Infrastructure is a necessary but insufficient condition to eliminate inequalities in access to water: Research of a rural community intervention in Northeast Brazil

Given the importance of reducing diverse forms of inequality in access to water, highlighted both in the framework of the Human Right to Water (HRW) and in the Sustainable Development Goals (SDG), this work assesses conditions of access to water and related inequalities before and after the construction of a Water Supply System (WSS) in a rural community of Brazil's semi-arid region. A quasi-experimental study was performed to assess the conditions of access to water for study and control groups (amounting to 380 households). The methodology encompassed two phases, one prior and another subsequent to the construction of a WSS in the study community. The analytical framework of the HRW was applied, specifically the normative content regarding quality, accessibility and availability. The case study's findings help to evidence the limitations and challenges of merely infrastructure-related measures to improve access to water. The construction of a new WSS in the studied community was an improvement as it provided water of good quality to the beneficiary households, which entailed a decreased or even a no-longer-existing need to collect water for children and adolescents. However, certain problems persisted, such as the continued practice of collecting water and the use, by certain families, of water that was fecally contaminated. In a different perspective, the WSS made it possible to increase the per capita volume of water consumed by families and to reduce inequalities associated with this aspect. Meanwhile, the research reveals the possible limits of the WSS in ensuring that higher volumes of water will be consumed per capita, especially among households without intra-household water distribution infrastructure.

Having a toilet is not enough: the limitations in fulfilling the human rights to water and sanitation in a municipal school in Bahia, Brazil

Background

This article addresses the enjoyment of the human rights to water and sanitation (HRTWS), in particular access to toilets, in a public school in Bahia, Brazil.

Methods

Participant observation of the school’s routine, focus groups with students in grades 8 and 9 of primary school (13 to 17 years old) and individual, semi-structured, interviews with members of school staff were applied, exploring access to water and sanitation by adolescent girls and boys.

Results

Students and school staff reported that the amount of toilets was insufficient and that their conditions were often inadequate because they were plugged or dirty. The impact on girls is greater as toilets do not offer a clean and healthy environment for menstrual hygiene management. Several elements of the normative content of the HRTWS, especially accessibility, acceptability, quality, safety and dignity, were largely not fulfilled. The study identified that, to comply with the HRTWS, it is necessary to go beyond infrastructure, as the lack of maintenance; cultural elements and student participation hinder the usage of sanitary facilities. Since schools can be privileged spaces to train critical and reflective citizens and to foster autonomy and emancipation, education oriented by human rights and citizenship is an opportunity for a more equitable society. By increasing access to social, economic and cultural rights in all phases and aspects of life, including when children and adolescents are in a school environment, people are able to enjoy better living conditions and a higher standard of health.

Conclusions

The study raised the importance of considering each community’s sociocultural aspects in analyzing access to sanitary facilities in schools, which are spaces where citizens’ rights should be exercised and fulfilled.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6469-y) contains supplementary material, which is available to authorized users.

O controle social em saneamento e em saúde: análise comparativa com base nos marcos legais federais brasileiros

Resumo A comparação entre os marcos legais federais brasileiros das áreas de saúde e de saneamento, sob a perspectiva do controle social, é o fio condutor deste trabalho, tendo em vista o pioneirismo da primeira e sua possível influência sobre a segunda. O esforço comparativo foi realizado a partir de seis critérios analíticos: mecanismos de controle social definidos; caráter conferido ao controle social; responsabilidade, recomendações e apoio para viabilizar o controle social; acesso à informação; controle sobre o uso dos recursos; controle da implementação das deliberações. Avaliaram-se possibilidades de o marco do saneamento se beneficiar das formulações no campo da saúde e lograr produzir práticas mais efetivas de controle social na condução dessa política pública. Os resultados revelam que, mesmo tendo recebido alguma influência da área de saúde, o marco do saneamento é mais restrito e tem menor potencialidade de produzir práticas mais efetivas, uma vez que apresenta: 1) mecanismos mais restritivos por não serem necessariamente deliberativos; 2) ausência de uma política de formação de conselheiros e de educação popular como incentivo e fortalecimento ao controle social; 3) ausência de mecanismos efetivos voltados para a fiscalização do uso dos recursos.

