Public health problems in Mombasa district: A case study on sewage management

Abstract

This study presents the public health problems of concern in Mombasa District through a case study on sewage management, where urbanization has increased the demand for infrastructure and services. The population has .. doubled in the last 15 years;' creating pressure on the existing sewage infrastructure leading to water pollution and the onset of sewage related diseases. The waterborne sewerage in use is old and dilapidated, while the on the site sanitation facilities are not satisfactory. Inadequate sewage management is thought to be responsible for freshwater contamination leading to diseases like typhoid, cholera, diarrhea and malaria that afflict many residents. This study has been undertaken on recognition that sewage is a major land based source of pollution affecting human and ecosystem health, (GPA, Washington, 1985). It is also recognized that only 10% of urban wastes in developing countries receives treatment, (Rio Earth Summit, 1992), which affirms the assertion that sanitation problems in Mombasa have been linked to the poverty condition in the area, (Mombasa Municipal Council, 1997). Sewage pollution also undermines the tourism industry. Finally it has been noted that the decline in water quality in Mombasa, is a major coastal resource management issue. This makes the study worthy undertaking. Munga et al. (1993), studied the sources of pollution to the marine environment from land based activities. Skanda and Mwaguni, (2001) studied the innovations by the beach hotels in sewage management, but no meaningful studies have attempted to understand the problem of sewage management. This study therefore attempts to fill this gap by exploring the sewage management infrastructure and practices, observing the impacts of sewage on air, vegetation, and on the soils. The impacts on the marine and groundwater sources are also investigated, so is the extent of sewage related diseases. Strategies that could offer solutions to the problems have been proposed. Visits to areas affected by sewage have been made and interviews conducted with stakeholders in a bid to understand the problem. Water samples were taken from boreholes and wells, from the creeks and in the lagoons, for analysis in the laboratory to check for sewage contamination. Medical records have been inspected for records of sewaqe related diseases. Library searches were conducted as a prelude to the exercise. The scope and limitations of this study hinged on the constraint of time, which limited comprehensive investigations. For this reason, it was not possible to carry out the study to reflect the condition over a more reasonable time scale for trend analysis on the problem. Nevertheless despite the constraint, the study accomplished the intended purpose of providing indicator results of pollution that are presented in this study. The study found that the sewage infrastructure is inadequate to serve the everincreasing population. While the population has grown over the years, the infrastructure has not. In some cases, the existing infrastructure was found to be inappropriate. The on-site sanitation methods ranged from good, fair to worse, depending on the settlement types. It was poor in the slum areas, but take good care of in the other habitations. The sewage management in Mombasa is still offered as a social service, a situation that is not sustainable. Cost recoveries if any, are inadequate to cover operational costs, leading to inadequate sewage management, resulting in impacts at the disposal site, on both fresh and marine waters. Groundwater quality is below safe levels for drinking water, with over 50% of all the public health problems in the district being water related, as evidenced by the frequent occurrence of such diseases like cholera, diarrhoea, dysentery and malaria. To address the problems, there is need for political commitment and public awareness, institutional arrangement and legislative framework supportive of sewage management, and technical options that adopt affordable sewage treatment technology, technology transfer and the promotion of re-use of sewage effluents. Financial arrangements that emphasize community financing in sewage management have also been suggested.