CDC

Hundreds of thousands of ethnic Rohingyas crossed the border into Cox’s Bazar, Bangladesh to escape violence in Rakhine State in Myanmar. More than 900,000 forcibly displaced Myanmar nationals live in refugee camps in Bangladesh. Because conditions are crowded and the area is prone to flooding, the risk of Acute Watery Diarrhea (AWD) and other waterborne disease outbreaks had to be reduced during the 2018 monsoon season. Humanitarian partners distributed household water treatment products throughout the camps and combined this with messages to promote good hygiene. However, a recent water, sanitation and hygiene (WASH) survey estimated that only 13% of households treat household water. Of the 182 households that reported to treat water using chlorine tablets, only 53 (21%) had detectable chlorine in their stored water, an indicator of whether water was treated and was protected from recontamination during storage in households. Bucket chlorination, where an attendant sitting by the well directly chlorinates each bucket of water as it is collected was also implemented, but only at a small number of wells. Because of low levels of household water treatment in the camps, the water, sanitation, and hygiene (WASH) team recommended to scale-up bucket chlorination to ensure households were using chlorinated water during the monsoon season.

The WASH team within CDC’s Emergency Response and Recovery Branch (ERRB) worked with UNICEF and non-governmental partners to increase bucket chlorination from June to September 2018. In July, ERRB WASH specialists measured chlorine levels in one camp to provide a snapshot of current levels of chlorine in the water. After this, the WASH team started a program to monitor bucket chlorination, using mobile phone surveys to ensure chlorinators were present and that chlorine was in water in nearby households. In addition, they piloted guidelines to help identify which drinking water wells should receive bucket chlorination first. Finally, the WASH team provided guidance to implementing partners on how to scale-up and improve bucket chlorination based on assessment and monitoring results.
In addition, CDC supported the WASH Sector in Cox’s Bazar and UNICEF by training local staff on how to conduct water quality testing and drafting guidance on water quality monitoring, including a system to monitor E. coli levels in wells through the dry and monsoon seasons.
The Rohingya face extremely challenging circumstances as they seek refuge in makeshift camps. The 2019 UN World Water Day theme is “leaving no one behind” and CDC seeks to assist partners in providing safe, treated drinking water to the world’s most vulnerable communities.

NYT

• “….Venezuela’s current rate of infant mortality from diarrhea, which is closely related to water quality, is six times higher than 15 years ago, according to the World Health Organization…..”
• “…..In the latest study, 40 samples were taken from the capital’s main water systems and tested for bacteria and for chlorine, which keeps water safe. The study also tested alternative water sources used by city residents during supply outages.  One third of the samples did not meet national norms……”
• “….Now, the Inter-American Development Bank estimates only 30 percent of Venezuelans have regular access to safe drinking water, compared to 60 percent in 2000. …..”

WASH in Healthcare Facilities

https://www.globalhealthnow.org/2019-09/safe-surgery-and-uhc-hinge-wash?utm_source=Global+Health+NOW+Main+List&utm_campaign=a4e0c0754d-EMAIL_CAMPAIGN_2019_09_23_12_42&utm_medium=email&utm_term=0_8d0d062dbd-a4e0c0754d-893211

“…..Yet the state of hundreds of thousands of healthcare facilities in low- and middle- income countries is deplorable. Take into account that this data includes developed countries. Worldwide, 1/4 lack basic water services and 1/5 lack adequate sanitation services, leaving 2 billion people without access to safe, affordable surgical care.…The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene, report—the first-ever effort to collect baseline water and sanitation data in healthcare facilities around the world, released last April—evaluated over 560,000 facilities in 125 countries.….”

WHO Microplastics Document 2019

“……..Background
Over the past few years, several studies have reported the presence of microplastics in treated tap and bottled water, raising questions and concerns about the impact that microplastics in drinking-water might have on human health. This report, which contains a summary of the evidence, key findings, recommendations and research needs, is the World  Health Organization’s (WHO) first effort to examine the potential human health risks associated with exposure to microplastics in the environment. The focus of this report is on the potential human health impacts of exposure to microplastics through drinking-water. However, brief information on other routes of human exposure is included for context.
This report was informed by literature reviews undertaken on the occurrence of microplastics in the water cycle, the potential health impacts from microplastic exposure and the removal of microplastics during wastewater and drinking-water treatment. Throughout the report, WHO experts examined the quality and relevance of the studies they found. The report was also informed by reviews conducted by several major entities; these are referenced throughout the report.
As a category, microplastics encompass a wide range of materials with different chemical compositions, shapes, colours, sizes and densities. There is no scientifically-agreed definition of microplastics, although most definitions focus on composition and size. ………

 

“……Recommendations
Routine monitoring of microplastics in drinking-water is not recommended at this time, as there is no evidence to indicate a human health concern. Concerns over microplastics in drinking-water should not divert resources of water suppliers and regulators from removing microbial pathogens, which remains the most significant risk to human health from drinking-water along with other chemical priorities. As part of water safety planning, water suppliers should ensure that control measures are effective and should optimize water treatment processes for particle removal and microbial safety, which will incidentally improve the removal of microplastic particles.
However, for researchers, it would be appropriate to undertake targeted, welldesigned and quality-controlled investigative studies to better understand the sources and occurrence of microplastics in fresh water and drinking-water, the efficacy of different treatment processes and combinations of processes, and the significance
Executive summary xiii
of the potential return of microplastics to the environment from treatment waste streams including the application of sludge biosolids to agricultural land.
Measures should also be taken to better manage plastics and reduce the use of plastics where possible, to minimize plastic and microplastic pollution despite the low human health risk posed by exposure to microplastics in drinking-water, as such actions can confer other benefits to the environment and human well-being. 

