If you’ve never experienced an asthma attack, it feels sort of like the aftermath of a really vigorous run. The type of an exhaustion a first time marathoner experiences, or the first time you ever ran more than a mile. Now imagine if you aren’t running any more, you’re resting, you’re pacing, you’re breathing deeply, you gasp… But nothing works. No matter what you do, you can’t catch your breath.
An asthma attack is like going immediately to that stage of breathlessness, often while doing nothing at all.
About a month or two ago, I had what was the scariest moment of my life. Sarah and I had gone out with some friends and a few couchsurfers and had wonderful evening. It started around 2pm at a coffee shop and conversation over cookies, coffee and the roaring laughter of fifteen or odd people who had just met and instantly bonded. Then someone suggested we go to a concert featuring a number of touring francophone bands and musicians. By now it was well into the evening and we headed to a local Korean restaurant for a hearty meal.
I remember having a mild attack during the course of this. I measure the severity of my asthma attacks like so: light (eventually goes away, without medication), mild (goes away with the help of medication), heavy (medication followed by rest and a lot of deep breaths) and critical. Until, this night, a ‘critical asthma attack’ was unknown territory for me. After all, although I was born asthmatic it didn’t really manifest until I was around four or five. And by high school it was completely gone. Whatever allergen or cause (the doctors told me dust and pollen were to blame) triggered the attacks, I guess my body built up an immunity to them. Growing up among the lush florals of a south Georgia farm and the thick hazy smog of Atlanta, I suppose those extreme conditions forced me to.
I haven’t considered myself an asthmatic since I was maybe 16, that’s the last time I can remember having an attack. Although much like alcoholics, asthmatics are never cured, we’re just in lifelong recovery. Apparently over a decade later I would relapse.
The relapse happened the day I set foot in Uganda. Maybe not THE day but for someone who assumed that the days of sitting out P.E. and consulting a doctor before exercise were behind him, it was pretty clear right away that something wast right. Whether it was the dust in the air (a thin coat of red dust covers almost everything in Africa), the dense pollution, or the particles in the air here previously alien to my body, I was not prepared for the air here. If not the first day, it was only a matter of days before I needed to purchase an inhaler. The first that I’d bought in ten years. That last inhaler I bought, followed me around for six years (just in case) before I eventually threw it away in a move.
Going back to that night, although I drank a lot and had a splitting headache, there was nothing particularly wrong with me by the time Sarah and I made it home for bed. I was tired from the long day, and the two of us sank into the fake IKEA bed like we do every night.
Just past midnight I woke up with a start. My body was not in the best shape. I assumed it was the rumblings of too much Ugandan beer, which has this substance in it called sorghum, but a few trips to the bathroom didn’t help. My chest felt tight, I keep an inhaler by the bed for mild attacks during the night. I took a puff and went back to sleep. At this stage the attack was light,
Again, I woke up. My chest was tighter. I’d moved to mild. When you’re in bed and you feel like this, you start to toss and turn. You can’t breathe ob your back, side, stomach, sitting-up…but you still feel like you need to do something. Your body wants you to find a comfortable position so you can breathe. I took more puffs from the inhaler and drifted off back to sleep.
Around 4am I felt awful. This wasn’t a hangover, my stomach was convulsing and my head was swimming. This also didn’t feel like asthma but I could breathe. I made a number of trips to the bathroom and rushed over to find an inhaler (we keep several around the house in case we can’t find one when I need it). I took a puff of the inhaler. Nothing. I took another puff. Nothing. Odd. Usually two puffs from the inhaler and I’m immediately feeling better. Something was wrong.
I stumbled back to the bed, still feeling bad. At this point Sarah had woken up from all the commotion. I didn’t want to unnecessarily alarm her, so I told her I was fine and sat on the edge of the bed trying to will the attack away. There are some things that you instinctively know about a situation. I have an asthma attack, I reach for an inhaler. Even after such a long absence from my life, this is the reaction because this is what works. The inhaler was my survival so this was like drowning at sea, and reaching for a rope that’s not attached to anything. So, when I sat on the edge of our bed and tried three separate inhalers, only to have none of them do what they had always done. I was lost.
