well water in angkor chum health and practicality

Well Water in Angkor ChumHealth and Practicality

Five Villages – Five Chiefs – One Flood

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Empowering people to help themselves with what they already have . . .

GratitudeMany thanks to the generous people of

PLAN-Cambodia and WTOoffering guidance, transportation, translation, housing

and friendship

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Where were the wells?Angkor Chum District, Siem Reap ProvinceFive villages, an NGO office and PP restaurant12 wells testedTested in July 2011

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Inexpensive water testing$2 per test - plus shippingNo incubator required

but it will take 48 instead of 24 hours

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How much is too much?A CFU is a colony forming unitAlmost all health standards in the world say E-coli, fecal

coliforms and Salmonella should be 0 CFU per 100 mlThe WHO recognizes that is difficult to attain in developing

countries

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WHO Guidelines for drinking-water quality – Second EditionVolume 3, Surveillance and control of community supplies

What’s an E-coliAlmost all health standards in the world say

E-coli, fecal coliforms and Salmonella shouldbe 0 CFU per 100 ml

E-coli (from Theodor Escherich, 1885) is important as an indicator bacteria

Infectious dose is 20 to 108 depending on typeMost common cause of pediatric Urinary Tract Infections

http://emedicine.medscape.com/article/969643-overview

Remember – e-coli is an indicator of probability that other infectious bacteria are present

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2 to 3 micros long and 0.5 wide

What’s Salmonella?Health standards in the world = 0 CFU/100ml One form causes typhoidDiarrhea, fever, vomiting, stomach cramps

Headache Infectious dose is 15 to 20 cells

US Food and Drug Administration

Infectious dose is lower for children

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2 to 5 micros long and 1 wide

What’s Aeromonas?Most water standards do not

include AeromonasMost cases of aeromonas related pneumonia

are found in the 16,000 to 160,000 neardrownings in the USA each year

Respiratory illness, skin and soft tissue infections, fever, vomiting, stomach cramps, headache, eye infections, (not so much diarrhea)

Infectious dose ? Infectious dose is lower for children

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1 to 3 micros long and 0.7 wide

Non-sealed, hand-dug or bore-holewells less than 25m deep offer aconvenient water supply – not safety.Contaminated water is always presentHand Dug Wells (HDW) are shallow, 3m -5mWe all know to put a latrine 20m from a drinking water well.

The same holds true to put it 20m from a paddy or otherpuddle of water.

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Chief Lek Hat of Svay Chhum130 FamiliesVillage wells were not testedAfter the flood, villagers bailed out the

wells and started using the waterThere was little increase in diarrhea

Many people in the village, including the Chief, got a sickness after the flood that included high temperature, vomiting, dizziness, headache, and sleepiness. The illness lasted about two weeks.

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Chief Huon Oeum of Tumroab133 FamiliesAll wells tested were contaminated in JulyWater levels in HDW = paddy water level The village wells did not flood

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21m deep bore hole

40 e-coli/100ml20 salmonella120 aeromonas

Hand-dug well #1

2.000 e-coli/100ml20 salmonella10,000+ aeromonas

Hand-dug well #1

5.000+ e-coli/100ml20 salmonella10,000+ aeromonas

Chief Rein Satuon of Koak Kroul 136 FamiliesAll wells tested were contaminated in JulyAll village wells were floodedAfter the flood, villagers bailed out the

wells and started using the waterThe Chiefs brother got

typhoid fever after theflood

The chief’s ceramic filterremoved all bacteria wetested for

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nophoto

nophoto

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Chief’s ceramic filter

0 e-coli/100ml0 salmonella0 aeromonas

Hand-dug well in paddy field

2.000+ e-coli/100ml2,000+ salmonella2,000+ aeromonas

Hand-dug well used by Chief

2.000+ e-coli/100ml2,000+ salmonella2,000+ aeromonas

Chief Khat Khoan of Romiet 74 FamiliesAll wells tested were contaminated in July14 village wells floodedAfter the flood they started using the well water

without emptying or decontaminatingThere were outbreaks of

fever and diarrhea for two-weeks after the flood

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Hand-dug well #1 800 e-coli/100ml640 salmonella1,200 aeromonas

Hand-dug well #2 220 e-coli/100ml800 salmonella10,000+ aeromonas

Chief Mao Mang of Chumpung 101 FamiliesAll wells tested were contaminated in JulyNot much flood damage or health problemsNo wells were flooded

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0

Hand-dug well #1 4.000+ e-coli/100ml600 salmonella2,000 aeromonas

Hand-dug well #2 300 e-coli/100ml1,000 salmonella3,000+ aeromonas

Along the road and an NGO Both wells tested were contaminated in JulyWater levels in HDW = paddy water level

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nophoto

Bore-hole well 40m w Rope pump 20 e-coli/100ml0 salmonella0 aeromonas

Hand-dug well NGO office 100 e-coli/100ml100 salmonella10,000+ aeromonas

Phnom PenhRestaurant

120 e-coli/100ml40 salmonella40+? aeromonas

The “Take Away” on health effectsAsk health Department to present bi-annual WASH related

illnessdata during WATSAN meetings. This information would be powerful for targeting, monitoring and independent evaluation. By District every six months starting next year By Commune, every six months, starting in 2017

Ask Health Department to investigate whether aeromonas is a major cause of respiratory disease in Cambodian children less than 5. Might explain high incidents of acute respiratory illness (5 to

10 times more prevalent than diarrhea). Might shift WASH sector to putting more resources toward

HWT www.naturehealingnature.org mark@naturehealingnature.org www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425

The “Take-Away” on wells All hand-dug wells should be considered contaminated unless proven

otherwise. Wells should be tested in August, September, or October (wettest season)

New well installation programs should include household water treating training and efforts to make HWT devices available . Alert the villagers to the hazards of thinking the well water is clean Coordinate with NGOs to offer HWT products Tell villagers to boil or use SODIS or pasteurization if they can not afford a

HWT device

We all know to put a latrine 20m from a drinking water well.The same holds true to put a drinking water well 20m from a paddy or otherpuddle of water – especially if it leaks!

Continue to dig HDWs in Cambodia, but synergistically concentrate on HWT until we can afford deep-well (minimum 20m deep) sealed bore holes everywhere or centralized water distribution systems that work.

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Thank you and good luck.

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Well Water in Angkor ChumFive Villages – Five Chiefs – One Flood

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Empowering people to help themselves with what they already have . . .