General Education challenges in hygiene, sanitation, and household water management

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Water can have adverse effects when it is either too much or too little. Many problems come about as a result of the lack of or excess water. The lack of access to clean and sanitized water can lead to diseases and even death.

Water related deaths are more common among children, especially those less than five years of age. Therefore, water must be at the right quantity for it to be helpful to a society. There are other problems that come about due to poor drainage of flooding or stagnant waters. According to UNICEF, “More than 2.6 billion people – forty per cent of the world’s population – lack basic sanitation facilities, and over one billion people still use unsafe drinking water sources.” A great majority of these people usually become sick from preventable water and sanitation related diseases. Annually, persons afflicted by diseases related to water range between 2.2 to 5 million.

Disease Agents and Mode of Transmission

Disease agents in the water that cause diseases can be categorized into three major vectors:

• Bacteria

• Viruses

• Helminthes and protozoa

Contraction of water borne diseases can be through - Ingesting contaminated water (Water borne).

This causes diseases like:

• Amoebic dysentery(Protozoan caused), dysentery( bacteria), cholera ( bacteria caused)

• Gastroenteritis (virus)

• Giardiasis (protozoa)

• Infective hepatitis which is caused by a virus and Leptospirosis ( Weil’s disease ) reflect symptoms of jaundice and fever.

• Salmonella and Typhoid fever which are caused by bacteria show diarrhea and fever as some of their symptoms

Washing with contaminated water (Water washed)

• Scabies, caused by mites can lead to skin ulcers

• Trachoma which is caused by a virus and can cause partial or complete blindness

• Shigellosis also known as Dysentery which is a bacterial infection and causes diarrhea

Parasitic infections that have water as one stage in their cycle (Water based)

• Schistosomiasis’, a disease that is caused by a worm, has symptoms ranging from tissue damage and blood loss in bladder liver to other intestinal venous drainage.

• Filariasis is a worm-caused disease that leads to blocked lymph nodes, and permanent damage of the tissues.

• Guinea worms cause arthritis of the joints.

Fecal Coliform

Individuals can be infected with dreadful diseases through the fecal-oral mode of transmission. When fecal matter finds its way into ingestible water and is consumed by humans, the transmission is known as fecal-oral contamination. This is a big concern in developing nations where water sources and drainage outlets often mix. Where there are no drainage systems, or drainage gutters are open, the polluted water seeps into the underground water system and causes contamination of underground water. This factor greatly contributes to the high morbidity and mortality rates of people especially children less than five years of age. This is the reason as to why latrine construction has to be done in such a manner that the contents do not seep into wells that are constructed around the homesteads.

In water treatment plants, water can be tested for fecal coliform bacteria like Escherichia coli (E-coli) and Klebsiella Pneumoniae which may compromise about 10% of intestinal bacteria.

Water-Borne Diseases

The cause of water-borne diseases is by water that has been contaminated by human, animal, or chemical wastes. According to the World health Organization (WHO), they are diseases, which are transmitted by consuming unsafe water that is contaminated by feces or urine, infected by disease causing microorganisms. Worldwide, the lack of sanitary waste handling and disposal result in over 12 million deaths a year. These diseases include polio, typhoid, cholera, shigellosis, meningitis, and hepatitis A and E amongst others. Human beings and animals alike can at times act as hosts to the, viral, bacterial or protozoal organisms that cause these diseases.


Improving communal cleanliness and providing clean water supply are the basic steps leading to the prevention of most water-borne diseases and deaths. Constructing sanitary latrines, treating wastewater to allow for the decomposition of human wastes will help reduce the chances of diseases caused by pollution.

According to a study of 144 reviews from the 1980s, done by the USAID, “infant and child deaths fell by an average of 55% as a result of providing clean water and sanitation.” This study suggests that the proper handling and disposing of water is very important.

Water-Based diseases

Aquatic organisms that spend part of their life cycle in the water and another part as parasites of animals cause water-based diseases. These parasites may thrive in both polluted and unpolluted water. Most of them are worms, which use transitional animal vectors like snails to thrive, and then directly infect humans by either boring through their skin or by ingestion.

