JayColingham-Writing Sample - PHA2011

Integrated Water Resource Management as
an International Development Method for
Increased Health
Jay Colingham
International Health and Development
Public Health Analysis
Spring 2011

Abstract
Man kind has traditionally followed water and chosen to live at the whim of it’s course. Over a
few centuries of engineering and the awareness of the Scientiﬁc Method, water has been one of
the most coveted and desired resource to civilization. Ancient Romans, Egyptians, Chinese, and
Mesopotamians all fought, monitored, engineered, and overused their water. In those same
locations today, the impacts of their failures are still visible in salinization of soil, destroyed
river banks, poor water quality, and canals. Current use has left many concerned about the
presence of scarcity and the growing danger of being unable to satiate the global demand for
water. Practiced control of water often does not have an integrated approach to conservation,
reuse, and the downstream user.
! Integrated Water Resource Management provides a programatic system to reduce water
use and involve strong levels of sustainability and reuse. The system is scalable but lends itself
to use in under developed regions that have not built an infrastructure. In urban settings,
municipalities can provide building codes, collect ﬁnes, and even control the treatment of water
for the end user. Rural communities do not have the capital necessary to create the
infrastructure for such amenities. In undeveloped areas, there is often a complete lack of
infrastructure, resulting in an absence of hygiene and sanitation. Using resource management
to control water has direct effects on population health, economics, education, waste, and the
need for international relief. With a multilateral approach culturally suited to the community
the program is implemented in, there can be strong growth with long term impacts and
program sustainability. Sanitation and hygiene are at once possible. Irrigation of crops and
biological fertilization through waste water bio-solids is available. Reduction of disease and
increases in productivity, equity, and abundance is an expected result. Implementing Integrated
Water Resource Management should be a consideration of any program in developing
communities.
Background
Water is part of every environment in which it exists. The mere presence of water can cause
permanent change to the surrounding landscape, lives, cultures, and health of the organisms it
contacts. With current conditions of freshwater access in mind, the ways population, health, and
environment were integrated in prior civilizations success and failure, and examples of change
Jay Colingham! ! ! ! ! ! Public Health Analysis 2

in water management that caused devastating results on a Malthusian level (Getzinger 2000) are
necessary to provide a successfully integrated model for water resource management. The
concept becomes evident that water was the root and means of most actions and reactions in
early civilization. Interestingly, some of the failures in early civilization reﬂects latter failures.
Previously, the existence of water allowed civilization to occur; now civilization creates a
demand to control and bring water.
! Cultural, technological, and governmental limitations to clean water leaves communities
unable to thrive and often hinders their health. With a population growth rate set to hit a
projected 8.9 billion people world wide in 2050 and urbanization to reach over 60% by 2030,
current infrastructure will not be able to provide at a functional level for the worlds population
(Getzinger 2000). Over 1 billion people do not currently have access to clean water with many
unable to access safe sanitary systems (WRI 2005). Agriculture is the largest user of water in
most developed countries and as urbanization increases, will become a major user of irrigated
water (Hlavinek, North Atlantic Treaty Organization. et al. 2006; Unesco 2006). With the high
erosion rate resulting from increased irrigation and fertilization, water treatment will become
important to reduce the illness, disease, and years of life lost in developing nations (Steininger
and Cogoy 2006). Integrated Water Resource Management is an approach used in many
developing parts of the world to provide both drinking water, irrigation water, and treat waste
water in the most effective manner available (Warner 2007; Wouters, Dukhovny*i et al. 2007).
! IWRM (Integrated Water Resource Management) is best thought of as the coordination
of most sustainable practices for procuring, distributing, reusing, and treating water (Reinhard,
Folmer et al. 2009). With rising costs on water and growing difﬁculty in attaining clean water
for drinking, the concept of a free good are simply no longer reasonable (Reinhard, Folmer et al.
2009). In Islam, water is called a free good in the Qu’ran by God through the prophet
Muhammed. For many Islamic republics, water is provided for free with high costs to the
government in the form of maintenance and provision. This is a growing problem for
developing a system and illustrates how all integrated water resource management systems will
need to be unique to the community it is implemented in.

