Mohan Mba Project1

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Geographical Mapping of India with respect to

Water Borne Diseases

MBA Project(MBA699)

Submitted to Dr. Helferich

By MohanReddy Somanolla


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Table of Contents

Abstract

Introduction

Cholera

Typhoid

Diarrhea

Conclusion

Recommendations

Appendices


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Abstract

World population is facing a critical time dealing with water problems. Many developing and

under develop countries has issues related to water scarcity and water borne diseases which are

directly related to poor sanitation and lack of awareness among the people. India, in particular is

facing quite toil in dealing with this problem resulting in many deaths. In this present research

paper, an effort has been made to geographically map the water borne diseases in each and every

state of India. This will give an in depth analysis of the situation existing in each and every state

of India. Along with the conclusion, a set of recommendations has been made.

Key words: water problem, water borne diseases, India.


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Introduction

Worlds population has been increased three times in the 20th

century and with that the use of

water has raised to six fold. The entire world is facing a common problem of water.Worlds

population is expected to increase by 40-50% within the next fifty years coupled with growth in

industrialization and urbanization; demand for water has raised and making the safe drinking

water inaccessible (WorldWater Council, 2009). Although fresh waters availability in the world

is decreasing, todays water crisis is not about the scarcity but about the access of safe drinking

water. It is estimated that approximately out of eight people only one person has access to safe

drinking water, which accounts for around 884 million people did not have access to safe

drinking water. Every year 3.575 people around the world die from water borne diseases. Poor

people pay more money per liter of water than the wealthy people living the same cities.

Children around the globe die because of water borne diseases. Many children under five die

because of diarrhea, which remains to be second leading position. 1.5 million Children who are

under five are dying each year.Water borne diseases kill a child every 20 seconds. Developing

countries have more prevalent cases of diarrhea due to lack of safe drinking water and 90% of all

diarrheal diseases have caused deaths of children under 5 in developing countries (Water.org,

2008).

India has a problem of water scarcity and most of its water resources are being polluted over the

years and it requires a sustainable water management system. Indias population growth and

industrial growth has led to over exploitation, higher pollution and degradation in natural

resources. The population of India has been exceeded 1 billion and is expected to double by the

next twenty to forty years.With this the demand for water resources is continue to rise in the

future. Only 5% of the total water usage is devoted to domestic purpose like drinking and


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sanitation. The countrys per capita availability of the fresh water has been dropped and is

expected to drop further in the future resulting in more water stressed regions. Almost six of

twenty major river basins of the country has fell under the water scarcity threshold with five

more to be added to the list in the next three decades. The water problem in India poses a high

threat to health in the region. It is estimated that almost 0.5 to 1.5 million children will die of

diarrhea who are under 5 years of age. 0.7 Million people suffer from water borne diseases in

Maharashtra alone with 1000 die annually. Most of the ground water resources and almost 70%

of its surface water resources have been contaminated by organic and inorganic toxic pollutants

etc. Even most of these resources have been considered unfit for drinking and irrigation

purposes. Poor quality of water contributes to more water scarcity as most of it makes it

unavailable for any human usage. Most of the available river basins stretches are being polluted

and severity lies in the areas nearer to urban regions where there is high industrial growth. The

chemicals which are used in agriculture have been on the rise over the past decade in India which

contributed extremely to the pollution in surface and underground water resources (Development

Alternatives, 2010).

Indian population is effected by many water borne diseases because of the consumption of

unsafe drinking water. The most prominent of them all are diarrhea, cholera and typhoid. An

attempt has been done in order to map these diseases using an updated geographical information

system, so that one can have a clear picture of which state is mostly affected by which disease.

Geographical mapping is one of the most efficient methods of representing a complicated data

relating to a region. It shows the clear and precise picture about the region by taking some inputs

of data.


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Research Methodology

The Research methodology that has been employed for this particular research paper is

secondary research. All the information that has been used for this paper is entirely depended on

the journal articles, websites and governments sources. The data about the various diseases

relating to specific regions that has been used is deducted from the government websites for

geographical mapping of diseases. The deducted data has been inputted into an updated

geographical information system and the resulting picture has been used to explain the current

situation.

Cholera

Cholera is one of the water borne disease which is caused because of the consumption of

polluted water. It can even kill a person if the deceased person is left untreated. Estimation shows

that around 3-5 million were effected by cholera and 100,000 to 120,000 people dies each year.

Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with

the bacterium Vibrio Cholera ( (Health Topics, 2011). The main symptoms include watery

diarrhea and vomiting and the transmission of the disease is primarily through consuming

contaminated food and drinking water. Usually the symptoms start one to five days after the

transmission of the bacteria. If the disease is not treated in the early stage then the victim may

suffer from severe dehydration which might include electrolyte imbalances and the symptoms of

diarrhea include low blood pressure, wrinkled hands and a rapid pulse. Most persons infected

with Cholera do not become ill though the bacterium is present in them for 7 14 days and

nearly 80% of the cases are mild or of moderate intensity and only 20% of the cases are severe

which requires immediate care and proper medication.


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Cholera still remains a global threat and it has become one of the key factors of social

development and it poses even greater threat to developing countries where safe drinking water

and proper sanitation facilities are still not sophisticated. Almost every developing country faces

a cholera epidemic. In order to control the epidemics of cholera, WHO has established a task

force in the year 1992 with the aim to reduce mortality and morbidity, associated with the

disease and also to address the social and economic consequences of cholera.

Cholera in India

India, which comprises of 28 states and 7 union territories, has a total population of about

1.15 billion people. Nearly two-thirds of them live in rural areas, where only 28% of households

use piped drinking water and 26% of households have access to good sanitation. It is not

surprising that cholera continues to be an important public health problem in the country.

However, cholera cases are hugely underreported mainly because disease surveillance is limited,

laboratory capacity is inadequate, especially at peripheral health-care centres, and authorities are

reluctant to acknowledge, for fear of societal repercussion, that there has been a breakdown in

sanitation and in the supply of safe water. Yet the above-cited reasons for poor case reporting

appear to apply to cholera exclusively. Acute diarrhoeal diseases overall are also underreported,

but mainly on account of poor reporting by private health-care services. According toNational

health profile 2008, 11, 231039 cases of acute diarrhoea were recorded that year, but only 2680

were cholera cases and only one death was due to cholera ( (Nair, 2010).


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Analysis

The analysis has been conducted on the data available on all the 28 states and 7 union territories

in India from the time period 2001 2008. A total of 20,187 cases have been reported till the

period 2008 from all the above stated regions. Some of the states such as Maharashtra, Tamil

Nadu and Delhi reported very higher number of cholera cases and states such as Karnataka and

West Bengal reported higher number of cases. Maharashtra reported a total of 5249 cases from

the period 2001 2008, Tamil Nadu reported 5229 cases and Delhi reported 3999 cases. In most

of the states, from the period 2001 2008, there has been a decline in the number of reported

cases for cholera but for some states such as Andhra Pradesh andWest Bengal, there has been

increase in the number of cases reported for cholera and this scenario is alarming and

Government of India along with the support of state government and other voluntary

organizations has to control this scenario. The geographical mapping of India has been done with

respect to cholera disease and it can be viewed which is included in the Appendices. The severity

of disease is correlated with intensity of the colour. The darker the colour the greater is its effect

in that particular state.

The following table consists of the information regarding Cholera cases in India.

2001 2002 2003 2004 2005 2006 2007 2008 Total

States/UTs

Cases cases Cases cases cases cases cases cases

Andhra

Pradesh 2 8 111 35 165 20 80 153 574

ArunachalPradesh N.R . N.R . 0 0 0 N.R . 0 0

Assam N.R . N.R . N.R . 0 0 0 NR 0

Bihar N.R . N.R . N.R . 0 N.R . N.R . NR 0

Chhatisgarh N.R . 2 2 0 0 2 10 0 16

Goa 0 0 0 0 0 N.R . 38 0 38


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(Source: www.indianstat.com, ministry of Health, government of India)