Guinea worm (dracunculiasis), clonorchiasis, paragonimiasis, and schistosomiasis (bilharzia) are some of the water-based diseases. These diseases, jointly known as helminthes are caused by an array of flukes, roundworms, tapeworms, pinworms and tissue nematodes. The diseases usually cause excreting pain especially those that attack the bowels.


Washing foods, especially foods that are consumed when raw, like fruits and vegetables can greatly prevent infection from water-based diseases. It is also important to thoroughly cook food to ensure that they nourish the body and not bring diseases to it. Again, refraining from swimming, wading or bathing in water bodies that are infested with the parasites will reduce the chances of getting the disease. In guinea worm endemic areas, individuals can use a piece of clean cloth or nylon gauze to filter out the guinea worm larvae, if clean water is unavailable. Follow this link for A Successful Solution: The Global Guinea Worm Eradication Effort. As is the case with other water related diseases, proper drainage and disposal of human and animal wastes helps control water-based diseases.

Water-Related Vector Diseases

Water breeding insects, bugs and other animals capable of communicating infection, for instances snails, mosquitoes and tsetse flies act as vectors of diseases. Such disease carriers like mosquitoes infect humans with malaria, yellow fever, dengue fever, sleeping sickness (tsetse fly), and Filariasis (worms).


The easiest solution to this problem would be to exterminate all insects and bugs that cause disease. However, this would probably lead to an ecological imbalance. Some of the solutions to reduce the transmission of disease to man have included the use of pesticides or introduction of other organisms that would feed on the insects and bug, for instance, fish that eat mosquito larvae. This only leads to a portion of the solution. Insects and bugs are becoming resistant to insecticides with time. Again, insecticides if not properly used can be harmful to health if humans ingest food or water contaminated with the insecticide

Inexpensive use of polystyrene spheres floating on the top of bodies of static water cover the surface of the water, leading to the death of the mosquito larvae die due to lack of air . In most of the emerging economy countries, people use cooking oil, or any other oil to acquire the same result as in the use of polystyrene spheres. Sleeping under insecticide treated nets to keep mosquitoes out will reduce chances of getting malaria. Cleanliness and sanitation can fill the remaining gap. These ideologies would include filling and /or draining unwanted stagnant water bodies; covering water storage containers; eliminating mosquito breeding sites by clearing bushes around the home and clearing canals periodically, installing sprinkler (appropriate technology traditional method sprinkler can be made using a water pipe and a plastic water bottle with holes drilled into it) . Community discussion on how to keep the locality free from vector diseases will go a long way to in ensuring a healthier community.

Water-Scarce Diseases

Diseases like trachoma, leprosy, tuberculosis, whooping cough, tetanus, and diphtheria—are water-scarce related. They are also known as water-washed diseases in that they thrive in conditions where water is scarce and sanitation is meager. Infections occur when there is lack of fresh water available for even basic personal hygiene like washing hands after visiting the toilet. Curbing these diseases needs improving hygiene, for which ample supply of freshwater is indispensable.

Catastrophe without Water

1. Fire stations without water

Due to water shortages in the developing world, lives and property have been lost to fire due to a lack of adequate water systems. Though local governments could have plans for water stations, fires cannot be put out because of lack of the same.

“Since October, he said, 18 people -- including eight from one family -- had died after their shacks caught fire: "There's no water to put out the fire. Fire brigades take hours, and by the time they arrived you would have lost your property or even your life."

“The ravaging effect of the fire spread very rapidly across the area because of the planks used in constructing the shanties. Unfortunately, all the affected residents have to watch helplessly as their properties were been destroyed by fire. Though fire fighters were alerted, they did not arrive at the scene of the fire until about 3hrs later. Sadly too, there was no water to fight the fire.”

2. Hospitals without water

To run certain institutions effectively, adequate water systems should be in place, especially in healthcare institutions like hospitals, clinics and nursing homes. A lot of work is needed to ensure the provision of tap water to clinics and hospital in places where water is scarce. It is important that when one goes to a hospital for treatment, they do not leave with other acquired diseases from a facility that was supposed to cure them and not add to the health concerns.

