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Unsafe water, inadequate sanitation and hygiene
How much suffering can be prevented?
How many are at risk?
1.1 billion people lack access to an “improved” drinking water supply: many more drink water that is
grossly contaminated.
How many are getting Sick?
4 billion cases of diarrhoea occur annually, of which 88% is attributable to unsafe water, and
inadequate sanitation and hygiene
How many are Dying?
1.8 million people die every year from diarrhoeal diseases, the vast majority children under 5.
How many more cannot escape poverty?
Lack of safe water perpetuates a cycle whereby poor populations become further disadvantaged, and
poverty becomes entrenched
How much of this can be prevented?
It is estimated that 94% of diarrhoeal cases are preventable through modifications to the
environment, including interventions to increase the availability of clean water, and to improve
sanitation and hygiene.
“1904:
Typhoid
Mary wa
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ish
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Your health can be compromised when the following happens
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When harmful bacteria, viruses and parasites contaminate drinking water either,
- At the source through seepage of contaminated run-off water,
- Or within the piped distribution system
Water can be polluted by runoff from such activities as intensive animal feedlots or by untreated
sewage wastes.
Unhygienic handling of water during transport or within the home can contaminate previously
safe water
“Simple techniques for treating water at home and storing it in
safe containers could save a huge number of lives each year”
How microorganisms enter the human body
The most common routes for
microorganisms to enter the human
body are through:
Air we breath
Water we drink
Food we eat
What are the most common symptoms of waterborne diseases?
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Diarrhoea “Runny tummy’ i.e. The frequent passage of loose, usually watery stools
Dysentery occurs if blood and mucus are also present in the liquid stools
Abdominal pain, Cramps, vomiting, and general feeling of malaise and weakness may also occur,
Circulatory shock occurs if the diarrhoea becomes severe, especially if vomiting is such that
fluids are lost more rapidly than they can be replaced
Summarised fact sheet on Cholera
Waterborne diseases are the diseases that are transmitted through drinking water, and interruption of transmission
is achieved by proper treatment of drinking water.
Household-level approaches to drinking water treatment and safe storage are also commonly referred to as managing
the water at the “point-of-use”. This refers to a variety of treatment procedures, for example, with chlorine or
other chemical disinfectants, sunlight or UV lamps, various filters, or flocculation- disinfection formulations.
Cholera - “Comma Bacterium”
What is Cholera?
Cholera is a diarrhoeal disease that is very sudden
in onset. It is characterized by a massive loss of body
fluids, through diarrhoea and vomiting, leading to
severe dehydration, which can be fatal. Stools have the
appearance of “rice water”. Infants and small children
show the most rapid advance of the illness. Untreated
cases of cholera can lead to death within 6 hours,
depending on the degree of dehydration.
How is Cholera Transmitted?
Any person can contract the disease by ingesting water or food contaminated by a toxic strain of
the bacterium called Vibrio cholera. The bacteria are excreted by infected individuals and can live for
at least three weeks in saline (a solution of salt and water), warm and alkaline ( pH higher than 7)
water. The bacteria can also survive in food especially seafood
Summarised fact sheet on Cholera
How should the patient be treated?
Urgent and immediate replacement of water and salts that are lost through diarrhoea and vomiting is
the most effective treatment for cholera. Such treatment is dramatically life-saving.
Interesting facts
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A large number of people who drink contaminated water can become carriers with little or no
symptoms at all. People who are carriers can continue to excrete the bacteria for a period of up
to a few weeks.
Vaccination of individuals with cholera vaccine can offer slight protection against the disease,
but this will only last for six months and does not prevent infection and therefore transmission
of the disease.
After ingestion of the bacteria it takes two to four days before cholera symptoms may show.
Although antibiotics may help by shortening the duration of diarrhea, the cause of death is
severe and rapid dehydration, which can only be treated by re-hydration through oral and/or
intravenous fluids.
Not all Vibrio cholera organisims are harmful, non toxic strains of the bacteria also occur
naturally.
Summarised fact sheet on Gastroenteritis
Waterborne diseases are the diseases that are transmitted through drinking water, and interruption of transmission
is achieved by proper treatment of drinking water.
Household-level approaches to drinking water treatment and safe storage are also commonly referred to as managing
the water at the “point-of-use”. This refers to a variety of treatment procedures, for example, with chlorine or
other chemical disinfectants, sunlight or UV lamps, various filters, or flocculation- disinfection formulations.
