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Today is World Water Day, when the United Nations draws attention to the importance of freshwater and advocates for sustainable water-resource management. This year, the focus is on water quality, which is declining worldwide.

According to the World Health Organization, each year 3.4 million people – most of them children – die from water-related diseases. That includes 1.4 million children dying from diarrhea annually, and 860,000 children perishing directly or indirectly from malnutrition arising from repeated diarrhea or intestinal nematodes. Many malnourished children do survive, but can suffer lifelong impairment.

Some of the most common neglected tropical diseases, which cause widespread impairment in developing countries, are water-related. Trachoma, which causes eye inflammation and is transmitted as a result of inadequate hygiene, affects more than 80 million people worldwide and has left eight million of them blind. Schistosomiasis, which spreads through water bodies contaminated with infected persons’ feces, causes progressive damage to either the bladder and kidneys or the liver, spleen, and intestines. WHO estimates that 200 million people have this preventable infection.

Because water-related diseases cause such a great reduction in quality of life and productivity, they’re a focus on the UN Millennium Development Goals. Under Goal Seven, “Ensure Environmental Sustainability,” one of the targets is “Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation.” The world has achieved substantial progress toward this goal, but it’s been uneven.
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Of the many wrenching stories coming out of Haiti, two stories about the public-health challenges facing earthquake survivors do a particularly good job encapsulating just how daunting the weeks ahead will be.

In the Los Angeles Times, Shari Roan reports that emergency medical responders “will have to create a public health system on the fly.” Only one hospital is functioning, and the large numbers of people infected with HIV and tuberculosis will struggle to access the treatments they need. Many Haitians are already undernourished, so it’s crucial that food shortages be addressed – but, as most of us have already heard, transporting basic supplies is difficult given heavily damaged infrastructure. Roan goes on to explain how a range of illnesses can spread under current conditions:

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Despite global efforts to improve access to clean water and sanitation, 2.6 billion people, or half of the developing world, lack access to even an “improved” latrine to allow for a basic level of hygiene and protect water supplies from contamination.

A lack of adequate funding and high-level commitment to the problem have certainly hampered efforts to meet the Millennium Development Goal target of halving the proportion of people who lack adequate sanitation (from 1990 levels) by 2015. There’s also a challenge that I found surprising the first time I heard of it: you can give people latrines or toilets, but that doesn’t mean they’ll use them. Apparently, unless people see the need for latrines and value them, the facilities may sit unused or turn into storage sheds (a problem that has sparked the Community-Led Total Sanitation movement).

The Washington Post’s Emily Wax brings us news of a trend in rural India that’s raising the profile of sanitation improvements: women are refusing to marry unless the prospective grooms provide them with toilets. An earlier article by the Christian Science Monitor’s Ben Arnoldy reports that the “No toilet, no bride” campaign by the government of the Haryana state has helped increase the percentage of homes with toilets from 5% to 60% in just four years. Apparently, making sanitation sexy can improve public health.

by Madison Hardee

Studying public health over the last two years, drinking water in the US and in the developing world is a regular topic of conversation.  In my studies, I was surprised to learn that only 1% of the world’s fresh water is available for human use (drinking, sanitation crops, etc.) The rest of the world’s water is salt water (97%) or locked in glaciers (2%).

In the developed world, water is something we rarely think about.  When I am thirsty, I just turn the knob on my sink.  When I want to take a shower, hot water comes out at the pull of a lever.  But for every time I turn on the faucet, there a hundreds of people in the developing world who lack access to clean, running water – something I take so for granted.

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The Charleston Gazette’s Ken Ward reports:

“Less than a week before leaving office, the Bush administration is preparing to issue an emergency health advisory for drinking water polluted with the toxic chemical C8.  …EPA plans to recommend reducing consumption of water that contains more than 0.4 parts per billion of C8, according to a draft of the agency advisory [6-page PDF] obtained by the Charleston Gazette.  …The [new] advisory level is tighter [and] a guideline in effect for residents near a DuPont Parkersburg [WV chemical] plant…are both 10 times weaker than a similar C8 water guideline set by New Jersey Environmental Commissioner Lisa Jackson.”

