| Abstract|| |
Background: In a developing country like Bangladesh, people are constantly battling different diseases most of which are caused by a lack of clean drinking water and sanitation. Improved hygiene (hand washing and safe water use) and sanitation (sanitary latrine) are also essential for reducing cases of diarrhea, parasitic infestation, morbidity, and mortality. A field study was carried out in the village of Batabaria in Comilla to identify the status of safe drinking water and sanitation. Materials and Methods: The village of Batabaria under Comilla Sadar was selected for data collection. Data was collected by using the direct observation method, a sample questionnaire, and discussions with key informants. Thirty houses were chosen from the village. A total of 158 respondents were interviewed to gather information for the study. Results: The average family size was 5.26, which is more or less the same average of Comilla, however, it is a little lower than the national average of 5.6. Most of the family members were students (40.5%) and housewives (22.78%). Thirty percent of the respondents live below the poverty line while the national average is 47%. The percentage of respondents engaged in agricultural work is 11.2%, which is far lower than our national percentage of 53%. All of the households use tube wells for drinking and domestic purposes, presumed to be arsenic free. A total of 98% use sanitary latrines. Among the respondents, 76% wash their hands before meals and after defecation. Conclusion: A comprehensive village development plan should be carried out in every village in Bangladesh to improve the standard of safe water use and sanitation.
Keywords: Safe drinking water, sanitation status, village
|How to cite this article:|
Amin MR, Ahmed W, Kashem M. The status of safe drinking water and sanitation in Batabaria, Comilla, Bangladesh. Ann Trop Med Public Health 2008;1:47-51
|How to cite this URL:|
Amin MR, Ahmed W, Kashem M. The status of safe drinking water and sanitation in Batabaria, Comilla, Bangladesh. Ann Trop Med Public Health [serial online] 2008 [cited 2020 Oct 31];1:47-51. Available from: https://www.atmph.org/text.asp?2008/1/2/47/50683
| Introduction|| |
Bangladesh is a densely populated agro-based country. Most of the people live in villages and among them a significant number of people live below the poverty line. While poverty exists, there is always a chance for a lack of education and health hazards. In a developing country like Bangladesh, people are constantly battling with different diseases, most of which are due to a lack of clean drinking water and sanitation. Access to safe water and hygienic disposal of human excreta are the most essential components of primary health care. The UN general assembly confirmed the access to safe water and sanitation as a basic right of children. The lack of safe water and the sanitary disposal of human waste significantly increases the morbidity rate of the country. Better hygiene and access to safe drinking water and sanitation will accelerate progress and reduce the mortality rate for children under 5 years old by 75% by 2015.  Water supply, sanitation, and health are linked in many ways.
Contaminated water that is consumed may result in water-borne diseases like diarrhea, cholera, dysentery, and other diseases. Without adequate quantities of safe water for personal hygiene, skin and eye infections can occur. Drinking water supplies that contain high amounts of chemicals (like arsenic) can lead to serious illnesses. Approximately 4 billion cases of diarrhea per year cause 0.2 million deaths under the age of 5 in developing countries.  Intestinal worms infect about 10% of the population of the developing world and cause malnutrition, anemia, and retarded growth. It is alarming that one sixth (1.1 billion) of the world population lacks access to an improved water supply and two fifths (2.4 billion) have no improved sanitation. , Most of these people live in Asia and Africa.
Water breaths life into the country making its land fertile; but, conversely, the country has been described as a massive open drain. People use ditches and streams as a disposal ground. The surface water has therefore become heavily polluted. People do not realize that the water they wash in and that their children play in is a potential killer, carrying many different diseases. As much as 80% of the diseases in Bangladesh are related to unclean water. Each child below 5 years old on average has 3.5 diarrheal episodes per year, which results in about 260,000 deaths per year.  Safe drinking water is of great importance to maintain better health for the population.
