Water Sanitation and Treatment

Krystel Tossone

This chapter will discuss water sanitation in two parts: The history of water

sanitation and present water sanitation in developing and developed countries.

Before this, it is important to briefly mention the benefits of water sanitation. The

benefits of water sanitation are numerousi,ii. First, there is an inverse correlation between

water sanitation and infectious and diarrheoal diseases. As water sanitation increases in

an area, the prevalence of infectious and diarrheoal diseases decreases. There are many

infectious diseases that are not diarrheal that are associated with poor water sanitation

and treatment, such as typhoid, schistosomiasis, trachoma, and intestinal wormsiii.

Second, there is an inverse correlation between fluoridation and removal of hard

chemicals in the water supply and a decrease in oral ailments, such as sores and cavities

(dental caries)iv. Third, water treatment and sanitation reduces the amount of hard mineral

and metal deposits that could result in poisoning, such as lead and arsenic.

1. The History of Water Sanitation:

I. The Indus Civilization to the Roman Civilization

One of the first civilizations to make a large contribution to water sanitation and

hygiene is the Indus Civilization (As early as 4600 BCE) in what would be modern-day

Pakistanv. Not only did they have sewer systems in the streets, both the peasants and the

wealthy had bathrooms that were on the street side of their homes next to their latrines

(which were holes in the ground connected to a large cesspool). To some historians this

means that they might have been stressing the importance of hygiene and cleanliness. The

sewer system was covered to protect people from the dirty water and the latrines were
flushed with clean water. It is interesting as well to note that the Indus Valley cities were

extremely organized and all followed the same basic plans.

Another early civilization worth mentioning were the Minoans on the modern-day

island of Crete 2700 to 1400 BCEvi. The drainage systems for storm water and human

waste that were used are still in use today in some parts in Crete.

Lastly, the Romans (800 BCE to 300 CE) used aqueducts, storm drains, and

latrinesvii. At first, they just used an underground sewer system for storm water run-off,

and threw their human waste into the streets. They then would wash the streets almost

daily, in which all of the waste would run into the storm drains. They would wash the

streets with water carried by the aqueduct system, which were large above-ground pipes

that carried water from the Tiber river into the city. It wasn’t until later that Rome started

connecting all homes to the aqueducts directly, and when latrines began being built.

Some of the early pipes used were made out of lead but the largest pipe in the city of

Rome is still being used today, and it is made out of stone.

II. Europe in the Middle Agesviii

Sanitation and hygiene was low on the priority list in the period between 1200 and

1800 AD in Europe. Sewage was thrown into the streets in the cities, causing epidemics.

In Paris, sewage was thrown into the rivers and streams, which resulted in the city

smelling so foul in the summer that people often left the city in those months to live in

the country. Sewer systems weren’t considered important until later, when most

European cities began constructing them as a result of overcrowding and therefore

unbearable amounts of human waste were accumulating. These sewer systems weren’t

really constructed for sanitation purposes but for aesthetic purposes.

 III. Industrialized Europe

Up until this point the main theory on the cause of disease was the miasmata

theory. The miasmata theory stated that disease was caused by “bad air” or poisonous

airix. These clouds often gathered around places that smelled foul, like the Thames River

in London (where cholera outbreaks were common). The miasmata theory was used

during cholera outbreaks to explain why they occurred where they did. The Thames River

was used as a sewer line by many sewage plants in London, and the sewage often

accumulated in certain spots on the river, where people lived nearby and their water

pumps were located. This resulted in people drinking and bathing in contaminated water,

which resulted in cholera outbreaks. Dr. John Snow, who believed that it wasn’t the air

that was causing the outbreaks, investigated these outbreaks but instead it was the water

sourcex. He ended up proving that it was the water source, but this wasn’t really taken

into consideration until after the germ theory became popular.

Louis Pasteur popularized the germ theory of disease in the late 1800s. The germ

theory of disease is the theory that we have now, which basically states that

microorganisms cause infectious diseasexi. It was without this knowledge, however, that

measures taken to clean up water in cities and for medical use occurred. These theories

shaped responses to water-borne and infectious disease. Industrialized Europe and the

United States put in sewer systems comparable to modern-day systems and toilets.

Although sewer systems were helpful in separating clean water from dirty water, modern

systems of water purification didn’t begin until the 20th century in the United States.

