Poor sanitation conditions and limited access to safe drinking water have triggered a sharp increase in the death rate of children in Greater Darfur, Sudan, according to a survey conducted by the World Health Organization (WHO) and the Sudan Ministry of Health. Since conflict in the Darfur region escalated, an estimated 1.2 million people have been internally displaced, seeking refuge in towns and villages in Darfur and also across the border in Chad.

The "Retrospective Mortality Survey Among the Internally Displaced Population, Greater Darfur, Sudan, August, 2004," found that despite relief efforts, crude mortality rate in the region is about three times the expected rates under normal conditions in Africa.

The main cause of death reported during the survey was diarrhea, particularly affecting children under five years old. Diarrhea-causing bacteria spreads quickly in refugee camps due to crowded conditions, a shortage of clean water, inadequate latrines, and insufficient soap. Proper hygiene becomes nearly impossible to achieve.

In response to these hazardous living conditions, WHO, the Sudanese government and UNICEF are intensifying their efforts to address the primary causes of mortality, specifically in the areas of water and sanitation.

For more information on humanitarian efforts to combat global poor sanitation and the full WHO survey, please go to http://www.who.int/disasters/repo/14652.pdf ( PDF)

According to the International Joint Commission (IJC) of United States and Canada, the Great Lakes of North America, the largest body of surface freshwater on the planet, are continually threatened by industrial and population growth. The IJC report entitled, "Twelfth Biennial Report on Great Lakes Water Quality," addresses the current health, water quality and vitality issues of the Great Lakes.

The Great Lakes Water Quality Agreement was created in 1972 for the purpose of restoring and maintaining the chemical, physical, and biological integrity of the waters of the Great Lakes basin. The IJC is directed to make a full assessment of the progress toward these objectives every two years. The new report triggers a review of the Agreement itself, a charter that has not been updated for 17 years. During that time, technology and scientific knowledge of the region have grown, as have challenges to the Great Lakes ecosystem.

Population growth and increased industrial expansion in the surrounding areas are identified as major contributors environmental issues facing the region. Among the issues raised by the report are the effects of urbanization, threats associated with alien invasive species, pathogens and disease-bearing microorganism in drinking water sources and chemical contamination.

For more information on the International Joint Commission and to read the full report, please go to the IJC website at: http://www.ijc.org/rel/news/040913_e.htm

The U.S. Food and Drug Administration (FDA) advised consumers affected by the recent spate of hurricanes to take precautions with their food and water supply in the wake of these storms. Many communities continue without power and are experiencing difficulties associated with residual flooding.

According to the U.S. Centers for Disease Control and Prevention (CDC), the extensive flooding that often accompanies hurricanes can contaminate the public water supply and cause a variety of illnesses. Unsafe water can originate from several sources, including water treatment plants that have ceased operating due to power outages, storm damaged water lines and hazardous chemicals seeping into the ground.

To ensure a safe drinking water supply, residents are advised to use bottled, boiled or treated water. Bottled water should only be used from safe sources and if the water's origin is not known it should be boiled or treated before use. Boiling water for one minute is the preferred way to kill harmful bacteria and parasites. If water cannot be boiled, the FDA recommends disinfecting the supply by adding 8 drops of newly purchased, unscented liquid household bleach per gallon of water, stirring it well and leaving it to stand for 30 minutes, before use.

For more information and safety tips, please visit the CDC's Emergency Preparedness web site at: http://www.bt.cdc.gov/disasters/hurricanes/index.asp

On the 150th anniversary of John Snow's groundbreaking work that curbed the spread of cholera in nineteenth century London, the public health pioneer's impact on disease prevention is being remembered as a seminal moment in public health history and a gateway to understanding current conditions that affect human health. Snow, a champion of the then unpopular theory that cholera was transmitted through contaminated water, researched death records and conducted personal interviews to identify water from London's Broad Street pump as the source of a cholera outbreak. Community leaders ultimately removed the pump handle on September 8, 1854, preventing further spread of the disease and numerous deaths.

In the September 3, 2004 issue of Morbidity and Mortality Weekly Report (MMWR), the U.S. Centers for Disease Control and Prevention (CDC) recognize Snow's work as one of the earliest examples of using epidemiology to identify disease risks and recommend preventive actions. His unique logic and original methodology led to modern approaches that remain critical for addressing public health challenges.

The MMWR issue offers reviews of a cross-section of current public health investigations rooted in Snow's work, including a cholera epidemic outbreak in Zambia linked to raw vegetables and a norovirus outbreak at a Vermont swimming club. In each case, as in Snow's investigation, the findings highlight the importance of safe water, sanitation, and basic hygiene for protecting public health.

To view the MMWR issue, please click on to http://www.cdc.gov/mmwr/weekcvol.html

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