Increasing detrimental impacts of water pollution on environment and serious health issues, this review aims to investigate
water quality status of Sindh, Pakistan.it also help us to determine current and future water demand of the province as well as
adverse impact on human health in regards with water borne disease. To conclude, some recommendations are also outlined.
Keywords: Water borne disease; Quality assessment; Water supply; Water contamination; Sindh; Pakistan
Introduction
Although surplus amount of water is available on the planet
of earth, but only small portion is available for human utilization.
Overall population wholly depend upon the water sources mainly
consist on groundwater and surface water. Currently, countries
around the world are facing water pollution as well as water scarcity
problems. Following the report of UN, the total populace increases
exponentially while accessibility of water decline with time. WHO
announced that by 2025, half of the total populace will live in
water-stressed zones? Unfortunately, water pollution stresses the
remaining small portion. During last decades, Urbanization and
industrialization further added burden on water resources around
the globe. Quality of water around the world has been deteriorated
with chemicals discharged into water bodies directly and improper
dumping of solid waste. According to Joint Monitoring Programme
(JMP) report 2017 on “Progress on drinking water, sanitation
and hygiene” 2.1 billion people lack access to safe drinking water
at home. Globally, 448 million lack to have basic drinking water
services from which 159 million individuals are those who rely
upon surface water. According to speech of UNO secretory on
world water day 2002, each year 5 million people died of water
disease i.e.10 times more than people died in war. Furthermore,
several studies have documented various contaminants such as
organic (Pesticides), inorganic (heavy metals), minerals (arsenic
and chromium) and microbial (pathogens) are responsible for
water pollution. Recently, water contaminated with arsenic has
been documented around the world, especially in Asian countries
including Pakistan, Bangladesh, India, Cambodia, Vietnam, China,
Taiwan, Hungary, Chile and Argentina [1-4].
Pakistan has been blessed by natural resources i.e. surface
as well as groundwater resources. Sudden rise in population,
industrialization and urbanization have brought huge stress on
water resources of country. The country once has surplus amount of
water is not including in water stressed zone. Most of the population
belong to different cities of country rely upon groundwater for
survival. While, current water supply is about 79% in Pakistan.
Pakistan has experienced six noteworthy floods between 2000-
2015, which killed many people and posed negative impact on
groundwater through salinization CRED [5]. Furthermore, Per
capita availability of water has been decreased from 5,600 cubic
meters in 1947 to 1,038 cubic meters in 2010. It is expected to
decrease further to 575 cubic feet in 2050 [6,7]. In addition to this,
quality of water resources has been declined due to intermixing
of municipal sewage with water supply line and direct release of
industrial wastewater into water bodies. Pollutants such as heavy
metals, pathogens and other dangerous chemicals have been found
in different regions of the country. Only 20% of the population
have accessibility to safe drinking water while 80% is compelled
to consume unsafe water for drinking. Each year 2.5 million deaths from
endemic diarrheal disease has been reported [8-13]. Pakistan
ranks 80th, out of 122 nations of the world, on the basis of water
quality [14-16]. According to a Worldwide Fund for Nature (WWF)
report titled, “Pakistan’s Waters at Risk”20-40% health centers
are filled with the patients of water borne disease which include
diarrhea, gastroenteritis, typhoid, cryptosporidium infections,
giardiasis intestinal worms, and some strains of hepatitis [17].
Quality of drinking water in Sindh province is unfit like
other provinces of Pakistan. Large portion of water available is
contaminated with pathogens, chemicals and toxic materials.
Several studies have documented that the four major contaminants
are responsible for water quality deterioration in Sindh i.e.69%
bacteria, 24% arsenic, 14% nitrate and 5% fluoride. According to
the report of Inquiry commission appointed by Supreme Court of
Pakistan “78.1 % of all water sample tested were found unsafe for
drinking”. The aim of this review is to analyses the status of water
quality in different divisions of Sindh, Pakistan. It also describes the
impacts of water quality on human health as well as outline some
recommendations.
Study Area
Sindh is second most populated province (Figure 1) with
population of 30.44 million situated in south-eastern part of Pakistan.