Gujarat 88 74 68 79 80 100 66 50 605

Haryana 11 3 22 10 7 9 22 27 111

Himachal

Prade sh 6 0 5 0 2 1 0 0 14

Jammu &

Kashmir 0 0 0 0 0 0 0 0 0Jharkhand N.R . N.R . N.R . 0 0 N.R . NR 0

Karnataka 347 341 170 255 214 80 117 254 1778

Kerala 15 105 42 88 27 12 5 7 301

Madhya

Pradesh 4 1 49 11 2 0 1 14 82

Maharashtra 1100 587 1458 473 724 284 527 96 5249

Manipur 0 9 0 0 1 0 2 NR 12

Meghalaya 0 N.R . N.R . 0 0 0 0 0 0

Mizoram 0 0 0 0 0 0 0 0 0

Naga land 0 0 N.R . 0 0 0 0 0 0O rissa 32 0 0 0 0 0 35 NR 67

Punjab 16 43 96 171 15 24 11 12 388

Rajasthan 0 2 8 6 2 0 1 0 19

Sikkim 0 0 3 0 0 0 0 0 3

Tamil Nadu 1100 01426 404 1501 724 213 297 990 5229

Tripura 0 0 0 0 0 0 0 0 0

Uttar Pradesh N.R . 7 16 2 0 6 0 31

Uttaranchal 0 0 0 0 0 0 1 0 1

West Bengal 178 146 126 274 236 133 176 236 1505

Andaman & Nicobar 0 0 0 0 0 0 0 00

Chandigarh 6 47 26 25 9 9 28 15 165

Dadra &

NagarHaveli 0 0 0 0 0 0 0 00

Daman &

Diu 0 0 0 0 0 0 0 0 0

Delhi 1273 661 296 01784 945 01052 01212 824 3999

Lakshadweep 0 0 0 0 0 0 0 0 0

Pondicherry 0 0 0 0 0 0 0 0 0


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Typhoid

Typhoid is considered to be the most communicable diseases in India and it is fifth most

communicable disease in India (Typhoid, 2010). It is very severe and life threatening disease. It

is one of the major causes of children deaths in India. Typhoid effected people show symptoms

of high fever with severe complications like persistent head ache, abdominal discomfort, nasal

bleeding etc. It is so severe disease if not diagnosed properly will result in mortality too

(Typhoid: most common communicable disease in India, 2010).

States 1998 1999 2000 2001 2003 2005 2006 2007 2008 2009 total

Andhra Pradesh 36 70 72 17 49 4 12 18 17 7 302

Arunacha l P rade sh NR NR NR NR 12 NR 23 NR 1 20 56

Assam 0 NR NR NR nr NR NR 7 75 0 82

Bihar NR NR NR NR nr NR NR NR NR NR 0

Chhattisgarh 0 0 0 NR nr NR 6 0 0 511

Goa 0 0 0 0 0 0 0 0 1 0 1

Gujarat 7 0 7 2 0 0 0 1 0 1 18Haryana 1 6 3 7 1 3 4 0 1 31 57

Himachal Pradesh 5 1 1 2 0 2 5 0 2 4 22

Jammu Division NR 0 0 0 0 0 0 0 0 0 0

Kashmir Division 0 0 0 0 0 0 0 0 0 0

Jharkhand 0 0 0 - NR nr - NR 284 0 5 5 294

Karnataka 54 41 84 292 191 77 5 4 16 11 775

Kerala 2 6 4 6 3 0 2 4 5 2 34

Madhya Pradesh 47 9 10 7 10 5 29 38 37 39 231

Maharashtra 32 16 12 7 24 1 8 14 8 12 134

Manipur 0 5 1 0 0 1 2 1 1 2 13

Meghalaya 0 3 1 1 3 4 1 0 0 0 13

Mizoram 0 1 3 6 4 1 2 6 9 4 36

Nagaland 3 0 0 0 0 1 0 5 0 09

O rissa 23 65 22 18 42 3 9 22 32 33 269

Punjab 1 4 0 5 5 2 3 6 4 1 31

Rajasthan 14 4 29 20 10 1 131 0 8 0 217


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Analysis

Typhoid has been a great threat in India over the years. Many people have been affected by

typhoid in India. The following statistics has been taken from Indian government sources. The

analysis of the below statistics clears shows that in India, the state Karnataka has been worst

effected and has taken the first position for worst effected state followed by Delhi andWest

Bengal in second and third position. These three states can be categorized as the most affected

states in India by typhoid. The moderately affected states as compared to worst states include

Uttar Pradesh, Andhra Pradesh, Jharkhand, Orissa etc., and there are some states which are very

least affected. Graph C (Appendices) will show a clear and precise picture of the situation

existing in India for typhoid. The geographical mapping of India has been done with respect to

typhoid disease and it can be viewed which is included in the Appendices. The severity of

disease is correlated with intensity of the colour. The darker the colour the greater is its effect in

that particular state.

The following table consists of the information regarding Typhoid cases in India.