“A gente tem acesso de favores, né?”. A percepção de pessoas em situação de rua sobre os direitos humanos à água e ao esgotamento sanitário

Resumo: Os direitos humanos à água e ao esgotamento sanitário (DHAES) afirmam que todos os seres humanos têm direito ao acesso seguro à água e ao esgotamento sanitário de forma não discriminatória. No entanto, populações vulneráveis têm esses direitos frequentemente violados, repercutindo em sua saúde e qualidade de vida, e agravando a exclusão social, como é o caso das pessoas em situação de rua. Em Belo Horizonte, Minas Gerais, Brasil, existiam 1.827 pessoas nessa condição em 2013. Este artigo apresenta a avaliação das condições e da percepção dessa população sobre o acesso à água e ao esgotamento sanitário e seus direitos nessa área. Observou-se que o acesso, tanto à água quanto ao esgotamento sanitário, é precário e que os conteúdos normativos e os princípios dos direitos humanos são potencialmente violados. Como conclusão, observa-se que esse grupo sofre violações dos DHAES e que estas estão associadas com a violação de outros direitos, como o direito à cidade, à moradia e à saúde. Essas violações têm repercussões negativas na vida econômica e social desse grupo populacional, aumentando a discriminação e a exclusão. O estudo chama a atenção para a importância de estimular a participação social desse grupo nos processos de tomada de decisão sobre a gestão da água e do esgotamento sanitário, no marco dos DHAES, em sua capacidade de ser instrumento de transformação social, gerando empoderamento, promovendo saúde, dignidade e cidadania.

X-ray investigation of hillebrandite

Hillebrandite was first characterized by Wright as a white, fibrous mineral with the composition 2CaO.SiO2.H2O, optical properties αNa 1·605±0.005, γNa 1·612±0.003, moderately weak birefringence, parallel extinction, optic axial angle 2E between 60 and 80° and density 2.692. X-ray powder data were first published by Vigfusson, but these have not been substantiated by later investigators (Clark and Bunn, McMurdie and Flint, and Heller and Taylor). Synthetic dicalcium silicate β-hydrate has been found to resemble hillebrandite closely.

The human right to water and sanitation: a new perspective for public policies

The recognition of the human right to water and sanitation (HRtWS) by the United Nations General Assembly and Human Rights Council in 2010 constituted a significant political measure whose direct consequences are still being assessed. Previous to this date, the HRtWS and its link to a healthy life and adequate standard of living had been recognised in diverse legal and judicial spheres worldwide, in some cases under the pressure of the initiatives of strong social movements. However, while the HRtWS is recognised by the UN State Members, it constitutes a concept in construction that has not been approached and interpreted in consensual ways by all concerned stakeholders. The present article presents a formal definition of this right with a base in human rights regulation. It attempts to dialogue with the different existing perspectives regarding the impact of its international recognition as a human right. It then elucidates the progressive development of the HRtWS in law and jurisprudence. Finally, it considers the urgency and challenge of monitoring the HRtWS and discusses important implications for public policies.

Development cooperation in water and sanitation: is it based on the human rights framework?

The water and sanitation sector is verifiably receiving increased attention and funding through international development cooperation. Not least because of the way that it affects incentives and institutions in partner countries, development cooperation can have either positive or negative effects on human rights though. The consolidated frameworks for the human rights to water and sanitation is becoming linked to the international community's coordinated development efforts, as evidenced notably in the 2030 Agenda for Sustainable Development. However, a review of major funders' official policies for development cooperation in the sector suggests that many only partially endorse the frameworks for the human rights to water and sanitation. An observation of development cooperation flows to the sector allows the hypothesis to be advanced that worldwide inequalities in access to these services may be reduced through a full and clear application of the human rights framework in development cooperation activities. The article presents findings of this research and explores key stakes for development cooperation in the water and sanitation sector that are relevant for their ability to either negatively or positively contribute to the realization of human rights.

[The Aranãs in mid-Jequitinhonha: socioeconomic, demographic and sanitary aspects of a landless indigenous population]

The lack of epidemiological and environmental data on Brazilian indigenous populations is a challenge for the elaboration of public policy. This lack of data is more acute for "landless" indigenous groups. From this perspective, it was considered relevant to describe the Aranã, a landless indigenous group living in Minas Gerais, focusing on the demographic, socioeconomic and sanitary dimensions. A household survey was conducted. The data collected were analyzed and compared with those from other national ethnic groups. The results revealed similarities between these findings and those from the 2010 Census related to the native indigenous population, especially those not living on indigenous lands or reservations. Asymmetric results were identified within the households, mainly sanitary disparities, which suggested a relation with the location. This result indicates the need for priority intervention for the Aranã living in rural areas, bringing to light the age-old discussion about rural and urban disparities. In addition, we suggest that the Brazilian Institute of Geography and Statistics (IBGE), responsible for the 2010 census, should refine its assessment methods concerning landless indigenous groups.

