發(fā)展中國家中的家用水處理和安全的存儲選擇:對目前執(zhí)行實踐的一個回顧中英文翻譯、外文文獻翻譯、外文翻譯_第1頁
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外文資料theUnitedNations’InternationalDrinkingWaterSupplyandSanitationDecade(1981–1990)failedtoachieveitsgoalofuniversalaccesstosafedrinkingwaterandsanitationby1990(WorldHealthOrganization[WHO],2003).Eventhoughservicelevelsrosebymorethan10percentduringthedecade,1.1billionpeoplestilllackedaccesstoimprovedwatersupplies,and2.4billionpeoplewerewithoutadequatesanitation,in1990(WHO/UNICEF,2000).Reasonscitedforthedecade’sfailureincludepopulationgrowth,fundinglimitations,inadequateoperationandmaintenance,andcontinuationofatraditional“businessasusual”approach(WHO/UNICEF,1992).TheworldisonscheduletomeettheMillenniumDevelopmentGoal(MDG),adoptedbytheUNGeneralAssemblyin2000andrevisedaftertheWorldSummitonSustainableDevelopmentinJohannesburg,to“halve,by2015,theproportionofpeoplewithoutsustainableaccesstosafedrinkingwaterandbasicsanitation”(WorldBankGroup,2004;WHO/UNICEF,2004).However,successstillleavesmorethan600millionpeoplewithoutaccesstosafewaterin2015(WHO/UNICEF,2000).Inaddition,althoughtheMDGtargetspecificallystatestheprovisionof“safe”drinkingwater,themetricusedtoassesstheMDGtargetistheprovisionofwaterfrom“improved”sources,suchasboreholesorhouseholdconnections,asitisdifficulttoassesswhetherwaterissafeatthehouseholdlevel(WHO/UNICEF,2004).Thus,manymorepeoplethanestimatedmaydrinkunsafewaterfromimprovedsources.HOUSEHOLDWATERTREATMENTANDSAFESTORAGEToovercomethedifficultiesinprovidingsafewaterandsanitationtothosewholackit,weneedtomoveawayfrom“businessasusual”andresearchnovelinterventionsandeffectiveimplementationstrategiesthatcanincreasetheadoptionoftechnologiesandimproveprospectsforsustainability.Despitegeneralsupportforwatersupplyandsanitation,themostappropriateandeffectiveinterventionsindevelopingcountriesaresubjecttosignificantdebate.Theweaklinksamongthewater,health,andfinancialsectorscouldbeimprovedbycommunicationprogramsemphasizinghealth1—aswellasmicro-andmacroeconomic—benefitsthatcouldbegained.Thenewfocusonnovelinterventionshasledresearcherstore-evaluatethedominantparadigmthathasguidedwaterandsanitationactivitiessincethe1980s.Aliteraturereviewof144studiesbyEsreyetal.(1991)representstheoldparadigm,concludingthatsanitationandhygieneeducationyieldgreaterreductionsindiarrhealdisease(36percentand33percent,respectively)thanwatersupplyorwaterqualityinterventions.2However,amorerecentmeta-analysiscommissionedbytheWorldBankcontradictedthesefindings,showingthathygieneeducationandwaterqualityimprovementsaremoreeffectiveatreducingtheincidenceofdiarrhealdisease(42percentand39percent,respectively)thansanitationprovisionandwatersupply(24percentand23percent,respectively)(Fewtrell&Colford,2004).Thediscrepancybetweenthesefindingscanbeattributedinparttoadifferenceininterventionmethodology.Esreyetal.