It is stretched from 66°8’ East Longitude to 71°, lies between 24°4›N
to 28°7’N and covers about 46,569 miles2
. Province is bounded by
the Thar Desert to east, the Kirthar Mountains to the west, and
the Arabian Sea in the south. It is divided into six divisions namely
Karachi, Hyderabad, Sukkur, Shaheed Benazirabad, Mirpurkhas
and Larkana. Karachi i.e. the capital of Sindh province ranked at
the top with 14.91 million and Hyderabad ranked the 8th most
populated with 1.73 million population among the list of 10 most
populated cities of Pakistan. Large number of populations of the
province depend upon the fresh water for domestic and irrigation
purpose. Indus basin is the major source of water provision in the
area. In Sindh Province, only 10 % of land area had availability of
fresh groundwater and occurs in shallow aquifers [18]. Following
high average annual temperatures, semi-arid climate, sea water
intrusion and high rate of evapotranspiration shallow aquifers are
highly saline [19]. Irrigated land i.e. almost 78% of the province rely
on saline groundwater which is not fit for irrigation. As the ground
water is saline in most areas, rural population is also depending on
supplies from the canal system. According to the survey conducted
by Pakistan Council of Research in Water Resources (PCRWR) in
22 districts of Sindh province out of 1247 surveyed water supply
schemes only 529 (42%) were functional with average duration
supply of 5 hrs/day. From which only 25% water samples were
fit for drinking while remaining are contaminated with microorganisms and arsenic.
Figure 1: Map of Study Area (Sindh Pakistan). Source: Modified from (Sindhidunya 2015).
Current Demand and Future Requirement of Sindh
In next 20 years, Province will undergo demographic change.
Current population of 33 million is expected to increase to 52.6
million and urbanization will increase from 50% to 64% in 2025.
Currently, Karachi’s demand for water supply is about 1,220 MGD
against which has an allocation of 34,000 l/s (1,200 cusecs) from
the Indus water which is expected to increase 65,460 l/s (2,320
cusecs), with increased population to about 23 million in 2025.
Likewise, water demand for other urban cities will also increase
which will put burden on water resources. In addition to this,
rural population of about 18.8 million will need an additional about 7,125 l/s (250 cusecs) for drinking purposes. Hence, total
municipal water requirement of the province in 2025 will be of
the order of 94,000 l/s (about 3.300 cusecs). Besides municipal
water requirement, water requirements for agriculture would
also increase by about 50%. Current water use is about 52.6 Bm3
(42.6 MAF) which means an additional 26.3 Bm3
(about 21.3 MAF)
required to meet the future demand of agriculture products (FAO).
Water Quality
Alarming increase in population is the single important driving
force affecting the water sector and cause water scarcity problem
in the province. Water pollution is another major problem which
is deteriorating the quality of remaining small portion of water.
According to Director General of Sindh Environmental Agency
Baqa Ullah Unar “every day almost 500 million gallons of industrial
waste and human consumption falls into Arabian Sea”.
80% samples from 14 different districts of Sindh are not safe
for drinking as well as 78% of water used in hospitals is above
standard limits. 90% of water had bacterial contamination and not
fit for drinking in Karachi only (PCRWR). Several studies have been
conducted in different cities of Sindh, Pakistan (Table 1) [20-29].
Table 1: Water quality in different districts of Sindh, Pakistan [20-29].
Abdul Hussain Shar [30] analysed the samples from Rohri for
the presence of total coliform (TC), E. coli (Ec) and heterotrophic
plate count (HPC) which result the contamination of all samples
with TC (100%), Ec (41.6%) and with HPC (100%). In Hyderabad
bacteriological tests on drinking water has been conducted by
PCRWR found that 15 monitored sources as unfit for drinking mainly
due to bacteriological contamination (93pc), excessive levels of iron
(47pc) and turbidity (93pc). Mashiatullah [31] carried out a study
on Malir and Lyari rivers, he analysed different Physiochemical and
biological parameters. The coliform contamination i.e.156-542
per 100 ml in high tide and 132- 974 per 100 ml in low tide were
observed which exceeded WHO guidelines. Aziz et al. [32] reported
a study for drinking water quality in Pakistan including both urban
and rural areas which results that total coliform and fecal coliform
were 150–2400/100 ml and 15–460/100 ml respectively. The
investigation reported the presence of anthropogenic activities
which resulted.
