Jefferson College of Health Dirty Water and Sanitation & Cholera Outbreak Discussion

I have 3 of my classmates posts. I need you to respond to each one separately. Also, one source at least for each one of them. Don’t write about how good their posts or how bad. All you need to do is to choose one point of the post and explore it a little bit with one source support for each response. The paper should be APA style.

the question was: Evidence is a key component in identifying trends and changing practice especially in the public health field. Choose a public health topic that you are especially passionate about. (e.g. water and sanitation, vaccinations, infectious disease, etc.) Discuss how studies/research support your views (for or against).

Choose a recent international or humanitarian crisis. What public health issues were associated with this incident? How would you manage these issues?

1st post from my classmate IBRA ALNA need to respond:

Dirty Water and Sanitation & Cholera Outbreak

Many epidemiological studies have shown that the inability to access such safe water and clean food results in many diarrheal diseases such as cholera. I would like to start with the theory of John Snow, a London physician, who began to monitor the cholera outbreak in the 1800s by drawing a map showing in which areas cholera epidemics triggered (Ruths, 2009). He found that cholera cases were “around a water pump on Broad Street” in London. After his investigation, he discovered that cholera transmitted by contaminated water and considered this disease as waterborne (Ruths, 2009). I believe that developing countries, particularly which have been impacted by disasters, have a large number of these diseases due to the lack of water and sanitation infrastructure. Haiti, for instance, has been negatively affected by the poor water infrastructure, which was triggered by the magnitude 7.0 earthquake in 2010 (Gelting et al., 2013). The damage of the earthquake forced many Haitians to live in camps in which contaminated water was utilized. As a negative result of this dirty water, the cholera outbreak will likely spread among these populations. I agree that having unsafe water sanitation in Haiti will result in spreading the cholera outbreak. Indeed, the number of cholera cases in Haiti increased dramatically after the earthquake to more than half-million cases and over 800 fatalities (Gelting et al., 2013).

Public Health Issues During Yemen Crisis

Yemenis have been adversely impacted on their health in many different ways since the conflict started there. Camacho et al. (2018) state that more than 8500 Yemenis died, and over 50,000 have been injured since 2015. The conflict has also damaged the water infrastructure, which forced the affected populations to use unsafe water. I believe that this damage will result in many infectious diseases because of utilizing dirty water. Hence, I think Humanitarian aid organizations should focus on improving the public health of the affected population as same as providing such food and shelters. These organizations also must ensure that their camps are established with full paying attention to the public health standards to protect the affected people from infectious diseases.

Studies have shown that many Yemenis in the affected areas utilize dirty water for a variety of uses because they are unable to access safe water. Since the significant reason for having unsafe water in Yemen is the conflict, it will be difficult for Yemenis to (Camacho et al., 2018). Thus, I believe that these people will be affected in their health while using dirty water, and there is a high possibility of spreading infectious diseases such as cholera outbreak. A recent study has shown that since 2017, the number of cholera cases has been seen in Yemen is more than one million cases (Federspiel & Ali, 2018).

Recommendations & Interventions

It is recommended that the Haiti and Yemen governments coordinate and collaborate with the World Health Organization (WHO) to prepare for, response to, and prevent such this outbreak. For instance, they should ensure that the affected populations are provided with WASH services, including clean water, adequate sanitation, and hygiene education (World Health Organization & UNICEF, 2017). No doubt accessing safe water and sanitation will improve the public health of the affected communities. I believe at least boiling water may decrease the percentage of the infection. I also agree that educating these populations about hygiene will likely minimize spreading cholera.

If I were an emergency responder in a camp in which an infectious disease such as cholera spread, I would immediately isolate the suspected cases from the contacted. Delivering Oral Cholera Vaccinations (OCVs) also plays a critical role in preventing cholera. Meanwhile, I would utilize a surveillance system to continue monitoring the populations and collect data to ensure that there is no such increase in the cases. For sure, having personal protective equipment PPE would be vital in the camp. Furthermore, needing such laboratory services will also be a critical aspect. For instance, after making the diagnosis of suspected cases, I will need to assure that whether these people are confirmed or not. Therefore, sending stool samples to the laboratory to verify that these people are affected by the outbreak is crucial for healthcare providers to prevent spreading the epidemic.

