Pakistan is facing complex water and sanitation problems in rural, urban and semi-urban communities. This problem is not new for our society; however implications linked with this sector have a direct impact on health, specifically on children. Poor water and sanitation is a leading cause of about 60 per cent of child mortality in Pakistan and patients suffering water-related diseases occupy 20 to 40 per cent of hospital beds in Pakistan.
The severity of an already pathetic situation has been augmented by the 2010-11 floods. According to the World Bank (2006) estimate, annually Pakistan bears a cost of Rs365 billion due to environmental degradation; out of this, Rs112 billion accounts for inadequate water supply, sanitation and hygiene. Out of this, the annual expenditure connected merely to water-related stomach diseases is estimated at about Rs55-80 billion. Sindh is at the top having diarrhoeal alerts and outbreaks which are higher than the average in Pakistan. We will try to explore reasons and barriers hindering improved water and sanitation facilities in Sindh province.
In Karachi and Hyderabad there are some areas where people have access to somewhat better water and sanitation facilities, but not all areas of these cities enjoy this luxury. Slums and semi-urban areas often lack these basic amenities altogether, and sometimes fare even worse than rural sites. A major chunk of population in Sindh is living in rural and far-flung areas where water and sanitation facilities are either insufficient or totally absent. If available, they are non-functional and no one takes responsibility for upkeep and maintenance while the role and willingness of concerned authorities including the Public Health Engineering Department (PHED) and Taluka Municipal Administration (TMA) for their improvement is questionable.
United Nation says access to safe drinking water and sanitation is a fundamental human need and therefore a basic human right.
The National Drinking Water Policy, 2009 in its preamble, mentions that providing safe drinking water to the entire population at an affordable cost is the responsibility of the state yet, the majority of rural Sindh and particularly communities living in remote areas lack safe water. The Pakistan Council of Research in Water Resources (PCRWR) reports that only 42 per cent of water supply schemes in rural Sindh are working. However, only the functioning of water supply schemes is not enough; are these schemes meeting the recommended drinking water quality parameters? Do these schemes have trained technical staff and water testing facilities? Unfortunately, the answer is no, therefore, public health is always at risk.
Rural communities of Sindh mostly rely on either surface canal water or groundwater boreholes and hand pumps for drinking purpose. Surface water is heavily loaded with organic pollution and faecal contamination is a major health concern in children and other age groups. There is a well-established link between intake of faecal-contaminated water and waterborne diseases.
Unfortunately, more than 80 per cent of water at source and household level is faecal-contaminated and does not meet WHO drinking water standards, except some sources where deep boreholes are possible.
It is pertinent to mention that the majority of villages in the coastal districts of Sindh including Badin and Thatta do not even have the option for groundwater because of high levels of salinity due to seawater intrusion. Other parts of Sindh face a similar problem but the coastal belt needs more attention.
Secondly, the hand pumps largely prevalent in rural Sindh, ultimately contaminate the water, even if the original source is safe.
This is because the community is not given any guidance regarding proper usage and maintenance of the concrete base which ultimately leads to seepage and contamination of the soil water. In addition, low quality hand pump material tends to rust causing iron contamination; the traditional design of the hand pump encourages algal growth in the outlet pipe which contaminates the water passing through it.
The million-dollar question is, how can common villagers learn whether the source they are drawing water from is safe from chemical and biological contamination, except on the basis of their traditional and folk knowledge, as there is no facility to get water tested quickly, scientifically and cheaply. Different types of chemical contamination including arsenic have been observed and vary from region to region across Sindh. Though the government has established water testing laboratories in some districts of Sindh, ironically the laboratory fee is about Rs1,700 for a single water sample analysis. Is it feasible for poor people, who are worrying about where their next meal will come from, to pay this amount?
Besides the provision of safe drinking water, adequate sanitation and hygiene conditions are equally important for the development of healthy communities. However, the sanitation situation in Sindh is perhaps, even darker than access to safe water. The sewage system is breaking down everywhere and open defecation is still a norm in rural communities. A national survey regarding knowledge levels, attitudes and practices for sanitation and hygiene conducted by the Ministry of Environment in 2001 revealed that the masses do not explicitly understand the link between unsafe excreta disposal and diarrhoea.
There is great need of political will combined with culturally accepted technical solutions to improve water and sanitation programmes on emergency basis in the country, as it is a lifesaving matter. The World Health Organisation suggests that investment of $1 in water and sanitation would generate an economic return between $3 to $34, depending on the region and technologies applied. Therefore, investment in water and sanitation is not a big deal, as it will pay multiple dividends in the national interest.
The writer is an Environmental Health professional, associated with an international organisation.
Source: http://dawn.com/2012/05/06/sanitation-pollution-unlimited/



