Clean Water and Sanitation Should Not Be Taken for Granted

According to the Bill and Melinda Gates Foundation: “2.5 billion people—practice open defecation or lack adequate sanitation facilities, and the consequences can be devastating for human health as well as the environment. “ In India alone 600 million people practice open defecation which is a major source of the so called “water-borne” diseases, and human suffering and premature death. According to UNICEF, 2.2 million people die each year from diarrhea. Human waste is carried by precipitation to ditches onto streams and into rivers where it enters the water supply. Flies and vermin carry bacteria and disease from feces to food stores and humans.

In addition to those without any sanitation, there are reported to be 2.1 billion people who use toilets connected to septic tanks that are not maintained, back up or use other systems that discharge raw sewage into open drains or surface waters without adequate treatment which degrades the rivers and streams. Drinking water tainted with sewage is the source of “water-related” diseases that are carried from one host to another through water. These diseases included salmonella, schistosomiasis, cholera, crytosporidiosis, campylobacter, giardia, meningitis, shigellois, dysentery, hookworm, roundworm, tapeworms, dengue fever, leptospirosis, hepatitis A, typhoid, scabies and botulism. Overall, 40% of the population of earth lack adequate sanitation facilities and reliable access to clean water. 

from CDC

In the United States access to adequate sanitation facilities and clean water is taken for granted. However, almost 25% of households depend on an individual septic system (also referred to as an onsite system) or small community cluster systems to treat their wastewater. Just having flush toilets to carry the waste from the house does not mean it is adequately treated. Maintenance of these systems is often left to the individual household. Many of these systems are aging beyond their natural lifetimes and many system owners simply do not know how to properly manage their septic systems and have not bothered to learn. Improperly managed septic systems can result in system back-ups and overflows, surfacing sewage in your yard, polluted groundwater and surface water -a risk to public health and the environment. Sixty percent of the households in the United States that have septic systems also have private drinking water wells.

Though responsibility and management of septic systems and private drinking water wells belong to the individual owner, oversight and regulation of these systems falls to the states and local health departments. Virginia like many states has struggled to try to get homeowners to properly maintain their septic systems, both conventional and alternative and to consider routine testing of their drinking water from private wells. Homeowners fail to see or simply ignore indications that their septic systems have failed, do not pump their tanks at appropriate intervals and do not comply with inspection and maintenance regulations or manufacturer recommendations for alternative systems. Homeowners think because they are not required to test their wells, it does not have to be done.

The United States has one of the safest and most advanced water supply and sewage treatment systems in the world. However, we struggle to find the political will to properly maintain our public water infrastructure in our cities and fail to convey to owners of septic systems and private water wells how to properly operate and maintain their systems and the importance of doing so. While the water still flows and toilets flush we would rather spend money on “life style” rather than maintaining essential services like water and sewage.

Under the Clean Water Act the United States has made tremendous advances in the past 35 years to clean up our rivers and streams by controlling pollution from industry and sewage treatment plants. I am old enough to remember taking river water samples before the regulations, so I know how far we've come; however we seem to have stalled out. We've failed to solve the problem of eradicating sanitation failures by reaching the individual household and private system owners how their systems work and the importance of ensuring that they do. Also, our public water and sanitation infrastructure is aging. The distribution systems leak, the treatment plants have often not kept up with growth in volume of sewage that needs to be treated. Finally, the 25% of households that operate their own systems are increasing in absolute number, the systems built in the 1970’s and 1980’s are reaching the end of their natural lives and this has created growing source of contamination to our waters. In order to continue to make progress in cleaning up our rivers and streams we must learn how to control pollution from these diffuse, or non-point, sources as well as maintain our water infrastructure.

Since the advent of the Clean Water Act mandating improved treatment of sewage, outbreaks of disease caused by drinking water are no longer common in the United States, but despite advances in water management and sanitation, waterborne disease outbreaks continue to occur in the U.S. and can lead to serious acute, chronic, or sometimes fatal health consequences. The Center for Disease Control and Prevention (CDC) collects data from all the states on waterborne diseases. From 1971 to 2002, there were 764 documented waterborne outbreaks associated with drinking water, resulting in 575,457 cases of illness and 79 deaths. The symptoms of water borne disease often include diarrhea, nausea, vomiting and sometimes fever. It is no uncommon to mistake a case of water related disease for “food poisoning” or a “24-hour stomach virus.” Contaminated water can often look, smell and taste fine. Not all water borne diseases are recognized as such or reported to the CDC.

The National Institute of Health (NIH) believes the true impact of disease is much higher. Research done at the NIH indicate that 10,700 infections and 5, 400 illnesses occur each year in populations served by community groundwater systems; 2,200 infections and 1,100 illnesses occur each year from private wells; and 26,000 infections and 13,000 illnesses occur each year in municipal surface water systems. In recent years, the proportion of outbreaks in the federally regulated public water systems has declined, although these still contribute the majority of outbreak-associated illnesses. Inadequately maintained or constructed private wells and plumbing systems continue to cause illness in growing numbers. In addition, the aging water infrastructure and drinking water distribution system are suspected to be a growing source of water borne disease outbreaks, and are the cause of the familiar "boil water notices" which seem to become more common in our cities. We cannot continue to ignore water and sanitation system repair, replacement, maintenance and improvement and expect to have on demand clean water.