Sanitary Survey of Public Drinking Water Sources in Slums of Bhubaneswar, Odisha (1)

A Study Conducted in Slums of Bhubaneswar, Odisha
Sanitary Survey of
Public Drinking Water Sources
H e a l t h o f t h e U r b a n P o o r P r o g r a m

Prepared by
Health of the Urban Poor (HUP) Program
Population Foundation of India
B-28, Qutub Institutional Area,
New Delhi – 110016
Author
Biraja Kabi Satapathy
Niladri Chakraborti
Special Inputs
Shipra Saxena
Merajuddin Ahmad
Dr. Sainath Banerjee
Photographs
HUP
Published
January 2015
Copyright: The contents of this publication
may be used freely for not-for-profit purposes,
provided the users duly acknowledge the
Publishers. However, anyone intending to use
the contents for commercial purposes must
obtain prior permission from the publishers.

Sanitary Survey of
Public Drinking Water Sources
A Study Conducted in
Slums of Bhubaneswar, Odisha

2
The study gives details of the survey
undertaken, its findings, and suggestions
for ensuring drinking water quality in the
slums of Bhubaneswar.

3Sanitary Survey of Public Drinking Water Sources
Summary
The sanitary survey of drinking water sources was done in Bhubaneswar slums
where PFI is running the Health of the Urban Poor Program. The purpose
was to understand the risk to public drinking water sources based on onsite
inspection and water testing of the source with field test for pipe water supply
and H2
S bacteriological contamination test for all the sources. The study report
gives details of the survey undertaken, its findings, and suggestions for ensuring
drinking water quality in the slums of Odisha. The report tried to capture the result
of the indicator-wise sanitary inspection and its relation with other indicators. We
hope the study will be useful for the government for making some policy level
corrections. We also hope that Government, Non Government and civil society
organisations will adopt the sanitary survey as a tool for identifying factors that
affect drinking water sources, which is essential for drinking water safety

Acknowledgements
We are grateful to field level staff of PFI-HUP for
conducting the onsite inspection of public drinking
water sources in 168 slums of Bhubaneswar. They
diligently tested all public drinking water sources with
the H2
S bacteriological contamination test kit, and
the public pipe water supply through stand posts for
residual chlorine test.
We are thankful to community representatives,
Anganwadi workers, Accredited Social Health Activists,
councillors of respective wards of Bhubaneswar
Municipal Corporation, local community leaders,
youth and women of the slum for participating in the
onsite sanitary inspection of drinking water sources in
their respective slums. Our special thanks go to the
members of Mahila Arogya Samiti (women’s group) for
their enthusiasm in helping the HUP workforce.
The study report has been shared in three round table
consultations in Odisha in the cities of Cuttack, Rourkela
and Bhubaneswar during March 2014.Officials from the
departments of Health and Family Welfare, Housing
and Urban development, Public Health Engineering
Organisation, Odisha Water Supply and Sewerage
Board, urban local bodies, civil society organisations,
and representatives of development partners like
UNICEF, World Bank, Practical Action, One Drop took
part. A similar round table was organised in New Delhi
in June 2014 at Population Foundation of India where
WASH experts from various leading development and
UN organisations like the World Bank, UNICEF, Water
Aid, Water for People, AKVO, CURE and FORCE, and
corporate houses like Coca Cola and FICCI participated.
We acknowledge and value the suggestions by all the
participants at these four round table consultations.

5
Contents
Summary 3
Acknowledgements 4
Chapter 1: Introduction 6
1.1 Sanitary Completion and Health 6
1.2 The Nature of Risk to Water Sources 7
1.3 Sanitary Survey for Sanitary Completion 8
1.4 Rationale for Undertaking the Current Study 10
1.5. Objective of the Study 11
Chapter 2: Sanitary Survey Methodologies 12
2.1. Type of Drinking Water Sources Surveyed 12
2.2. Study Area 14
2.3. Risk Assessment of Drinking Water Sources 15
2.4. Precautions Taken During Drinking Water Sample Collection 18
2.5. Survey, Ratification and Validation of Data 18
2.6. Software Used for Data Analysis 18
2.7. Expected Outcome of this Study 18
2.8. Limitation of this Study 19
Chapter 3: Findings of the Study 20
3.1 General Findings 20
3.2 Source wise Findings 27
Chapter 4: Suggestions 43
4.1 For Surveillance of Sources and Action 43
4.2. For Prioritisation of Area and WASH Intervention 46
4.3. For Community Participation 46
4.4. Advocacy with the Government 48
Annexure I : Ward Wise Water Source Distribution 50
Annexure II: Code of Slums Where Survey was Conducted 51
Annexure III: Repeat Residual Chlorine Test Regime 56
Annexure IV: Sanitary Survey Formats 57
Annexure V: Source Wise Risk Factors Segregation Matrix 64
References 65
Acronyms 68

6 Sanitary Survey of Public Drinking Water Sources
1.1 Sanitary Completion and Health
Sanitary completion impacts the microbial quality of water. It is essential to prevent the direct contamination
of groundwater or surface water supplied through pipelines at the point of abstraction or point of collection,
from the rapid recharge pathways close to the source. Sanitary completion includes underground and over
ground construction of the abstraction facility, as well as the immediate area surrounding the abstraction
point (Howards et al, 2006). Poor sanitary completion allows ingress of contaminated water close to the
point of abstraction, and therefore, may short-circuit protection measures designed to limit risks from
pathogens.
The direct contamination of drinking water sources caused by poor sanitary completion has been linked
to both endemic and epidemic diseases. Outbreaks linked with poor sanitary completion have been noted
in many countries. For instance, Olsen et al (2002) related an outbreaks of E. coli in Alpine, Wyoming,
including cases of hemolytic uremic syndrome, to a poorly protected spring. Sanitary survey further
identified the spring at risk from contamination by surface water. Poor sanitary completion measures also
appeared to have played a role in the Walkerton outbreak in Canada (O’Connor, 2002). In developing
countries the use of poorly protected groundwater sources have been linked to acute diarrheal diseases
(Trivedi et al, 1971, Nasinyama et.al 2000). In November 2003, Odisha witnessed an outbreak of cholera
at Parbatia, which was found associated with an unprotected well (Das et al, 2009).
The effectiveness of sanitary completion in reducing risk of all pathogen is profound as it provides barriers
to direct contamination of sources. (Robertson & Edberg, 1997). However multiple interventions are
required to act as barriers.
Chapter 1: Introduction

1.2 The Nature of Risk to Water Sources
For sanitary completion measures, it is important to understand the multiple factors leading to contamination
of drinking water sources. There are ranges of factors that may compromise quality close to water sources.
These can be broadly categorised into hazard, pathway and indirect factors (Howard A. G., 2002).
• Hazard factors: These are sources of fecal material located in the environment which contaminates
the water. An example is a pit latrine overlying an aquifer and close to an abstraction point.
• Pathway Factors: These are the potential routes by which contamination may enter into the water
supply. Pathway factors include cracks in the lining of borehole, improperly sealed apron, etc. Pathway
risk factors often result from poor operation and maintenance.
• Indirect factors: These represent a lack of control measures to prevent contamination (and therefore,
increase the likelihood of a hazard or pathway developing) but do not themselves represent either a
hazard or pathway. An example is a fence around water source. Absence of fence will not lead directly
to contamination but may allow animals or humans to gain access to the source and create either a
hazard (by defecating) or a pathway (by causing damage to the source or its immediate surroundings).
The source-pathway-receptor model of contamination is also relevant to sanitary completion of water
sources. In this model, the source is the source of hazards, the receptor is the water supply and the
pathway is the means by which the hazard can leave the ‘source’ and reach the receptor (Godfrey &
Howard, Water Safety Plans (WSP) for Urban Piped Water Supply in Developing Countries, 2004).
The model recognises that the presence of hazards in the environment is insufficient on its own to represent
a risk. A feasible pathway must exist that allows hazards to travel from source to the water supply.
Box 2: Salient features of
sanitary survey
• It’s a cheap process.
• It tells us what need to be done to
improve and protect a water source.
• It reduces risks of outbreaks of
waterborne diseases.
• It helps to protect public health.
• Often sanitary survey is preferred
over water quality analysis alone, as
the latter can’t identify the sources of
contamination.
Box 1: Source – Pathway- Recep-
tor Relationship
Pathway
Receptor
Vulnerability
of the water
supply
Receiving
water
infrastructure
Source
Hazard
event/
environment

1.3 Sanitary Survey for Sanitary Completion
Sanitary survey provides an easy but effective way of monitoring sanitary completion, particularly when
this employs a standardised and quantifiable approach (Lloyd and Bartram, 1991; Lloyd and Helmer,
1991). Sanitary survey involves two principal activities, one is sanitary inspection and other is water-quality
analysis. Sanitary inspection is done on-site to identify actual and potential sources of contamination of a
water supply that pose potential danger to the health and well being of the consumers. The first attempt
of the expert called into pronounce upon the character of potable water should be made through sanitary
inspection (Prescott and Winslow, 1904). When sanitary inspection of drinking water sources is made in
conjunction with water quality testing, it is called a sanitary survey. Sanitary inspection identifies potential
hazard, while water-quality analysis indicates whether contamination is occurring and, if so, its intensity.
According to World Health Organization (WHO, 1997), Sanitary inspection is an on-site inspection and
evaluation by qualified individuals of all conditions, devices and practices in the water-supply system that
pose an actual or potential danger. In the preamble to the “Interim Enhanced Surface Water Treatment
Rule (IESWTR)”,1
United States Environment Protection Agency defines a sanitary survey is defined as:
“An onsite review of the water source (identifying the source of contamination using results of source water
assessment where available), facilities, equipment, operation, maintenance, and monitoring compliance
of a public water system to evaluate the adequacy of the system, its sources and operations and the
distribution of safe drinking water”.
There is a need to conduct sanitary surveys on a routine basis to prevent contamination of drinking
water supply and eventually reduce public health hazard. The information is used to take appropriate
remedial action to improve or protect the water supply. Sanitary surveys are an opportunity to work and
communicate with the water system in a preventive mode (USEPA, 1999). A sanitary survey should also
be considered in the following cases:
1 United States Environment Protection Agency (EPA), The Interim Surface Water Treatment Rule, June 2001: In 1989, EPA issued
two important National Primary Drinking Water Regulations (NRDWR): The Total Coliform Rule (TCR) and The Surface Water
Treatment Rule (SWTR). The IESWTR builds on the TCR by requiring sanitary surveys for public water systems using surface
water and ground water under the direct influence of surface water.
Sanitary inspection is
done on-site to identify
actual and potential
sources of contamination
of a water supply that
pose potential danger to
the health and well being
of the consumers.