DESCENTRALIZAÇÃO INSTITUCIONAL E GESTÃO DE RECURSOS HÍDRICOS SOB O ENFOQUE LEGAL: O CASO DO COMITÊ DA BACIA HIDROGRÁFICA DO RIO DAS VELHAS, MG, BRASIL

A pesquisa tem como foco o estudo da gestão institucional de recursos hídricos sob a perspectiva do enfoque legal, uma vez que o modelo de gestão pública participativa, descentralizada e integrada proposto juridicamente no país apresenta problemas e demanda constante avaliação analítica. Para tanto o objeto de estudo é o do Comitê da Bacia hidrográfica do Rio das Velhas, localizado em Minas Gerais, Brasil, sendo um dos mais antigos do Estado, pioneiro também ao utilizar diversos mecanismos burocráticos e legais de gestão hídrica. O objetivo é identificar as principais restrições e potencialidades para que um comitê de bacia hidrográfica possa atuar atualmente dentro da estrutura institucional e jurídica brasileira existente. Isso é realizado pela utilização da metodologia de triangulação de métodos de pesquisa de base qualitativa (estudo documental, observação participante e de análise de conteúdo de entrevistas com lideranças do segmento hídrico). Os resultados alcançados indicam que há um distanciamento entre o discurso e prática da gestão pública dos recursos hídricos, com a manutenção de diversas assimetrias e poderes e de capacidade de decisão. É concluído assim que as interações institucionais e sociais são fundamentais para que a dimensão legal seja melhor empregada no sistema de gestão de recursos hídricos.

Grain-resolved analysis of localized deformation in nickel-titanium wire under tensile load

The stress-induced martensitic transformation in tensioned nickel-titanium shape-memory alloys proceeds by propagation of macroscopic fronts of localized deformation. We used three-dimensional synchrotron x-ray diffraction to image at micrometer-scale resolution the grain-resolved elastic strains and stresses in austenite around one such front in a prestrained nickel-titanium wire. We found that the local stresses in austenite grains are modified ahead of the nose cone-shaped buried interface where the martensitic transformation begins. Elevated shear stresses at the cone interface explain why the martensitic transformation proceeds in a localized manner. We established the crossover from stresses in individual grains to a continuum macroscopic internal stress field in the wire and rationalized the experimentally observed internal stress field and the topology of the macroscopic front by means of finite element simulations of the localized deformation.

O direito humano à água e ao esgotamento sanitário como instrumento para promoção da saúde de populações vulneráveis

Resumo O conceito de promoção da saúde, baseado nos determinantes sociais, alinha-se com princípios dos direitos humanos como: participação social, responsabilidade, transparência e não discriminação. O Direito humano à água e ao esgotamento sanitário (DHAES) foi aprovado em 2010 pela Assembleia Geral das Nações Unidas e Conselho de Direitos Humanos, e visa garantir acesso à água e ao esgotamento sanitário sem discriminação para toda a população. Dito isso, o presente artigo tem como objetivo analisar de que forma o referencial dos direitos humanos, em especial do DHAES, pode ser mobilizado para fortalecer a promoção da saúde de populações vulneráveis. Para isso, inicia apresentando a relação entre saúde e direitos humanos, em seguida demonstra como o conceito de vulnerabilidade social se baseia nestes, e finaliza mostrando a relação entre o DHAES e a promoção da saúde de grupos vulneráveis.

Determinants in implementing a public policy for an essential volume of free water in Bogotá and Medellín, Colombia

Within the framework for the realization of the human right to water and sanitation, States have the obligation to implement programs and public policies that satisfy the basic needs of their population, especially its most vulnerable demographics. In Colombia, this challenge has been addressed through policies that provide a determined essential amount of free water to people whose access to water and sanitation services are limited due to low income. Through a review of legal and technical documents as well as relevant literature, this article presents an analysis of the particular determinants involved in implementing this program in Bogotá and Medellín, as well as some related concerns. Among such factors, we discuss the evolution and changes of the tariff model used in service provision, estimates of basic consumption, the role of social movements and collective action, and user disconnection due to non-payment. The main particularities and differences of each case highlighted the inconveniences related to the method of identifying eligible users and applying assistance to beneficiary user groups, and the need for national guidelines in implementing this policy.

