Sanitation

views updated

Sanitation

Sanitation can be defined as the measures, methods, and activities that prevent the transmission of diseases and ensure public health. Specifically, "sanitation" refers to the hygienic principles and practices relating to the safe collection, removal and disposal of human excreta, refuse, and wastewater .

For a household, sanitation refers to the provision and ongoing operation and maintenance of a safe and easily accessible means of disposing of human excreta, garbage , and wastewater, and providing an effective barrier against excreta-related diseases.

The problems that result from inadequate sanitation can be illustrated by the following events in history:

1700 b.c.: Ahead of his time by a few thousand years, King Minos of Crete had running water in his bathrooms in his palace at Knossos. Although there is evidence of plumbing and sewerage systems at several ancient sites, including the cloaca maxima (or great sewer) of ancient Rome, their use did not become widespread until modern times.

1817: A major epidemic of cholera hit Calcutta, India, after a national festival. There is no record of exactly how many people were affected, but there were 10,000 fatalities among British troops alone. The epidemic then spread to other countries and arrived in the United States and Canada in 1832. The governor of New York quarantined the Canadian border in a vain attempt to stop the epidemic. When cholera reached New York City, people were so frightened, they either fled or stayed inside, leaving the city streets deserted.

1854: A London physician, Dr. John Snow, demonstrated that cholera deaths in an area of the city could all be traced to a common public drinking water pump that was contaminated with sewage from a nearby house. Although he could not identify the exact cause, he did convince authorities to close the pump.

1859: The British Parliament was suspended during the summer because of the stench coming from the Thames. As was the case in many cities at this time, storm sewers carried a combination of sewage, street debris, and other wastes, and storm water to the nearest body of water. According to one account, the river began to "seethe and ferment under a burning sun."

1892: The comma-shaped bacteria that causes cholera was identified by German scientist, Robert Loch, during an epidemic in Hamburg. His discovery proved the relationship between contaminated water and the disease.

1939: Sixty people died in an outbreak of typhoid fever at Manteno State Hospital in Illinois. The cause was traced to a sewer line passing too close to the hospital's water supply.

1940: A valve that was accidentally opened caused polluted water from the Genesee River to be pumped into the Rochester, New York, public water supply system. About 35,000 cases of gastroenteritis and six cases of typhoid fever were reported.

1955: Water containing a large amount of sewage was blamed for overwhelming a water treatment plant and causing an epidemic of hepatitis in Delhi, India. An estimated one million people were infected.

1961: A worldwide epidemic of cholera began in Indonesia and spread to eastern Asia and India by 1964; Russia, Iran, and Iraq by 1966; Africa by 1970; and Latin America by 1991.

1968: A four-year epidemic of dysentery began in Central America resulting in more than 500,000 cases and at least 20,000 deaths. Epidemic dysentery is currently a problem in many African nations.

1993: An outbreak of cryptosporidiosis in Milwaukee, Wisconsin, claimed 104 lives and infected more than 400,000 people, making it the largest recorded outbreak of waterborne disease in the United States.

The problem of sanitation in developed countries, who have the luxury of adequate financial and technical resources is more concerned with the consequences arising from inadequate commercial food preparation and the results of bacteria becoming resistant to disinfection techniques and antibiotics. Flush toilets and high quality drinking water supplies have all but eliminated cholera and epidemic diarrheal diseases. However, in many developing countries, such as the Pacific islands, inadequate sanitation is still the cause of life or death struggles.

In 1992, the South Pacific Regional Environment Programme (SPREP) and a Land-Based Pollutants Inventory stated that "[t]he disposal of solid and liquid wastes (particularly of human excrement and household garbage in urban areas), which have long plagued the Pacific, emerge now as perhaps the foremost regional environmental problem of the decade."

High levels of fecal coliform bacteria have been found in surface and coastal waters. The SPREP Land-Based Sources of Marine Pollution Inventory describes the Federated States of Micronesia's sewage pollution problems in striking terms: The prevalence of water-related diseases and water quality monitoring data indicate that the sewage pollutant loading to the environment is very high. A recent waste quality monitoring study (as part of a workshop) was unable to find a clean, uncontaminated site in the Kolonia, Pohnpei, area.