Given the facts, improved hygiene (hand washing) and sanitation (sanitary latrines) are also essential for reducing diarrhea, parasitic infestation, morbidity, and mortality and helping each child to grow. Endemic diarrhea is not water-borne but is transmitted from person to person by poor hygiene practices. Therefore, increased health education has a greater impact than improved water quality because it makes it possible (or at least most feasible) for hygienic behavior. Keeping this in mind, it is important to address the problem related to safe drinking water and sanitation.
Batabaria, a small village of 1.5 square kms under Adorsha Sadar Upazilla of Comilla, Bangladesh was included in this study. The village is lush and is located near the Asian highway. The natural scenery of the village is wonderful. There are 82 families living in the village with a total population of 564 (294 males and 270 females). In this small area, there are 33 ponds and most of them are arranged near the houses for provision of water for domestic use.
There are 49 shallow tube wells and one deep tube well. Sanitary latrines were observed in most of the houses; a total of 44. Thirty-eight latrines were not hygienic and in those houses the kitchen was also not up to par. The remarkable feature of the village was its educational status. Besides a few people from the older generation, most of the people are educated (nearly 100% enrollment in school). There is one primary school and one girls high school. One mosque and one moktob are established in this village so that the religious Muslim boys can have their study and practice of religion in peace. There is also a Comprehensive Village Development Co-Operative Society working for their own development.
| Objectives|| |
The general objective of this study is to assess the sources of safe drinking water and the socioeconomic profile of the residents. The specific objectives of this study are as follows:
- To asses the existing use of water sources and the health situation
- To assess the sanitation system and its use in the village
- To identify the prevailing problems relating to health and sanitation
| Materials and Methods|| |
Study Area: Batabaria under Adarsha Sadar, Comilla was selected for data collection. Study Method : The study was conducted on the basis of a simple survey method. The houses were selected randomly and the interview was done with the head of the household using structured questionnaires. An observational study relating to water usage and sanitation was also performed in the field. Preparation of the Questionnaires and Collection of Data: The questionnaire was prepared to record the required information on various aspects of sanitation and socioeconomic status of the household interviewed. It contains particulars about the members of the household, their occupation, income, literacy, habit of latrine use, water consumption, personal hygiene maintenance, incidence of water-borne disease, treatment seeking behavior, etc. Discussions with key informants and some group discussions also gave the overall picture of the village. Some secondary data were also collected for different books and journals. Sample Size: Thirty heads of households were interviewed to gather information for the study. A total of 158 respondents were included for data interpretation. Duration of the Study: Data were collected from 10 October 2005 to 11 October 2005. Analytical Technique: Collected data were analyzed in accordance with the objectives of the study. In this study, the tubules techniques of analysis included classification of data in the forms of tables. The used techniques are based on arithmetic means percentage ration, correlation, etc. Data Interpretation: All collected data was scrutinized and was recorded as a number and percentage; the EP Info 6 manual was used for analysis of the data. Scope of the Study: Due to the selection of a single village and random sampling, the demography and socioeconomic profile of the village was observed in access to the main objectives of the safe drinking water and sanitation profile. The interim sanitary situation and personal hygiene was also observed side by side. The safe water practice and arsenic situation in this village were also observed in this study. Limitations of the Study: The limitations of the study were 1) Only 30 families were included in this study, which is a small sample for interpretation, 2) The performed questionnaires led to face-to-face interviews for data. The objective evidence was not observed. The biasness from the respondent could not be curtailed, and 3) Logistic support was not available (e.g., arsenic contamination was not observed by arsenic test kit). Results: Thirty families with a total of 158 respondents were included in the study.
Socioeconomic Profile of the Study Area
Different socioeconomic characteristics are given below. The average family size is about 5.26, with a male to female ratio of 1.05:1.
A majority of the population is between 16 and 55 years old, (86 people; 54.43%). There are 63 people between the ages of 1 month to 15 years old (39.87%) and 9 people are over 55 years old (5.69%).
Occupation of the Family Members
A majority of the respondents were students [Table 1], which accounts for 64 people (40.5%) followed by 36 housewives (78%), 16 businessmen (10.12%), 14 farmers (8.86%), 9 service holders (5.69%), and 3 rickshaw drivers (1.89%).