Mahmood et al. [33] measured the physical, chemical and
microbiological parameters for the different groundwater samples
collected from Thatta in pre-monsoon and post-monsoon seasons,
respectively. It was observed that concentration of heavy metals
were; As (0.0045 to 0.0055 mg/l), Cd (0.15-0.22 mg/L), Zn (0.040
to 0.046 mg/l), Pb (1.40-1.49 mg/l) and Cu (0.001- 0.87 mg/L) in
both the seasons and were in order of Pb > Cu > Cd > Zn > As
in premonsoon and Pb> Cd > Cu > Zn > As in post- monsoon
respectively.
Other parameters Electrical conductivity (233-987 μs/cm), pH
(6.9-8.9), TDS (161.1-690.9 ppm), Temperature (24-33°C), chloride
(81.79-131.78 ppm), total hardness as CaCO3
(124.40-188.81
ppm), nitrate (2.10-5.20 ppm) were within prescribed standard
limits. Some common diseases were found to be nausea, vomiting
and kidney damage.
Suresh Kumar Panjwani [34] collected Thirty-five groundwater
samples and analysed for 22 different parameters including
physicochemical parameters and bacteriological contamination.
Three drinking water samples (9%) contain Fluoride as 1.83
mg/l to 0.44 mg/l which exceeds WHO limits. Two water samples
(5%) were contaminated with nitrate–nitrogen i.e. 23.61 mg/l to
0.97 mg/l. (45%) 16 water samples were contaminated with E.
coli ranges from 01-too numerous to count CFU/ml exceeding the
prescribed limit by WHO (0/100ml). None of the drinking water
samples (0%) were found bacteriological safe for drinking purpose.
In 2014, another study examined water quality in Thatta, Karachi
and Hyderabad found presence of heavy metals that exceeded the
WHO drinking water guidelines [35].
Outbreak of Water Borne Disease
Improper treatment and dumping of waste in water bodies
accounted for rise in water borne disease. Deteriorated quality
of water in Sindh province had badly affected the human health.
More than 20,000 children die annually in Karachi only, from
which majority of deaths caused by drinking contaminated water.
Outbreak of water borne disease have been noticed in different
parts of Sindh including typhoid, cholera and diarrhea. According
to Zahid J [36] areas surrounded by poor households, children
with mothers married in early ages, children having small size
at birth and ages less than 24 months and children belonging to
uneducated mothers are found most vulnerable where prevalence
of diarrhea found non-ignorable. In Sindh, Tando Allahyar (46%),
Matiati (50%), Hyderabad(44%), Badin (40%), Mirpur Khas (40%)
Karachi East (40%) and Karachi South (52%) have highest rate of
cases while lowest rate found in children from rich house holds’
of Larakana (6%) and Jacobabad (8%). In some areas including
Gadap, Kathore and coastal areas 30-35% of people have been
found infected with viral hepatitis. While 20-25% of the population
is infected with the deadly viral disease said by Dr Shahid Ahmed,
consultant gastroenterologist and patron of the PGLDS on World
Digestive Health Day 2018 (WDHD 18).
Recently, a drug-resistant typhoid strain identified first in
Hyderabad, spread from the city to various parts of the country.
5,274 cases of XDR typhoid have been reported by Provincial
Disease Surveillance and Response Unit (PDSRU) from 1 November
2016 through 9 December 2018.69 % (3658) of cases were reported
in Karachi only, following 27% (1405) in Hyderabad, and 4% (211)
in other districts of the province. On 9th July 2017, outbreak of
acute watery diarrhea and abdominal pain in village Mir Khan
Otho, District Shaheed Benazirabad were reported to the DG Health
Office Sindh in Hyderabad. A total of 30 cases were identified (22
through active case finding) and n=16 (53.7%) were females. Mean
age was 25.3 years (range: 1-50 years). Overall attack rate was 23%.
People aged 21-30 years were the most affected (n=10; AR 43.5%).
