WHO calls for health sector to become involved in water management

According to Water for Health – Taking Charge, a report published by the WHO on the eve of World Water Day, on the 22 March, the health sector must become fully involved in water management, and move away from their strictly medical approach of the last 50 years which has ended in the current situation of growing resistance to antibiotics, insecticides and standard drugs.

“Society generally looks at the contribution of development to health. The contribution of health to development has been largely ignored,” said Dr Gro Harlem Brundtland, Director-General of the WHO. “It is time to reverse this way of looking at things. And it is high time to recognise safe water supply and adequate sanitation to protect health are among the basic human rights.”

At present, says the WHO, more than one billion people drink unsafe water, 2.4 billion, 40% of the human race, are without adequate sanitation, and 3.4 million people, mostly children, die every year of water-related diseases. However, the picture is not all bad as there are a number of practical initiatives, such as purifying water and improving hygiene, which could turn the situation around, according to the WHO’s report.

Two methods of water purification heralded by the report are chlorination and a simple heat treatment technique called SODIS – solar water disinfection. “We looked at how chlorinated water could be provided to poor households through a simple, low-cost treatment and secure storage method,” says Mark Sobsey, Professor of Environmental Microbiology at the University of North Carolina, in the United States. “What we know now is that even in conditions of very poor sanitation and hygiene, where people are collecting whatever water is available to use for their household water supply, if the water is chlorinated, the water is improved microbiologically, and you can find statistically significant decreases in diarrhoeal disease,” he said.

One example of a successful chlorination strategy is found in the Maldives, where it is used as a national programme. Twenty years into the project, deaths from diarrhoea on the islands are now virtually unknown.

Even cheaper and easier than chlorination, the water purification technique known as SODIS, uses transparent bottles which are filled with water and placed horizontally on a black flat surface in sunlight for about five hours, so that ultraviolet light kills the pathogens in the water. The effect is enhanced by heat produced by the absorption of solar energy by the black surface. Field studies in a number of countries have proved that the process works.

A third recommendation of the report calls for changing behaviour and attitudes in favour of hygiene. “Our research shows that washing with hand soap would probably sharply reduce deaths from diarrhoeal disease,” said Valerie Curtis, a lecturer in hygiene promotion at the London School of Hygiene and Tropical Medicine. “All it requires is soap and motivation. But that’s more easily said than done.” Curtis points out that the traditional ‘scolding’ and moralistic method of changing behaviour turns people off, with some communities interpreting the message as implying that they are “dirty dogs”. “We used a positive motivation approach in a three-year project in Bobo-Dioulasso, Burkina Faso, and at the end they had tripled their use of soap.” Studies of diarrhoea show that the simple act of washing one’s hands with soap and water reduces incidence of the disease by 35%, she said.

“Clearly, a problem of this magnitude cannot be solved overnight, but simple, inexpensive measures, both individual and collective, are available that will provide clean water for millions and millions of people in developing countries – now, not in 10 or 20 years,” said Dr. Brundtland. “We do not have the luxury of waiting around for large infrastructure investments to provide water supplies and basic sanitation services for all who need them. It makes no sense, and it is not acceptable, to ignore the immediate priorities of the most needy.”