3. Hunger and poverty

Since water is needed for life, hunger is a direct result of a lack of water. Water is needed to irrigate dry lands, to water animals and for human consumption. Lack of it creates poor food security, leading to hunger and poverty.

4. Diseases spread through lack of water


Trachoma is an eye infection spread mainly through poor hygiene caused by lack of adequate water supplies and unsafe environmental sanitation conditions. About 6 million people worldwide are blind today because of trachoma. It affects women two to three times more than men. Children are also especially susceptible. Studies have found that providing adequate water supplies could reduce infection rates by up to 25 per cent.


Catastrophe within the Water

1. Waterborne diseases due to flooding and stagnant water

A. Malaria

Malaria is a serious disease caused by a parasite carried by the female Anopheles mosquito. Humans are infected when bitten by the mosquitoes and each year about 1 million children die from it. Covering water tanks, clearing bushes and draining stagnant water pools help reduce mosquito-breeding places and thus reduce cases of malaria. For more information on malaria visit


Malaria is preventable. Simple known methods that have been learnt over the years include keeping the compound within dwelling places clean, draining puddles and stagnant waters, or pouring oil over puddles that would not drain to disrupt mosquito-breeding places, and clearing bushes. When affordable, it is important to sleeping under treated mosquito nets, applying mosquito repellent jellies use insect sprays and mosquito coils to reduce chances of mosquito bites. Further, building door and window screens to prevent mosquitoes and other bugs from coming into the house even when windows and doors are opened.

B. Bilharzia

This disease, also known as Schistosomiasis, is caused by schistosomes’ parasitic worms, which inhabit human hosts. They penetrate the skin of people swimming, bathing or washing in contaminated water, thus causing infection and can eventually damage the liver, intestines, lungs and bladder. It affects over 200 million people worldwide; however, studies have found that adequate water supply and sanitation could reduce infection rates by up to 77 per cent (UNICEF). For more information on bilhazia visit these websites:,

For the prevention of bilharzia, people should avoid wading through, swimming in, or bathing with water that is unsafe.

2. Waterborne diseases due to the intake of unsafe water

A. Diarrhoea

Diarrhoea is a symptom of disease that may be caused by viruses, bacteria and protozoans. Diarrhoea dehydrates a person of both water and electrolytes. Prolonged diarrhoea may lead to death. Most of the water related diseases manifest themselves through diarrhoea. For more information on diarrhoea, visit

B. Cholera

This bacterial infection affects the intestinal tract. Cholera is one of the deadliest illnesses known to man. A healthy person may die from cholera within 2-3 hours if no treatment is provided. It is dreadful to note that the disease advances from the first liquid stool to shock in 4-12 hours, with subsequent death in 18 hours to several days. For more information visit

C. Intestinal worms (Helminthes)

Intestinal parasitic worms infest humans through contact with soil that has been contaminated with human feces from an infected person, or by eating contaminated food. About 10 per cent of people in the developing world get infected each year. Severe cases of infestation lead to malnutrition, anaemia or/and retarded growth. Children are particularly susceptible. According to UNICEF, “about 400 million school-age children are infected by roundworm, whipworm and/or hookworm.”

D. Fluorosis

Fluorosis, a bone disease related to the presence of high concentrations of fluoride occurring naturally in groundwater, can be detrimental to teeth and the bones. In some parts of the developing world where water sources have a high concentration of fluorine, people usually have browning or black teeth that chip away with time.

E. Guinea worm disease

People contract this disease when they drinking water contaminated with Dracunculus, a larva that causes debilitating ulcers. However, the spread of the disease is checked and decreasing, there were still about 50,000 cases reported in Africa in the year 2002.

F. Dysentery

Dysentery is an illness that for a long time has been called the bloody flux. It involves the passing of severe bloody stool. It is caused by eating food that is contaminated by the disease causing pathogens that inflame the intestines.

G. Typhoid

Typhoid fever is a bacterial infection caused by ingesting contaminated food or water. Symptoms are characterized by headaches, nausea and loss of appetite. About 12 million people are affected by typhoid every year.

