Health impacts of urban water supply on the vulnerable communities of selected areas of Dhaka city

Abstract

Water plays a vital role to shape up the health quality of dwellers of Dhaka city. Quite a large number of people are usually affected by waterborne diseases in each year and various studies reveal that due to presence of high percentage of lowincome and slum communities in the capital, the high rates of diarrhoeal incidences mostly come from these vulnerable communities who lack of adequate water, sanitation and knowledge on personal hygiene. This study identifies the vulnerable community composed of people (73%) mainly from other districts coming for economic reason. A bimodal distribution of diarrhoeal incidences especially before rainy season (March-May) and during rainy season (July-October) has been observed from these communities. It is seen that maximum number of HHs (65%) of vulnerable communities had their supplied water of DWASA through private connections and the rest 35% had their supplied water of DWASA through public connections. A high percentage of diarrhoeal (74%), typhoid (60%) and eye infections (77%) incidences in case of private connections were reported. Majority of vulnerable communities' HHs (47%) were having urban water supply options like "Hand pump connected to supply line", 38% of HHs were having "Piped water supply without reservoir" and rest 15% HHs were having "Piped water supply with reservoir". So it was about 85% (47%+38%) of the total HHs those were to rely on unsecured water supply. On the other hand, 95% of HHs never had their demand fulfilled out of which only 55% could mitigate their daily need by just half of their demand. Only 5% showed their fulfillment of their demand as per as water availability are concerned. Overall 68% of HHs did not boil water for drinking purpose and slum do not boil water just for economic reason. The slum community had more pit latrine system (64%) where low-income community based on septic tank system (67%).83% of slum HHs did not use any media to wash their hands following defecation, on the contrary 100% low-income HHs were found very much aware about use of media (in this case soap). Samples of water from WASA pumps showed the quality of water was quite acceptable as per Bangladesh Standard but the water samples from user ends showed high contamination of water with faecal coliform. It was observed that most of the private connections (mainly slum community) were made with leaky pipes drawn over the waste and wet lands. Moreover maximum water points were in very close proximity to latrines or poorly maintained. About 58%, 23% and 56% of HH members were suffering from diarrhoea, typhoid and eye infections respectively. It was seen that male were more vulnerable to the waterborne diseases than those of female. It was also seen that female children <5 years(10%) suffer from diarrhoea just double than male percentage (5%). Gender differences could be one of the reasons. Overall vulnerability of communities indicate that slum had higher combined vulnerability scores for diarrhoea (CVSdiacrhoea= 5.86) and eye infections (CVSeye infeclion=s 6.67) than those of low-income community and overall vulnerability of selected areas indicate that the slum and low-income communities of Gulshan area are the most vulnerable, followed by the slum and low-income communities of Tejgaon, Mirpur and Badda. This study found that for each non-reported diarrhoea incidence remained on average for 5.03 days with standard deviation of 2.02 days. The direct, indirect and total costs were Tk. 759, Tk. 762 and Tk. 1522 respectively. Again each typhoid incidence remained on average for 17.4 days with standard deviation of 7.2 days. The direct, indirect and total costs were about Tk. 3621, Tk. 1361 and Tk. 4982.68 respectively. Finally eye infections' incidence remains on average for 6.3 days with standard deviation of 1.5 days. The direct, indirect and total costs were Tk. 205, Tk. 712 and Tk. 917 respectively. The total cost of diseases for selected areas for one year could be from 87,138,383 Tk. to 149,892,036 Tk. and for slum areas of whole Dhaka city is 5,653,819,098Tk. or 81,726,209 USD. This huge amount of money is generally expended by these groups and might remain unnoticed or not considered during city planning or any national development plan. The prevalence rate (PR) reveals that vulnerable people are more susceptible to the diarrhoea (PRdia"hoea = 480.95) than those of eye infections PReye infections = 309.52 and typhoid (PR'yphoid = 47.62). This study identifies an exponential correlation between numbers of diarrhoea incidences of reporting cases with temperature of Dhaka city. Moreover it also has identified a negative correlation between the demands of water with the number of non-reporting diarrhoea incidences.