A cultural-spatial analysis of excreting, recirculation of human excreta and health--the case of North West Frontier Province, Pakistan.

The sanitation issue is entering the development discussion and the UN proclaimed 2008 the year of sanitation. The study aims to understand the cultural-spatial dimension among Muslim communities of excreting and recirculating human excreta in North West Frontier Province in Pakistan. Information on local perceptions and cultural understanding was collected through interviews, group discussions and observations in four selected villages. The study identifies a diversity of excreting practices among age groups and sexes, and varied adherence to expressed cultural norms. Interviewees express less resentment towards urine compared to faeces, however, their negative attitude subsides when faecal matter is mixed with water since this changes appearance, odour-and cultural meaning. Religious dictums about excreta and sewage accommodate contradicting routine behaviours to cater for needs of residents and farmers. For example, when mothers pray wearing soiled clothing, and in the use of wastewater as fertiliser for food production. The excreta-related practices are compatible with good hygienic behaviour as outlined by WHO Guidelines, except for children who are allowed to defecate anywhere.

Health impact caused by poor water and sanitation in district Abbottabad.

BACKGROUND: Large proportions of people still do not have excess to safe drinking water and proper sanitation. METHODS: Qualitative and quantitative approaches were used to assess the health impacts. Random households were selected. Information was collected from questionnaire through interview schedule method, group discussion and observation checklist. RESULTS: People rated water and sanitation condition in urban as: 10% very good, 27% good, 20% bad, 43% very bad, and none of them said we don't know While in rural areas they rated 10% very good, 36% good, 44% bad, 6% very bad, and 4% of them said we don't know. Water sources in selected urban and rural areas were different. 37% in urban and 68% in rural area depended on bore wells as water source, 22% depended on hand pumps. In urban areas, the disease ratio was typhoid 20%, hepatitis 13%, diarrhoea 27%, skin infection 23%, stomach problems 53% and allergies 33%. In rural areas, after stomach problems, diarrhoea, hepatitis and typhoid ratio was very high as compared to urban area. In rural community, 70% were unaware of poor water and sanitation consequences on health. CONCLUSION: The water and sanitation condition in urban as well as in rural community is poor but in rural community it is even worse The drinking water was contaminated with E. coli, Enterobacter, Salmonella and Clostridium. This observation was correlated with prevalence of many water born diseases especially in rural communities of Abbottabad.