Ensuring Safe Water for All

 

Introduction

Over the last three-four decades, deteriorating quality of drinking water has become a major global concern. On 28 July 2010, the general assembly of the United Nations passed a resolution recognising "the right to safe and clean drinking water as a human right" (UN, 2012). India has voted in favour of this resolution. Unsafe drinking water, and inadequate hygiene and sanitation contribute to an estimated 1.9 million annual deaths, primarily in children under five (WHO, 2012).

As per WHO report (2007), 1.1 billion lack access to "improved" drinking water supply. Annually, 4 billion cases of diarrhoea are reported of which 88% is due to unsafe water, and inadequate sanitation and hygiene conditions. India has recorded 0.4 – 0.5 million diarrhoeal deaths in children under five (Planning Commission of India, 2002). WHO estimates that 94% of diarrhoeal cases are preventable. NSSO1 in its report on housing condition in India states that highest deprivation is in squatter settlement with18% having insufficient drinking water. Development Alternatives2 (DA) in its field study observes that people use water supplied by private tankers or pipelines tapped and water collected from pits for drinking purpose.

Water may be safe at the point of treatment or distribution but contaminated by the time consumed, putting people’s health at serious risk (Wright J et al, 2004). Guidelines for Drinking-Water Quality (GDWQ)-WHO, 2011b states, "household water treatment approaches has potential for rapid and significant positive health impacts in situations where piped water systems is not possible".

Challenges and Potentials

DA study indicates low awareness levels on water quality-health impacts amongst communities in slums. Also, low cost Household Water Treatment Systems (HWTS) is not practiced much due to perceived change in taste, unavailability of technologies and non-familiarity. Although quality of supplied drinking water in urban areas is the responsibility of government but they are unable to reach increasing number of informal settlements so people are sourcing and consuming drinking water from dubious sources. Moreover, poor awareness regarding unsafe water, disease-health nexus and contamination at collection and storage points at homes indicates that advocacy on HWTS3 as point-of use treatment of drinking water is required to enhance health and economic productivity. The study elucidated interesting observations on challenges to HWTS in informal settlements in Delhi:

  • Scepticism on the effectiveness of water quality interventions like HWTS due to lack of robust data to back.

  • Belief that diarrhoea is not a disease and a natural condition, especially in young children, not requiring preventive measures.

  • Belief that if water is visibly clear, it is pure and has been consumed so far and does not need any treatment.

Most HWTS in India and the world has been done by NGOs and private sector and public sector role is limited to setting standards. Uptake and scaling of HWTS requires sustained use leading to behaviour change, which takes time. Similar findings are stated by WHO (Thomas F.C. 2009) on HWTS experiences from low income economies including India. The report concludes that the current coverage and uptake of HWTS is far from demonstrating its potential contribution to health emphasising on the need for recognized standards or certification procedures for HWTS products. It underscores public sector priority to quantity and access and greatly under-prioritizes quality issues.

Significant efforts are required for behaviour change amongst communities for HWTS uptake through concerted public health awareness initiatives by government. HWTS can help reduce disease burden considerably leading to reduction in maternal and child mortality, higher school attendance and better economic productivity.

The Policy imperative

Analysis of existing public health and urban services reveal that safe drinking water for all will take time despite all efforts. Therefore public awareness of water-health nexus and HWTS as a measure by families themselves attains significance. A multi-pronged awareness campaign for behaviour change linked with training of public health workers incorporating in existing outreach programmes is required. Following is recommended for enhanced effectiveness.

  • Inclusion in training curriculum of grass-root workers in Jawaharlal Nehru National Urban Renewal Mission, Basic Services for Urban Poor, Total Sanitation Campaign, Anganwadi and ASHA workers for creating awareness.

  • Awareness generation be incorporated in schemes and programmes of Ministry of Women & Child Development and NIPCCD (National Institute for Public Cooperation and Child Development) like ICDS.

  • Ministry of Human Resource Development should include HWTS in school curriculum and in adult education.

  • Urban Local Bodies (ULBs) have a role in maintaining sanitary conditions and appropriate drainage in slums. This has a direct bearing on community health therefore the ULBs mandate should include promoting HWTS practice.

  • Incentives to promote HWTS (for areas which follow HWTS practices on a regular basis) similar to Nirmal Gram Puruskar for open defecation free areas.

Once the significance of HWTS is highlighted through above mentioned policy interventions, it can be an ongoing behavioural practice for ‘Point of Use’ treatment at household level.  q

References
 • http://www.who.int/water_sanitation_health/publications/combating_diseasepart1lowres.pdf
• http://planningcommission.nic.in/aboutus/committee/wrkgrp12/hud/wg_Final_Urb_Pvt.pdf
• http://whqlibdoc.who.int/publications/2011/9789241548151_eng.pdf
• Thomas F.C., 2009. Report on ‘Scaling Up Household Water Treatment Among Low-Income Populations’ by Thomas F. Clasen, JD, PhD, London School of Hygiene & Tropical Medicine for WHO in 2009.
• http://www.un.org/waterforlifedecade/human_right_to_water.shtml
• http://en.wikipedia.org/wiki/Water_purification
• Wright J. et al. (2004) ‘Household drinking water in developing countries: a systematic review of microbiological contamination between source and point of use.’ Tropical Medicine and International Health 9(1): 106-17
• Water Resources Division, India Assessment 2002: Water Supply and Sanitation, New Delhi: Water Resources Division, Government of India Planning Commission

Alka Srivastava
asrivastava@devalt.org

1 NSSO - National Sample Survey Organisation
2 DA study on HWTS in 10 slums of Delhi (sponsored by Eawag Aquatic Research) during 2010-2013
3 HWTS include physical processes viz. filtration, sedimentation, and distillation, biological processes viz. slow sand filters or biologically active carbon, chemical processes viz. flocculation and chlorination and use of electromagnetic radiation viz. ultraviolet light (Water purification, Wikipedia)

 

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