Nigeria – The water vendors, BBC News

February 6, 2009 · 0 comments

nigeriaIsa earns a hard living pushing a heavy water cart around the rutted streets of the suburbs of Nigeria’s capital, Abuja.

He is one of tens of thousands of water vendors who deliver jerry cans full of water to houses built without any kind of sanitation.

“Kai! it is hard work, pushing my cart,” the 20-year-old says.

Nigeria is Africa’s most populous nation, and according to analysts has made over $1.1 trillion in revenues from the oil industry over the last 30 years; but most Nigerians still rely on people like Isa for their water.

He and a dozen of his friends sleep in a makeshift shelter behind a small household goods shop.

They wake before dawn to queue up at a nearby borehole, where they fill 14 yellow 25-litre jerry cans on their handcarts before setting off around the streets looking for customers.

Heavy load

Fully loaded, the carts weigh at least 350kgs.

The roads they push them over are dirt tracks, rocky and pitted, with sewers running down the middle.

“In the future I want to get another job, but at least I make enough money to live doing this,” Isa says.
The urban poor pay more for water than the urban rich

Prices for water from private boreholes vary in the suburbs.

Isa pays around 10 naira ($0.07, £0.05) per jerry can at the borehole and sells for double that.

He makes around 700 naira a day ($4.70, £3.20), to cover food and living costs.

A large Nigerian family may need around 10 of these jerry-cans every day, customers say.

That adds up to about $486 (£339) every year, a massive pressure on a country where the average person lives on $2 a day.

This is a pattern repeated around the world, according to the UN Development Programme.

The urban poor in developing world cities including Abuja pay much more for their water than citizens of rich cities such as New York or Tokyo, precisely because the poor have to depend on private providers rather a piped municipal supply.

Government failure

Virtually none of the suburbs of Nigeria’s capital city have what is known here as “pipe-born water” provided by the government.

Private individuals have to drill boreholes for themselves.

They are most often fitted with two sets of taps – one for the household, and another facing the street so the owners can make a bit of money on the side.

John, a 25-year-old borehole manager, says the place he looks after in Nyanya Gwandara earns his boss 7,000 naira ($47, £32) a day.
We cannot wait for the government to do anything, we are relying on other wealthy people to dig boreholes.

“The man is from Kogi State where he lives, far away. He dug several boreholes in this area for an investment,” he says.

His customers are grateful.

“We cannot wait for the government to do anything, we are relying on other wealthy people to dig boreholes,” says Janet Daniels, who lives in the area.

She cannot afford to buy the water from the delivery boys, so comes every morning to the borehole to save money.

She fills two 20-litre buckets every morning and carries them on her head back to her home.

“I have to boil the water that we drink because its a very shallow borehole, and sometimes its got little particles of stuff in it.”

Otherwise the quality of the water from here is ok, she says.

Husseini, another water vendor working at a borehole in Nyanya Gwandara, says people like the water from this hole, and he even charges more for it on his rounds.

Scummy rivulets

But other water vendors try and find free sources of water like streams and ponds.

These scummy rivulets are often fed by the sewer-streams that run through the middle of the streets. Diseases like polio, cholera and other types of gastric infection disproportionately affect those in poverty, who get water from bad streams.

Abuja, like other cities in Nigeria, is rapidly growing.

The government has fallen so far behind in providing water here, it may never catch up.

Over the last year the price of a jerry-can of water has doubled.

These problems will only get more acute, and the price of water will only go up.

Source – BBC News

Cameroon – Pathogenic Microorganisms Associated with Childhood Diarrhea

February 5, 2009 · 0 comments

Int J Environ Res Public Health. 2008 Dec;5(4):213-29. Pathogenic Microorganisms Associated with Childhood Diarrhea in Low-and-Middle Income Countries: Case Study of Yaoundé – Cameroon.

Yongsi HB. Department of Nursing and Human Sciences, University of Chicoutimi/555, boulevard
de l’Université Chicoutimi (QC), G7H 2B1, Canada E-Mail: Blaise_nguendo-yongsi@uqac.ca.

