Quality of Water and Water Related Diseases in Urban Areas

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1 5.1.2 Incidence of water borne diseases in states of India The water borne diseases in India are occurring over the years despite various water quality management plans by the Government of India. Regardless of the initial water quality, unhygienic practices during collection, storage and consumption led to diarrhea causing germs and other water related diseases (Montogomery A and Elimlech M, 2007). Incidence of water borne diseases in some selected states of India is presented in table 5.2. There is a wide range of water borne diseases like diarrhea, cholera, malaria, Japanese encephalitis, hepatitis, dengue, enteric fever etc. But here due to some constraints, comparative data of some water related diseases was not available. Diarrhea is one of the most occurring diseases in most of the states of India. There were 8,501 thousand diarrhea incidences in various states in 1998 which decreased to 8,414 thousand in 2006 with a fall of 1.02 percent change. Main states affected due to diarrhea were Andhra Pradesh, Delhi, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and West Bengal. Malaria had 1668 thousand incidents in 2001 which decreased in 2005 to 1537 thousand. The states affected with malaria were Andhra Pradesh, Assam, Bihar, Delhi, Gujarat, Haryana, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh, West Bengal and Uttarakhand. The water quality policies were successful in bringing down the malaria incidences by 7.8 percent. Hepatitis is also one of the water related disease. It was reported that there were 140 thousand incidences of hepatitis in , which fell to 129 thousand in The states affected by this particular disease were Andhra Pradesh, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and West Bengal. Governments of various states were successful enough in bringing down hepatitis incidences as there was a fall of 7.8 percent in hepatitis incidences in the country collectively. Table 5.2 was a collective presentation of incidences of various diseases in different years in different states. Table 5.3 presents incidence of water borne diseases in particular states in different years. 72

2 Table 5.2: Trends in the incidence of water borne diseases in selected states of India Incidence Percentage States affected Disease (in thousands) change 1. Diarrhea 8501 (1998) 2. Malaria 1668 (2001) 3. Hepatitis 140 ( ) 8414 (2006) 1537 (2005) 129 (2006) Note: Figures in brackets shows the years of study. Source: 1. MoHFW, GOI, National Health Profile 2006, CBHI, DGHS MoHFW 3. MoHFW, GOI, Annual Report, Andhra Pradesh, Delhi, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh, West Bengal Andhra Pradesh, Assam, Bihar, Delhi, Gujarat, Haryana, Jharkhand, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh, Uttarakhand, West Bengal Andhra Pradesh, Gujarat, Haryana, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh, West Bengal Andhra Pradesh had 18, 52, 642 incidences of diarrhea in 1998 which fell to 12, 15,659 in Malaria cases were 57,735 in 2001 which dropped to 39,099 in 2005 and hepatitis cases too bowl down to 17,846 in 2006 from 27,595 in This shows that although there were a large number of various water related diseases in Andhra Pradesh, but the government had been successful enough in bringing down the incidences over the years. Diarrhea cases had fallen in 2006 in comparison to 1998 in Andhra Pradesh, Delhi, Haryana, Kerala, MP, Maharashtra, Orissa, Punjab and Uttar Pradesh while the incidences had increased in Gujarat, Karnataka, Rajasthan, Tamil Nadu and West Bengal. West Bengal had a different case as there were 7, 20,352 diarrhea incidences in 1998 which increased to an astonishing figure of 26, 22,968 incidences in Malaria incidences too had increased in West Bengal. Other states in which malaria incidences had increased from 2001 to 2005 were Gujarat, Haryana, Jharkhand, Kerala, Punjab, Tamil Nadu, Uttar Pradesh, and Uttarakhand. While the states of Andhra Pradesh, Assam, Bihar, Delhi, Karnataka, Madhya Pradesh, Maharashtra, Orissa and Rajasthan had reportedly less incidences of Malaria in 2005 as compared to