IV. The Beginnings of Modern Water Sanitation Efforts

 From the end of the 19th century to the beginning of the 20th century, the

connection between human waste and drinking water being made by people motivated

them to create better systems to separate the two and also to treat the sewage before

putting it back into their water source. Scientists were starting to prove that there was a

positive correlation between turbidity in the water and the increase of microbial

contaminationxii. Because of this, they began water filtration using sand in the early 20th

century. Chlorination began in the United States, which actually developed out of

discovery and use of it in the U.S. Militaryxiii. Other methods that began to be developed

in the early to mid 20th century included:

• Aeration
• Ozonation
• Flocculation
• Granular Activated Carbon Absorption
• Reverse Osmosis

2. Present-Day Water Sanitation in Developed and Developing Countries:

I. Modern Methods of Water Treatment and Purification

Before proceeding further, one should briefly define modern methods of water

treatment and purification that are used in modern-day cities and also some methods used

in developing countries. These include not only physical methods of water purification

and sanitation but also social measures that governments and groups use to encourage

water sanitation and water hygiene practices. First, the methods used in developed

countries:

• Chlorination is the use of liquefied chlorine in drinking water to purify itxiv. It is

effective, as it kills most bacteria, but there are chlorine-resistant bacteria, and this

has motivated scientists to create other methods of water purificationxv. Today it

 is the most commonly used method of water purification in the United States and

Europe, but there have been suggestions that it may have harmful side effects.

• Ozonation is the use of ozone, which is created by an electric current, in water to

disinfect it and remove metalsxvi. It disinfects better than chlorine, but it doesn’t

prevent or inhibit regrowth in bacteria. It is more commonly used in Asia and

Europe than the U.S., and places that do use it in the United States are still

required to use chlorination by law.

• Aeration is the creation of air bubbles in water to help decrease sediments, metals,

wastes, and algae growths. This is used as a secondary treatment. It doesn’t

actually disinfect on its own, so it has to be used in concordance with some other

method of water treatment.

• Flocculation is a process where particles in the water are clumped together to

make it easier for filtrationxvii. Certain metals are used to do this that are

considered safe for consumption, such as aluminum and magnesium.

• Granular Activated Carbon Absorption is the process of using activated carbon

particles to remove pollutants from the water supplyxviii. The carbon is usually

charcoal dust. The particles are very fine and cover a large surface area, so

technically, a little goes a long way. This method is also relatively safe, as carbon

is safe for consumption, so it has been being used increasingly throughout the

years as a source for water filtration, but it does not remove microbes, sodium,

nitrates, fluoride or hardness. However, it does remove chlorine, so it is effective

in being used as a home filtration device to further filter drinking water.

• Reverse Osmosis is a process where water is forced against the gradient using

pressure, forcing the separation of it from particles contained inside of it. It is

used in desalination and has also been shown to be effective in killing bacteria as

well. It’s effective but costly financially as well as environmentally; quite a bit of

energy and water is used to desalinate. It’s used in parts of the world that don’t

have naturally occurring freshwater deposits, and it can be used for personal home

water filtration.

• Flouridation of water is the process of dissolving fluoride in the water supply to

prevent tooth decay. There have been some controversies surrounding the use of

fluoride, as some studies have shown a relationship between bone softening and

fluoridation. As a result of this, some countries have banned fluoridation.

• Boiling of water kills microbes and reduces hardness. However, it doesn’t prevent

regrowth of bacteria, so after a while water needs to be boiled again. A process

that uses boiling is distillation, which creates water vapor, which is almost 100

percent pure water. A drawback of this method is that it also doesn’t prevent

regrowth, and studies have shown that the apparatus used can harbor bacteria and

disease.

• Social methods can include but aren’t limited to: Signs and programs about hand-

washing, education about the spread and infection of waterborne diseases, and

education about how to use water sanitation and purification methods.

II. Methods Used in Developing Countries and the Shift From Community-Based

Methods to Household-Based Methods

 Most methods used in developed countries are too expensive and not technically

feasible in countries with the largest need for clean water. Some of these methods used

employ filtration using a medium such as sand or gravelxix. This is often the most

employed and accepted filtration in developing countries. Sand is cheap and inert, and the

device can be easily made. Another method that has been used in Brazil is using an

upflow solids filter, which uses a combination of a medium (such as sand) and a

flocculant to decrease turbidityxx. It is relatively easy and cheap to do, but not something

that is widely employed yet. Both of these methods work best in really dirty water with

high turbidity.

