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									      THE IMPACTS OF SODIS WATER ON HEALTH AND DIGNITY OF VARIOUS
    RURAL COMMUNITIES THROUGH CITIZEN COMMUNITY BOARDS IN PUNJAB,
                               PAKISTAN
                                           By
                            Qamar-ul-Islam* and Adeel Anwar**
                            *Professor, City & Regional Planning Department
                           University of Engg & Technology, Lahore, Pakistan
                                         Qamar49@hotmail.com

                          ** Program Officer Punjab Rural Support Program
                                 Head Office, LDA Plaza, Lahore

   International Seminar:         Arsenic in Groundwater: A Growing Threat in Pakistan
   Venue:                         Lahore College University for Women, (Lahore - Pakistan)
   Dated:                         (September 22, 2005)


ABSTRACT

In the rural communities of developing countries, water borne diseases are also spreading
due to contaminations of water. Even our food prepared with such water is also not safe.
In addition to the impacts on health of the people. in this paper the researchers have also
tried to investigate some social and psychological factors affecting the dignity of the
people who use sodis water.

With the great help of Citizen Community Boards under the current 21 century Matching
Grant program of Pakistan have shown worth of this technology appropriate and useful in
27 out of a total of 34 experimental areas. However this technology for providing safe
drinking water has proved to be simple, cheap and environment friendly and more over has
improved the quality of cooked food, health and living conditions in various rural localities.

(1) It has reduced the seasonal death rates of people, (2) patients due to water born
diseases. (3) It has also saved time, energy and some incomes of majority of households
who have adopted this technology for getting safe drinking water in (a) desert areas
(Derawar in Cholistan Desert), (b) plain area (Jhang district) and (c) mountainous area
(Chakwal district).



This study also shows some psychological effects in terms of safety, comfort, respects
and confidence leading to human dignity among the rural households. These dignity
elements proved to be very important for sustainable adoption of sodis water in Pakistan.




                                                                                             1
The Problem

There are about 4 million cases of diarrhea per year, out of which 2.5 million cases end in
death. One third of the population in third world countries has no access of water which
should be safe. Every 15 seconds a child dies of dehydration due to diarrhea. The
researchers have found that contamination does occur, affects our food and if hygienic
conciliations improves it will improve the environment and safe guard our water. This safe
water then can protect our food and beverages.

Drinking water conditions are more dangerous in numerous third world countries as more
than one third of the rural population has no access to sufficient and clean water.
Diarrheas diseases are transmitted through contaminated drinking water and cause the
death of over three million people every year. Thus of safe water is a priority for the
health of the displaced populations in the aftermath of the Southeast Asia earthquake and
tsunami remains.

However various methods and technologies have been established to get safe drinking
water but they are not accessible to the mass majority of general people. Water filtration
plants are highly expansive moreover neither affordable, nor convenient among the mass
majority of the people who are poor in the developing countries. Pakistan including South
Asian region also represents similar conditions. Thus to find a cheapest and convenient
technology, appropriate to disadvantaged communities remained a big challenge for a long
time. The Swiss researchers succeeded to explore such a solar technology appropriate to
such communities. This is called "Solar water disinfection" or briefly as "Sodis
technology" or simply "sodis" which means getting safe drinking water from this
technology. Is sodis technology an appropriate to our communities in the country ? In this
context in the next section the concept of "Technology" and appropriateness of "Sodis
technology" will be highlighted.

Sodis

Sodis means Solar Water Disinfection which improves microbiological quality of drinking
water. It is an appropriate technology for getting safe drinking water by any community
any where at domestic level. It is a simple water treatment method using solar UV-A
radiation and temperature to Inactivate pathogens causing diarrhea and other related
disease. It’s salient features are the following:

            (1)   It is a water treatment process depending on solar energy only

            (2)   It is a treatment method to eliminate the pathogens which cause water-borne
                  diseases.
            (3)   It is a an ideal to disinfect small quantities of water used for consumption
            (4)   An alternative water treatment option for use mainly at household level




                                                                                             2
Sodis is an appropriate technology

It is the technology which is most appropriate, relevant to our communities, cheapest,
convenient and environment friendly equally for men and women. The tools and processes
are simple plastic or glass bottles which are affordable and available under the free and
abundant solar (sun) energy. However like many technologies sodis technology has also
it's limitations. Moreover safe drinking water received through appropriate technology is
beneficial to the communities in many respects.

