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Vivek Rai, State Consultant ( Water Quality ) Public Health Engineering Department

The Problem
In India,
Every year, nearly 4 lakh children under 5 die of

diarrhoeal diseases
India contributes 25% of worlds child death 48 per cent of children suffer from malnutrition

The Root Cause

In the Developing Countries, 80% of the common diseases result from: Poor hygienic practices Contaminated drinking water, and Lack of environmental sanitation

Sanitation coverage of 1% and 27% for rural and urban India in 1981 As per 2001 Censusoverall 36% (rural-22% ) One of the lowest in the world even among developing countries Presently 35% rural coverage estimated Only 45% of primary schools have toilets Persistent high Infant Mortality Rate 4-5 lakh children below five years of age die due to diarrhoea annually

For better and healthy life Prevention of disease Personal comfort and convenience Dignity and Privacy of women Avoid pollution of water sources Hand washing after defecation & before meal alone can reduce 60% of water & excreta related disease

Excreta-related Diseases

Diarrhoea Cholera Gastroenteritis Food poisoning Bacillary dysentery Amoebic dysentery Typhoid Poliomyelitis

Hepatitis A & E
Gastric ulcer Round worm

Thread worm Tape worm

Whip worm, etc. etc.

Vector-borne diseases
Filaria Japanese Encephalitis Dengue Chikungunya Kala azar, etc.

More diseases
Skin infections
Eye infections Ear infections Other infectious diseases like Tetanus, Plague,

Anthrax, common cold, influenza, SARS, Bird flu, Swine flu etc.

The Solution


And Why Better ?

Even with adequate treatment Cure is never a

guaranteed result Many diseases, e.g. the viral infections, have no specific treatment Even a so-called common disease may become a killer disease Many of these diseases have not been eradicated in spite of spectacular progress in the medical sciences

Most of these diseases are Diseases of Poverty affecting the common man who cannot afford expensive diagnosis and treatment Many of them have no effective vaccine The pathogens of many diseases are rapidly becoming drug-resistant The cost of diagnosis and treatment is fast going out of reach of the common man Most of the common diseases are infectious and preventable

From experience, we know that
PREVENTION through improvement of environmental sanitation and good hygiene is The easiest, the safest, the cheapest and the most effective way to control diseases

A FACT to remember
The Developed countries actually controlled these common diseases through better sanitation and hygiene even before the development of the antibiotics and many other life-saving drugs.

By ensuring
Clean Environment Good hygienic practices Healthful lifestyle

A Clean Environment
A Clean Environment is an

environment where the disease agents are prevented entry, growth and free movement A clean environment can be achieved and maintained only through TOTAL SANITATION

Transmission of Excreta-related Diseases



Source Hands


Healthy body

Vegetable etc.


Transmission of other diseases

Through bites of mosquitoes and other vectors (

malaria, filaria, dengue etc.) Through air, dust or fomites (respiratory infections, eye infections etc.) Through contact ( skin infections, STDs etc.) Through soil ( Hookworm )

The Key Hygienic Practices

Use of sanitary latrine instead of open

defaecation and urination Hygienic disposal of children excreta Proper hand-washing after anal washing or handling children excreta, after coming in contact with any fomites, after coughing and sneezing Compulsory hand-washing before handling food

Key Hygienic Practices

Proper management of solid waste by

composting/recycling/hygienic disposal/less use of non bio-degradable articles Ensuring water safety i.e., safe source, safe collection, safe transport & storage and safety during use Proper management of waste water by reuse/recycling/hygienic drainage contd

Key Hygienic Practices

Proper washing of vegetables, fruits & utensils in

fresh running water

Protection of food from dust and flies Avoiding foods sold open in the market Use of Improved Chullah to control kitchen smoke


Hygienic practices
Use of footwear while going outdoors
Proper oral and dental care Avoiding spitting here and there

Covering the nose and mouth while sneezing or coughing

Using bed-nets and other precautions against



Hygienic practices
Following other essential practices for personal

cleanliness Immunising children with vaccines according to the prescribed schedule Maintaining overall cleanliness of the household and the village surroundings Once Nirmal Gram status is achieved, maintaining the status through continued monitoring and vigilance

Healthful Lifestyle
Take the right food, i.e., balanced food of the right quantity at the right time. Chew foods well. Keep adequate gaps between meals. Avoid excess of fat, sugar, salt, spice, fast foods etc. as far as practicable
Avoid coloured food and drinks from the market

Drink safe water and enough of it (3/4 litres per day)

Healthful Lifestyle
Avoid tobacco (in any form), drugs, alcohol etc.
As far as practicable, maintain regularity in daily

life Take right amount of sleep avoiding late hours Avoid excesses and indiscretions in sex life

Healthful Lifestyle
Take adequate and regular physical exercise.
Avail of the health care facilities like

Immunisation, health check-up etc. Avoid self-medication without physicians advice. Avoid mental tension

Quality of Life
Measured by Infant Mortality Rate, i.e. lower the IMR higher is the quality of life Life expectancy, i.e. higher the life expectancy, better is the quality of life Literacy rate, i.e. higher the literacy rate better is the quality of life

Better Quality of Life

Better Sanitation Less Disease

Reduced IMR

Better Quality of Life

Better Quality of Life

Better Sanitation Less Disease

Higher Expectancy Of life

Better Quality Of life

Our last chance !

Provisions under TSC offer us the last chance to ensure sustainable sanitation, And if, we fail to utilise this last opportunity, just think about

Our future
During the past 30/40 years only one disease (small-

pox) has been eradicated. But numerous new and re-emerging disease-agents are threatening mankind globally. It has been established that simple hygienic practices can prevent or keep most of them under control

We are doomed if we do not take a lesson from these facts. It is for us to decide and design our own future