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The curse of the Acacia tree

In the clinic area, some 150 people gather together for the daily painful ritual. The common thing between these poor souls is the thick stick they all support themselves on. They are all infected by Kala Azar. The treatment is extremely painful as the patient gets a high dosage of medicine injected on the seat muscle. During the 17 days of treatment, most of the patients have to be hold down by 3-4 people and to manage to walk afterwards; they have to use a walking stick. But even though the pain, these patients are the lucky ones. Some children have to walk days with high fever just to reach the clinic, and others never make it there.

The eruption

Life goes on in the villages as women carry water and children playing around. The big acacia tree looks beautiful at sunrise and sunset and the children likes to play around it. But it is here that the black sand fly is that infects 500,000 people a year. It is when the sun is on its way down that the fly’s swirls around the red tree. Children up to the age of 4 are most affected that attacks the skin, eyes and mouth.

2010 has been the year with large eruption since the largest epidemic happened in Sudan on the west side of Upper Nile under the civil war in 1980 and 1990’s. 100,000 people lost their life and many villages were left empty.

The reason for the epidemic can be explained by the large amount of refugees returning back after the peace deal between north and south in 2005 and an increased number of internally displaced in the states of Upper Nile and Jonglei.

South Sudan has been battling with the worst epidemic of the deadly kala azar disease during the last 8 years, with tens of hundreds of people infected according to medical charity Medecins Sans Frontieres.

If the patient is untreated, the parasitic disease, spread by the bite of an infected fly, is fatal in almost 100% of cases. By the end of November, MSF had treated 2,355 south Sudanese for the disease. By the end of October 2010, more than 9,330 cases in south Sudan had been reported to the World Health Organisation (WHO), most of these were children. Almost 5% of those who received treatment at medical facilities later died, according to the WHO.

What is Kala Azar?

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Kala Azar is a deadly disease caused by parasitic protozoa Leishmania donovani, transmitted to humans by the bite of infected female sandfly, Phlebotomus argentipes. It lowers immunity, causes persistent fever, anemia, liver and spleen enlargement, loss of body weight, diarrhea, and fatigue and if it is left untreated, it kills. The disease suppresses the immune system so that the patient is vulnerable to other infections. Kala Azar was first discovered of Western doctors in 1824 in Jessore, India (today’s Bangladesh) thinking it was malaria. The name Kala Azar is derived from Kala which means black in Sanskrit, Assamese, Hindi and Urdu and the Persian Azar for disease. It is regarded as the second disease after Malaria taking lives.

Current situation

The disease is endemic in three countries; Bangladesh, India and Nepal and approximately 200 million people in the Region are “at risk” from the disease. The disease is now being reported in 45 districts in Bangladesh, 52 in India and 12 in Nepal. The total number of districts reporting Kala Azar exceeds 109. Of the estimated 500,000 people in the world infected each year, nearly 100,000 are estimated to occur in the Region. In the endemic countries, Kala Azar affects the poorest as they have little knowledge about the disease and unlikely to seek early treatment and most of those who start treatment cannot afford to complete it.

Treatments

The Indian medical practitioner, Upendra Nath Brahmachari, was nominated for the Nobel Prize in Physiology or Medicine in 1929 for his discovery of ureastibamine (an antimonial compound for the treatment of Kala Azar) and a new disease, post Kala Azar dermal leishmaniasis.

Even with recovery, kala-azar does not always leave the person unmarked. Sometime after successful treatment, a few months with African Kala Azar, or several years with the Indian one, a secondary form of the disease may set in, called post Kala Azar dermal leishmaniasis, or PKDL. This condition shows up as small, measles on the face, which gradually increases in size and spreads over the body. Eventually the lesions may form disfiguring, swollen structures resembling leprosy, and occasionally causing blindness if they spread to the eyes.