Notwithstanding significant advancement in the understanding of pathogenesis and management, diarrheal illnesses remain one of the principal causes of global childhood mortality and morbidity. Infections account for most illnesses, with pathogens employing ingenious mechanisms to establish disease. In 2002, an interdisciplinary program “Populations et al. Espaces à Risques SANitaires” (PERSAN) was set up under the patronage of the Development Research Institute (IRD).

Focused on health in Cameroon’s urban environment, the program mainly sought to identify diarrhea risk factors in Yaoundé. So for, a cross-sectional epidemiological study in children aged 6-59 months was carried out using a standardized protocol. The survey was initiated in 2002 and conducted during April to June in the year 2005. 3,034 stool samples were collected from children in twenty neighbourhoods in Yaoundé and examined at the Epidemiology and Public Health Laboratory of the Cameroon Pasteur Institute. About 60% of the patients were aged less than two years and 52% were male. Among the 437 patients with the diarrheal disease, 260 were found to be of infectious etiology, i.e. micro organism was detected in 59.5% of the cases. Out of which, 10 (03.8%), 96 (36.9%), and 154 (59.2%) were respectively caused by pathogenic viruses, pathogenic bacteria and pathogenic parasites.

Higher prevalence was found in overcrowded and under supply spontaneous settlement (78.4%) than in less crowded and formal residential settlement (21.5%). Etiologic data on diarrheal diseases and their spatial distribution are important tools for public health management and control strategic planning.

Editorial – Failing South Africa in a time of cholera

February 5, 2009 · 0 comments

INSIGHT: Failing South Africa in a time of cholera, Source: Dispatch, 2009/02/05

FEW would have imagined that the dreaded disease of cholera would ever ravage communities in South Africa as it did in Caribbean countries in the late 19th century, providing the setting for Gabriel Garcia Marquez’s famous novel, Love in the Time of Cholera. But it has, and the tragedy is no less profound.

Adding fuel to the fire of xenophobia, many fingers point north to Zimbabwe, where dire poverty provided the ground for the cholera disease after the collapse of the country’s water and sanitation systems late last year, with more than 50 000 infections recorded. But with the latest press reports on the growing crisis in the north of South Africa confirming the disease’s toll of 44 lives and 6200 sick, what blame should be laid at the door of our own water and sanitation systems and, by implication, the municipalities entrusted with delivering these services?

While recent media reports have speculated that infected Zimbabweans in South Africa may have sparked the epidemic, it is the lack of service delivery by municipalities in Mpumalanga and Limpopo that has facilitated the deadly spread of cholera in this country.

The Health Department’s head of communicable diseases, Frew Benson, has confirmed that most cholera cases have been registered in Limpopo and Mpumalanga, although cases have also been identified in the seven other provinces, and at least 50 new cases a day are expected to be identified in Limpopo and Mpumalanga in the short term before the crisis is brought under control. The spread of the epidemic is underpinned by poverty and a lack of infrastructure, which severely compromises the residents of rural areas.

Advice to avoid contaminated water and ensure good hygiene has been issued, but is shockingly naive in light of the conditions facing those who live in the worst-affected areas. To be sure, cholera can be prevented by boiling water or sterilising it using chlorine tablets or household bleach, and by washing hands thoroughly with soap and clean water. But this assumes an abundance of clean water (boiled or sterilised) to cook and wash with, as well as a low dependence on ground or surface water – all ground or surface water in cholera areas is considered potentially contaminated – and, indeed, adequate information about cholera among those at risk. Is this a fair assumption?

Those involved in development planning or poverty alleviation recognise that there is a strong correlation between the different determinants of poverty that keep poor people marginalised and trapped in a cycle of poverty. A few of these traps are: poor access to services, low income levels, as well as high levels of unemployment. Confirming this, Municipal IQ research on productivity levels demonstrates how residents of rural or previous homeland municipalities in South Africa are far more likely to be poor than residents of other municipalities. Municipal IQ reasons that reasonable access to tap water (assuming tap water is not affected by the cholera virus) and minimum sanitation (Municipal IQ excludes the bucket system) would ensure that residents of the average South African municipality are reasonably well protected from the cholera virus. Hence, where there is inadequate provision of basic municipal services, cholera is likely to surface.