Apart from diarrhea, abdominal cramps (n=28; 93%) was the most
common symptom. On bivariate analysis, consumption of water
from the hand-pump near the swamp was significantly associated
with the disease (OR=8.4, 95% CI: 3.1-22.7) [37].
In 2016, 22,000children have been hospitalized and more
than 190 have died in Tharparkar district due to drought-related
waterborne and viral diseases. According to the Joint UN Needs
Assessment, water scarcity has been severely affected several
districts (62% in Jamshoro and 100% in Tharparkar) which resulted
in reduced harvest by 34-53% and livestock by 48% UNICEF [38].
According to local media, the total under- 5 deaths were rising from
173 in 2011, 188 in 2012, 234 in 2013, 326 in 2014, and 398 in
2015. According to the provincial health secretary, 450 children
lost their lives in 2017, 479 died in 2016 and 398 in 2015 while
reasons for the deaths vary. Furthermore, According to authorities
in Tharparkar district, Sindh province, 99 children and 67 adults
(43 men and 24 women) have reportedly died in Tharparkar since
the beginning of 2014 as well as an outbreak of sheep pox occurred
which has killed thousands of small animals (Pakistan: Drought -
2014-2017) [39]. Furthermore, three months after floods began in
Pakistan, 99 cases of cholera were reported from across the floodaffected areas of the country (WHO).
In 1994, first ever case of dengue has been reported in Pakistan,
sudden rise in cases first occurred in Karachi in November 2005.
Since 2010, Pakistan has been encountering dengue fever that has
caused 16 580 affirmed cases and 257 deaths in Lahore only also
about 5000 cases and 60 death confirmed from other parts of the
country (WHO) [40]. The three provinces have faced the epidemic
are Khyber Pakhtunkhwa, Punjab and Sindh. In Sindh province,
2088 dengue positive cases had been reported as well as two people
had died of dengue in Karachi city in 2018. Currently, according to
the weekly report issued by Prevention and Control Programmed
for Dengue (PCPD) in Sindh, from January 1 to January 7, 2019 a
total of 38 dengue positive cases were detected. From which 36
were reported in Karachi only while two were in other districts of
Sindh (PPI).
Contamination Sources
Climate Change
For water resources, climate change is a long term and
unmitigated risk. Water demands is expected to increase up by
5 percent to 15 percent by 2047 due to climatic change. In the
upper Indus Basin, climate change will increase the risk of flood
outbreak by accelerate glacial melting while in the lower Indus
Basin, sea level rise and increases intensity of coastal storms
also exacerbate seawater intrusion into the delta and into coastal
groundwater. Furthermore, in coastal Sindh, groundwater quality
will further be deteriorated and also impact the ecosystems, and
irrigation productivity of the province. In addition to this, Sediment
dynamics in the Indus sourcing, transport, and deposition have
been significantly altered by water resources development. Past
floods in Pakistan not only posed physical damage but also affected
human lives in terms of flood-related death and illness as well as
clean water and sanitation facilities. The flood destroyed 54.8% of
homes and caused 86.8% households to move, with 46.9% living
in an IDP camp. Lack of electricity increased from 18.8% to 32.9%
(p = 0.000), lack of toilet facilities from 29.0% to 40.4% (p=0.000).
Access to protected water remained unchanged (96.8%); however,
the sources changed (p=0.000) [41].
Since 2013, Tharparkar has been influenced by a drought‐like
circumstance affecting employments, nourishment and wellbeing
conditions. In south-eastern Sindh, low rain fall throughout 2016
in districts including Tharparkar, Umerkot and Sanghar sharply
reduced the cereal production also causes loss of small animals due
to diseases and severe shortages of fodder and water. Moreover, it
has aggravated food insecurity and caused acute malnutrition [42].