The inhalers stop the asthma.
The inhalers stop the asthma.
That’s what they do. They stop the asthma.
The asthma isn’t stopping.
That thought ran through my mind, maybe a hundred times in only a few seconds. I was panicking which is the thing all doctors try to get asthma patients NOT to do, because it only makes everything worse. But what does a doctor do when a treatment, the only thing way they know and have studied, doesn’t work? I can only assume they panic a bit too. By now I had broken into a cold sweat. The attack was getting worse and the inhalers weren’t working. The only solution I knew of in the world for a heavy attack was useless….this meant I was critical. This meant it could be fatal.
Well that realization is not one you want to come to when your objective is NOT to panic. Not at all.
Sarah rushed to my side, still awake and sensing trouble. It was time to put my pride aside, I couldn’t breath. I needed to breath.
I could barely speak but I managed to gasp, “They aren’t working.” I think she realized what this meant more immediately than I did.
I stumbled out onto our porch that over looks, Kampala. This time of morning everything was quiet. All I could hear was my own wheezing and the faint sounds of human traffic miles away. The sun was barely over the horizon. I’d gone out there because I thought fresh air would help. But that didn’t work either. I was confused and at this point I was breathing so little oxygen that I could feel myself threatening to blackout. My heart was pounding. My head was pounding. I was fully drenched in sweat. I’m convinced that, in a time before modern medical invention (long before most of us were born) this was how people died from asthma. Not wanting anything more than one final full, glorious breath of crisp air. I was petrified.
By now Sarah had rushed out of bed into some clothes…or maybe pajamas (I don’t remember)….and had called a taxi. The taxi driver usually stages at the bottom of the hill but it was barely 5 a.m. Where would he be? What would he be doing? Would it be a long wait? Were there ambulances in Kampala? Those thoughts raced through both of our minds as we waited.
Needless to say, the taxi driver arrived swifter than we imagined he would at that hour. He could tell by looking at me that there was no time for the normal pleasantries. “The surgery!” Sarah urged him. We went racing off towards the only 24 medical facility in Kampala that I know of. The rest is a blur, I know Sarah was urging me to relax, trying to soothe my breathing while the driver navigated early morning traffic. When we arrived at the Surgery I was rushed in and after explaining that it was severe asthma attack, I was put on some type of oxygen tank. I don’t know the name of the medicine (Beclomatsone?) but Sarah later told me it was a steroid but I was told to breath from it for several minutes. Eventually, I could feel the color coming back to my face, and with it an easing of my lungs. The treatment was working, I could breathe.
There are people in the world with worse asthma that I have. There are people here in Uganda with asthma and NO inhaler…their families can’t afford them. I don’t know the numbers, or have the research to back it up. But one day, provided I’m able to acquire the resources and the contacts, I will work on improving the air in Africa. Whether it’s natural triggers like dust and pollen, or artificial one’s like pollution, I assume that there’s little focus on such a big problem. I doubt the any of cars here would pass the same emissions tests that we have in the U.S. As annoying as it is, those tests were started for a reason.
Never in my life have I had an attack like that and I haven’t had one since. However, it was enough of a shock to me that I realize as long as I’m here I face quite a bit of risk. It’s not my motivation to leave, it’s even more motivation to improve conditions here for others.
Written by Jon in Life ~
This morning, started like most mornings do these days.
Jon got up around 4 because he couldn’t sleep any longer. He let Zipper out and then put her back to bed. She had her first trip to vet yesterday, and was feeling kind of under the weather from her deworming medication and her rabies vaccine, and so she wasn’t much into playing.
I got up around 7 and let Zipper out again. She did her thing, came back inside, ate her breakfast, and curled up to go to sleep on her pile of “Zipper’s towels.”
Jon and I took turns getting ready for work, both emailing from the kitchen table and drinking coffee for a while—taming the mass of emails that pile up over night when all of colleagues, friends, and family are active—before 9, when we called a special hire and went to Good African Coffee, a restaurant that has finally caught on that if you give free access to relatively decent internet, you do a bang up business. And business we give them.
Anyway, at 9, we let Zipper out one more time before she was put into “Zipper’s house,” which used to be our front half-bath, that was never really used.
