Waterborne diseases affect millions of people around the world every year.  However, it doesn’t need to be this way.  Clean water, proper sanitation facilities and good hygiene can eliminate the risk of these diseases.  Below you’ll find several brief overviews of the most common diseases, how they are treated, and how they can be prevented.  The links at the bottom of the article can be used to help your community stay safe and healthy.  Let’s start with what is maybe the worse waterborne disease out there…

Diarrhea

• Sources: Diarrhea is the second leading cause of death among children under 5, killing 760,000 children a year.  Globally, 1.7 million people are infected with diarrheal disease every year.  Diarrheal diseases come from bacterial, viral and parasitic organisms that are present in water contaminated with human or animal fecal matter.  It can also be transmitted from person to person due to poor hygiene, and from food that is stored or cooked in unhygienic containers.  Further, crops can also be contaminated if it is irrigated with infected water.
• Symptoms and Effects: Diarrhea is classified as the passage of three or more loose or liquid stools per day.  It also is sometimes accompanied by vomiting.  Diarrhea causes dehydration, which is the biggest threat, and can lead to death.  Other symptoms include sunken eyes, shock, loss of consciousness, rapid pulse, low blood pressure and pale skin. Diarrhea also leads to malnutrition, which can cause other health problems.
• Treatment: Dehydration is treated either through drinking clean water (from a clean source, by boiling for at least 1 min, or mixing in chlorine or bleach), oral rehydration salts (a mixture of clean water, salt, and sugar) or an intravenous drip.  If dehydration is not treated as soon as possible it could lead to death. Zinc treatment, has been known to reduce the duration of the diarrhea by 25%.  Nutrient rich foods are important to break the cycle of diarrhea. For children this includes breast milk.
• Prevention: Diarrhea can be prevented by only drinking water that is known to be clean (which includes storing water in clean containers), using improved sanitation facilities that are located at least 30 meters from your drinking water source, practicing good hygiene which includes hand washing with soap, and keeping food and food containers clean.

Arsenicosis

• Sources: Arsenic is a naturally occurring element found throughout the world and where there is arsenic in the ground there is arsenic in the groundwater. Arsenicosis (or arsenic poisoning) is caused by drinking water that has arsenic in it over a long period of time. Absorption through the skin is minimal so hand washing, bathing, etc. in arsenic contaminated water is okay.  The WHO Guideline Value for an appropriate amount of arsenic in water is 0.01mg/liter.
• Symptoms and Effects: The symptoms of arsenicosis take a while to show.  It occurs after drinking arsenic contaminated water for 5-20 years.  Arsenicosis can cause skin problems (color change, hard patches on palms of hands and soles of feet), skin cancer, cancer of the bladder, kidney and lung, diseases of the blood vessels in the legs and feet, hair loss, and possibly diabetes, high blood pressure, and reproductive disorders.
• Treatment: There is no single and completely effective treatment for arsenicosis.  For long time sufferers treatment may not be effective.  Flushing of the bowels with a polyethylene solution has been used to flush the arsenic out of the system, however, this is not a proven treatment.  A treatment called Chelation has had some success.  This treatment uses drugs that selectively bind to and inactivate the arsenic.  The arsenic is then excreted through the urine.  The drug usually used for this treatment is called Dimercaprol (also known as BAL), but others, such as Succimer (DMSA), and Dimerval (DMPS) have been known to work also.  Blood transfusions can help, but only if done soon after the exposure to arsenic.
• Prevention: Arsenicosis can be prevented by drinking clean water.  This can be accomplished, in some cases, by drilling deeper wells, however, sometimes even at very deep depths you will still find arsenic in the water. Harvesting rainwater is another way to procure clean water, and can provide a year-long supply in areas with substantial rain (but care must be taken to store and transfer it properly so that it does not become contaminated by other means). Finally, the use of arsenic removal systems can be used, although, this may not be appropriate in all situations.  Community reverse osmosis systems, ion exchange systems, coagulation, and adsorption are more expensive options, but are effective.  Simple filters have also been found to be quite effective in removing arsenic.  You can find some of these options, and how to build them, here and here.