• When contamination is suspected, to identify the likely cause
• During an epidemic of water borne diseases like cholera, to identify potential sources or risks
• To interpret results from water-quality analysis, to establish how the water became contaminated
The limitation of sanitary inspection is that it can determine the most obvious source of contamination,
but may not reveal all sources of contamination. Therefore, water sources that show low or intermediate
risk for contamination should still be tested for bacteriological contamination to confirm the result. The
assessment criteria in many standard sanitary inspection forms are scored on a two-way ‘yes or no’
answer. The possibility of variations between the set out criteria in the forms and the observed sanitary
faults are not provided for within the two-way answer system, thereby making the assessment rigid.
The scores, therefore, may not represent the correct sanitary problem, as they may either exaggerate or
underplay particular risk factors (Oluwasanya, Smith, & Carter, 2011).
Odisha is one of
the top ﬁve
states with
23.1%
of its urban
households
located in slums.
377
slums out of which
only 99 slums are
authorised
1,63,983
people reside in slums across
the BMC

1.4 Rationale for Undertaking the Current Study
According to Census 2011, Odisha is one of the top five states with 23.1% of its urban households located
in slums. A total of 1,63,983 people reside in slums across the Bhubaneswar Municipal Corporation (BMC)
area and its outgrowth (Census 2011). The city has a total of 377 slums out of which only 99 slums are
authorised (BMC, 2009). Most of the slums have sprung up on unutilised government land, and railway
lands which were lying temporarily vacant. Low income group people reside in those areas in poor living
condition devoid of basic services and amenities (Mohanty & Mohanty, 2005). With the proliferation of
slums, the city started getting its share of challenges in terms of complex disease etiologies and risk
factors.
As per a study, Urbanisation and its Implications for Child Health, three major type of pathologies are
emerging in the urban slums of Third World countries. One of these is infectious and gastro-intestinal
diseases, often termed as ‘diseases of poverty’. Though these have largely disappeared from the
developed nations, they are a major source of mortality and morbidity among children and women in
developing countries (WHO & UNEP, 1988). Slums in Bhubaneswar are not an exception. Often this type
of pathology is found in direct correlation to the poor infrastructure for drinking water and sanitation. The
access to safe water supply in slums gets compromised as inadequate sanitation, drainage and poor solid
waste disposal invoke ‘hazard factors’ for water sources. Further, poor operation and maintenance leads
to ‘pathway factors’. As most of the slums are un-notified, provisioning of water supply, maintenance and
management of drinking water sources gets limited attention (Sajjad, 2014 & Subbaraman, et al., 2013). In
slums, there are numerous ‘indirect factors’ as well which pose a risk to drinking water sources. With these
arrays of risk factors, slum dwellers are entangled in a vicious cycle of morbidity caused by waterborne

diseases. This cycle can only be broken once the predominant risk factors are indentified and corrective
measures taken. Adopting such measures demands ownership and collective action. The current study is
relevant especially in the slum context.
HUP-PFI Odisha, under its city demonstration program, conducted a sanitary survey of 742 water
sources spreading across 168 intervening slums in 25 wards of Bhubaneswar Municipal Corporation
from May 3 to August 14, 2013. Out of 168 slums, only 30 slums are notified and rest 138 slums
are non-notified. All the public drinking water sources used by slum dwellers in the study area were
considered for the survey.
1.5. Objective of the Study
The study survey aimed to do an onsite review of the public drinking water sources, facilities, equipments,
operation and maintenance of water supply system in HUP- PFI intervening urban slum areas for calculating
the risk factors and taking the necessary remedial measures in coordination with concerned government
departments and urban local bodies. The following were the objectives of the study:
• Identify potential sources of contamination risk associated with water supply
• Quantify the hazard attributed to the sources and supply
• Clearly explain the hazards to the user and provide guidance for the remedial action required to protect
and improve the supply
• Generate primary data for research to be used in systematic, strategic planning for improvement in
quality water supply and minimising risk
• Analyse gaps in the water supply system and suggest ways to bridge them.
The access to safe water supply
in slums gets compromised as
inadequate sanitation, drainage
and poor solid waste disposal
invoke ‘hazard factors’ for water
sources.

Chapter 2: Sanitary Survey Methodologies
2.1. Type of Drinking Water Sources Surveyed
The sample strategy was based on capturing all types of water sources like unprotected dug well, protected
dug well, tube well (majority India Mark II), bore well fitted with mechanical pump and pipe water supply
through stand posts commonly used by the community in Bhubaneswar slums. A couple of protected
dug wells were also found and inspected. Table 1 below describes each type of drinking water source
surveyed in the study.
According to WHO and UNICEF (2010), the first four types of drinking water sources mentioned in Table 1,
i.e. the stand post, tube well fitted with hand pump, bore well fitted with mechanical pump and protected
dug well are categorised as improved water sources and the remaining type, that is the unprotected dug
well, is an unimproved water source.
Out of total 742 public drinking water sources surveyed, pipe water supply through stand posts stood
at 293 (around 40% of the sample size), bore wells fitted with mechanical pump were at 108 (15%),
tube wells with hand pump were at 177, (almost 24%), while unprotected dug wells were 162 (22%) and
protected wells were just two in number. Hence, in the study area, the stand post was found the major
water source, followed by the tube well fitted with hand pump, the unprotected dug well and bore well
fitted with mechanical pump. The table 2 depicts the distribution of inspected water sources:

Table 1: Types of drinking water sources surveyed with illustration
Water Source Type Description
Stand post Piped water supply through a stand post consists of
a water-lifting mechanism from source, a distribution
network through pipe lines and individual delivery
points such as public stand posts. Treated water is
generally supplied through piped network.
Tube well fitted
with hand pump
Ground water could be extracted through a tube
well with a hand pump. This consists of a borehole,
a platform with a drainage and soak away pit
which protects from surface water infiltration and
contamination, and a hand pump – the water lifting
device.
Bore well fitted
with mechanical
pump
Mechanical pumps are generally used to draw water
from much greater depth through drilling a borehole
to reach deep aquifers. Water from deep bore holes
is less likely to be affected by pollutants originating
from land or surface waters.
Protected Dug
well

A dug well is covered from the top with a concrete
slab and the hole at the centre draws water through
a hand pump or a mechanical pump to minimise
the likelihood of contamination. Ideally the top cover
stands about a foot above the ground.
Unprotected dug well Unprotected dug wells are uncovered from top.
Open or poorly covered well heads pose the
commonest risk to well-water quality. The water
may be contaminated by the use of inappropriate
water-lifting devices by consumers.
Source: Preparation of pictorial illustrations on access to water supply and sanitation facilities for use in national household surveys ,
prepared for JMP, by UNICEF & WHO)

Table 2: Distribution of inspected drinking water
sources
Types of source Frequency Percent
Stand post 293 39.5
Bore well with mechanical
pump
108 14.6
Tube well with hand pump 177 23.9
Protected dug well 2 0.3
Unprotected dug well 162 21.8
Total 742 100.0
2.2. Study Area
The current study was conducted in 25 out of 60 municipal wards2
of Bhubaneswar Municipal Corporation
(BMC). The study area covers 168 slums out of 3773
where Health of The Urban Poor Program has its
presence. Out of total 168 slums 138 are notified or authorised and 30 are non-notified or unauthorised
slums4
. Figure 1 depicts the study area -
Figure 1: Map showing surveyed wards in Bhubaneswar
2 During the study period, the number of wards in Bhubaneswar was 60, but as per the Government of Odisha, Housing and
Urban Development Department notification No. Ele 165/2013/26459 dated 24.08.2013, the area of the Municipal Corporation
is divided into 67 wards.
3 As per Bhubaneswar slum profile, Bhubaneswar Municipal Corporation, 2009, there are 99 authorised slums and the rest 278
are unauthorised slums.
4 Authorised slums are with dwellers having land rights. Unauthorised slums are with dwellers not having land rights and staying
on Central/state government lands.
293
177
108
162
2
Stand post
Tube well
Bore well with ﬁtted with mechanical
pumps
Unprotected dugwell
Protected dug well

2.3 Risk Assessment of Drinking Water Sources
2.3.1 Risk Assessment by Onsite Sanitary Inspection
The sanitary inspection report forms are designed so that every fault that may reduce the quality of the
supply is listed and checked during sanitary inspection. Each fault represents a sanitary hazard. (WHO,
1997)
The sanitary inspection form prescribed by WHO was customised to the urban context and translated into
the local language (Oriya). The standardised survey formats consist of a set of 10-12 diagnostics questions
which capture dichotomous response either “yes” or “no” for on-site inspection of various categories of
sources. The questions are structured in a way, so that the ‘’yes’’ answer indicates that there is a risk of
contamination, and the ‘’no” answer indicates that the particular risk is absent. Each “yes” answer scores
“1” and “no” answer scores “0” attributing same value to each risk factor (usually 1/10-12) based on
statistical correlation between the importance of microbiological/chemical contamination as determined
by laboratory analysis and different diagnostic information identified through sanitary survey (Ferretti, et
al 2010). At the end of the inspection, all the affirmative responses (yes) collectively decide the risk of
contamination of each source. Based on the score, the risk of contamination is classified as low [0-2];
intermediate [3-5]; high [6-8] and very high [9 and above].
2.3.2 Water Quality Testing along with Sanitary Inspection
Sanitary inspection identifies the potential hazards of drinking water sources, while water quality analysis
indicates the actual quality of water and the intensity of contamination. Two tests were done under the
current study along with the inspection. One was the presence – absence test of E.Coli5
(Fecal Indicative
Organism) in water samples which indicates the fecal contamination. It is not feasible to test every type
of human pathogen that may be present in an aquatic environment. This is due to their great diversity
spanning the phylogenetic spectrum from virus and bacteria to protozoa and worms, and because
detection methods are often difficult and costly (WHO, 1999). Therefore FIO is used as proxy-indicator
of increased probability of pathogens’ presence (EPA, 1986; WHO, 1999;WHO, 2003). This test was
5 Escherichia Coli –a thermo tolerant (TTC) bacteria- is a member of fecal coliform group and is more specific indicator for fecal
pollution than other (Odonkers et al, 2013)
Sanitary inspection identifies the potential
hazards of drinking water sources, while
water quality analysis indicates the actual
quality of water and the intensity of
contamination

conducted for all the sources surveyed. The
second test was to find trace of residual chlorine
in piped water supply and bore well fitted with
mechanical pump.
2.3.2.1 Water Testing by H2
S
Bacteriological Kit
In order to test for faecal contamination, the
sample water was collected in H2
S vials from
each drinking water source that was inspected.
The Hydrogen Sulphide (H2
S) vial is a useful tool
for screening water sources and drinking water
for faecal contamination.6
The H2
S strip is easy
to use and readily available.
The method of testing by the H2
S kit:
• Dry and sterile media are provided in the
screw-capped bottles, which are ready for
use. Fill the water to be tested in bottle up to
the mark and cap it.
• Shake the bottle gently after five minutes to
dissolve the contents completely.
• Keep it at room temperature preferably at 25-
35 degree Celsius for 24 to 48 hours (WHO,
2002).
• Observe for blackening of the contents.
• If the water turns brown or black, it is likely
that it is not fit for drinking.
H2
S test uses a medium with thiosulphate as a
sulphur source and ferric ammonium citrate as
indicator. During incubation, hydrogen sulphide
is produced by some enteric bacteria — E. coli by
reducing thiosulpahte. Hydrogen sulphide then
reacts with ferric ammonium citrate producing
a black insoluble precipitate and indicating the
presence of the bacteria (Mosley & Sharp, 2005).
6 The results for bacteriological contamination using H2
S
strip technique are at best indicative and in case of
contaminant detection, one must go for further testing
to a water quality laboratory.
Figure 2: Fecal contamination present-
absent test with H2S vial
Figure 3: Residual chlorine test with
DPD-FAS kit

