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 ~
I’m sitting in Kampala traffic on my way to Entebbe to pick up Jon from the airport. Don’t worry, I’m not driving! At the wheel is my favorite taxi driver. He’s the driver the hotel sent to get us from the airport when we first arrived to Uganda. Since then, we’ve become friends, and it’s always good to see him. While I’m waiting, I thought I’d update you on what I’ve been working on recently.
This week has been a busy one. A few weeks ago, I wrote about meeting with SNV (the Netherlands Development Organization). At that meeting, they told me about the Water and Sanitation Reverse Expo that they would be having in October.
What is a Reverse Expo? In a traditional trade expo or exhibition, vendors set up shop and pedal their wares to potential buyers. At an expo in the water industry, vendors show off their best pipes, their perfect water tanks, and their improved hand pumps. Their goal is to tell passersby that their product is the answer and to sell as much of their product as they can. The consumers at traditional expos are private water contractors, government, and NGOs. They listen to what the vendor has to say and make decisions about what kind of technology their clients will receive. However, their clients are not in attendance to represent themselves. As a result, their clients—communities without water or sanitation—receive whatever technology the vendor chose for them, whether they like it or not. When they don’t like it, often they stop using it for one reason or another.
The Reverse Expo was established to give communities—the consumers—a voice. They were the ones on exhibit, and their role was to tell manufacturers, government, and NGOs what they like and what they don’t like. Community groups set up booths that depicted what they their needs, their priorities, and told the story through their voices. The idea was that this forum would give consumers the opportunity to tell the people who usually make decisions for them what was working and what wasn’t. If they like rainwater harvesting tanks, but hate that the tap con the tank is always breaking, the Reverse Expo would give them a chance to say that. If they don’t like how difficult it is to pump water from a deep borehole, this was the time to say it, to the people who make the pumps, and to the people who install them.
The Reverse Expo was three days long, and was held at Hotel Africana, off Jinja Road. I arrived on Monday at 8:00 am. I registered and as I walked in, a student band kicked up. Blaring trumpets and pounding drums put out a quite a cacophony. Through it all, I made out some familiar, if not surprising tunes, including “Guantanamera.”
The community groups were still setting up their stalls when I arrived and it wasn’t yet crowded, and so it was a nice time to tour around and read those posters that were already hanging. Some stalls were quite elaborate. One group from Mukono brought a small rainwater harvesting tank that a group of women masons had built. It was pretty simple—cement stuccoed around chicken wire—and, I’m told, quite heavy. They brought the tank to demonstrate that it’s not necessary to have big plastic tanks, and that there are ways to make the tanks within the community without much outside resource.
Another group brought a biosand filter made out of concrete and locally available materials. The biosand filter was shaped like a square column about 10 inches on each side and about waist-high. On the front was a spout. A wooden lid had been placed over the hollow center. One of the community members showed me three types of sand of descending coarseness. He explained to me that the different sands were layered at the bottom of the column. Water was poured into the center everyday for 30 days and allowed to filter through the sand and out through the spout. As the water filtered through the various layers of sand, pathogens and other foreign materials were filtered out. During the 30 days, a layer of biofilm formed within the filter, which further slowed the filtration process, allowing the remaining pathogens to die “a natural death,” as he put it. Basically, they were deprived oxygen long enough that they died and were no longer harmful. The result was water that was 93% safe. We talked about methods that could be used to decrease the remaining risk, but all and all he was happy with the result of the filtration.
Throughout the day, several community groups performed dramas about the challenges they face in their communities to an effort to begin conversation with those in attendance. One skit (conveniently in English), was performed by a woman’s groups from Arua, in the north of the country. It depicted the challenges faced by women as a result of not having safe drinking water. A mother and her daughter got up and walked a long way to get water. Once home, the mother found that her husband had already gone out drinking. When he came home, quite drunk (the woman playing the husband, I imagine, had lots of experience dealing with drunk men, as her performance was quite impressive), he was belligerent and abusive. The daughter got sick as a result of the water that she drank, and had to go to the hospital. However, there was no money because the husband had spent it on Waragi, a local liquor. Instead, the child was taken to the witch doctor, but died on the way.
Although there were some funny moments, the drama demonstrated well a number of challenges. Over the last two months, I’ve heard many times that there is a big problem with husbands drinking all day long and leaving their wives to tend the field, haul the water, and take care of other household necessities. I’ve not yet heard any solutions to this problem, but it’s one that’s on people’s minds.
