Pj. Kolsky, WATER, SANITATION AND DIARRHEA - THE LIMITS OF UNDERSTANDING, Transactions of the Royal Society of Tropical Medicine and Hygiene, 87, 1993, pp. 43-46
Citations number
24
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
This paper reviews the application of epidemiological understanding of
diarrhoeal disease to interventions in water and sanitation. Over the
past 20 years, great efforts have been made to elucidate the relation
ships between water supply, sanitation and diarrhoeal disease. At the
outset, it was hoped that improved understanding of these relations co
uld provide a rational framework for the planning of public health eng
ineering interventions. This paper also reviews historical and recent
perceptions of water, sanitation, and diarrhoeal disease, and summariz
es progress to date. On the one hand, some fundamental ideas about the
relative importance of water quality and quantity in the transmission
of diarrhoeal disease have changed, and there is increased recognitio
n of the complex interrelationships between interventions, hygiene beh
aviour and health. On the other hand, our understanding of the impact
of interventions is painfully incomplete, and is unlikely to improve d
ramatically in the near future. While further research can usefully il
lustrate a variety of interactions in specific contexts, globally appl
icable planning guidelines and design criteria appear a dangerous will
-o'-the-wisp. While we know more than ever before about water, sanitat
ion and diarrhoea, much remains unknown, and is perhaps unknowable.