Access to Safe Drinking Water: Effects on Health and Time Management

Garimella Rama Rao, International Institute for Population Sciences (IIPS)
Sita K, Independent Consultant
Prasad M.N.V., International Institute for Population Sciences (IIPS)

Introduction It is an accepted fact that access to safe drinking water is a major factor in ensuring human health and efficiency. Water-borne diseases such as diarrhoea are among the world’s greatest killers contributing to deaths of 3 million children and causing about a billion episodes of illness each year. At any one time more than 900 million people are affected with Roundworm infection and 200 million with Schistosmasis. Recent studies suggest that diarrhoea deaths rates are 60 percent lower among children in households with adequate water and sanitation facilities than among those households without such facilities. Improved access to safe water also yields direct economic benefits. For many rural areas, obtaining drinking water is time consuming and heavy work and takes up 15 percent of women’s time. In spite of this, over one billion people worldwide lack access to this essential resource. In fact, with increasing demand, the problem is getting aggravated. In India the importance of providing safe drinking water was recognized in the Fifth Five Year Plan and included in the Minimum Needs Programme. In 1986, a National Technology Mission on Drinking Water was launched in order to provide a scientific and cost effective impetus to the centrally sponsored Accelerated Rural Water Supply Programme. The main thrust of this Programme was to provide water free from biological and chemical (fluoride and iron) contamination. In spite of this, in 1991, 40% of the rural population of India did not have access to safe drinking water. In the state of Andhra Pradesh, India, 850 villages were identified as having fluoride contamination of drinking water. Several of these are in Anantapur district. Under these conditions, the Sri Sathya Sai Baba Central Trust, a public charitable trust, undertook a major infrastructure project, namely, Sri Sathya Sai Water Supply Project. The present paper focuses on the significant effects on health and time management due to the implementation of this scheme. Sri Sathya Sai Water Supply Project The Sri Sathya Sai Baba Central Trust decided to launch in 1994, Sri Sathya Sai Water Supply Project (SSSWSP) covering 731 villages as well as the urban centres such as Anantapur, Kadiri, and Dharmavaram in Anantapur district, Andhra Pradesh, to provide safe drinking water to a million people, who had lived all their lives in the shadow of drought and despair. Sri Sathya Sai Water Supply Project is a collaborative effort of Sri Sathya Sai Baba Central Trust, the Government of Andhra Pradesh and Larsen & Toubro Limited-ECC Construction Group. The uniqueness of the project was its resolve to complete the construction with speed and efficiency within a year, an almost impossible task, but made possible because of a driving sense of urgency. The Sathya Sai Central Trust was prepared to undertake the Water Project, at whatever cost (approximately US $ 70,000,000) in order to relieve the immediate suffering of the people living in the drought-stricken area of Rayalaseema. . Objectives The objectives of this paper are 1.To examine the changes in morbidity pattern with particular reference to water borne and fluoride related diseases. 2.To evaluate the changes in time management. Methods & Materials: Study Area The study area as mentioned earlier, is the Anantapur district, one of the four districts in the Rayalaseema region of Andhra Pradesh. It was declared as a drought prone area since it had low rainfall with temperature reaching over 45 degrees Celsius in summer. There is an acute shortage of drinking water particularly in the summer season. The study focussed on villages that were covered as well those that were not included in the Sri Satya Sai Water Supply Project. Sampling Design The Sathya Sai Water Supply Project covered 731 villages. Out of these villages, 15 villages were selected by using Simple Random Sampling. Seven adjacent villages having similar socio-economic characteristics, which were not covered under the same scheme, were also selected for the purpose of comparison. From each selected village 50 households were selected by using Systematic Circular Sampling. Altogether 1105 households were selected and information collected through structured questionnaires regarding the sources and utilization of water for household purposes and morbidity among individuals. In addition, the views of community leaders on the SSSWSP scheme and that of medical officers regarding their perception of morbidity patterns were obtained. The investigators were instructed to write observations in detail regarding the opinion and problems in the utilization of all the SSSWSP schemes. Tools The bi-variate and multivariate techniques, particularly, logistic binomial regression model were applied. Standardised age incidence rates were computed for covered and not covered villages by taking the age distribution of Andhra Pradesh as the standard population. Major Findings: § It was found that, prior to the implementation of the scheme, both in covered and not covered villages, two-thirds of the households used to depend on public hand pumps and another one-fourth of the households on public taps provided by Rural Water Supply (RWS) as the main source of water for drinking, bathing and washing. After the implementation of the scheme, nine out of ten households in the covered villages shifted to public taps provided under SSSWSP. § A significant reduction was observed in crude and standardized morbidity incidence rates in 'covered villages' (CIR 159 and SR 155) as compared to 'not covered villages' (CIR 231 and SR 232). Access to safe drinking water resulted in a significant reduction in crude incidence rates (CIR) of waterborne diseases (covered 13 and not covered 19) as well as ailments related to fluoride ingestion (covered 29 and not covered 91). Further, chances of sickness in the 'not covered villages' under the scheme were 1.6 times more as compared to 'covered villages’ after controlling for socio-economic variables. § Prior to the implementation of the scheme, three-fourth of the housewives collected the water by travelling long distances and spending considerable time. There is a remarkable shift in collection of water from housewives (40 percent) to children (55 percent) after the implementation of the scheme. As a consequence of this, the women had more time to devote to household work and teaching their children.