Gastroenteritis - “Stomach bug”
What is gastroenteritis?
Gastroenteritis is a disease where there is sudden onset in vomiting and watery
diarrhoea often accompanied by moderate fever and sometimes stomach cramps. The
incubation period is generally short (8 to 48 hours). The disease is colloquially referred
to as” gastric flu” or “ stomach bug”. Gastroenteritis can be caused by a wide variety of
microorganisms.
Healthy adults usually recover within a few days, but the disease can be life
threatening in case of infants, the elderly and individuals in the advanced stages of
HIV infection
How is Gastroenteritis transmitted?
Transmission of the disease can occur by a variety of routes, such as eating
contaminated food or drinking contaminated water. Very rapid spread within families
or groups of people sharing the same utensils, or living together is common, especially
with the viral forms of the disease, as it is spread via faecal oral route with poor
hygiene.
Summarised fact sheet on Gastroenteritis
The microorganisms causing gastroenteritis can survive freezing and ice blocks made from
contaminated water can be a significant route of infection.
How should the patient be treated?
Urgent and immediate replacement of the water and salts that are lost, especially in infants and
elderly, is of critical importance. Antibiotics are not recommended as a routine measure, except in
very young infants, some elderly persons, or in the presence of fever or bloody stools.
In emergencies, sports drinks containing isotonic fluids can be used
to replace the necessary fluids. A weak solution of salt and sugar
can also be used (get details from your local clinics).
Interesting facts
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Carriers showing no symptoms can occur, thus the importance of proper personal hygiene,
washing your hands after going to the toilet and the proper cleaning of soiled clothes with hot
water.
Vaccination is not possible in practice, as there are so many microorganisms that can cause
Gastroenteritis.
Gastroenteritis can be life threatening in the case of an individual with advanced HIV infection,
thus, extra vigilance to ensure clean drinking water and food is essential for such patients.
Adequate sanitation, treatment of wastes and fly control as an added precaution.
Summarised fact sheet on Typhoid Fever
Waterborne diseases are the diseases that are transmitted through drinking water, and interruption of transmission
is achieved by proper treatment of drinking water.
Household-level approaches to drinking water treatment and safe storage are also commonly referred to as managing
the water at the “point-of-use”. This refers to a variety of treatment procedures, for example, with chlorine or
other chemical disinfectants, sunlight or UV lamps, various filters, or flocculation- disinfection formulations.
Typhoid fever
What is typhoid fever?
Typhoid fever is caused by the bacterial organism Salmonella typhi. Following infection, after an
incubation period of 1 to 3 weeks, the patient has gradual onset of illness, starting with a headache,
followed by fever and abdominal pain. Constipation is more common than diarrhoea in the early
stages of the illness. Later bronchitis develops. In untreated cases death can occur from intestinal
perforation or haemorrhage. The infection can last up to 3 weeks or even longer. In some individuals
infection may occur with no signs of illness at all.
How is typhoid transmitted?
Typhoid bacilli are excreted in the stools of infected individuals,
and continue to be excreted by untreated patients after the
recovery for up to 4 months. The disease is transmitted via the
faecal-oral route, either via drinking water, or food. Flies may
also play a role as a passive vector leading to food contamination.
Summarised fact sheet on Typhoid Fever
How should the patient be treated?
The use of antibiotics at the early stage of infection is essential to prevent the appearance of
life-threatening complications, and bed rest is essential. A loss of appetite and weight loss are
characteristics of the diseases. The consequences of typhoid can be very severe in the case of HIV
positive individuals.
Transmission route
Typhoid fever is predominantly a water-washed disease, but may also be waterborne.
Interesting facts
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The typhoid bacillus only lives in humans, and apparently healthy carriers are usually the source
of new outbreaks.
Infections can be acquired from ice cubes prepared from contaminated water.
A common source of infection is contaminated water or food from street vendors
Existing technologies to combat waterborne diseases
Existing low cost technologies can save lives today by combating
waterborne disease
Chlorination
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Chlorination - Adding chlorine in liquid or tablet form to
drinking water stored in a protected container.
At a dose of a few mg/l and contact times of about 30 -60minutes
(one teaspoon of domestic bleach to 20 litres of water and leaving
it for one hour), free chlorine generally inactivates >99.99% of
enteric bacteria and viruses, provided water is clear.
Household chlorination has achieved widespread use, and is
appropriate for on-site disinfection.