The medicine is expensive and the treatment very painful. The fact that this disease affects the poor and malnourished is making it worse. Most of the doctors working in the cities do not have the possibility to get to many villages or to transport the medicine for various reasons. To help these people, much needs to be done, and much money is needed for medicine and transport. The fact that children have to walk for days under the burning sun for days with high fever and extreme pain is sad and hard to imagine for us but unfortunately true.

 

International Water Day

Approximately 71% of the Earth’s surface is covered by ocean, a continuous body of water that is customarily divided into several principal oceans and smaller seas.

More than half of this area is over 3,000 metres (9,800 ft) deep. Average oceanic salinity is around 35 parts per thousand (‰) (3.5%), and nearly all seawater has a salinity in the range of 30 to 38 ‰. Scientists estimate that 230,000 marine species are currently known, but the total could be up to 10 times that number.

The major oceanic divisions are defined in part by the continents, various archipelagos, and other criteria. These divisions are (in descending order of size):

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  • Pacific Ocean, which separates Asia and Australia from the Americas
  • Atlantic Ocean, which separates the Americas from Eurasia and Africa
  • Indian Ocean, which washes upon southern Asia and separates Africa and Australia
  • Antarctic Ocean, sometimes considered an extension of the Pacific, Atlantic and Indian Oceans, which encircles Antarctica.
  • Arctic Ocean, sometimes considered a sea of the Atlantic, which covers much of the Arctic and washes upon northern North America and Eurasia.

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The Pacific and Atlantic may be further subdivided by the equator into northern and southern portions. Smaller regions of the oceans are called seas, gulfs, bays, straits and other names.

Geologically, an ocean is an area of oceanic crust covered by water. Oceanic crust is the thin layer of solidified volcanic basalt that covers the Earth’s mantle. Continental crust is thicker but less dense. From this perspective, the earth has three oceans: the World Ocean, the Caspian Sea, and Black Sea. The Mediterranean Sea is at times a discrete ocean, because tectonic plate movement has repeatedly broken its connection to the World Ocean through the Strait of Gibraltar. The Black Sea is connected to the Mediterranean through the Bosporus, but the Bosporus is a natural canal cut through continental rock some 7,000 years ago, rather than a piece of oceanic sea floor like the Strait of Gibraltar.

Lack of clean water


Almost 50% of the developing world’s population; 2.5 billion people lacks improved sanitation facilities, and over 884 million people still use unsafe drinking water sources. Inadequate access to safe water and sanitation services, coupled with poor hygiene practices, kills and sickens thousands of children every day, and leads to impoverishment and diminished opportunities for thousands more.

Poor sanitation, water and hygiene have many other serious repercussions. Children – and particularly girls – are denied their right to education because their schools lack private and decent sanitation facilities. Women are forced to spend large parts of their day fetching water. Poor farmers and wage earners are less productive due to illness, health systems are overwhelmed and national economies suffer. Without WASH (water, sanitation and hygiene), sustainable development is impossible.

Source; UNICEF, July 2010

Facts about water

Today’s water crisis is not an issue of scarcity, but of access. More people in the world own cell phones than have access to a toilet. And as cities and slums grow at increasing rates, the situation worsens. Every day, lack of access to clean water and sanitation kills thousands, leaving others with reduced quality of life.

  • 884 million people lack access to safe water supplies; approximately one in eight people.
  • 3.575 million People die each year from water-related disease.
  • The water and sanitation crisis claims more lives through disease than any war claims through guns.
  • People living in the slums often pay 5-10 times more per liter of water than wealthy people living in the same city.
  • An American taking a five-minute shower uses more water than a typical person in a developing country slum uses in a whole day.

Sanitation

  • Only 62% of the world’s population has access to improved sanitation – defined as a sanitation facility that ensures hygienic separation of human excreta from human contact.
  • Lack of sanitation is the world’s biggest cause of infection.
  • 2.5 billion People lack access to improved sanitation, including 1.2 billion people who have no facilities at all.
  • Of the 60 million people added to the world’s towns and cities every year, most occupy impoverished slums and shanty-towns with no sanitation facilities.