(1991)reviewedstudiesthatlargelymeasuredtheimpactofwaterqualityimprovementsatthesource(i.e.,thewellheadorcommunitytap).Since1996,alargebodyofpublishedworkhasexaminedthehealthimpactofinterventionsthatimprovewaterqualityatthepointofusethroughhouseholdwatertreatmentandsafestorage(HWTS;Fewtrell&Colford,2004).Theserecentstudies—manyofthemrandomizedcontrolledinterventiontrials—havehighlightedtheroleofdrinkingwatercontaminationduringcollection,transport,andstorage(Clasen&Bastable,2003),andthehealthvalueofeffectiveHWTS(Clasenetal.,2004;Quicketal.,1999,2002;Conroyetal.,1999,2001;Relleretal.,2003).In2003,astheevidenceforthehealthbenefitsofHWTSmethodsgrew,institutionsfromacademia,government,NGOs,andtheprivatesectorformedtheInternationalNetworktoPromoteHouseholdWaterTreatmentandSafeStorage,housedattheWorldHealthOrganizationinGeneva,Switzerland.Itsstatedgoalis“tocontributetoasignificantreductioninwaterbornedisease,especiallyamongvulnerablepopulations,bypromotinghouseholdwatertreatmentandsafestorageasakeycomponentofwater,sanitation,andhygieneprogrammes”(WHO,2005).HWTSOPTIONSThisarticlesummarizesfiveofthemostcommonHWTSoptions—chlorination,filtration(biosandandceramic),solardisinfection,combinedfiltration/chlorination,andcombinedflocculation/chlorination—anddescribesimplementationstrategiesforeachoption.3Weidentifyimplementingorganizationsandthesuccesses,challenges,andobstaclestheyhaveencounteredintheirprojects.Weconsidersourcesoffundingandthepotentialtodistributeandsustaineachoptiononalargescale,andproposegoalsforfutureresearchandimplementation.Thisarticlefocusesonpoint-of-usedrinkingwatertreatmentandsafestorageoptions,whichcanacceleratethehealthgainsassociatedwithimprovedwateruntilthelonger-termgoalofuniversalaccesstopiped,treatedwaterisachieved.Bypreventingdisease,HWTSpracticescancontributetopovertyalleviationanddevelopment.Theirwidespreaduse,inconjunctionwithhygieneeducationandsanitation,couldsavemillionsoflivesuntiltheinfrastructuretoreliablydeliversafewatertotheentireworldpopulationhasbeencreated.WeuseaconsistentevaluationschemeforeachoftheHWTSoptionsdiscussed(seeTable1):1.DoestheHWTSoptionremoveorinactivateviral,bacterial,andparasiticpathogensinwaterinalaboratorysetting?;2.Inthefield,istheHWTSoptionacceptable,canitbeusedcorrectly,anddoesitreducediseaseamongusers?3.IstheHWTSoptionfeasibleatalargescale?Thesodiumhypochloritesolutionispackagedinabottlewithdirectionsinstructinguserstoaddonefullbottlecapofthesolutiontoclearwater(ortwocapstoturbidwater)inastandard-sizedstoragecontainer,agitate,andwait30minutesbeforedrinking.Infourrandomizedcontrolledtrials,theSWSreducedtheriskofdiarrhealdiseaseby44–84percent(Lubyetal.,2004;Quicketal.,1999,2002;Semenzaetal.,1998).AtconcentrationsusedinHWTSprograms,chlorineeffectivelyinactivatesbacteriaandsomeviruses(AmericanWaterWorksAssociation,1999);however,itisnoteffectiveatinactivatingsomeprotozoa,suchascryptosporidium.5InitialresearchshowswatertreatedwiththeSWSdoesnotexceedWHOguidelinesfordisinfectionby-products,whicharepotentiallycancer-causingagents(CDC,unpublisheddata).BecausetheconcentrationofthechlorinesolutionusedinSWSprogramsislow,theenvironmentalimpactsofthesolutionareminimal.Chlorination:ImplementationStrategiesSWSimplementationhasvariedaccordingtolocalpartnershipsandunderlyingsocialandeconomicconditions.Thedisinfectantsolutionhasbeendistributedatnationalandsubnationallevelsin13nationalandsubnationallevelsin13countriesthroughsocialmarketingcampaigns,inpartnershipwiththeNGOPopulationServicesInternational(PSI).InIndonesia,thesolutionisdistributedprimarilybyprivatesectorefforts,ledbyalocalmanufacturingcompany.Inseveralcountries—includingEcuador,Laos,Haiti,andNepal—theministriesofhealthorlocalNGOsruntheSWSprogramsatthecommunitylevel.InKabul,Afghanistan,theSWSisprovidedatnochargetopregnantwomenreceivingantenatalcare.TheSWShasalsobeendistributedfreeofchargeinanumberofdisasterareas,includingIndonesia,India,andMyanmarfollowingthe2004tsunami,andalsoinKenya,Bolivia,Haiti,Indonesia,andMadagascarafterothernaturaldisasters.WhenSWSprogramsareinplace,theproduct’sreadyavailabilitygreatlyfacilitatesemergencyresponse.TheCDChasdevelopedanimplementationmanualandprovidestechnicalassistancetoorganizationsimplementingSWSprojects(CDC,2001).SolarDisinfection:BenefitsandDrawbacksThebenefitsofSODISinclude:?Provenreductionofbacteria,viruses,andprotozoa;?Provenhealthimpact;?Acceptabilitytousersbecauseoftheminimalcosttotreatwater,easeofuse,andminimalchangeinwatertaste;and?Unlikelyrecontaminationbecausewaterisconsumeddirectlyfromthesmall,narrowneckedbottles(withcaps)inwhichitistreated.Thedrawbacksinclude:?Needtopretreatwaterthatappearsslightlydirty;8?Lowuseracceptabilitybecauseofthelimitedvolumeofwaterthatcanbetreatedatonetimeandthelengthoftimerequiredtotreatit;and?Requiresalargesupplyofintact,clean,andproperlysizedplasticbottles.SolarDisinfection:ImplementationStrategiesAsavirtuallyzero-costtechnology,SODISfacesmarketingconstraints.Since2001,localNGOsinsevencountriesinLatinAmerica—aswellasinUzbekistan,Pakistan,India,Nepal,SriLanka,Indonesia,andKenya—aredisseminatingSODISbytrainingandeducatingusersatthegrassrootslevel,providingtechnicalassistancetopartnerorganizations,lobbyingkeyplayers,andestablishinginformationnetworks.TheprogramhasbeenfundedbytheAVINAandSolaquaFoundations,privateandcorporatesponsors,andofficialdevelopmentassistance.TheprogramhasshownthatSODISisbestpromotedanddisseminatedbylocalinstitutionswithexperienceincommunityhealtheducation.Creatingawarenessoftheimportanceoftreatingdrinkingwaterandestablishingcorrespondingchangesinbehaviorrequiresalong-termtrainingapproachandrepeatedcontactwiththecommunity.TheSwissFederalInstituteforEnvironmentalScienceandTechnologyhasdevelopedanimplementationmanual,andprovidestechnicalassistancetoNGOsimplementingSODIS.Themethod,whichhasbeendisseminatedinmorethan20developingcountries,isregularlyappliedbymorethanonemillionusers.CeramicFiltration:ImplementationStrategiesPFPisaU.S.