IWRA World Water Congress 2008 Montpellier France
1. Water availability, use and management
Health Impact, water supply, sanitation, epidemiology
AbstractIntroduction: Water and sanitation are ones of the primary drivers of public health. Health status is closely related to
the quality of drinking water (water-borne diseases), to its scarcity (water-scarce diseases) and to the efficacy of
wastewater treatment. A very large water program was designed for the 2004-2008 period to improve water supply
and sanitation coverage in the urban coastal districts of Tangier (750,000 inhabitants). At the same time, a monitoring
study was undertaken to assess the health benefit of this program and is ongoing.
Methods: An epidemiological
register was implemented in 17 health facilities in order to follow the incidence of three water-related diseases:
diarrhoea in children under 5, conjunctivitis and skin diseases in the overall population. At the same time, twice-
yearly surveys were conducted in two pilot districts which had no water supply other than wells/fountains nor
wastewater systems, at the beginning of the study. Each time, 70 households (≈400 people) were questioned
to qualify water use, hygiene practices, health outcomes, exposure to sea bathing. Water samples were also
collected for microbiological analyses. Finally, a fortnightly monitoring of the microbiological quality of sea water and
beaches sand was also set up.
Results: Available data were collected before the widespread opening of the water
supply and waste water system.
From September 2004 to December 2005, 2,780 cases of diarrhoea in children
(1% severe), 2,112 cases of conjunctivitis and 2,016 cases of skin infection (bacterial or fungic infection) were
treated in the public health care facilities of Tangier.
One of the two surveyed areas was characterised by the
opening of a new fountain which markedly reduced 1°) the average distance between homes and the nearest water
source from 580m to 130m; 2°) the percentage of contaminated drinking water from 93% to 46%; 3°) the
percentage of children under 5 with diarrhoea in the last month from 45% to 26%.
Conclusion: Waiting for the
end of civil engineering works these first promising results need to be confirmed both for the health impact and the
quality of drinking and sea water.