Water, Sanitation and Hygiene condition amongst the inhabitants of the Bamusso Sub Division of the South West Region of Cameroon in relation to their health

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background to the study

Water,  Sanitation  and  Hygiene  (WASH)  is  a  group  of  interrelated  public  health  issues  that  are  of  particular interest to international development programs. Access to safe water, adequate sanitation, and proper hygiene can reduce illness and death. Epidemics such as outbreak of cholera are often associated with bacteriological pollution of water.  The number of affected people can be reduced using purification method and good sanitation habit. Nepal earthquake 2015 also highly affected the WASH facilities.  Providing  schools  with  adequate  access  to  water  and  sanitation  facilities  and  supporting  the  implementation  of  hygiene  promotion  programs,  including  a  disaster  risk  preparedness plan, can play significant roles for a sustainable recovery phase [1]. 

Safe water, sanitation and hygiene (collectively known as WASH) are crucial for human health and well-being. Yet, millions of people globally lack adequate WASH services and consequently suffer from or are exposed to a multitude of preventable illnesses. Lack of safe WASH negatively impacts quality of life and undermines fundamental human rights. Poor WASH services also weaken health systems, threaten health security and place a heavy strain on economies [2].

Safe drinking-water, sanitation and hygiene are crucial to human health and well-being. And it is not only a prerequisite to health, but contributes to livelihoods, school attendance and dignity and helps to create resilient communities living in healthy environments. Drinking unsafe water impairs health through illnesses such as diarrhoea, and untreated excreta contaminates groundwater and surface waters used for drinking-water, irrigation, bathing and household purposes causing detrimental health problems [3].

Safe and sufficient WASH plays a key role in preventing numerous NTDs such as trachoma, soil-transmitted helminths and schistosomiasis. Diarrhoeal deaths as a result of inadequate WASH were reduced by half during the Millennium Development Goal (MDG) period (1990–2015), with the significant progress on water and sanitation provision playing a key role [4].

Evidence suggests that improving service levels towards safely managed drinking-water or sanitation such as regulated piped water or connections to sewers with wastewater treatment can dramatically improve health by reducing diarrhoeal disease deaths. Sanitation facilities safely separate human waste from human contact, but when people don’t have access to safe toilets, they opt to defecate in the open, and exposed human waste is transferred back into people’s food and water resources. About one-fourth of those defecating in the open in the world live in sub-Saharan Africa and they spend an average of 2.5 days per year trying to find a private location to defecate. Women spend extra time looking for a safe place to go and are therefore put in a position where they can experience gender-based violence in the process.

The use of contaminated drinking water and poor sanitary conditions results in increased vulnerability to water-borne diseases, including diarrhoea, cholera, dysentery, and typhoid. More deaths occur among children under 2 years of age living in South Asia and sub-Saharan Africa. It is reported that 115 people in Africa die every hour from diseases linked to poor sanitation, poor hygiene, and contaminated water [5].

When a person doesn’t have access to clean water and sanitation, they are also at risk of decreased school attendance, missed workdays, malnutrition, and poverty. When girls and women lack access to safe sanitation and water, their education suffers because they experience period poverty and can’t afford menstrual products, clean themselves safely, or access separate bathrooms.In Africa, especially sub-Saharan Africa, more than a quarter of the population spends more than half an hour per trip to collect water. The task of fetching water tends to fall on women, and this burden can also prevent girls from attending school [5].

Poor hygiene, inadequate quantities and quality of drinking water and lack of sanitation facilities cause millions of the world’s poorest people to die from preventable diseases each year. Women and children are the main victims. Water, sanitation and health are linked in many ways: contaminated water that is consumed may result in water-borne diseases including viral hepatitis, typhoid, cholera, dysentery and other diseases that cause diarrhoea, without adequate quantities of water for personal hygiene, skin and eye infections (trachoma) spread easily, water-based diseases and water-related vector-borne diseases can result from water supply projects (including dams and irrigation structures) that inadvertently provide habitats for mosquitoes and snails that are intermediate hosts of parasites that cause malaria, schistosomiasis, lymphatic filariasis, onchocerciasis and Japanese encephalitis. Also, drinking water supplies that contain high amounts of certain chemicals (like arsenic and nitrates) can cause serious disease [6].

Inadequate water, sanitation and hygiene account for a large part of the burden of illness and death in developing countries: Approximately 4 billion cases of diarrhoea per year cause 2.2 million deaths, most-1.7 million-children under the age of five, about 15% of all under 5 deaths in developing countries. Diarrheal diseases account for 4.3% of the total global disease burden (62.5 million DALYs). An estimated 88% of this burden is attributable to unsafe drinking water supply, inadequate sanitation, and poor hygiene. These risk factors are second, after malnutrition, in contributing to the global burden of disease. Intestinal worms infect about 10% of the population of the developing world, and can lead to malnutrition, anaemia and retarded growth. 6 million people are blind from trachoma and the population at risk is about 500 million, 300 million people suffer from malaria, 200 million people are infected with schistosomiasis, 20 million of whom suffer severe consequences [7].

Improved hygiene (hand washing) and sanitation (latrines) have more impact than drinking water quality on health outcomes, specifically reductions in diarrhoea, parasitic infections, morbidity and mortality, and increases in child growth [8]. Most endemic diarrhoea is not water-borne, but transmitted from person to person by poor hygiene practices, so an increase in the quantity of water has a greater health impact than improved water quality because it makes it possible (or at least more feasible) for people to adopt safe hygiene behaviors[9].

