Transcript Document

Drinking Water Supply Sanitary Survey
and Microbiological Water Quality
Assessment from Source to Home
Storage in Gambella, Ethiopia
Waltaji Terfa Kutane, WHO Ethiopia
[email protected]
14-18 October 2013
University of North Carolina
Outline
• Introduction
• Study Objective
• Methodology
• Result and Discussion
• Conclusion
• Actions following the study Result at national level
Introduction
• The principal risks to human health associated with the consumption
of contaminated & polluted water are microbiological in nature.
• Dated back to Dr.John Snow's discovery of 1854 Broad Street cholera
outbreak in England was spread by contaminated water.
• Most common & widespread danger contamination is either directly
or indirectly, by sewage, by other wastes, or by human or animal
excrement
• Exacerbated by poor Sanitation & hygiene behavior/practice in the
water supply system including household
• Coliform bacteria are present in large number in excrement &
sensitive indicator of the presence of faecal contamination.
Introduction
Poor latrine facilities and open defecation coupled with hygiene behavior are
responsible for improved water supply contamination
Prüss-Üstün A, Bos R, Gore F, Bartram J. Safer water, better health: costs, benefits and sustainability of
interventions to protect and promote health. World Health Organization, Geneva, 2008.
Introduction… Ethiopia
• Access to safe water supply was 49% (U=97%,
R=39) using 2011 data
– Piped 9%
– Other improved 40%
– Current coverage 54% National WASH Inventory
• Access to improved +shared sanitation facilities
was 34% % (U=69%, R=25%)
• Access to any sanitation facilities 55% including
un improved latrine facilities
Source:2013 JMP update
Introduction… Ethiopia
Safe water supply coverage based on the national standard is:
•
Adopted from WHO GV the 2001 Ethiopia Standard:
– Drinking-water should not contain any microorganisms known to be pathogenic—
capable of causing disease—or any bacteria indicative of fecal pollution
•
Urban:
–
•
Rural:
–
•
dwellers that can obtain at least 15 liters/person/day throughout the year from a source with in 1.5 km of
the household.
In both cases the water must either be collected from:
–
–
•
dwellers that can obtain at least 20 liters/person/day throughout the year from a source within 0.5 km of
the household.
an improved source such as protected well, improved & protected spring, sanitary rainfall catchment, etc.;
or
can otherwise be treated to acceptable standards
The national definition is in line with the five basic indicators included in the definition of safe
water supply :
–
–
–
–
–
Quantity
Quality
Cost/ affordability
Continuity(24hours/day; 7days/week, 30 days/month, 365days/year)
Coverage /accessibility
Study Objective
• To identify risk factors responsible from source to household level
for poor microbiological water quality of water supply system
targeted for the survey
• To determine the level of contamination & microbiological quality
of water supply system and household targeted by the survey
• To verify whether water supply included in this study met the
national definition/satandard of safe water supply
• To inform the water supply system, health decision &development
partners the importance drinking water quality incremental
improvement through risk identifcation & management/ mitigation
Methodology
Household have access to
improved source
Observation and interview
WHO standard sanitary survey
form for water source & HH
risk identification
Indicator bacteria test (Total
coliform and E. coli using
Membrane filtration technique
Result and Discussion
•
69.8%, 20%, 19.3%, 6.3%, 4.1% and 2.7% of the survey
respondent households use municipal supply, protected wells,
protected springs, river & pond respectively.
• Only 30.6% of the surveyed
households getting
half(10/litter/person/day) of the WHO recommended 20 litters per
person per day for developing countries; 53.4% less than 6 litter &
16% they don`t know
• No reliable system at grass root level, which can track timely the
issue of maintenance, community has to wait for more than a
month from center to get back broken hand pumps.
Result and Discussion
Result of Sanitary Risk Assessment for Improved Water Source
Type of Source Number
Protected well
15
Protected
Spring
Piped water
supply
Total
11
4
30
Sanitary Risk Score
Low
Interme High
diate
1
2
8
(53.3%)
2
1
5
(45.5%)
1
2
1(25%)
4
(13.3%)
5
14
(16.7%) (46.7%)
Very High
4
(26.7%)
3(27.3%)
365
Low
37
(10.1%)
Intermediate High
Very High
29
194
105
(53.2%) (28.8%)
(7.9%)
Improved vs Safe
Drinking Water

Boreholes & tube
wells…31% not safe

Protected
springs…….37% not
safe

Protected dug wells…..
57% not safe

Source
http://www.undispatch.
comndg.water.target.m
et.but.what.about.sanit
ation.and.darrhea
0
7
(23.3%)
Household level Sanitary Risk Assessment Result
Number of
Sanitary Risk Score
Household