When we first brought her home, we gave her a house in her house—a cardboard box that one of Jon’s work computers came in. Although I think she really liked her cardboard box (which a few days into getting to know each, Jon and I turned on its side to make it more of a cave than a box), she proceeded to chew it up completely. We didn’t really mind, because it’s a box, and it’s hers, but it eventually became rather unusable and we pitched it. Anyway, long story short, there seems to be a shortage of crates in Kampala right now, so we’ve given Zipper reign of the whole half-bath, and she does pretty well.
Zipper is about 3 months old now, and so she spends all of her time when we’re not available to keep an eye on her in her house. She is pretty well housebroken these days, as long as we’re paying attention and do our part. Knock on wood, she also still finds “Zipper’s toys” more exciting than most of “Sarah and Jon’s toys.” Again, that’s when we’re keeping an eye on her.
All of that is to say, that today started out just as any other day.
At Good African Coffee, Jon and I both worked for the morning. He had had a lunch meeting planned there for 1, and I planned to have my lunch, and come home around 1 to let Zipper out, play with her a little and then get back to work. I ordered my lunch around 12 and didn’t end up actually arriving until 1:40 (somewhat unusual for lunch at Good African Coffee, but not so unusual in Kampala generally).
I ate my lunch—an “herbed seasonal vegetable sandwich,” which I’ve finally convinced them to make with a side of steamed vegetables rather than fries or fried potato wedges—and then I packed up to come home around 2. Normally I would have called one of our regular special hires who are safe, reliable, and cheap, but I didn’t have my phone with me, and so I picked up a special from outside the restaurant. After negotiating what should be a 5000 UGX ride from 10,000 UGX down to 7000 UGX, we were off.
Four minutes after leaving, we were waved off the road by a traffic woman. She talked to my driver and asked for his permit. He gave some paper to her, which isn’t usually what people pull out. She seemed only moderately satisfied. She walked around the front of the car and found that one of the headlights was broken. She shook her head. She walked around the other side of the car and checked out the insurance.
I could only hear a little of the conversation, because the radio was still blaring behind me, Ugandans tend to be much softer spoken than we loud Americans, whom I’m sure Ugandans must think yell all the time, and because it was a combination of English and Luganda. It seemed, though, that there was some issue with the permit, not that it was expired, but there was maybe some tax that hadn’t been paid. There was also the issue of the headlight.
My driver tried hard to convince the police officer to let him go and drop me and then return to clear whatever fines he had to pay. Not unreasonably, the police officer didn’t want him to do that. She proposed to drive with us to my house. The driver didn’t like that idea. They went back and forth for a while, and eventually she settled on filling in blank piece of paper with his name, age, vehicle number, and maybe a few other details, and gave him a warning that he’d better return immediately after dropping me, because if he didn’t, she’s have his car impounded. Done. And it only took 20 minutes.
Finally, I got home. When I walked in the house, I found the door to “Zipper’s house” open. And, not surprisingly, I did not find Zipper inside. Oh dear. Remember, we’re not really sure how well to trust her when we’re not watching.
As I was discovering the open door and putting my bag down, Zipper came and greeted me waggily. We went outside where she peed just a little bit (oooh, no good…), and pooped (well, that might be good…?), and then we went back inside to assess the damage.
Front of the house: Zipper finished her both of food that was nearly, but not quite, finished this morning. Seemed that nothing was chewed, and there didn’t seem to be any telltale puddles or piles. I then checked the kitchen, which also seemed to be okay. I could tell that Charmime, our housekeeper, had been here. Hmm, a clue?
Back of the house: Back of the house? Oh no. Although the front of the house is not completely puppy-proofed, there’s not too much that she can get into. The back of the house, though, is currently off-limits to our little four-legged one, and so has not been puppy-proofed. Hallway looks clear.
The room that was formerly our office remains fairly empty, as we’re not totally sure what we want to do with it, yet. In the mean time, Charmime has been doing the ironing there, and leaves the clothes in a pile on the floor. “Zipper’s blankets,” which proved to be really fun to destroy were in there, folded. However, when I got home, they were less folded, and one of “Zipper’s toys”—her favorite toy—was next to the blankets. Cute. Across the room, I spotted the toilet brush from the guest bath next to the clean towels, where Zipper had also been sitting. Gross. But the dog does like to sit on towels. I put the brush back in the guest bath. Otherwise, nothing seemed amiss.
