AN ASSESSMENT OF THE CONTRIBUTION OF FAECAL DISPOSAL PRACTICES ON THE BACTERIOLOGICAL QUALITY OF DRINKING WATER SOURCES IN ISIOLO COUNTY, KENYA

ABSTRACT
The basic needs of people such as safe drinking water, improved hygiene and sanitation must be fulfilled for a dignified life of human beings. However, this has not been the case in Isiolo County where there is rampant practice of open defecation and reliance on unprotected water sources for drinking purposes, with little or no regard to adequate drinking water treatment handling and storage. This study sought to establish the contribution of faecal disposal practices among residents on bacteriological quality of drinking water sources in the County. In a cross-sectional survey of 150 households, data on faecal disposal and water handling practices was obtained through questionnaires, observation and key informant interviews. In addition, water samples from both source and household stored water were subjected to bacteriological analysis using the Membrane Filtration Technique (MFT). The data was then analysed using descriptive and inferential statistics at α = 0.05 level of significance. According to the findings, the water sources sampled recorded high levels of contamination with bacterial pathogens. Results indicated mean counts of 7.9, 2.1, 5.3, and 6.4 (x 103CFU/100ml) from water source and 5.8, 1.6, 3.6 and 3.8 (x 103 CFU/100ml) from household stored water samples for Faecal streptococci, Escherichia coli, Salmonella typhi and Total coliform respectively with contamination levels falling below the World Health Organization (WHO) recommended standards. Sanitary risk analysis around these water sources revealed low levels of hygiene and poor source protection in 78% of the water sources, making them prone to faecal contamination. At the household level, 43% of the households surveyed did not have access to latrine facility, promoting un-healthy behaviour such as open defecation, burying and paper bag disposal of faecal matter among households. From the study findings, it was concluded that poor faecal disposal practices and low levels of hygiene among households could be linked to poor bacteriological quality of drinking water. There is need to increase households access and use of latrines. In addition, it is necessary to instil safe drinking water treatment and handling practices especially at point of use. This will help minimise the negative health impacts associated with consumption of faecal contaminated water at households.

CHAPTER ONE
INTRODUCTION
Background information
Open defecation is the practice of defecating outside, in and around the local community as a result of lack of access to toilets, latrines or any form of improved sanitation (Bartram et al., 2012). According to the Sanitation Update report by World Health Organization (WHO), close to 1.3 billion people are practicing open defecation and 2.6 billion people lack access to improved sanitation, almost all in developing countries and predominantly in rural environments (WHO, 2015). India for instance, has the largest number of open defecators in the world, estimated to be over 600 million of them (Coffey et al., 2014). The United Nations approximates that 14% of the population in Democratic Republic of Congo are open defecators. Nearly 540 million people, more than 60% of Africa’s population, currently do not have access to safe sanitation, defined as an improved latrine or septic tank. According to MacDonald and Calow (2009), more than a third of Africans practice open defecation, mostly in the rural areas.

The practice of open defecation is common in Kenya, both in rural and urban areas. For instance, Nairobi, the capital city of Kenya, is home to over 4 million people of whom 60% live in informal settlements (WHO, 2010). In these informal settlements, there is limited access to improved sanitation facilities and the existing ones are typically in a state of disrepair and not connected to the municipal sewerage system (Montgomery et al., 2009). This creates a scenario where residents defecate in plastic bags, which are then disposed off in an ad hoc manner (WHO, 2010).

Among pastoralist communities, open defecation is a common practice. Onganya et al. (2012) attributes this practice to the nomadic lifestyles that hinder the provision of permanent sanitation facilities. Isiolo lies in an ASAL area with latrine coverage as low as 22%, with open defecation prevailing in numerous rural environments of Isiolo County (ICIDP, 2010). In 2011, the Ministry of Health (MOH) under the Open Defecation Free (ODF) Rural Kenya Roadmap rolled out an implementation plan which sought to declare several villages of Isiolo County open defecation free (UNICEF 2013; GoK, 2011). This has however been met by challenges though the program is still on-going. Musa (2015) further explains that open defecation is a major contributing factor to a multiplicity of water and sanitation related diseases, such as diarrhoea, cholera and typhoid. An estimated 80% of all diseases and one-third deaths in developing countries are caused by consumption of contaminated water and one-tenth, on average of each person’s productive time is sacrificed to water related diseases (WHO, 2010).