Municipal IQ data, combined with the latest Statistics SA data, suggests that most residents of Mpumalanga have reasonable access to services, but are not that well off – about ninepercent lack access to either clean water or minimum levels of sanitation (far better than the average access to basic services in KwaZulu-Natal or the Eastern Cape), but unemployment is at almost 34 percent, and 55 percent of households earn less than R800 a month. Considering that a quarter of municipalities in the province are classified as being either rural or former homeland municipalities, it is easy to identify systemic disadvantage and those most at risk of infection.

These municipalities, with worse than average levels of water access, are at particular risk. In addition, those residents residing in municipalities with low levels of access to clean water will also be more likely to be reliant on ground or surface water and, given their likely geographical isolation, are likely to be the least well informed about the risks of cholera and ways of treating it.

The situation in Limpopo is significantly worse – 17.5 percent of residents do not have adequate access to water, relying instead on contaminated natural water sources. Access to adequate sanitation levels is somewhat better at 11.9percent, but with provincial unemployment of 38.5percent and almost two thirds of households living on less than R800 a month, it can be assumed that poverty is endemic. Even more so in marginalised areas; with almost half of Limpopo’s municipalities classified as either former homeland or rural, many municipalities present fertile territory for cholera, where high HIV/Aids infection rates and inadequate nutrition and healthcare compound the negative consequence of a legacy of deprivation and inadequate basic service infrastructure.

The incidence of cholera throughout the country suggests that no one is completely safe from contracting the disease, but least of all those in poor households where, typically, access to water and sanitation is limited and spread among many household members, and standards of sanitation are compromised by squalid living conditions associated with poverty.

Special attention must be paid to specific rural or former homeland municipalities which may contain higher levels of poor households with lower than average access to clean water and adequate sanitation.

In Limpopo, with almost a fifth of all households not accessing clean water adequately, more urgent attention is required to address the epidemic and to ensure clean water is available to residents of all municipalities.

And it should be asserted that disaster management should be more than just helping the victims, but should include providing health information to remote areas, accompanied by water purification products, soap and, if necessary, water tankers.

More systemically, ensuring early warning systems monitor water quality and address failures (at local and national levels), as well as the long-term rollout of basic services, are crucial. – By KEVIN ALLAN AND KAREN HEESE.
————-
Kevin Allan is Municipal IQ’s MD, while Karen Heese is Municipal IQ’s economist. Municipal IQ is a web-based data and intelligence service specialising in the monitoring and assessment of SA’s municipalities. This article first appeared in Business Day.

India – Urban Poverty Report 2009

February 4, 2009 · 1 comment

India’s booming economy has helped marginalise the growing number of impoverished city dwellers while lifting millions out of poverty, a government report said on Tuesday.

The proportion of India’s urban poor halved in the 30 years to 2005 but absolute numbers rose from 60 to 81 million during the period, said the report produced with the United Nations Development Programme (UNDP).

“Would bringing out an urban poverty report put some shadow on the shining and glittering performance of India?” asked Professor Amitabh Kundu, the chief coordinator of the “India Urban Poverty Report 2009,” which was released in New Delhi on February, 3, 2009.

“When you’re watching the process of development, where you stand is very important — whether you see the speed of the engine or you get overwhelmed by the smoke.”

The urban poor accounted for 25.7 percent of the country’s total urban population in 2004-5 compared with 49.01 percent in 1973-74, said the report which defines urban poor as anyone living on less than 20 rupees (29 pence) a day.

However, the rate of overall decline in poverty slowed from 0.82 percentage points per year from 1973-74 to 1983-84, to 0.61 percentage points from 1993-94 to 2004-05, the report said, revealing the flip-side of the country’s economic success.

India’s economy grew at around 9 percent in each of the past three years.

“Certain aspects of economic development and the changes associated strongly with the process of urbanisation in India have created a backwash effect for the poorer sections of the urban community,” the report said.

The “backwash” is also blamed on the decline or relocation of traditional industries such as textiles and steel.

“The urban workers are increasingly being pushed into the informal sector,” the report said.