On to our bedroom (again, normally all of these doors are closed, but Charmime had been here and so everything was open. Nothing grossly out of order in our bedroom. A few socks out of place, but not terrible chewed. Luckily, Zipper didn’t seem to find interesting my open suitcase that remains on the floor. Mostly it’s unpacked, but what remains are all of the various pills and lotions that I travel with that TSA seemed to have poured out of their bags on my last trip back. I need to reorganize it all, but I haven’t done it yet. So, that was, amazingly okay. I did find a chewed pack of Ventallin asthma pills that had been on the floor. I know that Jon had taken one of them, but I’m not sure he had taken two. Zipper may have gotten one. Not great, but probably not the end of the world for her.
Finally, I make into our bathroom. Yes, our bathroom got the worst of it. Zipper found a roll of toilet paper and shredded the outer layers. She did so, kindly, on a towel in front of the shower, though, so it wasn’t so terrible to clean up. She found a random pair of sunglasses, that I think must have been left here by a Couch Surfer or something, because they’re not familiar. The base to the toilet brush was in the middle of the floor, but the brush was nowhere to be found. There was some mystery liquid in a few places on the floor. I have to say, though, I couldn’t tell if it was pee or if was mop water, or if it was the liquid that pools at the base of the toilet brush (gross again!). I wiped it up, and still couldn’t really tell. The towel was also sort of damp. Maybe she peed, or maybe it was damp from my shower this morning. Also, a mystery that likely we won’t find an answer to. Stranger still was that there was an envelope on the towel that contains our lease to the house. Where did she find that?
And where was the toilet brush? Come to think of it, where had Zipper gotten off to while I was cleaning up the bathroom?
I left the bathroom on my way back into the bedroom. I passed through the little hallway that contains my closet, and I heard a little shuffling. I looked, and there was Zipper, inside the bottom cubby of my closet where I’ve been storing our “important documents that need to be kept, but don’t have a good home”—like the lease! I bent down, along with Zipper, I found the toilet brush! Zipper had been hanging out there during the day!
So, Zipper had a big day out. All and all, I think she did pretty well. Could have been a lot worse, that’s for sure. She’s now all tuckered out and has curled up on “Zipper’s towels” next to me to go to sleep.
How did she get out? Like the mystery water in the bathroom, it remains a mystery. Our best guess is that Charmime let her out. It’s possible, I suppose that we didn’t quite get the door closed all the way this morning, but that seems sort of unlikely. I suppose it’s also possible that she has magical opposable thumbs that she saves for just such occasions.
Written by Sarah in Life, Photos, Uganda ~
On Saturday, June 13, Jon and I adopted a 10-week-old Kampala mutt from the USPCA.
We’d been talking for a long time about getting a dog, but with the general craziness of the last several months, we just hadn’t been able to do so. But finally, we’ve done it.
Zipper’s first few nights with us were a little difficult, but we’ve figured each other out pretty well. She’s done a good job of getting house-trained, and she’s becoming a mighty explorer of the backyard.
She has quickly wiggled her way into our hearts, and we’re happy to have this addition to our little family.
Written by Sarah in Life, Uganda ~
May 21, 2009
It’s hard to believe that it’s been exactly a year since I had my first day in the Water For People office in Denver. It’s been a great year. The first two months were spent getting to know my Denver colleagues and learning about Water For People’s current Africa program, then in July, Jon and I made “the big leap” and moved to Uganda. Neither us had ever been here, though I’d spent a lot of time in Western Kenya, which has some similarities, so it was a big leap indeed. At least here, English is one of the official languages, and so most people speak at least a little.
Once we got here, we had the great fun of finding a house to live in and establishing it from scratch. One of the differences we found was that most of the houses and apartments for rent don’t even have appliances when you move in, and so we not only had to figure out how to bargain for couches, dining furniture, and our bed, but also how to assess and bargain for a used fridge and stove. We learned later that we probably paid too much for appliances that don’t really work (and have since had to replace our fridge, which we bought new the second time around), but we laugh about it and chalk it up to being a part of the great learning curve.
