1. A Link NCA was conducted in four municipalities in Masbate Province, Philippines between 2014-2015. Due to a typhoon, the quantitative survey had to be stopped and data from a previous UNICEF survey was used instead.
2. Key findings identified poor sanitation infrastructure (hypothesis K), open defecation (hypothesis J), and poor liquid/solid waste management (hypothesis L and M) as major contributors to undernutrition.
3. Participants reported issues with open defecation due to lack of toilets and public latrines. They also faced challenges with solid and liquid waste management due to lack of disposal systems and garbage collection.
CDC: Understanding the Cholera Epidemic, HaitiStanleylucas
CDC epidemiologic study provides several additional arguments confirming an importation of cholera in Haiti. There was an exact correlation in time and places between the arrival of a Nepalese battalion from an area experiencing a cholera outbreak and the appearance of the first cases in Meille a few days after. The remoteness of Meille in central Haiti and the absence of report of other incomers make it unlikely that a cholera strain might have been brought there another way. DNA fingerprinting of V. cholerae isolates in Haiti (1) and genotyping (7,21) corroborate our findings because the fingerprinting and genotyping suggest an introduction from a distant source in a single event (22).
Assessing the availability of community water at Madlangamphisi, a community ...Agriculture Journal IJOEAR
The research was conducted to assess the availability of domestic water and the extent of the problems associated with water scarcity at Madlangamphisi area in the Hhohho district of Eswatini. The research was a descriptive survey. A questionnaire was used to collect both qualitative and quantitative data for the survey. A total of 169 households out of 300 households in the community were randomly selected to participate in the survey. The majority (56.2%) of the households confirmed that there was water scarcity problems in the area as the streams they used for domestic water frequently dried up during the winter months. The study showed that a majority, 51.5% used water from rivers as the main source of domestic water, while 40.2% of the people travelled for more than 1,000 m to fetch water. To cope with water scarcity problems, 43.2% of the households reduced their water consumption level during droughts while 45% practiced rooftop rainwater harvesting. The study concluded that Madlangamphisi community experienced serious water scarcity problems since they relied on unprotected water sources for domestic use. Moreover, they had to travel for more than 200 m to collect water from nearest sources which is considered an indication of water scarcity by the WHO. The study observed that there was a need to introduce a rural water supply scheme in the area to solve the water scarcity problems and that households should treat water for drinking by either boiling or use a disinfectant to eliminate pathogenic organisms in the water.
This booklet was prepared by Biome Environmental Trust for the Wipro earthian schools program. While the target audience is school students from 6th to 12th stds, it is valuable for people of any age. The Kannada version is available at https://www.slideshare.net/biometrust/wipro-earthian-water-booklet-kannadapdf/biometrust/wipro-earthian-water-booklet-kannadapdf
“Public services are never better performed than when their reward comes in consequence of their being performed, and is proportioned to the diligence employed in performing them.”
- Adam Smith
"If you stand up and be counted, from time to time you may get yourself knocked down. But remember this: A man flattened by an opponent can get up again. A man flattened by conformity stays down for good."
- Thomas J. Watson, Jr.
“What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others that will determine the significance of the life we lead.”
- Nelson Mandela
"You've got to go out on a limb sometimes because that's where the fruit is."
- Will Rogers
CDC: Understanding the Cholera Epidemic, HaitiStanleylucas
CDC epidemiologic study provides several additional arguments confirming an importation of cholera in Haiti. There was an exact correlation in time and places between the arrival of a Nepalese battalion from an area experiencing a cholera outbreak and the appearance of the first cases in Meille a few days after. The remoteness of Meille in central Haiti and the absence of report of other incomers make it unlikely that a cholera strain might have been brought there another way. DNA fingerprinting of V. cholerae isolates in Haiti (1) and genotyping (7,21) corroborate our findings because the fingerprinting and genotyping suggest an introduction from a distant source in a single event (22).