References

Camacho, A., Bouhenia, M., Alyusfi, R., Alkohlani, A., Naji, M., de Radiguès, X., … Luquero, F. (2018). Cholera epidemic in Yemen, 2016–18: an analysis of surveillance data. The Lancet Global Health, 6(6), e680–e690. https://doi.org/10.1016/S2214-109X(18)30230-4

Federspiel, F., & Ali, M. (2018). The cholera outbreak in Yemen: lessons learned and way forward. BMC Public Health, 18(1), 1–8. https://doi.org/10.1186/s12889-018-6227-6

Gelting, R., Bliss, K., Patrick, M., Lockhart, G., & Handzel, T. (2013). Water, sanitation and hygiene in Haiti: past, present, and future. The American Journal of Tropical Medicine and Hygiene, 89(4), 665–670. https://doi.org/10.4269/ajtmh.13-0217

Ruths, M. (2009). The lesson of john snow and the broad street pump. The Virtual Mentor: VM, 11(6), 470–472. https://doi.org/10.1001/virtualmentor.2009.11.6.mhst1-0906

World Health Organization, & UNICEF. (2017). Progress on drinking water, sanitation and hygiene: 2017 update and SDG baselines. Retrieved October 10, 2019, from https://apps.who.int/iris/bitstream/handle/10665/258617/9789241512893-eng.pdf

2nd post from my classmate ALI need to respond:

1. water sanitation and hygiene

I believe that access to plenty of water for appropriate washing is the basis for the prevention of a public health crisis. Proper sanitation is key in preventing many diseases, and lack of access to enough water is the cause of thousands of illnesses and deaths in the world. My view is that before focusing on anything else regarding public health, access to water and sanitation must be covered.

After a crisis or disaster, water supply and disposal of the stool have to be implemented quickly in order to minimize mortality and disease. A sufficient amount of water is more important than having perfectly clean water- this means that the water needs to be sufficient but not perfectly clean, and there has to be plenty in order for it to fulfill its purpose. The construction of one latrine for every 20 persons is the guideline, but this is unfortunately rarely possible (Noji, 2005). Noji bases this information on different studies that serve as evidence for his points. For example, a 2001 study about the impact of access to clean water after a cyclone in Madagascar (Mong et al., 2001).

A second article by Jamie Bartram et al., (2005) based on data from the World Health Organization and the United Nations, supports my view by giving out some key facts: In the world, more people suffer from lack of access to water and sanitation than from the effects of war, terrorism, and weapons of mass destruction. Almost half of the world’s population suffers from one of the diseases caused directly by the lack of water and sanitation, including diarrhea (which kills infants), trachoma (which causes blindness), intestinal helminths and schistosomes.

1. Venezuela’s humanitarian crisis

Venezuela is going through a humanitarian crisis caused by the failure of its current regime. The inflation rate is the highest in the world, and 66% of Venezuelans live in extreme poverty. On top of that, medical experts and other scientists have fled or are fleeing the country. The humanitarian crisis has caused many public health issues in the country. Vector-borne and vaccine-preventable diseases have seen outbreaks that have extended even to neighboring countries. Measles and diphtheria have appeared, while there is also a possibility for the return of polio (Paniz-Modolfi et al., 2019). Infant mortality rates have gone higher, and the lack of access to contraception and birth control is creating problems of unwanted pregnancies. Malaria cases have increased because of the lack of treatment and lack of action to control mosquitoes. Tuberculosis and HIV have seen a rise in mortality due to a lack of testing and treatment (HRW, 2018).

The Venezuela public health issues are results of a political and economic crisis that put the country in poverty. This suggests that a change of regime is necessary in order to address the root of the problem. However, it would take years before Venezuela goes back to normal after many years of crisis. In order to manage the public health issues, it is essential to negotiate with the Venezuelan government so that it gives access to NGOs and governmental organizations to bring water, food, and medicine to vulnerable people inside the country. Secure access to volunteers and medical staff as well as resources is necessary. Secondly, refugee camps in neighboring countries have to be adequate to receive the massive numbers of Venezuelans who are leaving. These camps need access to water and sanitation, latrines, fumigation of vectors, and access to medical services. Doctors Without Borders and the Red Cross would be useful both inside Venezuela and in refugee camps.

