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Waterborne diseases underestimated

According to a new report from India’s planning commission, major efforts to improve access to drinking water across India have not been matched by proportionate declines in deaths and illnesses from waterborne diseases, which remain grossly underestimated.

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According to a new report from India's planning commission, major efforts to improve access to drinking water across India have not been matched by a proportionate decline in death and illness due to waterborne diseases, which remain grossly underestimated. Between 400,000 and 500,000 children aged under five years die each year from diarrhoea, citing a failure to improve personal and home hygiene as a factor. The data in the report indicated that the incidence of viral hepatitis is 12 cases per 100,000 people. But at least two studies in urban communities have shown that the incidence might be around 100 per 100,000. The report also said that only a small proportion of diarrhoeal diseases are picked up through surveillance. The report, which was sponsored by the World Health Organisation and UNICEF, said that improvements in hygiene behaviour are not likely, unless sanitation coverage improves dramatically. Without an adequate water supply children cannot wash often enough and are prone to eye infections and skin conditions such as scabies. Poor water quality and the lack of adequate disposal of human, animal, and household wastes also contribute to waterborne diseases. Just 30% of the waste-water from India's cities is treated before disposal. The rest flows into rivers, lakes, and groundwater, contaminating the sources of drinking water. Figures from India's Central Bureau of Health Intelligence show that the incidence of diarrhoea, enteric fever, viral hepatitis, and cholera has stayed at the same level over the past decade. Fluoride contamination of fresh water also affects large parts of rural India, the report said. More than 25 million people across 17 states have to drink water with fluoride concentrations higher than the maximum permissible limit of 1.5 parts per million, it said. Excess fluoride can cause a condition called skeletal fluorosis.

India Assessment 2002: Water Supply and Sanitation in BMJ, June 2003; Vol. 326

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