Integrating surveillance data on water-related diseases and drinking-water quality; action-research in a Brazilian municipality

The Brazilian Ministry of Health proposed a research study involving municipal professional staff conducting both epidemiological and water quality surveillance to facilitate the integration of the data which they collected. It aimed to improve the intersectoral collaboration and health promotion activities in the municipalities, especially regarding drinking-water quality. We then conducted a study using the action-research approach. At its evaluation phase, a technique which we called 'the tree analogy' was applied in order to identify both possibilities and challenges related to the proposed interlinkage. Results showed that integrating the two data collection systems cannot be attained without prior institutional adjustments. It suggests therefore the necessity to unravel issues that go beyond the selection and the interrelation of indicators and compatibility of software, to include political, administrative and personal matters. The evaluation process led those involved to re-think their practice by sharing experiences encountered in everyday practice, and formulating constructive criticisms. All this inevitably unleashes a process of empowerment. From this perspective, we have certainly gathered some fruit from the Tree, but not necessarily the most visible.

An original architectured NiTi silicone rubber structure for biomedical applications

This paper deals with composite structures for biomedical applications. For this purpose, an architectured tubular structure composed of Nickel Titanium (NiTi) Shape Memory Alloy (SMA) and silicone rubber was fabricated. One of the main interests of such structures is to ensure a good adhesion between its two constitutive materials. A previous study of the authors (Rey et al., 2014) has shown that the adhesion between NiTi and silicone rubber can be improved by an adhesion promoter or plasma treatment. However, adhesion promoters are often not biocompatible. Hence, plasma treatment is favored to be used in the present study. Three different gases were tested; air, argon and oxygen. The effects of these treatments on the maximum force required to pull-out a NiTi wire from the silicone rubber matrix were investigated by means of pull-out tests carried out with a self-developed device. Among the three gases, a higher maximum force was obtained for argon gas in the plasma treatment. A tube shaped architectured NiTi/silicone rubber structure was then produced using this treatment. The composite was tested by means of a bulge test. Results open a new way of investigations for architectured NiTi-silicone structures for biomechanical applications.

[Health and environment in the rubber-tree plantations in the Bolivian Acre (1870-1903): the role of exogenous factors and processes]

A peculiar situation marks the conditions of human and environmental health in the first major cycle of rubber production in the Acre region of the Western Amazon, whereby the bulk of the boom (1870-1903) occurred in the territory that at that time still belonged to Bolivia. Based on this historical background, this work seeks to describe and comprehend how these factors and processes, which are exogenous to these two fields of analysis mediated the risks that originated in the environment, gave rise to sickness and death in the population of the "Brazilian" rubber-tree plantations established in Bolivian territory. In this manner, the inter-relations between health and environment linked to historically specific configurations of the physical-natural, socioeconomic, political, and cultural conditions, are examined. The work shows that these extrinsic factors and processes to the productive activities exerted an influence not only on its organizational but also functional aspects, while also resulting in the unhealthy conditions observed in the productive regions. It further highlights the fact that the extant infrastructure of the time was sufficient for extractive production and reproduction.

Reducing occurrence of Giardia duodenalis in children living in semiarid regions: impact of a large scale rainwater harvesting initiative

Background

In Brazil, about two million people living in rural semiarid regions were benefited with the construction of rainwater cement cisterns, as an initiative from the program “One Million Cisterns” (P1MC). Nevertheless, few epidemiological studies have been conducted to assess health risks or protection effects associated with consumption of this water source. The aim of this study was to evaluate whether access to rainwater harvesting cisterns is associated with the decrease in the occurrence of Giardia duodenalis infections in children, compared to other children living in households supplied by other water sources.

Methodology/Principal Findings

A quasi-experimental study with two concurrent cohorts was developed in two rural municipalities of the semiarid region of Brazil. A sample of 664 children, aged between 4 months and 5 years old, was followed up, of which 332 had access to rainwater cisterns (cistern group) and 332 did not, having water supplied from alternative sources (comparison group). In a period of approximately one year (2010) intestinal parasites were investigated in feces three times. The prevalence of G. duodenalis in children from the cistern group ranged from 4.8 to 10.5%, while the prevalence in the comparison group ranged from 7.6 to 16.7%. Multivariate analysis (GEE) showed a higher risk of G. duodenalis infection in children who did not have access to rainwater cisterns, when compared to children who did (OR 1.72; 95% CI 1.14–2.59). The other variables associated with G. duodenalis infection were: number of rooms per house (OR 0.89; 95% CI 0.80–0.99); family income (OR0.48; 95% CI 0.26–0.88); birth order (OR 1.72; 95% CI 1.17–2.51); preterm children (OR 1.70; 95% CI 1.19–2.43); and improper hand hygiene prior to food preparation (OR 4.78; 95% CI 1.95–11.76).