2.3. 2. 2 Water Testing by Chlorine Field Test Kit
The presence of chlorine residual in drinking water indicates
that:
• A sufficient amount of chlorine was added initially to the
water to inactivate the bacteria and some viruses that
cause diarrheal disease; and
• The water is protected from recontamination during
transportation and storage. The presence of free residual
chlorine in drinking water is correlated with the absence
of disease-causing organisms, and thus is a measure of
the portability of water.
When chlorine is added to drinking water, it proceeds
through a series of reactions. Some of the chlorine reacts
first with organic materials and metals in the water and
is not available for disinfection (this is called the chlorine
demand of the water). The remaining chlorine concentration
after the chlorine demand is accounted for is called total
chlorine. Total chlorine is further divided into: 1) the amount
of chlorine that has reacted with nitrates and is unavailable
for disinfection which is called combined chlorine and, 2)
the free chlorine, which is the chlorine available to inactivate
disease-causing organisms, and thus a measure to determine the potability of water (CDC, 1990).
In current sanitary survey water samples from all inspected stand post and bore wells fitted with mechanical
pump were collected and tested for residual chlorine with a DPD (N, N-diethyl-p-phenylenediamine – FAS
(Ferrous Ammonium Sulphate) reaction based filed test kit.7
The method of testing by the chlorine field test kit:
According to the method described with the field test kit,, a buffered DPD indicator powder is added to a
water sample which reacts with chlorine to produce the pink color characteristic of the standard DPD test.
Ferrous Ammonium Sulfate (FAS) solution of appropriate strength is then added drop by drop until the pink
color completely and permanently disappears, signaling the endpoint of the reaction. To get the reading,
the number of drops used to cause this color change is multiplied by the factor (as it was given 0.1 in this
test method along with the test kit) for the concentration of free chlorine in the water sample.
7 DPD (N, N-diethyl-p-phenylenediamine), is the most common method for measuring free chlorine. At near neutral pH chlorine
oxidizes the DPD to form a pink colored compound. Utilizing this, the quantitative technique suitable to measure free chlorine at
site has been developed. A reducing agent, Ferrous Ammonium Sulphate (FAS) is used as a titrant which reacts and changes
the pink colored solution to a colorless solution, the end point. (Harp, 2002)

2.4. Precautions Taken During Drinking Water Sample Collection
Every sample collected in an H2
S vial was marked with unique code8
along with the date and time of
collection of water sample. To make sure that sample collected from a tube well represents ground water,
only after sufficient pumping, it was collected in the vial. To minimise the reporting of false positivity due to
the presence of bacteria in the spout of tube well and the tap of the stand post, a sample was collected
only after disinfecting the spout and taps by burning with match sticks or a lighter. Precaution was also
taken while handling the H2
S vial. Directly touching the rim and filling water to the brim was avoided to
ensure that bacteria gets enough space to thrive.
2.5. Survey, Ratification and Validation of Data
The survey was carried out by the front line workers of Health of the Urban Poor (HUP) Program. The
surveyors were trained on using the simple and standard survey format. They were sensitised on the
importance of safe water for health and factors that affect the water quality at source and at point of
use. They were also trained on how to use H2
S bacteriological testing kit and residual chlorine testing kit
while conducting the survey in the field. Each surveyor was given a kit, containing an H2
S vial, a sticker
for putting the code on the vial, a marker, a small bucket with a rope for collecting water from a dug
well, a match box, and a measuring tape. The community was represented in the field at the time of the
survey through the slum secretary, president, Mahila Arogya Samiti (MAS – women’s group) members,
and the Anganwadi worker. After the respective format for each source was filled, it was duly signed
by the community representatives to ratify the information. In many cases, members from MAS actively
participated in collecting the water sample from the sources. The entire process of data collection was
monitored and validated by the HUP state and city teams during and after the sanitary survey activity.
2.6. Software Used for Data Analysis
Software like MS Excel 2010, SPSS v16 were used for data warehousing and subsequent analysis.
Other than calculating simple frequency and percentage, some bi-variate and multivariate correlation,
regression was done to find the association between contamination and several risk factors as per the
standard protocol. Considering the cross sectional nature of the study, the odds ratio was calculated in
95% confidence interval and the chi-square test was done to explore if there is any significant association
between risk factors and contamination. The software Aarch View 3.2 was used for mapping.
2.7. Expected Outcome of this Study
The sanitary inspection survey of all types of public drinking water sources located in the intervention slums
of Bhubaneswar will help in:
• Raising awareness on factors that affect the drinking water source and draw attention on operation and
maintenance of sources
• Developing models of water safety plan in vulnerable slums followed by specific WASH intervention
8 Program code/Slum code/Source code/Location of the source code

• Provide an opportunity to enhance knowledge for
operation and maintenance of water sources
• Developing WASH sector specific BCC and
capacity building strategies making drinking water
as a focal point
• Identifying vulnerable slums for intervention on
priority under NUHM, RAY, JnNURM etc.
• Advocating with respective state agencies and
ULBs for strengthening WASH service provision
2.8. Limitation of this Study
In this study, samples from all public drinking water
sources used by the slum dwellers were taken, and
individual drinking water sources were excluded.
Further, as the sanitary survey exercise was done
once, from May to August 2013, the comparison of
pre and post monsoon analysis could not be done.
The test to trace bacteriological contamination and
the presence of residual chlorine in the collected water
samples was done by the field test kit only. Samples
from water sources that were found with bacteriological
contamination could not be confirmed by a lab test.
• Individual drinking
water sources were
not taken
• Pre and post
monsoon analysis not
done
• Testing of water done
by field test kit only

3.1 General Findings
3.1.1 Contamination Risk of Various Drinking Water Sources
Irrespective of the type of source, the current survey reveals that 19 % of the total sources come under
low category of risk, whereas 43% belong to intermediate, 35% to high and 2% come under the very high
category of risk.
Table 3: Risk pattern for water sources
Category of risk Frequency Percent
Low 144 19
Intermediate 320 43
High 260 35
Very high 18 2
Total 742 100.0
It is evident from Table 3 that majority of the water sources either come under the intermediate or high risk
category.
Chapter 3: Findings of the Study

Table 4: Percentage of sources as per risk category
Category of risk Type of sources (in percentage)
Stand post Tube well
with hand
Pump
Bore well with
mechanical Pump
Protected
dug well
Unprotected
dug well
Low (n=144) 55.6 18.1 9.7 0.7 16.0
Intermediate(n=320) 41.2 22.2 17.5 0.3 18.8
High(n=260) 31.2 30.0 13.5 0.0 25.4
Very High (n=18) 0 11.1 16.7 0.0 72.2
Source wise further exploration (Table 4) shows that stand post tops the list of low risk category sources (55.6%, n= 144), while
unprotected dug well occupies the top slot of very high risk category of sources(72.2%, n=18).
The spread of contamination risk scores are presented in Figure 4 where the upper and lower points
represent maximum and minimum. Boxes indicate 25th
and 75th
percentile boundaries. The intersecting
line in each box represents the median value. The median risk score of stand post was found 4 with Inter
Quartile Range 2,6 which is also the median risk score for the bore well fitted with mechanical pump with
different IQR[3,6], median risk score for both tube well fitted with hand pump and unprotected dug well is
5 with same IQR[3,7]. So on an average, the stand post and the bore well fitted with mechanical pumps
STAND POST
Contaminationriskscore
BORE WEL
WITH MECHANICAL
PUMP
TUBEWEL
WITH HAND
PUMP
PROTECTED
DUG WEL
UNPROTECTED
DUG WEL
12
10
8
6
4
2
0
Figure 4: Median risk score of water sources

emerged as better performing water sources in the slum context in comparison to the tube-well and
unprotected dug well. The median risk score for the protected dug well was even lesser than the stand-
post. However, the sample size of the protected dug well was not representative enough to conclude
anything.
3.1.2. Bacteriological Contamination of Various Sources
Water sample from each inspected source was collected in an H2
S vial and was allowed to incubate for the
prescribed time i.e. 24 to 48 hours. Based on the change of the colour of the sample (black or deep brown)
the sample was considered positive, i.e. trace of fecal contamination was confirmed. Table 5 represents
the result of the test for all water sources.
Twenty three percent of the sources were found with fecal contamination, while 77% of the sources were
found to be free from it during the survey. In other words, almost one in every four water sources was found
to be contaminated with the bacteria.
3.1.3 Source Wise Bacteriological Contamination
As expected, the maximum proportion of unprotected dug wells, which are an unimproved source, were
found with the contamination (52%, n=162), followed by tube wells fitted with hand pump (29%, n=177).
Table 5 shows the percentage of different sources found positive during water source inspection.
Table 5: Distribution of contaminated sources
Type of drinking water sources % reported with contamination
Stand Post (n=293) 10
Bore well with mechanical pump(n=108) 8
Tube well with hand pump(n=177) 29
Protected dug well(n=2) 0
Unprotected dug well(n=162) 52
Traces of fecal bacteria were also detected in around 10% of the stand posts. In slums, both dug wells and
tube wells cater to large chunks of population alongside piped water supply. The vulnerability of both the
sources for bacteriological contamination reveals the magnitude of the population at risk of several water
borne diseases.
3.1.4. Correlation between Bacteriological Contamination and Risk
Categories of Water Sources
The current study tries to establish the connection between the bacteriological contamination of drinking
water sources along with their risk results obtained from onsite sanitary inspection. A cross tabulation
shows that majority of the contaminated sources belong to either the intermediate or high risk category.
A greater risk of contamination is associated with a higher grade of contamination. In the present case,
a Chi-square test establishes significant association between bacteriological test positivity and higher
contamination risk score with χ2 = 9.15, p(0.027)<0.05. However, a high sanitary risk score with a low

level of contamination or no contamination still requires urgent action, as water quality in such sources
gets compromised following rainfall (Howard et al, 2003; Godfrey et al, 2006). This indicates the outburst
of contamination any time and the need for preventive action.
Table 6: Contamination and risk category cross tabulation
Sources Category of risks
Low (%) Intermediate (%) High (%) Very high
(%)
Total
Contaminated 17 40 39 5 N1=173
Not Contaminated 20 44 34 2 N2= 569
N=742
A bivariate correlation test (Pearson Correlation)9
further establishes significant positive correlation between
the bacteriological contamination of a source and its corresponding risk score or category of risk.
9 Pearson’s correlation coefficient is a statistical measure of the strength of a linear relationship between a paired data. In a sample
it is denoted by r and is by design constrained as -1≤r≤1. Positive value denotes positive correlation and negative value denotes
negative correlation. The closer the value is to 1 or -1, the stronger the correlation.
Figure 5: Ward wise distribution of contaminated sources
Water sample from each inspected
source was collected in an H2S vial
and was allowed to incubate for the
prescribed time i.e. 24 to 48 hours.