H. Arsenicosis

Arsenicosis is a disease that comes about because of drinking water containing high levels of arsenic over a long period. A chronic illness that affects the skin pigmentation by discoloring the skin and forming hard patches, causing skin cancer, cancer of the kidney, bladder and the lung. It can also lead to gangrene. The World Health Organization recommends a limit of 0.01 mg/L of arsenic in drinking water.

I. Dengue fever

Dengue fever is contracted from a mosquito known as Aegypti. This mosquito bites during the day and feeds mostly on human blood. Dengue is a viral disease and thus, antibiotics cannot cure it. Its symptoms include a blushing rash and excruciating pain in the bones. This disease is also known as the break bone fever.


Whereas HIV/AIDS is not a water related diseases, its emphasis in this issue because it is prone to kill due to opportunistic infections that are generally related to using unsafe water. Since unclean water causes symptoms that relate to diarrhoea, upset stomach, and vomiting, a person who is infected can easily get opportunistic diseases like Listeria and salmonella infections among many others.

Consequences of Water Related Diseases


Many people have died due to illnesses caused by using unsafe water. Even when death is more common in children under the age of five, older people are also prone to death. The death rates are even higher due to the fact that in developing countries and among the rural poor, social amenities like clinics or hospitals are a considerable distance away. The roads are poor and sometimes the clinics lack facilities that can help the sick individuals.

Reduced Productivity From Sick Individuals

When people get sick they spend most of their time resting or recuperating. This leads to lost time that would have otherwise have been put in productive use. Other times, they individuals do not fully recover leading to general reduced productivity over the years.

• Stress And Strain On Savings

It is a strain when the little money that a household may have to save is used up looking for cure for illnesses that are preventable. As much as it would be a strain on the savings, many a times, poor households do not even have the saving, making them to borrow and end up being indebted in the search of cure for diseases that are preventable.

Vulnerability to Illness

The immune system is ever compromised whenever people become sick. This is so especially when other diseases are opportunist. This means that these diseases attack when the immune system of an individual is reduced, for example Human Immunodeficiency Virus (HIV).

Poverty When useful time, money and other resources are spent in fighting diseases that can be prevented and are curable, a lot of work force is put to waste leading to poverty. Poverty may not be immediate but rather it would encroach into a household. This is so because if the household does not practice good hygiene then the chances of the communicable diseases affecting other members of the household is high.

Infecting Immediate Family Members

Some problems that come in one but may rapidly multiple are communicable diseases like diarrhea, flu, and even skin diseases like scabies. In a household where water is unsafe, or not enough, it becomes very easy for loving family members to pass on their illness to others, when they are being taken care of as sick people. When the sick people interact with other family member in simple ways like preparing food, sharing meals, sharing beddings and clothing, or even sharing basins and other communal equipment they may communicate their diseases to others.

Access to safe water in developing countries leads to:

• Reduced deaths of persons, especially children under five

• Less illnesses and contagious diseases

• Time saving (women spend over 6 hours looking for water) and less strenuous activities

• Increased food security

• Increased sanitation in homes, hospitals and other social facilities like hotels and restaurants

• Water for firefighting and other public issues e.g. streets and public toilets.

Prevention and Solutions

Water borne diseases can be prevented in several ways. These may include-

A. Improved Sanitation

According to the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) Global Water Supply and Sanitation Assessment 2000 Report, improved sanitation means “access to facilities that hygienically separate human excreta from human, animal and insect contact. Facilities such as sewers or septic tanks, poor-flush latrines and simple pit or ventilated improved pit latrines, provided that they are not public,” However the education behind the proper use of these facilities is important. Improved sanitation in this paper will therefore include personal hygiene traits like washing hands after visiting the toilet, and before and during the preparation of meals, and proper disposal of wastewater, amongst other sanitary etiquette.

