MIT OpenCourseWare http ocw mit edu 11 479J 1 851J Water and Sanitation Infrastructure in Developing Countries Spring 2007 For information about citing these materials or our Terms of Use visit http ocw mit edu terms Financing Water Supply and Sanitation Peter Rogers Guest Lecture Water Sanitation Infrastructure in Developing Countries 11 479J 1 851J Week 11 Tuesday May 1 2007 Image removed due to copyright restrictions photograph of water tap located next to a public urinal and near animals eating garbage What s wrong with this picture This is adequate WSS according to the WHO And Now a Word from Our Sponsors Image removed due to copyright restrictions Cover image for Rogers Peter M Ramon Llamas and Luis Martinez Cortina editors Water Crisis Myth or Reality Oxford UK Taylor Francis 2006 ISBN 978 0415364386 Rogers Jalal and Boyd Introduction to Sustainable Development Harvard Press 2006 Rogers and Lydon Water in the Arab World Harvard Press 1994 Rogers America s Water MIT Press 1992 Global Burden of Health Showing Percentage of Environmental Contribution by Disease Diseases With The Largest Environmental Contribution Diarrhoea Lower Respiratory Infections Other Unintentional Injuries Malaria Road Traffic Injuries COPD Perinatal Conditions Ischaemic Heart Disease Childhood Cluster Diseases Lead caused Mental Retardation Drownings HIV AIDS Malnutrition Cerebrovascular Disease Asthma Tuberculosis Suicide Depression Poisonings Falls Hearing Loss Violence Lymphatic Filariasis Lung Cancer 0 1 2 Environmental Fraction Non Environmental Fraction 3 4 5 6 7 Fraction of total global burden of disease in DALYs d Figure by MIT OpenCourseWare WHO Preventing Disease 2006 Reported in Disability Adjusted Life Years DALYS Main Diseases Contributing to the Environmental Burden of Disease Among Children 0 14 years2 Other Diarrhoeal diseases Intestinal nematode infections 1 5 19 Drownings Road traffic injuries Malnutrition 29 2 2 4 5 Childhood cluster diseases Perinatal conditions 16 6 6 Lower respiratory infections 10 Malaria Neuropsychiatric disorders a The environmental disease burden is measured in disability adjusted life years a weighted measure of death illness and disability DALYs Figure by MIT OpenCourseWare WHO Preventing Disease 2006 p 62 What Constitutes Other IF Diarrhoeal diseases account for 29 Malaria for 10 Neuropsychiatric disorders 6 Intestinal nematode infections 1 5 THEN Other water related illnesses must be some part of the remaining 19 Ischaemic heart diseases Hg Childhood cluster diseases industrial chemicals Mental retardation Pb Hg Poisonings As toxics etc Lymphatic filariasis Huge needs An old story over 1 billion people without safe water 2 w o sanitation 4 w o sewage treatment existing systems are run down needs in developing and transition economies up to 50bn year or 1 of GDP No money fiscal what can we do constraints official aid stagnant 3bn yr WB 1bn public utilities unable to self finance or to carry debt private investment a relative trickle so far Janssens J 2003 MOTIVATION FOR PROVIDING SAFE WATER KEEP IN MIND Over 1 billion people without safe water 2 4 billion without access to adequate sanitation 10 of the world s food is grown with water from aquifers which are being depleted faster than the rate of recharge In the next 30 minutes about 180 children in developing countries six children per minute will have died from disease caused by unsafe water What does this mean for ordinary people in the developing world In many parts of the world access to water and power distinguishes the poor from the non poor DEATHS BY AGE AND CAUSE 2002 Data for Children 0 4yrs Developing countries high mortality World Tuberculosis 1 Tuberculosis 1 Respiratory infections 38 Developing countries low mortality HIV Aids 7 Respiratory infections 37 Total 5 008 054 Modified from Evans Hutton and Haller 2004 HIV Aids 2 HIV Aids 8 Respiratory infections 44 Malaria 22 Diarrhoeal diseases 32 Tuberculosis 1 Malaria 5 Malaria 24 Diarrhoeal diseases 30 Total 4 528 061 Diarrhoeal diseases 48 Total 428 791 The Environment is not just Water In addition to classical water borne diseases there are many other illnesses caused by anthropogenic water use that may impinge on the aquatic environment or be environmentally mediated in other phases of the environment before ending up in the water For example long range transport of mercury from coal burning is mediated through the atmospheric part of the environment until it deposits in water courses where it is in turn mobilized by the chemistry in the sediments to enter the human food chain via fish consumption There are many other toxic assaults that have not been adequately studied or assessed In addition to the human caused contamination naturally occurring inorganic toxics arsenic fluoride selenium uranium etc may be mobilized by exploitation of water resources For example in Bangladesh as many as 20 77 million people are at risk from arsenic poisoning due to the mobilization of toxic levels of arsenic due to lowering ground water levels by irrigation and domestic water use pumping Many of these mechanisms have not been well studied Environmental Classification of Water Related Diseases Category 1 1 Feco oral waterborne or water washed Low infective dose High infective dose 2 Water washed Skin and eye infections Other 3 Water based Penetrating skin Ingested 4 Water related insect vectors Biting near water Breeding in water 5 Transport of toxic chemicals Example 2 Cholera Bacillary dysentery Trachoma scabies Louseborne fever Schistosomiasis Guinea Worm Sleeping sickness Malaria Arsenic mercury lead and domestic and industrial water pollutants Modified from Table 3 in D D Mara and R G A Feachem Water and excreta related diseases Unitary environmental classification J Environ Eng pp 334 339 April 1999 TRADITIONAL WATER RELATED DISEASES Image removed due to copyright restrictions Graphic of representative waterborne parasitic diseases showing the disease transmission cycle of lymphatic filariasis malaria dracunculiasis guinea worm and schistosomiasis blood fluke See Fenwick 2006 p 1079 Prevalence of water related diseases in Africa Condition Malaria Cases in Africa 300 million Hookworm 198 million Ascariasis 173 million Schistosomiasis 166 million Trichuriasis 162 million Lymphatic filariasis 46 million Onchocerciasis 18 million Dracunculiasis 0 1 million Fenwick 2006 p 1078 Roll Back Malaria UN WHO 2000 Magnitude of Classical Water and Other