Table 7: Pearson Correlation presentation
Correlations
Water safe or not Category of Risk
Water safe or not Pearson Correlation 1 .081*
Sig. (2-tailed) .028
N 742 742
Category of Risk Pearson Correlation .081* 1
Sig. (2-tailed) .028
N 742 742
* Correlation is significant at the 0.05 level (2-tailed).
3.1.5 Identification of Vulnerable Wards in terms of Contaminated Water
Sources
The color coded map of Bhubaneswar (Figure 5) is to show the spread of vulnerable wards in terms of
percentage of contaminated sources identified against total sources surveyed in those respective wards.
3.1.6 Distribution of Water Sources across Municipal Wards According to
their Risk Category
The current study has categorised all the water sources located in the study area based on responses
to the diagnostic questions. Figure 6 presents the percentage of water sources identified under each
risk category out of the total number of water sources surveyed within each slum. Extrapolation of this
graphical interpretation may help in categorising and prioritising while taking remedial measures.
12 26 45 56 47 27 31 11 2 9 16 53 57 15 32 52 58 54 1 33 7 30 34 8 46
0
10
20
30
40
50
60
70
Low
Figure 6: Ward wise percentage distribution of the water sources with low
risk category

Figure 6 represents the distribution of low
risk category water sources across the
surveyed wards. Slums located in Wards
12, 26, 45 and 56 were not identified
with any sources belonging to the low
risk category. Ward 46 was identified with
having maximum percentage of low risk
sources. According to the Figure 5, this
ward belongs to the green zone, where
0-5 % of the total sources were found
contaminated with fecal bacteria. Ward
number 12 was also found in green zone
though no low risk sources were identified
in the slums of this municipal ward.
Figure 7 shows that other than Ward 12,
all wards have a considerable proportion
of water sources belonging to the
intermediate risk category. Bacteriological
contamination wise however, those wards
come under the entire range of green to
red category (Figure 5).
12 2 27 1 33 26 7 32 30 46 34 8 57 54 11 53 31 16 15 58 9 47 45 56 52
0
10
20
30
40
50
60
70
80
90
Figure 7: Ward wise percentage distribution of water sources with
intermediate risk category

Figure 9: Ward wise percentage distribution of water sources with high risk
category
Figure 9 presents the predominance of very high risk category of water sources in seven wards. According
to bacteriological contamination vulnerability spectrum presented in Figure 5, none of these wards comes
under the green category and are closer to the red category. In terms of taking remedial measures these
wards demand top most attention.
52 46 8 34 30 15 58 16 56 45 9 47 54 7 53 11 31 57 33 32 1 2 27 26 12
0
20
40
60
80
100
120
Figure 8: Ward wise percentage distribution of water sources with high risk
category
1 11 12 26 31 32 33 45 46 47 52 53 54 56 57 58 8 9 7 15 30 34 16 2 27
0
2
4
6
8
10
12
14
The above chart represents the distribution of water sources belonging to the high risk category across
the surveyed wards. The critical observation here is that though Ward 12 was in green type in terms of
bacteriological contamination of water sources (Figure 5), yet it was detect with 100% high risk sources.
As we know water quality varies seasonally (Godfrey et al, 2006), water quality in such sources mostly
get affected post a rain event (Howard et al, 2003). Eventually a single measure may often present such
ambiguous findings, which otherwise can be ruled out by more frequent assessments (Luby, et al., 2008).

3.2 Source Wise Findings
3.2.1 The Stand Post
3.2.1.1 Proportion of Stand Posts
Belonging to Different Contamination Risk
Categories
In present study, a total of 293 stand posts
were inspected out of which 27% were found
belonging to the ‘low risk’ category, 45% were in
the ‘intermediate risk’ category and 28% were in
the high risk category. No stand post was found
in the ‘very high risk category’. It is evident from
the data that in a slum context even the safety of
pipe water supply, which is considered as one of
the development indicators, gets compromised.
Though only 10% of the total inspected stand
posts (n=293) were found with bacteriological contamination, risk score wise 11% of the intermediate
stand post (n=132) and 15% of high risk stand post(n=81) were found contaminated yet the potential
hazards outburst from the stand post cannot be ruled out. The following table shows the situation of all
the inspected stand posts against the prescribed risk factors.
Surrounding area insanitary (hazard factors), stagnant water surrounding the stand post, plinth cracked
and eroded (pathway factors), and animals having access to the source (indirect factors), emerged as the
predominant risk factors associated with pipe water supply alias stand post in Bhubaneswar slums.
Stand post, n=293
Table 8: Existing situation of stand posts in Bhubaneswar slums
Risk factors %
Leakage in tap 21
Surrounding area insanitary 72
Stagnant water surrounding stand post 46
Discontinuity of water supply for last 10 days 6
Leakage in distribution pipe 21
Stand post below ground level 38
User reported pipe breaks last week 9
Plinth cracked and eroded 45
Animals have access to stand post 83
Cracks and leakage in adjacent tank 8
The sanitary inspection and water quality for stand posts is presented in Table 9:

Table 9: Distribution of contaminated sources against each risk factor
Risk factors % reported with H2
S test positive
Leakage in tap (n=62) 13
Surrounding area insanitary (n=210) 12
Stagnant water surrounding stand post(n=135) 17
Discontinuity of water supply for last 10 days(n=16) 19
Leakage in distribution pipe(n=61) 20
Stand post below ground level (n=110) 9
User reported pipe breaks last week(n=27) 11
Plinth cracked and eroded (n=132) 10
Animal has access to stand post(n=244) 10
3.2.1.2 Estimation of the Strength of Association Between Risk Factors and
Contamination
Stand posts with leakage in the distribution pipe, where the water supply had been discontinued
for the last 10 days, and those surrounded by stagnant water, were the ones that were found to be
more contaminated. To test whether this contamination happened by chance or there is statistically a
significant association between each or multiple risk factors and bacteriological contamination, the odds
ratio (OR)10
was calculated along with the Chi-square test11
for each risk factor in the 2 X 2 contingency
table.
10 Odds are the probability of an event occurring divided by the probability of not occurring. An odds ratio is the odds of the
event (here bacteriological contamination) in one group. For example, those stand posts exposed to certain risk factor divided
by odds in another groups - stand posts not exposed to certain risk factor (David et al. 2008). Odds ratio above 1 indicates a
positive relationship between the risk factors and water contamination. Confidence interval and p-value gives an indication of the
statistical significance of the odds ratio and eventually about the relationship of the risk factor and water quality compromisation
(Howard et al, 2006).
11 Chi-square is a statistical test commonly used to compare observed data with data we would expect to obtain according to a
specific hypothesis.

The findings are placed in the following contingency table for stand posts. In the following table, only two
risk factors that is ‘surrounding area insanitary’ and ‘leakage distribution pipe line’ have been found to have
significant association with water contamination at p value 0.024<0.05 and .004<0.05.
Table 10: Contingency table for stand posts
Risk factors Water sample detected with bacteriological
contamination
OR 95% CI p-value
Leakage in tap 1.481 .622 ,4.032 0.372
Surrounding area insanitary 3.77 1.108,12.820 .024
Stagnant water surrounding stand post 1.753 .805,3.815 0.083
Discontinuity of water supply for last 10 days 2.227 .595,8.333 .223
Leakage in distribution pipe 3.095 1.388,6.896 .004
Stand post below ground level 1.159 0.518,2.592 0.72
User reported pipe breaks last week 1.154 0.325,4.095 0.825
Plinth cracked and eroded 1.010 0.467,2.183 .98
Animals have access to stand post 1.042 0.377,2.878 .937
Cracks and leakage in adjacent tank 1.167 .259,5.249 .841
The round odds ratio in both the cases is greater than 1 and 95% confidence interval, which provides
information about precision excludes 1 (Odds ratio =1 signify no association between exposure and
outcome), and thus signifying positive association.
Multivariate Logistic regression models12
were developed using SPSS to further investigate the causes
of exceeding water quality targets (Howard et al, 2003). While doing the regression however only those
covariates where Odds ratio showed relationship significant at least to 95% confidence interval level.
‘Surrounding area of stand post insanitary’ and ‘Leakage in distribution pipeline’ are two such covariates
[Table: 10].
The result of binary logistic regression model is shown below.
Table 11: Logistic regression for stand posts in Bhubaneswar slums
Model -2LL Variables Log
estimate
(B)
S.E. df Sig. Exp
(B)
95.0% C.I. for
EXP(B)
Lower Upper
Source found
contaminated
[H2
S test
positive]
177.468 Constant -3.467 .599 1 .000 .031
Area insanitary 1.189 .630 1 .059** 3.285 .956 11.292
Leakage in distribution
pipe line
1.011 .414 1 .015** 2.747 1.221 6.183
**p<.05
12 Such a model is used to explore the association between one outcome variable (dichotomous, contamination=1, no
contamination=0) and two or more exposure variables. In the present study, all the risk factors are exposure variables. This
model helps in isolating the relationship between the exposure variable and outcome variable from the effect of one or more other
variables called covariates or more precisely confounder.

The model explains that leakage in the pipeline
distribution is 2.747 times more likely to have
contamination in the water supplied through
piped connection. Similarly, stand posts
surrounded by insanitary areas are 3.285
times more likely to have contamination.
Such findings are in agreement with other
similar studies. Infiltration of contaminated
surface or sub surface water occurs
when there is reduced pressure within the
supply pipeline and simultaneously there is an existence of a physical route i.e. leakage caused
either by corrosion, cracks or outright breaks (Robertson, Standfield, Howard, & Bartram, 2003).
Leakage rates are typically found high with even well operated system experiencing rates of 10-
20 % (LeChevallier et al, 1999; WHO & UNICEF, 2000). Several epidemiological studies through
environmental investigation identified pipe line leakage and its cross connection with sewerage,
open-drain, stagnant storm water pool etc. as a causal factor associated with the outbreak of various
waterborne diseases (Bhunia, et al., 2009; Bhunia, Ramkrishnan, Hutin, & Gupte, 2009; Haque, et al.,
2013 Sailaja, et al., 2009)
3.2.1.3. Presence of Residual Chlorine in Pipe Water Supply through Stand Post
Residual chlorine13
in water samples from all stand posts was tested with the field test kit. Samples from
total 293 stand posts were found with a minimum 0.0 ppm to 5.50 ppm residual chlorine with a mean of
0.47 ppm and a standard deviation of .479. The slight higher standard deviation indicates that there is
wide variation of the presence of residual chlorine in different samples and presence of an outlier as well.
The excessive high amount of residual chlorine determined on a few sources is the evidence against the
existence of such outliers.
With reference to permissible limit of residual chlorine in drinking water (0.2-0.5 ppm), the entire stand
posts were further classified into four categories. The results are presented in Table 12:
Table 12: Presence of residual chlorine in water from stand post
Residual chlorine Frequency Percent (%)
Absent 3 1.0
Below permissible limit 45 15.4
Within permissible limit 180 61.4
Above permissible limit 65 22.2
Total 293 100.0
13 The World Health Organization recommends that the residual chlorine in treated drinking water should be within the range of 0.2
to 0.5 ppm (mg/l) for preventing further growth of bacteria during transportation of water through pipe line and in the course of
storage.

