Transformative Education
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Let’s not forget water – a critical determinant of health

Let’s not forget water – a critical determinant of health By Patricia Gan

Today, there is already a wide recognition among health professionals and health sector organizations worldwide that health is multifactorial. Aside from the common understanding that patient health can be measured by physical standards, other dimensions such as emotional, intellectual, spiritual, and social factors should also be taken into account. Anything that affects these components of everyday life should therefore be a concern for health professionals and health students all over the world.

Following this logic, water, which plays a huge role in the maintenance of a person’s health, should also receive adequate attention from the health sector. Water is a powerful underlying dynamic that can affect a person at different levels and in various degrees. As health students, we know that the human body is made up of 2/3 water. The basic functioning of body systems can either be disrupted or improved by water. Different disease conditions that we as health professionals need to deal with inside the clinic are related to water in one way or another, whether be it an infectious water-borne diarrheal disease or dehydration due to low consumption of this vital resource.

In addition, an environment with guaranteed access to clean water improves people’s lives on a larger scale. Potable water does not only ensure protection from certain diseases and improve people’s physical bodies, but it also uplifts a person’s mood, which can lead to a huge increase in satisfaction of society as a whole. Neighborhoods can become cleaner with water, making them more liveable and comfortable for citizens. Fresh water supply in homes, towns and cities is a source of pride for the community and preserves the dignity of its residents. Society benefits, thrives even, from clean, safe, and adequate water supply.

Water affects people in many ways, making it important for every health student to understand not just its physiology, but also the broader systems that interact with it – what we call the social determinants of health. Below are additional illustrations of these linkages:

1. Access to water can lead both to positive economic effects and increased stability in the community. A direct increase in economic return is observable with every increase in water investment. By reducing the death and sickness toll, improved water facilities can contribute to increased productivity of individuals and communities, therefore leading to huge economic benefits.

2. Available clean water can increase the quality of education. Fewer occurrences of water-borne diseases generally lead to less incidents of school absenteeism, providing students with more opportunities for learning. Such improvements in community literacy also contributes to advancements in workforce productivity in the long term.

3. Ecological systems necessitate the constant availability and high quality of water. The loss of clean water can affect trees and other natural elements that help sustain life on a daily basis. Water affected by man-made pollution, for instance the occurrence of acid rain, may lead to loss of trees, damage in infrastructure, and eventually harm to people’s lives.

4. Livelihood, which offers sustenance and security to people, can also greatly suffer when clean water is unavailable. Industries that directly rely on water, such as fisheries and agriculture, will be the first to suffer. From there, other employees and workplaces that rely on their output would experience detrimental effects.

Last June, I was fortunate to attendthe 2015 Children’s WASH Forum in Tajikistan. From there I learned all these interconnections between water, health, and society. I also learned a new acronym - ‘WASH’ - which stands for ‘Water, Sanitation, and Hygiene.’ I found out that addressing WASH is so critical in global development, and that is why a high-level meeting of the United Nations such as this one needs to happen.

As a health student, I learned many things that I never thought would matter to my future career as a doctor. I realized that everything I learned about water cannot be considered separately from the people that every health student aspires to care for. From the conference, I discovered the importance of water conservation and sustainability. Without water, the mere delivery of basic health services cannot be accomplished. The importance of water also becomes more illuminated in disaster situations, which my country, the Philippines, has to repeatedly endure in an era of climate change.

I became aware of how every component of the world - including water - can make a huge impact on human health. I can honestly say that I, as a student, can be a far more effective health worker if I understood how water works not just in the human body but in the broader ecosystem. Unfortunately, many health students fail to realize that diseases can be caused by society and the surrounding environment as much as they can be caused by bacteria or virus. We must understand that treating a patient and yet having them return to the same conditions is a deadly cycle. As health students, our goal is not simply to cure diseases, but to eradicate the ‘causes of the causes’ that lie in the social and environmental conditions in which people live and thrive– and this includes examining water –a critical determinant of health.

In his text Air, Water, and Spaces, Hippocrates, the Father of Medicine, reminded students of medicine: “Whoever would study medicine right must learn of the following subjects. First he must consider the effect of the seasons of the year and the differences between them. Secondly he must study the warm and the cold winds, both those which are in common to every country and those peculiar to a particular locality. Lastly, the effect of water on health must not be forgotten.” As health professionals in training, let us not forget this commandment – especially the last one.

I thank Dr. Renzo Guinto for his invaluable inputs, feedback, and mentorship.

About the Author

Patricia Gan is a first year medical student of the University of the Philippines Manila under its accelerated 7-year Integrated Liberal Arts and Medicine (INTARMED) Program. She is one of the two Filipino youth who participated in the Children’s WASH Forum held last June 6-8, 2015 in Dushanbe, Tajikistan as part of the High Level International Conference on the Implementation of the International Decade for Action “Water for Life” 2005 – 2015. She enjoys sports and is currently a proud member of the Medical Student’s Society and the Indayog Dance Varsity.