Environmental Health Blog
Thursday, May 27, 2004
 
The Water Challenge, one of world's ten 'biggest concerns'

Frank Rijsberman, Director General, International Water Management Institute, Sri Lanka, and professor of water education in The Netherlands has authored a paper on world water and sanitation issues for Copenhagen Consensus 2004.

The Water Challenge:

Lack of access to basic water supply and sanitation services has a broad range of impacts at the household level for what are generally referred to as "the unserved". These range from the high costs the urban unserved pay to water vendors for minimal amounts of water, to large amounts of time spent carrying water in rural areas, or time not spent by adults on productive activities while caring for sick children suffering from water-related diseases. The water-related health impacts are well established. (Excerpt)
The Copenhagen Consensus, a project of the Environmental Assessment Institute, Copenhagen, Denmark, is striving to improve prioritization of the world's limited means as we face the challenges of disease, environmental degradation, armed conflict, and more. The group focused on ten challenges that represent some of the world's biggest concerns, and invited ten specialists to each prepare a background paper on the challenge within their field of research, so as to provide these experts with current knowledge of that concern.

At Copenhagen Consensus 2004 (May 24-28, 2004,) economic experts met in Copenhagen to review the challenge papers, and discuss, analyze, and rank the opportunities corresponding to each challenge, and the effects of various efforts to date.

Professor Henry Vaux, Jr., Department of Agricultural & Resource Economics, University of California, Berkeley, USA, and Professor John Boland, Professor Emeritus, The Johns Hopkins University, Baltimore, MD, USA, prepared opponent notes to The Water Challenge. Their responses, as well as the other nine challenge papers, are available at the Copenhagen Consensus website: http:www.copenhagenconsensus.com.

Frank Rijsberman is Director General for the International Water Management Institute, Colombo, Sri Lanka (F.Rijsberman@CGIAR.org, www.iwmi.org;) and Professor, UNESCO-IHE, for the International Institute for Water Education, Delft, The Netherlands; and Wageningen Agricultural University, Wageningen, The Netherlands.

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Training:

Three upcoming NETWAS* courses focus on water supply and environmental sanitation issues. Click here for application guidelines.
*Network for Water and Sanitation International

July 12-23, 2004, Nairobi, Kenya

Gender, Equity, and Income Generation: Linking Gender with Poverty in Water and Environmental Sanitation.

A gender, equity and income generation approach will ensure that the complementarity of men’s and women’s roles and responsibilities is mobilized to best effect the creativity, energy and knowledge of both genders, to contribute socially and economically to making water and sanitation facilities work better.
August 23-September 3, 2004, Nairobi, Kenya

Participatory Methods in Planning and Management of Water and Environmental Projects/Programs.

This course is intended to introduce various participatory methods and techniques, which are flexible and non-didactic, that planners and managers of WES Programs can use in planning and managing WES Projects/Programs as well as show how they complement each other at various stages of the project. These will include:
SARAR (Self Esteem, Associative Strengths, Resourcefulness, Action Planning, Responsibility);
PHAST (Participatory Hygiene and Sanitation Transformation);
PRA (Participatory Rural Appraisal);
SWOT (Strengths, Weaknesses, Opportunities, Threats);
MPA (Methodologies for Participatory Assessments).
The idea is that, instead of agencies coming in and appraising the local situation and drawing up plans, local people are encouraged to do this themselves, with the guidance of agencies. Potentially, this can make plans more realistic and better suited to local conditions; encourage local people to become involved in implementation; and help to empower local people to have more control over their future.
September 20–October 1, 2004, Nairobi, Kenya

Management for Sustainability of Water Supply and Sanitation Programs.

Over the past decades the number of rural and low-income urban water supply and sanitation facilities has increased tremendously. However, this has not always led to sustained access to functioning facilities, improved hygiene behaviour or a reduction in water-borne diseases. Improved levels of living through improved health conditions depend to a large extend on sustained management and use of water and sanitation facilities and improved hygienic behaviour.
Enrollment is limited. Click here to apply.

For more information visit the NETWAS website or contact:

NETWAS International,
Magadi Road, Off Langata Road,
P.O. Box 15614-00503 Mbagathi,
Nairobi, Kenya.
Tel: 254-2-890555/6/9/60
Fax: 254-2-890553/54
E-mail: Training@netwas.org
Web: http://www.netwas.org

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Reports:

Household water quality and sanitation are still major contributors to child mortality, especially among under-fives. Two World Bank reports provide updates on recent environmental health research into the causes of child death in China and India.

