Climate Change, Water Scarcity, and Health Adaptation in Southwestern Coastal Bangladesh
|
摘要
Climate change may affect human health through multiple and interactive pathways that include safe water scarcity. However, impacts of climate change-induced water scarcity on health and well-being are complex.About 80% of illnesses in developing countries are attributed to unsafe drinking water and waterborne diseases. In Southwestern Bangladesh, lack of safe drinking water is a severe crisis due to climate change. The study investigated the impacts of climate change on water resources and human health in a coastal area. A questionnaire survey was carried out in two villages of Shymnagar upazila on the southwestern coast to investigate the present status of safe water sources and health care facilities and their impacts on the local community. The results show that the local community believes that climate change is having substantial impacts on freshwater sources and health. More than 70% of the respondents identified diarrhea, dysentery,and skin diseases as the prime waterborne health risks that occur through climate-related safe water scarcity. By synthesizing the ground data, we suggest pathways to health adaptation to climate change effects and safe water scarcitythrough locally available adaptive practices such as the use of pond sand filters, rainwater harvesting, and importing potable water with the active participation of the government,nongovernmental organizations, and communities.
Climate change may affect human health through multiple and interactive pathways that include safe water scarcity. However, impacts of climate change-induced water scarcity on health and well-being are complex.About 80% of illnesses in developing countries are attributed to unsafe drinking water and waterborne diseases. In Southwestern Bangladesh, lack of safe drinking water is a severe crisis due to climate change. The study investigated the impacts of climate change on water resources and human health in a coastal area. A questionnaire survey was carried out in two villages of Shymnagar upazila on the southwestern coast to investigate the present status of safe water sources and health care facilities and their impacts on the local community. The results show that the local community believes that climate change is having substantial impacts on freshwater sources and health. More than 70% of the respondents identified diarrhea, dysentery,and skin diseases as the prime waterborne health risks that occur through climate-related safe water scarcity. By synthesizing the ground data, we suggest pathways to health adaptation to climate change effects and safe water scarcitythrough locally available adaptive practices such as the use of pond sand filters, rainwater harvesting, and importing potable water with the active participation of the government,nongovernmental organizations, and communities.
Climate change may affect human health through multiple and interactive pathways that include safe water scarcity. However, impacts of climate change-induced water scarcity on health and well-being are complex.About 80% of illnesses in developing countries are attributed to unsafe drinking water and waterborne diseases. In Southwestern Bangladesh, lack of safe drinking water is a severe crisis due to climate change. The study investigated the impacts of climate change on water resources and human health in a coastal area. A questionnaire survey was carried out in two villages of Shymnagar upazila on the southwestern coast to investigate the present status of safe water sources and health care facilities and their impacts on the local community. The results show that the local community believes that climate change is having substantial impacts on freshwater sources and health. More than 70% of the respondents identified diarrhea, dysentery,and skin diseases as the prime waterborne health risks that occur through climate-related safe water scarcity. By synthesizing the ground data, we suggest pathways to health adaptation to climate change effects and safe water scarcitythrough locally available adaptive practices such as the use of pond sand filters, rainwater harvesting, and importing potable water with the active participation of the government,nongovernmental organizations, and communities.
引文
Abedin,M.A.,U.Habiba,and R.Shaw.2014.Community perception and adaptation to safe water scarcity:Salinity,arsenic and drought risks in coastal Bangladesh.International Journal of Disaster Risk Science 5(2):110-124.
Akber,M.F.2010.The water crisis.Dhaka,Bangladesh:The Daily Star.3 May 2010.http://www.thedailystar.net/newDesign/newsdetails.php?nid_136756.Accessed 11 Jan 2018.
Alam,M.2003.Bangladesh country case study.National Adaptation Programme of Action(NAPA)Workshop,9-11 September2003,Bhutan.
Banglapedia.2012.Shyamnagar Upazila.http://en.banglapedia.org/index.php?title=Shyamnagar_Upazila.Accessed 20 Nov 2018.
BIRDEM(Bangladesh Institute of Research and Rehabilitation for Diabetes,Endocrine and Metabolic Disorders).2012.Health effects of climate changes in Bangladesh.Birdem Medical Journal 2(2):75-76.
