Impacts of Intermittent Water Supply on Water Quality in Two Palestinian Refugee Camps

Cytotoxicity of water supply in a Palestinian refugee camp and a Syrian informal tented settlement in Lebanon

Deficient water, sanitation, and hygiene (WASH) significantly account for a high burden of disease across the globe. Lebanon, an Eastern Mediterranean lower-middle-income country with a polluted environment, a fragmented healthcare system, and an ongoing severe economic crisis, faces serious challenges in sustaining safe water supplies, especially in vulnerable communities, while also hosting the world highest refugee population per capita. This study aimed to examine the mutagenicity, and the estrogenic and androgenic activities of water supplies, across both a Palestinian refugee camp and a Syrian informal settlement. Water samples were collected from two targeted camps in Dbayeh and Choueifat, North and South of the Capital City Beirut, respectively, between the months of September and October 2022. Microbial and physicochemical properties of samples were determined, including fecal contamination, total dissolved solids, and various minerals and salts. Organic pollutants were extracted using pre-packed solid phase extraction (SPE) columns, and then mutagenicity of extracts was examined using the Ames test in two Salmonella typhi bacterial strains. The estrogenic and androgenic activities of extracts were assessed using the yeast estrogen and androgen screen tests assays (YES/YAS). Results show excessive levels of total coliforms and total dissolved solids (TDS) in samples from both sites. In addition, the water supply from the Dbayeh Palestinian refugee camp is mutagenic, while the water supply from the Choueifat Syrian informal settlement shows anti-androgen activity. Our findings provide valuable WASH baseline data in two major vulnerable communities in Lebanon, and highlight the importance of a water toxicity testing approach concomitant with a water safety plan, based on a holistic strategy that covers all stages of the water supply chain.

Intermittent water supply and self-rated health in rural China's karst region

Introduction

With rapid economic and social development, surging demand for domestic water, and the increasing shortage of water resources, the applications of intermittent water supply systems have become more common in rural China and other developing countries. The accompanying hygiene risks require our more attention.

Methods

Based on the Grossman model, this paper conducted an IV-Oprobit model to investigate whether and how intermittent water supply affect rural residents' self-rated health status. Our data came from "China Karst Rural Economic Survey (CKRS)", which covers 8 provinces and 641 villages in rural China's karst region.

Results and discussion

We found that: (1) Intermittent water supply has adverse effects on the self-rated health status of rural residents. Compared with the rural residents under continuous water supply, the probability of "fair" health status under intermittent water supply significantly increases by 18.2%, while the probability of "excellent" significantly reduces by 58.8%. (2) Residents' water storage behavior and sanitary water habit are important mechanisms for intermittent water supply to affect residents' self-rated health status; (3) Intermittent water supply has a greater impact on the self-rated health of females and the groups with lower education levels. The results of our study have the following policy implications: relevant departments should make a rational plan about water supply methods and improve related supporting measures; we should strengthen health education for rural residents on water behavior to standardize their water storage and sanitary water behavior; government should enhance the pertinence of policy implementation and favor specific measures to specific populations.

Mapping and Visualizing Global Knowledge on Intermittent Water Supply Systems

Intermittent water supply systems (IWSSs) are prevalent in most developing countries and some developed ones. Their usage is driven by necessity rather than as a principal objective, mostly due to technical and economic deficiencies. Major health risks and socio-economic inequities are associated with such systems. Their impacts are aggravated by climate changes and the COVID-19 crisis. These are likely to have profound implications on progress toward advancing sustainable development goals (SDGs). Motivated by providing a comprehensive overview of global knowledge on IWSSs, the present work proposed to track and analyze research works on IWSSs utilizing bibliometric techniques and visual mapping tools. This includes investigating the trends and growth trajectories of research works on IWSSs and analyzing the various approaches proposed to expand our understanding with respect to the management, modeling, optimization, and impacts of IWSSs. The national and international contributions and collaboration figures are further analyzed at country, institution, author, and source levels. This analysis indicates that research works conducted on IWSSs have certain expectations in terms of productivity (total global productivity; 197 documents). The United States was the best country in terms of productivity (58 documents; 29.4%), while the Water Switzerland journal was the most productive journal (19 documents; 9.6%). The impacts of IWSSs on health and well-being have attracted considerable attention. The outcomes showed deep and justified worries in relation to the transition from intermittent to continuous supply, equity, and mitigating the health risks associated with IWSSs in the foreseen future. The utilization of artificial intelligence techniques and expert systems will drive and shape future IWSS-related research activities. Therefore, investments in this regard are crucial.

Microbial water quality improvement associated with transitioning from intermittent to continuous water supply in Nagpur, India

Nearly half a billion people living in Indian cities receive their drinking water from an intermittent water supply (IWS), which can be associated with degraded water quality and risk of waterborne disease. The municipal water supply in Nagpur, India is transitioning from intermittent to continuous supply in phases. We conducted cross-sectional sampling to compare microbial water quality under IWS and continuous water supply (CWS) in Nagpur. In 2015 and 2017, we collected 146 grab samples and 90 large-volume dead-end ultrafiltration (DEUF) samples (total volume: 6,925 liters). In addition to measuring traditional water quality parameters, we also assayed DEUF samples by droplet digital PCR (ddPCR) for waterborne pathogen gene targets. At household taps served by IWS, we detected targets from enterotoxigenic E. coli, Shigella spp./enteroinvasive E. coli, norovirus GI and GII, adenovirus A-F, Cryptosporidium spp., and Giardia duodenalis. We observed a significant increase in the proportion of grab samples positive for culturable E. coli (p = 0.0007) and DEUF concentrates positive for waterborne pathogen gene targets (p = 0.0098) at household taps served by IWS compared to those served by CWS. IWS continues to be associated with fecal contamination, and, in this study, with increased prevalence of molecular evidence of waterborne pathogens. These findings add mounting evidence that, despite the presence of piped on premise infrastructure, IWS is less likely to meet the requirements for safely-managed drinking water as defined by the Sustainable Development Goals. Importantly, these findings demonstrate the transition from IWS to CWS in Nagpur is yielding meaningful improvements in microbial water quality.

Assessment of water and sanitation systems at Palestinian healthcare facilities: pre- and post-COVID-19

The availability of safe drinking water and the proper management of wastewater in healthcare facilities are important pillars for maintaining safety of workers, patients, and visitors and protecting human health and environment. Water and sanitation services at 495 healthcare facilities in the West Bank of Palestine are assessed using the results of PCBS and MoH (2014) survey study. Services are reassessed after the COVID-10 pandemic using personal interviews with experts from healthcare facilities, regulatory authorities, and service providers. The results show that 92.1% of healthcare facilities were connected to public water networks, 12.9% of them purchased water tanks, and 10.8% of them depended on harvested rainwater which may cause contamination and waterborne diseases. Regardless the source of freshwater, the water quality has to be regularly examined and compared to local guidelines and international standards for health promotion. Almost 63.4% of healthcare facilities were not connected to wastewater networks and used either tight or porous cesspits. Once these cesspits are filled off, wastewater is randomly disposed into nearby valleys causing adverse environmental impacts on air, water, and land resources. Medical wastewater of hazardous substances should be treated before discharged to wastewater networks. Experts assured that although heightened procedures have been made by service providers to curb the spread of the COVID-19 disease, yet, more consistent protocols and stringent procedures are crucial. There have not been any new directives or procedures regarding the management of water supplies and wastewater services in the healthcare facilities. Stakeholder collaboration can help prevent the COVID-19 disease.