Attached

Whether pharmacists can contribute

to public health promotion?

January 18-31, 2002

　

Afghan refugee support advance troop of the Japanese Pharmacists

The Ordinary of Japan Pharmaceutical Association

Yozo Machida

Fumihiko Takemasa

Masaru Sakamoto

Investigation of water in Afghan refugees camps

�T Purpose and Significance

This time we examined the well water of Afghan refugees camps, because we, as pharmacists just wondered whether refugees could use safely water.

Pharmacists have big relation to water. We need water when we take medicine. There is no human race between Japanese and Pakistan for needs of water.

And weal is more to do hygienic life we can’t do that without water for washing hands, taking a bath and gargling. Pharmacists take part in such management of hygiene. Activity of school pharmacists in Japan is just like typical example.

We never eradicate (infections) nor troubles in gastro-intestines if they continue to use in sanitary water. To let them use unsanitary well water freely, hard treatments make nonsense. It is not too much to say that is same actions as sprinkling gasoline when extinguish a fire.

On the other hand, the photojournalist Mr. Kubota and others said that the present condition of refugees camps is the shortage of water that need to live that was caused by big brought. Are there any reasons for refugees to use such somehow insanitation limited riverhead?

Then, we first tried to understand the present condition, and we thought that our next duty is that base on, date that we gathered, we should do real investigation or give a concrete that we can improve soon.

In such country that has customs “Digging a well become independent”, it is not easy for alien to improve the condition of water. But we can’t go through without water problems if we try to support refugees with our pharmacist’s speciality.

�U Object of investigation

basic test (water temperature, appearance, smell, pH, COD, chloride ions)

heavy metal test (Fe, As, hardness)

pollution test (nitrous acid, phosphoric acid)

bacteria test (standard plate count, coliform group bacterial count)

We investigated those above all 13 items in several sources.

�V implements regent

・         thermo-hygrometer（ＦＪ−３２２２）

・         thermometer（−２０〜＋５０℃）（ＦＩ−３２３２）

・         ｐＨ meter（iuchi pH Scan1）

・         timer

・         counter

・         paper caps　10-30ml 100sets

・         pure water 1000ｍｌ

・         polyethylene syringe（ＦＩ−１１５０）

・         ＰＰ bottle（２５０ｍｌ）（ＦＧ−４９１６）

・         transparency meter （ＦＩ−３６４８）

・         disposable body warm　 for ３０times use

・         tweezers

Simple investigation tool of water and handy bacterial detection for each item

■　basic test

ＣＯＤ 100sets（ＦＫ−３３８５、ＦＫ−３３８６）

residual chlorine　100sets （ＦＫ−３３７２）

■　heavy metal test

Fe　120sets（ＦＫ−３３７７）

As　105sets（ＦＫ−３４００）

Hardness 100sets（ＦＫ−３３９９）

■　pollution test

NO2　１００sets（ＦＫ−３３７９）

PO3　105sets（ＦＫ−３３８８）

■　bacteria test（Central KAGAKU co,ltd）

standard plate count 100sets（ＦＬ−０３１３）

coliform group bacterial count 100sets(ＦＬ−０３１１)

�W　the method of operation

To against misunderstanding of local refugees, we operated shared water in accommodation where we stayed.

�@ standard test of pack test

1.         Sub divide collected water into paper caps

2.         Make a hole with a needle to pack test, and sucked necessary quantity in pack. To bring many needles into plane may cause many troubles. So, we checked with baggage.

3.         Seconds to minutes later. (various for tests)

4.         After leave them a definite time, color contrast. (c. f. check sheets)

5.        Examined above all items and write down on paper.

On that day if we can’t investigate collected water, we put them in cold and dark place.

�A　standard metal of bacillus exam

1.         Suck up a few ml of collected samples with syringe, powered in pack. (Dilute samples in necessary)

2.         Soak the test paper in sample for 3 seconds, and put the paper back.

3.         Cultivate for 24 hours on disposable body warm.

4.         Counts the number of spot by counter and decide.

5.        Convert in colony/1ml, and write down on paper

�X Result of investigation

Situation of collected place

Sample No.1

 UNHCR Koki refugees camps (3500ft). Pump up water from under 100m and store in tank. Tanked water.

Sample No.2

 New Jalozai camps. A little bit slimy water. We couldn’t confirm other well.

Sample No.3

 Chaman refugees camps.

Sample No.4

 UNHCR local office in Chaman refugees camps. Collected in water for washing.

