Safe drinking water in remote rural communities in present era

INTRODUCTION

Groundwater is widely acknowledged to be an important source of drinking water in low-income regions around the world. Also, there are many illnesses and deaths, especially in infants and children because of water consumed, a major media for carrying the causes of illnesses, particularly in rural communities around the world. Recent statistics reveal that only a small proportion, 18 per cent, of rural households get piped water supplied to their dwellings and more than half of all rural households still rely on public or common sources of water in India.¹ The comptroller and auditor general (CAG) in his performance audit report of the national rural drinking water programme in India 2018, reported that the “coverage of rural habitations increased by only 8 per cent at 40 litres per capita per day or water available per person (lpcd) and 5.5 per cent on the basis of 55 lpcd during 2012-2017 despite the expenditure of Rs 81,168 crores”.² The majority (51 per cent) of rural households in India use a tube well, or hand pump or borewell for their water requirements (NFHS-4, 2015-2016).² These sources dry up and become defunct as the groundwater table goes down during the summer month. According to the United Nations Resolution 64/292: “The human right to water entitles everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses”.³ Rogers et al have earlier opined that community water systems (CWS) were facing significant external forces for change due to decreasing water-resources, stricter water-quality regulations in some parts and no control in other parts of the globe.⁴

Objectives

Community based study was done to know about drinking water sources and action taken in rural communities.

METHODS

Information was collected by interviews of study subjects at the place in the village mutually convenient to research assistant and the woman after approval of ethics committee of base institution and recorded on the predesigned tool no one was given to fill the toot to fill.

Study setting

Study was carried out in tribal communities of 140 villages in forestry and hilly region near health facility.

Study design

It was a community based qualitative study using predesigned stool.

Study period

The duration of the study was from December 2021 to December 2022.

Study sample

The sample size (n) was 4500 women calculated by the following formula.

Results from Open Epi, version 3, open source calculator—SS Propor.

Inclusion, exclusion criteria

Total 4500 women of 15 to 60 years willing to be part of study, in a condition to answer questions, randomly including 25 women from each village.

Data analysis

The information collected was entered in an offline form, and the results were inserted in to Microsoft excel and analyzed. Data was checked for consistency and completeness; data entry errors were spotted and corrected.

RESULTS

Of 4500 study subjects, sources of drinking water for use at home were public taps 1671 (37.1%), public borewells 1195 (26.6%), wells in the outskirts of village 929 (20.6%), river 381 (8.5%) and other sources 324 (7.2%) (harvested rainwater, dams). Total 1522 (33.8%) women did not have road for going to source of water. Details of relationship with source of water with variables like age, education, job and economic status are in Table 1. There was significant difference with education and drinking water source at home (p value <0.0001), also with profession (p value is <0.00015). Of 4500 study subjects, only 1936 (43.0%) had drinking water at work places, 310 (16.0%) borewell, 313 (16.2%) matka (mud pot), 999 (51.6%) well, and 314 (16.2%) used other sources (harvested rain water, dams). The details of relation of water at workplaces with age, education, job, economic status are in Table 2. Those who did not have water at work places, 393 (15.3%) took water from home, 767 (29.9%) went to river for drinking water. They used their own hands or empty lunch boxes for drinking water from river, 740 (29.0%) went to well at a distance, at the periphery of village, 399 (15.6%) nearby borewell, and 261 (10.2%) used other sources. There was significant difference with education with drinking water source at work places (p value is <0.00001) and also profession (p value is <0.00015). Of 4500 study subjects, 3510 (78.0%) reported filtration of water before use at home, usually with cloth torn from used old saree, 690 (15.3%) boiled water, 300 (7.3%) used other methods (like adding bleaching powder or alum to water). The details of relation of processing in relation to age, education, job, economic status are in Table 3.

DISCUSSION

Access to safe drinking water is essential for healthy life, one of the basic human rights but is not being taken care in many parts of the world. Marino et al reported that there have been major changes in the way villages in State of Alaska in USA, procured water for drinking and other uses.⁵ Researchers of North Western Alaska did a study about using or not using centralized water systems by rural communities and concluded that local culturally specific ideas about health and acceptable drinking water quality must be taken into account for water schemes to be successful. In villages where study has been done did have some system, but not for every one and not all the time and all the seasons.