You can survive
about a month
without food, but
only 5 to 7 days
without water
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Existing technologies to combat waterborne diseases
Existing low cost technologies can save lives today by combating
waterborne disease
Solar disinfection
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One low cost technique involves exposing water in clear
plastic bottles to sunlight for six hours e.g. on the roof of
the house (or for 2 days if the sun is obscured by clouds).
A combination of heat and ultra-violet radiation from the
sun are used to inactivate pathogens present in water.
The water should be consumed directly from the bottle or
transferred to a clean glass.
To be effective, solar disinfection must be applied to
relatively clean clear water.
Additional advantages include water taste being largely
unchanged and minimal risk of re-contamination if water
is consumed directly from the bottle in which it was
treated.
Solar disinfection is suited for very poor households in
regions that draw relatively clear water.
Existing technologies to combat waterborne diseases
Filtration
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Water filtration is another way to purify water.
Higher quality ceramic filters with small pores, often coated with silver remove bacterial growth
as well as suspended solids.
Filters need to be cleaned regularly to maintain flow rates, and if properly maintained, they have
a long life.
Some commercial systems that combine filtration and disinfection are highly effective, though
their upfront cost may be an obstacle to low-income populations.
They are straight-forward to use.
Combined flocculation/disinfection systems
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Adding powders or tablets to coagulate and flocculate sediments in water followed by a timed
release of chlorine
These typically treat 10-15 litres of water, and are particularly useful for treating turbid water.
The water is normally stirred for few minutes, strained to separate the flocculant, and allowed to
stand for another half hour for complete disinfection.
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Existing low cost technologies to combat waterborne diseases
Boiling
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If practical, households can disinfect their drinking water
by bringing it to a rolling boil, which will kill pathogens
(disease causing bacteria) effectively.
In order to be effective, however, the treated water must be
protected from re-contamination.
Caution must be exercised to avoid scalding accidents,
especially among young children.
Boiling is the most common treatment approach.
Safe Storage
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Water that is safe at point of collection is often subject to faecal contamination during
collection, transport and use in the home, mainly by unclean hands.
Vessels with narrow mouths and taps can significantly reduce such contamination and reduce
the risk of diarrhoeal disease
Safe storage should also be included in interventions to treat the water in the home.
Ensure that the containers that are used in the home for storing
drinking water are clean and that they are properly covered to
ensure that flies and dirt do not settle into the water in the
container
Additional Management issues for domestic Water supply
In the management of water quality for domestic purposes it is important to bear in mind that the
achievement of safe water for drinking and food preparation rests with the management of safety of
the water supply along the whole water supply chain. The water supply chain consists of the water
source, treatment works, distribution system, the supply tap, the drinking water container, jug or cup.
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In the case of repair of a burst pipe where dirt may gain access to a supply line, which may
result in a temporarily elevation of the microbiological total plate count in the supply line, the
consumer will be alerted to the problem by brown water coming out of the tap. The situation is
usually remedied by flushing the pipe via the tap and allowing the plug of contaminated water to
flow down the drain.
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The general practice of personal hygiene is essential in limiting the spread of waterborne
diseases. Children must be educated from a young age, with the adults setting the example to
always wash their hands after going to the toilet. The use of soap is important as it helps to
disinfect the skin of the hands, which may be microbiologically contaminated after using the
toilet.
Where running water is not available e.g., when camping or out in the field, then a small basin
of clean water will also serve the purpose of making hand washing possible
•
Without wa
ter you wo
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tired more
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You may ge
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could beco
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me overwork
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to having
to concentr
ate
large amou
nts of wast
e in a
small volu
me of fluid
Additional Management issues for domestic Water supply
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Water for clothes washing must also be
microbiologically clean, as some micro-organisms can
survive on the clothing after drying, and can be a source
of infection either to an open wound to the skin, or via
inhalation of dust breathed in through the nose.
While prevention of waterborne diseases is the best
approach to use, medical treatment is essential when a
person is seriously ill with a disease.
Wash (using clean water) and peel fruit and vegetables
before eating.
Wash your hands after going to the toilet and before
preparing food.
Children should wash their hands thoroughly with soap
and water after handling pets and before eating food.
Always wash hands after changing baby’s nappies.
The benefits of drinking
water during pregnancy
include healthier skin,
less acne, washing away of
unnecessary sodium, less
chance for pre-term labour
or miscarriage and better
bowel movements.
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Conclusion
We at Rand Water hope that this educational material will teach the upcoming generation to follow
these good practices, and that they will understand the wisdom and knowledge which have led to the
formulation of these rules to minimise waterborne disease.