Sample No.5

 Muhammed Kheil refugees camps. (4300ft) Collected well water which has manual pump. That well is comparative new well that you can count the number of usable on the hand.

Sample No.6

 Muhammed kheil refugees camps (v135) well water. This is the well that has only hole. To against for children falling, it has mud wall around us are dropping into well on and on. We can find feces pallet around here.

*In Muhammed Kheil refugees camps. There are 460 shallow wells, but only 4 wells are using. In this camps 42000 refugees are living in 20 k�u area nowadays. And every 500 families are immigrating into these camps.

Sample No		1	2	3
ＤＡＴＥ		22-Jan	23-Jan	26-Jan
Appearance
Odor
pH Value	pH	７．９〜８．１	７．９〜８．０	７．８〜８．０
Chloride ions	ppm	０．２〜０．４	0	0
Iron	ppm	０．５〜１．０	０．５〜１．０	0
Calcium,Magnesium,etc.(Hardness)	ppm	２００〜	２００〜	２００〜
Arsenic	ppm	0	0	0
Nitrites	ppm	0	０．０２〜０．０５	0
Phosphoric acid	ppm	0.2	0.2	0
Standard Plate Count		after２４h　ー	after２４h　+	after２４h　+
Coliform Group Bacterial Count		after２４h　ー	after２４h　+	after２４h　+
Organic Substances(Consumption of Potassium Permanganate)	ppm	10	５０〜１００	ー
Organic Substances(Consumption of Potassium Permanganate)	ppm	ー	ー	0
Sample No		4	5	6
ＤＡＴＥ		26-Jan	28-Jan	28-Jan
Appearance				Sand mingled
Odor			Smell a little	Mud smelling
pH Value	pH	８．４〜８．５	9.7	8.3
Chloride ions	ppm	0	0	0
Iron	ppm	0.2	0	0.2
Calcium,Magnesium,etc.(Hardness)	ppm	２００〜	２００〜	２００〜
Arsenic	ppm	0	0	0
Nitrites	ppm	0	0.2	０．０２〜０．０５
Phosphoric acid	ppm	0.2	0	0
Standard Plate Count		after２４h ＋	after２４h　ー	after２４h　+
Coliform Group Bacterial Count		after２４h　ー	after２４h　＋	after２４h　+
Organic Substances(Consumption of Potassium Permanganate)	ppm	ー	ー	ー
Organic Substances(Consumption of Potassium Permanganate)	ppm	2	２〜４	6

�Y Consideration.

 From the above results the water that local refugees are using have various problems.

Problems of well water.

�@ The organization is not established to examine the condition of bacteria and dirt pollution periodically.

�A Chlorination doesn’t act regularly. (Sample No.1.After pumped up water and at the time when stock in tank, the chlorination seems to have been done.)

�B Sort age of manpower to maintain safety well water.

Problems of well structure.

�@ Some well have prevention of falling but most are the well which doesn’t have a cover.

�AFor dry up well to cover over is the ideal way, but consider for reclaim, they are leaved    

  as it is.

 For example, when we compared with Japan running water standard, only Sample 1 is conformed. (N.B. COD is the index for uniform drainage standard, daily life surrounding items but not for running water standard).To sample 4.We thought that is disqualified because we could identify the general bacteria but we couldn’t fix quantity.

Now in this phase if it is possible to remove bacteria (disinfections) it may possible to use for drinking

We detected nitrous acid in sample2､sample6.and also detected bacteria､this may happen because of dirt mixture

This time we collected water in January that is comparatively less season that infections are out break but in Summer days we may consider of possibility for infections of corpse of small animals､feces mixture if this control of well water will have continued

We also consider that when we take this preventive measures we can reflect for decreasing amount of use to chronic shortage of antibiotics

�Z Proposal

�@    To prevent spread of infection It may consider that its necessary to ｢Structure of well water safety control system｣ at that time､pharmacists have to take part in professional leader and they try to feed back the result for refugees

�A    We need to control the condition of water for condition of health and hygiene to each alien stuffs that participate to help activities of refugees

�[　Remark

●     We didn’t use paper cups, tweezers, and syringes for implements of exam.

●     At this time, condition of cultivate were bad we could only detection and not quantitative analysis of bacteria.

●     We need to prepare the thermostat to preserve sample next time when we do the quantitative analysis.

(This time we cultivated in hip pockets, we had the reaction but the sample didn’t fix. That’s why we couldn’t quantitative analysis.)