Children at risk of waterborne diseases

An edited version of this article was first published in The Express Tribune on Oct 22, 2012, as part of a special report on water quality in the twin cities of Rawalpindi and Islamabad.

Islamabad – Kids in the federal capital and surrounding areas might be at a greater risk of falling prey to waterborne diseases than adults.

“Although waterborne diseases can affect children and adults equally since the mode of infection is the same, kids have a greater propensity to contract these diseases because their immunity levels are less developed,” Dr Shahzad Munir, head of pediatrics at the Polyclinic Hospital in Islamabad, said.

Almost 57 percent of all children admitted to the Polyclinic pediatrics department in August suffered from waterborne diseases. The major diseases affecting children in this category include acute gastroenteritis, dysentery, hepatitis A and typhoid fever.

Another reason for the high number of kids affected by waterborne diseases is simply that children form a huge chunk of the population, Dr Munir said.

Exactly 35 per cent of Pakistan’s population is below the age of 15, according to 2012 estimates by the Population Reference Bureau, an international organization that collects population data.
Several practices help the spread of waterborne diseases.

“Lack of both personal hygiene and proper sanitation facilities contribute to the spread of waterborne diseases,” Dr Munir said.

Dr Munir said infection in toddlers sometimes spreads through utensils when the babies are not breastfed.

But the main culprit is contaminated water.

“Islamabad is more than fifty years old now and some of its water supply lines are in need of repairs,” Dr Munir said. He said the sewerage lines sometimes come in contact with the drinking water and contaminate it, so regular maintenance of the supply lines is necessary.

“If you move some 20 kilometres away from Islamabad toward the suburbs, people don’t even get tap water,” he added. “They use boring or water from wells, and that water might not be fit for drinking. So lack of clean drinking water is a major factor.”

Dr Munir said CDA should put up certificates of water quality at its filtration plants and people should make sure the certificates are not expired before they use water from those plants.

Statistics on waterborne diseases in Islamabad are difficult to find and where they are available, it’s equally problematic to vouch for their accuracy. At Polyclinic’s pediatrics department, Dr Munir said he had just started data collection after taking charge a couple of months ago.

At the children hospital of the Pakistan Institute of Medical Sciences (PIMS), data about waterborne diseases are being recorded at the Isolation ward apparently but those data reports are not being compiled and stored at the computer department.

No statistics were available on gastroenteritis, typhoid and hepatitis A was available at the PIMS children hospital. The computer department was only able to provide statistics on diarrhea.

From June to August 2012, the children’s hospital received a combined total of 1,571 diarrhea patients at its Diarrhea Training Unit and the Accidents & Emergency centre.

Diarrheal diseases are more prevalent in the summers because of increased water consumption according to Dr Munir, but the diarrhea patients at the PIMS children hospital’s emergency centre are only 3.5 per cent of its total admissions from June to August.

Harmless as it might sound, diarrhea is not to be taken lightly. According to the findings of the Pakistan Demographic and Health Survey 2006-07, diarrhea was responsible for 10.8 per cent of all under-five children deaths in Pakistan.

Dr Munir suggested a three pronged strategy to fight waterborne diseases: Proper maintenance of water supply lines in the city should be carried out to ensure sewerage doesn’t seep in to drinking water, campaigns should be run to raise awareness about personal hygiene and people should not compromise on the vaccinations of their children.

“Typhoid and Hepatitis A are fully preventable with vaccinations,” Dr Munir said.

·    Handwashing with soap and water can reduce diarrhoea among children under five years by up to 50 per cent. (2004 research paper titled ‘Effect of Intensive Handwashing Promotion on Childhood Diarrhea in High-Risk Communities in Pakistan’ written by Dr Stephen P. Luby, a University of Michigan professor and expert on diarrheal diseases, and his team.)
·    Improved sanitation can reduce under five children diarrhoea by up to 34 per cent (UNICEF)

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