Assessing the availability of community water at Madlangamphisi, a community ...Agriculture Journal IJOEAR
The research was conducted to assess the availability of domestic water and the extent of the problems associated with water scarcity at Madlangamphisi area in the Hhohho district of Eswatini. The research was a descriptive survey. A questionnaire was used to collect both qualitative and quantitative data for the survey. A total of 169 households out of 300 households in the community were randomly selected to participate in the survey. The majority (56.2%) of the households confirmed that there was water scarcity problems in the area as the streams they used for domestic water frequently dried up during the winter months. The study showed that a majority, 51.5% used water from rivers as the main source of domestic water, while 40.2% of the people travelled for more than 1,000 m to fetch water. To cope with water scarcity problems, 43.2% of the households reduced their water consumption level during droughts while 45% practiced rooftop rainwater harvesting. The study concluded that Madlangamphisi community experienced serious water scarcity problems since they relied on unprotected water sources for domestic use. Moreover, they had to travel for more than 200 m to collect water from nearest sources which is considered an indication of water scarcity by the WHO. The study observed that there was a need to introduce a rural water supply scheme in the area to solve the water scarcity problems and that households should treat water for drinking by either boiling or use a disinfectant to eliminate pathogenic organisms in the water.
This booklet was prepared by Biome Environmental Trust for the Wipro earthian schools program. While the target audience is school students from 6th to 12th stds, it is valuable for people of any age. The Kannada version is available at https://www.slideshare.net/biometrust/wipro-earthian-water-booklet-kannadapdf/biometrust/wipro-earthian-water-booklet-kannadapdf
“Public services are never better performed than when their reward comes in consequence of their being performed, and is proportioned to the diligence employed in performing them.”
- Adam Smith
"If you stand up and be counted, from time to time you may get yourself knocked down. But remember this: A man flattened by an opponent can get up again. A man flattened by conformity stays down for good."
- Thomas J. Watson, Jr.
“What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others that will determine the significance of the life we lead.”
- Nelson Mandela
"You've got to go out on a limb sometimes because that's where the fruit is."
- Will Rogers
Review the Effectiveness of Community-based Primary Health Care in Improving ...CORE Group
Review the Effectiveness of Community-based Primary Health Care in Improving Child and Maternal Health: Leveraging Results for Advocacy HENRY PERRY and PAUL FREEMAN
High Five program: final report (2011-2014)abby ati
The final report of High Five program, a sanitation and hygiene practices improvement program, implemented in three cities in Indonesia: Medan, Surabaya and Makassar.
Assessment of the Household Practices of Drinking Water Collection, Transport...ijtsrd
Introduction The supply of potable water in low resource countries has been a public health concern, with frequent water interruptions, leaving the population vulnerable to access to potable water in households, which renders the population at risk of waterborne diseases like cholera. Our objectives were to assess the household practices of drinking water collection, transportation and storage in the Fako Division of the Southwest Region of Cameroon.Methods This was a cross sectional study with a mixed method approach. Focus Group Discussions were done to get an inside of the observed practices and a quasi experimental study with education as an intervention. A total of 394 households were randomly selected and issued a pretested questionnaire. A multistage random sampling technique was used to recruit the participants in the households in the four health districts of Fako. For the quasi experiment, 50 water samples from 50 homes were tested before and after the intervention to measure the mean microbial score in stored household drinking water. A one sample t test was used to compare the mean microbial colony count at baseline and 3 months post intervention. Data were analyzed using SPSS version 23. Crude and adjusted odds ratios and confidence intervals were reported at a significance level of 0.05. Results Assessing the participants practice in drinking water collection and transportation, 273 69.3 of the participants reported public taps as their primary source of drinking water. The main alternative source of drinking water was spring 233 59.1 . More than half 56.3 of the respondents reported that they take more than 30 minutes to fetch water, done mostly by children 62.2 , and the majority 89.1 do this by trekking. Over half, 268 68 of the participants used buckets with lids, and 119 30.2 , use jerry cans to fetch water. A total of 184 46.7 reported a bucket with a lid as the water storage container meanwhile 34 8.6 and 176 44.7 stored water in a bucket with no lid and jerry cans respectively. Almost a half 180 46.9 store their drinking water for more than 2 days. The mean bacterial colony count 29.72 ± 40.07 after the intervention was significantly lower than the mean bacterial colony at baseline 71.4 ± 68.38, t 50 = 6.846, P 0.001 .Conclusion The primary source of drinking water in Fako is public tap, alternative source being a spring. More than half of the participants trek to fetch water and almost half of the participants store drinking water for more than 2 days. Intervention with health education significantly lowered the mean bacterial colony count in household drinking water. Malika Esembeson | Palle John Ngunde | Kamgno Joseph | Ronald Gobina | Vivian EA Eta | Binwi Florence Nkemayim | Ndefon Peter | Serge Ngekeng | Kukwah Anthony Tufon | Ngomba Divine Martin Mokake | Henry Dilonga Meriki | Njunda Anna Longdoh "Assessment of the Household Practices of Drinking Water Collection, Transportation and Storage in Fako Division, South-
7191 . the right to water and sanitation - a practical guideGian Paolo Pezzi
A Franciscan Perspective on the Right to Water. Francis’s respect for Sister Mother Earth reminds us that the right to water is certainly important, but at the same time we need to respect the Water’s rights too!