In addition, villagers have their own beliefs. Penn et al also opined that many researchers and professionals agreed that water insecurity was a problem in rural Alaska, although the scale and nature of the problem was contested.⁶

*Small scale, (food, shoes making, bamboo itoms) industry, welding workshop, brick furnace

*Small scale, (food, shoes making, bamboo itoms) industry, welding workshop, brick furnace; others –harvested rain water, dams

*Small scale, (food, shoes making, bamboo itoms) industry, welding workshop, brick furnace; others- bleaching powder or alum

Lucas et al did a study in communities paying for an in-home non-potable water reuse system in rural Alaska and reported that several rural communities lacked piped water and sewer services, leading to residents self-hauling drinking water and manually disposing of waste.⁷

The results also suggested myriad of local factors that impacted acceptance, desire and willingness to pay for in-home water reuse. Something like rural Alaska was happening in study villages of the present study, where of the 4500 interviewed study subjects, women of 15 to 60 years who were responsible for arranging water for the family, 1671 (37.1%) reported use of public tap, 1195 (26.6%) public borewell, and 929 (20.6%) well in the outskirts of their villages, but overall 381 (8.5%) women collected water from river, and 324 (7.2%) used other sources like harvested rainwater or from dam. In some villages there was system of disinfection with bleaching powder in wells and main water tanks which were connected to public taps with pipes but regularity of bleaching as well as surity of water in taps was notthere. Underground water collected from Borewell had no system of purification except whatever women did at home. Rowles et al ⁸ initiated a study for assessment of water quality, including microbial ecology, off the grid Alaskan water supply (i.e., primarily groundwater wells) and results revealed location-specific elevated Arsenic concentrations. Reddy et al did a study in Andhra Pradesh of India and reported that 69% rural households reported doing nothing at home to make the tap water safe for drinking, 90% reported storing water in utensils covered with lids and retrieving water by dipping glass kept around.⁹ The same was happening at the work places in the villages where study was done. Some women went to nearby river to drink water with their hands. The river banks were used for defection, washing clothes and animals were washed in the rivers with challenges of processing of water before use and changing such systems. Of 4500 study subjects, 3510 (78.0%) reported filtration of water with cloth torn from old saree, 690 (15.3%) boiled water, 300 (7.3%) used other methods (bleaching powder or alum at home). In the region where study was done, quite a few women used ground water without any processing. Lapworth et al reported that groundwater provided a vital source of drinking water for rural communities in many parts of Africa, particularly in dry seasons when there were few safe alternative sources.¹⁰ Bariki et al also did a study in the same state and reported that around 60% of the households got water from unprotected wells, surface water and unprotected springs.¹¹ For purification most communities did boiling (64%), some did chlorination (4%), cloth filtration (14%) and ceramic filtration (2%), but 16% did not do anything. Of the 100 households, 20% households reported that at least one household had suffered from water-borne diseases in the past year. Many households could access water sources, but access to safe drinking water was a major challenge. There was inconsistent and inadequate utilization of water purification techniques leading to consumption of contaminated water. Reddy et al also did a study in Andhra Pradesh, India and reported that 90% of spring water used for drinking, samples did not meet Bureau of Indian Standards (BIS) and World Health Organization (WHO) standards and were highly contaminated.¹² The interrelated effects have definite impact on developmental efforts and ill effects on health of the tribal communities because of water borne diseases. Wilson et al have reported that the material dimensions of water security alone were in adequate even in Yukon Canada.¹³ Researchers concluded that more holistic approaches were needed to explain relationships of health of indigenous people to water, including the use of traditional water sources such as mountain creeks and springs. Indigenous water relations invited a shift towards a holistic understanding of water security. Singh et al did a study in Maharashtra, India and reported that there were high levels of spatial heterogeneity in water services within, as well as between, blocks and there were broad patterns of priorities for planning and also policy purposes.¹⁴ Marwaha et al did a study for identifying agricultural managed aquifer recharge locations to benefit drinking water supply in rural communities of America.¹⁵ Targeted managed aquifer recharge on agricultural land near rural communities was one such strategy that could potentially stabilize groundwater tables and maintain or improve groundwater quality in domestic supply wells. The research revealed new understanding of the factors contributing to community vulnerability and resilience to changes in drinking water supply. Satyam also did a study in India and reported that the existing situation of drinking water supply under national rural drinking water programme (NRDWP) had clusters and habitations who were not able to access water from the common water supply schemes located in rural and tribal areas.¹⁶ Segev et al reported isolated incidences of lead and geologically-attributable arsenic exceeding environmental protection agency standard in rural Maine of USA.