EFFECT OF POOR SANITATION PRACTICE ON PUBLIC HEALTH
INTRODUCTION AND BACKGROUND TO THE STUDY
1.1 Introduction
POOR SANITATION PRACTICE
Efforts to assuage poverty cannot be complete if access to good water and sanitation systems are not part. In the 2000, 189 nations adopted the United Nations Millennium Declaration, and from that, the Millennium Development Goals were made. Goal 4, which aims at reducing child mortality by two thirds for children under five, is the focus of this study. Clean water and sanitation considerably lessen water-related diseases which kill thousands of children every day (UN, 2006). According to the World Health Organization (WHO), 1.1 billion people lacked access to an enhanced water supply in 2002, and 2.3 billion people got ill from diseases caused by unhygienic water. Each year 1.8 million people die from diarrhoea diseases, and 90% of these deaths are of children under five years (WHO, 2004).
. Despite efforts by the development partners, water supply and sanitation related diseases are highly prevalent in the state. Data obtained from the Public and Environmental Health Department of the Ministry of Health (M.O.H., 2008) showed that the top ten most prevalent diseases in the state include malaria, acute respiratory infections, skin diseases and diarrhoea. The others are acute eye infection, rheumatism, dental carries, hypertension, pregnancy related complications and home/occupational accidents. A lot more illnesses occur but on a lower scale and these include intestinal worm attacks, coughs and typhoid fever. A complete data on the top ten diseases prevalent in the state is attached as Appendix E. Table 1.1 is a selection of the illnesses that directly result from poor quality water and sanitation practices in the Bayelsa. POOR SANITATION PRACTICE
Table 1.1: HIGHLY PREVALENT DISEASES THAT DIRECTLY RESULTS FROM
POOR WATER AND SANITATION PRACTICE
Diseases | Prevalence rate per 1,000 population |
2006 | 2007 | 2008 |
Malaria | 350 | 320 | 300 |
Infant Diarrhoea | 30 | 30 | 30 |
Acute respiratory infection | 60 | 60 | 60 |
Dental Carries | 10 | 20 | 10 |
Source: Regional Directorate of the Ministry of Health, 2008
The number of malaria cases decreased from 350 in 2006 to 300 cases per 1000 population in 2008. Despite the decrease, the values involved are still quite high as compared to values available from neighbouring Bayelsa Amenfi East State for the same period (compare Appendix F and Appendix G). The incidence of diarrhoea among infants and acute respiratory infection remained 30 and 60 cases per 1,000 populations respectively. This can be attributed to several reasons, including population growth, lack of continuous services and inadequate functioning of facilities. In fact, according to the WHO(2004), an estimated 90% of all incidence of diarrhoea among infants can be blamed on inadequate sanitation and unclean water. For example, in a study of 11 countries in Sub-Saharan Africa, only between 35-80% of water systems were operational in the rural areas (Sutton, 2004). Another survey in South Africa recognised that over 70% of the boreholes in the Eastern Cape were not working (Mackintosh and Colvin, 2003). Further examples of sanitation systems in bad condition have also been acknowledged in rural Nigeria, where nearly 40% of latrines put up due to the support of a sanitation program were uncompleted or not used (Rodgers , 2007). In the Bayelsa approximately there are 224 public toilets, 560 hand-dug wells, 1,255 public standpipes and 3 well-managed waste disposal sites. According to the 2006 projection, the population of the state was expected to reach 295,753 by the end of the year 2009 (WWDA, 2006). POOR SANITATION PRACTICE
Development partners in the past have concentrated their efforts on facilities provision only. These facilities are prerequisites for the attainment of good sanitation practice but they have not looked well at the possible causes of the persistence of disease transmission despite the effort they are making. Relationships between household’s sociocultural demographic factors and people’s behaviour with respect to the practice of hygiene could prove an essential lead to the solution of the problem. The fact is, merely providing a water closet does not guarantee that it could be adopted by the people and used well to reduce disease transmission. Epidemiological investigations have revealed that even in dearth supply of latrines, diarrhoeal morbidity can be reduced with the implementation of improved hygiene behaviours (IRC, 2001: Morgan, 1990).
Access to waste disposal systems, their regular, consistent and hygienic use and adoption of other hygienic behavioural practices that block the transmission of diseases are the most important factors. In quite a lot of studies from different countries, the advancement of personal and domestic hygiene accounted for a decline in diarrhoeal morbidity (Henry and Rahim, 1990).For example, a literature meta-analysis by Curtis and Cairncross (2003) based on data from Burkina Faso found that the single hygiene practice of hand washing with soap is able to reduce diarrhoea incidence by over 40% and intestinal infections (cholera, dysentery, hospitalized diarrhoeas due to other causes) by over 50%. The World Bank (2003) identifies the demographic characteristics of the household including education of members, occupation, size and composition as factors influencing the willingness of the household to use an improved water supply and sanitation system. Education, especially for females results in well spaced child birth and greater ability of parents to give better health care. This in turn contributes to reduced mortality rates among children under 5years (Grant, 1995). POOR SANITATION PRACTICE
EFFECT OF POOR SANITATION PRACTICE ON PUBLIC HEALTH