NEPAL RED CROSS SOCIETY

Transcription

1 NEPAL RED CROSS SOCIETY NRCS AND ITS INTERVENTIONS IN WATSAN AND DRINKING WATER QUALITY IMPROVEMENT 14 Dec 2010, Kathmandu Umesh Dhakal Executive Director

2 Presentation Outline 1. Nepal Red Cross Society (NRCS) and its involvement in drinking water & sanitation 2. Contribution of NRCS in (a) arsenic contamination investigation (b) mitigation measures (c) health survey (d) capacity building (e) awareness raising etc.

3 Organizational capacity National Headquarters - 1 District Chapters - 75 Sub-chapters and Co-operation Committees - 1,363 Junior and Youth Red Cross Circles - 4,858 Total Organizational units - 6,297 Total Members - 1,019,779

4 NRCS engagement in WATSAN Initiated Watsan activities in 1980 NRCS Primary Health Care and Drinking Water Project (PHC/DWP) was first started in 1983 with support by Japanese Red Cross and Unicef from 1985 A new approach- Drinking water and Sanitation Programme was introduced in July 1993 with more emphasis on software approach Increased women participation Community Based Model 48 districts reached already

5 NRCS- Water Quality (Arsenic) Focused Project : Based on the findings, the program was extended & renamed as Drinking Water Quality Improvement Program (DWQIP) more than 11,000 tube well water samples tested Health survey on arsenic-induced adverse effects Mitigation measures Awareness programs

6 NRCS-Water : The program was extended as Drinking Water Quality Improvement Program- Follow up (DWQIP) Re-examination of identified patients Provision of appropriate alternative options Monitoring of the options Capacity building 2004/ : A new approach-blanket Arsenic Test and mitigation initiated.nrcs adopted the approach with support of JRCS, DWSS,UN Habitat and Unicef. All private public water source tested Arsenic Information Management System Mitigation strategy and plan developed Mitigation and Capacity building

7 Program Implementation Flow Nepal Red Cross Society Head Quarters Community Development Department DWQIP District Chapters Arsenic Information Centers Sub District Chapters In VDCs VDC Program Implementation VDC Community

8 NRCS in Arsenic Mitigation in Nepal Investigated the situation of arsenic contamination in ground water of Nepal in large scale. Played a role in the formation of National Arsenic Steering Committee (NASC) and working as an active member of it. Assisted to formulate the guidelines for NASC Conducted mitigation program in large scale in arsenic affected areas within the NRCS program areas. Conducted research on different types of arsenic mitigation options in Nepalese context.

9 NRCS. contd Prepared map on Arsenic based GPS Data. Conducted health surveys on arsenicosis cases Actively involved in Blanket Testing Program for arsenic contamination in Bara, Parsa and Rautahat districts. Regular monitoring of arsenic contamination levels Development and distribution of IEC materials. Capacity building (trainings to Health workers, maintenance of provided options etc)

10 Major Activities of Quality Improvement Arsenic Testing of all the installed Tube wells Testing of bacteria, Iron and other parameters Health Impact Study Provision of Mitigation Options Awareness Raising Campaign Sharing the experiences with interested agencies Establishment of Arsenic Information Center (AIC) at Districts.

11 Sampling and Testing of Tube Well Water For Arsenic 1. All the Samples were collected and tested by AAS. 2. For the monitoring, ENPHO Arsenic Test Kit was used.

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14 Health Impact Study in the Arsenic affected Areas of Nepal Study by: Senior Health Advisor

15 Study Design for Health Surveys Study Areas (Four District) Pre-Test Water Analysis Questionnaire Survey Clinical Examination Hair Urine Analysis Arsenicosis Patients M I T I G A T I O N O P T I O N Post-Test Water Analysis Questionnaire Survey Clinical Examination Hair Urine Analysis

16 Methodology used for Health survey Tube wells with arsenic contamination > 50 ppb were selected for Health survey Information on the recipients were taken with the help of structured questionnaires Trained Health workers who conducted the survey also observed the population and collected hair/nail and urine samples of the symptomatic persons Hair/nail and urine samples were brought to ENPHO lab for analysis Final confirmation of the symptomatic patients was done by Medical doctor/senior Health Adviser. In addition these patients were again confirmed by Doctors from Bangladesh)

17 Findings of Health Study 15,131 individuals were examined. The overall Prevalence rate was 2.9%. Prevalence increased by age Prevalence rate is higher in the age group of 50 years and above. Most of the patients were in the early stages of arsenicosis symptoms like melanosis and keratosis With the use of arsenic safe options provided under NRCS program, health condition of most of the patients (79%) have improved.

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19 Alternative Water Sources Provided Safe (Arsenic Free) Tube wells-advise provided. Improved Dug well (Dug well with good sanitary Protection) Arsenic Iron Removal Plant (AIRP) Installation of Tube wells in safe aquifer Household level Arsenic Removal Filters (Two Gagri System, Three Kolshi System, Arsenic Kanchan Filter)

20 Marking Tube-well

21 Dug well as an Alternative Option

22 Arsenic Content in Dug Wells Figure: Arsenic levels in Improved dug Well No. of Dug wells >50 Aersenic level (ppb)

23 Arsenic Iron Removal Plant (Nawalparasi)

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25 Two Gagri Filter Chemical packet contains: Ferric chloride (coagulant) Sodium hypochlorite (oxidant) Charcoal (adsorbent) Treated Water Raw Water Mixing & Settling Filtration (ceramic filter)

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27 Three-Gagri System Arsenic contaminated Brick chips 1.0 kg, iron nail 2.5 kg and coarse sand 2 kg Brick chips 1kg charcoal 1 kg & Fine sand 2kg Arsenic Free water Treatment Process: Absorption, Precipitation, and Filtration

28 Arsenic Kanchan Filter

29 Lessons Learnt Arsenic level fluctuate Need regular monitoring in future Needs to provide safe water option before recommending to stop/shut down existing contaminated tube well Need strong motivational program to change people s perception/behaviour Mitigation program should not run agency wise approach

30 Lessons Learnt... contd Kanchan Arsenic Filter (KAF) is found to be the most effective arsenic removal option among other filters While conducting health survey, individual with basic training on diagnosis is sufficient for patient screening

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