Experience shows that constructing water supply and sanitation facilities is not enough to improve health; sanitation and hygiene promotion must accompany the infrastructure investments to realize their full potential as a public health intervention. Changing hygiene behavior is complex. Hygiene promotion is most successful when it targets a few behaviors with the most potential for impact. Based on extensive research, WHO and UNICEF have identified hand washing with soap (or ash or other aid) after stool disposal and before preparing food; safe disposal of faeces and use of latrines; and safe weaning food preparation, water handling and storage as the key hygiene behaviors. A recent review (Curtis) of all the available evidence suggests that handwashing with soap could reduce diarrhoea incidence by 47% and save at least one million lives per year. This is consistent with other studies which found that 12 hand washing interventions in 9 countries achieved a median reduction in diarrhoea incidence of 35% [10].

Many of the most successful interventions provided soap to mothers, explained the oral-faecal route for disease transmission, and asked mothers to wash their hands before preparing food, and after defecation. There are fewer studies of results of interventions to improve faeces disposal, but Hill et al. found a median reduction of diarrheal disease of 26% (9 studies, range 0-68%), a median reductions in all-cause child mortality of 55% (6 studies, range 20-80%) and a median reduction in mortality from diarrhoea of 65% (3 studies, range 43-70%) [11].

1.2. Statement of the Problem

About 58% of inhabitants of Sub-Saharan Africa, including Cameroon, have no access to potable water. The water sector in Cameroon has undergone restructuring in the wake of public-sector reforms and privatization. It is framed within the United Nations Millennium Development Goal of reducing by half the proportion of people without access to portable water by 2015 and on the neoliberal argument for the privatization of public goods [12].

Just like in the BakassiPenicullar of Cameroon, the inhabitant of Bamusso sub division face a lot of difficulty with respect to safe potable and drinking water. Due to the lack of Toilets, wells, boreholes, Taps and springs, the Population of Bamusso and its environs are solely dependent on Rain water, as the main source of potable water for consummation with the mercy of seasonal changes during the rainy season; meanwhile, these water is kept in Drums gallons and jars and consumed throughout the dry season when there are little or no rain at all. Although some Institutional bodies and the government have done so much to combat the water situation in this sub division, the population still faces a  lot of  WASH-related diseases and risks  which  include infections transmitted by the faecal–oral route, health impacts from exposures to chemicals and other contaminants in drinking water, as well as impacts on well-being. WASH-related diseases and risks can be exacerbated by a number of factors including climate change, population growth, and rapid urbanization or, in the case of antimicrobial resistance, antibiotic use. 

Although a few researchers have done some work with regards to water crisis in similar islands, there is very limited information as to the different challenges faced by the inhabitants of  the Bamusso sub division with respect to the  water hygiene and Sanitation and hence the reason for this study.

Rapid and recent changes in the global environment, including the impacts of climate change and unprecedented growth of urban populations, have led to new WASH-related issues and challenges. Moreover, WASH-related diseases still prevail despite years of collective efforts. Significant inequities persist between urban and rural, poor and rich, and general and vulnerable population groups. Widespread use of antibiotics has allowed for control of infections arising from deplorable sanitary and hygiene conditions, yet conversely, has also allowed for neglect of WASH.

1.3. Justification of the Study

The researcher’s motivation to research on challenges of water, sanitation and hygiene and its impact on health in the Bamusso sub division is based on the fact that lack of access to safe, clean drinking-water and basic sanitation, as well as poor hygiene cause nearly 90% of all deaths from diarrhoea, mainly in children; more than 800 children die every day from diarrhoeal diseases linked to poor hygiene. The inhabitant of Bamusso sub division face a lot of difficulty with respect to safe potable and drinking water. Due to the lack of Toilets, wells, boreholes, Taps and springs, the Population of Bamusso and its environs are solely dependent on Rain water, as the main source of potable water for consummation with the mercy of seasonal changes during the rainy season; meanwhile, these water is kept in Drums gallons and jars and consumed throughout the dry season when there are little or no rain at all. Although some Institutional bodies and the government have done so much to combat the water situation in this sub division, the population still faces a  lot of  WASH-related diseases and risks  which  include infections transmitted by the faecal–oral route, health impacts from exposures to chemicals and other contaminants in drinking water, as well as impacts on well-being.

Primary prevention of diarrhoea through water, sanitation and hygiene interventions is based on reducing the faecal-oral transmission of pathogens, and includes the provision of an improved water supply, water safety planning, household water treatment and safe storage, improved sanitation facilities, and hygiene education. Hence, there is still much to be done to ensure the safety of everyone in Bamusso sub-division when it comes to health.

1.4. Significance of Study

This study will go a long way to help improve the level of Sanitation and hygiene among the population in the Bamusso Sub-Division.

This research will give us a guide to know the most prominent health problems faced by the population of Bamusso sub-Division and how these problems can be solved.

1.5. Research Questions

• What are the main sources of potable water in Bamusso Sub-Division?

• What are the different and most prominent health conditions faced by the inhabitants of Bamusso?

• What are the various means of waste disposal within the Bamusso community?

1.6. Objectives of the Study

The Main objective of this study is to examine the Water, Sanitation and Hygiene condition amongst the inhabitants of the Bamusso Sub Division of the South West Region of Cameroon in relation to their health.

Specific Objectives

• To identify the main sources of potable water in Bamusso Sub Division.
• To identify the challenges to having access to safer water, practice good sanitation and good hygiene in Bamusso Sub-Division.
• To identify common water disease associated to water hygiene and sanitation condition among the inhabitants of Bamusso Sub-Division.
• To assess the relationship between various means of waste disposal and most challenging health problem within the Bamusso Sub-Division.

HEALTH SCIENCE PROJECT TOPICS WITH MATERIALS