The Minister of State for Water (a woman!), attended the event for several hours. She walked around to ever stall and spoke with each of the community groups in attendance. As the community group from Rakai was showing her their vision of an improved community, the Minister asked them, “What role does your local government have in all of this.” I couldn’t hear the answer, as the Crane Performers, sang and danced their way by the stall.
At the end of the day, I participated on a panel about sustainability and creative financing solutions. (It was actually two panels joined together because it was already 6:00 pm.) I explained our creative loan program in Malawi which makes sanitation into a business and in so doing makes loans for latrines possible to pay back. The audience responded well to the idea and asked some good question about payments and timing of the loans. Their interest further confirmed what I am already thinking: That Uganda is a good place to try to replicate the Malawi program.
The panel wrapped up around 8:00 pm, and I headed home. I was very impressed with the day. Water For People has used a model of community choice and community demand for many years, and so it was good to see so many other groups who do not usually interact with communities in that way have the opportunity. I hope that everyone learned a lot.
It’s been about an hour and a half, and Lake Victoria is peaking in and out of view, signaling that we’re nearing Entebbe. Signposts indicate that the airport is about 2 kilometers away, and so it’s time to put my computer away. More soon!
Written by Sarah in NGO, Uganda, Water, water for people, work ~
Before we left Denver, I made a tentative travel schedule. I needed to come up with a budget for the regional expenses through the end of 2008, and to do so, I needed to have a general idea of when I would visit Hélène in Rwanda and Kate in Malawi. I tentatively said that I would make a trip to Rwanda the first week of September to see how the program was coming together after its first few months. However, I would only make the trip if at that point Hélène was ready for me.
As it turned out, in mid-August, I got an email from Hélène, saying that things were coming along well, but that she was really ready for some face-to-face time to discuss how to proceed with program development. We agreed that the first week of September was the right timing for my first visit.
Eileen and John Kayser asked Jon to come along and take photos. We wanted to have some “baseline” photos of the work that Hélène has been doing in Rwanda. One of the challenges of being the sole staff person in a country is that it’s very difficult to take photos at the same time you are leading meetings. We also wanted to make sure that we had some photos of Hélène at work.
Jon and I traveled last Sunday on the 9:00 am flight from Entebbe, Uganda to Kigali, Rwanda. Although the flight is less than an hour, it’s an international flight, and so we needed to report to the airport two hours early. It takes an hour to get from Kampala to Entebbe (where Uganda’s international airport is), and so Jon and I were in a taxi, before sunrise, at 6:00 am.
We flew over a piece of Lake Victoria, perhaps over some of Tanzania, and into Rwanda. It was very clear when we passed into Rwanda. Rwanda is the most densely populated country in Africa. The bird’s eye view showed us that the land was covered in small agricultural plots all lined up. Houses were close together, and from the air, everything looked well organized.
We arrived to Kigali and got settled. Kathryn Cooper, Water For People’s Water and Sanitation Leadership Fellow, had arrived to Kigali from Malawi the day before to begin her study of girls’ sanitation in Rwanda. She was set to stay at Hélène’s house for the two weeks she was working in Rwanda. They’d spent the morning at the market and invited Jon and me to dinner. It was great to have a chance to informally catch up with Hélène and Kathryn. We all exchanged stories of the last few months in our respective countries. We compared internet speeds, motorcycle taxis, and adventures in dining. Rwanda has a lot of avocados this time of year, and so Kathryn made a delicious guacamole. After the sun set, we sat down to a fantastic pasta dinner. Since Jon, Kathryn, and I were pretty road-weary, we called it an early night.
On Monday, Hélène and I spent a long time catching up on various administrative questions as well as some larger programmatic questions. We made a list of topics that we wanted to get through during the week, and began to work through them. Among the topics were:
- The 2009 budgeting process
- Potential partners and the status of choosing partners
- Water For People staffing priorities
- Timing the baseline mapping study so that it happens within the next six months, but doesn’t overlap the rainy season too badly
- Reporting requirements
- Water For People office space requirements and the timing for acquiring office space
- Potential programs and program design
It was an ambitious list, but one that we made significant progress on throughout the week.
