SBR- Content.pmd - INBO

State of the Basin Report - 20034.6 Data on diseases related to domestic water and sanitationComparable data appear to be limited in detail, with rather more available from Lao PDR thanelsewhere (see Table 6), but data are still largely limited to the monitoring of diarrhoea, cholera andschistosomiasis. There is still little systematic monitoring of the impacts from arsenic, fluoride,pesticides, nitrate from fertiliser, and other chemical pollutants. As stated previously, the countrydata discussed here are not necessarily representative of the LMB area.Box 7. The benefits of wide access to propersanitation in ThailandThailand has made remarkable progress inensuring universal sanitation, and, as a result,in reducing mortality due to diarrhoea and othergastro-intestinal diseases. A sixteen-foldreduction in deaths related to gastro-intestinalillnesses was achieved from 1960 to 1999.During this time period, there was a parallelincrease in sanitary latrine coverage from lessthan 1 percent to over 98 percent.Source: UNICEF 2001A recent MRC report 29 concluded that datacollection on water-linked diseases is notsystemised across the four countries andthere is no common database from which todraw basin-wide summaries andconclusions.There is clearly a need to establish a morestandardised and complete monitoringsystem for diseases related to domestic watersupply and sanitation. This could perhapsbe divided into diseases that aremicrobiological in origin and those ofchemical origin. Microbiological diseasescould in turn be classified into those that arewater-borne, linked to water washing, waterbased,and water bred/vector transmitted. Classification would help to spotlight the most appropriateinterventions. Such information could also enable broad comparisons between countries and overtime (see example in Box 7 above).However, there are well proven difficultiesin directly linking disease statistics withimproved water and sanitation alone.Attempts should be made therefore to assessthe proper use and functioning of improvedsupplies, and of monitoring behaviouralchanges with regard to hygiene. These couldthen be used as appropriate proxies forlikely impacts on health.From the limited data available, it is clearthat alongside the more specific faecal-oraldiseases such as cholera, typhoid, viralhepatitis and dysentery, general diarrhoeaIf pesticide use increases, it will threaten humans bothby contaminating water supplies and by concentrating inthe aquatic animals that people consumeis widely prevalent and has a high impact. Usually diarrhoea is linked to lack of domestic water andsanitation, and exacerbated by poor hygiene practices and low availability of water. In particular,rapid dehydration caused by diarrhoea is likely to be a major cause of mortality among children inthe basin. It has been estimated that improvements in safe water supply, and in particular improvementsin hygiene and sanitation, could reduce the incidence of diarrhoea by one-fifth and deaths due todiarrhoea by one-half. 30260