In majority of the samples collected (61.4%, n=293) from the stand posts, residual chlorine was found
within permissible limit (0.2-0.5 ppm). However, a significant percent of samples i.e. 22.2%, were detected
with chlorine above permissible limit. One third (n=22) of such sources were further tested and in 32%
cases the second time test also resulted with above permissible limit (Annexure III). In surveyed stand
posts, chlorine was absent in just 1.0% samples (n=293) and 15.4 % water samples from the stand posts
were found with chlorine below permissible level.
There was disparity in the amount of chlorine present during morning and evening supplies. In some stand
posts, the morning supply had excessive chlorine, where as the evening supply was within permissible
limits. The quality control of chlorine dosing at the water treatment point, or the proximity of the stand post
from water treatment plant, flow rate of water in the pipeline, all attribute to the presence of residual chlorine
below or above permissible levels in the supplied drinking water. As both conditions have significant public
health implications, it demands further study and exploration with water sample testing in the Public Health
Engineering Organisation (PHEO) authorised laboratory.
A logistic regression considering the presence of contamination as dichotomous dependent variable
and presence of residual chlorine within permissible limit or not as categorical exposure variable were
undertaken. The results are depicted in Table 13:
Table 13: Logistic regression of permissible chlorine in water and
bacteriological contamination
Model -2LL Variables Log
estimate
(B)
S.E. df Sig. Exp (B) 95.0% C.I. for
EXP(B)
Lower Upper
Source found
contaminated
[H2
S test
positive]
99.679 Constant -3.555 .454 1 .000 .029
Chlorine
within
permissible
limit
2.457 .563 1 .000** 11.667 .3.871 35.161
**p<.001
The quality control of chlorine dosing at
the water treatment point, or the proximity
of the stand post from water treatment
plant, flow rate of water in the pipeline,
all attribute to the presence of residual
chlorine below or above permissible levels
in the supplied drinking water.

The model reveals that stand posts carrying water with residual
chlorine are 11.6 times less likely to be contaminated.
It is to be noted that both the absence of residual chlorine and
excessive residual chlorine can attribute to the risk regime.
Though WHO(1993) promotes, “the risk of death from pathogen
is at least 100 to 1000 times greater than the risk of cancer from
disinfection by products (DBP)14
”, the same document quotes,
“because of the formation of the by-product the chemical
risk increases with increasing level of chlorine”(Morris, 1978).
Morris also cited, that with raised chlorine levels and exceeding
test and odor thresholds, consumers may switch to unsafe
sources.
3.2.2 Tube Well Fitted with Hand Pump
3.2.2.1 Proportion of Tube Wells Fitted with Hand
Pumps Belonging to Different Contamination Risk
Categories
Tube well fitted with hand pump (India mark II)15
comprises the
second largest proportion of all water sources surveyed under
the study. A total of 177 tube wells were surveyed, of which 15% were found in the low risk category, 40%
in the intermediate risk category, 44% in the high risk category, and 1% in the very high risk category. This
shows the extent of risk associated with the tube well – one of the major sources of drinking water in slums
– and the potential it has to be a public health threat. Out of the 177 tube wells, 29% i.e. almost 1/3 of the
sample inspected were found with traces of fecal contamination. Table 14 represents the contamination
pattern in different risk categories of tube wells.
Table 14: Risk category vs contamination cross tabulation for tube wells
Low (n=26) Intermediate (n=71) High (n=78) Very high (n=2)
Contaminated (%) 42 27 26 50
Often contamination is associated with high risk, but in the present study, 42% of the inspected tube wells,
which were found to be under the ‘low risk category’ were identified with fecal contamination. This finding
is consistent with the poor correlation noted between sanitary inspection scores of shallow tube wells
and water quality in Indonesia (Lloyd & Bartram, 1991). Table 15 depicts the situation of the tube wells in
Bhubaneswar’s slums.
14 DBP are produced by the reaction of residual chlorine and organic substances present in water. Chloroform, trihalomethanes are
the most predominant DBP.
15 India Mark II is a hand pump designed to lift water from 50 m or less. The pump was designed jointly by Government of India,
UNICEF and WHO in 1970. It can lift 12 litres of water in every 40 stroke(WaterAid).

Table 15: Existing situation of tube well in Bhubaneswar slums
Risk Factors %
Latrine within 10 m of the tube well 40
Nearest latrine on a higher ground than the tube well 20
Any other source of pollution (e.g. animal excreta, rubbish) within 10 m 81
Poor drainage, causing stagnant water within 2 m of the tube well 66
Faulty drainage channel (broken, permitting ponding) 50
Concrete floor less than 1 m wide around the tube well 63
Installation require fencing 81
Ponding on the concrete floor around the hand pump 36
Cracks in the concrete floor around the hand pump permitting water to enter tube well 45
Hand pump loose at the point of contact 36
Table 15 shows that all types of risk factors are associated with the tube well located in urban slums.
Identification of 40% of the total inspected sources (n=177) in close proximity of toilet, and 81% of the total
inspected sources in close proximity of other polluting materials -- excreta of animal and rubbish -- clearly
gives us an idea about magnitude of ‘hazard factors’ associated.
Whole gamut of ‘pathway factors’ are also found as the study reveals. Sixty six per cent the inspected
tube wells (n=177) had poor drainage causing stagnant water nearby, 50% of them had a faulty drainage
channel, 63% of the hand pumps were with concrete floor less than 1m diameter and 45% (n=177) had
cracks in the apron surrounding hand pump.
In current risk scenario, ‘indirect factors’ also have a profound presence as 81% of the tube wells are
actually in need of fencing. While the above table showcases the magnitude of each risk factor, around
85% of the total sources belonging to the intermediate, high or very high categories get the status by
having three or more of the above mentioned risk factors.
Sanitary inspection and water quality for tube well is presented in table below
Table 16: Distribution of contaminated sources against each risk factor
Risk Factors % of source found
contaminated
Latrine within 10m of the tube well (n=70) 34
Nearest latrine on higher ground than the tube well (n=35) 29
Any other source of pollution ( e.g. animal excreta, rubbish) within 10 m (n=144) 29
Poor drainage, causing stagnant water within 2m of the tube well (n=117) 29
Faulty drainage channel( broken, permitting ponding)(n=89) 30
Concrete floor less than 1m wide around the tube well (n=112) 22
Installation require fencing (n=144) 28
Ponding on the concrete floor around hand pump (n=64) 33
Cracks in the concrete floor around the hand pump permitting water to enter tube well (n=79) 24
Hand pump loose at the point of contact (n=63) 27

Sources in proximity of toilet, with faulty drainage channel, with ponding on concrete floor surrounding hand
pump, show slight increased trend for fecal contamination when risk and contamination data are cross
tabulated. However to know the significance of the association with each risk factors and contamination
odds ratio were calculated corresponding to each risk factors. In the following contingency table, the odds
ratio is presented with p-value and 95% CI.
Contamination
Table 17: Contingency table for tube wells
Risk factors Water sample found with bacteriological
contamination
OR 95% CI p-value
Latrine within 10m of the tube well 1.546 .8,2.985 0.194
Nearest latrine on higher ground than the tube well 1.015 .448,2.300 0.972
Any other source of pollution (e.g. animal excreta, rubbish) within
10 m
1.098 .471,2.559 0.828
Poor drainage, causing stagnant water within 2 m of the tube well 1.036 .520,2.063 0.92
Faulty drainage channel (broken, permitting ponding) 1.161 .605,2.227 0.653
Concrete floor less than 1 m wide around the tube well 2.32 1.191,4.524 0.012
Installation require fencing 1.300 .578,2.924 0.525
Ponding on the concrete floor around the hand pump 1.351 .693,2.636 0.377
Cracks in the concrete floor around the hand pump permitting
water to enter the tube well
1.531 .786,2.982 0.209
Hand pump loose at the point of contact 1.150 .579,2.283 0.69
Table 17 shows the significant positive association between fecal contamination and the size of the
concrete floor. The above table shows that pumps with concrete floor less than 1 metre of width are 2.32
times more likely (p=.012<.05) to be contaminated by fecal contamination. It is an important ‘pathway
factor’ that is contributing to the contamination of tube wells in Bhubaneswar.
Data was further analysed through logistic regression16
. The model developed is shown in following table.
After adjusting the confounding factors, the model reveals two more risk factors i.e. ‘ponding on concrete
floor’ and ‘cracks in apron’ has also contribution towards contamination of the water of tube well..
Sources
with ponding on concrete floor are 2.493 more likely to be contaminated (p=.05) and sources having
cracks on the concrete floor (pathway factor) are 2.556 times more likely to be contaminated (p=.045<.05).
16 Logic regression is a (generalized) regression methodology that is primarily applied when most of the covariates in the data to
be analyzed are binary. The goal of logic regression is to find predictors that are Boolean (logical) combinations of the original
predictors.
The regression model includes all co-variates where the odds ratios showed relationship significance at least to 95% level.
Although not significant at least to the 95% but other covariats were also incorporated in model seeing the increased number of
sources reported with those risk categories.