3 Table 5.3: Incidence of water borne diseases in major states of India States Diarrhea Malaria Hepatitis Percentage change Percentage change Percentage change Andhra Pradesh 1,852,642 1,215, ,735 39, ,595 17, Assam 596, ,142 67, Bihar N.R ,108 2, Delhi 133,089 94, ,484 1, ,007 4, Gujarat 207, , , , ,982 9, Haryana 375, , ,202 33, ,086 3, Jharkhand - 14, , , Karnataka 674, , ,625 83, ,571 14, Kerala 550, , ,289 2, ,521 7, Madhya Pradesh 479, , , , ,620 2, Maharashtra 1,098, , ,043 47, ,962 43, Orissa 793, , , , ,011 2, Punjab 196, , , ,796 3, Rajasthan 211, , ,233 52, ,601 3, Tamil Nadu 47, , ,551 39, ,740 4, Uttar Pradesh 564, , , , , Uttarakhand - 94,746-1,196 1, ,381 - West Bengal 720,352 2,622, , , ,831 7, NR: Not reported Source: 1.Ministry of Health and Family Welfare, GOI, National Health Profile 2006, CBHI, DGHS-MoHFW 3. MoHFW, GOI, Annual Report

4 Hepatitis cases too had a downfall from to 2006 in the states of Andhra Pradesh, Karnataka, Madhya Pradesh and Orissa, while in most of the states the incidence of hepatitis had increased in 2006 as compared to Apart from these diseases, the incidences of cancer deaths in Punjab are much higher than the accepted national and international averages. World Health Organization (WHO) reference regarding incidences of cancer was 80 affected persons from the population of one lakh while Punjab s survey revealed this figure as 90 affected persons from the population of one lakh (The Indian Express, Chandigarh, Tuesday, Jan. 29, 2013, 2:03 hrs.). A survey was conducted by Punjab Government in 2012 wherein it was revealed that 33,318 cancer deaths have occurred during last 5 years, out of which 14,682 were in Malwa region alone. As many as 4,000 of these deaths happened in Ludhiana Perception of households about the quality of water in various cities The perception of households about the quality of water being supplied by municipal corporations in different cities is shown in Table 5.4. Collectively taken, all 7 cities, approximately 3 percent households reported that water is not safe at all, 5 percent opined that water was not so safe, 21.3 and 28.4 percent respondents, respectively reported that water was somewhat safe and quite safe. Only around 26.0 percent households have the idea that water supplied by municipal taps was very safe. While 16.8 percent respondents have shown their inability to say anything about the quality of water. Contamination of municipal tap water has been a common problem in majority of the cities of India. Only about 1 percent respondents of Kanpur, state that water was very safe, while 57 percent respondents of Hyderabad city have the perception that water was very safe. Very small portion of the respondents of Mumbai reported that water was not safe at all, while 3 percent each of Delhi, Kolkata and Hyderabad respondents were of the same opinion. It seems that Kanpur respondents were more conscious for the quality of water being supplied by municipal taps as 10 percent respondents say that water was not safe at all for consumption and approximately 13 percent say that water was not so safe and 46 percent respondents were unable to say anything about the quality of municipal water. 75

5 Table 5.4: Perception of households about the quality of water in various cities: 2007 (percentage of households) Safety level All cities Delhi Mumbai Kolkata Hyderabad Kanpur Ahmadabad Madurai Not safe at all Not so safe Somewhat safe Quite safe Very safe Cannot say Total Source: Shaban and Sharma,

6 Approximately, 48 percent respondents of Madurai reported that water was quite safe while 43, 32, 31, 22, 15 and 10 percent respondents of Ahmadabad, Mumbai, Delhi, Hyderabad, Kolkata and Kanpur, respectively have the perception that water was quite safe for consumption. Water quality standards prescribe the maximum allowable limit for various pollutants in drinking water. Beyond that limit, water is not considered good for consumption. Although, most of the respondents were not aware of these limits, these perceptions and observations were general in nature Level of satisfaction with quality of water supply in different localities of Delhi The level of satisfaction with quality of water supply ranges from satisfied, fairly satisfied and not satisfied. All the respondents of Ambedkar Nagar, a resettlement colony were satisfied with the quality of water supply (Table 5.5) and all the respondents were paying for water supply. So here it seems that there is a direct association between quality of water and payment made. Next to that, 70, 40, 20 and 5 percent respondents each of Bhagat Singh Park, Bhalsawa, Rajeev Nagar and BD Patil Nagar, respectively were satisfied with the quality of water supply, while none of the respondents of these colonies were paying anything for water supply. None of the respondents of Sanjay Colony were satisfied with the quality of water. As opposed to that 90 and 60 percent respondents of Bhalsawa and Samaipur Gaon made payment for water supply and their level of satisfaction was 30 and 15 percent, respectively. Approximately 85 percent respondents of Sanjay Colony were dissatisfied with the quality of water supplied by municipal taps. 80 percent respondents each of BD Patil Nagar and Samaipur Gaon were dissatisfied and 55 percent respondents each of Bhalsawa and Bhalaswa Gaon respectively were not satisfied with the quality of water supply. While only 20 percent respondents of Bhagat Singh Park were not satisfied with the quality of water being supplied by municipal taps. 77