Rationale
Early Historical Water conflict in Civilization
Water was the means of most actions and the root of many reactions in early civilization. This is
well demonstrated in the laws of Hammurabi’s Code in Mesopotamia and pertinence of
responsible water practices. Law 53 is summarized as anyone who does not maintain their dam
and causes harm to others crops will be forced into a lifetime of servitude to repay for the loss in
crops (Solomon 2010). Slavery, for misuse of water and affecting the food supply of a neighbor.
When considering that ‘an eye for an eye’ is what Hammurabi’s code is remembered as, the
levity of crops and responsible water use had a hefty value with parity to freedom. Despite
having a Pressure, State, and Response system in place, Mesopotamian civilization did not
initiate politics around the over-cultivation of crops on a plot of soil (Getzinger 2000). Like most
ancient civilizations, the land settled was very arable due to the constant flooding or rich river
sediments left by former waterways. In Mesopotamia, the soil supported a fast growing city-
state culture with urban centers surrounded by agriculture. Eventually, the over production
lead to high salinity levels of the soil and a large shift in crop cultivation. Unlike the modern
Machakos of Kenya, the Mesopotamians changed only their crop of choice and did not modify
their method of irrigation6. The transition from wheat to barley was not without problems.
Helioceptic barley provided two-thirds the nutrients of wheat and as predicted by Malthus
(Getzinger 2000), the population decreased to fit the food supply. At the point all soil fertility
would be depleted, the resource hungry civilization would have declined completely. Wars and
territorial capture began and continued with water and agricultural land a typical reason for
initiation. Irrigation water was a valuable resource and until the civilization integrated into
later cultures, the pressure of growth led to blood shed.
! In the Indus valley, very basic irrigation and agriculture was designed around the
constantly moving rivers. Civilization identified the need to meet population needs in the face
of urbanization such as covered sewer systems to prevent malaria. While the Indus were aware
of the Population-Environment interaction with refuse, waste water, and covered sewage, they
did not appear to show as much understanding in the control of river ways. As leaders in early
sanitation, they did exhibit a Pressure, State, and Response model for handling waste and the
waterborne disease Malaria (Getzinger 2000). Here, population size did not grow to levels

rivaling Rome and perhaps the lack of impact on the environment and waterways had a great
deal to do with this.
! Roman civilization grew and developed Rome into the first city that had one million
people, with needs and demands rivaling that of a modern mega-city. With the advantage of
incredible engineering and technological advances in water management through water wheels
and aqueducts, the Romans were able to provide sanitation to the households of the rich and
bath houses of the public. Their environmental practices on the little marshland they cultivated
resulted in a lower incidence of malaria due to decreased still water levels. Importing much of
their food, they utilized a great deal of water power for grinding grain using floating mills in
Rome’s harbor and a few water wheels for pumping water or pressurizing it where needed.
Economic, security, and resource pressures placed on the city eventually resulted in moving the
center to Constantinople. Over the course of the development and perpetual rebuilding of
Roman civilization, there was a consistent Boserupian intensification as a result of continual
strains put on resources (Getzinger 2000). Romans were previously known for their frugal
water practices and vast water and road projects under leaders like Alexander the Great, by the
time Constantine was the leader, the abundance and demand for wasteful water use such as
bath houses had exceeded their functionality and reach Caligula level waste. Todays Rome was
reunited under the ‘water Popes’ who rebuilt the aqueducts, baths, and finally the rest of the
water ways (Solomon 2010). Due to it’s long existence, there are many models of P-E that Rome
modeled in different times and places. Each great leader had a unique approach to the
environment. Alexander the Great sought to model it to his liking, Julius Caesar wanted to
simply take advantage of the profits of the environment, while early leaders like Apius
Claudius sought simply to provide early aqueducts and water sources to the growing city.
Perhaps a deviation to Malthusian models of over use, Marcus Agrippa used innovation and
urban planning to repair and rebuild a system for water and distribution that would have been
sustainable into further emperors terms had they not been destroyed by barbarian tribes and
attacks in subsequent years.
Water in the Renaissance
By 1500 AD, the ascent of western civilization was taking place, as were new problems in water
and eventually sanitation (Solomon 2010). Primarily, water served as a tool for trade,