CCC(Climate Change Cell).2009.Climate change and health impacts in Bangladesh.Department of Environment,Ministry of Environment and Forests,Bangladesh.http://ngof.org/wdb_new/sites/default/files/Climate_Change_and_Health%202009.pdf.Accessed 12 Dec 2017.
Checkley,W.,L.D.Epstein,R.H.Gilman,D.Figueroa,R.I.Cama,J.A.Patz,and R.E.Black,2000.Effects of El Nin?o and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children.The Lancet 355(9202):442-450.
Costello,A.,M.Abbas,A.Allen,S.Ball,S.Bell,R.Bellamy,S.Friel,N.Groce,et al.2009.Managing the health effects of climate change.The Lancet 373(9676):1693-733.
Dankelman,I.,K.Alam,A.Khurshid,W.B.Ahmed,Y.D.Gueye,N.Fatema,and R.M.Kutin.2008.Gender,climate change and human security:Lessons from Bangladesh,Ghana and Senegal.Report prepared for the Hellenic Foundation for European and Foreign Policy(ELIAMEP).Prepared by the Women’s Environment and Development Organization(WEDO)with ABANTU for Development in Ghana,Action Aid Bangladesh,and Environment and Development Action in the Third World(ENDA)in Senegal.http://www.gdnonline.org/resources/WEDO_Gender_CC_Human_Security.pdf.Accessed 3 Feb2018.
Dasgupta,S.,B.Laplante,S.Murray,and D.Wheeler.2011.Exposure of developing countries to sea-level rise and storm surges.Climatic Change 106(4):567-579.
DFID(Department for International Development).2004.Water action plan.A DFID policy paper.London:DFID.
DFID(Department for International Development),EC(European Commission),UNDP(United Nations Development Programme),and WB(World Bank).2002.Linking poverty reduction and environmental management:Policy challenges and opportunities.Washington,DC:World Bank.
Faisal,I.M.,and S.Parveen.2004.Food security in the face of climate change,population growth and resource constraints:Implications for Bangladesh.Environmental Management 34(4):487-498.
Farhana,S.2011.Suitability of pond sand filters as safe drinking water solution in storm surge prone areas of Bangladesh:A case study of post-Aila situation in Shyamnagar,Satkhira District,Khulna.Master’s thesis.Postgraduate Programs in Disaster Management(PPDM),BRAC University,Dhaka,Bangladesh.
Habiba,U.,R.Shaw,and Y.Takeuchi.2011.Drought risk reduction through a socio-economic,institutional and physical approach in the northwestern region of Bangladesh.Environmental Hazards10(2):121-138.
Hoque,R.M.2009.Access to safe drinking water in rural Bangladesh:Water governance by DPHE.Master’s Thesis,Institute of Governance Studies,BRAC University,Dhaka,Bangladesh.
Howard,G.,and J.Bartram.2003.Domestic water quantity,service level and health.Geneva:World Health Organization.http://triplehelix blog.com/2011/03/unnecessary-and-deadly-the-post-disaster-cata strophe-of-waterborne-diseases/.Accessed 7 Dec 2017.
Hunter,P.,A.MacDonalds,and R.Cater.2010.Water supply and health.PLOS Medicine 7(11):1-9.
IPCC(Intergovernmental Panel on Climate Change).2001.Climate change 2001:Impacts,adaptation and vulnerability:Summary for policymakers.Contribution of Working Group II to the fourth assessment report of the Intergovernmental Panel on Climate Change.Cambridge:Cambridge University Press.
IPCC(Intergovernmental Panel on Climate Change).2007.Climate change 2007:Mitigation.Contribution of Working Group III to the third assessment report of the Intergovernmental Panel on Climate Change.Cambridge:Cambridge University Press.
Ishwaripur Development Foundation.2018.Installation of pond sand filter in southwest of coastal Bangladesh.Shymnagar,Satkhira,Bangladesh.
Jakobsen,F.,M.H.Azam,and M.M.U.Kabir.2002.Residual flow in the Meghna Estuary on the coastline of Bangladesh.Estuarine,Coastal and Shelf Science 55(4):587-597.
Khan,A.,P.F.Scheelback,A.B.Shilpi,Q.Chan,S.K.Mojumder,A.Rahman,A.Haines,S.Kovats,and P.Vineis.2014.Salinity in drinking water and the risk of(pre)eclampsia and gestational hypertension in coastal Bangladesh:A case-control study.PLOSOne 9(9):Article e108715.