The report said such exclusion is pushing a large number of urban workers such as street vendors and rickshaw pullers further into poverty.

Mass slum clearances have driven workers, such as those in domestic service, away from their place of work and pushed many into crime, the report said.

“When the urban poor are pushed away from the place of his/her livelihood, the result is complete loss of livelihood. As a result, many of the poor are pushed into crime.”

Source – International Herald Tribune

Pakistan – Neonatal mortality, risk factors and causes

February 3, 2009 · 0 comments

Neonatal mortality, risk factors and causes: a prospective population-based cohort study in urban Pakistan, WHO Bulletin, Feb 2009. (pdf, full-text)

Imtiaz Jehan, Hillary Harris, Sohail Salat, Amna Zeb, Naushaba Mobeen, Omrana Pasha, Elizabeth M McClure, Janet Moore, Linda L Wright & Robert L Goldenberg

Objective – To evaluate the prevalence, sex distribution and causes of neonatal mortality, as well as its risk factors, in an urban Pakistani population with access to obstetric and neonatal care.

Methods – Study area women were enrolled at 20–26 weeks’ gestation in a prospective population-based cohort study that was conducted from 2003 to 2005. Physical examinations, antenatal laboratory tests and anthropometric measures were performed, and gestational age was determined by ultrasound to confirm eligibility. Demographic and health data were also collected on pretested study forms by trained female research staff. The women and neonates were seen again within 48 hours postpartum and at day 28 after the birth. All neonatal deaths were reviewed using the Pattinson et al. system to assign obstetric and final causes of death; the circumstances of the death were determined by asking the mother or family and by reviewing hospital records. Frequencies and rates were calculated, and 95% confidence intervals were determined for mortality rates. Relative risks were calculated to evaluate the associations between potential risk factors and neonatal death. Logistic regression models were used to compute adjusted odds ratios.

Findings – Birth outcomes were ascertained for 1280 (94%) of the 1369 women enrolled. The 28-day neonatal mortality rate was 47.3 per 1000 live births. Preterm birth, Caesarean section and intrapartum complications were associated with neonatal death. Some 45% of the deaths occurred within 48 hours and 73% within the first week. The primary obstetric causes of death were preterm labour (34%) and intrapartum asphyxia (21%). Final causes were classified as immaturity-related (26%), birth asphyxia or hypoxia (26%) and infection (23%). Neither delivery in a health facility nor by health professionals was associated with fewer neonatal deaths. The Caesarean section rate was 19%. Almost all (88%) neonates who died received treatment and 75% died in the hospital.

Conclusion – In an urban population with good access to professional care, we found a high neonatal mortality rate, often due to preventable conditions. These results suggest that, to decrease neonatal mortality, improved health service quality is crucial.

WHO Bulletin, Feb 2009 – The urban animal: population density and social pathology

February 3, 2009 · 0 comments

The urban animal: population density and social pathology in rodents and humans

Edmund Ramsden. School of Humanities and Social Science, University of Exeter, Rennes Drive, Exeter, EX4 4RJ, England.

Correspondence to Edmund Ramsden (e-mail: E.Ramsden@exeter.ac.uk).

Bulletin of the World Health Organization 2009;87:82-82. doi: 10.2471/BLT.09.062836

In a 1962 edition of Scientific American, the ecologist John B Calhoun presented the results of a macabre series of experiments conducted at the National Institute of Mental Health (NIMH).1 He had placed several rats in a laboratory in a converted barn where – protected from disease and predation and supplied with food, water and bedding – they bred rapidly. The one thing they were lacking was space, a fact that became increasingly problematic as what he liked to describe as his “rat city” and “rodent utopia” teemed with animals. Unwanted social contact occurred with increasing frequency, leading to increased stress and aggression. Following the work of the physiologist, Hans Selye, it seemed that the adrenal system offered the standard binary solution: fight or flight.2 But in the sealed enclosure, flight was impossible. Violence quickly spiralled out of control. Cannibalism and infanticide followed. Males became hypersexual, pansexual and, an increasing proportion, homosexual. Calhoun called this vortex “a behavioural sink”. Their numbers fell into terminal decline and the population tailed off to extinction. At the experiments’ end, the only animals still alive had survived at an immense psychological cost: asexual and utterly withdrawn, they clustered in a vacant huddled mass. Even when reintroduced to normal rodent communities, these “socially autistic” animals remained isolated until death. In the words of one of Calhoun’s collaborators, rodent “utopia” had descended into “hell”.3

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Philippines – ADB study to help small water providers get access to financing

February 2, 2009 · 0 comments

THE ASIAN Development Bank (ADB) will undertake a project designed to help small-scale water service providers, get financing to enable them to serve households out of reach of bigger water concessionaires.

