• Issue 86 / March - April 2012

    Another Side to Water

    Ceyda Sablak

    Water plays a crucial role in maintaining the balance between life and death on Earth. It can either instigate health, or be a deadly disease vector (Govender, Barnes and Pieper 2011). Although the effects of water on human health can widely be seen throughout the globe, it is most amplified in Africa.

    Africa has many fresh water sources such as Lake Tanganyika, Lake Victoria, the Zambezi, Nile, and Juba Rivers. Theoretically, Africans should be able to at least, adequately sustain healthy life with this amount of water (Whiteford & Whiteford, 2005). On the other hand, several issues affect the water sources making them either inaccessible, or dangerous to use. Diseases form and spread all through Africa, deteriorating life due to deficient amounts of clean water (Whiteford & Whiteford, 2005).

    The reason for the water problems majorly involves dams and deforestation, along with pollution. Firstly, dams provide irrigation and hydropower, but hidden underneath these benefits are the massive and long-term detriments of destroying the well-known system of flood-plain agriculture and deforestation due to incomplete dam projects. Flood-plain agriculture is the classic system of agriculture that was mainly used along the Nile River as well as several other rivers in Africa. These traditional systems of agriculture depend on the annual floods in order to fertilize and water their crops. Water, as well as the silt that once functioned as fertilizer, are now built up behind the dams and are unusable. Secondly, deforestation dries up the land even more because interception and transpiration from trees stop, causing more forest fires and destruction of habitats. Deforested land becomes a dried up desert absolutely unusable by all habitats, especially humans (Jobin, 1999). Thirdly, pollution caused by poor sanitation techniques, in addition to industrial and chemical pollution are major reasons for the decline of life in Africa. Poor sanitation techniques lead to human and animal feces infest water, leading to increase in diseases related to water. The industrialization and urbanization in some parts of Africa leads to high levels of modern environmental health hazards. This results in other severe health problems indirectly related to water. For example, in the Nairobi River Basin in Kenya, there were effluent concentrations of elements such as nickel, copper, and lead, which were 60, 600, and 120 times higher than recommended (Nweke and Sanders, 2009). Another major cause of chemical pollution all across Africa is the use of pesticides in agriculture which have been detected in streams and rivers in different regions. These pesticides contaminate soil, water, air, and food sources, posing serious health threats to Africa's populations. Endosulfans, as well as more dangerous organochlorines, such as DDE and DDT have recurrently been detected at water sources near agricultural areas in South Africa. This contamination has been confirmed to regularly exceed the “European drinking water standard of 0.1 g/L" (Nweke & Sanders, 2009). This contamination not only poisons potential sources of food, but it also destroys habitats which all have a chain reaction pertaining to the sustainability in Africa. In summary, these factors influence the water quantity and quality in Africa. It also negatively affects people's habits regarding water usage. If people realize they have little water, they ration it ineffectively. For instance, they will take up water usage reducing habits such as not washing hands, clothes, food products, dishes, themselves, etc. leading to less hygiene and increasing the likelihood of getting disease. If there is plenty of water but it is contaminated, the pollutants in the water source will cause diseases. Therefore, due to poor water management in Africa, diseases related to water have been severely affected.

    Water-related diseases differ from waterborne diseases in that the disease is not directly caused by the water consumed. Instead, the vector of the disease uses water as a breeding ground from which the vector then emerges. Common water-related diseases include malaria, yellow fever, schistosomiasis or bilharzia, and onchocerciasis or river blindness (Whiteford & Whiteford, 2005).

    Schistosomiasis, also known as bilharzia, is a disease that is highly prevalent along the Nile River as well as all other fresh water resources throughout Africa caused by parasitic worms and snails (Jobin, 1999). The most common parasitic worms that cause bilharzia in humans are Schistosoma mansoni, D. haematobium, and S. japonicium (Centers for Disease Control and Prevention, 2010). Infection occurs when the larval stage of schistosomes search for a human host while swimming in the water. After parasitizing the human circulatory system by penetrating the skin of an individual in contaminated water, they reproduce in the human gut or bladder by laying their eggs there (Centers for Disease Control and Prevention, 2010; Jobin, 1999). These eggs pass out of the body by means of human waste and reach aquatic habitats of snails (Jobin, 1999). After the eggs hatch, they develop into larvae which penetrate the snail, developing further and “multiplying by astronomical factors" (Jobin, 1999, p. 66). The parasite larvae then leave the snail continuing the reproduction cycle. As written by Jobin (1999), “bilharzia is a debilitating disease which can cause early death of persons parasitized by large numbers of worms" (p. 68).

