Environmental Determinants of Health and WASH

Answer 1

What is environmental health?
What are some key environmental determinants of health?
What is the burden of some environmental determinants on disease?

Question 2

Definition

Answer 2

“Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors that can potentially affect health. It is targeted towards preventing disease and creating healthsupportive environments.”

Answer 3

Answer 3

Question 3

How big an issue is environmental health?

Answer 3

Where people do their job can significantly impact their health!
Environmental impacts on health are uneven across life course and gender – The health of children under five, and to a lesser extent up to 10, and that of adults between 50 and
75 years is most affected by the environment – Men are slightly more affected by the environment than women. Women bear higher exposures to
traditional environmental risks to health (e.g., exposure to smoke while cooking, carrying water).
Men are more exposed to occupational risks to health.
Low- and middle-income countries bear the greatest share of environmental disease
Shift to non-communicable (but environmentally related) diseases as causes of death
(epidemiological transition)

Question 4

Water, sanitation and hygiene (WASH)

Answer 4

Water = drinking, bathing, cooking
Sanitation = toilets, human waste management
Hygiene = handwashing, menstrual hygiene management
Solid waste management? Drainage?
“Environmental sanitation”  “WatSan”  WASH

Question 4

Disease classification

Answer 4

Question 4

How does water become contaminated?

Answer 4

Question 5

Side note: 1 gram of human faeces can contain…

Answer 5

Answer 6

Answer 6

Question 6

The household water cycle

Answer 6

Question 7

How does water become contaminated?

Answer 7

Question 8

How does water become contaminated?

Answer 8

Question 9

How does water become contaminated?

Answer 9

Question 9

How does water become contaminated?

Answer 9

Question 10

How does water become contaminated?

Answer 10

Question 11

How does water become contaminated?

Answer 11

Question 12

How does water become contaminated?

Answer 12

Answer 12

Question 13

How can water make us sick?

Answer 13

Water-related diseases
Water-washed: infections that decrease as a result of increasing the volume of available water
(e.g., where water is contaminated so can’t be used, or there just isn’t water around)
Water-based: where a necessary part of the life cycle of the infecting agent takes place in an
aquatic animal (e.g., where infecting agent contaminates water)
Water-related insect vector: those infections spread by insects that breed in water or bite near
it (e.g., where water is contaminated and becomes suitable for specific species to breed – some mosquitoes prefer dirty
water, or where stagnant water accumulates)
Water-borne: where water acts as a passive vehicle for the infecting agent (e.g., classic
contamination)

Question 14

This lecture

Answer 14

The global movement(s) to improve WASH
Practical ways to reduce physical harms of poor WASH
Social determinants of health and WASH

Question 15

Water is a human right

Answer 15

“The UN General Assembly recognizes that the human right to safe drinking
water entitles everyone, without discrimination, to have access to sufficient,
safe, acceptable, physically accessible and affordable water for personal and
domestic use”
Progressive realisation
Address inequalities (e.g. gender, ethnicity, disability)
Affordability
Policy

Question 16

Sanitation is also a human right

Answer 16

“The human right to sanitation entitles everyone, without discrimination, to
have physical and affordable access to sanitation, in all spheres of life, that is
safe, hygienic, secure, socially and culturally acceptable and that provides
privacy and ensures dignity”

Question 17

“Global” efforts

Answer 17

Question 18

Sustainable Development Goal 6

Answer 18

Answer 19

Question 20

How can water make us sick?

Answer 20

Water-related diseases
Water-washed: infections that decrease as a result of increasing the volume of available water
(e.g., where water is contaminated so can’t be used, or there just isn’t water around)
Water-based: where a necessary part of the life cycle of the infecting agent takes place in an
aquatic animal (e.g., where infecting agent contaminates water)
Water-related insect vector: those infections spread by insects that breed in water or bite near
it (e.g., where water is contaminated and becomes suitable for specific species to breed – some mosquitoes prefer dirty
water, or where stagnant water accumulates)
Water-borne: where water acts as a passive vehicle for the infecting agent (e.g., classic
contamination)

Answer 20

Question 21

User preference?

Answer 21

The SQUAT study found that 40% of households with a latrine have at least one
household member who still openly defecates, while 53% of people who own a
government latrine don’t use it at all. Others results included:
* the prevalence of open defecation was not because of poverty, water availability, lack
of education or poor governance
* latrines were considered “for the weak” such as the sick and elderly
* no negative stigma was attached to open defecation
* open defecation was seen as part of a “wholesome life”
* bringing waste closer to the household was considered less hygienic than open
defecation
* polluting public space was less frowned upon than polluting the home environment.

Question 22

Solution: Safely managed sanitation

Answer 22

Question 23

Faecally transmitted diseases

Answer 23

Answer 24