Sikkim 0 0 0 0 0 0 2 0 0 0 2

Tamil Nadu 5 4 10 5 6 - NR 4 129 1 1 165

Tripura 0 0 2 2 16 8 21 4 4 1 58

Uttarakhand 0 0 0 - NR NR - NR 2 0 0 49 51

Uttar Pradesh 68 29 20 13 1 - NR 13 53 31 67 295

West Bengal 0 86 71 124 62 - NR 70 53 74 78 618

Andaman & NicobarIslands

0 1 0 0 1 0 0 0 0 0 2

Chandigarh NR 1 0 8 2 - NR 1 3 - NR NR 15

Dadar & Nagar 0 0 NR - NR 1 1 0 0 0 0 2

Daman & Diu 0 0 0 0 0 0 6 0 0 0 6

Delhi 7 26 44 63 395 2 18 24 32 47 658

Lakshadweep 0 0 0 0 0 0 0 0 0 0 0

Puducherry 0 0 0 1 1 0 1 1 2 1 7


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Diarrhea

Diarrhea is one of the dangerous diseases which are taunting the entire global population,

especially in developing countries like India. Causes and Symptoms of diarrhea are varied

resulting in many definitions for its illness. Infection is the major cause of diarrhea in developing

countries like India. Poor sanitation facilities, polluted water, no knowledge of the disease causes

diarrhea to spread in India. Improvement in these areas will prevent diarrhea spread drastically.

Mainly children suffer a great deal because of diarrhea. Diarrhea patients needed to be given

enough fluid to rehydrate them because diarrhea causes dehydration in patients resulting in their

deaths (http://www.faqs.org/nutrition/Diab-Em/Diarrhea.html).


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States/UTs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Total

Cases Death

s

Deat

hs

Deat

hs

Deat

hs

Deat

hs

Deat

hs

Deat

hs

Deat

hs

Deat

hs

Deat

hs

Death

s

Andhra Pradesh 386 174 77 305 116 248 113 198 16 94 1513

Arunachal Pradesh 0 0 0 9 - 16 - NR NR 2 7 32

Assam 0 0 0 0 20 144 - NR 193 745 NR 164Bihar 0 0 0 0 - - - NR NR - NR NR 0

Chhattisgarh 0 0 0 0 - - 06 11 37 11 11

Goa 1 0 1 0 0 0 - NR 0 1 0 2

Gujarat 22 82 34 28 10 15 4 3 2 3 201

Haryana 27 49 7 48 39 32 33 18 46 33 235

Himachal Pradesh 35 15 11 29 37 21 23 33 17 24 195

Jammu &KashmirDiv

3 21 10 27 16 2 32 0 4 5 84

Jharkhand 0 0 0 0 - 3 1 2 4 4 10

Karnataka 416 434 58 391 562 262 1274 66 84 73 2196Kerala 37 24 22 14 21 5 4 12 1 4 131

Madhya Pradesh 95 46 227 205 87 65 88 302 148 134 859

Maharashtra 67 59 20 88 57 38 6 199 401 39 368

Manipur 14 14 19 14 3 2 12 15 4 8 74

Meghalaya 16 43 25 27 23 56 30 10 39 24 214

Mizoram 8 11 21 14 9 10 19 11 41 17 90

Nag a land 3 0 0 0 0 0 0 6 0 0 9

Orissa 164 99 106 102 44 92 39 64 76 91 698

Punjab 27 86 28 211 58 33 58 84 31 38 481

Rajasthan 40 71 42 36 26 13 21 3 41 26 254Sikkim 28 8 3 5 2 1 8 9 3 6 73

Tamil Nadu 87 24 8 9 41 134 12 13 16 18 337

Tripura 16 22 23 38 30 41 47 19 39 33 242

Uttaranchal 0 0 0 0 33 4 6 18 29 70 142

Uttar Pradesh 118 56 4 39 1 125 45 137 107 151 601

West Bengal 1103 1280 1770 1635 1571 682 701 807 829 725 9595

Andaman

&Nicobar Islands

0 2 3 3 4 6 1 4 0 0 23

Chandigarh 13 13 10 31 8 - - NR 7 - NR NR 82

Dadra & NagarHaveli

0 0 8 9 22 6 4 3 1 0 53

Daman & Diu 0 0 0 0 0 0 06 0 0 0 0

Delhi 90 60 118 1382 79 88 85 70 86 107 2010

Lakshadweep 0 0 0 0 1 0 0 0 0 1 2

Pondicherry 37 36 15 10 19 0 0 11 15 16 148

2853 2729 2670 4709 2939 2144 164 34 1125 1762 21129


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Analysis

West Bengal is the only state that is being worst effected by Diarrhea. This state has several

economic and social problems. The sanitation situation is very bad. Most of the places have

drinking water mixed with sanitation water. It seems to be the reason behind its severity inWest

Bengal. The next most effected states are Karnataka, Delhi and Andhra Pradesh followed by

other states (Diarrhea, 2011). The poor sanitation facilities and lack of pure and clean drinking

water is the reason behind these deaths due to diarrhea in Indian states. It is clearly show in the

following table which consists of the actual data from the Indian government sources. Graph B

(Appendices) will give the clear view about the situation of diarrhea in India. The geographical

mapping of India has been done with respect to cholera disease and it can be viewed which is

included in the Appendices. The severity of disease is correlated with intensity of the colour. The

darker the colour the greater is its effect in that particular state.