This practical guide shows the importance of water, the water's rights, and the commitment of the community towards water providing reflection, statistics, and exercises. Here you can find both the Power Point and a word text to facilitate the use of both in separate way. (Jpic-jp.org).
Study on Knowledge& Practice of WASH among Under 5 Children's Mother in Rural...AI Publications
Water, sanitation and hygiene is still a burning issue in the context of developing countries like Bangladesh as many diseases related to it and causing significant child’s death. The study helps to assess the knowledge & practice of mothers having under 5 children in Sylhet district of Bangladesh.A cross sectional observational study was undertaken in 10 villages of Sylhet Sadar, Golapganj and Kanaighat Upazila of Sylhet district in Bangladesh during September to December’2019. Total 100 mothers and their 100 under 5 children was taken for conducting the study. Purposive random sampling procedure with pretested semi structured questionnaire following interview technique was used to collect information. Collected data was coded, entered and analyzed in SPSS 20 for univariate and multivariate analysis. Out of 100 mothers, majority of participants (71%) had appropriate knowledge on water, sanitation & hygiene and one third (29%) had poor knowledge. Regarding practice, about two third (67%) participants did good practice and one third (33%) did poor practice. Almost 97% of the respondents used tube well as a source of drinking water and 68% used sanitary latrine for defecation. Concerning hand washing almost 100% respondent washed hand with soap & water after defecation of child & own self and any family business but 37% before preparing meal and 44% before feeding. Regarding homestead hygiene environment 72% was kept poultry in residence & only 28% in separate place. And concerning homestead waste management 50% & 39% respondents throw liquid & solid waste haphazardly in their homestead respectively. However 100% participants had positive attitude about water, sanitation and hygiene and believed every household should have good WASH facilities. The educational level & mother age found significant relationship with knowledge of WASH among mother having under 5 children at p<0.05 level. However, the educational level & household income also found significant relationship with practice of WASH among mothers having under 5 children at p<0.05 level. Present study shows that knowledge level of safe water, sanitation & hygiene among mothers affected by their educational & age level but practice level affected by their education & household income. So its need to spread information about the importance of proper practice of water, sanitation & hygiene in rural areas through available evidences based BCC strategies and multiple dissemination channels through IEC (information education & communication) activities towards awareness and practice of WASH among mothers having under 5 children.
My first publication at UNICEF sheds light on the impacts of climate change on children's access to safe water and sanitation. If you think about it, it's staggering how more than 7.3 billion people have to compete over the extremely small fraction (definitely less than 1%) of the planet's available water resources -- and it'll only exacerbate as climate change continues. Who will suffer the most? The poorest children in the most vulnerable regions, such as coastal areas or the regions with extreme heat stress. Check out this short brief prepared for #COP22 and stay tuned for the full report by next year's #Worldwaterday! So honored and privileged to work with the amazing colleagues. PROGRAMME DIVISION (WASH SECTION): Jose Gesti Canuto, Cecilia Scharp DIVISION OF COMMUNICATION: Philippa Lysaght DIVISION OF DATA, RESEARCH AND POLICY (PSN SECTION): Yoonie Choi, Christine Klauth, Cornelius Kuteesa, Nicholas Rees, Shangning Wang(graphic design)
Among the many water-related challenges worldwide, the crisis of scarcity, deteriorating water quality, the linkages between water and food security, and the need for improved governance are the most significant in the context of gender differences in access to and control over water resources.
