Recent outbreaks of typhoid cast doubts on the quality of potable water in Egypt, reports Mohamed El-Sayed Hundreds of people have contracted typhoid in the last three weeks. The infections have been blamed on sewage contaminating water supplies. Qalioubiya, with 276 cases, was the worst hit governorate. So far 147 people have been discharged from hospital, while 129 cases are still being treated. In Sharqiya 13 villagers from Abu Kebir and Faqous were admitted to hospital on Saturday. Abu Qurqas, in the governorate of Minya, has reported 53 cases, and 28 people have been hospitalised in Fayoum. Four cases were confirmed in the Red Sea governorate last week and there are reports, so far unconfirmed, of people suffering typhoid symptoms in Gharbiya. While government officials blamed the cases that appeared in Qalioubiya on groundwater pumps, widely used in rural areas where treated drinking water is not available, residents of Al-Baradaa village, where the highest number of cases were confirmed, believe the contamination occurred in the potable water network recently installed by the Executive Agency for Drinking Water and Sanitation. The contractor responsible for installing Al-Baradaa's water network is currently being questioned over allegations that sewage was pumped into drinking water without thoroughly cleaning it afterwards, leading to the contamination of potable water. People diagnosed with typhoid state that they felt the symptoms of the disease shortly after drinking tap water connected to their houses via the newly installed pipeline. The village is now being supplied with large tanks of water until the pipeline is thoroughly cleaned. Amr Qandil, head of the Central Department for Preventive Medicine at the Ministry of Health, says the recent outbreaks cannot be considered an epidemic. "The number of patients diagnosed with typhoid since the beginning of this year is 3,398. It is unlikely that the rate will differ from last year, when 6,867 cases were reported," he said. Meanwhile, 15 human rights organisations have filed a complaint with the prosecutor-general, calling for an urgent investigation into the case. "Government agencies are blaming it on one another. The Ministry of Health says that the cause of the spread of the disease is drinking water contaminated with sewage. The water company stresses that it is not responsible for the contamination and local authorities in Qalioubiya blame it on groundwater pumps," says Mohamed Nagui, director of Habi Centre for Environmental Rights. A number of MPs have also accused the government of "endangering people's health" and plan to table a motion in the People's Assembly calling for the formation of a fact-finding commission. Despite the fact that Minister of Housing and Urban Development, Ahmed El-Maghrabi, stressed -- in reply to a question posed by President Mubarak about the contamination of water in Qalioubiya -- that "all analyses of drinking water in Qalioubiya showed that it was safe", experts have raised questions about the quality of drinking water provided by treatment plants and say similar outbreaks could take place in other places due to the fact that the main source of water in Egypt, the River Nile, is susceptible to increased levels of pollution. "There are areas where the River Nile and its branches are contaminated due to untreated industrial wastewater being poured directly into it," says Tarek Samir, of the Water Department of the National Centre for Research. "Dissolved organic compounds arising from industrial, agricultural and sewage water poured into the Nile remain even after being treated by chlorine in potable water treatment plants," he points out. Water treatment stations in Egypt still add chlorine to water to purge pollutants even though more effective technologies and purifiers, like ozone and ultraviolet, are now being used in other countries. Water experts argue that old treatment methods are to blame for the bad quality of potable water. "When the pollutant load in Nile water is high purifying substances like chlorine can only remove between 30 to 50 per cent of pollutants from water," says Samir. "And some organic compounds interact with chlorine, producing harmful substances in drinking water." Samples taken from water produced at treatment plants across the country regularly fail to meet established standards. A report issued this week by the health department in the Upper Egyptian governorate of Assiut said that 43 per cent of water samples taken from the city of Dairout were below standard, carrying unacceptably high chemical and bacteriological loads. An official report issued in May showed that drinking water in six towns in Daqahliya governorate also failed to meet chemical and bacteriological standards. A recent study by the National Centre for Research concluded that drinking water in general "does not meet international standards". The study stressed that traditional treatment did not cleanse drinking water of particles of cadmium, chrome, copper and lead. The outcome of a study undertaken last year by senior UN water resource expert Ahmed Diab confirmed that 70 per cent of drinking water pollution was due to the fact that it was contaminated with sewage. "Drinking water is contaminated with pollutants leaking into broken pipelines and mains, which leads to wasting huge amounts of potable water worth millions of pounds and which also causes chronic disease," the study found. It highlighted the fact that "villagers are drinking groundwater -- the main source of water in rural areas -- that is contaminated with agricultural wastewater and sewage." The chairman of the Drinking Water and Sanitary Sewers Holding Company, Abdel-Qawi Khalifa, said earlier this year that some water mains in Cairo date back to the beginning of the 20th century. Though the government has spent $4.3 billion since 1985 to replace old water networks, in addition to $3.3 billion allocated to sanitation projects over the past two decades, insufficient attention has been paid to the safe disposal of sewage, especially in rural areas. A recent report issued by UNICEF's Cairo office points out that there are 4,500 villages in Egypt with no sanitation facilities, resulting in the disposal of sewage in watercourses and canals. The report estimated that in rural areas just 58 per cent of inhabitants have access to sanitation facilities, and even then they are usually primitive. All houses, the report argued, should be connected to a functional sewage network since proper disposal of waste would help protect people from water borne diseases including typhoid, diarrhea, polio, bilharzias and hepatitis C. An ounce of prevention is worth a pound of cure, say water experts. "If we are to improve the quality of water produced by treatment plants and prevent water-caused diseases, we have to first prevent pollution of the River Nile," says Samir.