Open defecation deteriorates the quality of drinking water, making the water unfit for drinking purposes (Tambekar and Neware, 2012).

Water acts as a medium for the transfer of a number of infectious pathogens and a wide range of diseases of microbial origin. According to Rajgire, (2013), faecal contamination of water leads to introduction of a number of enteric pathogens such as E. coli, which causes a number of water- borne infections. According to World Health Organization statistics, about 600 million episodes of diarrhoea and 4 million childhood deaths are reported globally per year due to drinking contaminated water and due to lack of proper sanitation. Lack of adequate sanitation also pollutes drinking water, which most significantly due to open defecation and has adverse impacts on human health (WHO, 2010). There is hence need for an assurance of drinking water safety since this will help in the prevention and control of water borne diseases. This study, therefore, was conducted in order to assess the influence of open defecation on the bacteriological quality of drinking water sources within Isiolo County, Kenya.

Statement of the problem
Sanitation coverage in Isiolo County is low and is characterised with rampant open defecation parctices. In addition, scarcity of potable water remains a key problem among majority of the households. This is because piped water, which is relatively safer, is in most cases provided in Isiolo town and sub-urban environments hence majority of the rural population rely on unprotected water sources that could be prone to faecal contamination. Water scarcity and economic constraints in Isiolo has led to the use of water from these unprotected sources without establishing its quality before use, thus exposing residents to health risks and propably reported high incidence of waterborne diseases within the County. Therefore, there is the need to provide data on faecal disposal practices and on the bacterialogical quality of water sources within the study area. This was achieved through collecting information on the faecal disposal practices and data on the microbiological quality of drinking water sources within the study area. This information will help inform water and sanitation interventions in an effort to safeguard human health amongst communities in Isiolo County.

Objectives
Broad objective
To assess the contribution of faecal disposal practices on the bacteriological quality of drinking water sources in order to safeguard human health in Isiolo County.

Specific objectives
i) To assess the sanitation characteristics in the Open defecation free (ODF) and Open defecation not free (ODNF) areas in Isiolo County.

ii) To document the various drinking water sources used by the residents of Isiolo and the household water handling practices involved.

iii) To analyse and compare enteric pathogen levels of E. coli, Faecal streptococci, Total coliform and Salmonella typhi in drinking water sources and at point of consumption (selected households) within the study area.

iv) To assess and map out the spatial distribution of open defecation points and latrine coverage in the study area.
Research questions

i) What are the sanitation characteristics in open defecation free and open defecation not free areas in Isiolo County?

ii) Which are the drinking water sources used by the residents of Isiolo County?

iii) Which are the household water treatment and handling practices used by the residents of Isiolo County?

iv) What are the comparison levels of E. coli, Faecal streptococci, Salmonella typhi and Total coliforms between the various water sources and at point of consumption (selected households) within the study area?

v) What is the spatial distribution of open defecation points in relation to latrine coverage in the study area.

