Contaminated water: a public health problem

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agua contaminada

In the eighth plenary session of the United Nations held in New York (September 2000), 189 countries made a historic commitment: “To eradicate extreme poverty and improve the health and welfare of the world’s poorest people within 15 years,” laid out in the Millennium Declaration. However, in the report Health and the Millennium Development Goals (MDGs) published five years later, the international community was alerted to the fact that, while there has been some progress, there are still too many countries that are falling behind in the area of health, a situation likely to affect education, gender equality, and poverty reduction. It thus seems that the MDGs that seek to create a better and more just world will not materialize in the forecast period.

From the aspect of health, the World Health Organization (WHO) held the first meeting for parasite control in Geneva in 2005, in which intestinal parasites were presented as one of the leading causes of morbidity in developing countries, with more than two billion people affected worldwide. This occurrence is associated with deficient hygiene, sanitation, and drinking water supply.

Diarrhea is a symptom of infections caused by a host of bacterial, viral, and parasitic organisms, most of which are spread by feces-contaminated water. Infection is more common when there is a shortage of safe water for drinking, cooking, and cleaning. According to the WHO Media Centre, the two most common causes of diarrheal diseases in developing countries are rotavirus and Escherichia coli. The problem of parasitic infections becomes of particular concern when diarrhea present in an individual combines with Escherichia coli, which together can cause death, especially in children under five years old.

According to world health statistics, 9.5% of deaths in children under five years old in the world are due to diarrhea. Children who die from diarrhea often suffer from underlying malnutrition, which makes them more vulnerable to diarrheal diseases. Each episode of diarrhea, in turn, worsens their nutritional status. Diarrhea is the second leading cause of malnutrition in children under five years old.

In the case of Colombia, the world statistics from 2012 indicate that mortality from diarrhea between 2000 and 2010 decreased by 1%, but they stand in contrast to figures published in Cooperation strategy with Colombia 2006-2010, in which it is shown that the provision of basic health services in urban areas obtained water supply coverage that reached 97.6% and sewage collection coverage that reached 90.2% in 2003; this in contrast to rural areas, where water supply coverage reached 53.1% and basic sanitation reached 57.9%, which is reflected in figures provided by the Colombian senator José David Name:

In 2005, the mortality rate for children under 5 years old in Colombia was 26 children per thousand; in 2010, the national average fell to 22 children per thousand. According to official surveys, in La Guajira figures are worryingly far from national figures. In 2005, for every thousand children, 43 died; in 2010, rather than decrease, the rate increased to 50 children per thousand.

To give a particular example, the leading cause of morbidity in the department of Nariño in 2011 (rate per 1,000 inhabitants) was diarrhea and gastroenteritis of presumed infectious origin (DGTE-A09X): 16.5 increasing to 23.5 in 2013 to move into seventh place, an occurrence that is reflected in the lack of water supply and water treatment observed in 73% of towns. For San Juan de Pasto, the capital city of the department, it went from 8.2 (ranked 12th) to 17.5 (ranked 7th), according to the 2011 and 2013 editions of the Epidemiological Journal of the Departmental Health Institute of Nariño. What is noteworthy in Pasto is that, despite the efforts of the Sanitary Works Company of Pasto, Empopasto—renovating the distribution networks, producing drinking water with an excellent water quality risk index (IRCA), etc.—the health problem persists.

The research study titled “Diagnosis of the sanitary quality of the water available in residential tanks in the town of Pasto,” led by researchers from the GIISE research group of the Universidad Cooperativa de Colombia School of Medicine—with the support of strategic partners such as the Universidad Mariana, Empopasto, and the UNIBAC clinical laboratory and taking advantage of the interrelationship between University, Company, and State—was able to establish that this is owing to poor water management in the housing units, as there exists a certain misconception about the installed tank. This tank is not a reserve tank but rather for recirculation, and when the tap is turned off and the water is no longer able to circulate, it soon loses its potability. In addition, when the tanks are washed, the internal distribution network becomes contaminated, as the tanks do not have an outlet valve for dirty water. The research study led to the design of a low-cost device that allows the dirty water to be drained into the greywater receiving channel without coming into contact with the water consumed in the home. This research was used as an example of coordination between University, Company, and State in the book University-Company-State: Towards a Culture of Research and Innovation.

In the first quarter of 2016, for example, the quality of drinking water distributed in Pasto was excellent, with an IRCA of 3.35 (rating of no risk), according to an Empopasto press release. However, although modernization of the water distribution networks continues, the trend that has been observed of diagnosed cases of diarrhea and parasitic infection remains similar to that of the years reported in the most recent 2014 Nariño Epidemiological Journal. Even in the weekly epidemiological journal No. 20 of 2016, it was reported that morbidity from acute diarrheal disease in all age groups reported to SIVIGILA was 67,759, showing a slight increase of 7.5% when compared with the same week in 2015, which reported 63,003.

As a rule, it can be said that a permanent supply of water that is suitable for human consumption is not enough if the educational component related to water management within the residences is not included. Moreover, wouldn’t the recommendations made by the researchers of the GIISE group have some value?

Iván Hernández Ramírez

Specialist in Epistemology and a candidate for a Master’s degree in the same area. He works as a researcher at the School of Medicine of the Universidad Cooperativa de Colombia, in Pasto campus. Email: ivan.hernandez@ucc.edu.co.

Andrea Vanessa Ruales

Professor at the Pasto campus of the Universidad Cooperativa Medical School and a doctor in the surgical department of the Fundación Hospital San Pedro. 

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