WATER AND HEALTH

CAPT John Walmsley, REHSUS Dept. of Health and Human Services

Water and HealthAccess to safe drinking water is a

fundamental need and human rightSafe water is critical for:

Drinking/hydrationFood preparation and clean upPersonal hygieneMedical care (hospitals)

Safe water also impacts:Development of industryOther economic development (tourism)

Water and HealthSAFE WATER• Enormous health and economic benefits to

communities• Facilitates the achievement of all eight MDGs• Lack contributes to illness and death, esp.

children• Diarrhea is 2nd leading cause of death in the

“under 5s”• Children under 5 represent 90% of all deaths

caused by diarrheal diseases – nearly 1 in 5 deaths

Water and HealthDISEASES TRANSMITTED THRU WATERDiarrheal diseases including intestinal

parasites and wormsBacterial/viral infections including E.coli,

cholera, typhoid, hepatitis A and dysenteryWash water can also transmit diseases of skin

& eyesSurveillance and reporting systems don’t

capture wellChallenging to document scope of problemBaseline surveillance data is lacking

Water and HealthSURVEILLANCE & REPORTINGExtent of waterborne illness not always

obvious when communities have been impacted for a long time

Enhanced surveillance systems needed to develop accurate statistics and allocate program resources

Improved surveillance systems positively impact public health across the board – not just for waterborne illness

Water and HealthWATER SOURCESLarge scale catchment systems (airport runways)Residential rooftop catchment systemsFreshwater lenses and wellsSeawater run thru reverse osmosis systemsStreams and springs (Japanese spring

containment)Coconuts!Imported/bottled water (Kwajelein Army Base)Most PICTs have a need to develop and implement

water source protection measures to prevent contamination

Water and HealthDISTRIBUTION / REGULATIONPublic water systems in more urbanized areas

Regulated by local EPAs or WAsSmaller, village based water systems

May or may not be regulatedIndividual water supplies: catchment, wells,

streamsUsually not regulated

Bottled water companies in larger population centersRegulation highly variableIMPORTANT ROLE IN EMERGENCY RESPONSE

Water and HealthWATER RESOURCE VULNERABILITIESDrought and heat wavesTidal surgeTsunamiSevere storms / extreme weather eventsClimate change: rise in sea level will result in

saltwater intrusion into freshwater suppliesCRITICAL: Any disaster can impact water

resources – emergency preparedness & water safety plans should address risks posed by potential emergencies

Water and HealthTREATMENT ISSUESChlorination in municipal water systems – but

can be compromised due to loss of system pressure

“First Flush” mechanisms divert initial rainfall from carrying rooftop contamination into cisterns + screens

Chlorination plus periodic cleaning and sanitizing of cisterns and catchment tanks

Solar pasteurizationUV light disinfectionBoiling (often impractical)No treatment in many island settings

Water and HealthLOCAL EPAS/WA & HEALTH DEPARTMENTSHealth issues related to unsafe water dealt

with by health departmentsBUT – water systems overseen by EPAs and

Water AuthoritiesCritical that local HDs and EPAs work

together to improve on the availability of safe water

Much potential for enhanced coordination and collaboration

Water and HealthWHO’S WORKING ON WATER ISSUES IN THE

PACIFIC?US DOIUS EPAUS DHHS: OPH / CDC / FDAPRELSPC/SOPACSPREPADBWHO

Water and HealthWHO’S WORKING ON WATER ISSUES IN THE

PACIFIC?UNICEFUN-HABITATUoH College of Tropical Ag. and HRUoH Sea GrantUoG Water and Env. Research InstituteFramework for the Pacific WASH CoalitionPacific Framework for Action on Drinking

Water Quality and HealthGlobal WASH Cluster

Water and Health

CURRENTLYHHS working within the Department to

synergize efforts related to EH, including water (CDC, FDA)

Enhancing relationships with DOI, US EPA and other Federal agencies active in EH and water issues

Seeking to work with regional programs to promote EH programs and issues (NPEHA)

Water and HealthMDG 7 – Target 10: Halve, by 2015, the

proportion of people w/o sustainable access to safe drinking water and basic sanitation

Water and sanitation interventions are cost effective across all world regionsEconomic benefits range from US$5 to US$46 per

US$1 spent (Journal of Water and Health, 2007)Investment in water services, hygiene promotion

and sanitation is among the most cost-effective ways of reducing child mortality (World Bank)

CAPT John Walmsley, REHSOffice of Pacific HealthHHS Region IXSan Francisco, CA415-437-8114John.Walmsley@hhs.gov