Table 18: Logistic regression for tube well in Bhubaneswar slums
B S.E. Wald df Sig. Exp
(B)
95.0% C.I.for EXP
(B)
Lower Upper
Concrete floor <1m .945 .389 5.892 1 .015** 2.574 1.200 5.522
Latrine within 10m(1) -.558 .380 2.155 1 .142 .572 .272 1.206
Pollution source within 10m(1) -.452 .527 .738 1 .390 .636 .227 1.786
Poor drainage causing water 2m(1) .034 .445 .006 1 .939 1.035 .433 2.475
Faulty_drainage_channel(1) -.035 .463 .006 1 .939 .965 .390 2.392
Fencing_HP_installation_inadequate_
damaged(1)
.366 .518 .500 1 .479 1.443 .523 3.982
Ponding_concrete_around_HP(1) -.914 .475 3.696 1 .055** .401 .158 1.018
Cracks_concrete_around_HP(1) .938 .468 4.015 1 .045** 2.556 1.021 6.400
HP_loose_point_attachemnt(1) -.520 .476 1.194 1 .275 .595 .234 1.511
Constant -.585 .458 1.627 1 .202 .557
**p<.05
3.2.3 Unprotected Dug Well
3.2.3.1 Proportion of Unprotected Dug Wells Belonging to Different Contamination Risk
Categories
The unprotected dug well was the third largest type of water sources inspected for the study. A total
162 unprotected dug wells were surveyed, of which 14% were found to be in the low risk category, 37%
were in the intermediate category, a whopping 41% in the high risk category, and 8% in the very high risk
category. Fifty two per cent of all unprotected dug wells inspected were detected with fecal contamination,
making them the most unsafe drinking water sources. Table 19 shows the contamination pattern across
various risk categories of unprotected dug wells.
Table 19: Bacterial contamination against risk category
Low (n=23) Intermediate (n=60) High (n=66) Very high (n=13)
The data clearly reveals that even dug wells that scored low in the risk category have traces of fecal
contamination. A study Tube well water quality and predictors of contamination in three flood-prone areas
of Bangladesh cited similar incidence, but in case of tube wells where predictor scores were less yet tube
well were detected with bacteriological contamination (Luby et al, 2008). The situation of dug wells located
in the slums of Bhubaneswar is shown in Table 20.

Table 20: Existing situation of unprotected dug wells in Bhubaneswar slums
Risk Factor %
Latrine within 10 m of the well 50
Nearest latrine on higher ground than the well 30
Poor drainage, causing stagnant water within 2m of the well 37
Faulty drainage channel (broken, permitting ponding) 26
Wall (parapet) around the well inadequate, allowing surface water 35
Concrete floor less than 1m wide around the well 57
Walls of the well inadequately sealed at any point for 3 m below the ground 56
Any cracks in the concrete floor around the well permitting water to enter the well 49
Rope and bucket left in such a position that they may become contaminated? 46
Installation require fencing 79
Fifty per cent of the total dug wells inspected were found within 10 metres proximity of a toilet (n=162),
in case of ‘other source of contamination’ the proportion is 62%. This gives an idea about the propensity
of hazard factors associated with a dug well. Pathway factors like ‘concrete floor less than 1m width’,
‘inadequately sealed wall’, ‘and cracks in apron’ or ‘rope bucket contamination route’ counted positive
ranging from 57% to 46% of the inspected dug well (n=162). Indirect factors like requirement of fencing
was identified in 79% dug wells (n=162). This table gives an idea about the magnitude of individual risk
factors. But like other sources, here too, 86% of the sources, which were detected within intermediate to

very high category, earned their score for being associated with three to 11 risk factors simultaneously.
Such a complex association of risk factors even makes sources more vulnerable towards compromised
drinking water quality.
Sanitary inspection and water quality for unprotected dug wells is presented in Table 21.
Against each risk factor, a whopping 45% to 59% dug wells were found contaminated. For an example,
almost half of those dug wells located in proximity of a toilet were found contaminated. In case of proximity
to other pollution sources (n=100), 48% sources were found contaminated. Such figures apparently show
propensity of ‘hazard factors’ towards contamination. But when 57% of the total dug wells detected with
faulty drainage channel (n=42) and 59% of the total dug well with poorly sealed wall (n=90) are found
contaminated, the influence of ‘pathway factors’ cannot be ruled out. When 53% of total dug well with
inadequate fencing (n=128) are found with fecal contamination one cannot exclude the potential indirect
factors and their contribution towards water quality degradation.
Table 21: Percentage of sources detected contaminated against each risk
factors
Risk Factor % of sources
found
contaminated
Latrine within 10m of the well (n=81) 49
Nearest latrine on higher ground than the well (n=49) 45
Any other source of pollution (e.g. animal excreta, rubbish) within 10 m (n=100) 48
Poor drainage, causing stagnant water within 2m of the well (n=59) 49
Faulty drainage channel( broken, permitting ponding) (n=42) 57
Wall (parapet) around the well inadequate, allowing surface water (n=56) 48
Concrete floor less than 1m wide around the well (n=93) 41
Walls of the well inadequately sealed at any point for 3m below the ground (n=90) 59
Any cracks in the concrete floor around the well permitting water to enter well(n=79) 51
Rope and bucket left in such a position that they may become contaminated (n=74) 49
Installation requires fencing (n=128) 53
Contamination
To test whether the contamination has association with the listed risk factors or just happened by chance,
the risk estimation was done by calculating the odds ratio for each of the risk factors. The corresponding
contingency is presented in Table 22. From the contingency table factors like ‘concrete floor less than
1m width surrounding dug well’ and ‘wall inadequately sealed 3m below ground level’ show positive and
statistical significance towards contamination of unprotected dug wells. It can be concluded in the present
context that these are the risk factor which are primarily responsible for contamination at p<.05 level. The

significance of association of different risk factors with water quality outcome may vary with each season
as well (Alam & Rahaman, 2011). Though the samples were collected in the wet season, seasonality was
not considered as one of the confounding factors.
Table 22: Contingency table for unprotected dug wells
Risk factors Water sample found with bacteriological
contamination
OR 95% CI p-value
Latrine within 10 m of the well 1.219 .658, 2.259 0.529
Nearest latrine on higher ground than the well 1.492 .760,2.927 0.243
Any other source of pollution (e.g. animal excreta, rubbish)
within 10 m
1.499 .792,2.841 0.213
Poor drainage, causing stagnant water within 2m of the well 1.184 .625,2.247 0.603
Faulty drainage channel (broken, permitting ponding) 1.333 .653,2.710 0.425
Wall (parapet) around the well inadequate, allowing surface
water
1.25 .653,2.392 0.501
Concrete floor less than 1m wide around the well 2.895 1.512,5.541 0.001
Walls of the well inadequately sealed at any point for 3 m below
the ground
1.894 1.011,3.546 0.045
Any cracks in the concrete floor around the well permitting water
to enter well
1.1 .594,2.038 0.762
Rope and bucket left in such a position that they may become
contaminated
1.267 .682,2.354 0.454
Absence of fencing 1.276 .598, 2.717 0.529

A logistic regression model was developed to further investigate the causes of exceeding the water quality
target. All co-vitiates where odds ratio showed relationship significant to the 95% confidence interval
level (p≤.05) and above, were included in the analysis. Although the odds ratios for proximity of toilet and
other sources, garbage within 10m were not found significant at 95% CI, yet they were incorporated in
the model. This was as they were deemed to be a plausible route of contamination, specially in the slum
context and when even low risk dug wells were also identified with fecal contamination.
Table 23: Logistic regression for unprotected dug wells in Bhubaneswar
slums
B S.E. Wald df Sig. Exp(B) 95.0% C.I.for
EXP(B)
Lower Upper
Latrine_10_m(1) -.292 .340 .738 1 .390 .747 .384 1.453
Pollution_source_10m(1) -.627 .359 3.054 1 .081 .534 .265 1.079
Concrete_floor_1m(1) -1.407 .371 14.374 1 .000** .245 .118 .507
Wall_inadequately_
sealed_3m_GL(1)
1.145 .374 9.400 1 .002* 3.144 1.512 6.538
Constant .796 .399 3.976 1 .046 2.216
*p≤.05 ; **p≤ .001
The model depicts that even after adjusting confounding factors, proximity of a toilet or other sources
doesn’t exhibit any significant association with contamination of dug well. But dug wells with concrete floor
less than 1 metre around are found 1/.245 or 4.08 times more likely to be contaminated (p=.000<.001),
where as wells with an inadequately sealed up wall to three metres below ground level are 3.144 time
more likely to be contaminated. Association of contamination with improper sealing can be attributed to
subsurface leaching. Further scope for exploration was not included in the study design.
3.2.4 Bore Wells Fitted with Mechanical Pump
3.2.4.1 The Proportion of Bore Wells Fitted with Mechanical Pump Belonging to Different
Contamination Risk Categories
Bore wells fitted with mechanical pump are one of the major sources of drinking water in the slums
located in nine [Ward number 1, 2, 7, 9, 11, 15, 16, 47 & 54] out of 25 wards where the current study
was undertaken. In wards number 15 and 16 this type of source was found predominant [Annexure: I]. In
this type of water source, the mechanical pump (a submersible pump found in study area) gets fitted with
the bore well to extract ground water and lift it up to an over head tank. Water from the over head tank
then reaches to the door step of the consumers through pipeline connection. These installations were
found to be either by NGOs or as community initiatives. In many cases, the community had converted
the pre-existing tube well into this advanced version. Often these sources were found to cater to a group
of families, who take care of its maintenance and management, and pay the electricity bill by collective
subscription. In ward 47 the local Corporator (ULB representative) had utilised the untied fund to install
a similar bore well for slum dwellers. In the present study, a total of 108 bore wells were surveyed, out

of which 8% (n=108) were found to have fecal contamination, which is less than all other types of water
sources surveyed (excluding protected dug wells as the sample size was not considerable). Majority of the
bore wells were diagnosed under the intermediate risk category (52%, n=108), followed by high (32%),
low (15%) and very high (3%) category. Table 24 shows the contamination pattern across various risk
categories for the bore well.
Table 24: Contamination and risk category
Low (n=14) Intermediate
(n=56)
High (n=35) Very high (n=3)
The situation of the bore wells located in Bhubaneswar slums is shown in Table 25.
Bore wells fitted with mechanical pump (n=108)
Table 25: Existing situation of bore wells in Bhubaneswar slums
Risk factors %
Latrine within 15-20m of the well 62
Nearest latrine is pit /unsewered 22
Uncapped well within 10-15 m 14
Faulty drainage around pump house 19
Fencing inadequate/damaged 43
Floor of pump house permeable to water 31
Well seal insanitary 30
Chlorination is not functioning 100
Chlorine absent 100
Like all other sources surveyed for the study, ‘hazard factors’ are also associated with bore wells as 62%
(n=108) are in proximity of a toilet, where as 59% of the total sources were found closer to other sources
of pollution — animal feces or garbage. ‘Pathway factors’ show a lesser tendency to be associated with
this type of water source. Interestingly, as none of the sources had any inbuilt mechanism of chlorination,
residual chlorine was not found in any of the sample. Interaction with the community reveals that the over
head tank is not used for storing water. It is used to make lifted water gravity fed. So the need of regular
chlorination was not felt. Bleaching powder is used for cleaning the tank. However, a clear conclusion
regarding the frequency of cleaning the over head tank could not be drawn as it was not an integral
component of the current study design. But no chlorination and minimum presence of fecal contamination
this literary ambiguous condition demands an in depth study exclusively for this type of source.
Sanitary inspection and water quality for bore wells is presented in Table 26.

