Approximately 2.1 billion people in the world lack access to clean water. In 2016, 870 000 people died due to a lack of clean water and difficulties in practising good personal hygiene – most of the deaths were attributable to diarrhoeal disease. One of the UN’s Global Sustainable Development Goals is therefore access to clean water and sanitation.
Unrealistic water supply plans
In Kazakhstan – a former Soviet republic – 40 per cent of the population live in sparsely-populated rural areas where in many cases there are great distances between villages. During the period 1950–1980, the Soviet state built out a water supply system in an attempt to provide the entire rural population with drinking water. After the collapse of the Soviet Union in 1991, this supply system rapidly deteriorated and the expansion programme ceased.
“In 2011, Kazakhstan’s government set a target for 80 per cent of rural areas to have access to tap water from a central water supply system in 2020. However, that is not going to be possible”, says Kamshat Tussupova, researcher in the strategic research area, the Middle East in the Contemporary World (MECW).
A lack of current data and expertise
Kamshat Tussupova and her students have conducted surveys in rural Kazakhstan and observed that the statistics used as a basis for state planning did not reflect reality. Their studies show that most people in rural areas use water from their own boreholes or wells, and that some use water from open springs. Therefore, according to Kamshat Tussupova, the authorities need to find out the level of access to drinking water and sanitation services before planning starts on restoring or extending the water supply system. They also need to know if people are willing to accept and pay for a new system.
“The lack of correct data can also cause problems in work to improve public health”, says Kamshat Tussupova. “If, for instance, you want to look at water-related health problems, such as diarrhoeal disease, there is a risk that you draw the wrong conclusions if you presuppose that most inhabitants use clean water from the water supply system. Or if you don’t realise that those who use other water sources are not connected to a sanitation system either.”
“There is nothing wrong in using water from boreholes or wells as long as they are not polluted by sewage. Many people in rural areas are aware of the problem of pollutants. They want to protect their water sources and maintain their sanitation systems, but they don’t always know the best way to do it. There seems to be lack of local support and expertise”, says Kamshat Tussupova.
Training to focus on the practical side
There is clearly a need for expert advisors and for current data for decision-makers, as Kazakhstan’s government is now refocusing on initiatives for public health. Kamshat Tussupova and her colleagues at Lund University have therefore been asked to establish a university study programme on health promotion.
“Within the WHO sub-programmes, Health Promoting Schools and Health Promoting Universities, we will help to improve education in the health promotion field”, says Kamshat Tussupova, “and with this approach we will be able to train experts in various WHO sub-programmes.”
The study programme will be both research-based and practically oriented, with an emphasis on the practical side.
“The students will have the opportunity to carry out practical work in the newly-established programme for Health Promoting Schools and in the forthcoming sub-programme Healthy Workplaces.
Teaching and research are connected
Throughout the study programme in health promotion, students will also have the chance to participate in research within three areas, of which two are the WHO programmes mentioned above. Doctoral students will be able to conduct parts of their research within these areas and Master’s students will have the opportunity to carry out small, well-delimited research assignments under supervision.
The third area of research in which students can be involved is Kamshat Tussupova’s ongoing project WASH (Water Sanitation Hygiene) – a continuation of her previous work in Kazakhstan. Within this project, she is now working on the testing and introduction of an online system that will enable information on the water sources and sanitation services that people actually use to be entered directly via devices such as a tablet. In the future, individual water users could be able to enter any changes directly. This means that the supporting data for planning will be more up to date and accurate than in previous inventories.
“We have started to test the system in two rural areas and later we will continue in several regions”, says Kamshat Tussupova.
In the next step of her WASH programme, Kamshat Tussupova and her colleagues want to work with people in rural areas of Kazakhstan so that they, along with local villagers, mayors and state institutions, can agree on how to improve local water supply and sanitation systems.