CLEAN DRINKING WATER & WATER-BORNE DISEASES

CLEAN DRINKING WATER & WATER-BORNE DISEASES Every living creature needs clean and safe drinking water. How much do you need? It depends - your size, activity level and the weather all make a difference. The water you drink is a combination of surface water and groundwater. Surface water includes rivers, lakes and reservoirs. Groundwater comes from underground. The United States has one of the safest water supplies in the world, but drinking water quality can vary from place to place. It depends on the condition of the source water and the treatment it receives. Treatment may include adding fluoride to prevent cavities and chlorine to kill germs. Lack of clean drinking water is a major problem in developing countries. Water-borne diseases are rampant in economically depressed rural areas because clean running water (typically provided by the municipalities) is simply not available. The only alternative is to install hand pumps or deep wells (drilled wells) to draw clean water from the ground depending on the depth of the water table. The depth of the potable water table varies from 20 to 3000 feet (~ 6 to 910 meters) depending on the region and local topography. Hand pumps are normally installed for obtaining water at the maximum depth of 130 feet (~ 40 meters).  Over 130 feet deep wells (drilled wells) are installed with pumps which can reach 3,000 feet (910 m) or more. Until recent centuries, all artificial wells were pump-less dug wells which were excavated with diameters large enough to accommodate men with shovels digging down to below the water table. Such wells were at times lined with stones or bricks; extending this lining into a wall around the well to reduce both contamination and injuries by falling into the well.  Modern dug wells are hand pumped.  While the cost of drilling is directly proportional to the depth of the water table, the average cost of installing a hand pump, along with maintenance of the hand pump for 5 years is approximately $200. Many cities with dense populations lack adequate fresh water because municipalities which should be supplying them are failing due to decaying infrastructure and rising population.  For such instances, Hidaya has started delivering water to the masses via a water tanker which is filled with fresh water from our own wells.  If not for this service, the people would literally be fighting with each other over scarce water sources. Deep wells (drilled wells) can get water from a much deeper level by mechanical drilling.  Drilled wells with electric pumps are currently used throughout the world, typically in rural or sparsely populated areas.  Most shallow well drilling machines are mounted on large trucks or trailers. Such wells typically range from 20 to 600 feet (6 to 180 meters), but in some areas can go deeper than 3,000 910 meter feet.

A growing world population, unrelenting urbanization, increasing scarcity of good quality water resources and rising fertilizer prices are the driving forces behind the accelerating upward trend in the use of wastewater, excreta and greywater for agriculture and aquaculture.The health risks associated with this practice have been long recognized, but regulatory measures were, until recently, based on rigid guideline values whose application often was incompatible with the socio-economic settings where most wastewater use takes place. In 2006, WHO published a third edition of its Guidelines for the Safe Use of Wastewater, Excreta and Greywater in Agriculture and Aquaculture. In four volumes, these Guidelines propose a flexible approach of risk assessment and risk management linked to health-based targets that can be established at a level that is realistic under local conditions. The approach is to be backed-up by strict monitoring measures. In response to requests from the Guidelines' readership, WHO, together with FAO, IDRC, and IWMI, produced two information kits with targeted guidance notes, discussion papers, fact sheets, and policy briefs, to further clarify methods and procedures. These focus on specific components of the integrated risk assessment and incremental risk management approach proposed by the Guidelines. The WHO/IDRC/FAO research project on non-treatment options for safe wastewater use in poor urban communities was concluded on 30 April 2010. A final workshop in Amman, Jordan (7-10 March 2010) summed up the conclusions and recommendations from this project, together with a list of lessons learned. The reports of all three consultative workshops under this project can be accessed here: The safety and accessibility of drinking-water are major concerns throughout the world. Health risks may arise from consumption of water contaminated with infectious agents, toxic chemicals, and radiological hazards. Improving access to safe dr inking-water can result in tangible improvements to health

Drinking water or potable water is water pure enough to be consumed or used with low risk of immediate or long term harm. In most developed countries, the water supplied to households, commerce and industry is all of drinking water standard, even though only a very small proportion is actually consumed or used in food preparation. Typical uses include washing or landscape irrigation. Over large parts of the world, humans have inadequate access to potable water and use sources contaminated with disease vectors, pathogens or unacceptable levels of toxins or suspended solids. Drinking or using such water in food preparation leads to widespread acute and chronic illnesses and is a major cause of death and misery in many countries. Reduction of waterborne diseases is a major public health goal in developing countries. Water has always been an important and life-sustaining drink to humans and is essential to the survival of all organisms. Excluding fat, water composes approximately 70% of the human body by mass. It is a crucial component of metabolic processes and serves as a solvent for many bodily solutes. The Unites States Environmental Protection Agency in risk assessment calculations assumes that the average American adult ingests 2.0 litres per day. Drinking water of a variety of qualities is bottled.  Bottled Water is sold for public consumption throughout the world.