Table 26: Percentage distribution of contaminated sources against each risk
category
Risk factors % of sources found
contaminated
Latrine within 15-20 m of the well (n=67) 10
Nearest latrine is pit /unsewered (n=24) 13
Any other source of pollution (e.g. animal excreta, rubbish) within 10 m(n=64) 6
Uncapped well within 10-15 m (n=15) 7
Faulty drainage around pump house (n=21) 5
Fencing inadequate/ damaged (n=46) 7
Floor of pump house permeable to water (n=33) 9
Well seal insanitary (n=33) 9
Chlorination is not functioning (n=108) 8
Chlorine absent (n=108) 8
From Table 26 it is evident that none of the risk factors are associated with increased contamination. Still
to explore the statistical significance of the strength of association with contamination, the odds ratio was
calculated like for other sources.
3.2.4.2 Estimation of Strength of Association Between Risk Factors and Contamination
Table 27: Contingency table for bore wells fitted with mechanical pump
Variables Water sample found with bacteriological
contamination
OR 95%CI p-value
Latrine within 15-20 m of the well 2.273 .449,11.494 0.309
Nearest latrine is pit /un-sewered 1.857 .428,8.055 0.402
Any other source of pollution (e.g. animal excreta, rubbish)
within 10 m
1.923 .486,7.634 0.345
Uncapped well within 10-15 m 1.318 .153,11.364 0.801
Faulty drainage around pump house 2.025 .239,17.145 0.509
Fencing inadequate/damaged 1.536 .363,6.949 0.557
Floor of pump house permeable to water 1.150 .270,4.906 0.85
Well seal insanitary 1.206 .283,5.155 0.799
Chlorination is not functioning NA NA NA
Chlorine absent NA NA NA
None of the risk factors shows a significant association with the contamination of the water supplied by
the bore wells. Data was further analysed in logistic regression model [Table 28] and even after adjusting
confounding factors no risk factor shows a significant association with contamination of the source.

The collective maintenance management, in some places NGO intervention, or construction design could
be responsible for the source to emerge as a comparatively safer source of water in densely populated
slums. But it requires further full length exploration.
Table 28: Logistic regression for bore wells in Bhubaneswar slums
B S.E. Wald df Sig. Exp (B)
Pollution_source_10 m (1) .847 .842 1.012 1 .315 2.332
Fencing_HP_installation_inadequate_damaged
(1)
.364 .883 .170 1 .680 1.440
Latrine_15_20 m_pump_house (1) -.860 .932 .852 1 .356 .423
Latrine_unsewered (1) -.534 .866 .380 1 .537 .586
Uncapped_well_within_15_20 m (1) .006 1.183 .000 1 .996 1.006
Faulty_drainage_around_pump_house (1) .995 1.344 .548 1 .459 2.704
Floor_pump_house_permeable_water (1) -.502 .899 .312 1 .576 .605
Well_seal_unsanitary (1) -.682 .922 .548 1 .459 .505
Constant -2.402 1.386 3.005 1 .083 .091

One important objective of the study was to identify gaps in the water supply system and find solutions.
This section of the report has been prepared based on the findings of the study, an extensive desk review,
individual interactions with Government officials, urban health and WASH professionals, functionaries of
civil society organisations and slum dwellers, and various consultations. The roundtable consultations
were organised in three major cities — Bhubaneswar (March 14, 14), Cuttack (March 4, 14) and Rourkela
(March 11, 14) of Odisha, one in the national capital, New Delhi (June 6, 14) and the other at the WASH
Summit in Jaipur, Rajasthan (June 27, 14). The current chapter suggests ways to improve the quality of
the water supply system and its surveillance.
Suggestions
4.1 For Surveillance of Sources and Action
4.1.1 Routine Inspection and Survey of Water Sources
Sanitary inspection of drinking water sources should be undertaken on a regular basis. Two minimum
annual inspections along with microbial water quality monitoring may be done by the surveillance agency.17
As per WHO, the minimum annual frequency of sanitary inspection for dug wells, dug wells with hand
pump is six times, and shallow and deep tube wells with hand pump is four times, which can be done by
the community with the support of the water supply and surveillance agency.18
17 Capacity building/skill development of staff at all levels on water safety and management may be taken up in a coordinated
manner. Refresher courses at regular intervals are required for different stakeholders responsible for water supply and its
surveillance. PHEO officials may be given special training on environmental engineering. As suggested in the Round table
consultation on safe water on March 4, 2014 in Cuttack.
18 Periodic monitoring of drinking water supply and its quality need to be done by a third party so that timely remedial steps may
Chapter 4: Suggestions

4.1.2 Placement of a Regular Water-Testing Quality Control Mechanism
which includes Inspection, Testing and Treatment for Ensuring Safe
Drinking Water
Out of total 742 drinking water sources surveyed, the trace of fecal bacteria was detected in all type of
sources. Fifty two per cent of unprotected dug wells, 29 per cent of tube wells fitted with a hand pump,
and 10 per cent of stand posts were found to be with fecal contamination. Drinking water sources with
bacteriological contamination pose a high risk of several water borne diseases. There is the need to place
a regular quality control mechanism for ensuring the safety of drinking water. Proper sanitary inspection
needs to be followed by regular bacteriological assessment and regular disinfection of all drinking water
sources. All these activities need to be planned and conducted on a regular basis. For this, there is a need
for cooperation and strong convergent action between the agency responsible for drinking water supply
in urban areas under housing and the urban development department, and the public health directorate
under the health and family welfare department.
4.1.3 Establishment of Water Quality Labs in Urban Areas
It is difficult to find a water testing labs in cities and towns. Almost all water testing labs are owned by public
health engineering organisations, and there are very few labs with the health department which monitors
food quality. The capacity of these labs to cater to the need of the general public is meager. Establishment
of such labs by the government and other agencies will allow consumers to find out the quality of water
they consume.19
be undertaken in ensuring effective water supply. Integrated sewerage system needs to be developed for proper waste disposal
leading water safety. As suggested in the Round table consultation on safe water in Cuttack.
19 Specific efforts need to be made for establishing water testing labs at least at district levels on a pilot basis to periodically check
the quality of water quality before it reaches the people. As suggested in the Round table consultation on safe water on March
14, 2014 in Bhubaneswar, Odisha

4.1.4 Maintenance and Supervision of Drinking Water Sources to Control
Various Hazard, Pathway and Indirect Risk Factors that may Compromise
Drinking Water Quality
Maintenance and supervision of drinking water sources is vital for ensuring drinking water quality. Out of
293 public stand posts of pipe water supply surveyed, 10 % found to have bacteriological contamination.
The major possible risk factors associated with the pipe water supply found from this study are leakage
in the distribution pipe, where the water supply has been discontinued for the last 10 days, and stagnant
water. Similarly, all type of risk factors are associated in case of the tube wells fitted with hand pumps.
These risk factors can be taken care of by the constant supervision and maintenance.20
4.1.5 Maintaining the Standard on Concrete Floor Around the Source
Recommended by WHO
As per the recommendation of WHO, the concrete floor around the well, tube well should be one metre as
mentioned in the sanitary inspection format. The study shows the concrete floor is less than one metre in
63% of tube wells. Similarly, 57% of un-protected dug wells had less than one metre of the concrete floor.
The study found a significant positive association between fecal contamination and the size of concrete
floor. Those tube wells with less than one metre wide concrete flooring are 2.32 times more likely to have
fecal contamination. The government could make it mandatory for any agency providing drinking water
facility — PHEO, ULBs, NGOs, CBOs-- 21
to follow the standard of concrete floor for various drinking water
sources.
20 The guidelines on management of water sources are required to be strictly adhered to and may be a part of the community
monitoring process. As suggested in the Round table consultation on safe water on March 11, 2014 in Rourkela, Odisha
21 A structural framework or protocol may be developed to bring role clarity among different stakeholders associated with drinking
water supply in the state, cities and towns. As suggestion in the Round table consultation on safe water in Bhubaneswar,
Odisha
As per the recommendation of WHO, the
concrete floor around the well, tube well
should be one metre as mentioned in
the sanitary inspection format. The study
shows the concrete floor is less than one
metre in 63% of tube wells. Similarly, 57%
of un-protected dug wells had less than
one metre of the concrete floor.

4.2. For Prioritisation of Area and WASH Intervention
4.2.1 Use of Sanitary Survey as a Tool for Identifying Vulnerable Slums or
Wards for Prioritising WASH Interventions
The sanitary survey could be used as a tool to identify the vulnerable slums and pockets in a city for water
supply, sanitation and health intervention.22
Apart from the department responsible for provisioning water
supply and ULBs, the sanitary survey tool may also be adopted by various civil society organisations
working in slums and those that have specific water, sanitation, health and hygiene interventions.
4.2.2 Water Safety Plan and its Execution
Safe water and its supply are always aimed at public health protection and disease prevention. So water
safety plans need to be planned and implemented taking a ward or a slum as a unit. The plan involves the
assessment of the drinking water supply system to determine the quality of water supply at the delivery
point, constant monitoring of the steps in the supply chain that are of particular importance in securing safe
drinking water, a systematic independent surveillance to verify and cross check that the system is operating
properly. It is worth mentioning that for water safety plan and its execution, local community leaders, ULB
representatives, front line workers, women groups, youth clubs, community groups of specific slums and
other community based organisations need to be involved.
4.3 For Community Participation
4.3.1 Sharing of the Report and Involvement of the Community in Sanitary
Survey
Involvement of community members is crucial for maintenance of community drinking water supplies. As
per Uniform Drinking Water Quality Monitoring Protocol of the Government of India, Ministry of Drinking
Water and Sanitation, 2013, “The result of the sanitary inspection and the remedial action that needs to be
taken to improve conditions should be discussed with the community. In small water supply schemes, it is
often possible for community members to carry out most of the inspections themselves using a standard
form.” As a first step to disseminate the message and involve the community in the sanitary survey of
drinking water sources, front line workers of various departments at the grass root level and functionaries
of ULBs can be trained on sanitary inspection and water quality testing with field test kit. They may carry
out the same under the guidance of public health engineering functionaries in their respective community.23
They may also be provided with a water quality field test kit and the H2
S strip for survey of drinking water
quality in a prescribed duration of time. It is important to involve the ward councilor/ corporator of the
concerned ward in the survey.24
22 It was suggested at the Round table consultation in New Delhi on June 6, 2014 that the sanitary survey format may be modified
considering the local environmental situation.
23 Numbering of tube wells may be done so that in case of need, the community may have a dialogue with the concerned authority
for its repair and management. The Mahila Arogya Samiti (MAS) may be used in mapping water sources in their respective
slums and the status report may be generated and shared in Ward Kalyana Samiti (WKS)/Ward Coordination Committee (WCC)
meeting for its smooth management under NUHM initiatives. As suggested in the - Round table consultation on safe water in
Bhubaneswar, Odisha and Round table consultation on safe water on June 6, 2014 in New Delhi.
24 A sound participatory monitoring mechanism to assess the water sources at regular intervals, especially in slum areas is of
inescapable necessity. There is need of basic information and its dissemination at all levels about the owners of water sources,