These methods are also used in combination with education about infectious

disease, water sanitation, and hygiene. There have been a number of programs

implemented worldwide, some of these by the World Health Organization, the CDC, the

Worldbank, and UNICEF. Some of the programs are also by private companies and

organizations, such as PUR’s Water Project. Some projects are:

• World Water Day is a result of a UN conference in 1992 that focuses on water

and improving water worldwidexxi. Every year, there is a focus of world water

day, for example, for 2008, the focus is on sanitation. This day brings many

organizations such as WHO, UNICEF, and the Worldbank together (all children

of the UN) to discuss the problems of sanitation and water in developing

countries. www.worldwaterday.org

• The Water and Sanitation Program is a partnership of the World Bankxxii. Its goal

is to achieve the millennium development goals that were set by the UN for 2015

to decrease by 50 % the number of people without clean water or sanitation

 worldwide. It supports other programs through offering monetary and educational

support. The Water and Sanitation Program often discusses poverty as being a

cause and an effect of poor water sanitation.

• The SafeWater System is a CDC program that provides safe and clean water to

developing countriesxxiii. This intervention has 3 steps: 1. “point-of-use treatment”

to target contaminated water using a salt solution, 2. Safe water storage in plastic

containers to prevent sanitation, and 3. Behavioral changes in the community such

as education about hygiene and the spread of infectious diseases.

• PUR’s water project is a project by Proctor and Gamble to provide clean water to

developing countries by using sustainable methods, such as the filtration method

using sandxxiv. Funding this is provided partly by consumers, such as the

promotion of using Proctor and Gamble coupons during the months of March and

April 2008 in order to donate a liter of 1 per coupon. www.givepurwater.com.

There has also been a shift in how programs and policies approach water

sanitation in developing countries. This shift has been from a community-based approach

to a household-based approach.

A community-based approach is involving community leaders in the funding,

implementation, and maintenance of a water sanitation and hygiene systemxxv. It requires

that members of the community are involved in every step of the water sanitation

program. These methods can also include large-scale methods, such as water piping. This

method has varied based on type of community, and now there is a shift to household-

based approaches to water sanitation.

 Household-based approaches are small-scale, and can include the point-of-use

water treatment, disinfection, and behavioral changesxxvi. These are usually inexpensive.

III. Current Problems in Developed and Developing Countries

Problems in Developed Countries

Many of the problems in developed countries such as Europe and the United

States involve maintaining access and availability of clean and fresh water at a low cost.

A problem often mentioned is that some parts of the United States are experiencing a

water shortage and drought conditions, not to mention that floods are increasing, causing

exposure to waterborne and diarrheal diseases. An example of this is Hurricane Katrina’s

effect on the Southeast states in 2005. As a result of flooding, some people were infected

with diarrheal diseases (mainly cholera), and 5 died from them.

Aside from maintaining access and availability, there is also the problem of lead

contamination in some areas in developed countries. Lead enters the water from old

service pipes that carry the water from treatment plants into homesxxvii. The

Environmental Protection Agency, or EPA, has provided a list of ways that people can

reduce lead in their drinking water in their homes. These are flushing your pipes after 6

hours of non-use with cold water, only using cold water in drinking and cooking as warm

water contains more lead, and getting your home tested. The EPA fact sheet also gives

information about possible sources of lead contamination, what lead poisoning does to

the body, and a question and answer section. The website is:

www.epa.gov/OGWDW/lead/index.html.

Another problem in developed countries is the presence of pharmaceutical drugs

in the water supplyxxviii. There haven’t been completed studies yet to discuss the possible
risks that this poses, but the causes of this are disposal of pharmaceuticals in the toilet or

sink and also throwing them in the trash.

Problems in Developing Countries

The problems of water supply and sanitation in developing countries range

depending on the country, but these problems can be divided into two groups: Acute and

chronic or long-term. Acute problems include lack of access to a water source, lack of

access to sanitized water source, and lack of sanitary bathing and toilet conditions. Many

countries, especially African countries, are facing drought conditionsxxix. Many of their

easily accessible water sources are drying up. Those with access to water often face the

problem of the water being unclean and contaminated with bacteria. This can come from

the use of drinking from the same water source that has been used as a latrine or as

bathing water.

Chronic conditions vary, and these tend to be economic and problems with

infrastructure in countries. Opinions vary depending on who it is that is discussing it.

Many cite corruption, or lack of knowledge in the ability to allocate resources and money

in terms of funding for water sanitation. These are just a few examples.

Conclusion

This chapter has discussed the past and present of water sanitation. The past was

an overview of the trends of water sanitation up until currently, and the present discussed

water sanitation in developed and developing countries.

Related Textbooks

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 Discusses results of poor water sanitation and discusses in depth different
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American Water Works Association. 2003. Water Quality.

Focuses on water quality regulations and the different types of contaminants that
can occur in the water supply.

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