[Table 2] shows that the majority of respondents, about 47.5%, are in the Class I-V group. Others are as follows-illiterate 3.8%, can sign only 5.7%, Class VI-X 15.2%, S.S.C/H.S.C 17.7%, and Graduate 10.1%.
Per-capita Annual Income
This study revealed that 30% of the total number of respondents live below the poverty line and 70% live above it.
Status of Water and Sanitation
Sources of Water
It is evident that 100% of the respondents use tube well (T.W.) water for both drinking and domestic purposes.
Ways of Washing Dishes
Household utensils were found to be washed with soap and ash 50% of the time, with only ash 30% of the time, and with only water 20% of the time.
All of the tube wells were plastered with brick and cement.
Distance of the Tube Well from the Latrine
It was found 70% of the tube wells were located away from the latrine while 30% were situated near latrine.
Extent of Sanitary Latrine Use
A total of 98% of the respondents use the sanitary and water seal latrine.
In this study, it was found that 76% of the respondents use soap and water for washing their hands before meals and after defecation. The remaining 12% use soil and water; 7% use only water and 5% use water with ash for washing their hands.
Diseases in the Study Area
The majority of the people in our study gave information about the diseases from which they suffer. The most common were cold followed by other diseases like peptic ulcer, arthralgia, weakness, etc. There were only a few complaints about water-borne diseases like diarrhea and dysentery.
Treatment Received By Villagers
[Table 3] shows that approximately 65% of the respondents receive treatment from qualified doctors in private chambers, 5% receive treatment from village doctors, 5% receive treatment from homeopaths, and the remaining 25% receive treatment from the health center.
Awareness Regarding Health
[Table 4] shows that approximately 50% of the respondents have excellent awareness about health and sanitation. Good and average awareness were observed among 30% and 10%, respectively. A total lack of awareness was observed in 10% of the respondents.
| Discussion|| |
Thirty families with 158 respondents in Batabaria, Adorsha Sadar, Comilla participated in this study. The average family size was 5.26, which is more or less the same average size for Comilla but is a little lower than the national average of 5.6. Most people in the study (54.43%) were between 16 and 55 years old, which is more effective in terms of income generation. In this study, it is interesting to see that only 5.69% of the respondents were above 55 years old. It may be due to the small sample size but can also be explained by single-family living rather than all-generation stay. Most of the family members were students (40.5%) and housewives (22.78%). These two groups are also involved in different ways to compensate for earning. Farmers (8.86%) although expected to be high as national figures were not seen here probably because of the location close to Comilla. The Asian Highway is very close, which allows people to work in distant towns and earn more money. Sixteen respondents (10.12%) were unemployed, which is also not consistent with the national report. The highlighting point of socioeconomic characteristics in this village was the entry to school for education. Only 3.8% of the respondents were found to be illiterate and 5.7% were able to only sign their names. The other 90.5% are well educated, which is not consistent with the finding of national figures. Thirty percent of the respondents live below the poverty line in this study; the national average is 47%. It indicates that the economic condition of the population in Batabaria is comparatively better. Respondents engaged in agriculture is 11.2%, which is far lower than the national situation (53%). Tube wells are the source of drinking water and are also used for domestic purposes in 100% of the respondents. In this context, it is 99.5% at Comilla and 97.4% at the national level, which is consistent as national programs for using tube wells as a water source were successful. As we did not use arsenic kits for the identification of arsenic in water, the arsenic free environment could not be described in this study. But the tube well marking was not seen in this village to identify the contamination of arsenic which is also a national program, and possibly assuming that Comilla and the nearby areas are free of arsenic. , 100% of the respondents use the pure water for drinking purposes from the tube well. The tube wells that are present were found to be plastered brick and cement and 70% of them are away from the latrines. Regarding the use of the sanitary latrine in their daily life, it was found that 98% of the respondents use sanitary and water seal latrines. This figure is far higher than that of Comilla (17.21%) and the national figure of 17.61%. Of the respondents, 76% wash their hands before meals and after defecation with soap and water, which is also much higher than that of Comilla (15.6%) and the national level (19.3%). A majority of the respondents complained of suffering from common colds as the disease of the area followed by peptic ulcer disease, arthalgia, etc. Water-borne diseases are very rarely found in this village. A total of 65 respondents took advice from qualified doctors from private chambers while 25% received care from health centers provided by the government. A total of 10% of the respondents still receive treatment from village doctors or alternative medicine. Therefore, proper health care with proper infrastructure should be provided to rural areas in order to achieve better health status.  In this study, 50% of the respondents have excellent awareness regarding health and sanitation while 30% and 10% had good and average awareness, respectively. A total lack of awareness was observed in 10% of the respondents. A total of 80% of the children were regular in nail cutting and using sandals for daily activity, which was a surprise observation in this study.
