After just a few hours in small town India, I ran out of the filtered water I brought with me from the neighboring megalopolis of Bangalore.
I wanted a refill, so that I could avoid buying bottled water, which would create waste and utilize two extra liters of water (the amount it takes to actually produce the bottle).
Unfortunately, finding clean water in Tiptur is quite the undertaking. There is no visible sewage treatment plant, open drains are ubiquitous, and the local river could be easily confused with a landfill (without all of the regulations we Americans normally associate with dumping grounds of that magnitude).
Most people here avoid drinking surface water by tapping borewells tens of meters below the ground, but even that water could harm my highly vulnerable immune system. While the borewell solution has been a safe and successful, if not somewhat unsustainable, strategy for many of the people of Tiptur, poor sanitation facilities have already deprived millions of others throughout India and around the world of clean water access. And when these borewells are tapped out, Tiptur residents are destined to face the same clean water conundrum.
One of the most notorious infections associated with the consumption of untreated wastewater is cholera, which affects 3-5 million people a year and kills over 100,000 of them.
Vibrio Cholerae, the bacteria responsible for cholera, can be spread through its natural existence in drinking water or through certain marine organisms. However, outbreaks are usually facilitated by the bacteria’s presence in the feces of people who have the infection.
India’s most recent cholera outbreak was in 2009. Within five days of the reported contamination in Hyderabad, another large South Indian city, five hundred people were admitted to hospitals and suffering from serious vomiting and diarrhea.
A 71-city study performed last year by the Delhi-based Center for Science and the Environment determined that nearly every Indian city is facing the same water management quagmire – contaminated surface waters, depleted ground water, and a lack of facilities to treat either.
Because the water pouring out of the taps in Indian cities can contain significant quantities of any sort of pathogen or chemical contaminant, many families like my own in Bangalore take it upon themselves to treat the water before drinking it. There are several water filtration systems available on the market, and recently companies have focused on producing inexpensive filters that can be utilized by low-income families. The cheapest so far is the Tata Swach, which requires an initial investment of $20 as well as $7 a month for filter replacements, but even the Swach is prohibitively expensive for about 40 percent of Indians, living on less than $1.25/day.
Perhaps, it’s both more cost-effective and socially responsible to put the onus of potable water on the central government, especially considering the number of school and work days missed and healthcare costs attributed to diseases transmitted through untreated water.
But massive government intervention is not an option yet for infant governments like Haiti’s. Thirty years ago, approximately a quarter of Haitians had access to sanitary facilities, but the number dwindled to 17 percent by 2008.
The January 2010 earthquake marked a turning point for Haiti – international support was leveraged to bring clean drinking water to nearly half the people in settlement camps at Port-au-Prince.
However, the situation worsened by the end of the year, and a 28-year-old mentally disturbed individual from the town of Mirebalais became the first victim of the 2010 Haitian cholera epidemic. Local villagers called him “Moun Fou,” meaning “crazy person” in Creole. Though Moun Fou had access to clean water, he would often bathe and drink from the Latem River, which received raw sewage from a UN encampment.
Between the rainy seasons there are only about 200 Cholera cases a day, but the next rainy season is looming, and international health organizations are debating how best to contain the epidemic.
Dukoral and Shanchol, the two available vaccines, have been found to be 60 to 90 percent effective, and while some are skeptical about their abilities to make a significant dent in the number of Haitians susceptible to the infection, Partners in Health (PIH), a U.S. based non-profit, is determined to prove to the public health community that the vaccine can be effective on a large scale.
PIH is collaborating with a local nongovernmental organization to deliver 200,000 doses to a rural area in the Artibonite River valley and the Port-au-Prince slum, Cite de Dieu, next month.
Borewells and vaccines are both temporary solutions, however, to a serious long-term problem – we’re running out of clean water. Ultimately, each country and community will need to develop a comprehensive solution – reducing overall water consumption and cleaning the water once its used.
Governments like India’s cannot skirt the sanitation issue much longer, and the international community will have to make sanitation infrastructure even more of a priority in communities that cannot afford to do so themselves because clean water is essential for development. Urban centers of the past often needed to be repopulated after water-borne diseases would wipe out large portions of a city, but we now have the knowledge to overcome the challenge of wastewater. We must make a global commitment to utilize that knowledge and address our sanitation crisis, or the dearth of clean water will threaten our ability to persist as a society.
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