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Cholera deaths: Government does not admit the presence of the disease

CONTENT

  • 1. INTRODUCTION
  • 2. Water-Related DiseasesD
  • 3. Diarrhoea in Bangladesh
  • 4. Treating The Water We Drink
  • 5. Polluted Water Increases Risk of Cancer
  • 6.Dirty Mineral Water
  • 7. COLANISATION'S DIRTY DOZEN
  • 8. World’s water problem
  • 1. INTRODUCTION

    Government hospital at Faridpur- patients lying on floorWater, one of the most essential elements of human survival, contributes to a large number of human diseases and deaths. According to the United Nations, in 1997 more than 2.3 billion people in the world were affected by diseases linked to water .

    According to epidemiologists, cholera is the oldest micro-organism, and has been living in the country for more than six thousand years. Out of seven pandemic (spreading throughout the region or the world) outbreaks of cholera, three arose from the lower Ganges delta. Hindu mythology describes cholera epidemic during 600 BC. Though cholera is very common in the country, the Bangladesh government does not admit the presence of cholera for fear of huge financial loss in reduction of food and vegetable export if the presence of cholera is detected. "The world's scientists are about to develop a cholera vaccine, but if the country's government does not admit the presence of the disease they won't be helped by WHO and other organisations to get the vaccine free or at lower cost," said an ICDDR,B epidemiologist.

    Scientists of the IEDCR found that 'vibrio cholerae 01' is the organism responsible for the recent diarrhoeal outbreak in greater Rangpur.

    There are two types of cholera organism usually found in the country - the 'classical type' and 'El Tor' type. These people were suffering infection by the 'El Tor (inaba)' type which is less virulent than the classical one.

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    2. Water-Related Diseases

    Table : Water-Related Diseases

    Waterborne diseases: caused by the ingestion of water contaminated by human or animal faeces or urine containing pathogenic bacteria or viruses; include cholera, typhoid, amoebic and bacillary dysentery and other diarrheal diseases..

    Water-washed diseases: caused by poor personal hygiene and skin or eye contact with contaminated water; include scabies, trachoma and flea, lice and tick-borne diseases

    Water-based diseases: caused by parasites found in intermediate organisms living in contaminated water; include dracunculiasis, schistosomiasis, and other helminths.

    Water-related diseases: caused by insect vectors, especially mosquitoes, that breed in water; include dengue, filariasis, malaria, onchocerciasis, trypanosomiasis and yellow fever.

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    3. Diarrhoea in Bangladesh

    Diarrhoea dogs nine districts 193 die, 0.227 million affected since January from diarrhoeal diseases in nine districts that claimed 193 lives and attacked 2,27,109 since January this year in nine districts reports the Daily Star (October 28, 2003).

    "The attack is nothing unusual in the post-monsoon period. At this time every year scores of people are attacked with such diseases. The reason for such attacks is taking contaminated food and water," said Dr Kanak Ranjan Talukder, director of Communicable Disease Control at the health directorate.

    According to experts, diarrhoeal disease is very common in Bangladesh with two seasonal outbreaks, one in the dry season in autumn, which the country is now facing, and another during monsoon (June-July). Rota Virus, E Coli bacteria, Salmonella, and of course cholera, are the main causative agents. Rota viral diarrhoea is common in children during this season. The recent diarrhoeal incidence has peaked about one and a half months ago in the northern districts and is continuing at the same rate. It has now have become countrywide.

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    4. Treating The Water We Drink


    It's ironic that many areas of the world face critical shortages of drinking water on a planet whose surface is 3/4 covered with water. Most of the water, of course, is seawater, which is far too saline for human consumption. And of the little "fresh" water that remains, most is trapped in polar ice caps where it is difficult to harness for use by the world's population.

    Much of the natural supply of potable water that is accessible faces stress from a growing world population, which increases the basic demand for this natural resource, while reducing the supply further through biological and industrial contamination.

    Major population centers in developing nations without established waste treatment or water treatment infrastructures often suffer from epidemics of waterborne disease. In these areas, raw sewage often directly contaminates the rivers and streams used for drinking, washing, and cooking. In other cases, unchecked industrialization leads to water contamination through improperly disposed-of chemical and biological wastes.