    Symptoms of bilharzia include developing a rash or itchy skin within days of infection. Within 1-2 months of the infection, symptoms such as fever, chills, cough, and muscle aches may also appear, but people tend to have no symptoms at this early phase. The eggs that travel in the body can also cause inflammation and scarring. As reported by CDC (2010), infected children may “develop anemia, malnutrition, and learning difficulties." All of these symptoms are reactions of the body to the eggs produced, and not by the worms themselves. Treating schistosomiasis is essentially effortless; you must take a pill 1-2 days (Centers for Disease Control and Prevention, 2010).

    Since the health care systems in some African countries are shoddy, and the majority of these populations cannot afford treatment or drugs, prevention is the most efficient technique to fight disease throughout the continent (Falola & Heaton, 2007). Bilharzia can easily be prevented in Africa by avoiding swimming in fresh water sources, health education, drugs, focal application of biocides to kill snails, and improved water supply and sanitation are also required to stop the spread of the infection. Using feces and urine contaminated water is a major cause of spread of the disease due to the nature of the parasite's reproductive system, but another equally important issue is intensifying agriculture. Increased agriculture results in runoff with high concentrations of nitrogen and phosphorous, which act as a fertilizer (Peace, 2006). These compounds trigger an increase in aquatic weeds, the ideal habitat for snails, which causes increased bilharzia transmission. In addition, since people wanted to clean the water sources from the weeds, they would manually try to clean the water supply, without taking any precautions. This exacerbated the situation by exposing themselves to the disease (Jobin, 1999).

    An example of the relationship between agriculture along with irrigation, and bilharzia as well as malaria transmission can be seen in the Gezira-Managil Irrigation System in Sudan. In 1925, when the irrigation system was first constructed, the overall agricultural intensity increased by 300%, this was because the natural system had been altered with. Naturally, the water should have dried out by April-May, but instead it ran 100% of the time. The Gezira-Managil Irrigation system became the main source of income in Sudan, producing 3/4 of the gross national cotton production. By 1970, the proliferation of agricultural pests, aquatic weeds, snails, mosquitoes and silt in the canal lead to the decline of the agricultural system. As a result, cotton was infested by the white-fly, pathogenic viruses and bacteria multiplied in the water making it unusable. Malaria mosquito populations increased, attacking at night and increasing transmission of disease, since there were no longer dry seasons to destroy their habitat. Similarly, bilharzia snails increased since the unnatural, man-made system had constructed an exceptionally ideal habitat for them, attacking during the day as people waded in the waters, and intensified the transmission of the disease. People who worked on the fields and near the irrigation system got infected, not being able to work on the nearly non-existent cotton fields. The country's gross income changed from approximately US $228 million to US $76 million by 1981. There was no longer any money, which meant no more facilities for community water supplies and sanitation, increasing disease and unemployment, resulting in even less money in a seemingly endless cycle (Jobin, 1999).

    There are many factors that act as obstacles in the way of African well-being. The most prevalent type of disease in Africa is waterborne and water-related. Sheik-Mohamed & Velema (1999) report that “major causes of mortality and morbidity seem to be preventable infectious diseases." Govender et al. (2011) similarly state that “diarrheal diseases are an important cause of morbidity and mortality in low- and middle-income countries" and that these diarrheal diseases can be prevented simply through improved water quality. Every 8 seconds a child dies from a disease related to having either unclean or not enough water. Diseases linked to water kill more 5 million people each year – ten times the amount of people killed in wars (Whiteford & Whiteford, 2005). These statistics are outrageous. Every human should have the right to have clean water. Every human should have the right to live in a healthy environment and be in good health.

    Centers for Disease Control and Prevention. (2010, November 2). Schistosomiasis:
    General Information. Retrieved October 2011, from Centers for Disease Control
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