-basedNGOwhosemissionistobuildaninternationalnetworkofpottersconcernedwithpeaceandjusticeissues.PFPhelpspotterslearnappropriatetechnologiesandmarketingskillsthatimprovetheirlivelihoodsandsustaintheirenvironmentandculturaltraditions.Afterstaffmemberswereintroducedtotheceramicfilterdesign,PFPestablishedafilter-makingfactoryinManagua,Nicaragua.Fundingfortheprojectinitiallycamefromprivatedonations.Thefilterfactoryisnowaself-financedmicroenterpriseinNicaragua.NGOspayUS$10perfilter,andtransportthefiltersthemselvestoprojectlocations.From1999–2004,PFPmadeandsoldatotalof23,000filtersinNicaragua.PFPhasalsoestablishedfilter-makingfactoriesin12othercountries,contractedbyorganizationsthatprovidefundingfortechnicalassistanceandfactoryconstruction.Inthecurrentmodel,thefactorysellsfilterstoNGOs,whothenimplementawaterprogram.ThismodelisattractivetoNGOsbecausetheydonothavetoproducethefilters,butitsuffersfromalackofconsistenttrainingandeducationforboththeNGOimplementersandtheusers.Poorcleaningandmaintenanceofthefilteroftenleadstorecontaminationoffinishedwater(Lantagne,2001b).Toaddressthisissue,PFPisworkingwithcooperatingNGOstodevelop,implement,andevaluateaneducationalprogramthatincludessafestorage,properproceduresforcleaningthefilter,andfollow-upvisitstoensureproperusecontinuesandbrokenfiltersarereplaced.Thiseducationalcomponentiscriticalfortherealworldperformanceofthefiltertomatchitseffectivenessinthelaboratory,andtotestwhetherfiltersmadewithlocallyproducedmaterialswillpreventdiarrhea.BioSandFiltration:BenefitsandDrawbacksThebenefitsoftheBSFinclude:?Provenremovalofprotozoaandapproximately90percentofbacteria;?Highuseracceptabilityduetoeaseofuse,andimprovedlookandtasteofwater;?Producedfromlocallyavailablematerials;?One-timeinstallationwithfewmaintenancerequirements;and?Longlife.ThedrawbacksoftheBSFinclude:?Lowrateofvirusinactivation;?Lackofresidualprotectionandremovaloflessthan100percentofthebacteria,whichleadstorecontamination;?Thecurrentlackofstudiesprovinghealthimpact;and?Difficultyintransportandhighinitialcost,whichmakescalabilitymorechallenging.TheBSFhasbeenimplementedthroughtwomainstrategies.IntheNGOmodel,employedinCambodiaandothercountries,thecostofthefiltersissubsidized,andaNGOpromotestheuseoftheBSFinthecommunityandprovidesthefilters.Inthemicro-entrepreneurmodel,usedinKenyaandtheDominicanRepublic,localentrepreneursconstructtheBSF,receivetrainingandstart-upmaterials,andthendevelopmicro-enterprisestosellfilterswithintheircommunities.FUTUREWORKAlthoughmuchresearchhasbeencompletedonHWTSoptions,moreisneeded,including:?Healthimpactstudies:?OftheHWTSoptionsthatarewidelydistributedbuthavenotyetbeenproveneffectiveatreducingdisease;?Ofalarge-scalereal-worldproject,suchasoneofthenationalorsub-nationalPSISWSprojects;and?Investigationsoftheeconomicsofmovingtolarge-scaleprojects,includingcostanalysis,economicdemandassessment,andsustainability;and?DeterminationoftherelativeandabsoluteimpactofHWTSoptionsandotherwater,sanitation,andhygiene(WASH)interventions,andresearchinvestigatingoptimalcombinationsofHWTSandWASHinterventions.Inaddition,importantoperationalresearchquestionsremain,including:?WhatmotivatesuserstopurchaseanduseaHWTSoption?;?Whatarecurrentpurchase(use)andrepurchase(sustaineduse)ratesindifferentdemographic,socio-economic,andculturalgroups;andhowdothesecorrelatewithwaterbornediseaseprevalencerates?;?WhatisthehealthimpactofroutineversussporadicuseofHWTSoptionsinthehome?;?Whatareoptimalbehavior-changestrategiesforhygieneandsanitationpractices;andhowdowebestincorporatetheseintodifferentHWTSimplementationstrategies?;and?Whatarethemostsustainableandcosteffectivewaystoreachruralandremoteareas?Toaddresstheseresearchquestions,theHWTScommunityshouldcontinuetoworkwithacademicinstitutionsthatprovidetechnicalknowledgeandstudentlabor.TheUniversityofNorthCarolina,EmoryUniversity,MIT,JohnsHopkinsUniversity,andtheLondonSchoolofHygieneandTropicalMedicine,amongothers,haveexistingprogramsinpublichealthorengineeringdepartmentsthatresearchHWTSoptions.Thispathhasresultedinnumeroussuccesses,suchasithlonger-termendpointsinchildren,includinggrowth,cognitivedevelopment,andmortality.?Developmentofreal-term,practicalparametersandperformancemeasurestopredictsafetyofdrinkingwaterindevelopingcountries;?Investigationsoftheeconomicsofmovingtolarge-scaleprojects,includingcostanalysis,economicdemandassessment,andsustainability;and?DeterminationoftherelativeandabsoluteimpactofHWTSoptionsandotherwater,sanitation,andhygiene(WASH)interventions,andresearchinvestigatingoptimalcombinationsofHWTSandWASHinterventions.Inaddition,importantoperationalresearchquestionsremain,including:?WhatmotivatesuserstopurchaseanduseaHWTSoption?;?Whatarecurrentpurchase(use)andrepurchase(sustaineduse)ratesindifferentdemographic,socio-economic,andculturalgroups;andhowdothesecorrelatewithwaterbornediseaseprevalencerates?;?WhatisthehealthimpactofroutineversussporadicuseofHWTSoptionsinthehome?;?Whatareoptimalbehavior-changestrategiesforhygieneandsanitationpractices;andhowdowebestincorporatetheseintodifferentHWTSimplementationstrategies?;and?Whatarethemostsustainableandcosteffectivewaystoreachruralandremoteareas?Toaddresstheseresearchquestions,theHWTScommunityshouldcontinuetoworkwithacademicinstitutionsthatprovidetechnicalknowledgeandstudentlabor.TheUniversityofNorthCarolina,EmoryUniversity,MIT,JohnsHopkinsUniversity,andtheLondonSchoolofHygieneandTropicalMedicine,amongothers,haveexistingprogramsinpublichealthorengineeringdepartmentsthatresearchHWTSoptions.Thispathhasresultedinnumeroussuccesses,suchasthedevelopmentofacomputermodeltoascertainSODISappropriatenessforanyareaoftheworldusingNASAdata(Oatesetal.,2002).Onequestiontoponder:arestudentsbeingtrainedforjobopportunitiesthatdonotyetexist?TheinterestinHWTSoptionsisveryhighatthestudentlevel.TheHWTScommunityshouldseektoidentifyandcoordinatefuturehumanresourceswiththegrowingnumberofgraduateswithrelevantfieldexperience.Lastly,HWTSoptionsneedtobeimplementedatscale,andinconjunctionwithotherwaterandsanitationprogrammingtohelpreducediseaseburdenandalleviatepoverty.Adiversearrayofcreativepartners,withadequatecapitalandtechnicalsupport,willbeneededtocompletethiswork.DISCUSSIONManyresearchers,privatecompanies,faith-basedorganizations,internationalandlocalNGOs,donors,ministriesofhealth,andendusersareinterestedinHWTSoptionsandinmechanismsfortheirimplementation.Theevidencebasefortheseinterventionsiswell-establishedandgrowing,andanactiveprogramoffurthertechnicalandoperationsresearchisbeingpursuedonmultiplefronts.HWTSimplementationhasenjoyednumeroussuccesses.Firstandforemost,field-basedprogramshavedocumentedreductionsofdiarrhealdiseasesinendusers.Factorsthatcontributedtosuccessfulprogramsinclude:?TheabilitytoobtainqualityHWTSoptioncomponents(andanyreplacementparts)locally;?Behaviorchangecommunicationsincludingperson-to-personcommunicationsand/orsocialmarketing;and?Availabilityofimplementationmaterialsandtechnicalassistancetosupporton-the-groundimplementer.HWTSimplementationprojectshavealsoencounteredsignificantchallenges,including:?Questionsregardingthehealthimpactoftheseinterventionsinlarge-scale“real-world”situations;?Long-termsustainabilityoftheprojects,especiallylong-termaccesstosupplies;and?Scalinguptoefficientlyreachpeoplewithoutaccesstoimprovedwatersources.CONCLUSIONHWTSsystemsareproven,low-costinterventionsthathavethepotentialtoprovidesafewatertothosewhowillnothaveaccesstosafewatersourcesinthenearterm,andthussignificantlyreducemorbidityduetowaterbornediseasesandimprovethequalityoflife.HWTSimplementationshavedevelopedfromsmallpilotprojectsintonational-scaleprograms,andnowfacethechallengeofreachingthemorethan1.1billioninneedofsafedrinkingwater,andeffectivelyworkingwithotherwater,sanitation,andhygieneprogramstoachievethegreatesthealthimpact.Theactive,diverse,andexpandingcommunityofresearchers,privatecompanies,faith-basedorganizations,internationalandlocalNGOs,anddonorsinterestedinansweringthesequestionscanplayamajorroleinhelpingtheworldachievetheMillenniumDevelopmentGoaltohalve,by2015,theproportionofpeoplewithoutaccesstosafewater(WorldBankGroup,2004).Achievingthisgoal,andsurpassingit,willrequirecontinuedcollaboration,investment,andresearchanddevelopment,butitisourbesthopeforrapidlyreducingwaterbornediseaseanddeathindevelopingCountries.中文譯文發(fā)展中國家中的家用水處理和安全的存儲選擇:對目前執(zhí)行實踐的一個回顧聯(lián)合國的國際飲用水供應(yīng)和衛(wèi)生十年(1981-1990),直到1990年也沒有讓全世界的人都喝上干凈的飲用水和使用良好的衛(wèi)生設(shè)施(世界衛(wèi)生組織,2003)。盡管在這十年間服務(wù)水平有了超過10%的提升,但是11億人還是無法使用改善的水供應(yīng)系統(tǒng),24億人在1990年還沒有足夠的衛(wèi)生設(shè)備。(世界衛(wèi)生組織/聯(lián)合國兒童基金會,2000)十年失敗的原因包括人口的增長,資金的局限性,使用和維護的不當以及傳統(tǒng)“按部就班”方式的延續(xù)。(世界衛(wèi)生組織/聯(lián)合國兒童基金會,1992).全世界計劃實現(xiàn)2000年聯(lián)合國大會上提出的“千年發(fā)展目標”。在約翰內(nèi)斯堡舉行的有關(guān)可持續(xù)發(fā)展的世界峰會上,它被修改為“到2015年為止,世界上一半人口可以喝到干凈的飲用水和擁有基本衛(wèi)生設(shè)施。”(世界銀行,2004:世界衛(wèi)生組織/聯(lián)合國兒童基金會,2004)但是,到2015年的計劃未必能成功,因為還有超過600萬的人無法喝到干凈的水。(世界衛(wèi)生組織/聯(lián)合國兒童基金會,2000).此外,雖然“千年發(fā)展目標”明確指出其中“安全”飲用水,但是用來評價“千年發(fā)展目標”的標準是水來自于“改進”資源,比如說地上鑿洞或者是修建用水管道。因為從日常用水的層面上來講,很難判定水是否“安全”。