    A team of scientists of the Institute of Epidemiology Disease Control and Research (IEDCR) went to the northern districts and found only 'Vibrio cholerae' (causative agent of cholera) in the stool samples of the patients. They did not find other any organisms having the potential to cause diarrhoea, like Salmonella, E Coli, etc. However, the scientists do not have the capability to detect the rota virus, one of the major causes of diarrhoeal diseases in the country. "As the investigation was carried out about one and a half months ago, we are not sure if it is the cholera outbreak that is spreading all over the country. A new causative agent might have emerged and caused another form of diarrhoea," said an IEDCR scientist. "Rota virus of E coli diarrhoea can be the other possibility," he added. According to epidemiologists, cholera is the oldest micro-organism, and has been living in the country for more than six thousand years.

    Diarrhoea causes rapid depletion of water and sodium - both of which are necessary for life. If the water and salts are not replaced fast, the body starts to "dry up" or gets dehydrated. If more than 10 per cent of the body's fluid is lost, death occurs. Severe dehydration can cause death. Most experts are of the opinion that no one should die of diarrhoea. However, the unfortunate fact is an estimated 1.5 million people throughout the world die of diarrhoea each year. Millions more are hospitalised and require urgent medical care to stop them suffering chronic dehydration and dying. And the number in Bangladesh, despite the use of oral saline, is still too large.

    Unfortunately, more than half the population of 130 million people do not have either access to safe drinking water and sanitary toilets - and it is believed that at the current rate of progress it will take more than 50 years before everyone does. In villages across the country, it is seen cows and other livestock being washed in the same water that is used for human consumption.

    What is most alarming is the fact that it is children who are most vulnerable to this disease. Children, who are malnourished suffer much more; in turn, diarrhoea weakens children and makes them more malnourished. Diarrhoea is also a major cause of child malnutrition.

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    5. Polluted Water Increases Risk of Cancer

    Rivers of Indian-Subcontinent, were increasingly contaminated over the years , primarily by discharge from an oil refinery, petrochemical and fertilizer plants, and untreated sewage disposal, and agrochemicals . As the exposure to pollutants increased, the rates of cancer incidence rose, and marine life was more severely damaged.

    Pollution in the Ganges Brahmaputra Delta Plain

    Increased risks for cancer were associated with organ sites having the highest contact with the water or in tissues with the known affinities of many of the reported toxics in the water,” the authors conclude. Routes of exposure and associated cancers included direct exposure via the skin (melanoma) and gastrointestinal tract (stomach, bowel, and salivary gland cancers), inhalation of heavy metals and volatile chemicals (lung), and absorption and deposition of carcinogens in fat-soluble target tissues (blood-forming organs and central nervous system).

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    How safe is bottled water?

    Branded bottled water sold in the country is said to be free from pesticide residue and foreign particles. But at least three voluntary organisations which tested it,, have a different story to tell.

    NOT SO long ago, water was considered a divine gift and it was always available in plenty. Nobody ever dared to refuse water to anybody who needed it. Similarly people quenched their thirst without questioning the source of water. For, water was not manufactured nor was it a commercialised product. Sale and adulteration of water was never heard of. But today, drinking water is a tradable commodity. With lakes and wells drying up, and rivers getting polluted, consumers are increasingly looking towards bottled water as a means of meeting some of their daily requirements. As a result, bottled water is a big business with a turnover of Rs. 1,000 crore. And a litre of drinking water costs anything between Rs. 10 and Rs.15, a few rupees more than a litre of milk.

    Yet, how safe is the bottled water? Are consumers getting value for their money? At least three voluntary organisations, which tested bottled water, have a different story to tell. The latest report from the Centre for Science and Environment (CSE) has found pesticide residues in more than the permissible limits in bottled water. The CSE analysed 17 brands purchased in Delhi and 13 brands from Mumbai and has reported that most of the brands contained as much as five different pesticide residues. Forgetting the controversy of standards used for testing the water, it is well established that bottled water is not all that safe.

    This is not the first time that bottled water has been found unsafe. In February 1998, while the BIS certification was not mandatory, the Ahmedabad-based Consumer Education and Research Society had done a similar study and found that out of 13 brands (eight drinking water and five mineral water) tested, only three brands conformed to all the required specifications. Tests were conducted against 27 parameters under the Prevention of Food Adulteration Act (PA) and 37 parameters of the Bureau of Indian Standards (BIS) and some of the standards in US Food and Drugs Administration, Codex and World Health Organisation were also referred.