Some health authorities have suggested at least eight glasses, eight  glass of water per day (and the  British Dietetic Association recommends 1.8 liters. This common misconception is not supported by scientific research. Various reviews of all the scientific literature on the topic performed in 2002 and 2008 could not find any solid scientific evidence that recommended drinking eight glasses of water per day. In the US, the reference daily intake (RDI) for water is 3.7 liters per day (L/day) for human males older than 18, and 2.7 L/day for human females older than 18 including water contained in food, beverages, and drinking water. The amount of water varies with the individual, as it depends on the condition of the subject, the amount of physical exercise, and on the environmental temperature and humidity An individual's thirst provides a better guide for how much water they require rather than a specific, fixed quantity.

In terms of mineral nutrients intake, it is unclear what the drinking water contribution is. However,  inorganic minerals generally enter surface water and ground water via storm water runoff  or through the Earth's crust. Treatment processes also lead to the presence of some minerals. Examples include calcium, zinc, manganese, phosphate, and fluoride and sodium compounds. Water generated from the biochemical metabolism of nutrients provides a significant proportion of the daily water requirements for some arthropods and desert animals, but provides only a small fraction of a human's necessary intake. There are a variety of trace elements present in virtually all potable water, some of which play a role in metabolism. For example sodium, potassium and chloride are common chemicals found in small quantities in most waters, and these elements play a role (not necessarily major) in body metabolism. Other elements such as fluoride, while beneficial in low concentrations, can cause dental problems and other issues when present at high levels. Water is essential for the growth and maintenance of our bodies, as it is involved in a number of biological processes. The most efficient way to transport and deliver potable water is through pipes. Plumbing can require significant capital investment. Some systems suffer high operating costs. The cost to replace the deteriorating water and sanitation infrastructure of industrialized countries may be as high as $200 billion a year. Leakage of untreated and treated water from pipes reduces access to water. Leakage rates of 50% are not uncommon in urban systems. Because of the high initial investments, many less wealthy nations cannot afford to develop or sustain appropriate infrastructure, and as a consequence people in these areas may spend a correspondingly higher fraction of their income on water. 2003 statistics from El Salvador, for example, indicate that the poorest 20% of households spend more than 10% of their total income on water. In the United Kingdom authorities define spending of more than 3% of one's income on water as a hardship.

Some efforts at increasing the availability of safe drinking water have been disastrous. When the 1980s was declared the "International Decade of Water" by the  United Nations , the assumption was made that groundwater is inherently safer than water from rivers, ponds, and canals. While instances of cholera, typhoid and diarrhea were reduced, other problems emerged.60 million people are estimated to have been poisoned by well water contaminated by excessive fluoride, which dissolved from granite rocks. The effects are particularly evident in the bone deformations of children. Similar or larger problems are anticipated in other countries including China, Uzbekistan, and Ethiopia. Although helpful for dental health in low dosage, fluoride in large amounts interferes with bone formation.