ADB said in a Jan. 30 update on its projects that it has allocated $50,000 for a study this year that will assess financing mechanisms now available to these small water utilities in the Philippines.

ADB noted that these small providers give water to about 20%-50% of house-holds not served by big concessionaires like Manila Water Co. and Maynilad Water Services Inc., including informal settlers who are not connected to piped water system.

The study, which was approved last month and is programmed to run for 10 months, will focus on understanding hurdles SSWPs face in order to be able to craft an appropriate financing model.

“While small-scale water service providers play a vital role in meeting the water and sanitation needs of the country, current situation is not conducive for [them] due to a number of issues, foremost of which are the lack of institutional or legal framework regarding their formal participation in WatSan provision and the lack of access to financing,” ADB stated.

WatSan is an initiative of FairWater, a Dutch Foundation that focuses on providing equitable, reliable water supply to the poor.

“Such lack of access to financing has limited the operations and expansion of [small water utilities] in helping the government provide water service connection, especially among the urban poor and rural areas not reached by the formal utilities,” ADB said in the project update. — AKKA

Source – BusinessWorld

Ethiopia – Prevalence of Bacteria and Intestinal Parasites among Food-handlers in Gondar Town

January 30, 2009 · 1 comment

Prevalence of Bacteria and Intestinal Parasites among Food-handlers in Gondar Town, Northwest Ethiopia, Journal of Health, Population and Nutrition, Dec. 2008. (pdf, 146KB)

Food-handlers with poor personal hygiene working in food-service establishments could be potential sources of infection due to pathogenic organisms. The study was undertaken to determine the prevalence of bacteria and intestinal parasites among 127 food-handlers working in the cafeterias of the University of Gondar and the Gondar Teachers Training College, Gondar, Ethiopia. Fingernail contents of both the hands and stool specimens were collected from all the 127 food-handlers. The samples were examined for bacteria and intestinal parasites following standard procedures. Coagulase-negative staphylococci were the predominant bacteria species (41.7%) isolated from fingernail contents, followed by Staphylococcus aureus (16.5%), Klebsiella species (5.5%), Escherichia coli (3.1%), Serratia species (1.58%), Citrobacter species (0.8%), and Enterobacter species (0.8%). Shigella species were isolated from stool samples of four food-handlers (3.1%). None of the food-handlers was positive for Salmonella species and Shigella species in res-pect of their fingernail contents. No intestinal parasites were detected from fingernail contents. Intestinal parasites detected in the stools of the food-handlers included Ascaris lumbricoides (18.11%), Strongyloides stercoralis (5.5%), Entamoeba histolytica/dispar (1.6%), Trichuris trichiura (1.6%), hookworm species (0.8%), Gardia lamblia (0.8%), and Schistosoma mansoni (0.8%); 1.6% of the study subjects were positive for each of A. lumbricoides, T. trichiura, hookworm, and G. lamblia. The findings emphasize the importance of food-handlers as potential sources of infections and suggest health institutions for appropriate hygienic and sanitary control measures.

Hoarding rainwater could 'dramatically' expand range of dengue-fever mosquito

January 28, 2009 · 0 comments

Ecologists have developed a new model to predict the impact of climate change on the dengue fever-carrying mosquito Aedes aegypti in Australia – information that could help limit its spread.

According to the study, published in the new issue of the British Ecological Society’s journal Functional Ecology, climate change and evolutionary change could act together to accelerate and expand the mosquito’s range. But human behaviour – in the form of storing water to cope with climate change – is likely to have an even greater impact.