    To make water safe, the level of arsenic, a cumulative poison, should not be more than 0.05 ppm as per IS and PFA standards. Arsenic is a common element in the earth's crust and can be found in minute quantities in many foods and water. But level beyond 0.05 ppm may lead to toxicity of water. One brand had arsenic up to 0.1 ppm and in the other brand, the level of aluminium was 0.2 ppm against the limit of 0.03 ppm. Aluminium is associated with Alzheimer's disease. Aluminium in water can be a problem for two specific groups - kidney dialysis patients and premature babies. This brand also indicated a higher presence of fluorides. Five brands of drinking water carried floating particles, visible to the naked eye.

    Almost all brands label their products as "germ free" and "bacteria free". But the fact is something different. No brand was free from bacteria though all were found to be non-pathogenic. In other words, these bacteria do not cause any disease. Another interesting finding was that same brands bottled in different parts of the country showed disparity in their composition and quality. So, should these brands be allowed to be sold in a single name?

    It appears that there is not much difference in mineral water and bottled drinking water as sold in Indian markets. Mineral water should contain a minimum of 250 ppm of Total Dissolved Solids (TDS) as set by the US, FDA. Such standards are not available in India. Surprisingly, the test found that one brand had a TDS of 299 ppm, though there was no such claim on the label.

    In March 1999, the Delhi-based Voluntary Organisation in the Interest of Consumer Education (VOICE) conducted a test of bottled mineral water. The 12 brands selected were Purettee, Fountain, Yes, Ganga, Bisleri, Florida, Himalayan, Golden Eagle, to name a few. The samples were tested for the presence of heavy metals, mercury, nitrate, cyanide, arsenic, alkalinity, fluoride etc. All the 12 were within the prescribed range and were said to be chemically safe. As per BIS specification, the minimum TDS for mineral water is 150 mg. per litre and maximum is 700 mg. per litre. Only three brands qualify for this category. On the other hand, brands such as Bisleri, Golden Eagle, Prime, and Bailey failed to qualify as they were far below the minimum required level of TDS.

    In the absence of universal standards for bottled drinking water and mineral water coupled with strict enforcement machinery, it is doubtful, consumers will be able to get safe drinking water. The best preventive method is to boil water before drinking. If that is so, why not go for water supplied by the government owned water boards? (Y.G. MURALIDHARA, The hindu, Feb. 13, 2003).

    6. DIRTY MINERAL WATER


    A sight I have seen ever so often at railway stations, are urchins running with empty mineral water bottles to taps on platforms, filling them up and then selling them to passengers, as genuine packaged drinking water. There is nothing furtive in the actions of these little fellows, they do it openly and everybody sees what they are up to. What is surprising is the public buying the bottled water, after knowing it was just filled from dirty tap around the corner..! What fools them into doing this is the bottle.

    On the bottle is still displayed the name of the company who first bottled the water. The label is still intact. The blue cap is still very much in place, without a seal of course, but who cares. The shape of the bottle still says seductively, 'drink me, I'm pure," and the water is drunk. Dirty, filthy, water..! And the packaging continues trapping us.In khaki uniform, we think 'security'! Blue helmet and we feel safe with fire! White Gandhi cap and are country is safe..!

    Day after day we are fooled by the bottle syndrome and drink the dirty water inside. The khakis we feel so secure about is wrapped around thousands of dishonest cops. Walk into any police station in this country and watch policemen making money hand over fist, day after day after day.

    The blue, fire fighters uniform. Most fire fighting units have a broker who negotiates the amount a builder has to pay to get past safety norms. There are buildings now in cities which have no room for fire engines to enter. There are restaurants whose kitchens are gas chambers waiting to explode. Theatres, with no fire exits. Shopping malls made of inflammable material .!

    And the politician. Ah the man who has been elected to serve his people. His whole interest in making as much money in his term in office, whether its crossing the floor a dozen times or turning a blind eye to every thing illegal. The white cap like mineral water bottle contains a head of corruption.

    What fools us is the bottle.

    dirty water for saleIts not that we don't know that inside the bottle is muck. It's just that we couldn't care less. We have reached a sad stage when we are too lazy to throw out the water. "So what?" we say. Meanwhile starched khaki droops inside and Gandhi cap covers rot.Mumbai saw the arrest of a man who was police chief just a day ago.

    Is there shock? Not really. The police are corrupt, we say. And life goes on.

    We drink the water the urchins bring to us. We smile at lovely bottle and don't feel disease and germ creep down throat. Wake up, before its too late. The vomit is beginning to surface (Robert Clements, Independent, December3, 2003).

    Bottled danger: Old Dhaka traders make quick bucks

    Unscrupulous traders in Old Dhaka fill up thousands of empty plastic water bottles with tap water and fix fake security seals to them for commercial sale. An investigation by The Daily Star yesterday revealed that these traders in Chankharpool and Keraniganj are doing a booming business in fake mineral water, posing serious health hazard. Some of the traders said they buy each 'flawless' bottle for Tk 0.20.