Justification of the study
Availability of adequate potable water remains a challenge in many parts of the world (Montgomery et al., 2009; Gunther and Fink, 2010). The use of water from un-improved sources has resulted to numerous health risks such as water borne diseases (Galan and Graham, 2013). Isiolo county is characterised by high incidences of open defecation occasioned by low latrine coverage and use. In 2011, an Open Defecation Free Rural Kenya Campaign Road Map was launched aimed at ending open defecation in rural villages of Isiolo County by 2013 (GoK, 2011; UNICEF 2013). Isiolo county, being prone to high cases of waterborne diseases such as numerous cholera outbreaks, was considered suitable for the study in a bid to understand the origin of faecal contamination of drinking water sources within the county, for appropriate intervention measures. The study is in line with Kenya’s Vision 2030 under the social pillar, which aims at a just and cohesive society with social equity in a clean and secure environment (GoK, 2007). The relevant sectors of government like public health and environment will use the study findings in the development of appropriate intervention programs to ensure good health and well-being and ensured access to clean water and sanitation as espoused in the United Nation’s Sustainable Development Goals (SDG’s), with Goal 3 focussing on universal access health and Goal 6 aimed at ensuring clean water and sanitation by 2030 (United Nations, 2015). The research will also contribute positively to realising the Ministry of Health ODF Rural Kenya Campaign Roadmap, which entails working through partnerships and devolved government structures throughout rural Kenya to reach all the communities and ensure that they are open defecation free (GoK, 2011). The research thus aims to identify and map open defecation hotspots within the study area, information that will be useful to water, sanitation and hygiene actors within the County of Isiolo.

Scope of the study
The study was conducted in Isiolo Sub-County, in two wards of namely; Ngare Mara and Burat wards in both the open defecation free (ODF) and open defecation not free (ODNF) villages and targeted both surface and below ground community drinking water sources. A cross-sectional survey was conducted to assess faecal disposal practices, determine the drinking water sources mostly used by the communities and the water treatment methods at households. Sanitary surveys accompanied by water sample collection were done in the selected drinking water sources for bacteriological analysis. Mapping was also done to indicate the extent of open defecation while relating it to latrine coverage.

Assumptions of the study
The study focused on sanitation practices and related them to potential contamination of the community drinking water sources. The study therefore assumed that the level of sanitation in terms of disposal of human waste had a strong bearing on the microbiological water quality of the adjacent water sources.

Limitations
Engaging in discussions regarding open defecation is a taboo among many pastoral communities. Some of the respondents were therefore reluctant to respond freely on issues regarding faecal disposal practices especially in open defecation prone areas. However, observations were made within the study households to gather more information on faecal disposal habits. Communication barrier especially in remote villages was also a challenge with some respondents hence assistance for translation by trained local research assistants.

Definition of key operational terms
Drinking water- refers to water used, or intended to be available for use by humans for drinking, cooking, food preparation, personal hygiene or similar purposes.

Household – A group of people living together in a house or homestead. It also refers to a group of people habitually eating and sleeping together in the same compound.

Hygiene- Refers to personal and household practices that serve to prevent infection and keep people and environments clean.

Improved drinking water source- is defined as one that, by nature of its construction or through active intervention, is protected from outside contamination, in particular from contamination with faecal matter.

Improved sanitation facilities-refers to sanitation facilities which hygienically separate human excreta from human contact.

Latrine Coverage- Proportion of households having ownership of an improved latrine facility. Open defecation-This refers to the practice of defecating outside and in public, in and around the local community as a result of lack of access to toilets, latrines or any form of improved sanitation.

Open defecation free- An area is open defecation free when there is absence of the practice of open defecation in a prescribed community, region or nation.

Open defecation not free- Refers to the presence of open defecation practices in a presecribed community, region or nation.

Potable water- means water that has been treated, cleaned or filtered and meets established drinking water standards or is assumed to be reasonably free of harmful bacteria and contaminants, and is considered safe to drink or use in cooking and bathing.

Sanitation- refers to the systems for provision of facilities and services for safe disposal of human urine and faeces. It also means building and availability of clean latrines as well as safe disposal of sewage.

Sanitary inspection- is an onsite inspection of a water supply to identify actual and potential sources of contamination.

Waterborne diseases- any illness caused by drinking water contaminated by human or animal faeces, which contain pathogenic micro-organisms. Water handling- Refers to the household practices of water fetching, treating and storage.

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Item Type: Kenyan Material  |  Attribute: 78 pages  |  Chapters: 1-5
Format: MS Word  |  Price: KSh900  |  Delivery: Within 30Mins.
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