UNSAFE DRINKING WATER IS ONE OF THE LEADING HEALTH CHALLENGES IN THE WORLD TODAY

Water is an essential part of life. Without it, people and animals simply can t survive, According to the United Nations, 1 billion people worldwide lack access to safe drinking water and 80% of all diseases in developing countries are transmitted through water. Throughout much of the world, women and children walk miles to get water for drinking and household use, the Streams, ponds and ditches, used as sources for water, are polluted, with this chore

often done by children who should instead be in school. This lack of water can lead to poor health, malnutrition, meager incomes and low agricultural productivity. Human feces, containing a wide range of bacteria, viruses and other microorganisms, pollute water sources used for drinking and washing. As a result, each year more than 900 million cases of diarrhea are reported, infectious diseases are rampant, and over 4 million children die. Microbiologically contaminated water places a tremendous burden on the lives and the health of the world's poorest people and causes needless misery and death where the struggle for life is the hardest. Even within major cities of developing nations, water from municipal systems is unsafe and needs to be boiled to prevent illness. Boiling unsafe water is an effective preventative measure for those who can afford it; however, boiling consumes scarce natural resources and contributes to deforestation and air pollution. The time and energy-consuming task of gathering firewood to boil water only adds to the already heavy burden of work for countless women and children in developing countries. And where firewood cannot be gathered, wood or other fuels must be purchased, with the cost often consuming up to 25% of a family's income.

SOME WATERBORNE DISEASES: DYSENTERY 5 million children under the age of 5 die each year from dysentery caused by contaminated water. Caused primarily by the Shigella

bacillus, dysentery may be simply defined as diarrhea containing blood. In addition to bloody diarrhea, the illness often includes abdominal cramping, fever and rectal pain. Less frequent complications of infection include sepsis, seizures and renal failure. Between 5% and 15% of cases are fatal. SCHISTOSOMIASIS (BILHARZIASIS) Approximately 600 million people are at risk, 200 million are infected, 120 million are symptomatic and 20 million have severe disease worldwide. It is prevalent in 54 countries of Africa, the Caribbean, the Eastern Mediterranean, South America and Asia. Schistosomiasis, also known as Bilharziasis, is a parasitic disease caused by five species of flatworm and leads to chronic ill health and serious weakness or death. It is second only to malaria among tropical diseases and is the third most prevalent parasitic disease in the world. People are infected by contact with infested water. The disease most commonly results in intestinal schistosomiasis, which leads to cirrhosis of the liver, and urinary schistosomiasis, which causes bladder cancer. Infected victims contaminate their environment through urine and feces into quiet rivers and lakes. The eggs hatch on contact with water and release larvae. A tiny larva finds a fresh water snail host, where it divides itself repeatedly to produce thousands of new parasites. Parasites are excreted into the water by the snail. They can penetrate the skin of a mammal within seconds, continuing the biological cycle once they make their way into the victim s blood stream. Within 30 to 45 days, the parasite is transformed into a long worm, residing in the blood vessels of the intestine or bladder. Only half of the eggs are excreted in the feces or urine. The rest are trapped in body tissues, damaging

other organs. It is the eggs, and not the worm, which cause damage to the intestines, the bladder and other organs. Schistosomiasis is a preventable disease, but the number of cases is continually rising. The provision of safe and adequate water supplies and sanitation facilities contributes substantially to reducing its prevalence and severity. TYPHOID FEVER An estimated 16 million cases of typhoid fever and 600,000 related deaths occur worldwide, with a concentration in Asia, Africa and Latin America. In the United States about 400 cases occur each year, and 70% of these are acquired while traveling internationally. Typhoid fever is an acute, life-threatening febrile illness caused by the bacterium Salmonella thphi. You can get typhoid fever if you eat food or beverages that have been handled by a person who is a carrier, or if sewage contaminated with the bacteria gets into the water you use for drinking or washing food. Therefore, typhoid is more common in areas of the world where hand washing is less frequent and water is likely to be contaminated with sewage. The disease is characterized by fever headache, malaise, anorexia, enlargement of the spleen, and abnormally slow heartbeat. Many mild and atypical infections occur. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever, but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their feces (stool). CHOLERA

During 1998, the number of cases worldwide doubled from 1997. Africa reported 212,000 cases and there were over 57,000 in the Americas. It is on a steep rise in Asia with large increases in Afghanistan, India, Cambodia, Malaysia, Nepal and Sri Lanka. Cholera is an acute, diarrheal illness caused by infection of the intestine with the bacterium vibrio cholerae. About one in 20 infected persons has a severe case characterized by profuse watery diarrhea, vomiting and leg cramps. Rapid loss of body fluids leads to dehydration and shock. Without treatment, death can occur within hours and fatality rates can be very high. A person may get cholera by drinking water or eating food contaminated with the cholera bacterium. In an epidemic, the source of the contamination is usually the feces of an infected person. The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. AFTER A DISASTER, THIS IS A VERY REAL DANGER, since regular water and food supplies are often unavailable. AMEBIASIS 50,000 people die each year out of 50 million cases reported worldwide. Transmission occurs through ingestion of cysts in fecally contaminated food or water and person-to-person contact. It is most common in tropical countries where crowded living conditions and poor sanitation prevail. Africa, Latin America, Southeast Asia and India have significant health problems associated with this disease. Typical symptoms are frequent diarrheal, often bloody bowel movements, abdominal pain, nausea, weight loss, and occasional fever. Recurrences are common unless the individual is treated.

Spreading of the ameba into the wall of the colon may cause colitis or dysentery, and in rare cases it can migrate to the liver, lungs, brain or other organs. DRACUNCULIASIS (GUINEA WORM) The number of people affected from this debilitating disease has declined dramatically, yet remains over 100,000. It is prevalent in rural areas of 16 countries in Africa as well as Yemen. Dracunculiasis is a disabling infection caused by the parasite, Dracunculus medinensis, commonly known as the guinea worm, which is the largest of the tissue parasites affecting humans. The disease is only contracted by drinking water sources contaminated with the infected hosts of the parasite. Stagnant sources of drinking water, such as ponds, cisterns, pools in driedup riverbeds, temporary hand-dug wells and step wells are the usual sites where the infection is transmitted. People become infected when they drink water containing tiny crustaceans, called copepods or water fleas, that act as intermediate hosts of the organism and harbor infective larvae. The parasite migrates through the body. Over the next year, female worms grow to maturity, reaching a length of 70 cm or more (2-3 feet). The worms usually emerge from the feet in 90% of the cases, but can also appear in the upper extremities, the trunk, buttocks, genitalia, etc. Symptoms include severe pain, nausea, vomiting, diarrhea and dizziness. Infected persons remain asymptomatic for approximately a year after infection when the mature female worm approaches the skin and forms a painful ulcer. Eventually it ruptures, exposing the worm. As the worm emerges through the

skin lesion, the affected person pulls it out slowly and carefully. This process causes unbearable pain and may last many weeks. If the worm breaks during extraction, an intense inflammatory reaction occurs, with pain, swelling and cellulitis. Partial or total disability can last from several weeks in isolated cases up to, in most cases, several months. Healing is no guarantee of immunity against further serious secondary infection.

By: Chiara Marlene