exploration, domination, and increasing resource supply. This less pertinent use of water was
matched by the greater availability of water to a growing population and the need for more
food due to irrigation demands. None-the-less, the explorers learned lessons in health while
spending years at sea. Magellan’s crew spoke directly to the water carried onboard the ship and
it’s “putrid” and “yellow” nature (Solomon 2010). However, most of the western advancements
in industry, transportation, and even political organization were the result of some new
understanding of water. China is used as a reference to this more modern group of european
countries because they had their renaissance sequentially, with Europe following China.
Creation of water wheels for industrial development was pivotal in the escalation of many
civilizations. Due to the faster waterways in Europe, there was a greater abundance of water
power. Despite grasping this source of energy millennia later than most early civilizations,
Europe harnessed enough power to provide adequate mechanized services such as grain mills,
textile mills, lumber mills, and irrigation pumps in a wide spread adoption of the technology.
Besides waterwheels and navigation, Solomon is quick to include a chapter concerning the
steam engine and it’s great importance to Europe. Capturing the power of water’s vaporization
properties, Thomas Newcomen produced a steam engine roughly as powerful as the current
waterwheel, but demanding coal for power to heat the water. James Watt provided the
necessary enhancements to the design founded by Newcomen and produced “what all the
world desires to have: Power” (Boulton 1775-1782). Quickly, the industrialization of ‘power’
produced by steam engines worked in the favor of the people. Water pumps removed ﬂooding
in coal mines, securing more fuel. Steam engines provided the necessary power to produce
cotton goods in spindle factories. Steam engines provided a wind independent method for
transportation of raw materials to European countries and exports to be traded. With the
greater power source, came an incredible increase in available resources. Irrigation was more
available creating more food and an increase in population (Getzinger 2000). Coal extraction
and mining was easier following the utilization of steam power which modiﬁed the
environment and the rate of resource depletion. Wood was less in demand and there was an
increase in mining. Waterways were not created as readily because there was an alternative to
waterwheels. The whole landscape of European industry found an alternative form with a
reduction in deforestation but an increase in irrigated land. As the pressure of civilization
demanded the goods produced by the steam engine rather than those of the water wheel, the

state of the environment changed and suddenly the managers had to respond by mining more
coal. Like the modern Machakos, innovation and response to a pressure resulted in a
technological achievement. The greatest difference in industrial Western Europe and the
modern Machakos is that the Machakos pressure was the need to produce more out of need,
where as much of Western Europe had pressure to produce with the steam engine out of
capitalism or economic demand. Perhaps these two things are not very different over all, but
the parallel of need and desire seem slightly maligned. Following the steam engine, population
growth increased in England with the eventual availability of agriculture and therefore the
demand for freshwater increased to accommodate the people. Freshwater was provided at an
additionally increased rate using the water pumps powered by steam engine in Paris by the
Périer brothers and in Philadelphia by Oliver Evans (Solomon 2010). The power and
advancement of water needs and of water as a tool was identified by the people and actively
managed. Steam powered locomotives began reshaping the topography of the west and
brought bridges, tunnels, major construction, and an increase in industry and projects. Some of
these projects evolved into large undertakings such as the Suez canal, and consequently the
great development projects in the United States that would affect all aspects of life and redefine
the sue of water as a source for powering civilization.
Modern Abuse of Water
! Steven Solomon provides a history on modern water projects, showing the in the United
States as an example of utilized water with modern technology. Prefacing modern
developments, Water describes the progression of sanitation from modified methods of
consuming water for safety to the disposal of waste. Showing the Thames in London as an
example of poorly executed sewage system and poor sanitation demonstrated the affect that
poor planning has on the population, the health of the people (Cholera), and even the
environment (Salmon). A brief history of the United States and it's connection to water ways,
the benefits of these resources, and the eventual progression to industrialization and expansion.
Following the industrial revolution, hydroelectric power through water turbines and dams
slowly became a fundamental power source in the United States. Explicit decline in the
environment surrounding dams were the consequence of huge increases in available water for
irrigation as well as a larger water supply on hand for human consumption (Abbey 1985).