One of the things that Hélène and I agreed was that because the Rwanda program is growing and changing so quickly that it makes sense to have more regular, frequent communication. For the next several months, and until we no longer feel it’s necessary, Hélène and I will have a short phone call twice a week to talk about where she’s gotten to and how she’s going to proceed. That type of frequent communication is one of the reasons that the Regional Managers have been moved from Denver to the field—by being physically closer, we’re able to give more regular support to our country offices.
On Tuesday, Hélène set up meetings in Kicukiru (pronounced KI-chee-KEE-roo) District, one of the districts where, through needs assessments, the Ministry of Water Resources of Rwanda has assigned Water For People to work. We met with the Executive Secretary of the District, where Hélène and I explained where she has gotten to in her program planning and what it meant for Kicukiru District. Hélène felt that it was very important for the District to see another Water For People face and to hear about the potential programming from someone else, and so I explained the programming ideas that Hélène and I had talked about. Rwanda has three official languages—English, French, and Kinyarwanda—however, many people are much more comfortable speaking French. Poor Hélène was faced with the task of translating my explanations of the program from English, and in many cases, then translating his questions back to me. I’ve made it through two units of Rosetta Stone French lessons, but I have a ways to go, I’m afraid.
During the conversation, the Executive Secretary told us that public toilets had been built in a nearby market. We think that they were pay-for-use toilets, but it was unclear who was managing them. After our meeting, we set off to find the toilets in the market. When we arrived, we looked around, and the toilets seemed nowhere to be found. We asked several people, and finally got some direction from a group of very bold children. We wandered around and finally found what we think were the toilets. However, it was pretty clear that people were uncomfortable with a group of mzungus (foreigners) entering. As we were entering, a man approached us and said that if we’re looking for toilets, he’d bring us to them. He escorted us away from the public toilet and brought us to a private toilet. It’s a mission that Hélène will need to continue on her own.
Wednesday Hélène arranged for us to go to Rulindo, Water For People’s other district. Rulindo is about an hour away from Kigali. After being in Uganda, where distances are long and where many roads are full of potholes, Jon and I were impressed at how easy the ride was. Hélène explained that many of the roads were new. In the places where there were still a few potholes, she explained that they were roads that had not yet been fixed, and the potholes were left from bombs during the Genocide. It was a stark reminder of what happened in Rwanda only 14 years ago. Although a lot of repairs have been made, there is still some ways to go.
In Rulindo, we met with the Assistant Mayor. We again explained where we think the program is going and asked for his thoughts. In many cases he thought that the ideas would work, but he had some suggestions. Hélène and I thanked him and told him that we look forward to working more with him to put the program together. Government is an important partner in Water For People’s work.
Hélène also arranged for us to meet with a potential partner in Rulindo. We met the partner at the Assistant Mayor’s office, and we drove together to see a water system that the group had completed in 2002. We drove up, up, up into the hills. We stopped the car at the base of a hill, and we set out to hike. The water system we were visiting was a gravity flow spring catchment system. We hiked from the road, through a number of homesteads, past a number of women working their small subsistence farming plots, and down to where the spring had been captured.
The Director of the local NGO explained how the system works, and we observed a tap that had been left near the source so that the people in the surrounding area could still access the water while much of the water was piped to the communities below. The system seemed well made, although was in need of some regular maintenance. The Director explained that the fence that had been surrounding the spring source to protect it from animals and other potential contaminants had been stolen. Neighboring children had set up soccer goals on the cleared area, instead. We talked for a long time about the management of the system, how many people the system served, and ways that the NGO might be able to improve the management. Overall, the system appeared to be in good working order.
From there, we visited a church on a nearby hill where some of the water was pumped to. The local NGO was able to rehabilitate a water tank there that had been set up many years ago and had since lost its source. By connecting the new gravity flow system to the tank, the tank was again usable, and the church, school, and other public buildings again had access to safe drinking water. While we were listening to the explanation, a young girl approached the tank and took a drink.
Thursday Hélène and I wrapped up. We finished our list of questions and had a few more meetings. At 3:00 pm Jon and I were on our way back to the airport and back to Uganda. It was a very productive trip. It was excellent to see what Hélène was working on, and to work together through some challenges that she was experiencing. She is making good progress on the Water For People—Rwanda program. It’s going to be an exciting program that will serve to use the good work that the Government of Rwanda is currently doing in the water sector as a base, and hopefully will provide some new ways of thinking that will improve services to Rwanda’s population.
Written by Sarah in Africa, Life, NGO, Travel, Water, water for people ~