Lead author, Dr Michael Kearney of the University of Melbourne says: “The potential direct impact of climate on the distribution and abundance of Ae. aegypti is minor when compared to the potential effect of changed water-storage behaviour. In many Australian cities and towns, a major impact of climate change is reduced rainfall, resulting in a dramatic increase in domestic rainwater storage and other forms of water hoarding.”

“Water tanks and other water storage vessels such as modified wheelie bins are potential breeding sites for this disease-bearing mosquito. Without due caution with water storage hygiene, this indirect effect of climate change via human adaptation could dramatically re-expand the mosquito’s current range,” he says.

Ae. aegypti probably arrived in Australia in the 19th century on ships carrying mosquito larvae-infested water barrels. During the late 19th century, Ae. aegypti was widespread in urban Australia, stretching as far south as Sydney and Perth. By the late 1960s, Ae. aegypti was restricted to the northern half of Queensland (where it currently resides) thanks in part to removal of old galvanised tin rainwater tanks, installation of piped water, insecticides and new power lawnmowers that helped people keep their back yards tidy.

The study has major implications for public health interventions in Australia and other areas of the world affected by dengue and other mosquito-spread diseases. According to Dr Scott Ritchie, a mosquito control expert and contributing author: “The better we understand the underlying processes, the better we will be able to manage disease risk into the future. Our results highlight that dengue-vectoring mosquitoes can spread to areas where they are currently not found once suitable breeding sites, such as containers, become available. Our research can help target water hygiene education campaigns to areas most at risk of dengue mosquito establishment.”

The predictions come from a new “bottom-up” model that takes into account the mosquito’s biology and its physiological limitations, such as the ability of its eggs to tolerate drying out.

To construct the model, Kearney and his colleagues needed to predict the microclimates mosquitoes experience. “Like all mosquitoes, the dengue mosquito has an aquatic larval phase and it is very particular about breeding in artificial containers like water tanks, buckets and old tyres. So we developed a model of the temperature and depth of water in different containers as a function of climate. We modelled two extreme types of container – a large (3600 litre) water tank receiving rainwater from a roof catchment, and a small (20 litre) bucket only receiving rainwater from directly above. We considered each container type in high and low shade,” Kearney says.

The authors also took evolution into account – the first time this has been done in such models. According to Professor Ary Hoffmann, a coauthor of the study: “Evolution happens all the time in nature and can be very rapid, taking only a few generations to influence the fitness of populations. Our results show that evolution can make a very large difference when predicting changes in species ranges under climate change.”

###

Michael Kearney et al (2009). Integrating biophysical models and evolutionary theory to predict climatic impacts on species’ ranges: the dengue mosquito Aedes aegypti in Australia, Functional Ecology, doi: 10.1111/j.1365-2435.2008.01538.x, is published online on 28 January 2009.

Source – Eureka Alert

Bangladesh – Cities must prepare to combat climate change

January 28, 2009 · 0 comments

Dhaka, January 28 (bdnews24.com) — Bangladesh must look at the links between urbanisation and climate change, said finance minister AMA Muhith at a seminar on Wednesday.

“We have not looked at the impact so far of climate change on urban life,” said Muhith at the conference, in which discussants stressed the need for cities to prepare for climate change challenges.

“We have focused on urban poverty and climate change separately, but have yet to study how climate change and urbanisation are related,” said the minister.

“We want to see development of slums as part of urbanisation.”

“Rural development is our first priority, but that does not mean only development of agriculture and creation of employment. It also means the municipal facilities should be available in rural areas.”

IUCN country representative Professor Ainun Nishat said, “The per capita emission rate in Bangladesh is very low, but Bangladesh is one of the most vulnerable countries to climate change impact.”

“Night temperatures are not as low as expected this winter, so Boro production could be affected. Food security is being threatened,” he said.

Professor David Hulme, from Manchester University’s Brooks World Poverty Institute, said: “Everywhere in Bangladesh, it looks as though you are getting increasingly big numbers of poor urban people concentrated in incredibly small areas.”

“Because they have no security over their land … and the density is just going to get bigger, we have to find a way of increasing the land area that poor people have access to.”

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