B. Access to Clean Safe Water

Clean safe water is water that is free from germs and diseases. Clean safe water can be contaminated by the use during collection, transportation, storage and even in usage. Therefore, for water to be clean and safe for consumption, taking precaution in every stage of its handling is very important. For instance, safe water that is collected in a contaminated container would otherwise be unsafe. Therefore, containers used to collect water should be safe too. When water is being transported, by human beings, animals or vehicles, dirt and dust that are disease causing may settle into the water. It is important to cover the water when transporting it to the place of use. Storing water in a container that has no lid offers a chance of contamination too. People have to dip their hands in the stored water to be able to use it. The use of a tap at the end of the container to reduces the chances of contaminating safe water. This means that users do not have to dip their hands or other water collecting containers into the storage container when they need to use the water.

C. Sanitary Latrines

It is of the greatest importance that contents from a latrine do not seep into a water source like a well. Since most diseases can be transmitted through the human matter. This is the reason as to why the latrine has to be built at a safe distance from the well or any other water body. It is also important to note that the latrine should be at a level where the content does not flow into the underground water system. Therefore, the well should be on a higher level than the latrine. A point to note also is that the latrine should have a vent from the pit and a lid to cover the latrine hole to reduce the breeding of housefly.

D. Etiquette in the Handling of Wastewater

The disposal of wastewater in a manner that does not pollute other water sources is a big step in ensuring that water sources are protected from harmful pathogens. This could be quite easy to do in a household setting where there is no gutter system. Digging a cesspit and filling the cesspit with rocks such that bath water and kitchen water seep into the ground may ensure that the kitchen garden or the homestead lawn is well watered even in a place where there is scarcity of water, and it will help reduce flies and other insects that would breed on stagnant waters.

Prevention of Water Related Insect Vector Diseases

A. The use of pesticides

Spraying the home and its environs with insectides will kill insect vectors and inhibit their breeding rates. However, if not used according to instructions, insecticides may cause harm. It is therefore important to carefully follow the manufacturers’ instructions when using insecticides. Keep them out of the reach of children.

B. Destroying insect and worm breeding places

This can be done by draining puddles and clearing bushes where the insects breed. However, on water bodies that take a while to drain, oiling can be used to inhibit the breeding process of these insects and bugs. Pouring a small amount of used car oil into the latrine hole will help prevent the breeding of bugs and insects, and furthermore it will kill the bugs which live in the latrines and that can crawl into the house.

C. Eliminating rodents that transmit diseases through the introduction of natural predators and sterile insects

Setting rodent traps and keeping other pets that would help eliminate the rodents and other insects that may act as disease vectors. Some types of fish have been used over the years, in ponds to eat the mosquito larvae. Naturals predators like pet cats can prevent the breeding of rats and mice, which can lead to other diseases.

D. Covering water storage tanks and containers

Stored water can act as breeding places for parasites. Therefore, water that is stored must be covered to avoid being contaminated by floating germs in the air, and to prevent parasites that breed in standing waters from using the water as a base.

Prevention of Water Based Diseases

The implementation of these preventive methods of water-based diseases will reduce the chances of being sick.

A. Washing of hands regularly,

• It is important to wash hands before, during and after the preparing of meals. There are foods that must be cooked and others can be consumed raw. It is very important to ensure that the hands and utensils are washed before handing foods that are eaten raw, when preparing cooked food and salads. Otherwise, bits of the foods that must be cooked may end up being ingested with the raw foods through cross contamination.

• Wash hands before eating to avoid eating with dirt hands that may be full of germs that are diseases causing.

• After visiting the bathroom/latrine, and after handling animals or their waste, it is vital to clean hands by washing and sanitizing to kill germs.

• When someone in the household is sick, especially is the disease is contaminable, keen care of the invalid and the person taking care of them should be paramount to reduce the chances of transmitting the communicable diseases. Washing hands and airing the room is important to reduce the accumulation of disease causing germs within the room and on contact areas.

B. It is important to refraining from wading through water puddles, and stagnant waters that may be breeding places for disease causing pathogens.

C. Putting good drainage systems in place will make it difficult for stagnant water parasites to breed, for instance, bilhazia-causing snails and malaria

D. Purifying water to remove parasites and to ensure that water is safe for consumption. It is important to stress again that clean safe water must be stored safely to ensure its purity at the time of its use.

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