    "Bottles with dents or without proper labels are rejected. But we don't mind if the lids are damaged since these could be produced elsewhere," said one of the traders at Nawab Katra Road. Another trader, who purchases such used bottles worth around Tk 2,000 to Tk 5,000 a day, said, "We resell the bottles to some other traders who clean them and refill them with plain water. These are then supplied to markets."

    After filling up, the bottles are wrapped with transparent plastic sheet and put in boxes, just as the original manufacturers would do. The finished products look exactly like the original ones. There are several small tin-shed 'plants' in Keraniganj where such brisk businesses are going on for years. It is alleged that the traders pay huge bribes to local police to run the illegal business openly (The Daily Star, October 1, 2003).

    The Daily Star story on the bottled water scandal goes to show how vulnerable our heath is at the hands of some unscrupulous traders. They have been filling up empty plastic containers collected from sundry places with tap water and selling these off as mineral water with fake security seals affixed. This is the height of commercial fraudulence surreptitiously at work. It is dumfounding to note how indifferent those traders could be to the health hazard their business has been causing to the consumers. They did not seem to have any qualms in admitting and explaining how their illegal trade operated. They even improvised on the bottles to make them look like the originals.

    Bangla daily Prothom Alo has also reported that Bangladesh Standards and Testing Institution (BSTI) seized huge jars of adulterated water of a company that does not even have a trade licence. The old Dhaka story only showed it was a tip of the iceberg. BSTI along with the law enforcers must protect the interests of consumers. It is time we had a consumer law, which understandably, has been on the anvil for too long for any comfort.

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    7. COLANISATION'S DIRTY DOZEN

    12 brands of cold drinks put to the test the coolest event of our times. They put to the test the most aggressive, glitzy, gutsy, premium, imaginative, high-quality, expensive and successful attempt to globally grab people's stomach share. As it turns out, Pepsi, Mountain Dew, Diet Pepsi, Mirinda orange, Mirinda lemon, Blue Pepsi, 7-Up, Coca-Cola, Fanta, Limca, Sprite, and Thums Up are indeed colanisation's dirty dozen

    The Pollution Monitoring Laboratory (PML) of the Centre for Science and Environment (CSE) places in the public domain its analysis of the contents of 12 cold drink brands sold in Delhi.

    The test found: organochlorine pesticidesLINDANE (ý-HCH):

    This deadly insecticide damages the body's central nervous system as well as immune system and is a confirmed carcinogen.
    It was found in 100 per cent of cold drink samples. Its concentration ranged from 0.0008 milligram per litre (mg/l) to 0.0042 mg/l in the samples tested. This last amount is 42 times the 0.0001 mg/l EEC limit - a set of standards stipulated by the European Economic Commission to control contamination in water used as 'food' - for maximum admissible concentration for an individual pesticide. It was found in Mirinda lemon. On an average, lindane concentration in all brands was 0.0021 mg/l, or 21 times higher than the EEC norm/p>

    In the popular Coca-Cola brand lindane concentration was 0.0035 mg/l - a level of concentration which was 35 times higher than the EEC norms.

    DDT AND ITS METABOLITES (DDD & DDE):

    ): Also detected in 81 per cent of the samples. Absent in Diet Pepsi, their concentration is as high as 0.0042 mg/l in Mirinda lemon (42 times higher than EEC norms). On average, total DDT and metabolites found in the samples stood at 0.0015 mg/l, 15 times higher than EEC limits. In the popular Pepsi brand it was 16 times higher than EEC norms. In the equally popular Coca-Cola brand, it was 9 times higher than the EEC limit.

    Organophosphorus pesticides

    CHLOROPYRIFOS: Especially dangerous for mothers-to-be and babies as it is a suspected neuroteratogen (it causes malformations in foetuses), this pesticide was found in 100 per cent of the samples. Maximum concentration was in Mirinda lemon flavour: 0.0072 mg/l , or 72 times more than the EEC single-pesticide norm. The average amount of chlorpyrifos found in all samples was 0.0042 mg/l , 42 times higher than the EEC norm.

    MALATHION: Detected in 97 per cent of the samples, its concentration was highest in a Mirinda lemon sample: 0.0196 mg/l , or 196 times the EEC limit for a single pesticide. Coca-Cola had malathion 137 times higher than EEC norms. Malathion gets activated in the human liver to produce malaoxon, deadly for the nervous system. It is also a confirmed mutagen - it can tinker with the body's chromosomal set-up.