Initially, the environment was sacrificed for supporting the population. “Water scarcity, in
short, was the defining geographic condition of America’s Far West.” (Solomon 2010). The
pressure of a growing population in the west resulted in a state of water scarcity (Steininger and
Cogoy 2006). Enormous undertakings such as the Hoover Dam, the Grand Coulee Dam, and
the Bonneville Dam occurred under the New Deal of President Franklin D. Roosevelt (Solomon
2010) and acted as a response to the growing demand. Mark Reisner spoke to the effect of
dammed water for irrigation and energy in his book Cadillac Desert, “It rescued thousands of
farms that were already there, including many that were far larger than the law
allowed.” (Reisner 1986). Reisner had a point when speaking of California. The Sierra
Nevada's rivers had been completely utilized for water supply to coastal cities and irrigation,
while turbines drew water energy out of the water passing through the dams. Although, only
10% of farms had electric lights at the beginning of the New Deal, and all would have access to
them by the end of the construction period (Solomon 2010). Solomon points out a troubling fact
that 75,000 dams were constructed in the United States in it’s history, one per day from
President George Washington’s last day in office until President George W. Bush’s inauguration
(Solomon 2010). Solomon delivers on his promise to compare water and population by citing a
a 200% increase in US population between 1900 and 1975. Dam building may have kept
Americans afloat through a large growth period and nearly met the demand for fresh water
supply, challenging the Malthusian model to another round of resources to consider. The
United States was fully electrified, fully plumbed, and fully irrigated. Suddenly we were the
most urbanized country in the world and the need for fresh water and food was imperative.
Political action with the 1972 Clean Water Act and the 1974 Safe Drinking Water Act were
created to insure that the environment associated with waterways was secure and in turn,
recognized that the condition of water was a long term consideration and freshwater was not
unlimited. Unlike most countries, many of the rivers in the United States have headwaters
within the political borders of the country. As more countries expand and demand freshwater
and electricity, this option becomes a greater concern and does not allow for Riprarian rights to
be observed (Nazirov 2006).
Identifying Scarcity and Addressing the Problem

! Scarcity is the word most feared in the world of water management. Similar in impact
as Climate Change or Oil Crisis, water scarcity is an encroaching problem with no alternative.
Steven Solomon demonstrates in his book how water scarcity can result in de-civilization, such
as in the Muslim empire or Indus Valley. Freshwater usage is increasing at twice the rate of
population (Solomon 2010). Historians learn from the failures of water management and can
educate for a future of sustainability and conservation. Waterborne disease, inadequate water
and sanitation plague most people in the developing world. Water necessary for food is not
available in these places where it is not even sufficient for water consumption. Malthusian
crisis model by Ehrlich fits the domestic numbers for countries that do not have enough water
supply to irrigate their crops and provide water and food to all people. Solomon has a shocking
fact that, “By 2025, up to 3.6 billion people in some of the driest, most densely populated and
poorest parts of the Middle East, Africa, and Asia are projected to live in countries that cannot
feed themselves.” (Solomon 2010). That number will account for nearly 40% of the projected
world population in 2025 (Solomon 2010). One-third of the current population of the world has
access to less than one-twelfth of the worlds renewable water supply (Assessment 2005). Yet,
Solomon analyzes the presence of scarcity in the current world and first looks towards the
Middle East. In Israel, Palestine, Jordan, and Egypt, water supplies have been outgrown and oil
provides the means to import water and agricultural products to it’s increasingly arid region.
With rapid population growth in this region, it stands to be a prime example of a Malthusian
crisis where a population exceeds it’s resources (Getzinger 2000). Similar distress in Asia is seen
in a rapidly shifting role from water rich history to water poverty. China and India alone
demand similar water levels to that of the United States. While incredibly resourceful at
obtaining water, the infrastructure and utilization of it is leading to scarce conditions (Solomon
2010). Population growth in India is expected to rise at least through 2050 but China is
remaining stable if not decreasing ever so slightly (Solomon 2010). Inevitably, the scarcity of
water will need to be controlled by measures of democratic sustainability. The dramatic
movement towards a possible Malthusian crisis over freshwater appears to be more likely than
one based on oil based on Steven Solomon’s arguments for scarcity. Perhaps this is one last
incidence when we will find another technology to get us by.

Rationale Summarized
Integrated Water Resource Management addresses all of the issues discovered, past and present.
The concept is simply a detailed analysis on the effectiveness of past measures, successful
projects in similar cultural, climatic, and economic regions, and potential for maintaining a
sustainable practice of an IWRM project at the location through time. Because of growing
scarcity in water supplies and increased demand for water, a management system that
integrates demand is necessary for the greater good of the people. In developing countries,
especially those with undeveloped infrastructure, laying a foundation of resource management
for development to follow will provide a more efﬁcient, usable, and sustainable future in those
communities (Lenton, Muller et al. 2009).
Goals and Objectives
1. Describe the impact of water purity on international health and development as an
argument for Integrated Water Resource Management to be .
2. Show the impact of drinking water on life expectancy, population, and disease.
3. Show the impact of water quality on agricultural yield.
Materials and Methods
Scholastic Sources
Primary articles were initially collected through a course taught at Tulane University in the
School of Public Health and Tropical Medicine by Dr. Laura Murphy. The course title was
Population-Environment Theory and Evidence. Connections between water system
development over the history of civilization supported modernizing agriculture and drinking
water systems world wide. Pulling from core-corse material in the International Health and
Development department provided extension to disease and economics. Three more courses
were used to gather academic knowledge and materials, including Toxic and Hazardous Waste
Management, Fundamentals of Environmental Chemistry, and Water Quality Management.
Each of these courses integrated some international experiences and compared them to
development in the United States and Europe. An internship in Tajikistan provided valuable
insight into the methods of providing water, it’s direct impact, and the value of water to a

