Saturday, April 25, 2009

Silent Danger Lurks in Water

This is a shortlisted essay at the International Essay Competition 2008 held by Global Health Forum. Published in "Young Voices for Health 2008" bulletin. LANCET publication.


French language essay authors and Ida Ansharyani featured in Paris colloquium at Cité des Sciences et de l'Industrie. From left to right: Marame Ndour (Sénégal), Claire Élise Burdet (Canada), Ida Ansharyani (Indonesia), Susan Jupp (Global Health Forum), Raquel Bertoldo(Brazil). This photo and their essay are published at: http://www.globalforumhealth.org/Site/002__What%20we%20do/005__Publications/012__Young%20Voices%20in%20Research%20for%20Health.php


There is growing evidence that climate change will significantly impact on the rural populations of developing and poor countries. Rural people, who represent the majority of inhabitants in developing countries and whose livelihoods depend upon natural resources, such as water, will be affected by changes in rainfall patterns and greater weather extremes. This will put pressure on already scarce resources and affect all aspects of their lives, including their state of health.

To fulfill their daily water needs, such as for drinking, cooking and sanitation, rural people use water from various sources. Commonly they use water from wells, rivers and springs. In more remote areas, rural people depend on rain harvesting. In many places clean water is very limited. In the dry season, many people face particular difficulties in obtaining fresh water and are often forced to walk for hours to find it. River water is dwindling. The number of wells is limited and they are usually located quite far from settlements. In particular areas, due to climatic and geological conditions, water resources are indeed rare (for example, in arid or temperate regions and limestone karst1 areas). In more developed villages pump water is provided, however, not all people can afford to access this supply.

Besides problems of quantity, water quality is a common issue in villages. Even if there are abundant water resources, poor water quality means these resources are often unsuitable for human use. It is frequently found that a river has abundant water all year round, but unfortunately the water is impure and reddish in colour, especially in the rainy season. In some places with certain geological conditions, the water contains harmful substances in high concentrations (e.g. carbonate and acid). Sometimes pump water is also unclean, especially in the rainy season. This means people who have access to pump water must look to other sources, such as spring water and wells, for clean water.

Water problems are a real threat to rural people’s health. Health problems caused by poor water quality and lack of access to sufficient supplies are exacerbated by limited access to health facilities. Many villages are isolated because of poor road infrastructure. This means people have to walk for hours to reach the nearest health facility and this also prevents health officers from visiting communities on a regular basis. The facilities themselves are very limited and often inadequately staffed. The health facility in many villages is only staffed by nurses with no access to a qualified doctor. Professionally trained midwives to help mothers give birth are often not provided, so it is not surprising that mother and infant mortality is high in village communities. The perception and habits of people in rural communities can also cause health problems. Many people in rural areas believe that all diseases can be overcome with pills or vaccinations from health officers. The health officers providing medicine and vaccinations, however, are often unqualified to do so. Many villagers are also in the habit of drinking non-boiled water and often suffer from gastroenteritis and skin diseases.

Climate change is threatening the health security of villagers. Droughts occur on a vast scale, river water dwindles and in some places there is no water. While at the same time, people use water to take baths, wash and engage in other sanitation activities. This degrades the water quality through pollution from bacteria and contamination by various substances in high concentrations. One dire impact of contaminated water on people is exceptional diarrhoea. People in villages tend to suffer from similar complaints, such as kidney problems, due to high carbonate or rotten teeth because of acid in their water. Dirty water also causes infections and is one of the major factors contributing to mother and infant mortality in villages. The increasing frequency of flooding has caused water sources to become turbid, however, people continue using the water because they have no other choice. Such conditions directly threaten people’s health security. In addition, natural resources are becoming scarce, with some rural populations in developing countries struggling to survive with very limited resources. Such conditions can contribute to malnutrition.

Climate change not only affects physical health, but also creates psychological pressure on villagers. Many become stressed because they don’t know what has happened or why big changes occur in their daily lives. For example, many farmers plant their seeds according to the regular planting season. They become confused when rainfall becomes unseasonably scarce or too heavy causing flooding that destroys the seeds they have planted. Unpredictable, extreme weather threatens food security in several ways; paddy fields cannot be cultivated, seeds cannot grow optimally or harvests fail. Farmers suffer considerable loss both in materials and energy. This puts more pressure on them, as the cost of their daily basic needs increase. In some places, this pressure has pushed farmers to deadlock in fulfilling their basic needs. This condition is very stressful and can lead to many health problems.

Further research into the health implications of water resources on developing communities, such as whether drinking water is safe, is urgently needed. Such research needs to be done in many places periodically and intensively because climate change has altered water resource systems across the globe. Mindful of the considerable limitations in terms of human resources and funding to conduct such research in many places, we need to find a method that enables local people to monitor the quality of their local water supply. Any monitoring system needs to be simple and user-friendly, and should be explained in laymen’s terms so that local people can easily understand it. Water quality monitoring could be included in school subjects and extra-curricular activities so that rural school children are able to continuously monitor their everyday drinking water. Equipped with this knowledge, they could immediately detect any drastic changes to water quality before people are negatively affected.

At the same time there is a transfer of skills to monitor water quality, and rural communities need to be supplied with information about climate change and its threat to water resources, as well as impacts on their health. This matter becomes vital because health services and facilities are very minimal in developing and poor countries. Thus rural society ought to be provided with both the knowledge and the tools to enable them to protect one of the most important and basic elements of living – clean and non-harmful fresh water.

Research into the psychological impacts of climate change and its influence on the health of rural societies in developing countries is also required. The results could be fed into developing health services in rural areas. It is also important to raise awareness among rural health officers of the effects of climate change on health.

Local health officers are often related to or know the people they treat within their community. It is therefore vital that they are key stakeholders in the monitoring of water sources before climate change generates even worse impacts on their local communities. It is important to provide mental health clinics or services that can contribute to psychological healing for communities affected by climate change. Implicit in this healing process is the provision of correct information about the impact of climate change on their lives so they are empowered to find creative solutions to their problems.
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1 Karsts are areas of irregular limestone where erosion has produced fissures, sinkholes, underground streams and caverns.
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By: Ida Ansharyani

This essay can be found at:
http://www.globalforumhealth.org/filesupld/Young%20Voices/08/art/YoungVoices2008web_Ida%20Ansharyani,%20Indonesia.pdf

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