Recovery after drought in MDA : protecting Health

1
Recovery after drought in MDA protecting Health

• Ion Salaru,
• National Centre for Preventive Medicine,
• MoH MDA

2
Introduction

• MDA is a small country in SEE, size 33,7
  thousands sq. km, 4,1 millions inhabitants,
  divided into 4 municipalities, incl. capital
  Chisinau, and 40 districts. Two main water basins
  - transboundary rivers Dniester and Prut
  (Danube). For drinking water supply are used 4
  water intakes at r. Dniester, 7 at r. Prut,
  supplying 30 of general population, According to
  the data from the Ministry of Health, 3315
  artesian wells, 116.000 shallow wells and 804 DWS
  systems are in use.
• Up to 45 of the general population without
  access to safe water sources, rural population
  75.
• 55 of the population has connection to DWS
  systems 85 urban, 25 rural. Access to improved
  sanitation systems 42 - 67 in urban and 10 in
  rural locations
• Water management authorities National Water
  Agency and 2 basin agencies under construction.

3
Drought effects

• During last 2 years (2006-2007) MDA was affected
  by severe drought, comparable with registered in
  1946-1947 one. The periods with heat waves with
  canicular temperature (gt35oC) became longer 14
  days (7 consecutive) in 2006 and 17 days (10
  consecutive) in 2007 during July and August.
  Drought effects in DW supply sector were more
  pronounced in 2007, when the average annual
  temperature was higher with 2,50C than as usual.
  (Source-Hydrometeo Service).
• Water debt decreased in more that 80 of shallow
  wells form average 3-4 m3 to 1-1,5 m3.
• Totally dried over 15 of shallow wells because
  less precipitations and increased water
  consumption for hygiene and agricultural needs
• Increased water demand up to 50-60 in Chisinau,
  where the daily water consumption increase from
  200-220 th. m3/day to 300 th. m3/day.

4
Drought Health effects

• In 2006-2007 were reported 3 WBD outbreaks with
  Shigellosis 2 in rural area with 25
  (contaminated water in shallow wells) and
  respectively 138 cases (contaminated water in
  storage reservoirs) and one in urban with 80
  cases.
• The incidence rate of diarrhoeal increased from
  368 cases per 100.000 populations in 2005 and 440
  cases in 2007 (Source Annual reports of the
  sanitary-epidemiological situation,
  www.sanepid.md).
• More than 20.000 calls to emergency units during
  heat-waves in 2007 mainly because of
  cardiovascular problems.

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Drought and heat waves health risks

• Detection of E.coli in water samples from shallow
  wells during summer 2007 increase to 45-60 in
  rural areas from average value of 30 .
• Surface water quality of non-complying water
  samples on microbial parameters increase from 24
  in 2002 to 46 in 2007 in Dniester river and from
  33 to 45 on r. Prut. Main causes discharges
  with untreated waste waters and decreased self
  purification process of rivers
• Bathing waters no single national recreational
  cites allowed for bathing purposes (from 8
  existing) during summer 2007 because of poor
  microbial quality.

6
Drought economical effects

• Calculated by the Government up to 1 bn USD,
• Water scarcity produce high negative impact on
  food production which affect national food
  security.
• Economical loses of fisheries because of changes
  in aquatic ecology increased water temperature,
  decreased O2 content in many lakes - lower than
  1mgO2/l, what cause dramatic decrease of aquatic
  population in many artificial lakes.
• Local tourism affected.

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Recovery measures - operational

• Hydrometeo issues alerts of EWE to MoH and to
  other authorities.
• Water delivery organized for to the most affected
  locations,
• Developed infrastructure during 2007 ware built
  70 DWS systems and 16 sanitation systems, which
  offer access to safe water sources for 100.000
  population.
• Rehabilitation of 6 irrigation systems under Food
  Security Programme.
• Increased monitoring frequency for drinking
  waters in rural areas from 1x3monts to once per
  month during summer for bathing waters from
  once per month to 1x10 days.
• Public information campaign through mass media,
  also locally on the wells and in near to
  recreational sites posted information about water
  quality and warning on possible health effects.

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Recovery measures - tactical

• Developing infrastructure - by GD 662 on 13.06.07
  approved National Strategy for drinking water
  supply and sanitation -provides better water
  management, reforms and capacity building in
  water sector.
• Initiated National Policy Dialogue on IWRM.
• Developed and approved by the Ministry of Health
  a guidebook for the general public on preventing
  and reducing impact of heat waves.
• Action Plan for implementing IHR in MDA, approved
  by Governmental Decision in April 2008
  framework for managing health security treats.
• Development and implementation of Water Safety
  Plans in pilot locations, to be extended to the
  whole territory

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Recovery measures - Strategic

• By the Climate Change Office at the Ministry of
  Ecology and Natural Resources developed a Climate
  scenario for the next 25-50 years. According to
  this scenario, in Moldova slowly will increase
  the quantity of precipitations but also will
  increase temperature more rapidly, which will
  maintain risk of water shortage (hydrothermic
  index will increase).
• Harmonization of national legislation Sanitary
  norms on drinking water quality adopted in 2007
  contain specific requirements for DWS in
  emergencies, also drafted Water Law, National
  norms for small and very small drinking water
  supply systems, Sanitary norms on Drinking Water
  Quality surveillance - contain a chapter on
  acting in the case of EWE.

10
Recovery measures - Strategic

• Under development a new Health Information System
  capable to count health impact because of EWE,
  with daily evidence on mortality rate and
  hospital admissions related to climate change
  health impact (CVD, RD).
• Institutional framework - drafted GD for
  transforming Sanitary Epidemiological Service
  into Public Health Authority, responsible for
  designing strategies and measures to prevent and
  reduce health impact related to EWE.

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Weaknesses

• No Health Crisis coordination unit in the MoH
  no budget for preparedness.
• No overall leadership of the health sector at
  district level for planning and during crisis
  situation (many vertical health systems).
• Local public authorities are not enough prepared
  to respond to this new situation.
• More special actions are necessary.

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More actions to be taken

• To find commitment at the national level between
  responsible authorities to act jointly in the
  case of EWE.
• To establish a modern Early Warning System for
  EWE.
• To finalize Urban Development Plan for National
  Territory, taking into account Climate Change
  aspects.