Khan,A.E.,W.W.Xun,H.Ahsan,and P.Vineis.2011.Climate change,sea-level rise,&health impacts in Bangladesh.Environment:Science and Policy for Sustainable Development53(5):18-33.
Kovats,R.S.,D.Campbell-Lendrum,and F.Matthies.2005.Climate change and human health:Estimating avoidable deaths and disease.Risk Analysis 25(6):1409-1418.
Kundzewicz,Z.W.,L.J.Mata,N.W.Arnell,P.Do¨ll,P.Kabat,B.Jime′nez,K.A.Miller,T.Oki,et al.2007.Freshwater resources and their management.In Climate change 2007:Impacts,adaptation and vulnerability.Contribution of Working Group II to the fourth assessment report of the Intergovernmental Panel on Climate Change,ed.M.L.Parry,O.F.Canziani,J.P.Palutikof,P.J.van der Linden,and C.E.Hanson,173-210.Cambridge:Cambridge University Press.
Lama,J.R.,C.R.Seas,R.Leo′n-Baru′a,E.Gotuzzo,and R.B.Sack.2004.Environmental temperature,cholera,and acute diarrhoea in adults in Lima,Peru.Journal of Health,Population and Nutrition 22(4):399-403.
Manton,M.J.,P.M.Della-Marta,M.R.Haylock,K.J.Hennessy,N.Nicholls,L.E.Chambers,D.A.Collins,A.Gdaw,et al.2001.Trends in extreme daily rainfall and temperature in Southeast Asia and the South Pacific:1961-1998.International Journal of Climatology 21:269-284.
Ministry of Environment and Forest,Bangladesh.2005.National adaptation program of action.Dhaka:Ministry of Environment and Forest,Government of the People’s Republic of Bangladesh.
Motoshita,M.,N.Istsubo,and A.Inaba.2011.Development of impact factors on damage to health by infectious diseases caused by domestic scarcity.International Journal of Life Cycle Assessment 16(1):65-73.
Parvin,G.A.,F.Takahashi,and R.Shaw.2008.Coastal hazards and community-coping methods in Bangladesh.Journal of Coastal Conservation 12(4):181-193.
Rana,S.2006.Rain water harvesting for drinking in rural area.In Proceedings of MEDA Water International Conference on Sustainable Water Management,21-24 March 2007,Tunis Tunisia.https://www.ctahr.hawaii.edu/hawaiirain/Library/papers/Rana_Md.Sohel.pdf.Accessed 15 Nov 2018.
Reid,H.,and A.Sims.2007.Up in smoke?Asia and the Pacific.Up in Smoke Working Group on Climate Change and Development.https://www.oxfam.ca/sites/default/files/file_attachments/mil lions-of-vulnerable-people-in-asia-bearing-the-brunt-of-climatecrisissays-new-report_2.pdf.Accessed 11 Jan 2018.
SDWF(Safe Drinking Water Foundation).2018.Water and human health.https://www.safewater.org/fact-sheets-1/2017/1/23/water-and-human-health.Accessed 11 Nov 2018.
Sharma,S.,and J.Sharma.2008.A study of stress&cope-up strategies of service sector employees.Indian Management Studies Journal 12:19-35.
Shaw,R.,and D.Thaitakoo.2010.Water communities:Introduction and overview.In Water communities,ed.R.Shaw,and D.Thaitakoo,1-13.Bingley,UK:Emerald Publishers.
Sikder,R.,and X.Jian.2014.Climate change impact and agriculture of Bangladesh.Journal of Environment and Earth Science 4(1):35-40.
Singh,R.B.K.,S.Hales,N.de Wet,R.Raj,M.Hearnden,and P.Weinstein.2001.The influence of climate variation and change on diarrhoeal disease in the Pacific Islands.Environmental Health Perspectives 109(2):155-1594.
Swapan,S.S.A.,and Md.M.Mamun.2006.In search of safe drinking water:In the context of climate change and salinity.Satkhira,Bangladesh:Uttaran and Water Committee.(English version of the Bangladeshi monograph,translated by A.R.Quazi.)https://uttaran.net/publications/insearchofsafedrinkingwater.pdf.Accessed11 Dec 2018.
