Water Risk Perception and the Use of Water Bottles

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Source: http://cbwa.info/

~Written by Joann Varickanickal (Contact: joann.varickanickal@gmail.com)

It is important to examine how social, organizational and cultural factors of the environment interact to influence health (Laverack, 2014). This has become increasingly evident as water quality and quantity is assessed to determine its impacts on the health of a community. As water is vital to human health, access to clean tap water is important; however, bottled water is often seen as a better alternative to tap water; especially in less developed regions. Many people in low-resources countries, such as Lebanon and Jordan, believe that bottled water is better than their tap water (Massoud, et al., 2013). However, the bottled water is not always effectively monitored for safety, and many are still at risk for various waterborne diseases. Thus, citizens face economic strain to pay for water that is perceived to, but may not be cleaner (Massoud et al., 2013).

Even when bottled water is cleaner than the local tap water, the poor are often unable to afford it, which further increases the gap between the different social classes (Massoud et al., 2013). Citizens should not have to pay for something that is a human right (Parag & Roberts, 2009). Encouraging the use of tap water pushes NGOs and government agencies to improve infrastructure that would make water available to all regardless of social class (Massoud et al., 2013)..

Although tap water in developed regions such as Canada is clean and reliable, bottled water is still popular as it is often purchased for convenience (Mikhailovich & Fitzgerald, 2014). Although the socio-economic implication of using plastic water bottles may not be as severe in such settings, there are still negative environmental consequences (Parag & Roberts, 2009). Manufacturing, packaging, transporting and disposing plastic water bottles is an inefficient use of resources and creates a large amount of waste (Parag & Roberts, 2009). This can have a negative impact on the ecosystem, as this waste can influence plants, animals, minerals and water (Parag & Roberts, 2009). As these systems interact with humans they eventually have a negative impact on the health of a population (Parag & Roberts, 2009). Thus, encouraging the use of re-usable water bottles encourages environmental awareness.

Nevertheless, non-reusable plastic water bottles have been beneficial for emergencies when clean water is not easily available (Canadian Bottled Water Association). With the gradual discontinuation of these bottles, alternative methods need to be determined to ensure that clean water is distributed during emergencies.

Overall, clean water is vital for human health, and easy accessibility is crucial. Thus, clean tap water must be made available and plastic bottles should be phased out in order to allow for greater use of re-usable bottles. This would be a lower burden on the environment, and decrease wealth inequality, consequently, having a positive impact on the health of citizens. 

References:

Laverack, G. (2014). A-Z of health promotion. UK: Palgrave Macmillan.

Massoud, M. a., Maroun, R., Abdelnabi, H., Jamali, I. I., & El-Fadel, M. (2013). Public perception and economic implications of bottled water consumption in underprivileged urban areas. Environmental Monitoring and Assessment, 185, 3093–3102. doi:10.1007/s10661-012-2775-x

Mikhailovich, K., & Fitzgerald, R. (2014). Community responses to the removal of bottled water on a university campus. International Journal of Sustainability in Higher Education, 15(3), 330–342. doi:10.1108/IJSHE-08-2012-0076

Parag, Y., & Roberts, J. T. (2009). A Battle Against the Bottles: Building, Claiming, and Regaining Tap-Water Trustworthiness. Society & Natural Resources, 22(7), 625–636. doi:10.1080/08941920802017248

The Environmental Cost that Living in this World Puts on Our Health

~Written by Sarah Khalid Khan (Contact: sk_scarab@yahoo.com)

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Source: Environmental Health, World Health Organization (WHO)

As revolting as it sounds, there are places in the world where the chances of consuming one’s neighbours’ faeces are quite high if one is not vigilant regarding sanitation and hygiene. That being the condition of many areas in low and lower-middle income countries does not mean that high and higher-middle income countries are exempt from any environmental conditions that are harmful to health.

But, what is environment health? The World Health Organization (WHO) defines the term as, “All the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours”. It, however, excludes genetics and the social and cultural environment.

In low-income settings, concerns for environmental health may arise in the context of sanitation and hygiene, as well as indoor and outdoor pollution. In high-income countries, many chronic diseases like diabetes and cardiovascular disease, are associated with sedentary lifestyles. While these might be attributed to behaviour, one must consider that such behaviours can arise from changes in the environment. Over 80% of communicable and non-communicable diseases can be attributed to environmental hazards.  Overall, conservative estimates indicate that about one quarter of the total global burden of disease is owing to this cause (WHO, 2011). Furthermore, the biggest killers of children under 5 years are all environmental-related diseases, including diarrhoea, respiratory infections, and malaria.

Other diseases of concern are helminthic infections, trachoma (a bacterial eye infection), Chagas disease, leishmaniosis, onchocerciasis, and dengue fever. All of which are associated with impoverished conditions and can be mitigated by improving sanitation, hygiene, and housing. Although conflicts and natural disasters might be catastrophic for any country, struggling economies tend to suffer more because disasters worsen the poor conditions which directly affect sanitation and hygiene practices, creating conducive conditions for various infectious diseases, and ultimately feeding into the vicious cycle of poverty.

