Waterborne diseases: Article by Tine Bruås

Waterborne diseases

Tine Bruås


The increase in big urban cities poses a growing challenge for people in undeveloped parts of the world. Safe removal of wastewater is little to non-existent for many of these people. The unclean wastewater is discharged into waterways, landfills and drains, along with oceans, lakes and rivers, which pollutes the poor residential areas. This can cause a range of waterborne problems. Inadequate water, sanitation and hygiene kill more than 800 000 people in low- and middle-income countries each year.

There is no doubt that improved sanitation will reduce the risk of several waterborne related diseases and problems. Some of these include diarrhea, intestinal worms, skin infections, malnutrition, hepatitis A, typhoid, polio and cholera. A WHO study from 2010 calculated that just a small investment in sanitation, no more than US $1, would result in a $5,50 decrease in health costs, along with more productivity and fewer premature deaths. In addition to the medical diseases caused by contaminated water, improving sanitation will promote recovery of water, renewable energy and nutrients from fecal waste (WHO, 2018).

Only 39% of the global population have access to a safely managed sanitation service, meaning access to a toilet or latrine, with a system to ensure the excrements are disposed of in a safe manner. 892 million people still defecate in the open, which means the contamination of wastewater is a major issue. At least 10% of the global population consumes food irrigated by wastewater. Untreated wastewater can contain parasites or different bacteria leading to cholera. This is why it’s so important to clean vegetables and fruits before consumption to remove these possibly dangerous pathogens. A problem with this is that people in these areas might not have the knowledge to understand how bacteria and unclean water play pose a severe health risk.


What can be done?

The main factors in preventing waterborne diseases is a clean water supply and appropriate sanitation. This is a major issue, seeing as 844 million people worldwide are lacking access to clean water sources. To prevent cholera, a safe oral cholera vaccines should be administered in conjunction with water and sanitation improvements (WHO and UpToDate). WHO recommends that the oral cholera vaccine should be part of an integrated control program in risk areas and endemic areas.

One should have access to solutions that will purify drinking water if sanitary water is inaccessible. Implementation of long-term sustainable WASH solutions can be used to ensure use of safe water. Interventions like safe water access and improvement of sanitation will prevent a wide range of waterborne diseases. At the same time it would assist in achieving goals related to poverty, malnutrition and education. These interventions require long-term investments, which is difficult to achieve in less developed countries, because of funding and the need for continued maintenance (WHO).






Rehydration project, 2018: “Diarrhoea”. URL:


UpToDate, 2018: “Cholera: Clinical features, diagnosis, treatment, and prevention” URL:


WHO, 2018: “Cholera”. URL:


WHO, 2018: “Sanitation”. URL:


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