Faeces as daily diet

The presence of faeces in what should be potable water in Lilongwe’s Area 18 residential estate has sparked national outrage; but that is nothing compared to the dirt The Nation has dug up.

A review of various studies conducted in Blantyre, Lilongwe and Mzuzu cities as well as some districts in the Southern Region—plus interviews with experts in water, sanitation and urban development—shows that the majority of Malawians drink water with high levels of faeces and other coliforms everyday nationwide.

In some study findings, the faecal contamination is at least a thousand times more than the levels the World Health Organisation (WHO) recommends as safe for human consumption and falls well below the modest standards that Malawi’s own Ministry of Agriculture, Irrigation and Water Development sets.

For the roughly 25 percent of the 17 million Malawians who have varying levels of access to piped water, contamination is through broken water board pipes along aged water systems that let in coliforms, which is waste mostly carrying disease-causing bacteria.

The toxic effluent comes from dilapidated sewer infrastructure as was the case in Area 18; pit latrines and open defaecation, among others and finds its way into piped water.

But the problem is worst in informal settlements such as Bangwe in Blantyre; Kauma in Lilongwe and Chibavi in Mzuzu—which are much poorer than the middle density Area 18 where sanitation and hygiene conditions are much better, residents there can afford piped water and its source as well as treatment are far more superior; although rural areas are exposed as well.

Moreover, of the 25 percent, only around three percentage points of the country’s population has piped water in their homes while the rest either share with others within a plot, get from kiosks and/or supplement with water from unsafe sources largely because most people are too poor to buy from kiosks every day.

For the remainder (around 75 percent)—who access water from shallow wells, boreholes, rivers, lakes, da

ms and springs, among other unsavory sources—the faecal contamination and other effluent is direct, according to experts.

More worrying, one study finds, is that in some of the water contamination-hit peri-urban areas, only 40 percent of respondents said they treat their water before drinking it.

This finding—says epidemiologist and public health specialist professor Adamson Muula—exposes people, especially the poor, to fatal diseases such as cholera and cancer.

At least 60 percent of Malawi’s urban population lives in peri-urban areas, which are basically informal settlements, according to official figures.

In his study titled Water and Sanitation in Urban Malawi: Can the Millennium Development Goals be met? conducted in 2009 in informal settlements in three cities, Mtafu Zeleza Manda finds that the water from shallow wells used for “bathing, washing clothes and plates” and, when there are dry taps, also for drinking, is heavily contaminated with faecal coliform (FC).

FCs mostly come from the gut and faeces of warm-blooded animals. An expanded version of coliforms is total coliform (TF), which includes bacteria that are found in the soil, in water that has been influenced by surface water, and in human or animal waste. But experts largely use FC for indication of animal or human waste.

WHO recommends that faecal coliform in consumption water be zero per 100 millilitre (ml), but Zeleza Manda’s findings are grim.

In Mzuzu, the study—conducted in Chibavi and Salisbury—found faecal streptococcus in water that in some cases were too numerous to count (TNTC)—meaning they were beyond measurement.

In Lilongwe, the study carried in Federation, Mgona and Mchesi finds water to have faecal streptococcus up to 1 900 per 100ml and in Blantyre the quality of water in a study conducted in Misesa, Chiwembe and Zingwangwa establishes faecal streptococcus of up to 120 per 100 ml.

Another study by Chikumbusko Chiziwa Kaonga, Christabel Kambala, Chikondi Mwendera and Theresa Mkandawire titled Water Quality Assessment in Bangwe Township to assess microbial contamination of water in boreholes and open wells showed that faecal coliform levels exceeding WHO and Malawi Bureau of Standards (MBS) safe standards are observed in 79 percent of all samples analysed.

“The results suggest that the quality of water in the villages often fails to meet one or more of WHO and MBS recommended safe levels as such, poses a potential risk to the health of those individuals living in such villages.

“The results reveal that faecal coliform counts for the water sources ranged from 2 to 1400 CFU/100mL.  The most contaminated water source was the open well at Mvula Market, which may be due to both market activities and also the number of people using the water source,” reads the report.

In a 2016 study by Messrs M. Pritchard, T. Mkandawire and J.G. O’Neill on biological, chemical, and physical drinking water quality from shallow wells in Malawi using Blantyre, Chiradzulu, and Mulanje districts as case studies, the results show that the drinking water quality is “very poor and grossly polluted with faecal matter”.

“From these results, it is very clear to see that the drinking water from the shallow wells tested in southern districts of Malawi, is grossly contaminated microbiologically, with this contamination becoming worse in the wet season. Microbiological water quality results show that the water is grossly polluted with faecal matter,” reads the study paper.

The study report says TC and faecal coliform and FC values in the wet season (February and April) are much higher than those in the dry season (August and October).

In terms of TC, the results show that approximately 80 percent of the shallow wells tested in the dry season and 100 percent of the wells in the wet season did not meet the drinking water temporary guidelines set by the Ministry of Water Development (MoWD) of a maximum of 50 TC/100ml for untreated water, which are more modest than WHO standards.

