Through water it spreads

Greater Kashmir

Water borne diseases

Water, one of the greatest blessings, can turn a curse if not taken pure. Dr Hashim Iqbal writes on the danger and spread of water borne diseases and measures to meet the threat of an epidemic
 The full picture of water associated diseases is complex for a number of reasons. Over the past decades, the picture of water related human health issues has become increasingly comprehensive, with the emergence of new water related infection diseases and the re-emergence of ones already known. Data are available for some water, sanitation and hygiene-related diseases (which include salmonellosis, cholera, diarrhoea, hepatitis, enteric fever, shigellosis), but for others such as malaria, schistosomiasis or the most modern infections like legionellosis or SARS CoV the analyses remain to be done.  The burden of several disease groups can only partly be attributed to water determinants. Even where water plays an essential role in the ecology of diseases, it may be hard to pinpoint the relative importance of aquatic components of the local ecosystems.
 Water borne diseases spread by contamination of drinking water systems with the urine and faeces of infected animal or people. This is likely to occur where public and private drinking water systems get their water from surface waters (rain, creeks, rivers, lakes etc.), which can be contaminated by infected animals or people. Runoff from landfills, septic fields, sewer pipes, residential or industrial developments can also sometimes contaminate surface water. This has been the cause of many dramatic outbreaks of faecal-oral diseases such as cholera and typhoid. However, there are many other ways in which faecal material can reach the mouth, for instance on the hands or on contaminated food. In general, contaminated food is the single most common way in which people become infected. The germs in the faeces can cause the diseases by even slight contact and transfer. This contamination may occur due to floodwaters, water runoff from landfills, septic fields, and sewer pipes. The only way to break the continued transmission is to improve the people’s hygienic behaviour and to provide them with certain basic needs: drinking water, washing and bathing facilities and sanitation.
 About half the world’s reported cases of polio, a crippling disease virtually wiped out in Western countries, occur in India. Each year, diarrhea kills 500,000 Indian children. A jaundice epidemic strikes a small district of India’s Rajasthan state as regularly as the annual monsoon. Those deadly diseases and others that afflict India can be traced to the same source: drinking water contaminated by human waste. Infected water causes an estimated 80 percent of disease in India, according to the World Health Organization (WHO), making poor sanitation and inadequate sewage disposal the nation’s biggest public health problems. “Waterborne diseases in India are very, very common. Every year, there’s bound to be a few epidemics of viral gastroenteritis, typhoid, hepatitis and cholera.
 Fewer than 30 percent of India’s 950 million people have bathrooms in their homes or easy access to public toilets. The rest routinely relieve themselves in the open, along roadsides, on farmland or in municipal parks. No more than 250 of the country’s 4,000 cities and towns have sewer systems, and many of those systems do not have treatment plants. The bulk of municipal sewage, even from such major cities as Bombay and Calcutta , flows untreated into rivers, lakes or the sea.
 The worst hit states are Bihar, Assam and Uttar Pradesh, where hospitals are packed with people suffering from water borne diseases, as per the United Nations Children’s Fund (UNICEF).So far this year, some 14 million people in India and five million in Bangladesh have been displaced or marooned by flooding, according to government figures.
 If we talk about our state in Jammu and Kashmir 25157 cases of enteric fever were reported in year 2000, 25020 in the year 2001, 24876 in the year 2002, 33654 in the year 2004 and 25107 cases in year 2004. Besides 478768 cases of diarrhoea were reported in the year 2000, 447611 in the year 2001, 628034 in the year 2002, 497387 in the year 2003 and 438229 cases were reported in 2004. 6171 cases of hepatitis were also reported in the year 2000, 4226 in the year 2001, 6245 in the year 2002, 8432 in the year 2003 and 6959 cases in 2004. It indicates that our state has also been on the suffering side so far as water born diseases are concerned. Here 85.7% of urban population are using piped drinking water while as 85.6% of our urban population are having access to toilet facilities. In rural areas 42.7% of population are using piped drinking water while 50.9% of population are having access to toilet facilities in rural areas , thus total 56.1% of our population are using piped drinking water where as 61.7% of population are having accessibility to toilet facilities. These figures are reported in CBHI, Ministry of Health and family Welfare. Poor sanitation, unsafe drinking water in this state is the primary cause for the spread of such type of diseases and is further intensified by floods which often lead to spread of such epidemics. On more factor which is a contributing lot to this phenomena in the south Kashmir is impact of Amarnath Yatra where pilgrims visit Phalgam including Lidder valley which is the major source of drinking water for the bulk of population in south Kashmir. The pilgrims are throwing all sorts of waste in the Lidder River which ultimately results in the outbreak of such epidemics. There is a dire need to put some sort of check on them so as to prevent the pollution of water.
 Since clean water is a pre-requisite for reducing the spread of water-borne diseases. It is well recognized fact that the prevalence of water-borne diseases can be greatly reduced by provision of clean drinking water and safe disposal of faeces.
 Water is disinfected to kill any pathogens that may be present in the water supply and to prevent them from growing again in the distribution systems. Disinfection is then used to prevent the growth of pathogenic organisms and to protect public health and the choice of the disinfect depends upon the individual water quality and water supply system.
 Without disinfection, the risk from waterborne disease is increased.  The two most common methods to kill microorganisms in the water supply are: oxidation with chemicals such as chlorine, chlorine dioxide or ozone, and irradiation with Ultra-Violet (UV) radiation. It’s important to understand how pathogenic micro organisms live and function, and how they can be passed from one person to another. Since water is as important to microbes as it is to us, it can serve as a pathway from one host to another. Water treatment protects us in two ways: by cleaning wastewater before it reenters the environment, and by cleaning drinking water between its source in the environment and the consumer. Water suppliers must conform to a strict set of standards, not only because they are required to, but because they take seriously their role in protecting public health.


(The writer can be mailed at drhashimiqbal@gmail.com)