Many central wastewater treatment plants constructed with funds from United States Environmental Protection Agency in Pohnpei and in Chuuk States have failed due to lack of trained personnel and funding for maintenance.

In addition, septic systems used in some rural areas are said to be of poor design and construction, while pour-flush toilets and latrines—which frequently overflow in heavy rains—are more common. Over-the-water latrines are found in many coastal areas, as well.

In the Marshall Islands, signs of eutrophication—excess water plant growth due to too much nutrients—resulting from sewage disposal are evident next to settlements, particularly urban centers. According to a draft by the Marshall Islands NEMS, "one-gallon blooms occur along the coastline in Majuro and Ebeye, and are especially apparent on the lagoon side adjacent to households lacking toilet facilities." Stagnation of lagoon waters, reef degradation, and fish kills resulting from the low levels of oxygen have been well documented over the years. Additionally, red tides plague the lagoon waters adjacent to Majuro.

There is significant groundwater pollution in the Marshall Islands as well. The Marshall Island EPA estimates that more than 75% of the rural wells tested are contaminated with fecal coliform and other bacteria. Cholera, typhoid and various diarrheal disorders occur.

With very little industry present, most of these problems are blamed on domestic sewage, with the greatest contamination problems believed to be from pit latrines, septic tanks, and the complete lack of sanitation facilities for 60% of rural households. As is often the case, poor design and inappropriate placement of these systems are often identified as the cause of contamination problems. In fact, even the best of these systems in the most favorable soil conditions allow significant amounts of nutrients and pathogens into the surrounding environment, and the soil characteristics and high water table typically found on atolls significantly inhibit treatment. In addition, the lack of proper maintenance, due to a lack of equipment to pump out septic tanks, is likely to have degraded the performance of these systems even further.

Forty percent of the population in the Republic of Palau is served by a secondary sewage treatment plant in the state of Koror, which is generally thought to provide adequate treatment. However, the Koror State government has expressed concern over the possible contamination of Malakal Harbor, into which the plant discharges. Also, some low-lying areas served by the system experience periodic back-flows of sewage which run into mangrove areas, due to mechanical failures with pumps and electrical power outages. In other low-lying areas not covered by the sewer system, septic tanks and latrines are used, which also overflow, affecting marine water quality.

Rural areas primarily rely on latrines, causing localized marine contamination in some areas. Though there have been an increasing number of septic systems installed as part of a rural sanitation program funded by the United States, there is anecdotal evidence that they may not be very effective. Many of the septic tank leach fields may not be of adequate size. In addition, a number of the systems are not used at all, as some families prefer instead to use latrines since the actual toilets and enclosures are not provided with the septic tanks as part of the program.

Wastewater problems also result from agriculture. According to the EPA, pig waste is considered to be a more significant problem than human sewage in many areas.

Because sanitation has become a social responsibility, national, state and local governments have adopted regulations that, when followed, should provide adequate sanitation for the governed society. However, the very technologies and practices that were instituted to provide better health and sanitation now have been found to be contaminating ground and surface waters. For example, placing chlorine in drinking water and waste water to provide disinfection, has now been found to produce carcinogenic compounds called trihalomethanes and dioxin . Collecting sanitary waste and transporting them along with industrial waste to inadequate treatment plants costing billions of dollars has failed to provide adequate protection for public health and environmental security.

Increasingly, the solution seems to be found in methods and practices that borrow from the stable ecosystems model of waste management . That is, there are no wastes, only resources that need to be connected to the appropriate organism that requires the residuals from one organism as the nutritional requirement of another. New waterless composting toilets that destroy human fecal organisms while they produce fertilizer , are now the technology of choice in the developing world and have also found a growing niche in the developed world. Wash water, rather than being disposed of into ground and surface waters, is now being utilized for irrigation . The combination of these two ecologically engineered technologies provides economical sanitation, eliminates pollution, and creates valuable fertilizers and plants, while reducing the use of potable water for irrigation and toilets.

Simple hand washing is now re-emerging as the most important measure in preventing disease transmission. Handwashing breaks the primary connection between surfaces contaminated with fecal organisms and the introduction of these pathogens into the human body. The use of basic soap and water, not exotic disinfectants, when practiced before eating and after defecating may save more lives than all of the modern methodologies and technologies combined.

[Carol Steinfeld ]