World Water Day is observed every year on March 22 to focus on the importance of access to clean and fresh water, sanitation, and hygiene, which are huge challenges in developing nations in particular.
In 2010, the United Nations’ General Assembly recognized water and sanitation as human rights. It is not just about access to water, but it is also about the quality of water people drink. There are more than 663 million people around the world who live without supply of safe water near their homes; several people have to queue up for hours or travel long distances to access something so basic as water.
The need for clean drinking water cannot be overemphasized, as contaminated water (in water bodies) can lead to a whole host of ailments such as gastrointestinal infection, cholera, and dysentery, which can cause life-threatening forms of diarrhea.
The global statistics on diarrhea are alarming and disconcerting. The disease causes 4 percent of all deaths and 5 per of health loss to disability, worldwide (WHO statistics). It is said to be the second major cause of death among children under the age of five. Across the world, 2,195 children die due to this disease every day; this is more than the deaths due to diseases like AIDS, malaria and measles put together. Diarrhea is responsible for 1 out of 9 child deaths worldwide.
In India, about 1.2 lakh children under the age of five die due to this disease every year. This means there are 328 diarrhea-related deaths every day and 13 every hour! (Source: Ministry of Health).
Dr. Amita Bhandarkar, Senior Consultant – Internal Medicine and Diabetology, Columbia Asia Hospital Sarjapur Road speaks on the causes of diarrhea.
The root of the problem is gastrointestinal infection, which leads to the death of 2.2 million people every year across the world, especially in the developing nations.
Diarrheal infection is caused due to bacteria, virus, protozoa and other parasitic organisms (mainly E. coli, salmonella, hepatitis and rotavirus) that are spread from one person to another. The main reasons for diarrhoea are contaminated water, unclean food, malnutrition, improper sanitation, poor hygiene, and absence of immunization.
In under-developed and developing countries, water is contaminated with human faeces from sewage, septic tanks and toilets. Animal faeces too spread diarrhea-causing microbes. Fish and seafood from polluted water also can contribute to diarrhea.
How diarrhea affects people
A person suffering from diarrhea passes loose watery stools (in cholera) very frequently (more than three times a day). In the case of dysentery, stools are passed with blood. Diarrhea can last for a few days or even several weeks (if it is persistent).
Chronic and long-term diarrhea that lasts over three weeks is dangerous and is associated with bowel disorders. Severe diarrhea is life-threatening, especially among infants, young children and people with low nutrition and weakened immunity.
Diarrhea is also related to infections like malaria and measles.
People with diarrhea experience nausea, dehydration, fatigue, fever, abdominal bloating, cramps in the abdomen, pain in the rectum, and the urge to go to the toilet frequently. Blood or pus in the stool, liquidy stools and dark stools are also signs of trouble. In children, watch out for these symptoms: high fever, irritability, loss of skin elasticity, lack of saliva, sunken eyes, abdomen and cheeks.
Diagnosis and treatment
If the above symptoms are noticed, consult a healthcare provider or doctor immediately. Stool culture will help determine the bacteria or other organisms that are causing the infection. A blood test is done to ascertain the diseases that are not present in the body. A sigmoidoscopy investigates the inside of the lower part of the colon and rectum, while a colonoscopy will assess the entire colon.
Diarrhea is treated by replacing the fluids and electrolytes lost due to excessive passage of water in the stool. This is done by drinking oral rehydration fluids and salt solutions, water, clear soups and diluted juices. This will relieve the symptoms.
Diarrhea is usually allowed to run its course and resolve on its own; otherwise, it will lead to the body retaining the toxins that have to be ejected.
In case of severe dehydration, intravenous fluids may be given. Antibiotics are opted for only in case of moderate to severe diarrhea.
Ways to prevent diarrhea
- Drink safe, clean, boiled water.
- Use of good water filters.
- Practice good sanitation and personal hygiene.
- Wash hands often with soap and clean water, before and after eating, after using the bathroom, after changing diapers, after playing with pets, and after touching currency notes and coins.
- Do not tap water even for brushing.
- Avoid raw and exotic fish and meat.
- Eat more of cooked vegetables and fruits that can be peeled.
- Wash vegetables and fruits thoroughly in clean water.
- Do not eat raw/undercooked meat and seafood.
- Avoid non-pasteurized dairy products.
- Do not eat uncovered food from the street.
- Be careful while using public toilets and restrooms.
Above all, awareness and health education about diarrhea and how it spreads will go a long way in preventing this dreadful disease. This calls for governmental intervention, community support, and personal will to follow simple yet essential hygiene practices.
By: Dr. Amita Bhandarkar