The ICN’s position statement for universal access to clean water supports the Millennium Development Goal Seven (MDG7), the number of people without access to safe water and basic sanitation will be cut in half by the year 2015 (WHO, 2013). Clean water is necessary for optimum health. Statistics The ICN Position Statement, universal access to clean water, is important for nurses because “dirty water and poor sanitation kill more children than AIDS, Malaria, and Measles combined” ("World water day 2013," n. . ). More than one billion people do not have access to clean water and more than two billion people do not have access to “improved sanitary facilities” (WHO, 2013). World Health Organization, WHO, also reports that more than two million people die every year, due to mostly preventable diarrhea conditions. Many of the two million that die every year due to lack of clean water, and lack of sanitary conditions, are children under the age of five (WHO, 2013).
Drop in the bucket is a non-profit organization that builds wells and sanitation systems at schools in Africa; they report “more people have access to a cell phone than a toilet” ("Solutions," n. d. ). World Water Day Many groups are working to meet the MDG 7: WHO, UNICEF, CARE USA, Drop in the bucket, and many more. World Water Day 2013 is March 22; this day is set aside to raise awareness that many of our global population do not have the basic sanitary needs that most of us in the United States take for granted.
Helene Gayle, President and CEO of CARE USA, suggests that “we must work together to raise awareness” and that “on World Water Day, March 22, join us by standing in solidarity with people in poor communities” (CARE USA, n. d. ). Meeting MDG7 will also help meet Millennium Development Goal Two, MDG2, achieving universal primary education, Goal Three, MDG3, promoting gender equality and empowering women and Goal Four, MDG4, reducing child mortality. Dirty Water Complications Cleaning up the water is not as simple as it may initially sound. To have clean water there must also be basic sanitation.
In many areas of the world, people get their drinking water from the same place that they wash in. WHO reports that over one billion people defecate in the open, causing environmental contamination (2013). The open defecating causes increased incidence of cholera, shigellosis, hepatitis, salmonellosis, and possible infestation of worms. Clean water and soap are also necessary for hand washing. Miller, and Gibson indicates that not having enough clean water can also contribute to dehydration and electrolyte imbalance, problems with incontinence, constipation and urinary tract infections (2012).
Education is needed to teach the importance of good hygiene. In areas without clean water access, the burden to get clean water is on women and girls. The women must walk to the nearest clean water, sometimes spending hours walking every day to obtain the clean water. Women would have more time to earn an income if they were not spending time fetching water for their family. “Over 40 billion work hours are lost in Africa [due] to the need to fetch drinking water” ("Billions struggle without clean water or basic sanitation," 2005).
CARE USA encourages women to lead their families and communities in teaching and educating the importance of essentials, like hand washing (n. d. ). Many of the schools do not offer clean water, if the children want water to drink, or to clean with, they must carry it to school in containers. Some children will avoid using the open latrines at school because of flies, foul odor, and lack of privacy. If the girls are going to school, they will usually quit school at the age of puberty because of the embarrassment associated with the menstrual cycle, and the lack of soap and water (CARE USA, n. . ). Having basic sanitary abilities and clean water can keep the girls in school, fulfilling MDG3. Due to lack of basic sanitation, girls will often hold their bowel movements until it is dark, which increases the risk of being attacked by wild animals, bitten by bugs or snakes, or being raped ("Four ways toilets change girls' lives," n. d. ). Care USA promotes a program called SWASH, (school wash), and works to provide clean latrines, soap and water, and touts that the program “prevents disease” and the girls will stay in school (CARE USA, n. d. ). Ending Open Defecation
Contamination of water by fecal coliform is usually due to poor management of resources (Massoud, Al-Abady, Jurdi & Nuwayhid, 2010). “Community Approaches to Total Sanitation (CATS) is supported by UNICEF and is in 50 countries around the world” (UNICEF, n. d. ). The individuals from the communities work together to end open defecation, by setting their own goals, and working together to design a program to suit the needs of the community. Even areas of extreme poverty such as Sudan have been able to have success in five communities demonstrating that poverty is a barrier that can be overcome. No operation in the world can provide toilets for 1. 1 billion people. They have to do it for themselves – with support. And we’ve found, in fact, that it is only when they do it for themselves that the changes are achievable and sustainable” (UNICEF, n. d. ). When a goal is set by the people who are trying to achieve it, they are more likely to be inspired to succeed. Water Treatment Options A centralized solution to the rural communities of the globe is not a practical solution. Solutions need to be available where the people are, at the point of use.
One way to clean the water is by boiling. Boiling water costs roughly ten dollars per person, per year. Wood for the fire is not available everywhere and the smoke from the fire can cause respiratory problems. Another way to clean water is with a sand filter, but most sources suggest this is not practical due to the size and cost. The size is too large for the average family and the space is not available to store the unit. Using bleach is another option to treat water. Bleach is relatively cheap water treatment. A con to using bleach is that there can be a bleach odor or taste.
Solar disinfection is another method being used to treat water. It is not as effective if the water has a high level of turbidity. Procter and Gamble PUR water purification system is a disinfection system that is easy to use and works well at removing pathogens. PUR can leave a ‘bleachy” taste and odor. Using the PUR water treatment system cost approximately six dollars per person, per year ("Water, sanitation, and health in developing countries," n. d. ). Successful Ideas Drop in the bucket has several inspirational ideas on how to assist communities in obtaining clean water and basic sanitation.