community. A capstone personal experience of attending and participating in the United
Nations conference on water in Dushanbe connected concepts to legislation and professionals in
the field. This was partnered with meetings to gather information from JICA, the EU, SDC,
USAID, and Mercy Corp. Most of these resources are accompanied by written sources for the
purpose of the analysis.
Academic Sources
Further sources include book research under the key term of ‘Water’. A secondary source of
writing that proved helpful in finding historical sources and some academic studies was Steven
Solomon’s book ‘Water’. Additional sources would found on the United Nations website, the
Environment Protection Agency website, and the government of Tajikistan.
! Electronic searches were conducted using the Tulane University journal source portal
through the school library with key terms of “Integrated Water Resource Management”,
“Agriculture Water Management”, and “Environmental Resource Management”. With a
cumulative results list of over 400 sources, the most relevant were selected by abstract review.
Some books were available to review off the shelf and many titles were available electronically.
Results and Discussion
The impact of integrated water resource management in international development of
communities is a cyclical reduction in poverty, waste, disease, and political economic burden.
Having observed the impact of simple gravity fed water systems on drinking water and
integrated systems for agriculture, the impact was immediately evident between communities
with and without the resource. Starting an understanding of the cycle, beginning with the
health aspect, will be the simplest location because it is directly observed.
Burden of Disease from Water-Related Pathogens
Diseases such as Cholera, Escherichia coli, Giardiasis, Salmonella, Rotavirus, Norovirus,
Amebiasis, Buruli ulcer, Campylobacter, Cryptosporiasis, Dracunculiasis, Schistosomiasis,
Shigellosis, Typhoid Fever, Leptospirosis, and Fascioliasis are specifically associated with the
disease of people in developing countries exposed to unsafe water sources in both drinking
water and agriculture (Prüss-Üstün A 2008). Clostridium difficile is the most common cause of

hospitalized diarrhea in the world and is a source of acute diarrhea in the 1 billion people that
do not have access to safe drinking water. Due to improper sanitation, disease such as Chagas,
Leprosy, Leishmaniasis, Onchocerciasis, Trachoma, Yaws, Dengue, and Tryanosomiasis are still
not uncommon and are affecting 1 billion of the world population (CDC 2010). These diseases
cause multilateral problems across all parts of life in the communities they burden. An overall
cost on society for the impact of disease is easy to underestimate and results in relatively
undervalued importance of working to fix the water resource management system. Like most
fields of health, water’s portion of environmental studies will require a sensational case to
receive the attention it warrants but can alternately be rolled into all other fields of development
through IWRM programs.
! Understanding that 1.5 million people die each year from water and sanitation caused
illness and 1 billion suffer from infection of water-related disease with varying levels of
ailments, the reduction of water-related infection in the burden of disease on man-kind would
alleviate a large portion of medical relief money from donating countries towards developing
countries (Schnabel 2009). Instead of treating many of these diseases in hospitals or designing
prophylactics to build a barrier in the pathogenic pathway, prevention through infrastructure
should be considered. Integrated Water Resource Management would be a model for
communities that could install wells, pumps, or rain-water catchment systems to allocate water
for safe consumption in responsible and sustainable methods. This is definitely a matter of
community, culture, and environment. One application in Tajikistan will not be viable in
Uganda. Having different stressors will impact the way that an IWRM program can be used.
As disease from water-related pathogen is an important consideration for drinking water
systems, Integrated Water Resource Management programs are able to factor in limiting,
reducing, and eliminating exposure to applicable pathogens when communities are ready to
build infrastructure. One example is in covered pipelines and wells in areas that have endemic
Malaria so that zoonotic vectors cannot thrive. In most systems, dual cased piping may be a
necessary expense for safety to insure that pipelines are not compromised and water
contamination does not allow pathogenic infection to occur. With control of resources to
agriculture, irrigation water will be treated to specification and distributed to crops, thus
reducing food borne illness from pathogens like E. coli. Furthermore, specific waste products
such as biosolids can be easily treated with waste lagoons in developing communities to

