HEALTH ISSUES

Water contamination causes serious problems and water supply standards set by WHO are rarely met (SDPI 1995). 50% of the population has access to piped water (Dr. Mehboob Ul Haq - 1997) and the rural water supply coverage in 1997-98 was 90% according to an appraisal done by the World Bank (Human Development Index, 2003). However this did not take into account the private sector's provision of potable water.The surveys by UNICEF/Ministry of Health, give different indications. In the 1995 survey by UNICEF (Multiple Indicator Cluster Survey), it was revealed that 17% of the rural households have piped water and 52% had family handpumps (Social Development in Pakistan, 1999).

Water quality is deteriorating due to biological contamination from human waste, chemical pollutants from industries and agricultural inputs, salinity and siltation. Piped water also gets contaminated because pipes are laid very close to sewerage lines or open drains and chemicals like chlorine, which is mixed to kill bacteria, corrode the supply lines. 62% (UNDP) or 33% (Haq, 1997) of the people have access to sanitation and only 55% to health services. (Haq 1997, UNDP 1997). In the HDI it is reported that approximately 65% of Pakistan's population has access to essential medicine. 45% of infant deaths have been attributed to diarrhoea and 60% to overall infectious waterborne diseases. 25-30% of the diseases are gastro-intestinal in nature (WHO).

(Pakistan Demographic and Health Survey 1990-9

Diseases such as malaria, diarrhoea and chronic respiratory infections are common in rural areas and areas with a wide ratio of persons per room. Respiratory infections in rural areas are related to smoky indoor atmosphere whereas in the urban areas they are due to increased vehicular emissions and dust from unregulated cement manufacture and construction work.

Hazards to Health within the Urban Environment

1. Biological pathogens or pollutants within the human environment that impair human health-including pathogenic agents and their vectors (and reservoirs)-for instance the many pathogenic microorganisms in human excreta, airborne pathogens (for instance those responsible for acute respiratory infections and tuberculosis) and disease vectors such as malaria-carrying ( Anopheline ) mosquitoes.
2. Chemical pollutants within the human environment - including those added to the environment by human activities (e.g., industrial wastes) and chemical agents present in the environment independent of human activities.
3. The availability, cost and quality of natural resources on which human health depends - for instance food, water and fuel.
4. Physical hazards (e.g., high risks of flooding in houses and settlements built on floodplains or of mud slides or landslides for houses on slopes.
5. Aspects of the built environment with negative impacts on physical and psycho-social health (e.g., overcrowding, inadequate protection against noise, inadequate provision of infrastructure, services and common areas).
6. Natural resource degradation (e.g., soil and water quality) caused by wastes from city-based producers or consumers which impacts on the health/livelihood of some urban dwellers.
7. National/global environmental degradation with more indirect but long term influences on human health:

• the depletion of finite non-renewable resource bases
• wastes from human activities that contribute to possible threats to the functioning and stability of global cycles and systems and the increasing frequency of extreme climatic conditions (e.g., greenhouse gas emissions and gaseous emissions that contribute to the depletion of the stratospheric ozone layer).

Source: Impact on health of urban environments , D. Satterthwaite; Environment and Urbanization, Vol 5, No 2; Health and wellbeing in cit