Sanitation issues pose a big burden on healthcare, and hence evaluating different remedial
measures along with their affordability, purpose and long-term benefits to the society at large
needs to be considered. Weighing different options to deal with human wastes like on-site or
off-site disposal, sewage treatment measures, etc. should be set depending on the density of
population and other social and geographic factors. Good sanitation is the basic need for a
society and to develop a healthy country. Simple measures taken can compound healthy benefits
at large. Sustainable growth and expansion will only become a possibility when sanitation
measures become considered as the foremost pedestal to tackle.
What involves basic sanitation?
Before we try to list down the various criteria that fall under basic sanitation, it is
important to understand and define 'sanitation accurately. The definition of sanitation
is dynamic and is often defined on the basis of priority issues and problems being faced
pertaining to sanitation. To summarise, the colossal idea behind sanitation, it may be said
to involve:
Safe and logical collection of human wastes, their proper treatment and disposal or recycling
(recycling would majorly involve human urine and faeces)
Management/recycling/reuse of solid wastes and
sullage from human settlements
Collection and proper management of industrial
waste products
Disposal, reuse/recycling of sewage effluents
Management and proper disposal of hazardous wastes generated by hospitals,
chemical and radioactive wastes, etc.
Why Sanitation has to be focused on?
Needless to say wherever humans are, the amount of waste generated will be huge. Though
a lot of progress is being made in meeting efficient sanitation, many areas and people lack to
find proper means to dispose of wastes. Non-effective management strategies of wastes,
especially in heavily populated areas eventually lead to an increase in risk towards many infectious
diseases and epidemics. Such conditions majorly end up targetting the young, elderly generations
or individuals with low resistance power towards fighting diseases. Again, poor management of
wastes too contributes in making the surroundings unpleasant eventually putting even other
species at risk affecting the ecological balance. The major routes that are directly affected due
to poor sanitation include:
Drinking water
Food chain which majorly involves sites used for growing fruits, vegetables and breeding
of animals for their meat and fishes Recreational sites, etc.
Communicable Vs Non-communicable
Communicable ailments include the infectious conditions which if not controlled have the
potential to become epidemics posing a major threat to human life and colossal burden to
the healthcare system. The one fundamental threat for the aforementioned calamity is sanitation
conditions. Non-communicable ailments though have risen to epidemic proportions in our country
today, majorly caused due to lifestyle habits and geneties, it is the communicable ones which can
be completely eradicated with appropriate and monitored sanitation measures in place.
Poor sanitation = Healthcare in distress
Poor or no sanitation in human settlements is an ideal opportunity for spread of many infections.
In fact, human excreta alone have been involved in transmission of diseases such as typhoid,
cholera, Hepatitis, ascariasis, etc. and even encephalitis. Estimates by WHO prove that diarrheal
diseases alone caused due to poor sanitation are a major responsible factor for deaths among
children less than 5 years of age.
Among parasitic diseases, malaria holds the first rank with the affected regions showing poor or
no sanitation and is majorly a concern in tropical and subtropical regions of the world. Conditions
like ascariasis is found almost worldwide having greatest frequency again in tropical and subtropical
regions affecting more of the areas with less sanitation. Ascariasis also contributes to be the major
chunk of intestinal worms infection in the developing regions of the world.
Yet another parasitic infection prevalent in many developing areas more precisely in Asian countries
is that of Trematodes. Flatworm infections mostly spread through fecal contamination, as the larvae
are present in the faeces of an infected individual. Trematode infections enter the food chain through
fish, shellfish and finally into humans. Global estimations of WHO prove almost 10% of the population
to be at risk.
Another leading cause of preventable blindness - trachoma infection is again linked to
poor sanitation! Again to add to the misery, it is the sole reason for making almost 6 million people
around the globe permanently blind. This contribution of trachoma infections in causing preventable
blindness is majorly supported by poor sanitation, substandard hygiene related to drinking
water, etc.
Besides being the major cause for spread of infectious diseases, adverse conditions fueled by
industrial effluents and heavy metal exposure too have not been left behind in adding to the
despair. Lack of proper management, disposal/reuse/recycle of heavy metals,
inorganic and toxic wastes have been on rise in most developing countries including ours.
Contamination of water bodies with industrial effluents and toxic elements eventually enter
the food chain causing
severe damage to human health. Many of these also harbour the property for bioaccumulation
bearing the potential to affect generations. The damages caused include organ dysfunctions,
inflammation, irritation, damage to the nervous system, congenital malformations to even cancer.
Increase in nitrate content through industrial wastes causes its deposition in ground water eventually
leading to its entry into the food chain; wherein it can cause fetal complications like
methaemoglobinaemia (blue baby syndrome) in infants exposed to the same. Also, a rise in inorganic
compounds in ground water can cause eutrophication which becomes breeding grounds for algae
and many toxic compound producing cyanobacteria. Such challenges in sanitation have also shown
to affect biodiversity leading to its loss.
Proper sanitation - Need of the hour!
Looking at the predicament that arises due to lack of adequate sanitation, it is important
for the health communities and welfare institutions to be the first one in taking measures
to tackle the menace caused by the same. Considering the ever increasing rate of population,
meeting the requirements of proper sanitation becomes imperative. Most of the poor and
developing countries which lack to keep stride with the increasing population growth should
be the first ones to implement and incorporate strategies in meeting the requirements of proper
sanitation.
