ABSTRACT
Introduction
Water is essential to life, the scarcity of municipal water in Damaturu has led to the dependence on privately owned boreholes as a source of domestic water supply amongst the residents of Damaturu. Therefore, the specific objectives of the study were to assess the physical, chemical and microbiological quality of ground water, using, pH, temperature color, turbidity, coliform count, hardness, lead, arsenic, fluoride, nitrate and iron as reference point, to asses if the site of the boreholes met standards, to assess the knowledge and practice of the owner/users of boreholes to standards for ideal boreholes, and to survey the morbidity pattern of households using the borehole as source of domestic water supply.
Methodology.
The study was conducted between December and February 2009, a period spanning 12 weeks. A descriptive, cross sectional study design was employed and a multistage sampling technique was used to select a total of 170 boreholes and 580 household heads that depend on the boreholes as their source of domestic water supply. Data was collected by administering a semi structured, researcher administered questionnaire, on the household heads, water from selected boreholes for laboratory analysis and a check list was used measure adherence of boreholes to standards.
Data was analyzed electronically using the Statistical package for Scientific Solution (SPSS) version 15 and Computer Program for Epidemiology (PEPI), with statistical significance set at P <0.05.
Results.
All boreholes yielded fluoride with mean value 0.12 ± 0.13 which is about 85 percent below the reference range of 0.8 - 1.5mg/l. In Chungul Jabbari and Damakasu LGA all the boreholes yielded acidic water (pH<7), 36.5 percent of all boreholes had water with abnormal pH. All the boreholes were properly constructed, but 27.6 percent of the borehole sited wrongly. Only 1.2% of boreholes were registered or got government approval. The owners/users had poor knowledge (76.4%) and poor practice (81.2%) of standards.
The morbidity pattern survey showed that malaria had the highest frequency among the acute illness, while hypertension had the highest frequency amongst chronic illness (17.1%).
Conclusion and Recommendation
Water from boreholes in Damaturu was relatively safe for domestic purpose, except for the low fluoride content. In terms of site and construction, boreholes were generally good. However, the owner/users of boreholes lacked knowledge and hardly practiced standards for ideal boreholes.
It is important that families using borehole water as domestic water begin to use topical fluoride gel to prevent against dental caries.
Key words-Borehole, water analysis, head of households, morbidity pattern.
CHAPTER ONE
Introduction
• Background to Study
In ancient times, health and illness were interpreted in a cosmological and anthropological perspective. Medicine was dominated by magical and religious beliefs, which were an integral part of ancient cultures and civilizations.1 In the middle nineteenth century when Pasteur advanced the “Germ theory of disease” it seemed to have finally answered the relationship between health and disease. Away, from the Germ theory so many other theories have been propounded to explain this intricate relationship between health and disease. One of such model which is the most accepted now is the Holistic model, which recognizes the strength of social, economic, political and environmental influence on health.1 In fact the influence of environment on health cannot be over emphasized. Considering the world’s population as a whole, the environment affects people’s health more strongly than any of the other determinants.2 The key to man’s health lies largely in his environment, in fact much of man’s ill health can be traced to adverse environmental factors, such as water, soil, and air pollution, poor housing conditions, presence of animal reservoirs and insect vectors of disease which pose constant threat to human health.3
The bulwark of environmental health is water supply and it contributes to human health or otherwise4. The importance of water supply to health and the quest for pure water in adequate quantity and quality dates back to antiquity.3 Water constitutes about seventy one percent of the Earth’s surface area with only about three percent of this as fresh water.2 It contributes directly to health when ingested in liquids and as a constituent of food, and it also contributes indirectly to health and well-being through its use in agriculture, industry, power generation, waste disposal, recreation and transportation.5
About fifty five to seventy five percent of the total human body weight is water; the amount varies by age, body composition, gender and a few other factors. Younger people have more water than older people; the total body weight of a new born is about seventy five percent water, while an elderly individual’s weight is fifty percent water. Lean tissue (muscle) has more water than fat, therefore the leaner the individual the higher the water proportion. Blood is about eighty three percent water, lean muscle is seventy three percent water, fat is twenty five percent water and bone twenty two percent water.6
The main source of the body’s water requirement comes from drinking water. However, that is by no means the only source. Juicy fruit and vegetables like lettuce, water melon, grape fruit and tomatoes are all more than ninety percent water. Other foods such as chicken, fish, bread, pasta and even butter and margarine contain various amount of water, oils do not contain water.6