During that time, I was also beginning to establish the Water For People’s program in Uganda. That process started in Denver, where I began the process of registering our office in Uganda. Water For People operates as a local NGO in the countries where we work, and so it’s important for us to be recognized by those local governments. Registration establishes us in a country and sets us up to be able to hire staff, make purchases and sign a lease for an office, and more importantly begin to program in the country. I say that I began the process of registration in Denver because the process itself had several steps that couldn’t be completed until after arrival, and even then the process took several months to finally be completed. That said, we were finally successful at registration in September—a huge accomplishment.
While our registration was working its way though the system, I spent several months learning about the water and sanitation sector in Uganda. In so doing, I talked with lots of local NGOs and visited their work. During our visits, I learned about their individual groups, but I also learned about the sector. One of the most interesting things to me about the water and sanitation sector in Uganda is that access to safe water is slowly increasing, but access to improved sanitation has flat-lined in many districts, and in several areas, access is actually decreasing. There seem to be many challenges, but two that stood out are (1) many NGOs focus on water, but sanitation is something of an afterthought, and (2) management of household sanitation seems to be difficult—when a family finally gets a latrine, they don’t maintain it very well and so it collapses or becomes unusable, or even if they do maintain it, once it is full, they don’t build another one. For these reason, Water For People—Uganda is going to start by looking creatively at sanitation management and maintenance and will work to build a strong sanitation program before looking at water. That’s by no means to say that access to safe water doesn’t need to be addressed. I just would like Water For People—Uganda to become set an example in prioritizing sanitation, and in the mean time give some good thought to really understanding what the challenges are in water and how Water For People can help to address them.
Water For People—Uganda has found two local NGOs with which to begin developing a sanitation program. These NGOs helped to determine which districts to begin work. They also helped to lead Water For People’s initial work in each district, which was to take GPS coordinate readings and to fill in a baseline questionnaire for each water point in the chosen areas. The water points and a sample of households’ latrines and hygiene behaviors will be given scores that are color-coded, those colors will be marked on the map where the water points where found. The maps created will be used by Water For People, our partners, and other actors in the districts, including local government and other local NGOs to strategize where to work to be most effective. We’re expecting the results within the next month, which will be a great way to start our work.
In addition to starting the Uganda program, as Regional Manager for Africa, I also work with our ongoing program in Malawi and our new program in Rwanda. It has been great fun getting to know those two programs, and I’m excited because we’re beginning to share program ideas between the three countries. Last week when I was in Malawi, for the first time we had staff from all three countries together, and it was really fun to hear and participate in conversations between the three countries. There are some differences, for sure, but there are also a good number of similarities between countries, and there are enough that I think we’re going to be able to share learning and adapt programs fairly readily.
Water For People—Rwanda is in a similar place to Water For People—Uganda. The Rwanda program was registered in April 2008 and since then has been doing similar needs assessments and programmatic prioritization. One of the exciting things about Rwanda is that the private sector seems to be very strong there. The Rwandan government has been promoting Public-Private Partnerships in the water sector for some time in Rwanda. Those systems show some strength, but still have some challenges, again, primarily in management. One of the things that Water For People—Rwanda is going to explore is what happens if we move from Public-Private systems where a private company builds the water system but then the government manages it, to more of a standard utility model where the same company that builds the system also manages it and users pay a user fee to the utility. The neat thing about a management system like that is that it ties the community and the utility together, which will hopefully mean that when the water system needs to be upgraded, either because it is worn out and needs to be replaced, or because the community grows, the utility will already have a relationship with the community and will be able to offer that service.
An easy way to think about this type of program is like a US cell phone plan. For example, when you sign up for service with AT&T, you sign a contract with AT&T saying that you will stay with AT&T for two years. During that time, your contract says that you will pay your cell phone bill, and in return, AT&T will keep your phone working. If you fail to pay your bill, AT&T will be able to cut off your service to encourage you to keep up your end of the deal, and if AT&T stops providing good service, you’ll hold them responsible by not paying for service you haven’t gotten. At the end of two years, you’ll have the option to upgrade your phone. That upgrade might be free if you get basically a new version of the same phone, or you might pay a little extra if you get a more advanced model or decide that you want more service.