Taps and Toilets: How Greater Access Can Radically Improve Africa’s FutureEric Firnhaber
The International Futures modeling system is used to explore the impact of sanitation and clean water on development in Africa through improvements in access to them. The paper explores a Base Case and alternate scenarios that reflect, respectively, enhanced rates of access and stagnating rates of access. Impacts on development are measured through infant mortality, communicable diseases, GDP, and state fragility. The analysis includes a preliminary cost-benefit analysis.
Drinking Water Quality and Sanitation Issues: A Survey of a Semi-Urban Settin...IJRES Journal
An assessment on the drinking water quality from major source (borehole) and household in a semi-urban setting in Nigeria was carried out. Structured questionnaire was administered to randomly selected households in seven zones of the municipality to determine the common method of collection and transportation, storage, and sanitation practices. Water samples collected were subjected to laboratory analyses for physico-chemical and microbial properties. The result of the physico-chemical analysis when compared against the World Health Organization (WHO) and Standard Organization of Nigeria (SON) drinking water quality benchmark revealed that the water samples were within standards for consumable water except for the presence of feacal contamination. The result revealed that before water can be totally considered safe for drinking, further treatment is required at the household level due to fecal contamination, and water safety concerns are also highlighted. The result translates to the fact that compliance assessment with standards and impact assessment studies in determining the fate of pollutants is necessary at all levels.
Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa Ea...Premier Publishers
The study examined the sanitation and hygienic conditions in urban communities in Gomoa East District in Central Region of Ghana. A cross sectional survey research design was adopted for the study. Simple random sampling technique was used to select 360 inhabitants from three urban communities. A structured questionnaire was used for data collection. Descriptive and inferential statistics were used to analyse the data. The study revealed that tap water was the major source of drinking water in the communities, usually purchased from water vendors and stored in closed containers. Most inhabitants (42.5 %) used Public Ventilated Improved Pit (VIP) latrines. Some household toilets (21.7 %) never had covers whilst the ones which had covers too were not closed after they had been used. As a result, most toilets produced offensive odour. Unwholesome environmental practices such as open dumping and burning of garbage were prevalent in the study area. The result of the multiple logistic regression showed significant association between gender and their participation in community sanitation exercise (p < 0.05) with male showing more participation than females (OR = 0.516, C.I = 0.308 – 0.865). The state of sanitation and hygienic conditions in the Gomoa East District was inadequate. There is the need for the District Environmental Health and Sanitation Department to establish and enforce a more robust environmental sanitation approach and health education to improve upon sanitary conditions in the Gomoa East District.
Examples of Successful Experiences in Safe Drinking Water
Of all the natural resources needed for survival and economic development, water is the most crucial. The global water crisis is one of both quality and quantity and is closely linked to the global environment crisis and the degradation of critical ecosystems. It is a crisis of fragmented
institutions, inadequate policies and legal systems, insufficient funding for
water supply and pollution control, and lack of political will.
Volume 11 was produced by the Special Unit for South-South Cooperation in the United Nations Development Programme (UNDP), the Academy of Sciences for the Developing World(TWAS), the Third World Network of Scientific Organizations (TWNSO) and World Meteorological Organization (WMO).
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
1. 1
Link NCA Case Study 2: Masbate Province, Philippines
Selection of Link NCA Results
A Link NCA was conducted in four municipalities of Masbate Province, Philippines, between September 2014 –
January 2015: Aroroy, Cawayan, Milagros, Monreal. The Link NCA methodology initially included a qualitative
survey, a SMART and a Risk Factor Survey. Due to the impact of a typhoon during the quantitative survey, it
was decided to stop the data collection and to use the data collected by UNICEF for their baseline survey. The
quantitative data collected during the Link NCA were analysed to verify the coherence between secondary data
(UNICEF baseline survey) and qualitative data gathered at the time of the Link NCA.
This document presents the local causal model and selected results by causal hypothesis classified as major or
minor contributors to undernutrition.