Conclusions/Significance

Ownership of a rainwater cistern is associated with a lower prevalence of G. duodenalis infection in children after adjustment for environmental and family-related factors. Nevertheless, the study suggests the necessity to complement physical interventions with actions related to personal and domestic hygiene to enable further reductions in parasite infections affecting mainly the underprivileged populations.

Currently, rainwater harvesting cisterns built up through the “One Million Cisterns” Program, coordinated by the Brazilian Government, represents the most important public policy for water supply in the rural semiarid region of Brazil. Despite the extensive use of this water provision, few studies have been performed to assess the associated health impact. To assess such impact, this study investigated factors associated with the occurrence of Giardia duodenalis (protozoan closely related to the ingestion of contaminated water) in children aged between 4 months and five years old. Two distinct groups of children, one with access to rainwater cisterns (cistern group) and the other without cisterns, with water supplied from alternative sources, including rivers, springs or dams (comparison group) were followed up for approximately one year. It was observed that the risk occurrence of G. duodenalis prevalence was greater in children from the comparison group, when compared with those from the cistern group, indicating that the odds of infection by this parasite were 1.72 times greater for comparison group children. In conclusion, the study showed health benefits related to rainwater cisterns, but also identified that other complementary sanitation interventions are needed to minimize the risk of disease in populations with limited access to drinking water.

(A falta de) Controle social das políticas municipais de saneamento: um estudo em quatro municípios de Minas Gerais

Tem sido crescentemente acentuada a ênfase normativa para a participação social e o controle das políticas públicas de saneamento no Brasil, o que recebeu reforço com o marco legal para o setor, que destaca a importância da intersetorialidade, do planejamento e do fortalecimento do controle social. Diante desse quadro, como estariam os poderes locais, titulares dos serviços, se organizando para planejar as suas políticas de saneamento? As questões de saneamento estão presentes nas discussões no âmbito de instâncias municipais destinadas ao controle social, incluindo conselhos de políticas urbanas, da saúde, das cidades, da habitação e do meio ambiente? Para essas questões, buscaram-se respostas em conselhos urbanos situados em quatro municípios de portes populacionais distintos, pertencentes à Bacia do Rio das Velhas, em Minas Gerais: Contagem, Nova Lima, Sete Lagoas e Vespasiano. O estudo é delineado pela visão da atuação dos conselheiros e sua percepção quanto à inclusão da temática do saneamento na agenda dos conselhos, bem como à importância conferida ao tema. As análises de documentos oficiais dos conselhos e de entrevistas realizadas com conselheiros mostraram que, na ausência de instâncias formais de controle social, específicas para a área, são as instâncias de participação constituídas para outras políticas públicas que recebem os temas do setor de saneamento; contudo, eles encontram-se à margem do processo de implementação das políticas. Observam-se, assim, insuficiências e precariedades no processo de participação desenvolvido, resultando em sua incapacidade de exercer controle sobre a política pública de saneamento local.

Electrotransfer of single-stranded or double-stranded DNA induces complete regression of palpable B16.F10 mouse melanomas

Enhanced tumor delivery of plasmid DNA with electric pulses in vivo has been confirmed in many preclinical models. Intratumor electrotransfer of plasmids encoding therapeutic molecules has reached Phase II clinical trials. In multiple preclinical studies, a reduction in tumor growth, increased survival or complete tumor regression have been observed in control groups in which vector or backbone plasmid DNA electrotransfer was performed. This study explores factors that could produce this antitumor effect. The specific electrotransfer pulse protocol employed significantly potentiated the regression. Tumor regression was observed after delivery of single-stranded or double-stranded DNA with or without CpG motifs in both immunocompetent and immunodeficient mice, indicating the involvement of the innate immune system in response to DNA. In conclusion, this study demonstrated that the observed antitumor effects are not due to a single factor, but to a combination of factors.