The utility model works the same way. The community and the utility will have a contract stipulating what the utility owes the community and what the community owes the utility in return. It will also stipulate what the consequences are if either party fails to make good on its part of the contract. After the contract period, or as needed, the utility will be able to work with the community to upgrade service as needed or as wanted by the community. It puts the community in charge of making decisions about what kind of service they want—which is a very good thing.
This program is still being developed in Rwanda, but we’re excited to get it going and adapting it as needed to work in the specifically Rwanda context. We will likely look at this model in Uganda, too, when we begin to water programming.
Water For People—Malawi is also doing some really interesting things right now, and in fact, we’re modeling all of our sanitation programs in the region on the work that Water For People—Malawi is doing. Water For People—Malawi recently declared that it was no longer going to support subsidized sanitation. Instead, Water For People—Malawi is working helping to establish sanitation businesses. One model of sanitation businesses that the program is supporting uses the strength of the fertilizer market in Malawi. Malawi has a large agriculture sector, and that sector uses a lot of fertilizer, which is a valuable commodity. Water For People is working with entrepreneurs to start businesses that sell “humanure” which can be abundantly available if more households use composting latrines. The entrepreneur sells composting, or “EcoSan,” latrines to households. Household use the latrines, which creates compost, and then the entrepreneur buys the compost from the household and resells it to a fertilizer company.
Like the Rwanda water model, this model ties the household to a private-sector company who maintains the toilet. Because households receive payment for compost, they are encouraged to keep using their latrine as intended. In this way, household sanitation will be sustained for longer than it might be otherwise. It also encourages the sanitation market, meaning that households won’t have to rely on subsidies for sanitation, which also means that sanitation coverage can expand beyond Water For People’s direct support—a very powerful prospect. Water For People—Uganda is going to focus on trying out and adapting that model for sanitation, and Water For People—Rwanda will begin to try out this type of work as well.
All of that is to say that it’s been a great year. Water For People is doing some really exciting work in Africa. It’s great being in Kampala where I can get to visit the Rwanda and Malawi programs more frequently than if I were in Denver, and it’s been a blast establishing the Uganda program. I’m excited to begin hiring staff in the next few months and really beginning to see that program take off.
Written by Sarah in Africa, Life, NGO, Uganda, water for people, work ~
BBC NEWS
Where clean water is a pipedream
By Richard Black
Environment correspondent, BBC News website
If you want a graphic demonstration of the health impacts of poor drinking water, look no further than Zimbabwe.
Three thousand people dead, at least 60,000 ill - all from a disease that is almost completely preventable.
In general, with very few exceptions, people simply do not get cholera when the water supply works. It is almost unknown in the west for that single, simple reason.
As the World Health Organization (WHO) puts it: “Measures for the prevention of cholera have not changed much in recent decades, and mostly consist of providing clean water and proper sanitation.”
In Zimbabwe, political and economic circumstances have created a situation where the availability of clean water and proper sanitation is no longer routine.
People are now feeling the impacts of that lack of investment - investment that research shows is well worthwhile.
“Research shows that if you invest $1 in clean water and sanitation, the return is between $5 and $28,” says Yves Chartier of WHO’s water, sanitation, hygiene and health unit.
The cholera bacterium is far from being the only infectious microbe lurking in dirty water. Typhoid, cryptosporidium, giardia
the list continues.
“About 10% of the total global burden of disease is down to poor water, sanitation and hygiene,” says Dr Chartier.
It was this kind of statistic that led governments to sign up in the year 2000 to the Millennium Development Goals (MDGs) - a set of targets on issues such as maternal health, education and poverty.
The water target is straightforward - to halve the proportion of the world’s population without access to clean water and proper sanitation by 2015.
In the years immediately following the signing of the MDGs, water and sanitation were seen as “poor cousins”, attracting less aid money and interest than some of the other issues.
But on water, at least, that has changed.