Poor Water Supply and Sanitation
USAID reported that in Pakistan about 60% of the total number
of child mortality cases are caused by water and sanitation-related
diseases. Pakistan Strategic Environmental Assessment of the
World Bank, 2006 stated that about 2,000 mgd of wastewater
is discharged to surface water bodies in Pakistan. 13,000 tons of
municipal waste daily generated in Karachi only, following 3,581 in
Hyderabad while 48 million tons a year around the country. Water
and sanitation sector have the highest financial cost to Pakistan
from environmental degradation at Rs112bn a year as reported
by WB. This is based on health cost of only diarrhea and typhoid
and accounts for 1.81 per cent of the GDP. While figures for Sindh
are not available. According to the media (The news) “More than
50 per cent of the people were suffering from diseases related to
water and sanitation due to the lack of proper sanitation in the
Sindh province” speakers told on‘ World Toilet Day with the 2018
theme ‘Toilets and Nature, the Pathway to Neat and Clean Sindh’.
In Karachi, 42 percent of the city’s total population have no access
to a proper toilet and appropriate sanitation system and live in
539 slums. Furthermore, Karachi Metropolitan Corporation and
Cantonment boards have public toilets at only 13 places.
Poor Water Management
According to Rubina Jaffri, the general manager of Health
and Nutrition Development Society (Hands), only 440 MGD is
being filtered out of 640 MGD of water supplied to Karachiat
seven filtration plants. A recent survey accounted that 40% water
samples collected from different parts of Karachi were not properly
chlorinated. In Karachi, long transmission route also causes
leakages and water thefts problems which account for the loss
of almost 30% of the city’s water supply, said by Jawed Shamim,
former chief engineer at KWSB (The Karachi Water and Sewerage
Board).Moreover, Parallel water supply and sewage pipes currently
lead to cross contamination and corrosion. Chief Minister Syed
Murad Ali Shah, in Sindh there were 2,109 water filtration plants,
including 1,620 RO plants, and 818 of them were non-functional.
He also added that there were 5,091 water supply and drainage
schemes and 2,494 of them were non-functional and 244 of them
had been abandoned (PPI).
Agriculture sector consumes up to 90% of the available fresh
water of the country. About 70% of the canal water is lost from river
to the end user. The larger portion of canal water (35%) is wasted
at field level which needs proper attention of the policy makers.
furthermore, 30 MAF is equal to 10 trillion gallons which can feed a
population of more than 500 million people has been dumped into
Arabian sea instead of storage. Problem is the absence of efficient
conservation, storage and usage of water [43-50].
Recommendations
a) Basic filtrations units and 24 hours water quality
monitoring stations should be established
b) Proper usage, efficient storage and conservation strategies
are utmost practices to deal with water scarcity problem
c) Rearranging of water supply line to deal mixing of
municipal sewage into water supply
d) Latest and technical irrigation strategies to use water
efficiently such as drip irrigation and sprinkling.
e) Proper waste management system and treatment of
industrial effluent should strictly implement
f) Institutional capacity management in order to operate
and maintain the water supply schemes
g) Proper design of water distribution network to deal with
the water loss.
h) Education on the water conservation and utilization
practice should be provided to people by arranging seminars
and utilizing media
i) Water thief and corrupted people should be deal according
to law and regulations
j) Construction of new water reservoirs and proper check in
balance on old ones to enhance storage capability by resolving
siltation problem
k) Encouragement of new polices and proper implementation
as well as check in balance
l) Awareness campaign should be encouraged about water
quality and water borne disease
m) Basic health care and relief facilities should be provided
at doorsteps when needed to reduce death related to water
borne disease
n) Involvement of community to reduce water pollution by
providing basic knowledge and changing lifestyle.
o) Proper check in balance on water filtration plants to
provide safe drinking water to communities.
p) Mitigation strategies to improve the response to climate
change-induced effects on health and agriculture
Conclusion
Conclusively, water quality status of Sindh Pakistan has been
reviewed. Most of the water in different areas of the province is
contaminated with bacteria which causes outbreak of waterborne
disease including, diarrhea, cholera, hepatitis and typhoid in many
cities and caused millions of deaths simultaneously. Arsenic is
the second hazardous chemical found in water of Sindh mostly
in coastal areas. Fluoride and nitrite are other metal which pose
threat to human lives in Sindh Pakistan. Thus, many policies have
been established and many schemes were organized by provincial
government to deal with the water crisis but still some gaps related
to implementation exist that needs to be executed. Moreover, new
reservoirs and flow distribution line should be constructed to deal
with water scarcity and water loss problem of the province.
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