Rapid and Rampant Urbanization- A Threat to Good Health
We all are aware of this trope, 'a simple farmer pack his bags, takes his mother's blessings
and with stars in his eyes, heads toward the big city to fulfill his dreams. Such idealization
also translates into reality when, along with modernization and industrial development,
urbanization also spreads rapidly. In fact, it is estimated that, by the year 2030, 42% of total
Indian population will reside within the cities with inhabitants numbering over 1 million.
This rapid and mostly unplanned growth of cities have, however, made itself a hub of
diseases. This is due to a variety of factors. People who live in urban settings fall prey to
The deleterious effects of water, soil, noise and air pollution
Extremely ill-planned waste management
Unhygienic as well as overcrowded living and working environments
Exposure to industrial wastes.
The cramped housing and unhygienic living conditions can increase the risk of all-worne
diseases, as well as expedite their cross-transmission between people. Those who live in
localities with stagnant water are also more likely to get infected by diseases transmitted
through vectors. Some of the diseases which are most common in India are
Malaria
Transmitted by the mosquito and caused by the parasite Plasmodium, malaria is responsible
for about 1000 deaths annually in India alone. The emergence of resistance to the most
commonly used antimalarial drug, Chloroquine has become a cause of concern, with the
development of multidrug resistance becoming a more pressing issue.
Tuberculosis
As with malaria, the biggest threat with respect to tuberculosis in this country is the
development of antibiotic resistance. Further, as this is an air-borne communicable
disease, cramped living conditions greatly facilitate its spread. Accounting for 1.7 million
deaths in 2016 alone, India bears the greatest burden of this disease. Poor knowledge
of both the disease progression as well as diagnostic options are some of the contributing
factors for the spread of disease.
Maternal Health Issues
India records one of the highest maternal deaths (approximately 22% per year) throughout
the globe. The reasons ranges from poor healthcare accessibility to the remote locations,
lack of basic healthcare facilities, quality care and comfort for the mother and her newborn,
as well as poor outreach of newborn care programmes. Extremely poor nutrition, below the
global average poverty, child marriage and early childbearing, as well as exposure by both
mother and child to the harmful substances are other maternal health related issues that
need to be immediately addressed.
Most deaths in women during delivery occur due to excessive bleeding and abnormally
High blood pressure. Preexisting conditions like maternal anemia are also high risk factors
for maternal mortality. The children born under these circumstances are at an increased
risk of suffering from many health complications and inborn errors of Metabolic.
Conditions in children
Metabolic disorders like Phenylketonuria and Galactosemia, although are of genetic
origin, can be effectively managed with timely and proper guidance so they do not cause
any long-term harm to the baby. Certain birth defects may also arise due to nutrient
deficiencies or toxins in the mother, and by transmission, to her child.
Malnutrition
As the country is progressing, access to good and nutritious food should become a reality.
However, the nutritional status in our country lacks still, not just in terms of deficiencies,
but also due to excessive consumption of empty calories.
Nutrient deficiency- In addition to eating less food due to reasons like poverty, the over
consumption of junk food while foregoing nutritious homemade food has made many victims
of nutrient deficiencies. Vitamin D which can be easily selfsynthesized through exposure
to sunlight is still one of the most commonly deficient vitamin.
Heart disease
Poor eating habits, especially consumption of excessive carbohydrates are a major risk
factor for abnormal levels of fat in the body. These imbalances can lead to accumulation
of LDL-bad cholesterol in the bloodstream and can damage blood vessels, resulting to high risk of Cardiac Risk Markers Test. Heart disease is one of the leading causes of morbidity and mortality in our country.
COPD
Chronic Obstructive Pulmonary Disease is a lifelong disorder that is characterized by
difficulty in breathing due to exposure to some types of irritants, especially those
that spreads due to Smoking.
Poor Health Awareness
Low educational status translates to poor health awareness, especially for those conditions
that can either be completely prevented or managed if detected in time. In this, the difficulty
in identifying a symptom as an indication of a much bigger disease and delay in undergoing
testing for identifying the disease are common risk factors for transmissible diseases, as is
the lack of awareness of proper steps to take to avoid these diseases.
Cancers
Cancer
Development of drug resistant TB
While TB is a disease that can be cured by antibiotics, the general lack of awareness regarding
sticking to the prescribed regimen of antibiotics, among other factors, has resulted in increased
number of the antibiotic resistant TB cases. In this condition, the bacteria become immune to
some of the commonly
used anti-TB drugs, making it difficult to treat
HIV and AIDS
When a person is infected by an HIV virus, they are known as HIV positive patients. If this
infection is not correctly managed, it can severely compromise our immune system and
impair our ability to fight other opportunistic infections. If this deterioration of the immune
system continues, then this condition is called AIDS. It is importanti to know that HIV
infection is not the end of the line and can be effectively managed if one is aware regarding
how to go about it. Risk factors and modes of HIV transmission should be openly discussed
to increase general awareness.
As per the Indian HIV Estimation report released in 2015, the prevalence of HIV is at an
average of 0.26% among all adults between 15-49 years of age, with the highest prevalence
found in the states of Manipur, Mizoram, Nagaland, Andhra Pradesh, Karnataka, Goa and Gujarat.
We see the attempts of our government in improving the health and livelihood of its citizens
through the "Swachh Bharat Abhiyan", but what about our own responsibility towards our health
and the health of the community as a whole? Ignorance is the first hurdle that has to be surpassed
towards achieving a healthy India; after all how can we fight what we do not know.