“The world as a whole is now on target to meet the water MDG, but a number of countries and regions are still off track,” says Andrew Hudson of the UN Development Programme’s (UNDP) water governance programme.
“Most of the countries that have made impressive progress were poor countries, and that to me is a tremendous message because it shows it’s less about the money and much more about the political will.”
Protect and survive
Statistics are compiled on the basis of “reasonable” access to “improved” supplies of drinking water. This means that within a kilometre or so there should be a source such as a standpipe, a borehole, a protected well or spring - or, of course, it can come straight into your house.
The “protection” element is aimed at making sure that unwanted things including the cholera bacterium do not get into the water source - especially preventing people and animals from defecating in the vicinity.
That is sometimes easier said than done, especially in city slums, where the sheer lack of space often means latrines have to sit next to supply streams - or even, in extreme cases, that the outflow from the latrines becomes the supply stream.
UNDP data shows that in many countries, as the urban population increases, the proportion of that urban population with access to safe water declines; infrastructure investment does not keep up with a growing urban population.
And whereas investment in water has put the world on target for the water element of MDG 7, sanitation is a different matter.
“There’s still a stigma of talking about sanitation,” comments Dr Hudson.
“But countries such as India, that have mounted massive community-led campaigns on things like elimination of open defecation, have made really big strides.”
Underground movement
In eastern India, however, and in neighbouring Bangladesh, another way that poor water causes poor health has come into dramatic relief in recent years.
In the 1980s, tales of illness in Bangladeshi villages began circulating - an illness that was eventually traced to arsenic in the water they were drinking.
With surface water sources likely to harbour disease-causing microbes, aid agencies had initiated a programme of digging wells to provide safer drinking water - not realising that the water would bring with it enough arsenic to constitute a chronic poison.
The problem has now been detected in other countries, and according to one recent estimate, about 140 million people are at risk from drinking water containing the toxic metal, which causes cancers and lung disease.
Compared with water-borne microbes, water-borne pollution has received little attention, according to the Blacksmith Foundation, a charity whose aim is to clean up pollution hotspots in developing countries.
Cleaning up the India/Bangladesh arsenic problem is probably beyond anyone’s capacity right now - although agencies are looking at it - but industrial pollution is a different matter.
In the slums of many developing world cities, you find water of hues that water does not naturally assume - blues, yellows, purples and greens that speak of industrial outflows not very far upstream.
“So we’ve been running pilot projects in India trying to clean up hexavalent chromium, which is produced by the country’s huge tanning industry,” says Blacksmith’s executive director Meredith Block.
(Hexavalent chromium, the pollutant involved in the Erin Brockovich case in the US that was immortalised on celluloid by Julia Roberts, is a known carcinogen.)
“And by injecting a chemical (an “electron donor” into the groundwater we could turn it to the [non-toxic] trivalent form; analysis suggests it’s working, with no side-effects.”
One of these pilot projects, in Kanpur, was on a site that Ms Block says is typical of many developing world cities - an industrial estate, home to perhaps 50 or more small factories, working with or producing a mix of hazardous substances such as heavy metals and pesticides.
The health impact of water pollution globally is unknown.
A 2007 study from Cornell University estimated that 40% of deaths worldwide were associated with some kind of pollution - though how much of this is water-borne is another question.
But, says Ms Block, it is proving hard to interest agencies in polluted water.
“The environmental causes aren’t related to climate change or global warming,” she says. “And it seems that people in the US couldn’t care less if you can’t relate an issue to global warming.”
Diseases such as cholera, by contrast, do have a climate link. The cholera bacterium ( Vibrio cholerae ) appears to survive better in warmer waters, leading to fears that it could emerge in regions such as the southern coasts of the US as sea temperatures increase.
But for the mass of humanity, climate is likely to be a minor determinant of the water quality they get, and the disease burden that implies.
To quote the WHO on cholera: “Since 2005, the re-emergence of cholera has been noted in parallel with the ever-increasing size of vulnerable populations living in unsanitary conditions.
“The provision of safe water and sanitation
remains the critical factor in reducing the impact of cholera outbreaks” - as it does for many other diseases of water.
It sounds easy - but for the 100 or so countries off target with MDG 7, most spectacularly Zimbabwe, it is proving anything but.
