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A State renowned for being the exemplary of nationalist wellness successful the state and 1 which has consistently recorded immoderate of the champion wellness indicators nationwide, is present battling recurrent outbreaks of assorted water-borne diseases specified arsenic shigellosis. The irony is stark, for Kerala has demonstrated the responsiveness and resilience of its wellness strategy by having a steadfast grip connected a illness arsenic unpredictable and analyzable arsenic Nipah.
Now, accelerated urbanisation and societal improvement connected the 1 broadside and inadequate attraction paid to biology health, h2o prime measures, mediocre sewage and sanitation infrastructure connected the other, is threatening to undo the State’s estimation arsenic a beacon of bully nationalist health. The detonation of water-borne diseases and zoonotic diseases successful the State points to the system’s nonaccomplishment to wage attraction to the societal and biology determinants of health.
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Scale of contamination
A look astatine the outbreaks of Acute Diarrhoeal Diseases (ADD), Hepatitis A, shigellosis and norovirus successful caller years gives an denotation of the interaction of groundwater contamination connected people’s health.
Between 4 to 5 lakh cases of ADD are reported each twelvemonth successful the State. Since the past 2 decades, Kerala has besides been experiencing respective ample and tiny Hepatitis A outbreaks. In 2025, the State reported 31,536 cases and 82 deaths owed to Hep A. This twelvemonth too, arsenic of June 15, adjacent to 9,000 cases and 25 confirmed deaths person been reported.
Amoebic meningoencephalitis, which has besides emerged arsenic a important nationalist wellness occupation successful Kerala, is being linked to the faecal contamination successful home wells, successful which free-living amoeba thrive. This corruption has claimed the highest fig of lives successful the State, with 134 cases and 34 deaths reported arsenic of June 15 this year.
Various studies person reported that groundwater resources successful the State person been nether expanding stress, with 62% of the colonisation depending connected crushed h2o from adjacent to 7 cardinal wells.
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Lack of sewage system
As of 2025, Kerala has little than 6% due sewerage web coverage, with astir large cities having virtually nary household sewage postulation systems. The CAG’s 2025 study stated that astatine the closure of the AMRUT Mission, a Central inaugural aimed astatine ensuring cosmopolitan entree to harmless h2o and reliable sewerage connections crossed municipality areas, Kerala’s wide accomplishment was conscionable 11.25% and lone 0.13% households got sewerage connections.
While Kerala does person precocious sanitation sum with a important proportionality of households relying connected septic tanks oregon on-site sanitation systems, these septic tanks are poorly designed and located adjacent to home wells which pb to groundwater contamination. The information that Kerala is 1 of the astir densely populated States with tiny landholdings and houses situated adjacent to each different aggravates the issue. High levels of faecal contamination person been reported successful implicit 70% of the unfastened wells successful the State by agencies specified arsenic the Centre for Water Resources Development and Management. A survey successful the municipality areas of Thiruvananthapuram successful 2018 had reported that coliform contamination was prevalent successful 73% of wells and that good chlorination and cleaning practices were inadequate.
Recurring outbreaks of Hepatitis A and shigellosis successful the State showed that astir each outbreaks had been successful agrarian areas and were linked to the section root of drinking water. Epidemiological investigations person revealed that h2o for determination proviso systems is often pumped into proviso lines without capable chlorination oregon filtration, and that these lines often tally adjacent to sewage drains — immoderate breaks successful the pipeline tin pb to large contamination.
It is besides existent that astir of the interventions to supply harmless drinking h2o to radical prevarication extracurricular the wellness sector, demanding coordinated inter-sectoral efforts. Thus, alternatively than a nonaccomplishment of nationalist health, the existent occupation of water-borne diseases seems to beryllium the effect of the State’s under-investment successful establishing due sewerage networks.
Prevention of water-borne diseases requires semipermanent investments successful municipality planning, establishing harmless h2o organisation systems, sewer networks, wastewater attraction plants arsenic good arsenic measures for biology and h2o prime surveillance.
maya.c@thehindu.co.in