¹⁷ So there are various issues in water for human consumption around the world, though the problems are much more in developing countries, especially in rural remote regions and more in forestry regions as was found in the present study. Of the 4500 study subjects, 1522 (33.8%) did not even have road for going to water source. Water was almost always collected by women. It is so dangerous for young girls, elderly and pregnant women with water pots on head, or shoulder walking on broken stony narrow pathways and river water for drinking without processing, very dangerous practice. Maramraj et al did a study in India and reported 709 acute diarrheal disease (ADD) outbreaks.¹⁸ Researchers investigated to describe the epidemiology, identify risk factors, and provide evidence-based recommendations and reported that an ADD outbreak with high attack rate in a remote tribal village was associated with drinking water from shallow downhill bore-wells, likely contaminated via runoff from open defecation areas after heavy rains. Researchers reported 27% not having accessibility to safe drinking water and 75% households not having toilets. Collins et al reported that government initiatives to address the chronic problem of ‘boil water advisories’ within indigenous communities, did not recognize, source water protection (SWP) planning as a cost effective tool for improving drinking water quality.¹⁹ McLeod et al did a study with quantitative analysis of drinking water advisories among rural communities in Canada and reported the disparities associated with indigenous and non-indigenous small drinking water systems.²⁰ Carrard et al from Australia reported that their review findings supported the case for governments and development agencies to strengthen engagement with groundwater resource management as foundation for achieving sustainable water services for everyone.²¹ Alam et al reported that assessment of water samples from various methods indicated that majority of the ground water in the study area was chemically suitable for drinking and agricultural use in Delhi India.²² However microbial study was not done. Lapworth et al from Africa reported that while the overall level of microbiological contamination from hand pump equipped boreholes was low, results from their study strongly suggested that at a national and regional level, microbiological contamination rather than chemical contamination provided a greater barrier to achieving targets set for improved drinking water quality.²³ Efforts should be made to ensure that boreholes are properly sited and constructed effectively to reduce contamination. A study in Pakistan by Khan et al revealed that the order for the overall safety level for water quality in their study area was tube wells, followed by open wells, hand pumps and springs, both geogenic and anthropogenic activities with the sources of drinking water contaminated.²⁴ Waterborne diseases were highest in respondents who took their drinking water from springs, whereas reports of diseases were moderate in respondents taking water from open wells and hand pumps and lowest in respondents taking water from tube wells. In the present study of 4500 study subjects, 1671 (37.1%) used public tap connected, with main tanks which had erratic chlorination. Wells in out skirts also had erratic system of chlorination. Wells were not covered with any things. Water levels of wells became so high in rains that animals could drink water directly from well, 1195 (26.6%) public borewell, 929 (20.6%)wells at outskirts, but 381 (8.5%) collected water from river, and 324 (7.2%) used other sources for drinking water at home. In the present day drinking untreated river water where animals are cleaned and cloths washed is dangerous. It must be changed. Actually river banks are used for defection also. Over all of 4500 study subjects, only 43% had drinking water at work places, (6.9% borewell, 7% matka, 22.2% well, and 7% other sources). Of 56.9% who did not have drinking water at work places, only 8.7% women took water from home, 17% went to river, 16.5% wells, 8.9% to borewell, and 5.8% to other sources including harvested rain water. Universal access to safe water and sanitation remain unrealised due to both historical disparities and current challenges in high income communities. These challenges have been mostly invisible in the global water, sanitation, and hygiene (WASH) discourse, which focuses primarily on low income and middle-income countries.²⁵ Masten et al reported that the highly visible cases like the lead crisis in Flint, Michigan, United State of America in which more than 100000 people were exposed to elevated lead levels in drinking water.²⁶

Hermans et al reported that the inadequate water and sanitation in refugee camps in Greece showed gaps in services deeply affected the health and quality of life of marginalised populations, even in countries with ample resources to address such problems.²⁷

Wolf et al by using database estimate that 1·4 (95% CI 1·3–1·5) million deaths and 74 (68–80) million disability-adjusted life-years (DALYs) could have been prevented by safe water, sanitation and hygiene (WASH) in 2019 across the four designated outcomes, representing 2·5% of global deaths and 2·9% of global disability-adjusted life-years (DALYs) from all causes.²⁸

Limitations

Limitations of the study were the amount, frequency of bleaching powder or alum used to clean water, chlorination of wells, water tanks cleaning was not known.

CONCLUSION

In a reasonably well doing province of India using unsafe water for drinking, a dangerous practices need to be changed. It is much more dangerous at work places as river water is used with not any action. Also, women walk long distances with no roads to get water to drink.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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