The following table consists of the information regarding Diarrhoea cases in India.



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Conclusion

India is suffering from severe water crisis along with dangerous water borne diseases like

cholera, diarrhea and typhoid. Some of the Indian states are unable to provide the basic sanitation

facilities, pure drinking water to its citizens. The geographical mapping of India with respect to

water borne diseases has been done successfully. From the mapping, the paper can be concluded

by saying that although India is severely affected by the major water borne diseases like cholera,

diarrhea and typhoid, there are some states which are extremely affected and there are some

states which are moderately affected, with some states which are less affected by those diseases.

The paper concludes with the mapping of those diseases like cholera, diarrhea and typhoid for

India with an in-depth mapping with regards to each and every state. It even maps the intensity

of those diseases too. Finally, paper concludes with some recommendations directed towards

future scope of areas where local health groups and organizations should work to solve the

problem associated with these water borne diseases. Also the data regarding the water borne

diseases is consistent due to the lack of proper infrastructure and hence conclusions made in this

regard needs to highlight this fact.


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Recommendations

From the paper, it is recommended to implement bio-sand water filter in three phases in India. In

the first phase, target states like Delhi andWest Bengal which are extremely affected by water

borne diseases. In the second phase, target states like Tamil Nadu, Andhra Pradesh, Karnataka,

Madhya Pradesh and Uttar Pradesh. If bio-sand filters are successful in these states then it will

definitely remove about ninety percent of the threat due to water borne diseases in India. Finally,

the third phase would be much easier by implementing it in other remaining states. The main

reason for those worst affected states is that there are no good sanitation facilities, no knowledge

or awareness among the people about the diseases. If these things can be improved then its

severity will reduce to a great extent there by solving most of problems resulting in saving the

lives of many people. The Central and state governments needs to emphasize more on the

severely water borne disease affected states and health schemes to implement the requisite health

processes and proper infrastructure needs to be installed in those areas or states. Also it is

recommended to take the help of non-profitable organizations, governmental agencies and

charitable trusts to spread the importance of using safe drinking water and maintaining proper

sanitation facilities which could eradicate the effects of water borne diseases. Also, the data

available in India regarding water borne diseases is rather inconsistent as most of the places do

not have the efficient mechanism to identify and measure the impact of these water borne

diseases.Water borne disease cases are being identified mostly in rural areas and agencies need

to concentrate on these areas which lack proper infrastructure regarding drinking water and

sanitation facilities. So, it is highly recommended to organize awareness camps in and around

those places.


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References

Development Alternatives. (2010, December). Retrieved from www.devalt.org:

http://www.devalt.org/water/

Diarrhea. (2011, December). Retrieved from faqs.org: http://www.faqs.org/nutrition/Diab-

Em/Diarrhea.html

Health Topics. (2011). Retrieved January 2011, fromWorld Health Organization:

http://www.who.int/topics/cholera/en/

Nair, B. (2010). Cholera in India: An analysis of Reports.Bulletin of the World Health

Organization .

Typhoid. (2010, December). Retrieved from www.lakshdeep.com/typhoid.htm:

http://www.lakshdeep.com/typhoid.htm

Typhoid: most common communicable disease in India. (2010, December). Retrieved from

www.causeindia.com: http://www.causeindia.com/health/typhoid.php

Water.org. (2008). Retrieved from http://water.org/learn-about-the-water-crisis/facts/

WorldWater Council. (2009). Retrieved fromWorldWater Council Forum:

http://www.worldwatercouncil.org/index.php?id=25

Water borne diseases in India. (2008). Retrieved from

http://www.indiastat.com/table/health/16/others/17873/449232/data.aspx

Diarrhea. (2011, December). Retrieved from faqs.org: http://www.faqs.org/nutrition/Diab-

Em/Diarrhea.html


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Appendices: Graphs

Graphs A

Cholera:

Graph B

Diarrhea:


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Graph C

Typhoid:


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Geographical Mapping:

Typhoid:


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Diarrhea:


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Cholera:

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