Water and disease

Last Saturday, the Ministry of Health issued a press release in which it revealed that for the first four weeks this year over 11,000 cases of diarrhoeal disease had been reported, representing a slight increase in the numbers reported for the corresponding period in 2009. The release duly trotted out the statistics according to age group for the first month of this year as well as the totals for the whole of last year. The seasonality of gastroenteritis was referred to (the highest incidence occurring in December, January, February and March) as well as the causes of diarrhoeal illnesses.

Stating that “good hygiene will work all the time” the ministry in its press release advised citizens to guard against contracting diarrhoeal diseases by observing such practices as regular hand-washing or the use of sanitisers, boiling water for drinking purposes or using bleach to disinfect it, cooking food thoroughly and washing fruits and vegetables before use.

The ministry said it had been receiving “an unusual” number of calls from the public regarding diarrhoeal diseases and it listed the usual causes of these diseases as staph, E. coli, rotarvirus, salmonella, shigella, and some common parasites, while stating that the reason for the increased cases in Guyana was not known. Typically, the main cause of diarrhoeal diseases here has been contaminated water, followed perhaps by poor hygiene practices usually because of a lack of access to potable water.

Though there is probably no empirical evidence to support this, there is definitely a connection between the seasonality of diarrhoeal diseases and Guyana’s wet/dry spells. In the wet season, especially when there is flooding, there is usually a higher risk of water being contaminated and citizens are advised to boil water or disinfect it with bleach before use. Lack of access to water is linked to unhygienic practices, which the Health Ministry has urged citizens to be wary of and which typically happen in the dry season.

Just prior to the Health Ministry’s statement, Guyana Water Incorporated (GWI) had noted that the ongoing dry season had occasioned a countrywide water shortage and urged that citizens conserve. The Ministry of Agriculture and Cabinet Secretary Dr Roger Luncheon reiterated this, though the latter in his usual less than erudite fashion, referred to “voluntary” and “involuntary” conservation, meaning that GWI would just cut the water off, if citizens did not heed the conservation call.

So here we have a Catch 22 situation; there is a need for absolute observance of good hygiene because of the looming threat of an outbreak of diarrhoeal disease, but water to promote such practices is scarce. Not that this is a new phenomenon, it has occurred before and will no doubt continue for as long as central Georgetown’s dependence on surface water endures.

In addition, despite the fact that numerous studies on water indicate that water purified at the source is not the safest water there is, GWI insists that the water it produces is safe for household use, expect for instances when it issues ‘boil’ orders, and that its rusty colour is not an indication of impurity. However, given the numerous leaks in the local system, which GWI admits are there, purification at the household level should be the rule rather than the exception. Certainly, if the Ministry of Health is determined to reduce the incidence of diarrhoeal diseases, which sometimes result in deaths depending on the age of those infected and their access to medical resources, one sure way of doing so would be to halt the pretence that chlorination and other treatments at wells and surface facilities is sufficient. The ministry should ensure that GWI works with it in promoting household interventions such as filtering, boiling or bleaching in addition to the source treatment.