Remark
All HH use
the above
improved
sources
Result and Discussion
Sample source
Improved Spring
Improved Well
Pipe System
Pipe reservoir
Home storage
Total
Number of
Sample
4
8
3
1
14
30
Cfu/100ml(Total Coliform)
<1(A)
1-10(B)
11-50©
0
4(100%)
0
0
2(25%)
6(75%)
0
3(100%)
0
1(100%)
0
0
3(21.4%) 10(71.4%)
0
13(43.3%) 16(53.3%)
50+(D)
0
0
0
0
1(7.2%)
1(3.3%)
Based on WHO
Grading system of
microbial quality
Grade A…0%
Grade B……43.3%
Grade C…53.3%
Grade D……3.3%
Improved well 4(50%) +Ve for E.coli
Household level 3 (21.4%) +Ve for E.coli
Similar Study in North Gondar….
E.Coli
Water Line Pipe (n=14) …. 7(50%)
Improved Well(n=14)……….4(28.6%)
Improved Spring(n=14) …5(37.7%)
Source: Ethiopia, JHD, 2004
Result and Discussion
• WHO/UNICEF JMP RADWQ, 2004-2005 result for Ethiopia Compliance
with national standard & WHO Guide line
– Microbiological Quality sample from source
• Piped…………………..87.6%
• Protected springs …. 43.3%
• Borehole…………………67.9%
• Protected well………..54.9
• Total……………………….72%
– Microbiological Quality sample from household (n=1000)
• Fecal contamination ……………….55%
– Sanitary survey Result
• Protected springs 316 inspected found spring box absent or
faulty38.3% and diversion ditch above the spring absent or nonfunctional 87%
• Piped water distribution system 428 inspected found cracks in the
pre-filters 21.1% and mud balls or cracks in any of the filters 15.8%
Result and Discussion
Knowledge of respondent about disease prevention by using safe Water supply by
educational level , Gambella, Ethiopia
Education
Diarrhoea
Typhoid
Dysente
Hepatiti
ry
s
%
No %
No
level(n=635)
No
%
N
Cholera
Parasite
%
No
%
No
%
o
1-3
22
3.5
3
0.5
7
1.1
0
0.0
11
1.7
7
1.1
4-6
64
10.
13 2.0
9
1.4
5
0.8
20
3.1
23
3.6
7-9
48
7.5
14 2.2
11
1.7
6
0.9
16
2.5
21
3.3
10-12
80
13
2
3.1
19
2.9
9
1.4
27
4.3
26
4.1
0
>12
29
Read & write 86
Illiterate
Total
4.6
11
1.7
9
1.4
6
0.9
14
2.2
15
2.4
14
7
1.1
10
1.6
2
0.3
31
4.6
34
5.4
139 22.0 19 2.9
13 2.0 9
1.4 32 5.0
78
12.3
468 74.6 87 13.5 78 12.1 37 5.7 151 23.4 204 32.2
significant difference with educational level on prevention of diarrhoea
with safe water compared greater than 12 grade with illiterate (X²=
10.96; P<0.001).
Better understanding
/knowledge with
respect to diarrhoea,
cholera and parasite
Result and Discussion
Knowledge of respondents on water container contamination as means
of waterborne disease transmission in the home, Gambella, Ethiopia
Education
level
(n=579)
1-3
4-6
7-9
10-12
>12
Read and
write
Illiterate
Total
Cup
Dirty
container
No
14
32
29
48
15
72
%
2.4
5.5
5.0
8.3
2.6
12.4
No
11
29
23
47
19
66
%
1.8
5.0
3.9
8.1
3.3
11.4
82
292
14.2
50.4
100 17.3
295 50.8
Uncovere
d
container
No %
10
1.7
45
7.7
28
4.8
50
8.6
19
3.3
37
6.4
Dirty
cover
No
4
15
15
26
13
13
113 19.5 42
302 52
128
Chicken/
animals
Drawing by
hand
No
0
6
10
11
8
3
%
0
1.0
1.7
1.8
1.4
0.5
No
10
54
31
44
16
20
%
1.7
9.3
5.4
7.6
2.7
3.5
7.3 17
22.1 55
2.9
9.3
39
214
6.7
36.9
%
0.7
2.6
2.6
4.5
2.2
2.2
More than half of respondent claimed that
uncovered container , dirty container & use of
the same cup for water drawing & drinking
are responsible for disease transmission
Photo, Arto S, WASH COM
Result and Discussion
Drinking-Water Handling Practice at Home (n=635)
Result and Discussion
Latrine and hand washing facilities availability, utilization and cleanse(n= 635)
Conclusion
• The aim of any safe water supply program/project is to reduce the
risk of contamination at least to the lowest level. However, in the
study area this objective was not achieved.
• Four major problem areas of public water supply were identified:
– Quality with sensitive indicators coliform and E.Coli organisms indication of
contamination
– Risk factors for contamination from source to household level
– Knowledge gap on disease prevention using safe water and contamination of
water
– Quantity acute shortage & none functionality/lack of reliable preventive
operation and maintenance system
• Ad hoc water quality testing and absence of risk assessment/
sanitary survey in the study area
Conclusion
• Finally three conclusions can be drawn from this study:
– Though, putting in place water supply infrastructure is apriority in any
water supply programme/project, the risk of contamination is all ways
there regard less of the complexity of the infrastructure.
– Availability of the water supply infrastructure does not grantee always
the five basic indicators included in the definition of safe water supply :
•
•
•
•
•
Quantity
Quality
Cost/ affordability
Continuity(24hours/day; 7days/week, 30 days/month, 365days/year)
Coverage /accessibility
– Once water supply infrastructure is in place hygienically management
from source to mouth need systematical well designed and planned
interventions at home to achieve the objective of Framework for safe
drinking-water
Recommendation
Addressing Water Quality strategically
As part of
O&M
Risk
identifcation,
prioritization
&
prevention/mi
tigation
As integral
part of the
water supply
system
Management
Actions following the study Result
Mitigation of risks based on the priority
Capacity building training and field level
water quality testing equipment
National Drinking Water
Quality Monitoring
Surveillance Strategy
developed with detail
financial resource
requirement and activities
Recent development
WSP piloting and
framework
development