produce biosolids for fertilizers. This will help insure that waste that could have pathogens is
treated in a safe manner that is distinctly separate from any consumptive water and further
reducing the impact of disease on a community. By utilizing an Integrated Water Resource
Management program to enhance a community, the reduction of disease also decreases the
extent of poverty.
Poverty Reduction from IWRM Programs
Integrating water management into a community will provide relief for disease as well as
reduce time needed to access water sources. In communities where people spend a large
portion of their time gathering water and ﬁrewood to boil water, there will be an excess of man
hours that can be used to provide income generating work. More available time with children
will result in higher levels of education and often in equality of education between the sexes.
The daily burden of girls in some communities in Africa will be reduced and their average level
of education will be increased with this change. Having an educated community will result in a
more disease resistant populace with greater capacity to add income based work for their
families. In many communities, increased education has resulted in a rise of the average age of
marriage for women as well as the average age of mother at time of ﬁrst child birth. Family
Planning practices and disease treatment are greatly affected by environmental factors of water
in both the global and community level. An additional indicator that would observe the
reduction of poverty in a community that implements an IWRM program would be the birth
rate among women.
! In communities where clean water has become scarce, birth rates have risen (Nazirov
2006). In places where water has been systematically provided to people in a safe and planned
manner, birth rates have decreased (Schnabel 2009). By having a plan for all community water
development, children and mothers will be less exposed to pathogens and disease burden will
be less for families. At the point where every child is safely assumed to reach it’s full potential
without inhibition from waterborne disease, population stresses will naturally reduce the desire
for larger families. As people are able to provide for their children without resorting to relying
on having more children to take on the roles of gaining income, there is less demand to have
more children. Reducing the burden of disease, increasing the yield of crops, and increasing
access to safe drinking water will provide children with a better environment to grow and be
nurtured. Inevitably, the access to more secure and sustainable food and water sources will

reduce stunting and wasting in children. Paired with the later age of first birth in mothers and a
reduced birth rate, the population dynamic will begin resembling that of a developed country
with strong infrastructural support (Getzinger 2000). The population composition will be more
reflective of the support provided by the environment and this will be a great impact on the
community and its health. Healthy communities are able to work more hours and reduce the
Years of Partial Life Lost and Disability Adjusted Life Years are reduced (WHO 2002). With the
health in better standing from IWRM programs, the management of resources is more
sustainable and less complicated to maintain for small communities.
Reduced Political-Economic Burden from IWRM
After reducing the burden of disease, increasing the health of a community, affecting the age
composition and family model, and increasing productivity through proper implementation of
an IWRM, the need to provide for the community from unsustainable incomes will be reduced
(Brevard, Reid et al. 2009). With extended health and greater access to agriculture, communities
will be less reliant on outside food and financial sources and should be able to retain a more
sustainable community model. This outcome is very theoretical.
! Many citations note the cultural model that reaches a point where sustainability should
be met, but an antagonist often deters from completion of the cycle. Strong IWRM models are
built slowly over time and involve the whole community. By instilling the values of the IWRM
and installing a Water User Association to publicly govern the water apart form village and
community government, the risk of antagonist can be relatively reduced. In observations of this
program, there are several methods for properly founding Water User Associations but the
community and culture must not conflict with it or there will be resistance at the first
shortcoming encountered (Nazirov 2006). Advocacy from the community is important for
successful outcome in IWRM implementation.
! Aid money and relief work to provide for the underemployed, diseased, or failing
developing countries has created an unsustainable dynamic of need. Communities that adopt
and choose to closely follow the Water User Association of the Integrated Water Resource
Management project will reduce the total cost of relief efforts in the future and provide a
network of resources for the community (Lenton, Muller et al. 2009). The benefit to the
destination countries receiving funds is that they are able to better align funds with outcome
generating projects. With infrastructure in place, the dollar stretches farther to provide aid.