Healthy environment plays a role crucial in preventing illness. Indeed, poor water, sanitation and hygiene
negatively impact child nutritional status due to exposure to pathogen. NCA findings identified hypothesis J
(Open Defecation) and L (Poor liquid/solid waste management) as direct consequences of a lack of adequate
sanitation infrastructures (hypothesis K “Poor or inadequate sanitation”) rather than a lack of adequate hygiene
practices knowledge.
Hypothesis M: Inadequate/poor access to safe water
Use of unsafe water can negatively impact general health situation of the communities. Indeed, exposure to
pathogens may cause illnesses, including water-related diseases such as diarrhea, which may lead to
undernutrition1
. Moreover, an increased number and duration of diarrheal episodes is a significant risk factor
for childhood stunting.
Most of the villagers have a regular access to water through the year, with less water available during kwarisma2
season. Time to get water (time to go to the source, get water and get back to the house) was rarely mentioned
as more than 30 minutes with in general one to two trips in a day. Some of the participants explained having to
go farther during kwarisma, as their usual source of water might be empty.
Sources of drinking water vary from one barangay to another and mainly are improved sources such as
protected spring, tube well, well or pipelines. According to UNICEF survey, population largely use improved
sources (between 68% for Milagros and 79.1% for Aroroy). Usage of bottled water as a main source of drinking
water remains low with 2.4% for Monreal and 8.3% for Aroroy.
Qualitative findings explain that people do not often consume bottled water due to the cost and the availability.
Indeed, in the four barangays survey, bottled water was available only in Cawayan Poblacion (1 gallon for 25
pesos).
Cost of drinking water varies from one barangay to another. For example in Cawayan Poblacion, one gallon of
faucet water costs 3 pesos.
Not all participants reported treating the water before consumption, also habits vary depending on the weather
conditions. Indeed, participants mainly assumed that clear water is safe for direct consumption while trouble
water should be treated, explaining that it is mainly the case when it is raining or just after a typhoon. Water is
kept in cover containers and treatment methods used at home are mainly clothes filtration followed by boiling.
Some of the participants combined both methods while some others will let settle the water first. Finally, some
of the participants explained boiling water only for their young children. UNICEF data3
confirmed that a large
part of the population do not use any water treatment method (between 29,9% for Milagros and 55,5% for
Cawayan) with a majority of them using improvised filter through cloth, foam, sponge (15% for Monreal and
42,2% for Aroroy) or boiling (14,8% for Aroroy and 30,9% for Monreal).
1 Checkley W, Gilman RH, Black RE, Epstein LD, Cabrera L, Sterling CR, Moulton LH.2014. Effect of water and sanitation on childhood
health in a poor Peruvian peri-urban community. Lancet, vol 363, no9403
2 Kwarisma season refers to the dry season that length usually from February to April
3 This data excludes households with bottled/purified water as main source of drinking water
2. 2
Qualitative findings for Famosa, Monreal showed a different situation, since the barangay is benefiting from the
Philippines Red Cross’ programs. In 2012, a well was renovated and transformed in a borehole, with 20%
invested by the barangay. 20L of water cost 1 peso, collected for maintenance. A committee, constituted by
twelve yearly elected members, are in charge of the maintenance and operating the borehole. The collected
amount is deposed to a specific account. The barangay captain’s wife mentioned that approximately 15,000
pesos were already deposited to this account. The barangay plans to build another borehole when the amount
will be sufficient. Indeed, since there is only one functioning twice a day4
and is the only source of water in the
area, queue can be very large and some villagers still need to travel to the nearby barangay to collect their water.
Therefore, a large proportion of the community travel to Real to collect water at the Matang Tubig open spring,
located at 30 minutes from Famosa by motorbike. Participants explained that they might need two to three
hours to collect water in their barangay. Some respondents mentioned filtering the water while most of them are
not doing anything, assuming the water should be safe since the source is regularly inspected by a sanitary
inspector. Most of the women allocated usually half a day twice a week to wash clothes at the same spring.
Hypothesis J: Open defecation
UNICEF results showed alarming rate of open defecation ranging from 40.1% (Aroroy) to 69.3% (Cawayan).