On January 14, Ms. Jackson had her confirmation hearing as President-elect Obama’s pick for U.S. EPA Administrator. C8 is the abbreviation for ammonium perfluorooctanoate (PFOA), a compound used to make Teflon and other non-stick surfaces.  And following Ken Ward’s article on Jan 15, U.S. EPA does in fact have a link to this document on the agency’s website.

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by revere, cross-posted at Effect Measure

One of the triumphs of 19th and 20th century public health was the provision of piped water into cities and towns. With the use of modern methods of disinfection (primarily chlorination) water as a source of mass distributed poisons rapidly receded, and with it the preponderance of infectious diseases that were the scourge of urban life. Urban water supplied were an efficient means to provide a healthy required substance, water, to the whole population and once. But of course it is also an efficient means to distribute unhealthy stuff — not just microbes but chemicals. I’ve worked on the health of effects of chemicals in drinking water for many years and I wish I could say that the chemicals that occupied much of my professional attention — solvents, organic contaminants, by-products of the disinfection process — were off the radar screen. They aren’t. They are still around and causing trouble. But now the radar screen has gotten more crowded, with blips representing chemicals that mimic hormones and more and more often, pharmaceuticals. A paper just published in the journal Environmental Science & Techonology (ES&T) is quite surprising. Surveying 29 water supplies serving more than 28 million people, the most frequently found chemicals were unregulated organics, all pharmaeuticals except for one regulated pesticide.

Here’s the top 11 (via New Scientist):

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Updated below ( 12/24/2008 )

Here are just some of the reports coming out of Harriman, Tennessee:

“Millions of yards of ashy sludge broke through a dike at the TVA’s (Tennessee Valley Authority) Kingston coal-fired plant, covering hundreds of acres, knocking one home off its foundation, and putting environmentalists on edge about toxic chemicals that might be seeping into the ground and flowing downriver.  One neighborhing family said the disaster was no surprise because they have watched the 1960’s era ash pond’s mini-blowouts off-and-on for years.”  [The Tennesseean, here]

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The official figure for cholera deaths in Zimbabwe is 565, but The Independent cites a senior health official’s report that the death toll is closer to 3,000. On Wednesday, riot police in Harare used batons to disperse and beat a group of doctors and nurses expressing anger over the outbreak. Barry Bearak summarizes the country’s grim conditions in the New York Times:

The cholera epidemic and the new crackdown on dissent come in a country already mired in desperation. The government is paralyzed by a stalemated power-sharing deal, and the official inflation rate is 231 million percent. Grocery shelves are largely barren. Most public hospitals and schools are closed.

Zimbabwe’s health minister has appealed to the international community for medicine, equipment, and funds to pay health staff. The crisis extends beyond the health system, though. In Harare, the water has been shut off due to a lack of necessary purification chemicals, and soldiers upset with the deflated value of their pay rampaged through the central part of the city. A union official told the New York Times that at Wednesday’s demonstration, police assaulted several women, some of whom were pregnant.

Bearak contrasts today’s horrible conditions to pre-Mugabe Zimbabwe:

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By Ruth Long

We, in the United States, generally feel safe when it comes to our water.  Most people turn on their faucets at home without so much as a thought to where the water comes from or whether it is safe to use (consume).  It would baffle us to no end if, for whatever reason, the water simply did not come out of the faucet when it was turned on. 

Yesterday, in the Washington Post, Kari Lydersen brought the topic of our water to the forefront.  It is a good article expressing concerns that we, even here in the United States, need to consider with the changes in our environment and how it will affect our health:

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By Nathan Fetty

Every so often, my wife and I take our daughter, who’s now two-and-a-half, on one of our favorite walks in the country here in central West Virginia.  To get there, unfortunately, we have to pass by torrents of orange acid mine drainage (photo examples here and here) and through a landscape brutalized by mining.  But the woods and streams beyond this devastation are as prime as any in West Virginia. That’s why we keep going there.  We want our child to know these kinds of special places.

Our daughter’s becoming more and more verbal. She loves to point out things as she’s going along. “I see a school bus,” she’ll say, or “I see doggies!”  Earlier this year, we passed the old mine site on our way to someplace more beautiful. Our daughter was jabbering as usual and then declared, “I see orange water.”

And then it hit me.

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