The basic physiological requirement for drinking water has been estimated to be about two liters per capita per day.3 This is just for survival, from the stand point of public health and improvement of the quality of life, water should be provided in adequate volume. The consumption of water however, depends upon the climatic conditions, standard of living and habits of people.3 In Nigeria separate water supply and sanitation considerations are made to match the three socio-economic profiles of the population as follows:
• In Rural areas with population of about 150 to 5000 people, water supply should guarantee minimum level of 30liters per capita per day within 250meters of the community, serving about 250-500 person per water point.7
• Semi (small towns) represent settlement with population of between 5,000-20,000 with a fair measure of social infrastructure and some level of economic activity, water supply should be a minimum standard of 60liters per capita per day with reticulation and limited or full house connections as determined by the beneficiaries/government.7
• Urban areas with population greater than 20,000 inhabitants should be served by full reticulation and consumer premise connection, with a water supply of 120liters per capita per day.7
Beyond meeting human physiological needs, water contributes to sustainable development in other ways such as
• To meet the demand of a growing population, global agriculture will have to increase by 60% from 2000-2030. Over the next 30 years, 70% gains in cereal production will come from irrigated lands, and this requires an increase by 14% water used for irrigated agriculture. . Considering it takes about 3000liters of water to produce our daily food ration,8 the quest for water in adequate quality and quantity may have just begun, so that by 2025, it is expected that 34 billion people will be living in countries defined as “water scarce”.8
In Nigeria, the quest for adequate potable water can be traced to the early twentieth century, with the constitution of public water works in a few towns, under the management of the lowest administration level.7 Globally, the United Nations General Assembly in 1980 launched the International Drinking Water Supply and sanitation decade:- 1981-1990. The aim was to provide all people with adequate supply of safe water and sanitation by 1990.3 The year 2005 marked the beginning of the International Decade for Action-Water for life (2005-2015) and the Millennium Development Goals targets reduction by half the number of people without access to safe drinking water.8 It has been asserted that the provision of water and sanitation will speed up the achievement of all eight MDGs.9 It is so easy to appreciate this fact considering the fact that every day, approximately 5000 people die from diarrhea disease from easily preventable causes. Most of these people being young children, provision of sufficient and better quality drinking water and basic sanitation can cut this figure drastically.9
Clean water and adequate sanitation are critical to human health and protection against a wide variety of diseases. Lack of safe water and adequate sanitation is the world’s single largest cause of illness. Two million people, most of them children die every year from waterborne diseases such as diarrhea, and millions become seriously debilitated.9 Unsafe water and inadequate sanitation are the major underlying factors behind the 10 million child death every year. Over half of the hospital beds in the developing world are occupied by people suffering from preventable disease caused by unsafe water and poor sanitation.9
More than 70 percent of water-borne disease pathogens live a fraction of their life cycle in water.10 Studies have shown that over 70 percent of health issues and death among infants and young adults could be traced to contaminated water.10 The crises situation is even made worse in developing countries where there is scarcity of public water supply. It has been estimated that about 1.3 billion people in developing countries lack access to clean and plentiful water.10 In Nigeria it has been estimated that only about 48 percent of the inhabitants of Urban and semi urban areas and 39 percent of rural areas have access to potable water supply. 7 In spite of these low figures, the average water supply for urban population is only 32liters per capita per day as opposed to the recommended 120 liters per capita per day, while that for rural population is 10 liters per capita per day as opposed to the recommended 30 liters per capita per day. The quality in most cases is suspect.7
Unfortunately, women suffer disproportionately from this crises situation. All around the world, women’s life are intricately connected to water. Women play a central role in providing, managing and safe guarding water and they are the main role models within the family when it comes to sanitation and hygiene. Women also suffer disproportionately from water related disasters, such as, floods as they do not receive warning or other information about hazards and risk.8
Water may be abstracted for use from any one of a number of points in its movement through the hydrological cycle. In general, water source must conform to 2 criteria.