UN Water.2007.Coping with water scarcity:Challenge of the twenty-first century.Prepared for World Water Day 2007.http://www.unwater.org/wwd07/downloads/documents/escarcity.pdf.Accessed 23 Mar 2007.
UNDP(United Nations Development Programme).2007.Human development report.Country fact sheets:Bangladesh.
Uzzaman,M.A.2014.Impact of sea level rise in the coastal areas of Bangladesh:A macroeconomic analysis.Journal of Economics and Sustainable Development 5(18):105-109.
WaterAid.2012.Handbook on climate change and disaster resilient water,sanitation and hygiene practices.Dhaka,Bangladesh:Wateraid in Bangladesh.
WHO(World Health Organization).2008.Guidelines for drinkingwater quality.Geneva:WHO.
WHO(World Health Organization).2009.Protecting health from climate change:Global research priorities.Geneva:WHO.
WHO(World Health Organization)and UNICEF(United Nations Children’s Fund).2017.Progress on drinking water,sanitation and hygiene:2017 update and SDG baselines.Geneva:WHOand UNICEF.https://www.who.int/mediacentre/news/releases/2017/launch-version-report-jmp-water-sanitation-hygiene.pdf.Accessed 17 Dec 2018.
WHO(World Health Organization),and UNICEF(United Nations International Children’s Emergency Fund).1990.Joint Monitoring Programme for Water Supply and Sanitation.http://www.wssinfo.org/en/122_definitions.html.Accessed 18Nov 2018.
World Bank.2000.Bangladesh:Climate change and sustainable development.Report No.21104 BD.Dhaka:World Bank.
1 Safe water access is defined as the availability of at least 20 L of water per person per day from an improved water source within a distance of 1 km of the user’s dwelling(WHO and UNICEF 1990).
Akber,M.F.2010.The water crisis.Dhaka,Bangladesh:The Daily Star.3 May 2010.http://www.thedailystar.net/newDesign/newsdetails.php?nid_136756.Accessed 11 Jan 2018.
Alam,M.2003.Bangladesh country case study.National Adaptation Programme of Action(NAPA)Workshop,9-11 September2003,Bhutan.
Banglapedia.2012.Shyamnagar Upazila.http://en.banglapedia.org/index.php?title=Shyamnagar_Upazila.Accessed 20 Nov 2018.
BIRDEM(Bangladesh Institute of Research and Rehabilitation for Diabetes,Endocrine and Metabolic Disorders).2012.Health effects of climate changes in Bangladesh.Birdem Medical Journal 2(2):75-76.
CCC(Climate Change Cell).2009.Climate change and health impacts in Bangladesh.Department of Environment,Ministry of Environment and Forests,Bangladesh.http://ngof.org/wdb_new/sites/default/files/Climate_Change_and_Health%202009.pdf.Accessed 12 Dec 2017.
Checkley,W.,L.D.Epstein,R.H.Gilman,D.Figueroa,R.I.Cama,J.A.Patz,and R.E.Black,2000.Effects of El Nin?o and ambient temperature on hospital admissions for diarrhoeal diseases in Peruvian children.The Lancet 355(9202):442-450.
Costello,A.,M.Abbas,A.Allen,S.Ball,S.Bell,R.Bellamy,S.Friel,N.Groce,et al.2009.Managing the health effects of climate change.The Lancet 373(9676):1693-733.
Dankelman,I.,K.Alam,A.Khurshid,W.B.Ahmed,Y.D.Gueye,N.Fatema,and R.M.Kutin.2008.Gender,climate change and human security:Lessons from Bangladesh,Ghana and Senegal.Report prepared for the Hellenic Foundation for European and Foreign Policy(ELIAMEP).Prepared by the Women’s Environment and Development Organization(WEDO)with ABANTU for Development in Ghana,Action Aid Bangladesh,and Environment and Development Action in the Third World(ENDA)in Senegal.http://www.gdnonline.org/resources/WEDO_Gender_CC_Human_Security.pdf.Accessed 3 Feb2018.
Dasgupta,S.,B.Laplante,S.Murray,and D.Wheeler.2011.Exposure of developing countries to sea-level rise and storm surges.Climatic Change 106(4):567-579.
DFID(Department for International Development).2004.Water action plan.A DFID policy paper.London:DFID.
DFID(Department for International Development),EC(European Commission),UNDP(United Nations Development Programme),and WB(World Bank).2002.Linking poverty reduction and environmental management:Policy challenges and opportunities.Washington,DC:World Bank.
