1. Eline Boelee Multiple Uses of Water and Health

2. Relevant health issues Water quality Water availability: quantity & accessibility Hygiene behavior Vector-borne diseases Other issues Incorporation in planning and design Winrock meeting 26Apr06

3. Different requirements –Irrigation –(human) consumption –other uses (e.g. laundry, animals) Chemical / biological water quality – trade offs Perceptions Treatment Water quality

4. Chemical water quality Arsenic Fluoride Salinity Iron (taste) Often geological origin Occasionally agro-chemicals or industrial Sometimes treatment possible

5. Biological water quality Main cause of diarrhea Bacteria, viruses, parasites Sources of contamination –lack of sanitation –upstream activities –transport & in-house contamination Often preventable Water treatment effective Opportunity –Ecosan, wastewater irrigation –Closing nutrient cycle

6. WHO norm for drinking water Example: biological water quality Legedini bacteria parasites 0.6% of children positive for Giardia (n=326)

7. Treatment options Central treatment –Expensive if quantities increase –No guarantee for safe consumption Point of use treatment –Availability of options –Training for safe use –Sustainable? Component approach –Lowest quality required as starting point –Not more expensive if planned for –Treatment of community storage

8. Quantity: 15, 50, or 100 lpcd? In dry areas: using available water wisely Demand vs supply-driven Accessibility to all, near house, for large part of day/night → time gain (women & children!!) Condition (but not sufficient) for improved hygiene More water for (other) productive purposes Seepage from unlined canals & reservoirs: impact on availability and quality of water for drinking Water availability

9. Increase access Domestic-plus systems –Increased pipe diameter –Cattle troughs –Right of use Productive-plus –Steps, laundry sites –Cattle crossings –Water rights Multipurpose –All users and uses, including landless, women, poor –Users’ priorities! –Multiple sources for multiple uses –Incremental services over time

10. Domestic-plus

11. Productive-plus

12. Multipurpose Adidaero, Tigray, Ethiopia

13. Also in dry areas For many farmers, livestock has first priority!

14. Vector-borne diseases Guinea worm (filtration) Schistosomiasis –Case detection and treatment –Separate facilities for washing and bathing –Sanitation and environmental snail control Malaria and other mosquito-transmitted diseases (dengue, yellow fever, filariasis) –Early detection & treatment –Personal protection: bed nets –Source reduction Larviciding not compatible with several water uses Filling & draining Biological control

15. Other issues Nutrition Drowning Zoonoses Changes in labor requirements (women and children) Perceptions of changes in human health Conflicts over water Increased income Environmental hazards

16. Health issues in planning & design Sufficient quantities for all purposes Clean water for drinking –Reduction of upstream pollution –Innovative approach to treatment Sanitation and hygiene education Prevention of vector breeding Participation & perceptions

17. Thank you