Microorganisms in the water are destroyed by using sodis technology.

Various research experiences have shown that pathogenic bacteria, viruses and also
protozoa are destroyed by Sodis. The inactivation of the following microorganisms has
been observed (Stefan Gampher: 2004):

Viruses: bacteriophage f2, rotavirus, encephalomyocarditis virus.
Bacteria: Esccherichia coli (E-coli), Vibrio cholerae, Streptococus faecalis, Pseudomonas
          aerugenosa, Shigella flexneri, Saimonella hyphil, Salmonella enterditis,
          Saimonella paratyphi
Yeast and mold: Aspergillus niger Aspergillus flavus, Candida. Geotrichum
Protozoa: Giardia spp., Cryptosporidium spp.

It was questioned whether Sodis produce sterilized water? Answer: Sodis does not sterile.
It should be remembered that drinking water does not have to be satirized. Further details
regarding diseases and Sodis effectiveness have been tabulated (Table-1).

Table-1: Details of pathogens, illness and reduction through Sodis:

 Pathogens                            Illness                              Reduction through Sodis
                                                                           at water temperature of 40 degree centigrade
 Bacteria
 E-coli                               Indicator for water                                         3-4 log
                                      quality & entertis                                      (99.9-99.99%)
 Vibro cholera                        Cholera                                                     3-4 log
 Salmnella spp                        Typhoid                                                     3-4 log
 Shigell spp                          Dysentery                                                   3-4 log
 Viruses
 Rotavirus                            Diarrhoea, Dysentery                                     3-4 log
 Polio Vus                            Polio                                                  Inactivated
 Hepatitis Virus                      Hepatitis                                    Reduction of cases of sodis users
 Protozoa
 Giardia app                          Girdiasis                                       3-4 log (Infectively of Cysts)
 Crytosporidium spp                   Crytosporidiasis                                2-3 log (Infectively of Cysts)

Source: (1)Learnt from Mr Tim, researcher from Switzerland in Rajoa, Jhang (2004).       Various reports by EAWAQ and SANDEC
and technical notes on Solar Technology for safe drinking water in South Aian countries (2005).



                                                                                                                          3
Role and relevance of CCBs under Matching Grant (MG) program for sodis technology.

Citize community boards are serving in local community based projects under MG
program. Therefore it was very important for the researcher to introduce solar technology
to the locals with the help of already functional and popular CCBs in the respective study
lands.

Under the new procedures, rules and regulations till the end of August 2005 more than
20,000 CCBs under 21 st century MG program have been established to implement
community based projects in various districts of Pakistan. However it became clear to the
researchers that for the introduction of solar technology for getting safe drinking water
and poverty alleviation could be possible if group work shops were to be designed through
MG program. The onward methodology, analysis and results will show that how far
CCBs of MG program has been useful to save lives and reduce patients with water born
diseases through solar technology in various areas of Punjab in Pakistan. This will also
show the important psychological factors affecting for the adoption of sodis water among
these communities.


Objectives of the workshop

   (1)     To explore how far with sodis water under citizen community boards (CCBs)
            the health of respective households have been improved (i) in terms of saving
           lives (ii) and reducing patients of water born diseases.

   (2)     To safe guard staple food

    (3)    To investigate psychological aspects related to dignity of the local households
           affecting the adoption of sodis in Cholistan desert, mountainous Chakwal and
           Jhang districts.

   (4)     To make recommendations to serve in other areas of the country.


Methodology

This section will highlight on methodology in short. To involve the local public and
private organizations and departments into the issues of contamination in drinking water,
researcher from City and Regional Planning Department in collaboration with Friends
Forum, Citizen Community Boards (CCBs) serving under Matching Grant (MG) Program
has organized workshops at various centers in Cholistan desert, Chakwal and Jhang
districts. The major theme of these joint efforts through workshops was to develop
strategies for the promotion of safe drinking water in and around the selected centers by an
active involvement of all the stakeholders.