Faisal,I.M.,and S.Parveen.2004.Food security in the face of climate change,population growth and resource constraints:Implications for Bangladesh.Environmental Management 34(4):487-498.
Farhana,S.2011.Suitability of pond sand filters as safe drinking water solution in storm surge prone areas of Bangladesh:A case study of post-Aila situation in Shyamnagar,Satkhira District,Khulna.Master’s thesis.Postgraduate Programs in Disaster Management(PPDM),BRAC University,Dhaka,Bangladesh.
Habiba,U.,R.Shaw,and Y.Takeuchi.2011.Drought risk reduction through a socio-economic,institutional and physical approach in the northwestern region of Bangladesh.Environmental Hazards10(2):121-138.
Hoque,R.M.2009.Access to safe drinking water in rural Bangladesh:Water governance by DPHE.Master’s Thesis,Institute of Governance Studies,BRAC University,Dhaka,Bangladesh.
Howard,G.,and J.Bartram.2003.Domestic water quantity,service level and health.Geneva:World Health Organization.http://triplehelix blog.com/2011/03/unnecessary-and-deadly-the-post-disaster-cata strophe-of-waterborne-diseases/.Accessed 7 Dec 2017.
Hunter,P.,A.MacDonalds,and R.Cater.2010.Water supply and health.PLOS Medicine 7(11):1-9.
IPCC(Intergovernmental Panel on Climate Change).2001.Climate change 2001:Impacts,adaptation and vulnerability:Summary for policymakers.Contribution of Working Group II to the fourth assessment report of the Intergovernmental Panel on Climate Change.Cambridge:Cambridge University Press.
IPCC(Intergovernmental Panel on Climate Change).2007.Climate change 2007:Mitigation.Contribution of Working Group III to the third assessment report of the Intergovernmental Panel on Climate Change.Cambridge:Cambridge University Press.
Ishwaripur Development Foundation.2018.Installation of pond sand filter in southwest of coastal Bangladesh.Shymnagar,Satkhira,Bangladesh.
Jakobsen,F.,M.H.Azam,and M.M.U.Kabir.2002.Residual flow in the Meghna Estuary on the coastline of Bangladesh.Estuarine,Coastal and Shelf Science 55(4):587-597.
Khan,A.,P.F.Scheelback,A.B.Shilpi,Q.Chan,S.K.Mojumder,A.Rahman,A.Haines,S.Kovats,and P.Vineis.2014.Salinity in drinking water and the risk of(pre)eclampsia and gestational hypertension in coastal Bangladesh:A case-control study.PLOSOne 9(9):Article e108715.
Khan,A.E.,W.W.Xun,H.Ahsan,and P.Vineis.2011.Climate change,sea-level rise,&health impacts in Bangladesh.Environment:Science and Policy for Sustainable Development53(5):18-33.
Kovats,R.S.,D.Campbell-Lendrum,and F.Matthies.2005.Climate change and human health:Estimating avoidable deaths and disease.Risk Analysis 25(6):1409-1418.
Kundzewicz,Z.W.,L.J.Mata,N.W.Arnell,P.Do¨ll,P.Kabat,B.Jime′nez,K.A.Miller,T.Oki,et al.2007.Freshwater resources and their management.In Climate change 2007:Impacts,adaptation and vulnerability.Contribution of Working Group II to the fourth assessment report of the Intergovernmental Panel on Climate Change,ed.M.L.Parry,O.F.Canziani,J.P.Palutikof,P.J.van der Linden,and C.E.Hanson,173-210.Cambridge:Cambridge University Press.
Lama,J.R.,C.R.Seas,R.Leo′n-Baru′a,E.Gotuzzo,and R.B.Sack.2004.Environmental temperature,cholera,and acute diarrhoea in adults in Lima,Peru.Journal of Health,Population and Nutrition 22(4):399-403.
Manton,M.J.,P.M.Della-Marta,M.R.Haylock,K.J.Hennessy,N.Nicholls,L.E.Chambers,D.A.Collins,A.Gdaw,et al.2001.Trends in extreme daily rainfall and temperature in Southeast Asia and the South Pacific:1961-1998.International Journal of Climatology 21:269-284.
