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Twin cities: Water-borne diseases on the rise!

With the onset of hot, humid weather and early monsoon rains, situation of water-borne diseases such as viral hepatitis (A&E), gastroenteritis, typhoid and paratyphoid fever, cholera, dysentery, E-coli diarrhoea, giardiasis and intestinal worms, malaria, dengue fever, poliomyelitis and rotavirus diarrhoea in infants - the second major cause of childhood deaths - is likely to get worse if effective prevention and control measures are not adopted religiously.

Head of Community Medicine at Islamabad Medical & Dental College, Colonel (r) Professor Dr Muhammad Ashraf Chaudhry said this while talking to ‘The News’ Saturday in connection with rapid spread of water-borne diseases in twin cities of Islamabad and Rawalpindi and all across the country.

“An outbreak of gastroenteritis (also know as gastro) has already hit several localities of Rawalpindi, Lahore and Hyderabad and the number of patients is still on the rise,” he added.

According to data collected by ‘The News’, two of the three teaching hospitals in town including Holy Family Hospital and Rawalpindi General Hospital have received nearly 3,000 patients with gastroenteritis within past one-and-a-half months.

Water pollution has become a real threat to public health in Pakistan. The most common sources of water contamination are a result of human activity such as discharges from factories, leaky/rusty underground water pipelines, cross-connections between water supply lines and sewerage drainage pipelines, improperly treated sewage disposal, agricultural chemicals and pesticides, trickling and seeping in to underground water aquifers and unclean storage tanks.

To a query, Dr Ashraf said that water in many cities of Pakistan is unsafe for human consumption due to both bacterial and chemical contamination. “After 60 years of independence, we do not have a national drinking water policy and as well mandatory safety and quality standards for drinking water in Pakistan. Those who are responsible for treating water at source are either absent or not trained to do their job properly,” he said adding either their apparatus are not working or they have short of chlorine gas cylinders supply.

He said that in Pakistan, nearly 1.2 million people die each year due to water-borne diseases. Amongst these, 250,000 children are under the age of five who succumb to diarrhoea, mainly caused by the use of untreated water. “The water-borne illnesses account for nearly 60% of child deaths in Pakistan with approximately 630 children dying daily from diarrhoea.” Dr Ashraf said that residents of Rawalpindi are also vulnerable to water-borne diseases due to supply of contaminated water in many areas of the city. “About 80% of Rawalpindi population drinks contaminated water. Every day, nine out of ten times, the glass of water turns out to be ‘unfit for human consumption’ as the situation of public water sources, storage tanks, distribution channels etc. has become horrifying.”

According to statistics, the bacterial contamination in water pumped through tube-wells has increased from 33% in 2004 to 65 per cent in 2008 while in 2003, as many as 81,996 cases of water-borne diseases were registered in Rawalpindi. Dr Ashraf said that 80% of infectious and parasitic diseases are related to contaminated water while people suffering from water-borne diseases occupy 25% of hospital beds.

He said that globally, 250 million cases of water-borne diseases and 10 million deaths are reported each year. Usually water leads to 1 in 10 diseases and 6 per cent of deaths worldwide. “An estimated 2.2 million children die each year because of preventable water-borne diseases but still there seems lack of political will in Pakistan in addressing problems related to provision of safe drinking water,” he said.

Talking on guidelines for water pollution control authorities and the community in order to curb the incidence of water-borne diseases, Dr Ashraf said that water must be protected from pollution before drinking and sterilized by boiling or chlorination as ground water becomes contaminated due to frequent rains. “Water must be brought to ‘rolling boil’ for 5-10 minutes. Chlorination of water may be carried out by chlorine gas (on large scale), bleaching powder, chlorine tablets, and chlorine stock solution,” he said adding for emergency disinfections, two drops of ethanol solution of iodine are sufficient to one litre of water.

Uninterrupted chlorinated water must be supplied to consumers 24 hourly. Water treatment plants or chloronomes should be run by experts or well trained personnel. Every tube-well should have a chloronome and a filter, he said.

Professor Ashraf opined that proper inspection and sampling of water points should be carried out on regular basis by the local health authorities. Residual chlorine should also be checked periodically. Minimum 0.5 ppm (parts per million) of residual chlorine must be ensured at the consumer end. Surveillance has to be established at every point in the distribution system to ensure supply of safe water to the consumer.

He added that old, outdated and rusty water pipelines (more than 30 years old) should be replaced by new ones and laid far distance away from the sewerage lines in order to avoid cross-connections. “Every one rupee invested in this area would bring an additional benefit of ten rupees in healthcare savings and productivity,” said Dr Ashraf.

He suggested that water pollution control departments should be established at every district level and they should be provided necessary funds, staff and physical facilities for field surveys and laboratory work. He added that public water storage tanks as well as of houses should be got cleaned regularly at least twice a year.

“Don’t drink water at bus stops, rail compartments and from vendors. Utensils should not be washed from stagnant source of water. Soakage wells/septic tanks should be at least 15 meters away from underground water storage tanks. Water should be stored in clean and covered utensils and do remember that ice is contaminated by dirty cans, dirty covers and dirty containers,” concluded Dr Ashraf.