7 Table 5.5: Level of satisfaction with quality of water supply: 2005 (Percentage of households) Level of satisfaction BD Patil Nagar (JJ Cluster) Rajeev Nagar (Unauthorized Colony) Bhalsawa (Resettlement) Bhalsawa Gaon (Urban Village) Sanjay Colony (JJ Cluster) Bhagat Park (Unauthorized Colony) Ambedkar Nagar (Resettlement) Samaipur Gaon (urban) Satisfied Fairly satisfied Not satisfied Total Source: Singh and Shukla,

8 Percentage of households Quality of Water and Water Related Diseases in Urban Areas Fig. 5.1: Level of satisfaction with quality of water supply: 2005 (Percentage of households) 100 Satisfied Fairly satisfied Not satisfied BD Patil Nagar (JJ Cluster) Rajeev Nagar (Unauthorised Colony) Bhalsaswa (Resettlement) Bhalsaswa Gaon (Urban Village) Colonies Sanjay Colony (JJ Cluster) Bhagat Park (Unauthorised Colony) Ambedkar Nagar( Resettlement) Samaipur Gaon (urban) Source: Singh and Shukla,

9 5.1.5 Water quality status: Results of sample surveys A sample study in selected cities was carried out for 6,430 households. Seven hundred and eighty seven representative water samples were collected from the selected cities to know the quality of water. The selected samples were analyzed for the fifteen * drinking water parameters (Raju et al, 2007). In Hubli, 250 water samples were analyzed, out of which 98 i.e. approximately 39 percent samples were non-potable and 17 wards of Hubli were affected from various contaminants. Further, in Dharward 200 water samples were analyzed, from which 16 wards were supplied contaminated water as 45 percent samples were not fit for consumption. Table 5.6: Water quality status: 2007 (Results of sample study in selected cities) Cities Number of samples analyzed Number of nonpotable samples Total number of wards affected Hubli (39.2) 17 Dharwad (45.0) 16 Belgaum (20.5) 17 Kolar (97.08) 31 (all wards) Source: Raju et al., 2007 Figures in brackets are percentages Kolar was having a very depressive story as out of total 137 water samples, 133 i.e. approximately 97 percent water samples were contaminated with excess fluoride and all wards of Kolar were affected from pollutants. Belgaum wards were too affected with excess fluoride. Out of total water samples analysis, 20.5 percent samples were found to be non-potable Quality of potable water in Ludhiana city Potable water of Ludhiana city was tested for quality and the testing report was carried out on July 21 st, It was found that actual ph level in water was 7.05 whereas 6.5 to 8.5 was the desirable limit. The presence of total solids per milligram (mg) in one liter of water was 380 wherein the desirable limit was 500 mg/l and permissible limit was 2000 mg/l. Alkalinity levels in per mg per liter of water was 332, the desirable and permissible limits were 200 and 600 mg respectively (Table 5.7). * Turbidity, colour ph, electricity conductivity, total dissolved solids, chloride, sulphate, fluoride, nitrate, calcium, magnesium, sodium, iron and alkalinity and bacteriological parameters Most Portable Number(MNP) 80