Children

  • Diarrhea remains in the second leading cause of death among children under five globally. Nearly one in five child deaths – about 1.5 million each year – is due to diarrhea. It kills more young children than AIDS, malaria and measles combined.
  • Every 20 seconds, a child dies from a water-related disease.
  • Diarrhea is more prevalent in the developing world due, in large part, to the lack of safe drinking water, sanitation and hygiene, as well as poorer overall health and nutritional status.
  • Children in poor environments often carry 1,000 parasitic worms in their bodies at any time.
  • In the developing world, 24,000 children under the age of five die every day from preventable causes like diarrhea contracted from unclean water.
  • 1.4 million Children die as a result of diarrhea each year.

Women

  • In just one day, more than 200 million hours of women’s time is consumed for the most basic of human needs — collecting water for domestic use.
  • This lost productivity is greater than the combined number of hours worked in a week by employees at Wal*Mart, United Parcel Service, McDonald’s, IBM, Target, and Kroger, according to Gary White, co-founder of Water.org.
  • Millions of women and children spend several hours a day collecting water from distant, often polluted sources.
  • A study by the International Water and Sanitation Centre (IRC) of community water and sanitation projects in 88 communities found that projects designed and run with the full participation of women are more sustainable and effective than those that do not. This supports an earlier World Bank study that found that women’s participation was strongly associated with water and sanitation project effectiveness.

Diseases


  • At any given time, half of the world’s hospital beds are occupied by patients suffering from diseases associated with lack of access to safe drinking water, inadequate sanitation and poor hygiene.
  • The majority of the illness in the world is caused by fecal matter.
  • Almost one-tenth of the global disease burden could be prevented by improving water supply, sanitation, hygiene and management of water resources. Such improvements reduce child mortality and improve health and nutritional status in a sustainable way.
  • 88% of cases of diarrhea worldwide are attributable to unsafe water, inadequate sanitation or insufficient hygiene.
  • 90% of all deaths caused by diarrheal diseases are children under 5 years of age, mostly in developing countries.
  • It is estimated that improved sanitation facilities could reduce diarrhea-related deaths in young children by more than one-third. If hygiene promotion is added, such as teaching proper hand washing, deaths could be reduced by two thirds. It would also help accelerate economic and social development in countries where sanitation is a major cause of lost work and school days because of illness.

Economics

  • Over 50 % of all water projects fail and less than five percent of projects are visited, and far less than one percent have any longer-term monitoring.
  • Investment in safe drinking water and sanitation contributes to economic growth. For each $1 invested, the World Health Organization (WHO) estimates returns of $3 – $34, depending on the region and technology.
  • Almost two in every three people who need safe drinking water survive on less than $2 a day and one in three on less than $1 a day.
  • Households, not public agencies, often make the largest investment in basic sanitation, with the ratio of household to government investment typically 10 to 1.
  • Investment in drinking-water and sanitation would result in 272 million more school attendance days a year. The value of deaths averted, based on discounted future earnings, would amount to US$ 3.6 billion a year.

Environment


  • Less than 1% of the world’s fresh water (or about 0.007% of all water on earth) is readily accessible for direct human use.
  • More than 80% of sewage in developing countries is discharged untreated, polluting rivers, lakes and coastal areas.
  • The UN estimates that by 2025, forty-eight nations, with combined population of 2.8 billion, will face freshwater “stress” or “scarcity”. Our Water.org High School Curriculum
  • Agriculture is the largest consumer of freshwater by far: about 70% of all freshwater withdrawals go to irrigated agriculture.
  • At home the average American uses between 100 and 175 gallons of water a day. That is less than 25 years ago, but it does not include the amount of water used to feed and clothe us.
  • Conserving water helps not only to preserve irreplaceable natural resources, but also to reduce the strain on urban wastewater management systems. Wastewater is costly to treat, and requires continuous investment to ensure that the water we return to our waterways is as clean as possible.

Source; http://www.water.org

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