                                                                                            4
For the development of strategies regarding the promotion of safe drinking water in the
selected experimental areas, the participants were divided into different groups namely
Political, Health and Education. The participants were placed into these groups according
to their profession and interest. Each group identified activities, partners, fixed
responsibilities, resources and steps for the future. Each group leader presented their work
before the participants.


The respective data was collected in year 2004 This sort of data was also collected in year
2005 to assess the changes occurred in the impacts on health and psychological facts leading
to the dignity of the local households. The feelings and facts leading to human dignity are
the following:


       (i)     Feeling of safe life from using sodis water by the locals.
       (ii)    Feeling comfortable from using sodis water by the locals.
       (iii)   Feeling of respect in the eyes of people around.
       (iv)    Feeling confident by sodis users in future.


Interviews with the local households were held and the secondary data was collected from
the records of respective offices.




Analysis:


Our results have shown that 27 experimental areas out of total 34 areas in three different
districts have adopted solar technology. Out of total 17243 total, 12268 (71%) households
adopted solar technology, Over all analysis for all 27 experimental areas shows that solar
technology has reduced seasonal death rates from 55 to 27 persons which is a significant
positive change towards protection of lives see table-2.


But on the other side in non MG or MP prone areas 4194 households from 7 control areas
have not adopted solar technology for getting safe drinking water (see table-2). They have
been deprived of the benefits of such safe water due to solar technology.


After a year the seasonal death cases increased from 18 to 26. This clearly shows that in the
control areas water born diseases and the death rate has not been controlled rather it
increased. These households are also loosing other benefits which persist their poverty and
continuous difficulties in many respects.


                                                                                           5
Table:2     Changes in the seasonal death rates due to water born diseases in
            experimental and control areas.



 Experimental areas:                    Seasonal deaths due to water      Seasonal deaths due to water
                                        born diseases before adopting     born diseases after adopting
 Households adopted Solar               Solar Technology for drinking     Solar Technology for drinking
 Technology(CCB/MG Prone)               water                             water
 Cholistan Desert                       11                                6
 (8/10 areas: 1348/1776= 76% HHs)
 Chakwal District                       26                                13
 (11/14 areas: 7284/10036=73% HHs)
 Jhang District                         18                                8
 (8/10 areas: 3636/5431=67% HHs)
 Total                                  55                                27 (28 less than previous
 (27/34 areas: 12268/17243=71%                                            season)
 HHs)                                                                     28/55= (51% deaths reduced)

 Control areas: Households did
 not adopt Solar Technology
 (NON CCB/ NON MG or MP Prone)
 Cholistan Desert                       2                                 3
 (2 areas: 140 HHs)
 Chakwal District                       10                                14
 (3 areas: 2478 HHs)
 Jhang District                         6                                 9
 (2 areas: 1436 HHs)
 Total                                  18                                26 (8 more than previous
 (7 areas: 4194 HHs)                                                      season)
                                                                          8/18= (44% deaths increased)

 Source: Survey and analysis by the researcher : ( Surveys: 20-7-2004 To 21-10-04, Analysis: August 2005)




Table-3 clearly shows that cholera, cough, diarrhea, gas trouble and typhoid patients have
reduced in the experimental areas of Cholistan, Chakwal and Jhang districts after the use
of sodis (safe drinking water from solar technology). In control areas (non CCB or non
MG or MP areas) the patients of water born diseases could not be controlled rather they
have increased in this season.




                                                                                                            6
Table-3 Changes in water born disease cases before and after sodis use

 Water born diseases        Cholistan Desert      Chakwal             Jhang               TOTAL
                            (Derawar Centre)      (Saghar Centre)     (Badrajbana)
                            Patients reported     Patients reported   Patients reported   Patients
                                                                                          reported
 IN AREAS WHERE SODIS HAS BEEN USED (CCB/MG prone areas)
 CHOLERA
 Before sodis use           74                    267                 133
 After sodis use            59                    192                 99
 Changes                    15                    75                  34
 COUGH
 Before sodis use           486                   1889                937
 After sodis use            302                   1376                688
 Changes                    184                   513                 249
 DIARRHEA
 Before sodis use           85                    387                 198
 After sodis use            69                    298                 150
 Changes                    16                    89                  48
 GAS TROUBLES
 Before sodis use           139                   538                 263
 After sodis use            102                   371                 192
 Changes                    17                    89                  71
 TYPHIDE
 Before sodis use           57                    251                 132
 After sodis use            38                    188                 91
 Changes                    19                    63                  41
 TOTAL
 Before sodis use           841                   3332                1663                5836
 After sodis use            570                   2425                1220                4215
 Changes                    271    32%            907      27%        443     27%         1621
                                                                                          28%

