Water Gone Bad

Karen Schneider

Looking out over the ocean, I marvel at how many times water has touched me today. Minutes after wakening I was brushing and flushing. The kettle provided a bit of morning comfort, and a faucet enabled me to clean the dishes. The flowers that add color to the porch received a drink. The ocean as a source of recreation cooled the body and refreshed the spirit. When I returned to the house a glass of ice water quenched my thirst. Then a shower washed off the sand and salty ocean water.

Never do I worry if there will be enough water. Never do I worry if it will be safe. This is my reality nine months of the year.

Then there are the other three months.

I am a pediatrician who travels to countries with limited infrastructure to care for rural children who have no access to a physician. It is here – in Guyana, Kenya, Nigeria, Peru – that water sometimes becomes the enemy. Children who just days before were running around and playing are brought to us with debilitating abdominal pain, diarrhea, vomiting, dehydration, and weight loss, their lips cracked, their mouths pasty and their eyes sunken. Some are too weak to hold up their heads.

This diarrhea stems from a bad water source – rain water collected off a roof that animals and birds have stooled on, or an open basin contaminated by a dipping spoon left on the ground and then placed back into the basin, or a stream contaminated upriver with an animal carcass or feces. I could go on and on.

Along with pneumonia, diarrhea is the leading killer of children under five in developing countries, the World Health Organization says. Parents are told repeatedly to boil their water, but the poor have just a few pennies for a piece of wood to cook their meals. Most times there isn’t the luxury of an extra piece of wood to bring water to a boil.

One country I frequent is Haiti, treating children and others in a cholera epidemic that has continued since October 2010. Cholera bacteria is spread by contaminated water, causing sudden, profuse diarrhea and dehydration. Although it has fallen out of the news, Haiti’s cholera outbreak has led to more than 8,500 deaths, according to the Pan American Health Organization.

Two other water-related calamities worsen Haiti’s health ordeal: hurricanes and floods. Within three weeks in late summer 2008, Hurricane Gustav, Tropical Storm Hanna, and Hurricane Ike devastated the country. Hundreds died and tens of thousands were left homeless. In September 2008, with a medical mission trip planned for Haiti, I anxiously watched the weather news. After three days of airport closure in the wake of Hurricane Ike, we were finally placed on one of the first flights to Port-au-Prince. As soon as we arrived, my phone rang. It was the Haitian Red Cross asking my team to help at a disaster site at Cabaret, a small town north of the capital.

Sitting north of Cabaret are deforested mountains, where the topsoil has washed away and the earth is hard and almost impenetrable, forcing heavy rain to rush down instead of being absorbed by rich soil. With these latest storms, the force of the water caused the river to veer off its normal winding course and charge straight through, taking houses and people with it.

The first casualties were children battered by the rushing water, knocked down, dragged, pummeled by stones and debris. They presented with fractures and large abrasions where skin was scraped away. Within 24 hours came a second wave of children, presenting with diarrhea. The river had been their source of water; now it ran muddy and deadly. I asked one mother whose child had severe diarrhea and fever what water she had given her young one. She said she had collected water from the river and “let it settle,” spooning off the clearer water on the top. Even if she could find bottled water she had no money to buy it.

It took my “developed nation brain” a full day to realize that safe drinking water was now the urgent issue. People had no faucets to turn on. So instead of handing out the usual worm tablets and children’s vitamins, we made sure every child we treated for the next couple of days received a full bottle of safe drinking water. It was like Christmas morning: Each child’s eyes were big, with hands outstretched to grab the bottle and frantically try to open their gift.

Until the world’s vulnerable people have safe drinking wells and other water sources – and a knowledge of waterborne disease and protection from bad ecological practices – the global traumas of water gone bad will rampage.

Sister Karen Schneider, a Sisters of Mercy, is an emergency medical physician and faculty member at the Johns Hopkins Children’s Center in Baltimore.