaris lumbricoides)
16
Waterborne Pathogens Come Primarily from Feces by
Various Routes of Exposure
E. coli from Spinach Lettuce Tomatoes!
Adapted from Charles P. Gerba et al. 1975
17
Issues in Water and Health
  • Quality
  • Quantity
  • Access
  • Habitat and Ecology
  • Resources and Management
  • Economics
  • Behavior and Beliefs
  • Enabling Environment and Policies

18
Analyzing the Role of WSH in Reducing Disease
  • Recent meta-analysis shows major impacts by
  • Hygiene
  • Sanitation
  • Water quality
  • Water supply

19
Comparison of Impacts of WSH Interventions
Fewtrell et al. 2005 vs. Previous Studies
Good Studies
All Studies
  • Water quality interventions (POU water Rx) was
    more effective than previously thought
  • Multiple interventions (combined WSH) were not
    more effective than single interventions (?)

20
Piped and Non-Piped Water Supplies
  • Most people lack piped water
  • They collect water or have it delivered
  • Most wells in developing countries deliver NO or
    UNSAFE water!
  • Sources are often contaminated
  • Piped water is often contaminated
  • Classified as improved, but still unsafe

21
Piped and Non-Piped Water Supplies
  • Collected, stored water often becomes
    contaminated in the home
  • Water is often not treated, but used directly
  • Boiling is widely practiced
  • Disadvantages
  • Cost
  • Inconvenience
  • no residual protection (gets recontaminated in
    use!)
  • environmental degradation (deforestation)
  • air pollution (health effects)

22
Barriers against Microbial Contamination and
Waterborne Disease
  • Collect from a safe source
  • Store it with contamination safeguards
  • Treat water to reduce microbial contamination
  • Physical treatments
  • Heat, sunlight (heat UV), UV lamp radiation
    filtration
  • Chemical treatments (disinfection)
  • chlorine
  • Combined physical-chemical treatments
  • coagulation-flocculation-chlorination
    (conventional Rx)

23
Behavioral and Educational Components of WSH
Interventions
  • Increase awareness of the link between the 5Fs
    and disease and the benefits of appropriate
    hygiene behaviors
  • Behavior change techniques
  • social marketing
  • community mobilization
  • motivational interviewing
  • communication
  • education

24
World Health Organization Health-Risk Based
Framework
  • Risk-based framework
  • Source-to-consumer management approach
  • Establishes health based-targets for performance
  • Can set acceptable level of risk appropriate to
    setting and population
  • Establish and carry out Management Plans
  • Independent surveillance
  • Integrated. Consistent across, compatible with
    and applicable to all WSH measures

These principles apply to all types of WSH
measures!
25
WSH, Addressing the Global Burden of Disease by
Working towards Meeting the MDGs Still Plenty
to Do
  • Research
  • Implementation/Dissemination
  • Communication
  • Advocacy
  • Finance
  • Policies
  • Diplomacy and Politics

26
Celebrating Water for LifeThe International
Decade for Action2005 to 2015
2008 International Year of Sanitation
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