• The quantity must be sufficient to meet its present and future requirement
• The quality of water must be acceptable.
There are 3 main sources of water namely; rain water, surface water, and ground water. Rain water percolating in ground constitutes groundwater. Groundwater is the cheapest and most practical means of providing water to small communities.3 Surface water picks up the characteristics of the surface over which it passes. If water flows across a parking lot, gasoline, oil and other contaminant may be carried by or dissolved in the water. The same principle holds true for groundwater.2 As water enters the ground it picks up the characteristics of the formation through which it passes. Water may pick up pathogens from subsurface sewage systems, and many minerals from the soil dissolve in water. As water moves through the ground, the soil often filters out biological contaminants. The soil type and geological structure can have a great effect on the extent of biological filtration. Usually, the deeper an underground water source is located; the better is the biological quality, because of filtration. On the other hand, theoretically, the deeper the water source is located the poorer the chemical quality. Generally deep groundwater has been in the ground for a longer time, allowing prolonged contact with the underground strata. The increased contact time may cause additional minerals to dissolve into the water, changing the chemical quality.11 The quality of groundwater depends on the sanitary condition of the environment, the composition of the recharge water, the geologic formation from which it is obtained, the interaction of water and soil, soil gas and the anthropogenic activities.11, 12, 13.
There is an increasing demand for water for both domestic and industrial needs, to meet up with this demand; groundwater has become an important source of water.9 Groundwater can be found below the surface of most of the earth. The location of this water may vary from a few feet to thousands of feet below. In some areas the groundwater is pounded and almost no ‘new water’ entering from the hydrologic cycle, other areas have free-flowing underground streams that are recharged from water entering through the earth’s surface miles away, the flow direction coinciding with the general slope of the terrain.14 A porous stratum that stores water underground and yields the water is called an Aquifer and the upper water level in the saturable body is called water table.12
Groundwater can be tapped naturally by means of springs or artificially by wells. The four major types of wells are: Dug, Bored, Driven and Drilled (borehole). The type of well to be constructed is often dependent upon the geological formation in an area. The Borehole (Drilled well) is the most versatile of all these, water collected from boreholes are often less subject to reduced flows in times of drought and not as prone to biological contamination The versatility of Borehole makes it an easy and a ready source of water for both commercial and private use. In America boreholes account for at least 15 percent of privately owned water supply. In Nigeria, the inadequacy of the public water works has led to an indiscriminate drilling of private boreholes, without regulation from the appropriate authorities and water quality check is nonexistent.
The morbidity pattern of any society varies and depends on different factors which interrelates and interact with each other. Assessing the contribution of environmental exposures to the overall morbidity pattern is difficult.15 Studies have shown that the main morbidities in Nigeria are diarrhea diseases, infectious and parasitic diseases including HIV/AIDS, respiratory disease, nutrition and metabolic disease, hypertension and accidents.16-20
• Statement of the Problem
Water and health cannot be separated, two million people, most of them children die yearly from water borne diseases.10 About 88 percent of all diarrhea diseases are attributed to unsafe water, inadequate sanitation and hygiene. Unfortunately only 39 percent of Nigerians have access to potable water.7 The Federal Ministry of Water Resources estimates that about 71 percent of rural dwellers and 58 percent of urban dwellers lack access to water in adequate quality and quantity.7 In its general household survey spanning a decade, the National Bureau of Statistics estimates that the number of household in Nigeria, using unsafe water source increased from 30.8 percent in 1995 to about 35.8 percent in 2002 then decreasing marginal to 30.5 percent in 2005, averaging about 30 percent for the decade.21 In spite of the efforts by Government at all levels, the water supply in the country seems to be deteriorating.7 Therefore, there has been an increased reliance on privately owned boreholes as sources of drinking water due to inadequacy from local public water works. In a study of borehole water in Nanded City, a city which share some characteristics with Damaturu, such as increased population and dependence on groundwater as a source of drinking water, showed significant increase in the concentration of indicator organism in all samples during the monsoon season, therefore suggesting there might be seasonal variation on the level of contamination.22 Unfortunately Nigeria, is yet to establish an effective water quality monitoring system and data base.23 The drilling of boreholes are neither supervised nor the quality of the water checked by the appropriate authorities before being used as sources of drinking water. Very few studies have been done on the quality of ground water in this environment, especially as most houses now depend on it as a source of drinking water, as water may contain some dissolved elements which may be harmful or beneficial depending on the element and the quantity. The inverse relationship between hardness of water and cardiovascular mortality have been well documented.24 Also the effect of fluoride dissolved in groundwater, which when used as a source of drinking water was investigated, and results showed that excessive fluoride in drinking water can lead to dental fluorosis and dental caries.25 Groundwater can become contaminated from various sources, including human activities.11 Studies done in Damaturu, Ibadan, and Lagos on groundwater have shown contamination by both chemical and biological contaminants,26,27,28 which can become a source of ill health especially long term chemical poisoning.