Wang, Limin; van der Klaauw, Bas
Child Mortality in Rural India.
Working Paper No. 3281
April 21, 2004
Van der Klaauw and Wang focus on infant and child mortality in rural areas of India. They construct a flexible duration model framework that allows for frailty at multiple levels and interactions between the child’s age and individual socioeconomic, and environmental characteristics. The estimated results show that socioeconomic and environmental characteristics have significantly different effects on mortality rates at different ages. These are particularly important immediately after birth. The authors use the estimated model for policy experiments. These indicate that child mortality can be reduced substantially, particularly by improving the education of women and reducing indoor air pollution caused by cooking fuels. In addition, providing access to electricity and sanitation facilities can reduce under-five-years mortality rates significantly. (Author abstract edited)

Wang, Limin; Jacoby, Hanan
Environmental Determinants of Child Mortality in Rural China: A Competing Risks Approach.
Working Paper No. 3241
March 12, 2004
Jacoby and Wang use a competing risk model to analyze environmental determinants of child mortality using the 1992 China National Health Survey, which collects information on cause of death. Their primary question is whether taking into account of cause of death using a competing risk model, compared with a simple model of all causes of mortality, affects conclusions about the effectiveness of policy interventions. There are two potential analytical advantages in using cause of death information: (1) obtaining more accurate estimates and (2) validating causal relationships. Although the authors do not find significant differences between estimates obtained from the competing risk model and those from simpler hazard models, they do find evidence supporting the causal interpretations of the effect of access to safe water on child mortality. The authors’ analysis also suggest that a respondent-based health survey can be used to collect relatively reliable information on cause of death. Modifying future demographic and health survey instruments to collect cause of death information inexpensively may be worthwhile for enhancing the analytical strength of the surveys. (Author abstract edited)

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In the Journals:

C.S.J. Probert¹ ; P.R.H. Jones² ; N.M. Ratcliffe²

A Novel Method for Rapidly Diagnosing the Causes of Diarrhoea.

Gut: January 2004; 53(1): 58-61.

¹ Correspondence to: Dr C.S.J. Probert, Department of Medicine, Bristol Royal Infirmary, Marlborough St, Bristol BS2 8HW, United Kingdom; c.s.j.probert@bristol.ac.uk.
² Faculty of Applied Sciences, Centre for Research in Analytical, Materials, and Sensor Sciences, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, United Kingdom.

Background: The microbiological diagnosis of infectious diarrhoea may take several days using conventional techniques. In order to determine whether flatus can be used to make a rapid diagnosis, the volatile organic compounds associated with diarrhoea were analysed.

Methods: Stool samples were collected from 35 patients with infectious diarrhoea and from six healthy controls. Gaseous compounds were extracted from a headspace using solid phase microextraction and analysed using gas chromatography and mass spectroscopy.

Results: Characteristic patterns of volatile gases were found for the main causes of infectious diarrhoea in hospitals. Furan species without indoles indicated Clostridium difficile, ethyl dodecanoate indicated rotavirus, ammonia without ethyl dodecanoate suggested other enteric viruses, and the absence of hydrocarbons and terpenes indicated Campylobacter infection.

Conclusion: These results could be the basis of rapid near patient diagnosis of infectious diarrhoea. (Author abstract)

Mark A. Borchardt¹ ; Po-Huang Chyou¹ ; Edna O. DeVries² ; Edward A. Belongia¹

Septic System Density and Infectious Diarrhea in a Defined Population of Children.

Environmental Health Perspectives: May 2003; 111(5): 742-748.

¹ Marshfield Medical Research Foundation, Marshfield, Wisconsin, USA.
² Department of Pediatrics, Marshfield Clinic, Marshfield, Wisconsin, USA.
Address correspondence to M. Borchardt, Marshfield Medical Research Foundation, 1000 North Oak Ave., Marshfield, WI 54449 USA; Telephone: (715) 389-3758; Fax: (715) 389-3808; E-mail: borchardt.mark@mmrf.mfldclin.edu.

One-quarter of U.S. households use a septic system for wastewater disposal. In this study we investigated whether septic system density was associated with endemic diarrheal illness in children.

Cases: children 1 to < 19 years old seeking medical care for acute diarrhea--and controls resided in the Marshfield Epidemiologic Study Area, a population-based cohort in central Wisconsin. Enrollment was from February 1997 through September 1998. Study participants completed a structured interview, and septic system density was determined from county sanitary permits. Household wells were sampled for bacterial pathogens and indicators of water sanitary quality. Risk factors were assessed for cases grouped by diarrhea etiology.

In multivariate analyses, viral diarrhea was associated with the number of holding tank septic systems in the 640-acre section surrounding the case residence [adjusted odds ratio (AOR), 1.08; 95% confidence interval (CI), 1.02-1.15; p = 0.008], and bacterial diarrhea was associated with the number of holding tanks per 40-acre quarter-quarter section (AOR, 1.22; 95% CI, 1.02-1.46; p = 0.026). Diarrhea of unknown etiology was independently associated with drinking from a household well contaminated with fecal enterococci (AOR, 6.18; 95% CI, 1.22-31.46; p = 0.028).

Septic system densities were associated with endemic diarrheal illness in central Wisconsin. The association should be investigated in other regions, and standards for septic systems should be evaluated to ensure that the public health is protected. (Author abstract)
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EHP is sponsored by the Office of Health, Infectious Diseases and Nutrition,
Bureau for Global Health, U.S. Agency for International Development.

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