References

Bartram, J., Lewis, K., Lenton, R., & Wright, A. (2005). Focusing on improved water and sanitation for health. The Lancet, 365(9461), 810–812. doi: 10.1016/s0140-6736(05)71007-2

Human Rights Watch. (2019, April 11). Venezuela’s humanitarian emergency: large-scale UN response needed to address health and food crises. Retrieved from https://www.hrw.org/report/2019/04/04/venezuelas-humanitarian-emergency/large-scale-un-response-needed-address-health.

Mong, Y., Kaiser, R., Ibrahim, D., Rasoatiana, Razafimbololona, L., & Quick, R. E. (2001). Impact of the Safe Water System on Water Quality in Cyclone-Affected Communities in Madagascar. American Journal of Public Health, 91(10), 1577–1579. doi: 10.2105/ajph.91.10.1577

Noji, E. K. (2005). Public health issues in disasters. Critical Care Medicine, 33(Supplement). doi: 10.1097/01.ccm.0000151064.98207.9c

Paniz-Mondolfi, A. E., Tami, A. E., Grillet, M. A., Márquez, M. M., Hernández-Villena, J. G., Escalona-Rodríguez, M. A., … Oletta, J. undefined. (2019). Resurgence of vaccine-preventable diseases in Venezuela as a regional public health threat in the Americas. Emerging Infectious Diseases, 25(4), 625–632. doi: 10.3201/eid2504.181305

3rd from my classmate TARQ need to respond:

One important public health issue that is important in reducing the spreading of diseases such as typhoid and diarrhea is water and sanitation. Water is essential for all forms of life to thrive. For people, most of the content of their bodies are made up of water. Therefore, it is vital to ensure that communities have good access to water that is clean and safe for use. Research and experience over time from before the time of Florence Nightingale has proven that clean water and clean environments are vital for the maintenance of healthy communities.

Many studies have shown that clean water and sanitary environments are needed for the prevention of diseases. Egbinola and Amanambu (2015) conducted a survey in Northern Nigerian schools that aimed at examining the availability of water and soap in schools. The researchers found out that the absence of clean potable water and sanitary conditions contributed to the frequent illnesses among the learners. Clasen and Smith (2019), on the other hand, found that the inclusion of air cleanliness was important in studies that examined the impact of a clean environment on the health of people. Therefore, research supports the fact that water and clean surroundings are critical in maintaining healthy communities.

A recent humanitarian crisis that has been associated with infectious diseases due to the lack of access to clean water and air is the Hurricane Michaels that hit the Bahamas. The hurricane hit the area at high speeds of about 185 miles per hour, leading to the loss of 50 lives. More lives were, however lost due to the inaccessibility of the survivors to clean water and the exposure of cuts as a result of the event to contaminated environments (Mansoor, 2019). While people with chronic illnesses like diabetes had obvious issues like the lack of access to insulin, the general population had the challenges of the lack of clean water because most of the water sources were contaminated. Therefore, one of the crucial things to do while responding to the emergency was to provide clean water.

The issue of the lack of clean water and sanitation can be solved in several ways that all seek to improve the cleanliness of the pace and decontaminate the water. The issue can be solved by providing people with preventive measures such as means of filtering the water and treatment of the water (Clasen & Smith, 2019). People should also be helped to reconstruct toilets or provide mobile toilets that people can use as the situation goes back to normal to prevent the contamination of the remaining sources of clean water. Public health initiatives may also help prevent the spreading of communicable diseases.

In conclusion, water and sanitation are very important in the survival of people in cases of disasters like floods and hurricanes. Even though there are usually many other serious problems, the lack of water and clean environments is usually among the most important problems and therefore should always be corrected as soon as possible to reduce the effects of inadequate water.

Reference

Clasen, T., & Smith, K. R. (2019). Let the “A” in WASH Stand for Air: Integrating Research and Interventions to Improve Household Air Pollution (HAP) and Water, Sanitation and Hygiene (WaSH) in Low-Income Settings. Environmental Health Perspectives, 127(2), 1–6. https://doi.org/10.1289/EHP4752

Egbinola, C. N., & Amanambu, A. C. (2015). Water supply, sanitation and hygiene education in secondary schools in Ibadan, Nigeria. Bulletin of Geography. Socio-Economic Series, 29(29), 31–46. https://doi.org/10.1515/bog-2015-0023

Mansoor, S. (2019). The Bahamas Faces Infectious Disease Risk After Hurricane Dorian. Retrieved from https://time.com/5673532/hurricane-dorian-bahamas-disease/.