 IN CONTROL AREAS WHERE SODIS HAS NOT BEEN USED (NON CCB area)
 Before(in the year 2004)   89                    1131                658                 1878
 After(in year 2005)        103                   1288                754                 2135
 Changes                    14     16%            147      13%        96                  257
                                                                                          14%
Source: ( Surveys: 20-7-2004 to 21-10-04, Analysis: August 2005)




Over two third majority (8760=71%) households from a total of 12,268 household
beneficiaries belong to lower income group who are poor. This indicates that mass
majority of the poors have benefited by reducing their seasonal death rates, water born
diseases, reducing fuel energy, time and money. This way their poverty has been
alleviated(see table-4).




                                                                                                     7
Table:4      Households adopted solar technology by income levels in experimental areas
             of Punjab.

 Name of             HHs adoped             Lower income           Middle income          Upper income
 localities, which   Solar technology       level HH               level HH               level HH
 adopted solar                              Rs. 0 - 5,000/PM       Rs. 5,001-10,000       Rs. > 10,000/PM
 technology
 1. Derawar          1348    100%           1056     78%           182     14%            110       8%
   Cholistan
 Desert
 2. Talagang         7284    100%           5179     71%           1339    18%            786       11%
    Chakwal
 District
 3. Shorkot          3636    100%           2525     69%           724     20%            387       11%
    Jhang District

 TOTAL               12,268 100%            8760     (71%)         2225   (18%)           1283      (11%)

Source: ( Surveys: 20-7-2004 to 21-10-04, Analysis: August 2005)




Safe guarding cooked food at domestic level

In addition to saving lives and reducing diseases, sodis water has also safe guarded general
staple cooked food at domestic level. Out of 12,268 total, two third majority of sodis HHs
from all three districts (27 areas) protect their food from contamination of water borne
diseases by using sodis water in their cooking (see table-5). The sodis HHs have been
found satisfied with the quality from sodis safe drinking water and respective benefits (see
table-6).



Table: 5 Households saving their cooked food by sodis water in experimental areas of
         Punjab.

 Name of localities, which          HHs adoped Solar technology            HHs who safe guard their
 adopted solar technology                                                  cooked food.
 1. Derawar                         1348   100%                            876     65%
   Cholistan Desert
 2. Talagang                        7284   100%                            4858       67%
    Chakwal District
 3. Shorkot                         3636   100%                            2526       69%
    Jhang District

 TOTAL                              12,268 100%                            8260       (67%)

Source: ( Surveys: 20-7-2004 to 21-10-04, Analysis: August 2005)




                                                                                                            8
Table: 6 Households feeling satisfaction by using sodis water in experimental areas of
         Punjab.

 Name of localities, which                  HHs adoped Solar technology              HHs who are satisfied with
 adopted solar technology                                                            sodis water.
 1. Derawar                                 1348        100%                         1146     85%
   Cholistan Desert
 2. Talagang                                7284        100%                         5024     69%
    Chakwal District
 3. Shorkot                                 3636        100%                         2857     79%
    Jhang District

 TOTAL                                      12,268 100%                              9027    (74%)

Source: ( Surveys: 20-7-2004 to 21-10-04, Analysis: August 2005)



Dignity: Psychological aspects

Assessing the impact of water interventions on health is difficult task and while there is no
simple answers to assessing the impact on human dignity. However the researcher has raised
following basic questions which can be used to guide such an approach:

     1.   Do you feel safe for life by using sodis water ?
     2.   Do you feel comfortable using sodis water ?
     3.   Do you feel respected by those around you ?
     4.   Do you feel confident for using sodis water in future ?