Using “sewage eater flush toilets” in areas that have open pit latrines is an improvement in sanitation. The toilet does not use electricity, and it treats the sewage using microbial activity. This is a low maintenance option due to the microbial activity being self-sustaining. The sewage eater flush toilets do not smell, or attract flies, and never fill up. Drop in the bucket recommends hand washing after using the restroom to decrease the spread of pathogens and disease. Since it is not recommended that a water source be near the sanitary facilities, Drop in the bucket supports use of a “round about”.
The “round about” is essentially a merry-go-round, and uses the energy of children at play to pump water to a water tower near the sanitary facilities. The water tower provides water for the hand washing stations that are located at the base of the tower. Drop in the bucket supports “essential flow funding”. “VSLA program is a highly structured system of saving, borrowing and lending money generated from local contributions that provides a financial incentive for those in the community to maintain the wells” ("Solutions," n. d. ).
The program is set up to maintain water supplies for communities and is operated by members of the community. The well and pump are installed, and local members of the community are trained to maintain and repair the well. The persons trained also get paid to maintain the well. The community members pay a small fee for use, which is then used for maintenance of the well. The money can be loaned to members of the community and used to encourage business ventures within the community ("Solutions," n. d. ). The system provides a sense of pride through independence, and cohesiveness within the community.
United States Water The United States has well established water and sewage systems in place, but has other problems. Many towns and cities have chemicals in their water supply that can cause cancer, lead poisoning, kidney failure, Parkinson’s disease, and many other illnesses. In 1974, the Safe Drinking Water Act was created. At that time 91 contaminants were listed as unsafe to be in the drinking water. There are now more than 60,000 chemicals in the U. S. Since 1974 we have learned that many of the contaminants that were thought safe in large amounts are not safe in small amounts.
The EPA has determined healthy levels of most of the chemicals, but the legal levels have not been updated. Communities are required to treat the water supply to keep the levels of contaminants below the legal level, when many times the healthy level is significantly below the legal level. In 2009 the New York Times published a series called Toxic Waters. This series listed several cities that have serious problems with their water supply. Arsenic levels in three cities were at levels that are associated with Cancer, the cities are Scottsdale, Arizona, Reno, Nevada and El Paso Texas, and these cities were still below the legal limits.
Also, Uranium levels were high enough to cause kidney damage in Edmond, OK, Millville, NJ, and Pleasantville, NJ; again the levels were below the legal limits. In Los Angeles, a water reservoir was known to have chemicals in it that when exposed to the sun became carcinogenic; the reservoir was covered in black plastic balls to prevent the sun from entering the water. The reservoir is now an eye sore and the community does not understand why it needed to be done if the water tested below the legal limits (Duhigg & Palmer, 2009).
What’s In Your Water? Go to http://www. ewg. org/tap-water/ to find out what is in your water. In my area, the water supply has contained high levels of lead, radium 226, radium 228, alpha particle activity, and tetrachloroethylene. I was shocked. Jet fuel can be in the water supply in the United States and it will still comply with federal regulations, per the Safe Drinking Water Act. The contaminants that are regulated by the Safe Drinking Water Act have not been updated since 2000.
There has been inaction on updating the list of regulated contaminates because communities fear higher prices for their water, industry and businesses fear the cost will be too high to remove the contaminants and have lobbied against more regulations. The lobbyists have been successful. Conclusion The community needs to be aware of contaminates in their water supply and take steps to make changes. Talk to your congressman and representative, encourage them to update the Safe Drinking Water Act, using the knowledge that is currently available from the EPA, and make regular updates to the act.
On a local level registered voters should approve tax increases for improved sanitation in the water department, to make the water safe to drink; the choice is to pay now or pay later with your health, an easy choice. If clean water were available to all people, there would be less sickness globally, and nurses could concentrate on other medical needs. In the long term, the fiscal savings will be significant. Nurses can support the ICN position that “the right to clean water is non-negotiable” (ICN, 2008) by supporting and joining professional organizations that lobby for clean water.
There are also many opportunities for volunteering and fund raising that support the cause. The Millennium Development Goal Seven target, to cut in half those that are without clean water by 2015, should be met, but that sanitation part of the goal will not be met ("Billions struggle without clean water or basic sanitation," 2005). The WHO/UNICEF Thematic Report on Drinking Water indicates that meeting the 2015 goal for safe water will still leave 672 million people without safe drinking water (2011). Without meeting this goal, girls will not get needed education, and children will continue to die from preventable diseases, as will adults.
Florence Nightingale indicated that nurses should use the best methods that are available, that we should learn and practice those methods and that “health is not only to be well, but to use well every power we have” (Nightingale, 1851). References Billions struggle without clean water or basic sanitation. (2005). Journal of Advanced Nursing, 49(2), 223. Duhigg, C. , & Palmer, G. (2009, December 16). That Tap Water Is Legal but May Be Unhealthy. The New York Times. Retrieved from http://www. nytimes. com/2009/12/17/us/17water. html? pagewanted=6 Four ways toilets change girls' lives. n. d. ). Water. org. Retrieved from http://power. water. org/post/four-ways-toilets-change-girls-lives/ Massoud, M. , Al-Abady, A. , Jurdi, M. , & Nuwayhid, I. (2010). The challenges of sustainable access to safe drinking water in rural areas of developing countries: case of Zawtar El-Charkieh, Southern Lebanon. Journal Of Environmental Health, 72(10), 24-30. Miller, J. , & Gibson, S. (2012). Positive impact of water on children’s health and wellbeing. British Journal Of School Nursing, 7(1), 8-9. Nightingale, F. (1851). The institution of Kaiserswerth in the Rhine.
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