4.3.2 Inclusion of Water Quality in the Communication Plan of Allied
Departments and Awareness Generation Among the Community
Any water source, which has serious risks as suggested by sanitary survey report, should be brought to the
notice of the concerned authority. The community needs to be made aware for not using the water from
the contaminated source. Immediate action should be taken to treat the water and for other necessary
action as suggested by the sanitary survey. At the same time, a specific strategy in the communication
plan may be developed for awareness on various factors that compromise water quality along with the
importance of safe water, linkage of drinking water with health and well being, sanitary inspection of water
sources, safe handling of water, safe storage and home-based water treatment methods (Point of Use).
By demonstrating the use of H2
S strip and field test kit in the community, and the test results, awareness
can be created on safe water.25
4.3.3 Precaution for Proximity of Toilet to Drinking Water Sources
There is a direct relation of the presence of a latrine near the water sources with risk of contamination. As
per WHO’s sanitary inspection format, the minimum distance of the latrine from the drinking water source
needs to be 10 metres from the tube well, and 15 to 20 metres for a bore well with a mechanical pump.
The present study reveals that 40% of the tube wells and 50% of the unprotected dug wells surveyed had
a latrine within 10 metres. Similarly, 62% of bore wells fitted with a mechanical pump have the latrine within
so that at the time of need, the community may help the owners in successful and quality management and maintenance of the
water sources. As suggested in the Round table consultation on safe water in Bhubaneswar, Odisha
25 People residing closer to the pumping station often get water with higher residual chlorine. They should be told to leave the water
standing for a minimum for half an hour prior to consumption As suggested in the Round table consultation on safe water in
Rourkela, Odisha
The result of the sanitary
inspection and the remedial
action that needs to be taken to
improve conditions should be
discussed with the community.
In small water supply schemes,
it is often possible for community
members to carry out most of the
inspections themselves using a
standard form.

15-20 metres. Since slums are characterised by lack of space and density of population, extra caution
needs to be taken to follow the standard. Our experience in interacting with the community in slums shows
a lack of knowledge among various stake holders on this basic technical aspect of the distance from the
latrine to the drinking water source to restrict contamination. Special focus is required for disseminating
this message by the government, urban local bodies and NGOs among the people.
4.4. Advocacy with the Government
4.4.1 Easy Access of Sanitary Survey Report for Public Use
There is a need to maintain a standardised format for sanitary survey report which can be maintained by
the concerned water supply and surveillance agency for use. Such reports may also be linked with the
general HMIS system for public use. It will help in generating awareness and many agencies working in
health, nutrition, water supply and sanitation, and the community governance sector can use such valuable
information for research, specific project intervention and awareness generation among the people.
4.4.2 Establishment of a Public Grievance System for Complaints on
Water Quality
A public grievance mechanism needs to be developed for lodging complaints of drinking water quality in
urban areas so that immediate corrective action can be taken by the water supply agency. A time duration
may be kept for rendering the service. If it is not possible to treat or improve the water in the concerned
area, an alternative arrangement for providing potable water should be made.

4.4.3 Designing of Messages on Safe Water in Communication Plan
The list of questions in the sanitary inspection assess the risk to water sources. The messages in the
communication plan of various departments need to focus on the dos and don’ts for safe water. For
example, people must know the safe distance of the drinking water source from a latrine, why it is necessary
to keep the platform of the well and tube well clean and unbroken, what is the need for fencing around a
hand pump, and why it is important to have drainage channels for disposal of waste water etc.
4.4.4 Preparing the Community for Conducting a Sanitary Survey
In the current HUP sanitary survey study, MAS members and front line workers of HUP and various
government departments working at the community level were involved in conducting an onsite inspection
and survey. The Mahila Arogya Samiti members (women’s group) involved in sanitary inspection and water
testing exercise by the H2
S strip showed enthusiasm. To empower the community to assess the risk
factor and understand the factors affecting the contamination of water sources, the women’s group in
urban areas (MAS) under NUHM, the neighbourhood committee under SJSRY, frontline workers of various
departments like ANMs, Anganwadi workers and supervisors, ASHAs, sanitary inspectors and community
organisers may be trained on conducting the sanitary survey in support of water supply agencies in
respective cities and towns.
4.4.5 Promotion of Household Level Water Treatment and Safe Storage
Health can be compromised when harmful bacteria, viruses, and parasites contaminate drinking water
either at the source, through seepage of contaminated run-off water, or within the piped distribution
system. At the same time unhygienic handling of water during transport or within the home (at Point of Use)
can contaminate safe water. For these reasons, many of those who have access to improved water supply
through piped connections, protected wells or other improved sources may be exposed to contaminated
water. Therefore, household level water treatment and safe storage need to be promoted through various
water, sanitation, health, hygiene and nutrition programmes under various allied departments and urban
local bodies, especially in slum locations. 26
26 The knowledge on Point of Use water treatment of water may be percolated down to the community with involvement of NGOs,
CBOs and MAS under NUHM. Suggestion: Round table consultation in New Delhi, June 6, 2014
People must know the safe distance of the
drinking water source from a latrine, why
it is necessary to keep the platform of the
well and tube well clean and unbroken,
what is the need for fencing around a hand
pump, and why it is important to have
drainage channels for disposal of waste
water etc.

AnnexureI:WardWiseWaterSourceDistribution
1
11
12
15
16
2
26
27
30
31
32
33
34
45
46
47
52
53
54
56
57
58
7
8
9
Total
0
0
0
9
2
1
9
21
4
47
19
18
9
16
40
9
6
4
2
22
0
1
15
18
21
293
9
6
0
43
32
2
0
0
0
0
0
0
0
0
0
10
0
0
2
0
0
0
4
0
1
108
23
1
3
12
17
5
3
5
20
12
6
3
3
5
6
9
0
5
8
1
8
5
16
1
0
177
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
7
5
0
27
6
3
0
8
19
9
0
0
4
1
3
8
0
9
15
0
16
6
15
1
0
162
WARDNOSTANDPOSTBOREWELWITH
MECHANICALPUMPTUBEWELWITHHANDPUMPPROTECTEDDUGWELUNPROTECTEDDUGWEL

Annexure II: Code of Slums Where
Survey was Conducted
Sl. No. Name of the slum Code NGO
1 ABHIRAM NAGAR BASTI 1 GJS
2 ADIBASI GAON 2 MY HEART
3 AKHANDALMANI BASTI 3 BC
4 AKHANDALMANI BASTI, UNIT-1 4 GJS
5 AMBEDKAR SAHI 5 FPAI
6 ANANDA NAGAR PALLAS PALLI 6 GJS
7 ANANTA BASTI 7 OVHA
8 AUROBINDA BASTI 8 OVHA
9 BABA TRINATH ADIVASI HARIJAN BASTI 9 BC
10 BADHIHUDA 10 GJS
11 BAJPAYEE NAGAR 11 OVHA
12 BALITOTA SAHI 12 BC
13 BAPUJINAGAR RLY. BASTI 13 GJS
14 BASTI VIKASH PARISHAD 14 FPAI
15 BHAGABATI BASTI 15 BC
16 BHAGABATI BASTI 16 GJS
17 BHAKTAMADHU NAGAR 17 GJS
18 BHARATI MATHA BHOI SAHI* 18 GJS
19 BHIMATANGI PEOPLES BASTI 19 GJS
20 BHIMPUR BHOI SAHI 20 GJS
21 BIRSA NAGAR 21 FPAI
22 BISHNUNAGAR BASTI 22 GJS
23 BRAHMESWARPATANA BHOI SAHI* 23 GJS
24 CHILIPOKHARI 24 GJS
25 CHIRGOLATOLA BASTI (PRASANT VIHAR) 25 OVHA
26 CHUNUKULI BASTI 26 OVHA
27 CS PUR MANDAP SAHI 27 OVHA
28 CS PUR MUNDA SAHI 28 OVHA
29 DAMANA BASTI 29 OVHA
30 DURGA MANDAP BASTI 30 BC
31 EKAMRA NAGAR 31 MY HEART

Sl. No. Name of the slum Code NGO
32 FARM GATE OUAT BASTI 32 BC
33 FARM PADA 33 BC
34 FIRE STATION BASTI UNIT 8 34 BC
35 G TYPE BASTI 35 BC
36 GADAKANA SABAR SAHI* 36 OVHA
37 GANGA NAGAR 37 BC
38 GANGA NAGAR HOSTEL SIDE 38 BC
39 GANGA NAGAR PALLI A 39 BC
40 GANGA NAGAR PALLI B 40 BC
41 GANGANAGAR BHIMPUR BASTI 41 GJS
42 GOKHIBABA LEPROSY COLONY 42 GJS
43 GOPABANDU NAGAR UNIT 8 43 BC
44 GOURINAGAR BASTI 44 GJS
45 GYANA NAGAR HUDA BHOI SAHI* 45 GJS
46 H K NAGAR* 46 OVHA
47 HARIJAN BASTI, UNIT-1 47 GJS
48 HATIASUNI 48 MY HEART
49 ISANESWAR BASTI 49 OVHA
50 JADI SAHI 50 BC
51 JAGANNATH AMBA TOTA 51 OVHA
52 JAGANNATH BIHAR 52 MY HEART
53 JAGARNATH BASTI, UNIT-1 53 GJS
54 JALESWAR COLONY PAIKA BASTI 54 BC
55 JALI MUNDA SAHI PATIA 55 OVHA
56 JANATA NAGAR 56 MY HEART
57 JAY DURGA BASTI UNIT 8 57 BC
58 JAYADEV NAGAR BHOI SAHI* 58 GJS
59 JHARANA TALA SAHI 59 GJS
60 JHARANA UPPER SAHI 60 GJS
61 JOGESWARPATAN NAIK SAHI 61 GJS
62 JOGESWARPATAN BEHERA SAHI 62 GJS
63 JOGI SAHI 63 BC
64 K K NAGAR 64 BC
65 KABARI (SABAR) SAHI* 65 OVHA
66 KALIMANDIR BASTI 66 BC

Sanitary Survey of Public Drinking Water Sources in Slums of Bhubaneswar, Odisha (1)

Sanitary Survey of Public Drinking Water Sources in Slums of Bhubaneswar, Odisha (1)

Recomendados

Recomendados

Más contenido relacionado

La actualidad más candente

La actualidad más candente (20)

Destacado

Destacado (13)

Similar a Sanitary Survey of Public Drinking Water Sources in Slums of Bhubaneswar, Odisha (1)

Similar a Sanitary Survey of Public Drinking Water Sources in Slums of Bhubaneswar, Odisha (1) (20)

Sanitary Survey of Public Drinking Water Sources in Slums of Bhubaneswar, Odisha (1)