1. EVAN SYLVESTER WALDEN UNIVERSITY MAY 1, 2013 Murky waters; Seeking an Understanding to Water and Sanitation In Lakka, Sierra Leone

2. What is Public Health Edward Winslow, explains public health as an “Applied science based method to prevent disease, increase the quality of life and the years of life through organized community efforts in the maintenance of the environment, control of diseases, education, organization of medical services for early diagnosis and prevention of disease, and the development of structure” (Schneider, 2011).

3. Ten Essential Public Health Services 1. Monitor health issues 2. Diagnose and investigate health problems 3. Inform, educate, and empower the community of health issues 4. Mobilize community partnerships to solve health issues 5. Develop policies 6. Enforce regulations 7. Link people to needed health services 8. Assure a competent health care workforce 9. Evaluate effectiveness of population based services 10. Research for new insights and solutions to health problems Centers for Disease Control and Prevention (2010). National Public Health Performance Standards Program; 10 Essential Public Health Services. Retrieved from http://www.cdc.gov/nphpsp/essentialservices.html

4. Why Worry about Water Nearly 2.4 billion people worldwide do not have access to any improved drinking water Nearly 10% of the world’s diseases can be linked to unsafe water The life expectancy in 2010; - US 78.7 years - Sierra Leones 47 years WHO ~2 million people die every year from diarrheal disease 1 in every 5 deaths of children are linked to diarrhea

5. Water Issues Lack of Finances Sustainability Water treatment methods Hygiene and sanitation practices Education High poverty rates spread over great distance Poor infrastructure No centralized municipal water treatment

6. Water Treatment Decentralized Membrane Filtration Systems (DMFS) Bore wells (deep wells >80 meters) - Unprotected/protected wells Chlorination (residual protection) Boiling UV radiation Desalination

7. Water Associated Disease Increased morbidity and mortality Diarrheal disease from; - Bacteria - Viruses - Schistosmiasis - Giardiasis - Ascariasis - Trichuriasis - Hookworm worms Water washed disease; - Trachoma, lice, fleas

8. Sanitation 65% of people in developing countries lack waste treatment Contamination of; - Water - Soil - Fruits and vegetables - Animals - Hands

9. Major Findings of Health Assessment in Lakka 193 segments, 50 randomly selected n=356 in 24 segments 20% incidence rate of diarrhea 73% travel to retrieval water Fetching water; - 46.3% women - 27% children - 47% of them traveled 2-4 times a day to collect water

10. Associations of Results Disposal of pampers; - 10.3% disposed of them in the streams/rivers - 13.5% put them in a ditch - 22% used no form of pampers or nappies Segment areas compared to diarrheal rate had a Chi- squared sig. of <0.05 Diarrheal rate associated with the source of water had a sig. value of 0.010. Type of toilet used associated with diarrheal showed little association.

11. Water Cultures Guma Valley water is the most used; 6 of the 10 water samples from Guma exceeded US EPA water standards. People broke Guma water pipes to access water leading to cross contamination Protected wells also contaminated, likely from buckets Protected wells were often not covered

12. Water Samples

13. Water Sources

14. Waste Runoff

15. Right to Clean Water Clean drinking water falls under the Universal Declaration on Human Rights, states under Article 25, that “everyone has the right to a standard of living that promotes health and well being of themselves and their family” (Gostin, 2008).