Half of the Bangladesh's 12 million tube wells contain unacceptable levels of arsenic due to the wells not being dug deep enough (past 100 M). The Bangladeshi government had spent less than $7 million of the 34 million allocated for solving the problem by the World Bank in 1998. Natural arsenic poisoning is a global threat, 140 million people affected in 70 countries on all continents. These examples illustrate the need to examine each location on a case by case basis and not assume what works in one area will work in another. Over 90% of deaths from diarrheal diseases in the developing world today occur in children under 5 years old Malnutrition, especially protein-energy malnutrition, can decrease the children's resistance to infections, including water-related diarrheal diseases. From 2000-2003, 769,000 children under five years old in sub-Saharan Africa died each year from diarrheal diseases. As a result of only thirty-six percent of the population in the sub-Saharan region having access to proper means of sanitation, more than 2000 children's lives are lost every day. In South Asia, 683,000 children under five years old died each year from diarrheal disease from 2000-2003. During the same time period, in developed countries, 700 children under five years old died from diarrheal disease. Improved water supply reduces diarrhea morbidity by twenty-five percent and improvements in drinking water through proper storage in the home and chlorination reduce diarrhea episodes by thirty-nine percent. Parameters for drinking water quality typically fall under two categories: chemical/physical and microbiological. Chemical/physical parameters include heavy metals trace  organic compounds, total suspends solids (TSS), and  turbidity. Microbiological parameters include Coliform bacteria, E coli, and specific pathogenic species of bacteria (such as  cholera -causing  Vibrato choerae,viruses and protozoan parasites. Chemical parameters tend to pose more of a chronic health risk through buildup of heavy metals although some components like nitrates/nitrites and arsenic can have a more immediate impact. Physical parameters affect the aesthetics and taste of the drinking water and may complicate the removal of microbial pathogens. Throughout most of the world, the most common contamination of raw water sources is from human sewage and in particular human faecal pathogens and parasites. In 2006, waterborne diseases were estimated to cause 1.8 million deaths each year while about 1.1 billion people lacked proper drinking water. It is clear that people in the developing world need to have access to good quality water in sufficient quantity, water purification technology and availability and distribution systems for water. In many parts of the world the only sources of water are from small streams often directly contaminated by sewage.

Access to safe drinking water is indicated by proper sanitary sources. These improved drinking water sources include household connection, public standpipe borehole condition, protected dug well, protected spring, and rain water collection. Sources that don't encourage improved drinking water to the same extent as previously mentioned include: unprotected well, unprotected spring, rivers or ponds, vender-provided water, bottled water (consequential of limitations in quantity, not quality of water), and tanker truck water. Access to sanitary water comes hand in hand with access to improved sanitation facilities for excreta. These facilities include connection to public sewer, connection to septic system, pour flush latrine and ventilated improved pit latrine. Unimproved sanitation facilities are: public or shared latrine, open pit latrine, or bucket latrine.

Our body is estimated to be about 60 to 70 percent water. Blood is mostly water, and Our muscles, lungs, and brain all contain a lot of water. We need water to regulate body temperature and to provide the means for nutrients to travel to your organs and tissues. Water also transports oxygen to your cells, removes waste, and protects your joints and organs. Lose water through urination, respiration, and by sweating, and you lose more water when you're active than when you're sedentary. Diuretics, such as caffeine pills, certain medications and alcohol may increase the amount of water your body loses. Symptoms of mild dehydration include chronic pains in joints and muscles, lower back pain, headaches and constipation. A strong odor to your urine, along with a yellow or amber color, indicates that you may not be getting enough water. Note that riboflavin, a B vitamin, will make your urine bright yellow. Certain medications can change the color of urine as well. Thirst is an obvious sign of dehydration, and in fact, you need water before you feel thirsty. Some experts believe you can estimate the amount of water you need by taking your weight in pounds and dividing that number in half. That gives you the number of ounces you may want to drink each day. For example, if you weigh 160 pounds, you might want to drink at least 80 ounces of water or other fluids per day. Other factors include amount of physical activity and the climate where you are located. My water calculator can help you determine how much water you need to drink each day. At least twenty percent of the water you need comes from the foods you eat. The rest comes from the beverages you drink. Water is probably the best choice because it's cheap and has no calories or added ingredients. Sweetened soft drinks and sodas have added sugar that adds extra calories. Sports drinks contain minerals that may help keep your electrolytes in balance, but look out for added sugar and calories that you may not want. Fruit and vegetable juices are good because they have vitamins and minerals (read labels, however -- vegetable juices may be high in sodium Caffeinated beverages like tea and coffee count too, but too much caffeine can make you feel jittery. Worldwide, the popularity of recreational activities which involve contact with water is growing. Ease of travel and change in human behavior has altered the use of water for recreational purposes. Recreational exposures to pathogens may result in disease. Recreational users of water may be at risk of serious and potentially fatal diseases. In addition to disease with severe primary disease outcomes (e.g., typhoid, leptospirosis), a number of infections may lead to sequelae with serious consequences. Susceptible populations including people with reduced immune function or lack of immunity to locally endemic diseases (e.g., tourists), are at higher risk of contracting severe illnesses.

                                                            Prof. John Kurakar