(世界衛(wèi)生組織/聯(lián)合國兒童基金會,2004)因此,據(jù)估計越來越多的人可能會喝來自于改善水源的不干凈的水。家庭水的凈化處理及安全儲存:為解決用戶缺乏安全用水及相關(guān)衛(wèi)生設(shè)施的問題,我們必須摒棄傳統(tǒng)弊端,在加大技術(shù)運用及提升可持續(xù)前景的過程中,研究新的干預(yù)方案與有效的補給政策。在發(fā)展中國家,即使大多數(shù)人支持水源供給及衛(wèi)生系統(tǒng)設(shè)備,最適宜且最有效的干預(yù)方案還是常常遭受相當大的質(zhì)疑。通過執(zhí)行強調(diào)健康及由此取得的宏觀及微觀的經(jīng)濟利益的交流方案,水、衛(wèi)生和金融領(lǐng)域之間的薄弱環(huán)節(jié)可得以提升。研究者對新干預(yù)措施的研究焦點集中于再評估20世紀80年代以來的優(yōu)勢模式。144個案例的文獻綜述表明:衛(wèi)生實施的應(yīng)用和衛(wèi)生教育的實施比采取“水源供給或水質(zhì)干預(yù)”措施大大降低了腹瀉的發(fā)病率(分別減少36%和33%)。然而,受世界銀行委托進行的元分析卻反駁了上述結(jié)果。他們認為保健教育及水質(zhì)提升能更有效地減少腹瀉發(fā)病率(分別減少42%和39%),而衛(wèi)生設(shè)施及水源供應(yīng)引起的發(fā)病率相對較高(分別減少24%和23%)。這些研究結(jié)果的差異在某種程度上可歸因于干預(yù)方式的不同。埃斯里的學術(shù)評論仔細分析了水質(zhì)提升在本質(zhì)上帶來的影響,如水源、公共水龍頭等。自1996年以來,有相當數(shù)量的出版研究考察了通過家庭水凈化處理和安全儲存來提升水質(zhì)的干預(yù)方案所起的健康衛(wèi)生影響。這些最新的研究,其中很多是隨機干預(yù)之法,強調(diào)了飲用水在收集、運輸及儲存中受到污染,以及在HWTS影響下的衛(wèi)生價值。2003年,作為一種受益于HWTS的健康證據(jù),學術(shù)界機構(gòu)、政府、非政府組織和私營部門建立起國際互聯(lián)網(wǎng),以促進家庭水凈化處理及安全儲存。該組織為世界衛(wèi)生組織,坐落于瑞士日內(nèi)瓦。它的官方目標是:通過促進家庭水的氯化處理及安全儲存作為水、衛(wèi)生、保健工程的重要組成部分,尤其針對易感人群,為有效削減水質(zhì)疾病做出貢獻。這篇文章概述了5個最常見的HWTS方法:氯化、過濾(生物過濾法和陶粒過濾法)、日光消毒、組合過濾或氯化,以及組合絮凝或氯化;此外還描述了每種方法的補充策略。我們要組織及其在運行中遇到的成就、挑戰(zhàn)及障礙。我們要考慮研究成果的來源及潛力,從而大規(guī)模地分配和維持每一種選擇,為將來的研究與補給規(guī)劃目標。這篇文章強調(diào)了飲用水的凈化處理及安全儲存的方法,用以加速衛(wèi)生獲得與水質(zhì)提升,甚至達到廣泛使用管道水、處理水等長遠目標。通過預(yù)防疾病,HWTS實踐可致力于扶貧及發(fā)展。該方法的廣泛使用,在保健教育和衛(wèi)生設(shè)施的協(xié)力下,可以拯救上百萬生命,直到那個能將安全用水有效地傳遞到整個世界的基礎(chǔ)設(shè)施的建立。我們將對討論過的每一種HWTS方法使用一致的評價方案:1.HWTS方法消除或鈍化了實驗設(shè)置中的水中的病毒、細菌、寄生蟲的病原體嗎?2.在這個現(xiàn)場里,HWTS方法能被人接受嗎?它能被正確地使用嗎?它能減少使用者中的疾病嗎?3.HWTS方法可大規(guī)模使用嗎?次氯酸鈉溶液裝在瓶子里,和使用說明書包裝在一起。滿一瓶蓋的次氯酸鈉溶液可以凈化一標準尺寸容器里的水(兩瓶蓋則可以凈化渾濁的水),搖動后需要放置30分鐘才能飲用。通過四個隨機對照試驗,SWS降低了腹瀉病44%到84%的危險幾率在HWTS濃度測試里,氯有效地阻礙了細菌以及一些病毒的活動(美國自來水廠協(xié)會,1999),然而,氯對于一些原生動物卻不那么有效,例如隱孢子蟲。5初期研究表明,在SWS處理下的水沒有超過WHO對于消毒副產(chǎn)物的標準,其中可能含有潛在的致癌劑(CDC,未發(fā)表資料)。因為SWS程序所使用氯液濃度很低,所以該液體多于環(huán)境的影響微乎其微。用氯消毒的實施策略由于當?shù)睾献骰锇楹蜐撛谏鐣?、?jīng)濟狀況的變動,導致了SWS的實施發(fā)生了一定的變化。這種消毒液已經(jīng)通過社會市場營銷活動分銷到13個國家以及次于國家的層面上,特別是通過與非政府人口國際服務(wù)的合作。在印度尼西亞,這種溶液主要是通過由當?shù)刂圃焐坦芾淼乃綘I部門分銷出去的。在一些國家,包括厄瓜多爾,老撾,海地以及尼迫爾—其衛(wèi)生部門或是當?shù)氐姆钦M織在基層廣泛使用SWS。在阿富汗的喀布爾,對懷孕婦女提供免費的SWS產(chǎn)前護理。SWS對于一些災(zāi)區(qū)也同樣實行免費分銷,包括遭受2004年海嘯的印度尼西亞,印度,以及緬甸,當然還包括遭受過其他自然災(zāi)害的肯尼亞,玻利維亞,海地,印尼和馬達加斯加。有SWS的存在,一些產(chǎn)品在應(yīng)付緊急事故時就能發(fā)揮更好的作用。美國疾病控制與預(yù)防中心已經(jīng)建立了實施手冊,以及對于實行SWS項目的組織提供技術(shù)援助(美國疾病控制與預(yù)防中心,2001)太陽能消毒:實施策略作為一項幾乎零成本的技術(shù),太陽能消毒實施策略正面臨市場的限制。2001年以來,拉美七個國家的當?shù)胤钦M織同烏茲別克斯坦、巴基斯坦、印度、尼泊爾、斯里蘭卡、印度尼西亞、肯尼亞一樣通過培訓和教育基層用戶,向合作伙伴提供技術(shù)援助,游說主要參加者以及建立信息網(wǎng)絡(luò)來傳播太陽能消毒實施策略。該計劃由美國阿維納和Solaqua基金會,私人和企業(yè)贊助商以及官方提供資金和援助。該計劃顯示,當?shù)匾恍┯猩鐓^(qū)健康教育經(jīng)驗的機構(gòu)使太陽能消毒實施策略得到了最廣泛的傳播和推廣。要使大眾認識到凈化飲用水的重要性并建立相應(yīng)的行為變化需要一個長期的培訓方法并不斷與社區(qū)聯(lián)系。瑞士聯(lián)邦理工學院為環(huán)境科學與技術(shù)專門制定了一本實施手冊,并向?qū)嵤┨柲芟緦嵤┎呗缘姆钦M織提供技術(shù)援助。該方法已在20多個發(fā)展中國家傳播并擁有超過100萬的定期用戶。太陽能消毒的優(yōu)點和缺點日光消毒的好處包括:①保證減少細菌,病毒以及原生動物②保證無污染③能被用戶接受,因為用水量少,便于使用,以及幾乎不改變水的味道④不可能再次污染,因為液體裝在小的帶瓶蓋的容器里,并能直接使用

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