The overall status of the use of safe drinking water and the domestic use of water was excellent in this village. The personal hygiene and sanitation system was also highly satisfactory, which is completely different from the national scenario. All these differences were due to the presence of the Batabaria Comprehensive Village Development Samity, a project of village development by the Bangladesh Association of Rural Development (BARD) that is close to this village.
Weekly general meeting
After establishment, the samity under the guidance of BARD, has put in place many awareness programs related to safe water and sanitation including personal hygiene. These programs have been conducted for years and gradually the awareness has grown leading this village to be recognized as a model village for the nation. The other villages near the vicinity of BARD have also achieved similar results relating to the status of safe water and sanitation by establishing a comprehensive village co-operative samity of their own.
| Conclusion|| |
The overall socioeconomic status, water sources, and sanitation system of Batabaria is much better than that of the country because of the location of the village in the vicinity of BARD and the adjacent district town. The comprehensive village development program of BARD has set up the comprehensive village development co-operative society ltd in this village which has played a significant roll in the overall development of the village. In addition, the village is situated in a semi-urban area and most of the urban facilities are available here. The real scenario of our country will be the same as Batabaria if we can provide these facilities throughout the country. The governments of the developing world should make comprehensive village development programs to ensure the total development of villages including safe water and sanitation in rural areas. But it is not possible for only the government to maintain safe water and sanitation coverage. NGOs should also extend their hand of cooperation to government organizations for the promotion of safe water supply and sanitation for people in rural areas.
| Acknowledgements|| |
The authors gratefully acknowledge the kind support of the people of Batabaria, Comilla, Bangladesh for completion of the study.
| References|| |
|1.||Augustinos MT, Venter SM, Kifr R. Assessment of water quality problem due to microbial growth in drinking water distribution system. J Environ Toxicol Water Sources 2006;10:295-9. |
|2.||Forsberg BC, Petzold MG, Tomson G, Allebeck P. Diarrhoea case management in low- and middle-income countries: An unfinished agenda. Bull World Health Organ 2007;85:42-8. [PUBMED] [FULLTEXT]|
|3.||Malik A, Ahmed M. Genotoxicity of some wastewater in India. J Environ Toxicol Water Sources 2006;10:287-93. |
|4.||van den Broek JM, Roy SK, Khan WA, Ara G, Chakraborty B, Islam S, et al. Risk Factors for mortality due to Shigellosis: A case-control study among severely-malnourished children in Bangladesh. J Health Popul Nutr 2005;23:259-65. [PUBMED] |
|5.||Caldwell BK, Smith WT, Lokuge K, Ranmuthugala G, Dear K, Milton AH, et al. Access to Drinking-water and Arsenicosis in Bangladesh. J Health Popul Nutr 2006;24:336-45. |
|6.||Aziz SN, Boyle KJ, Rahman M. Knowledge of Arsenic in drinking-water: Risks and avoidance in Matlab, Bangladesh. J Health Popul Nutr 2006;24:327-35. [PUBMED] |
|7.||Anstiss RG, Ahmed M. A Conceptual model to be used for community-based drinking-water improvements. J Health Popul Nutr 2006;24:262-6. [PUBMED] |
Mohammad Robed Amin
Department of Medicine, Hathazari Upazilla Health Complex, Chittagong, Bangladesh. House No. 28, R.C. Church Road, Patherghata, Chittagong
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4]