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Well Water in Angkor ChumHealth and Practicality
Five Villages – Five Chiefs – One Flood
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
Where were the wells?Angkor Chum District, Siem Reap ProvinceFive villages, an NGO office and PP restaurant12 wells testedTested in July 2011
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
Inexpensive water testing$2 per test - plus shippingNo incubator required
but it will take 48 instead of 24 hours
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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.
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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.
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
Chief Huon Oeum of Tumroab133 FamiliesAll wells tested were contaminated in JulyWater levels in HDW = paddy water level The village wells did not flood
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
nophoto
nophoto
nophoto
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
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 [email protected] 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.
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
Thank you and good luck.
www.naturehealingnature.org [email protected] www.thecenterforrainwaterharvesting.org 016-685-915 & +1 832-423-8425
Well Water in Angkor ChumFive Villages – Five Chiefs – One Flood
www.naturehealingnature.org www.thecenterforrainwaterharvesting.org
016-685-915+1 832-423-8425Houston, Texas
Empowering people to help themselves with what they already have . . .