Table 7 shows the changes in the feeling of safe health from sodis water by households from
various rural communities in the desert, mountainous and plain regions of Punjab in Pakistan.
In the previous year 2004 in Cholistan desert only 52% households felt safe health by using
sodis water. After one year in 2005 more than three fourth 76% majority households felt
secured or safe with the use of sodis water. Within one year 24% households feeling safe
with sodis water have been increased.

Table: 7 Changes in the feeling of safe life from Sodis water by households from
         various rural communities in Punjab, Pakistan.
 Districts                  Feeling of safe life               Feeling of safe life          Changes
                            by HHs        (Year-2004)          by HHs (Year-2005)
 CHOLISTAN                  924/1776           = 52%           1348/1776            = 76%    424/1776        = 24%
 (DESERT)
 CHAKWAL                    4817/10036             = 48%       7284/10036         = 78%      2467/10036      = 25%
 (MOUNTAINOUS)
 JHANG                      2498/5431              = 46%       4073/5431          = 75%      1575/5431       = 29%
 (PLAIN)
 TOTAL                      8239/17243             = 48%       12705/17243        = 74%      4466/17243      = 26%

Source: Survey and analysis by the author (2004-2005)
HH= Households




                                                                                                                  9
The cases of mountainous communities in Chakwal district and plain areas of Jhang district
have also shown similar results. In total picture for all areas less than half (48%) households
showed feeling of safe water in 2004 which increased significantly to nearly three fourth
(74%) majority of households.


Table-8 shows that ultimately a lot of households have got rid off uncomfortable ways for
getting safe drinking water. In year 2004 less than half (44%) households in Cholistan desert
areas, 47% in Chakwal mountainous and 46% in Jhang plain areas felt comfortable. In year
2005 households feeling comfortable from sodis water increased to four fifth of total
households. Further it shows that in limited period of one year within a range of 33% to 36%
households have been increased in all regions. In year 2005 this figure reached to cover 81 %
households which was achieved at the rate of 34% per year.


Table: 8 Changes in the feeling comfortable from Sodis water by households from
         various rural communities in Punjab, Pakistan.
 Districts                  Feeling comfortable           Feeling comfortable         Changes
                            by HHs      (Year-2004)       by HHs (Year-2005)
 CHOLISTAN                  781/1776        = 44%         1420/1776        = 80%      639/1776     = 36%
 (DESERT)
 CHAKWAL                    4717/10036            = 47%   8229/10036       = 82%      3512/10036   = 35%
 (MOUNTAINOUS)
 JHANG                      2444/5431             = 45%   4236/5431        = 78%      1792/5431    = 33%
 (PLAIN)
 TOTAL                      7942/17243            = 46%   13885/17243      = 81%      5943/17243   = 34%

Source: Survey and analysis by the author (2004-2005)
HH= Households


Table-9 reflects feeling of respect in the eyes of others by households using sodis water. In
all areas less than half of the total households felt respect but in 2005 this figure increased
significantly higher within two third majority in each district. The rate of increase in
households per annum has been 26%.

Table: 9 Changes in the feeling respectful from Sodis water by households from
         various rural communities in Punjab, Pakistan.

 Districts                  Feeling of respect by HHs     Feeling of respect by HHs   Changes
                            (Year-2004)                   (Year-2005)
 CHOLISTAN                  710/1776         = 40%        1208/1776          = 68%    498/1776     = 28%
 (DESERT)
 CHAKWAL                    4617/10036            = 46%   7527/10036       = 75%      2910/10036   = 29%
 (MOUNTAINOUS)
 JHANG                      2553/5431             = 47%   3584/5431        = 66%      1031/5431    = 19%
 (PLAIN)
 TOTAL                      7880/17243            = 46%   12319/17243      = 72%      4439/17243   = 26%

Source: Survey and analysis by the author (2004-2005)
HH= Households




                                                                                                      10
Table 10 shows changes in the feeling confident from various rural communities in Punjab.
In the previous year less than half of total households felt confident to use sodis water in
future but in year 2005 the confident cases have been increased twice. The change shows that
majority of sodis water using households feel confident for using sodis water in future. This
reflects that sodis water technology is being popular day by day in all such rural communities


Table: 10 Changes in the feeling confident for using Sodis water in future by
          households from various rural communities in Punjab, Pakistan.

