SPHG 620 Week 7: Water and Sanitation
SPHG 620 Week 7: Water and Sanitation 620
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This 3 page Class Notes was uploaded by Victoria Snow on Thursday October 13, 2016. The Class Notes belongs to 620 at University of North Carolina - Chapel Hill taught by Karin Yeatts in Fall 2016. Since its upload, it has received 6 views. For similar materials see Exploring Public Health in School of Public Health at University of North Carolina - Chapel Hill.
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Date Created: 10/13/16
SPHG Week 7 Epidemiology “More than Money and Hardware: Water and Sanitation for Health in the Developing World” Professor of the Practice, Department of Environmental Science & Pete Kolsky,PhD Engineering WaSH (Water and Sanitation health) Water and Sanition mean? Drinking and domestic water supply Safemanagement of human extracta (wasteand where it goes) Health consequences of poor WaSH -Fecal-oral disease -Diarrhoeal disease -800K deaths/year from diarrhea (4 jumbo jet crashes/day) -Onebillion cases/year -4.3% of burde of diseaseDALYs (days addedto living ??) -58% attributable to inadequate WaSH Dangerous chemicals- Arsenic-skin lesions,20-60mil inBangladesh,major problem inS Asias Fluorosis- dental damage,crippling bone damage, affects millions (WHO)but often of mild form The F-Diagramme Feces fluids future victim “”fingers”” (likenotwashing hands) “”flies “” “” fields/floors”” food is the jackpot all feces cangoto sources above and then to food and then future victims If you improve water quality-canprevent contaminated fluids to getting to food/victims If you improve sanitation-prevent feces to getting to to all sources Hygiene-prevent all sources from getting to food and to getting to victim Children 4 yrs and younger- most likely to have and die from diarrheal disease Caution using “average” statistics,wedon’t livein an averageworld If head is inthe oven and feet inthe freezer, you’re justfine. Useas a guide to wisdom, but need to look atlocal level As of 2015: 1 in11 of us don’t have access tosafewater(low estimate) 31% of pop on LDC don’t havesafewater 2.1 billiongained access since1990 World pop increasedby 1.8 billion Counting WaSH is difficult “access” vs servicedelivery you have a tap in the house, but is the water clean? Easyto count toilets,but where does it go? Containment-> emptying->transport->treatment->resue/disposal In some places likeDhake,many have access tosewer or on-site facility,but not all cansafely empty the container or don’t atall and are leftto overflow or justabandoned. 1% practive open defecation. Very expensive to start up and maintain sewagetreatment plants. Designing andimplementing WaSH for health How ppl seetheir city- Protect their home, neighbors/school/workplace peri-domestic, some people care about ward, then ifall elseis clean,cleanwholecity, and then finallylook at rivers. Environmental engineering view- central treatment works WaSH interacts/overalps with other entities: Health-reduce fecal-oral disease. Oral rehydration/hygiene promotion as well as WaSH Overall environmental health relatively low on agenda Urban devel- Wastewater mngment for urban econ growth Needs ofthose not on the network Utility- Supply and manage water generated by piped network Environment Water wuality ofstandard of rivers, effluent Public health of fish Engineers-pipes,pumps, drains, how to deliver infrastructure Construction better than operations, management, budgeting Capital-intensive“richcountry” solutions,best tested, bestdocumented, have best evidence, completely irrelevant for most vulnerable who are poor They don’t know public health Urban scenario- Sewage project undertaken ingrow water supply Major clientis water utility- concerned about wastewater management Most people would not be on the water line Rural- vsuccessful Hygienepromotion, sanitationformerly handled by MoH financed by Min of Water as part of aidproject Donors now givebudgetary support to ministries Now in “zero sum game” over limited pot of money Hygienein number 10 on a listof3 priorities from min of health Social funds- CDDput ighpriority on water supply improvements, w street lighting,etc. Sanitation is lowon list, hygieneis not on list The good- WaSH intervention can make huge differences in health and quality of life In 2007- doctors saidthat the greatest medical advance in 140 years was sanitation Some now how to do it sensiblyandreach those who can benefit the most The bad- engineers are poorly educated- don’t know how to interact with health professionals and governemtn people Divorced from public health- pn both sides The ugly-politics,greed, bested interests (OPPand Parveen Rahman), laziness,cowardice By the time class is done,100 kids on averagewill have died from diarrhea disease Over hald would be aliveifthey and communities had good water, santiationand hygiene Need patience, persistence,imagination, and the will to listen,think hard.
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