SANIHEALTH CONCERN NEWS

Water, sanitation and hygiene for the prevention of diarrhoea.

Cairncross S, Hunt C, Boisson S, Bostoen K, Curtis V, Fung IC, Schmidt WP.
London School of Hygiene & Tropical Medicine, Department of Infectious & Tropical

Diseases, London, UK. sandy.cairncross@lshtm.ac.uk

BACKGROUND: Ever since John Snow's intervention on the Broad St pump, the effect

of water quality, hygiene and sanitation in preventing diarrhoea deaths has

always been debated. The evidence identified in previous reviews is of variable

quality, and mostly relates to morbidity rather than mortality.

METHODS: We drew on three systematic reviews, two of them for the Cochrane Collaboration, focussed

on the effect of handwashing with soap on diarrhoea, of water quality improvement and of excreta disposal, respectively. The estimated effect on diarrhoea mortality was determined by applying the rules adopted for this supplement, where appropriate.

RESULTS: The striking effect of handwashing with soap is consistent across various study designs and pathogens, though it depends on access to water. The effect of water treatment appears similarly large, but is not found in few blinded studies, suggesting that it may be partly due to the placebo effect. There is very little rigorous evidence for the health benefit of sanitation; four intervention studies were eventually identified, though they were all quasi-randomized, had morbidity as the outcome, and were in Chinese.

CONCLUSION: We propose diarrhoea risk reductions of 48, 17 and 36%, associated respectively, with handwashing with soap, improved water quality and excreta disposal as the estimates of effect for the LiST model. Most of the evidence is of poor quality.

More trials are needed, but the evidence is nonetheless strong enough to support

the provision of water supply, sanitation and hygiene for all.

India, Mumbai: largest sanitation project nearing completion


April 7, 2010 · Leave a Comment

The Mumbai Metropolitan Region Development Authority (MMRDA) has completed 80% of the country’s largest sanitation project, Nirmal Mumbai Metropolitan Region Sanitation Abhiyan. “After conducting surveys, we found that the backlog between the demand and supply was around 25,000 seats,” said Ashwini Bhide, joint metropolitan commissioner, MMRDA. The project was started in February 2008 with the intention of providing areas with community toilets. The completion date is May 1. Of the 24,000 toilets planned, which includes urinals, 19,000 are ready for use. The project covers five municipal corporations and 13 municipal councils in the metropolitan region, which includes the suburbs and Thane.
“Most toilets are built by demolishing the defunct ones,” said CK Patil, chief of Nirmal Abhiyan. There are separate toilets for women, men, children and handicapped people, bathrooms and washbasins, and a room for the caretakers. The centres have continuous water and electricity supply, and have a usage charge of Rs30 to Rs50 [Euro 0.50 t0 0.83] per month, per family. Passes are given to each family and records are kept by the caretaker.
(Source: Joanna Lobo, DNA, 7 Apr 2010)