    Forget pesticides. Standards for other substances - such as heavy metals like arsenic or lead - also are many times above the guidelines for drinking water issued by the ministry of urban development (Source CSE, 2003)

    In Bangladesh analytical data is not available but likely to contain the same trend.

    Indian probe confirms Coke, Pepsi contain pesticide

    A parliamentary probe said Wednesday (4. 02. 04) that soft drinks sold in India by US beverage giants Coca-Cola and Pepsi contained pesticide residue and urged tougher national health standards. The investigation was ordered after a private New Delhi-based environmental group, the Centre for Science and Environment (CSE), reported in July that 12 of the companies' soft drinks had such high pesticide levels they could lead to cancer and other diseases. "The committee has concluded that CSE stands corroborated on its finding pesticide residues in the soft drinks," the investigation said. But the 184-page report stopped short of telling Indians to avoid the soft drinks and instead called for the country to adopt more stringent safety standards. It said the "eventual goal" should be to eliminate any trace of pesticides in soft drinks sold in India.

    "It is prudent to seek complete freedom from pesticide residues in sweetened aereated waters," it added. "The committee has appreciated the whistle-blowing act of CSE in alerting the nation to an issue with major implications." Coca-Cola and Pepsi both deny their drinks pose any health hazards. "Our products manufactured in India are world-class and safe. We follow one quality system across the world," Coca-Cola India said in a statement. The CSE report, which said the fizzy drinks carried a "deadly cocktail of pesticide residues," triggered nationwide protests against Pepsi and Coca-Cola and even a temporary ban on the 12 beverages at the parliament's canteen.

    An initial government probe released August 21 found that the 12 soft drinks were "well within the safety limits" of India. But opposition lawmakers demanded a more thorough investigation, leading to the latest study in which two government laboratories researched 36 soft drink samples. India's growing 500 million-dollar-a-year soft drink industry saw sales slide by as much as 15 percent in the month after the CSE report. But the parliamentary probe noted that the billion-plus country still had one of the lowest rates of soft drink consumption at six bottles per person each year compared with 800 in the United States. (AFP, NEW DELHI, February 6, 2004).

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    8. World’s water problem

    A wide range of water problems faces nations and individuals around the world. These problems include international and regional disputes over water, water scarcity and contamination, unsustainable use of groundwater, ecological degradation, and the threat of climate change. At the heart of the world’s water problems, however, is the failure to provide even the most basic water services for billions of people and the devastating human health problems associated with that failure.

    The failure to provide safe drinking water and adequate sanitation services to all people is perhaps the greatest development failure of the 20 th century. The most egregious consequence of this failure is the high rate of mortality among young children from preventable water-related diseases. .

    According to the U.S. Bureau of the Census international data group and UN population estimates, global population between 2000 and 2020 will grow from just over 6 billion to as much as 7.5 billion, with most of the increase in developing countries of Africa and Asia (UN 2000, US Census 2002). Projections of future water-related deaths will depend on these future population estimates as well as a wide range of other factors.

    67 per cent of the people in Bangladesh do not have sanitation facilities.Now this is a serious problem as experience tells us that conventional sanitation programmes do not bring the desired results .One to focus attention on a problem that seems to be intractable and to emphasise the need for governments of the region to take up a more positive role in providing sanitary latrines to the poor. Promoting hygiene in a country where a large part of the population is illiterate, is no easy task but side by side with promotion activities, an awareness-raising programme is essential. But for those who cannot afford to pay, some arrangement must be made to supply them with sanitary latrines free of cost or on easy installments.

    As many as 76 million people will die by 2020 of preventable water-related diseases

    The failure to meet basic human needs for water is widely acknowledged to be a major development failure of the 20 th century. Yet efforts to provide universal coverage for water and sanitation continue to be largely rhetorical and piecemeal. The price for this failure will be paid by the poorest populations of the world in sickness, lost educational and employment opportunities, and for a staggeringly large number of people, early death.
    Even if the official United Nations Millennium Goals set for water are met – which is unlikely given the current level of commitments by national governments and international aid agencies – as many as 76 million people will die by 2020 of preventable water-related diseases. This is morally unacceptable in a world that values equity and decency, but at the present time, it appears unavoidable unless we rethink our approach to providing water and sanitation services and redouble international efforts to aid those lacking this most basic of human needs (Peter H. Gleick, August 15, 2002.)

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