! In countries looking to provide relief money and aid, there is would be great incentive to
provide integrated water resource management to communities while providing many other
projects. The incentive for communities that is great because it allows infrastructural support
from within while other services are introduced to the people. Aid money originating from
government organizations could mandate implementation of IWRM as a means to know efforts
will be more sustainable. The overall cost to groups like the World Bank and other political
interests could be greatly reduced through the decrease in provisions necessary to carry out a
project.
Waste Reduction with IWRM
One major problem found in many communities of developing countries is the build up of
waste and refuse in the environment. Despite biodegradation, 1.2 billion people still practice
open defecation and 2.5 billion do not have adequate sanitation (WHO 2008). Water pollution
from human waste cycles back to the diseases mentioned in the first section of the Results and
Discussion and extends to further pollute the people living down stream of any community. As
the world continues to urbanize, the initial numbers for open defecation will decline, but the
number of people with access to sanitation will begin increasing. If these systems are
maintained and serviced, they will provide a natural reduction in this indicator for health. For
people living in rural settings, the situation couldn’t be more different. No one is investing in
their infrastructure like the urban populace and many communities have a declining
infrastructure, like those found in countries that were recently subject to fighting and war
(Nazirov 2006).
! Integrated Water Resource Management can help communities of all sizes control their
waste and manage it to reduce exposure to the drinking water and irrigation water system.
Additionally, IWRM helps farmers with irrigation use so that excess run off from fields is not as
great of a problem (United Nations Human Settlements Programme. 2010). By managing the
resource of water holistically, the levels of contamination, disease, and waste are reduced
(Resources 2001). Human waste can be put in a lagoon and left to settle for use in non-root crop
applications such as orchards or unconsumed goods like cotton and hemp. The nutrients in
these solids will provide a cyclic reuse of the commodity of human waste while insuring that
the community is aware of where their waste goes. The increased awareness in waste location
should decrease the level of cross contamination through tandem efforts in information and

education programs as well as counting on the concern of the waste recyclers desire to make as
much profit as possible. After applying waste to crops and reducing water use to a reasonable
level, the management of agricultural run-off is equally important.
! Nitrogen and Phosphorus from fertilizer are nutrients that can destroy water bodies they
contaminate. Eutrophic zones created by agricultural run off hurt the ecology and result in very
low quality water sources (Organisation for Economic Co-operation and Development. 2006).
By only adding as much water as a crop can take and reducing pesticides and fertilizers by
using bio-solids or human waste, the effects of eutrophication are greatly reduced (Napier 2011).
Without IWRM in agricultural properties, many contaminants will wash into streams, rivers,
and can enter ground water with the result of downstream users having contaminated
resources. At the point of reaching the coast, large hypoxic zones can form where wildlife
cannot live (Darnault 2008). The Hypoxic zone formed off the Mississippi River outlet is a good
example of how even in developing nations, the lack of control and management in non-point
source contamination and pollution results in major problems. One of the more notable issues
is the economic cost of not being able to fish or cultivate shellfish in this zone. Similarly, many
streams may become sterile of consumable life and lakes can die if nutrient levels increase
beyond a threshold of the flora and fauna (EPA 1972). By utilizing resources associated with
water, the integrated water resource management provides a system for a community to
conserve and reduce contamination.
! Water User Associations also help with waste control because they have the capacity to
regulate the local water use. If a farmer floods his farm or uses a chemical pesticide or fertilizer
that can harm the water source, they can pull community backing to fine that farmer and use
the resources. Like micro-finance networks, local Water User Associations can be an effective
way to self moderate the way resources are used and save communities from running out of
water.
!
Conclusion and Recommendations
International communities where programs are being implemented in developing regions
should strongly consider whether Integrated Water Resource Management is a viable program
to reduce costs, increase health, and establish sustainability. Rural populations are greatly

affected by low quality drinking water, poor sanitation and hygiene, and inadequate food
production (WHO 2002) and working with communities to provide a means to account for these
risks can greatly increase the success of all other programs. Water is the foundation of life on
Earth and should be a part of every development programs analysis of community need.
! Programs identifying waterborne disease, poor water resource management, low female
education, high fecal coliform levels, excess fertilizer and pesticide use, and eutrophication of
water bodies should strongly consider suggesting and integrating IWRM into their program.
The value of adding sustainable community health and economic practices will bolster cases of
success. In theory, Integrated Water Resource Management should be implemented across the
globe and in each community. Developed countries need to use many of the practices more
than countries that are developing do but implementing infrastructure like this in places that do
not currently have any is just as necessary and may be the best way to prevent the occurrence of
future pollution, disease, and inequity. Integrated Water Resource Management is one of the
only ways to have communities participate in ﬁghting water scarcity.

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