Many interventions are underway to address these conditions, including Water, Sanitation and Hygiene (WASH) initiatives, Integrated Vector Management, Programme on Household Air Pollution, International Programme on Chemical Safety, Health and Environment Linkages Initiative, and Intersun Programme for the effects of UV radiation. The acknowledgement of the effects of the environment has grown. One of the Millennium Development Goals (MDGs) was, “To ensure environmental sustainability.” The Sustainable Development Goals (SDGs) are more extensive and thorough in placing focus on the environment. Goal 1 is to end poverty, goal 6 is to make provision of clean water and sanitation possible, and goal 13 is to stop climatic change resulting in floods and drought (United Nations, 2014).

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The Sustainable Development Goals. Source: United Nations System Staff College

It is encouraging to see steps being taken to control environmental hazards; however, the journey to measuring and eradicating such conditions still remains a challenge, which will hopefully be overcome through future endeavours.

References:

United Nations (2014). Sustainable Development Goals. doi:10.1017/CBO9781107415324.004

World Health Organization (2011). WHO Public Health & Environment Global Strategy Overview

Access to Toilets: Not as Common as You Might Think

~Written by Theresa Majeski (Contact: theresa.majeski@gmail.com; Twitter: @theresamajeski)

There are over seven billion people on the planet and 2.4 billion of them do not have access to proper sanitation. Almost one billion people still defecate in the open. The risk of disease and malnutrition increases with poor sanitation, especially for women and children. This year’s World Toilet Day on November 19 highlights the impact of poor sanitation on malnutrition.

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Figure 1 : World Toilet Day poster, 2015. http://www.worldtoiletday.info/wp-content/uploads/2015/10/wtd-artist-poster-724x1024.jpg

Every day, over 1,000 children die from preventable water and sanitation related diarrheal diseases. Half of all cases of under-nutrition associated with diarrheal or intestinal worm infections are directly due to inadequate water, sanitation, and hygiene. Stunting and wasting, which cause irreversible physical and cognitive damage, have been linked to poor (water, sanitation and hygiene (WASH) conditions. In 2014, almost 1 in 4 children under five years of age suffered from stunting globally. 58% of all cases of diarrheal disease are directly related to inadequate water, sanitation, and hygiene.

Access to proper sanitation, hygiene, and potable water is so important that it was included in the 2000 Millennium Development Goals (MDG). Since 1990 an additional 2.1 billion people have started using basic toilets, and today around 68% of people have access to proper sanitation. However, the final MDGs Assessment report shows that the world has fallen short of the MDG goal by 700 million people. This means that there is still work to be done, which is why access to sanitation and clean water is Goal 6 of the Sustainable Development Goals.

There are many innovations occurring in the WASH area. One example is a project by Give Water that promotes child health by developing child-sized latrines and teaching children about proper sanitation and hygiene practices in school. This ensures that proper WASH practices start from a young age. The WASH Impact Network website provides a lot of information about additional innovative WASH projects. 

Access to proper sanitation and clean water is a human right. While progress is being made towards this goal, there is still work to be done. World Toilet Day highlights the continued effort to provide proper sanitation facilities to every person on the planet.

Climate Change and Health, Part 1: Floods

~Written by Joann Varickanickal (Contact: joann.varickanickal@gmail.com)

The Lancet recently published an article on climate change and health, extensively examining the types of health risks related to climate change as well as recommendations for policy changes, in order to address these risks (Watts et al., 2015). This article re-emphasized how complex this issue is because there are several contributing factors, and elements that can be potentially impacted (Figure 1).  As there are so many aspects of this topic, for my next few blog posts I will focus on briefly highlighting some of the health risks associated with climate change. This post will focus on natural disasters, specifically looking at floods.

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Figure 1: Relationship between health, climate change and greenhouse gas emission (Watts et al., 2015)

Since 1900, floods have left more than 88 million people homeless, $595 billion in damages, and the deaths of nearly 7 million people (Khedun & Singh, 2013). Overall, climate change will have a direct impact on human health through natural disasters, such as flooding. South Asia is especially at risk as there is already regular flooding. A change in climate can affect the onset of monsoons. For example, in Kerala, a state in southern India, the monsoon season generally begins on June 1st and ends in early September, with a standard deviation of about seven days (Mirza, 2011). However, in the last 50 years this has more than doubled with the earliest onset on May 14th, and the latest date of onset on June 18th (Mirza, 2011). While this may not seem significant, it can influence the level of preparedness in communities that are at risk. Furthermore, the frequency and intensity of rainfalls will also increase. According to climate models, monsoon intensity increases during the summer, as the air over land is warmer than air over the oceans (Mirza, 2011). Floods, that result from the monsoon weather, not only increase the risk of drowning, but also affect the quality of water, thus increasing the exposure to waterborne diseases such as dysentery and diarrhea (Mirza, 2011).