Cholera

• Sources: Cholera can be contracted by drinking water or eating food which is contaminated with the cholera bacteria.  The cholera bacteria is found in water or food that is contaminated by fecal matter.
• Symptoms and Effects: Cholera causes diarrhea and vomiting which is caused by the infection of the intestines.  This leads to dehydration which can kill. People can be infected and show no symptoms. In severe cases it can be accompanied by rapid heart rate, low blood pressure, and muscle cramps. If you think you or someone you know has contracted cholera you should be treated as soon as possible because cholera can cause death if it is not treated rapidly.
• Treatment: Treatments for cholera include rehydration treatment , zinc treatment and antibiotic treatment, however antibiotics may not work in some cases because of  cholera’s resistance to drugs.
• Prevention: Cholera is prevented by drinking and using clean water (boil for at least 1 min, chlorine, bleach), and practicing good hygiene.  Good hygiene includes washing your hands with soap and clean water before you eat or feed anyone, after going to the bathroom, after cleaning your child’s diaper, after caring for someone ill with diarrhea. Also, you should use a latrine or bury your feces away from sources of drinking water.  Never go to the bathroom in or around a source of drinking water (at least 30 meters away). Further, you should cook food well (especially seafood), keep it covered, and eat it hot. Finally, don’t clean yourself or household items within 30 meters of source of drinking water.

Dysentery

• Sources:  Dysentery comes from fecal contamination of food and water. There are 140 million cases a year, and 600,000 deaths per year (mostly in developing nations).
• Symptoms and Effects: There are two kinds of dysentery: bacterial and amoebic.  Symptoms of a bacterial infection include fever, abdominal cramps, rectal pain and intestinal ulcers which cause bloody stools. An amoebic infection will remain mild if it stays in the intestines, however, if it invades the intestinal wall it can lead to fever, abdominal and rectal pain, vomiting, and bloody diarrhea.  An amoebic infection can become chronic if it invades the blood vessels which can lead to abscesses of the liver and brain.
• Treatment: Dysentery can go away on its own in some cases, but treatment using antibiotics is recommended.  Also,dysentery will cause dehydration which can be treated using oral rehydration salts, or if it gets really bad, intravenous fluids. To treat amoebic dysentery an amoebicide is used to kill the organism in the intestines, and then antibiotics is used for potential secondary bacterial infections.
• Prevention: Like with most waterborne diseases, washing your hands with soap, drinking and washing with clean water, and good sanitation practices as mentioned previously can prevent dysentery.

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There are quite a few waterborne diseases out there. The diseases listed above are only a few, but are the most common.  All of these diseases are preventable with the proper knowledge and resources.  Unfortunately, these resources are not always available to the people that need them the most. Below you’ll find several documents that can be used in your fight against waterborne diseases.  They include educational material about good hygiene, and documents that can show you how to make your own filters, latrines, and wells with simple technology and resources that can be found in many places at low to no cost.  Also included are documents to aid you in keeping your wells and water systems clean and safe.

Please use and share this material.  It can assist you and your community in becoming, and staying, healthy and safe, and help bring an end to the death of millions of people every year.  Thanks for reading, and I hope this finds you well.

A Guide to the Development of On-Site Sanitation – WHO

Solutions for Reducing Borehole Costs in Rural Africa

Technologies Applied for drinking water treatment in rural communities

Composting Latrines in Rural Panama: Design, Construction, and Evaluation of Pathogen Removal

Appropriate Technology for Water Supply and Sanitation (may take a while to load)

Cleaning and Disinfecting Wells

Rural Water Supply Design Manual

Biosand Filter Resources

Hygiene Standards Booklet

A Guide to the Construction and Protection of Hand Dug Wells

Sources:

UNICEF – Common Water and Sanitation Related Diseases

Voice of America: Waterborne Disease is World’s Leading Killer

CDC – Global WASH-Related Diseases and Contaminants

MedIndia – Arsenic Poisoning

WHO – Water Related Diseases – Arsenicosis

MedicineNet.com – Arsenic Poisoning

Infoplease – Water-borne Diseases – Cholera and Dysentery

WHO – Diarrheal Disease