Richard.Black-INTERNET@bbc.co.uk
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/science/nature/7873516.stm
Published: 2009/02/08 16:05:10 GMT
© BBC MMIX
Written by Sarah in Africa, Articles, Clippings, Water ~
On the way back from the U.S. for our Christmas Holiday, Sarah and I had a layover in one of my favorite cities. Here’s some pics of our outing that day.
Now that we are both back in Kampala, it’s business as usual. Sarah and I recently found and office space within walking distance from my house that we’ll share. In March I’ll be back in the U.S. to present at South by Southwest while Sarah heads off to Turkey to present at a water conference. Actually over the next month and a half we only see each other for a total of about a week!
Written by Jon in Photos, Travel ~
Recently my for-profit Uganda start-up Appfrica Labs was funded but that’s just the beginning. Now I have to make that money worth someone’s while! Anyways, here’s pictures of the new office, and the equipment I’ve purchased.
Written by Jon in NGO, News, Uganda ~
In 12 hours, Jon and I, along with two friends on the same flight, will be approaching the airport in Entebbe. We will heave out bags through security and get in the presumably long line (which I’ve learned to call a queue) to check in.
In 10 hours, Jon and I will be closing zippers and running through the list of things that has to happen before we go one more time–well, that will be me because I do love lists. Becca will probably be here, checking herself in for her house sitting gig, and Julia will likely be around, too.
In seven hours, I’ll acknowledge that there are just things that won’t get done before we leave, but that will be okay.
In five hours I’ll begin to think seriously about packing and wondering what has to get ironed before we leave and what can get thrown in the washer on Sunday and dried in a real drier.
In three hours I’ll become antsy that errands like paying the water bill, buying a broom and WaterGuard, and giving our askari his annual bonus won’t get done, and so I’ll take a break from work and do some of that stuff.
Looks like I better get down to business and get some stuff done!
Written by Sarah in Life, Travel ~
Last Saturday was the big “Facebook Developers Garage” at Makerere University that I helped organize here in Kampala. Someone from the Facebook staff (a senior engineer no less) actually flew to Kampala to run sessions about making Facebook Applications. You can find out more details about it all at the links below.
There were just over 100 attendees and everyone was focused, eager to learn and thrilled that someone from the company took out the time to come to Africa. IMHO, ICT is going to change this continent, we haven’t even seen the beginnings of what’s coming.
Project Diaspora’s Interview with me
My podcast the day before
Reactions from Uganda
Written by Jon in Life, Photos, Uganda, work ~
While out running some errands this morning I stopped to get some lunch to bring back for Sarah and I. We tend not to eat at the ’street’ vendors, mainly because the majority of them don’t come out until night time, well past normal dinner hours. I think this may because during the day the local restaurants are open but at night when people come out to party and enjoy music, the street vendors replace them. Still, today I managed to find one woman who had a stand making some weird concoction of…stuff.
On the left, we have spaghetti. Center stage, cabbage. On the right, we have chips (fries). In the back, obscured by the pink and purple lids, we have beef stew. Now, I know what you might be thinking. This will make an interesting plate. But no, mien friend, this meal doesn’t come on a plate. It ALL goes into the bag the woman is holding…including the beef stew!
First she places the chips in, then the spaghetti on top, then cabbage, then a healthy dose of beef stew. Here’s what the meal looks like when it comes out of the bag.
Oh, and here’s the bag it all came out of. The bag is pretty innovative in itself, it’s just a regular 8×10 sheet of paper, folded and glued to make it a lunch sack. It’s either someone’s homework or that last page of the Ugandan constitution. They line them with plastic, so they can pour large amounts of stew on top of your chip/spaghetti thing.
I asked the woman what the meal was called, and what the stew actually was but she didn’t seem to understand. She told me the stew was fish, but Sarah quickly pointed out later that it was beef when she took a bite. When I asked what it was called, she said something that sounded like ‘jingi’. But that could have also been her name. After going over the conversation in my head, I realized that she probably thought I was asking if ‘Beef’ was her name.
Perhaps next time I’ll opt for the bucket of grasshoppers.
Written by Jon in Life, Photos, Uganda ~
