Tag Archives: water-related diseases

Access to safe water and sanitation among top global public health achievements

Access to safe water and sanitation are among the ten top global public health achievements in the first decade of 21st century identified by the Centers for Disease Control and Prevention (CDC).

CDC asked experts in global public health to nominate noteworthy public health achievements that occurred outside of the United States during 2001–2010. CDC selected ten of these achievements and published an overview in Morbidity and Mortality Weekly Report (MMWR) of 24 June 2011.

Between 2000 and 2008, CDC reports that an additional 800 million people gained access to improved drinking water sources, and additional 570 million people gained access to improved sanitation. In addition, education and safe water technology have eradicated Guinea worm in all but four countries (Southern Sudan, Mali, Ethiopia, and Ghana), with complete eradication expected in 2012.

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Uganda, Kampala: living on the edge in Namuwongo

On a tiny crumbling concrete floor sits a raised makeshift building with stairs of half-baked bricks. With the upper part screened off by boxes and plastic materials, this is what passes for a toilet in Namuwongo. This, according to Jamila Erika would be remarkable, if the toilets were plenty and enough for everyone.

“We have been robbed of our dignity,” says Erika, a resident of Kanyogoga. “Can you imagine women living without a toilet in the house? The most difficult thing is to get a toilet because they are too few and they are closed at night.”

A levy of sh100 [US$ 0.05] is also imposed on the users of the shared toilet, which Erika says pushes some people to use the bush instead. For those who are not bold enough to engage in open defecation, there is an option [“flying toilets”], which is equally degrading.

“With plenty of empty plastic bags, women who stay home when their husbands are away, help themselves in the plastic bags and keep them inside their houses. When the night comes, most women move out and discard the plastic bags,” says Erika.

In some of the tiny corridors, children answer the call of nature. There are heaps of faeces as one moves towards the swamp, making it difficult to walk there.

Swarms of houseflies hovering over the shacks feast on the heaps and later make millions of landings on the dirty plates nearby.

[…]

Ironically, it is rare for Namuwongo residents to wash their hands, a practice, which Sam Mutono of the World Bank says would cut down on incidents of water-borne diseases by up to 60%. “This practice has not been nurtured in Namuwongo,” says Mutono.

At the stand pipes, Erika says a jerrycan of water goes for sh50 [US$ 0.025] and that most women have only sh200 [US$ 0.10] by the husbands to run the home for the whole day. “Can you imagine hunting for food, water and firewood with just that money?” asks Erika. “For us, putting food on the table is a miracle and spending money on a shared toilet is an afterthought.”

In their tiny crumbling houses, the women have an extra burden of nursing children that frequently fall sick when water-borne diseases become so rampant. “I have to spend most of the money treating children in the rainy season,” says Erika. “This also means that I have to stay home much longer when they are sick.”

In times of hardship, it is women and children that suffer most. “The men care less because they step out of home very early and come back too late to listen to the problems their wives and children are facing,” says Erika. “It is common for men to run to other women in different parts of Kampala to escape responsibilities at home.”

Most patients during the three devastating outbreaks of cholera that spread through Kampala in 1997, 2007 and 2008 came from Namuwongo. InOctober 2009, cholera revisited Namuwongo and claimed three lives. One victim was a woman and the other two were children.

Too much unsafe water

Erika says when it rains, it floods and dirty water from the dreaded Nakivubo Channel seeps into the spring water wells contaminating the drinking water, a reliable source for those who cannot afford tap water.

“Most children miss classes because they are sick”, says Emily Hashaka, who works with an NGO. “We provide some medicine, but this is like a drop in the sea.”

The occupants of this slum count themselves lucky if the rainy season passes without cholera striking. The women sometimes sell household utensils in order to get money to buy medicine and food, according to Hashaka.

The LC1 chairperson for Kanyogoga, Emmanuel Masengere, says unsafe toilets were demolished since floods easily drain away the faeces into the houses. “This place is congested with people. The water table is high and the pit latrines are floating on water. So we constructed public latrines, which are safer, but too few.”

Asked whether their cries have been heard, Masengere replies: “Government officials only come here when there is a crisis or for votes. They never attend to issues affecting the population until it becomes a full-blown crisis.”

According to Charles Nuwagaba, a lecturer at Makerere University, half of the population in the slums in Kampala do not have access to toilets. “This”, Nuwagaba points out, “is a serious shortcoming given that about 60% of Kampala’s population lives in slums.”

Less than 10% of the two million residents of Kampala have toilets connected to the sewer line. The poor disposal of sewage has turned the Nakivubo waterway into an open sewer, which drains into Lake Victoria near Namuwongo.

To the National Environment Management Authority, the residents of Namuwongo are encroaching on the swamp. However, some of the encroachers have met their match in the floods and have had to vacate even before NEMA’s action to evict them.

“But this never lasts long. Other tenants keep on coming to rent the cheap houses in the dry season. The problem with Namuwongo is that the people who have constructed houses in the slums never stay there,” says Mutono.

The Government with the support of World Bank wanted to remove Namuwongo two decades ago, but it never happened. The owners of land sold it to their richer colleagues and the poor tenants crossed the Port Bell railway for cheaper housing deeper in the swampy settlement.

Recommendations

Mutono suggests technologies that can work better than the pit latrines as part of the way out. “Key to this is the exposure of women to new technologies such as ecological sanitation toilets that separate urine and faeces with an aim of making fertilisers,” says Mutono. “Once exposed, the women could teach many others. It could take a long time to accept such technologies, but women should be put at the centre.”

Mutono also recommends that NGOs with lessons on how to deal with sanitation in slums should be encouraged to share such knowledge. “As much as the Government tries to improve the situation, sanitation is a household responsibility,” says Mutono.

Mutono also says the landlords should be compelled to enforce the Public Health Act to create better sanitation conditions for people like Erika to lead better lives.

Source: New Vision / allAfrica.com, 20 Feb 2010.

Sudan: People with HIV demand safe drinking water

For years, Lole Laila Lole, chairperson of an association for people living with HIV/AIDS in southern Sudan, had to drink, cook with, and bathe in the dirty, contaminated water he fetched from the River Nile. “There was no other way,” he told IRIN/PlusNews.

Due to their weakened immune systems, people living with HIV are particularly susceptible to infections and diseases that can be present in untreated water. But after testing positive [in Khartoum], Lole was forced to return to the virtually non-existent water system of Juba, the southern capital, which had been at war for close to two decades.

The conflict ended in 2005, but government leaders in the south say they lack adequate resources to redevelop the war-ravaged region and deliver services such as providing safe water.

Since the end of the war, treatment tablets have become available in the shops, and HIV-positive people who can afford them are now able to protect themselves from the outbreaks of cholera and other diarrhoeal diseases.

This year, Population Services International (PSI), with funding from the US Centres for Disease Control, began including water treatment tablets [Water Guard] in the basic care packets they distribute to people with HIV every three months. The decision to include Water Guard in PSI’s care packets was partly in response to pressure from people living with HIV.

Women in Sudan also face very high maternal health risks. The risks are significantly higher for HIV-positive mothers and babies, particularly if they are unable to access safe drinking water.

Read more: IRIN/PlusNews, 12 May 2008