Also the morbidity pattern of any society varies according to changing living standard and environmental conditions. A regular update of the morbidity pattern is essential in the evaluation of health policies and the changing lifestyle of our society. Therefore, as borehole water is becoming a major source of drinking water in Damaturu, a concomitant morbidity pattern survey will to serve as a baseline data of the health profile of those drinking water from boreholes for future reference. Usually the microbiological contaminants of water cause acute illnesses such as diarrhea, dysentery, and typhoid fever, most of the life threatening cases of diarrhea especially amongst children is attributable to unsafe drinking water. Globally, in 1997, diarrhea ranked as the first cause of morbidity and the sixth cause of mortality.29 Provision of potable water both in quality and quantity will drastically reduce this burden. On the other hand, chemical contaminants have been known to cause chronic illnesses and their deleterious action are usually insidious, stretching over many years. The growing evidence that relates drinking water contaminants and some cancers is overwhelming, such contaminants range from fluoride, nitrates, to asernic.25
• Justification of study
Often times the quality of water is judged by its physical qualities i.e. color, taste, smell and temperature. These qualities are usually not in short supply in borehole water due to the natural sand filters that the water goes through. However, groundwater may also posses the characteristics of the soil it passes through, dissolving in it chemicals that may be harmful either in short term or on a long term basis. Also if not properly sited and constructed, seepages from nearby sewers and run-off may contaminate the water thereby leading to an increase in the biological contaminant. Therefore as people begin to make borehole their source of drinking water it be important to know how safe this water is for consumption.
A concomitant household morbidity pattern survey will serve as a base line health profile data for people drinking borehole water for future reference. It may accidentally reveal a correlation between the quality of drinking water and frequency and prevalence of certain diseases. In west Bengal, India, investigators have reported hepatic damage following chronic consumption of arsenic containing groundwater. Some investigators have shown an inverse relationship between hardness of drinking water and cardiovascular disease.24 Therefore this study may awaken the possibilities of the role of drinking water in the morbidity pattern of a locality.
• Scope of Study
This is a cross sectional descriptive study to describe the quality of water from borehole in Damaturu, in terms of physical, chemical and biological aspects of water. It also intends to describe the morbidity pattern in household where borehole water is used as source of drinking water and to serve as a baseline health profile for those drinking borehole water.
• Aims and Objectives
1.5a General Objective
To assess the quality of ground water and describe the morbidity pattern of people using borehole as source of domestic water supply in Damaturu.
1.5b Specific Objectives of study
• To assess the physical, biological and chemical quality of ground water in Damaturu, using temperature, pH, turbidity, color, total coliform count, hardness, Lead (Pb), Arsenic (Ar), Iron (Fe), Nitrates, (NO) Fluoride
(F) as reference point.
• To assess if the sites of boreholes meet ideal standards.
• To assess the knowledge and practice of the owners/users of wells to standard for ideal boreholes.
• To survey the household morbidity pattern in houses using borehole as source of domestic water supply.
• Limitation of study
Some of the variables in this study were obtained through recall and self reporting, and both are subject to bias.
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