Mental health issues, such as anxiety and depression, can also develop after losing property or facing a financial crisis after a flood (Khedun & Singh, 2013). Furthermore, the impacts of climate change, such as increased flooding, disproportionately influence certain populations such as marginalized communities, women, children, and the elderly (Watts et al., 2015). Thus, they suffer most of the negative health consequences associated with flooding and other disasters related to climate change (Watts et al., 2015). This highlights the complexity of the issue in terms of trying to address how to help those who are most impacted by floods.

There are several mitigation efforts that can be taken in order to reduce the impact of floods. For example, urban planners and engineers can work to ensure that forested areas are preserved and development occurs in areas where soil and vegetation conditions work best to reduce the risk of flooding. Many non-structural methods can also be implemented. For example, in some areas it may be beneficial to create zoning laws that would prohibit development in areas that are prone to flooding (Watts et al., 2015). Government officials and private officials can also work together to improve early warning systems and develop better policies for flood-insurance and emergency preparedness (Watts et al., 2015). Taking these steps can help to ensure that health issues associated with floods will not be exacerbated.

References:

Khedun, C. P., & Singh, V. P. (2013). Climate Change, Water, and Health: A Review of Regional Challenges. Water Quality, Exposure and Health, 6(1-2), 7–17. doi:10.1007/s12403-013-0107-1

Mirza, M. M. Q. (2011). Climate change, flooding in South Asia and implications. Regional Environmental Change, 11(SUPPL. 1), 95–107. doi:10.1007/s10113-010-0184-7

Watts, N., Adger, W. N., Agnolucci, P., Blackstock, J., Byass, P., Cai, W., … Costello, A. (2015). Health and climate change: policy responses to protect public health. The Lancet, 6736(15). doi:10.1016/S0140-6736(15)60854-6

Examining How Women are Influenced by Inaccessibility to Clean Water

~ Written by Joann Varickanickal (Contact: joann.varickanickal@gmail.com)

Since 1990, 2-3 billion people have gained access to improved drinking water sources, however, much is yet to be done, as billions still do not have access to safe drinking water (Dora, et al., 2015). This has led to several negative health consequences among many communities, as one-third of deaths are linked to the intake of contaminated water in low-resourced countries (West & Hirsch, 2013). Women are often responsible for housework such as cooking, cleaning and maintaining good hygiene. They are also mainly responsible for the care of children and the sick. As all of these tasks require the use of water, women in low-resourced countries are disproportionately affected by the inaccessibility to safe water.

Risks Associated with Water Collection

In 71 percent of households in sub-Saharan Africa women are responsible for collecting water (West & Hirsch, 2013).  As a result, in places such as the mountainous areas of Eastern Africa, women use up to 27 percent of their caloric intake to get water (West & Hirsch, 2013). Sometimes, they must travel a long distance, often several times in one day. This can lead to physical strain, especially among the elderly. This strain can be exacerbated by extreme heat or with heavy pumps at well sites. Water collection can also be dangerous in remote locations where there is increased risk of rape or other forms of violence.

Impacts on Women as Caretakers, and the Terminally Ill

With a high prevalence of HIV and AIDS in these regions, there has also been an increase in care needed for the terminally ill, and once again, it is the responsibility of the woman to provide the needed care (West & Hirsch, 2013). This involves emotional support, but also other aspects such as bathing and toileting. Providing this type of assistance can become more difficult when there is little accessibility to clean water. Furthermore, caregivers also have an increased chance of developing physical pain and infections because of the risks they are exposed to. Increasing accessibility to clean water will not only improve the outcomes of HIV treatment, but it will also reduce the burden of care on women. As a result, this can improve the quality of life for both groups (Figure 1).

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Figure 1: How improved water and sanitation influences the health of those with HIV/AIDS, and caretakers (West & Hirsch, 2013).

Overall, inaccessibility to clean water increases the emotional distress on women and reduces the level of care they are able to provide to those around them. When mothers have poor health status they are unable to provide the adequate resources needed for the well being of their children, which can lead to growth stunts (Requejo, et al., 2015).

Like any other public health issue, this one is complex. Many factors must be examined to determine how improvements can be made to increase the availability of safe water, while also empowering women. For example, while women have to travel long distances in order to get clean water, this also gives them a chance to socialize with other women and spend some time away from the home. Thus, what can be done to preserve this time for social interaction, while minimizing the health risks?  In order to answer this and similar questions, governments and NGOs must critically analyze social systems, specifically gender norms, health systems and physical infrastructure in low-resourced countries.

References:

Dora, C., Haines, A., Balbus, J., Fletcher, E., Adair-Rohani, H., Alabaster, G., et al. (2015). Indicators linking health and sustainability in the post-2015 development agenda. The Lancet , 385 (9965), 380-391.

Requejo, J. H., Bryce, J., Barros, J. A., Berman, P., Bhutta, P., Bhutta, Z., et al. (2015). Countdown to 2015 and beyond: Fulfilling the health agenda for women and children. The Lancet , 385 (9966), 466-476.

West, B. S., & Hirsch, J. S. (2013). HIV and H2O: Tracing the connections between gender, water and HIV. AIDS Behaviour , 17 (5), 1675-1682.