Dire need for drinking water

BY BRYN NELSON | STAFF WRITER

December 30, 2004

An Indonesian man drinks water while waiting to buy gasoline in a long line as people have been waiting for three days at the petroleum station near Banda Aceh, Indonesia. (AFP Photo)

Access to clean drinking water is now the biggest single factor in determining whether Sunday's tsunamis will claim yet more victims, health officials said yesterday. But they warned that widespread damage to sanitation systems and the overcrowded conditions of temporary settlements springing up throughout southern Asia are adding to the risk of disease outbreak.

Among the waterborne ailments linked to floods, the World Health Organization cites bacterial and viral diseases such as cholera, typhoid fever, hepatitis A and leptospirosis, the latter of which can be spread through the urine of rodents attracted to flood debris.

Rob Holden, operations managers for Health Action in Crises, part of the Geneva-based World Health Organization, said cholera and other diarrheal diseases contracted by drinking polluted water, which can lead to life-threatening dehydration, can be prevented as long as adequate supplies and delivery systems are quickly put in place.

"The most critical concern from a disease prevention standpoint is getting access to clean water," he said. But the risk of disease is "very great," he added, due to the huge swath of destruction and vast number of people impacted.

A United Nations relief coordinator warned in comments to The Associated Press yesterday that respiratory and waterborne diseases could hit the region in "the next few days."

Shock and summertime heat will only increase the demand for water, said Dr. Irwin Redlenner, director of the National Center for Disaster Preparedness at the Columbia University Mailman School of Public Health in Manhattan.

"Overwhelming thirst can get people beyond their better judgment," he said, leading them to drink foul water that in turn compounds their misery.

Contrary to popular belief, however, bodies of the dead pose little danger to the living because infectious organisms cannot survive for long in decaying cadavers. After September's Tropical Storm Jeanne, which killed more than 1,000 Haitians, experts at the Pan American Health Organization urged against mass burials, labeling them as unnecessary and an addition to "the burden of suffering already experienced by survivors."

"Generally speaking, the risk of epidemics as a result of cadavers is negligible," stated one of the organization's recommendations. "Dead bodies pose less risk of contagion than a person who is alive and infected."

Holden said reports from hard-hit Sri Lanka have estimated that at least 500 settlement camps have sprung up since the weekend disaster. In these overcrowded conditions, often plagued with poor sanitation, pre-existing diseases can exact a heavy toll.

"The relocation problem is that it really takes people who are already vulnerable and moves them into circumstances that may not have the capacity to care for them," said Dr. Steven Rottman, director of the Center for Public Health and Disasters at the University of California, Los Angeles. Without clean water, he said, the risk of disease is greatest among those who can tolerate it least, especially children.

"The urgency to establish a source of clean drinking water, and then to rebuild water delivery systems, is pretty critical," he added.

Other health dangers may lurk. Standing water, for instance, can provide an ideal breeding spot for mosquitoes carrying the malarial parasite, or the viruses that cause yellow or dengue fever. And temporary shelters can leave inhabitants exposed to the elements - and mosquitoes - increasing their chances of falling ill.

To prevent further tragedy, relief workers will have to simultaneously deliver water and rehydration liquids, technology to purify more water, and equipment to fix sewage, sanitation and water systems - likely a long-term endeavor, said Columbia's Redlenner.

"The geographical expanse, as well as the degree of devastation, represent a virtually unprecedented challenge for the international relief agencies," he said, especially with regard to large-scale coordination. "We're really going to be stretched to our limits."

Putting it into perspective

As the confirmed death toll approaches 80,000, it becomes hard to fully comprhend the magnitude of the tsunami tragedy. Here's another way to conceptualize the event with respect to casualties, geographic reach and other aspects.

How high were the waves?

Some reports indicated that the wall of water reached as high as 30 feet, about the height of a three-story building.

How far did the tsunami travel?