Ministry of Environment and Forest,Bangladesh.2005.National adaptation program of action.Dhaka:Ministry of Environment and Forest,Government of the People’s Republic of Bangladesh.
Motoshita,M.,N.Istsubo,and A.Inaba.2011.Development of impact factors on damage to health by infectious diseases caused by domestic scarcity.International Journal of Life Cycle Assessment 16(1):65-73.
Parvin,G.A.,F.Takahashi,and R.Shaw.2008.Coastal hazards and community-coping methods in Bangladesh.Journal of Coastal Conservation 12(4):181-193.
Rana,S.2006.Rain water harvesting for drinking in rural area.In Proceedings of MEDA Water International Conference on Sustainable Water Management,21-24 March 2007,Tunis Tunisia.https://www.ctahr.hawaii.edu/hawaiirain/Library/papers/Rana_Md.Sohel.pdf.Accessed 15 Nov 2018.
Reid,H.,and A.Sims.2007.Up in smoke?Asia and the Pacific.Up in Smoke Working Group on Climate Change and Development.https://www.oxfam.ca/sites/default/files/file_attachments/mil lions-of-vulnerable-people-in-asia-bearing-the-brunt-of-climatecrisissays-new-report_2.pdf.Accessed 11 Jan 2018.
SDWF(Safe Drinking Water Foundation).2018.Water and human health.https://www.safewater.org/fact-sheets-1/2017/1/23/water-and-human-health.Accessed 11 Nov 2018.
Sharma,S.,and J.Sharma.2008.A study of stress&cope-up strategies of service sector employees.Indian Management Studies Journal 12:19-35.
Shaw,R.,and D.Thaitakoo.2010.Water communities:Introduction and overview.In Water communities,ed.R.Shaw,and D.Thaitakoo,1-13.Bingley,UK:Emerald Publishers.
Sikder,R.,and X.Jian.2014.Climate change impact and agriculture of Bangladesh.Journal of Environment and Earth Science 4(1):35-40.
Singh,R.B.K.,S.Hales,N.de Wet,R.Raj,M.Hearnden,and P.Weinstein.2001.The influence of climate variation and change on diarrhoeal disease in the Pacific Islands.Environmental Health Perspectives 109(2):155-1594.
Swapan,S.S.A.,and Md.M.Mamun.2006.In search of safe drinking water:In the context of climate change and salinity.Satkhira,Bangladesh:Uttaran and Water Committee.(English version of the Bangladeshi monograph,translated by A.R.Quazi.)https://uttaran.net/publications/insearchofsafedrinkingwater.pdf.Accessed11 Dec 2018.
UN Water.2007.Coping with water scarcity:Challenge of the twenty-first century.Prepared for World Water Day 2007.http://www.unwater.org/wwd07/downloads/documents/escarcity.pdf.Accessed 23 Mar 2007.
UNDP(United Nations Development Programme).2007.Human development report.Country fact sheets:Bangladesh.
Uzzaman,M.A.2014.Impact of sea level rise in the coastal areas of Bangladesh:A macroeconomic analysis.Journal of Economics and Sustainable Development 5(18):105-109.
WaterAid.2012.Handbook on climate change and disaster resilient water,sanitation and hygiene practices.Dhaka,Bangladesh:Wateraid in Bangladesh.
WHO(World Health Organization).2008.Guidelines for drinkingwater quality.Geneva:WHO.
WHO(World Health Organization).2009.Protecting health from climate change:Global research priorities.Geneva:WHO.
WHO(World Health Organization)and UNICEF(United Nations Children’s Fund).2017.Progress on drinking water,sanitation and hygiene:2017 update and SDG baselines.Geneva:WHOand UNICEF.https://www.who.int/mediacentre/news/releases/2017/launch-version-report-jmp-water-sanitation-hygiene.pdf.Accessed 17 Dec 2018.
WHO(World Health Organization),and UNICEF(United Nations International Children’s Emergency Fund).1990.Joint Monitoring Programme for Water Supply and Sanitation.http://www.wssinfo.org/en/122_definitions.html.Accessed 18Nov 2018.
World Bank.2000.Bangladesh:Climate change and sustainable development.Report No.21104 BD.Dhaka:World Bank.
1 Safe water access is defined as the availability of at least 20 L of water per person per day from an improved water source within a distance of 1 km of the user’s dwelling(WHO and UNICEF 1990).