 Districts                  Feel confident by HHs         Feel confident by HHs     Changes
                            (Year-2004)                   (Year-2005)
 CHOLISTAN                  924/1776        = 52%         1421/1776         = 80%   497/1776     = 28%
 (DESERT)
 CHAKWAL                    4817/10036            = 48%   8731/10036       = 87%    3914/10036   = 39%
 (MOUNTAINOUS)
 JHANG                      2498/5431             = 46%   4236/5431        = 78%    1728/5431    = 32%
 (PLAIN)
 TOTAL                      8239/17243            = 48%   14388/17243      = 83%    6149/17243   = 36%

Source: Survey and analysis by the author (2004-2005)
HH= Households




Conclusion:


Campaign for the adoption of sodis water has been successful in the areas where CCBs
under Mathing Grant program has helped their local rural communities. Two third
majority of households (12268/17243=71%) in 27 areas out of 34 in Cholistan desert,
Chakwal and Jhang districts have benefited from sodis water by saving lives and reducing
patients with water born diseases. Most (80%) of these beneficiary households belong to
middle and lower income groups. Two third majority (67%) households also protected
their cooked food with sodis water.

The impacts of psychological facts related to human dignity of local households also play
important role for the adoption of sodis water among various rural communities. Number
of households with changes in the feeling of safe life, comfort, respect and confidence do
increase but in due time.




                                                                                                    11
Recommendations



1. Since sodis technology is a simple method which must be encouraged at domestic
   levels in villages, towns and cities. It can also protect cooked food of various
   communities.

2. In order to integrate sodis in daily routine, continuous follow-ups are crucial. This can
   best be done by locally established institutions and area resource persons. Pakistan is
   lucky where such suggestions can be implemented through community based Matching
   Grant program which is already institutionalized and in current practice

3. In order to get safe drinking water other organizations can coordinate with the researchers
   of City and Regional Planning Department (CRP) of University of Engineering and
   Technology, Lahore.

4. In the corporate culture and environment, dignity of people are threatened by over-
   dependency on power and affluent groups. These aspects of dignity must be controlled
   rationally in time. Otherwise overall performance of good governance will also be
   affected.

5. The top-down approach will strengthen the corporate culture and weaken the dignity,
   therefore bottom up approach based on mutual consultations, participations, respects and
   confidence must be encouraged through CCBs in Pakistan.




Acknowledgment
   The researchers are very much thankful to the following:

   1.   Dr Nasim A Ansari (External supervisor) and Prof. Dr Ghulam Abbas Anjum (Internal supervisor)
   2.   Mr. Stefan Grampher (Tim) researcher from Switzerland, who met the researcher in Jhang district.
   3.   Prof Dr A R Saleemi, Dept of Chemical Engg, University of Engg & Technology, Lahore.
   4    Engr Mumtaz Hussain, Chief Coordinator, Environmenta House, Lahore and RDPI experts.




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References:

IUCN (2000) "Water for 21st century", Environment and Urban Division, Islamabad, see in
RDPI library.

Islam,Q (2005) "Solar technology for getting safe drinking water and poverty alleviation
through 21st century Matching Grant program of Pakistan", PhD research work, CRP Dept,
Lahore. [Paper presented at Seminar at Islamabad organized by RDPI on 3-5 August 2005].

Islam,Q (2004) "New ways: group work strategies for the promotion of safe drinking water",
PhD research work, CRP Dept, Lahore.

Joshi and Shrestha (2003) "Solar Water Disinfection in Nepal"

Roaf, S (2005), "Solar Cities" Oxford University, Brooks, UK

Tapp, Philip (1998), "Solar Energy Planning", Quide Azam Library, Lahore.

SANDEC (2005), " SODIS in Brief", Sandec, Duebendort, Switzerland

Stefan Grampher (2003)"Notes collected from meetings with Stefan Grampher from
organizations SANDEC/EAWAG , a Swiss researcher on drinking water", Rajoa, Jhang .

Swiss Federal Institute of Science and Technology (2005) "Solar water disinfection",
Switzerland.

Gupta A K ed (2001) "Criteria and Indicators of Sustainability in Rural Development",
Oxford and IBH Publishing Co. Pvt Ltd.




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