Research needs
To better assess human health risks and inform management actions, a number of research gaps need to be filled. With respect to exposure, there is a need to better understand microplastics occurrence throughout the water supply chain, using quality assured methods to determine the numbers, shapes, sizes, composition and sources of microplastics and to better characterize the effectiveness of water treatment. Research is also needed to better understand the significance of treatment-related waste streams as contributors of microplastics to the environment.
With respect to potential health effects, quality-assured toxicological data are needed on the most common forms of plastic particles relevant for human health risk assessment. Further, a better understanding on the uptake and fate of microplastics and nanoplastics following ingestion is needed.
Finally, given that humans can be exposed to microplastics through a variety of environmental media, including food and air, a better understanding of overall exposure to microplastics from the broader environment is needed.

Thomson Reuters Foundation

“…..Chennai was one of 21 cities the think-tank said could run out of ground water by 2020 and this week, taps ran dry as water levels in its four major reservoirs fell to one-hundredth of what they were this time last year.

The crisis in the southern coastal city has pushed schools, hotels and commercial establishments to close, while hospitals have put off non-essential surgeries…..”

UNICEF

The WHO/UNICEF JMP report, WASH in Health Care Facilities, is the first comprehensive global assessment of water, sanitation and hygiene (WASH) in health care facilities. It also finds that 1 in 5 health care facilities has no sanitation service*, impacting 1.5 billion people. The report further reveals that many health centres lack basic facilities for hand hygiene and safe segregation and disposal of health care waste.

These services are crucial to preventing infections, reducing the spread of antimicrobial resistance and providing quality care, particularly for safe childbirth.

“Water, sanitation and hygiene services in health facilities are the most basic requirements of infection prevention and control, and of quality care. They are fundamental to respecting the dignity and human rights of every person who seeks health care and of health workers themselves,” said António Guterres, United Nations Secretary-General.  “I call on people everywhere to support action for WASH in all health care facilities.  This is essential to achieve the Sustainable Development Goals.”

The WHO/UNICEF JMP report found that just half – 55 per cent – of health care facilities in Least Developed Countries (LDCs) had basic water services. It is estimated that 1 in 5 births globally takes place in LDCs, and that, each year, 17 million women in these countries give birth in health centres with inadequate water, sanitation and hygiene.

“When a baby is born in a health facility without adequate water, sanitation and hygiene, the risk of infection and death for both the mother and the baby is high,” said UNICEF Executive Director Henrietta Fore. “Every birth should be supported by a safe pair of hands, washed with soap and water, using sterile equipment, in a clean environment.”

In an accompanying report, Water, sanitation, and hygiene in health care facilities: Practical steps to achieve universal access for quality care, WHO and UNICEF researchers note that more than 1 million deaths each year are associated with unclean births. Infections account for 26% of neonatal deaths and 11% of maternal mortality.

“Imagine giving birth or taking your sick child to a health centre with no safe water, toilets or handwashing facilities,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “That’s the reality for millions of people every day. No one should have to do that, and no health worker should have to provide care in those circumstances. Ensuring that all health care facilities have basic water, sanitation and hygiene services is essential for achieving a healthier, safer, fairer world.”

At the 2019 World Health Assembly to be held in May, governments will debate a resolution on Water, Sanitation and Hygiene in Health Care Facilities which was unanimously approved by the WHO Executive Board earlier this year.

The WHO and UNICEF Practical Steps report provides details on eight actions governments can take to improve the WASH services in health care facilities including establishing national plans and targets, improving infrastructure and maintenance and engaging communities. These actions and resulting improvements in WASH services can yield dramatic returns on investment in the form of improved maternal and newborn health, preventing antimicrobial resistance, stopping disease outbreaks and improving quality of care.

According to UNICEF, 7,000 newborn babies died every day in 2017, mostly from preventable and treatable conditions including infections like sepsis. As part of its Every Child Alive Campaign, UNICEF is calling for governments and authorities to make sure every mother and baby have access to affordable, quality care. 

Last year, Fore and Dr Tedros called on countries to strengthen their primary health care systems as an essential step toward achieving universal health coverage.

–

T Reuters

“……The 2019 U.N. World Water Development Report said that while safe, clean drinking water and sanitation are human rights, the world is not on track to provide those things to everyone by 2030.

People who are poor or marginalised due to gender, age, ethnicity or religious identity are also more likely to have limited access to proper water and sanitation…..”

Science News

“…….Desalination facilities, which extract drinkable water from the ocean, discharge around 142 billion liters of extremely salty water called brine back into the environment every day, a study finds. That waste product of the desalination process can kill marine life and detrimentally alter the planet’s oceans…..”

NYT

“….The world’s roughly 150,000 glaciers, not including the large ice sheets of Greenland and Antarctica, cover about 200,000 square miles of the earth’s surface. Over the last four decades they’ve lost the equivalent of a layer of ice 70 feet thick…..”

 

Rand

• More than a quarter of all reported disease in Gaza is caused by poor water quality and access.
• The main source of Gaza’s water, its aquifer, is being depleted and its quality diminished by seawater intrusion, wastewater seepage, and agricultural runoff.