Yet, another study on the quality of drinking water and cholera prevalence in Ndirande Township done by John Kamanula, Omega Zambasa and Wellington Masamba finds that scarcity of safe drinking water is a big problem in the township. Consequently, establishes the study, residents use unsafe sources of drinking water other than the potable water provided by Blantyre Water Board (BWB).

The study establishes that only 15 percent of the respondents get water from BWB without supplementation from the other sources.

And four in 10 households do not treat the water through, for example, boiling.

“Forty percent of the respondents indicated that they did not treat their water before consumption,” reads the report from the study that was conducted in Makata, Chinseu, Golio, Safalao and Newlines in Ndirande Township between 2007 and 2008.

Jane Phiri, a mother of two who The Nation met at Ginnery Corner in Blantyre where she was selling tangerines and said she lives in the populous Ndirande Township, said it is expensive to boil water as she cannot afford to buy charcoal or firewood for the water treatment; let alone disinfectants such as Water Guard.

“Madziwo amaonekanso kuti ndioyera. [The water looks clean anyway],” she said. “Based on the results of this study, water from boreholes and shallow wells was heavily polluted with faecal matter, and therefore, not suitable for human consumption. Use of water disinfectants to treat well and borehole waters in the study area should be intensified.”

In the same Blantyre, a 2008 assessment of drinking water quality of Ntopwa Village in Bangwe Township corroborates the findings on people’s failure to treat contaminated water.

“People do not bother to treat the water because they think as long as the water is clear then it is safe to drink. Nonetheless, with the levels of biological contamination as indicated above, it shows that people who consume such water are prone to waterborne diseases once pathogens have been introduced into the water supply,” noted the study by T. Mkandawire and E. Banda of The Polytechnic’s Engineering Department.

Other experts reinforced the findings of the researchers during separate interviews with The Nation.

Tip of the iceberg

Environmental resource management specialist at the Lilongwe University of Agriculture and Natural Resources (Luanar) Dr Wilfred Kadewa observed in an interview that the Area 18 issue was a case of seepage from broken sewer-lines contaminating treated potable water in clean water pipes.

But he added that the Area 18 problem—which he said was one of management and not of treatment—is just a tip of the iceberg as the problem is also in Blantyre and other cities with sewer lines.

“The problem in my opinion is two-fold; firstly, you have the general public throwing solid waste into open sewerage man-holes, which blocks the sewer pipes, causing the sewage to infiltrate the surrounding environment underground or even overland. This may have resulted in the sewage getting into clean water pipes through broken or weak/worn out pipes.

“Therefore, in my opinion, this is not a Lilongwe Water Board treatment problem, but a case of lack of maintenance and timely replacement of pipes for both clean water and sewage waste. Lilongwe Water  Board treat their water to potable quality standards and they have stations where they check by collecting samples, but once the water leaves these check points going into users’ premises, there may not be much that can be done, and this is where the Area 18 problem fits into the puzzle,” he explained.

But Kadewa said what is worsening the problem is “a lot of unregulated construction activities going on in the cities”, where people digging and clearing sites may end up damaging pipes.

And the fact that sometimes people do not even report these incidences to the authorities, leads to problems that Area 18 experienced, that is, cross-contamination.

“In this regard, the management of transmission/transportation of clean water and sewerage water may indeed be a tip of the iceberg,” he said.

Senior lecturer in environmental and sanitation studies at The Polytechnic in Blantyre, a constituent college of the University of Malawi (Unima), Khumbo Kalulu, noted that broken pipes pass through locations littered with broken sewer pipes, stagnant water from makeshift bathrooms and dirt from dumping sites, thereby increasing the probability of infiltration into piped water.

“On face value, piped water might look safe. However,  it has been observed that in the locations where piped water pipes pass through, there are a lot of broken water pipes that pass in dirty areas, increasing the risk of contamination,” he said

Kalulu added that there are several studies showing “a lot of contamination taking place due to constant pipe breakages as well as insufficient protection from the source”.

He noted that there is poor sanitation in the informal settlement areas, which, among others, is largely due to pit latrines, makeshift dumping sites and stagnant water dotting the areas.

Head of Physics and Biochemical Science Department at The Polytechnic, Chikumbusko Kaonga, added that vandalism and carelessness are the major cause of water contamination since broken water pipes are exposed to seepages.

He said due to low pressure in piped water, whenever there is a broken pipe, chances of water seeping into the piped line are high, saying normally whenever there is low pressure that is when infiltration takes place.

Public Health Risks

In an interview, Muula—a Professor of Epidemiology and Public Health at Unima’s College of Medicine in Blantyre—said people living in well-planned settlement zones with running water in individual homes and sanitation facilities are better off than those in informal settlements in terms of water-linked epidemics.

“I worry more about people who are continuously accessing unsafe water in the various neighbourhoods in the cities. There are people who rely on Lingadzi, Lilongwe, Mudi and Naperi rivers for their use. There should be a movement towards making safe water available to these people,” he said.

Muula noted that whenever there is a cholera outbreak in Blantyre, for example, it is Mgona, Senti, Mtsiriza, Makheta and parts of Nkolokoti, Mthandizi and parts of Bangwe that are affected.

He said the same can be said of intestinal worms and similar diseases, adding that the availability of safe latrines and toilets is not evenly distributed.