Families should become empowered to take charge of their drinking water safety.
When it comes to drinking water
Rand Water ensures sparkling clear
water at an affordable cost!!!
Glossary
Bacteria: Unicellular microbes (very small living cells)
which utilize simple nutrients to grow and multiply.
There are various ways of classifying them. They can,
e.g.’ be divided into aerobic bacteria which need oxygen
to grow and anaerobic bacteria which can grow and
divide in the absence of oxygen. They can also be divided
into pathogenic (disease causing) bacteria and nonpathogenic (non-disease causing or friendly) bacteria.
Bacterium: Singular of the plural bacteria
Indicator organisms: These are microbes which are
found in large numbers in e.g. faeces and faecally polluted
water. Testing for the presence of these organisims
gives an indication of faecal pollution and the poosible
presence of pathogens associated to faecal matter.
Contamination: The entry of undesirable organisms
into some material or object.
Dehydration: The removal of water
Diarrhoea: Watery stools (faeces).
Dysentery: Diarrhoea with blood and mucus present.
Faecal material: Solid, usually brownish coloured
waste matter (excreta) produced during defecation, and
consists largely of undigested cellulose and food residues,
as well as bacteria.
Faecal Oral route: The most common route of
transmission of gastrointestinal disease where the
disease-causing organism is excreted in the faeces and
faecal matter containing the causative organisms finds
its way to the mouth of the same or another individual
either, e.g.’ via contamination of the water or food in the
faecal matter.
Immune system: cells and organs within a living animal/
human being that protect against specific diseases.
Incubation Period: The time lapse between the exposure
to an infection and the appearance of disease symptoms,
or the time period during which microorganisms
inoculated into a medium are allowed to grow.
Ingestion: The intake of food or water.
Parasite: An organism that lives in or on another
organism and derives nourishment from it.
Pathogen: Disease causing microorganism.
Viruses: Non-cellular infectious agents that pass through
filters that prevent the passage of bacteria.
Water quality snippets by quantity and quality
Quantity
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About two thirds of the human body is water. Some parts of the body contain more water than
others, for example 70% of your skin is water
Of all the worlds water, 97% is salt water found in oceans and seas
In order to burn 100g of fat you require the presence of 107g of water
You can refill a 250ml glass of water approximately 15 000 times for the same cost as a six-pack
of cool drink/ beer
A dairy cow must drink 4 litres of water to produce 1 litre of milk
Parts per million (ppm) or milligrams per litre (mg/l) equals
- One Minute in two years
- One cent in R10.000.00
20kg of water that woman in Africa and Asia carry on their heads, is equivalent in weight to the
allowed airport luggage
Approximately 99% of the calcium exists in the bones and teeth
Water is the best liquid to quench a thirst. Adult water requirements are approximately 1ml/
kcal: e.g. a 70kg man would require approxiamately1.75litres of water daily
Your bones are like a bank, you can deposit calcium until around the age of 30, and then for the
rest of your life you have to withdraw the calcium that you have “saved”
Calcium is the most abundant mineral in the body; it makes up about 1.5% to 2% of the body
weight and 39% of the total body minerals.
The fluoride in your drinking water is adequate (0.2 mg/l) and in most circumstances the food
that we eat contributes to fluoride intake.
Water quality snippets by quantity and quality
Quality
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Hard water is not a health hazard. In fact, hard drinking water generally contributes a small
amount towards total calcium and magnesium of human dietary needs
No, metabolic, physiological or biochemical reaction can take place in the body without the
presence of water
The intensity of exercise leads to a rise in body temperature - not the lack of water
In all cases where drinking water contains more than 40 mg/l of nitrate concentration,
an alternative source of water should be found for an infant as this may cause
methaemoglobinaemia, also known as “blue baby syndrome”
Water is useful to rinse out the mouth after eating to prevent the formation of dental cavities
and bad breath
The muddy appearance of water after a pipe burst could be due to sand that entered the pipe
supplying your home or during repairs or maintenance operations
An earthy or musty taste or odour is usually caused by a harmless substance called geosmin.
Algae (tiny water plants) in rivers and dams produce geosmin at certain times of the year,
usually during the summer months
Minerals such as calcium and magnesium in your drinking water tend to precipitate when
water is heated and cause a white substance (sediment) to collect in your kettle or on the
plate of your steam iron.
For more information
View the CD included in this pack
Contact our customer service center 0860 10 10 60
or visit www.reservoir.co.za