10 Total hardness in water was also below than the desirable and permissible limits prescribed by the Bureau of Indian Standards : The presence of chloride was much less than the desirable and permissible limits i.e. there was only 30 mg/ l of chloride present in drinking water while desirable and permissible limits were 250 and 1000 mg/l respectively. Table 5.7: Quality of potable water as per testing report conducted in Ludhiana: 2006 Parameter Actual Value Desirable Limit Permissible Limit ph to 8.5 No relations Total Solids (mg/l) Alkalinity (mg/l) Total Hardness (mg/l) Chlorides (mg/l) Sulphate (mg/l) Nitrate (mg/l) No relation Fluoride (mg/l) Faecal Coli (MNP/100 ml) Nil Source: City Development Plan, Ludhiana, 2006 Sulphate was found to be only 20 mg/l in the drinking water, while the desirable and permissible limits for the same were much higher as of 200 and 400 mg/ l respectively. The desirable limit for nitrate was 50 mg/ l while actually the presence of nitrate in the drinking water was 7.0 mg/l. Fluoride concentration was there in the potable water of 0.6 mg/l while the desirable and permissible limits for fluoride presence were 1.0 and 1.5 mg/l respectively. Faecal coli was found to be absent in the water quality testing report of drinking water in Ludhiana Water quality in Ludhiana City: Results of sample analysis The water sampling report of Ludhiana city for the period of January 2011 to May 2012 i.e. for approximately one and half year and was collected from Civil Surgeon Office, Ludhiana (Table 5.8). During January to December 2011, total 809 water samples were collected, out of which only 538 were found to be potable and

11 failed while the result was awaited for 3 samples till date. During January to May 2012, 271 water samples were collected out of which 65 failed and 206 were potable. Thus during this period, total 1080 samples were collected wherein 333 failed and 744 were potable. So this shows that the status of water quality is deteriorating with each passing day. Table 5.8: Period Water sampling report of Ludhiana city for the period January 2011 to May 2012 Water Samples Collected Potable Failed Result Awaited Jan. to Dec (100.00) 538 (66.50) 268 (33.12) 03 (0.38) Jan. to May (100.00) 206 (76.01) 65 (23.99) 00 (0.00) Total 1080 (100.00) 744 (68.88) 333 (30.84) 03 (0.28) Source: Civil Surgeon Office, Ludhiana, Water borne diseases in Ludhiana district Water borne diseases are spreading at a very fast rate both in rural as well as in urban areas. It is of great concern for the governments of different States/ UTs. An Integrated Disease Surveillance Programme (IDSP) has been started by the government and in Ludhiana district IDSP had collected the incidences of various water borne diseases (Table 5.9). Table 5.9: Period Water borne diseases in Ludhiana district for the period January 2011 to May 2012 Acute Diarrhea Cholera Hepatitis A and E Typhoid Total Jan. to Dec Jan. to May May Total Source: Integrated Disease Surveillance Programme Office, Ludhiana, 2012 Mostly diarrhea, cholera, typhoid and hepatitis A and E occur due to non- potable water. In 2011, around diarrhea, 6298 typhoid, 607 hepatitis A and E and 7 cases of cholera were reported. From January 2012 to May 2012,

12 No. of diseases Quality of Water and Water Related Diseases in Urban Areas diarrhea, 2491 typhoid, 336 hepatitis A and E were reported. Thus it made a total of cases of water borne disease in a period of 5 month. But if we analyze the status of only one summer month i.e. May 2012, then it came to light that in just one month total 2816 cases were reported which showed that the outbreak of water related disease is high in summer season Fig. 5.2: Water borne diseases in Ludhiana district for the period January 2011 to May 2012 Acute Diarrhea Cholera Hepatitis A and E Typhoid Jan. to Dec Jan. to May 2012 May-12 Time period Source: Integrated Disease Surveillance Programme Office, Ludhiana, 2012 In brief, water quality problems are due to pollution of surface or groundwater. The over- exploitation of groundwater leads to contamination of water and serious health problems crop up. The unsafe water causes various water borne diseases like diarrhea, malaria, cholera, skin infection, tuberculosis, etc. These incidences have been increasing year by year thus putting great stress on the health of the masses. Still many states suffer from the supply of contaminated water and this has led to spread of water borne diseases. So to provide safe drinking water to people various government institutions and departments are functioning so as to monitor the quality of water. But still the investment in water supply and sanitation sector and various pollution control boards does not coextensive with the health benefits. So there is a need to pump in more resources in the supply of the drinking water in the urban areas with special emphasis on the weaker sections of the society. 83

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