Inappropriate disposal of human excreta and personal hygiene is associated with a range of diseases including
diarrheal diseases and polio. Indeed, if the outlet of faeces is not well isolated from the environment by the use
of appropriate sanitation facilities, it can contaminate foods and water through several roots represented in the
figure below5
, commonly called the F-diagram:
Qualitative enquiry reported that open defecation is considered as one of the main issues of health hazards in
the communities that can cause spreading of diseases. Indeed, most of them do not have their own toilets and
public latrines are relatively rare and faeces are believed to cause presence of fly, bad smell and a risk to be
mixed with the source of water, especially in case of open well. Respondents also explained trying to keep open
defecation areas, as much as they can, far from their living area to avoid the development of an unhealthy
environment. Finally, respondents mentioned that open defecation may be dangerous due to the presence of
snake and because they have to go alone outside at night, what can also be unsafe. In coastal areas, participants
use to go to the seashore, expecting that faeces will be washed out by the sea during high tides. In other areas,
respondents reported going to the forest. Some of them reported digging a hole then covering it. Such adequate
behaviour is not adopted by the all community. Washable diapers are mainly used for infants. Disposable
diapers are less used due to lack of availability and costs. In both cases, parents do not dispose it safely,
increasing the risk of environment contamination. Indeed, washable diapers might be washed with other clothes,
sometimes close to the main source of water or in the river, while no specific safe disposal areas are identified to
throw disposable diapers. In coastal areas, they are often thrown in the seashore. Children also practice open
4At the time of the survey, water could be collected from 6 to 10:30 AM and from 3 to 6 PM
5 UNICEF, 1999. Towards better programming: A manual on hygiene promotion. Water, Environment and Sanitation Technical guidelines
series – No6
3. 3
defecation, most of the time close to the premises. Some parents explained that it such cases they are covering
the faeces. Meanwhile, some caregivers explained using an arinola (bowl) for them and their children and throw
the faeces in the seashore, outside of their premises or in the forest. Only few participants reported disposing
diapers in a trashcan. Children’s faeces are actually more dangerous than adults as they tend to contain a higher
concentration of pathogenic agents.
Qualitative survey showed that open defecation mostly results of difficulties of building latrines rather than a
lack of knowledge. The main reason mentioned was the cost, as participants did not know how to build latrines
with indigenous materials, or even did not know it was a possibility. Another important reason was the lack of
ownership of the land. Indeed, an important proportion of participants reported not being allowed by the
landowner to build their own latrines.
Knowledge of indigenous latrines construction was founded as more important in Poblacion Cawayan, which
can be explained by ACF campaign about “zero open defecation” in the barangay. Usage of latrines was found
are more usual in Famosa since a DSWD program facilitate the constructions of 25 latrines in 1998 by providing
the material. Even the participants reported that today most of these latrines are damage as the bowl was in
plastic, DSWD program seems to have initiated a dynamic among the barangay, where a large proportion of
participants reported having built their own latrines.
Hypothesis L: Poor liquid/solid wastes management
Participants identify poor liquid/solid wastes management as a critical issue for their community. Poor solid
wastes management was identified as one of the main cause contributing to create an unhealthy environment.
Respondents explained their inadequate behaviour by a lack of safe wastes disposal and absence of garbage
collection system. They also identified seashore as the most critical area since people usually throw their garbage
there. Indeed, plastic and metal containers are sold but in most of the cases, wastes are burnt. Only few
participants mentioned composting their leftovers or giving it to their pigs or dogs.
In Famosa, some participants leaving close to the seashore explained trying to maintain a healthy environment
by building their own waste disposal system. To do so, they dug large holes that should be sustainable for a year
and throwing their wastes at this place. Once holes are full, they would cover them and dig new ones. The same
respondents explained that such system are not optimal since wastes are left uncover when holes are still in use
and will remain there after use, with a risk of contamination of the soil. For this reason, holes were not built
close to their home.
Participants identify liquid wastes as less dangerous than solid wastes. Correlation between poor liquid wastes
management and health hazards was found as not obvious for most of the participants. Although respondents
try to throw their solid wastes far from their home, liquid wastes are usually thrown around their premises. Such
observation tends to show a lack of knowledge concerning risks of inadequate liquid management.