Safe Water and Sanitation: Multidisciplinary Approaches to Address Water related Diseases in Senegambia

Transcription

1 Safe Water and Sanitation: Multidisciplinary Approaches to Address Water related Diseases in Senegambia Shannon P. Marquez, MEng,, PhD Associate Professor & Director Master of Public Health Program Center for Global Health College of Health Professions Temple University

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3 The River Gambia

4 The Gambia Location The Gambia is located on the west coast of Africa and covers an area of about 10,700 square Km and Km wide. Smallest country in Africa Surrounded by Senegal (N S E)

5 The Smiling Coast...

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7 Demographics Ranked 155/177 countries in the 2004 human development index Illiteracy rate: 15 years and above = 63 % 83% of the population lives on less than $2 a day Infant Mortality Rate = 92/1000 live births Maternal Mortality Rate = 11/1000 live births Life expectancy at birth = 56 years

8 Water and Health Humans must drink water to survive (3 day max) Water plays a major role in hygiene simple hand washing prevents the spread of disease Access to clean water is critical One billion people lack access to safe water Hand washing with soap could save over 1M lives per year (LSHTM)

9 The Crisis: Water and Sanitation an indicator of progress Making strides on safe water 1996, only 69% had access Today, nearly 84% nationally 80 95% in urban areas 60 75% in rural areas But...these numbers include latrines as adequate sanitation!

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13 The Crisis: Health Services Health system made up of : Public sector services with 1477 beds 34 private and non governmental organization clinics. For 1.5 million people!

14 Public Sector Health Facilities 1 major hospital with specialty services 3 tertiary hospitals 6 major health centers 11 Minor health centers 18 Dispensaries/Outreach health posts

15 Geographic Location of Hospitals in The Gambia

16 Actual Number of Public Health Sector Staff in The Gambia Doctor Pharmacist RN EN 0 Doctor Pharmacist RN EN

17 The Crisis: Infant Mortality Infant mortality rate in The Gambia per 1,000 live births is 92 (US = 7/1000; 13.5/1000 AAW) Under 5 mortality rate per 1,000 is 135 (2001). Causes of IMR Malaria Diarrhea Malnutrition Acute respiratory infection

18 The Crisis: Malaria is the biggest killer here

19 Malaria is an environmental health and development issue The Effects of Poor Sanitation According to ESU of DOSH Infant mortality in The Gambia = 84/1000, and under five = 135/1000 Malaria cases = 129,768 Diarrhea cases = 25,827 (children) Environmental and water related illnesses account for over 50% of all patients Also has socioeconomic effects missed days of work, tourism, agriculture, etc.

20 Environmental Factor Have a Major Influence on Health Status

21 Multidisciplinary Factors Influencing Safe Water and Public Health Ed = education Env = environment Ec = economic D = development SC = social cultural 1. Low literacy rate has adverse affect (Ed) 2. Poor disposal of solid wastes and liquids (Env, D) 3. Dumping of solid wastes; poor water drainage (Env, D)

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30 Multidisciplinary Factors Influencing Safe Water and Public Health 4. Cultural beliefs and taboos (SC) 5. Transmission of certain diseases due to domestic practices and food hygiene (SC, Env) 6. Inadequate protection of water supplies (D, Env) 7. Influx of refugees and displaced persons creating rural to urban drift (Ec, SC)

31 Open, unlined wells

32 Post source water contamination

33 Open, unlined wells Post source water contamination

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36 Multidisciplinary Factors Influencing Safe Water and Public Health 8. Poor financing of services (Ec) 9. Centralization of decision making (Ec, D) 10. Shortage of health care professionals (Ed) 11. Poor management of waste and disease control vectors (Env)

37 Open, unlined wells

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40 Multidisciplinary Factors Influencing Safe Water and Public Health Uncontrolled development giving rise to poor surface water drainage (Env, D, Ec) Inadequate information dissemination (Ed) Lack of fully equipped public health lab (Ec)

41 Strategies in Malaria Control: Educating communities on issues related to environmental hygiene

42 Strategies in Malaria Control: Educating communities on issues related to environmental hygiene Cleanliness of the environment Avoiding stagnant waters Waste disposal

43 Application of Larvicides & Insecticides to Eliminate Mosquito Vectors Drainage system Wells that are not used Dumping sites

44 Use of Impregnated Bed nets and Mosquito Coils/Incense Solution provision Mosquito coils cost Sustainability

45 Early Recognition of Signs and Symptoms of Malaria Loss of appetite Generalize weakness Fever Vomiting

46 TRACHOMA AND WATER SUPPLY AND MANAGEMENT Trachoma Disease: what it is and how it works Trachoma is an easily spread infection of the eye. Repeated occurrences scar the upper eyelid, eventually turning it inward. The eyelashes then scratch the cornea, leading to blindness. It is a gradual yet painful condition affecting the poorest of the poor

47 The World Health Organization (WHO) designed SAFE strategy toward the eradication of Trachoma by the year 2020 in a bid termed GET 2020 (Global Eradication of Trachoma by 2020) Surgery for entropion/trichiasis; Antibiotics for infectious trachoma; Facial cleanliness to reduce transmission; Environmental improvements (e.g fly control and clean water) Surgery Antibiotics

48 WHO SAFE Strategy Suggestion: There is an association between trachoma, environmental sanitation, and personal hygiene (Parry Jones, Kolsky, 1994; Bailey and Lietman, 2001). However: Meager research into evidence base for the F and E components Relationship btw. water supply and trachoma complex (Cairncross S., 1999) Environmental Facial Cleanliness

49 Rationale for study in The Gambia The study was birthed from the recognition of the fact that although trachoma is world s leading cause of preventable blindness, issues surrounding its association to water supply are still not clearly defined.

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