Water supply and quality issues in Centraland Eastern Europe and the NewlyIndependent Statesby Jamie Bartram and Jens Jacob

Many of the countries once ruled by centralizedbureaucracies are faced with a particulardilemma - rising cases of infectious disease.At the same time, the collapse of heavy industryhas led to cleaner air and water. What does thefuture hold?

people continue toreceIve and consumewater and producewastes; and largenumbers of profes-sionals of diverse dis-ciplines continue towork to provide waterand sanitation ser-vices.

A diverseregionAlthough the areasnow generally referredto as Central andEastern Europe (CEE)and the NewlyIndependent Statescomprise a diversity ofenvironments, cultures

~ and economies, this.~ article attempts both toa. describe some of the~ principal changes in% water supply and sani-.2"$ tation, and to highlight1l some of the major:.:i challenges confronting

A government's ideology matters a lot less to people people working in thethan its ability to provide basic services. _ region.

The region's diver-CHANGES, UNTIL RECENTLY sity should not be underestimated. Itinconceivable, have been sweeping includes countries now expectedacross the area once referred to as the to be in the first wave of expansionSecond World. Many of the changes of European Union membership, tar-have attracted global attention; others geting convergence with ED levelsare barely noticed outside their imme- and standards of supply; the Russiandiate environment. Federation - which itself varies

The provision of basic services, such from relatively densely populatedas water and sanitation, falls into this 'European' Russia to the sparsely pop-latter category - unless, of course, ulated eastern regions; the Caucasianthere is large-scale foreign investment, States - some with oil wealth whichor spectacular outbreaks of water- could, potentially, fuel national pro-related disease to attract the media's grarnmes of development; and the fiveattention. Yet behind this wall of central Asian republics, one of which,apparent silence, millions of ordinary Kazakhstan, has a land area equivalent

to that of Western Europe. The regionvaries from northern tundra to the sub-tropical coasts of the Black Sea, andthe semi-arid Crimean peninsula. Itincorporates one of the largest freshwa-ter bodies in the world, Lake Baikal. Italso contains the remains of what wasonce one of the other great inland seas- the Aral Sea - now reduced to lessthan a fifth of its former volumelargely through abstraction of water,for irrigated agriculture, from its twofeeder rivers.

Period of changeMost of the countries of this region dobear the same social and economicconsequences of huge upheavals in thepolitico-administrative systems. Somehave also experienced war - be it civilor with neighbouring states.

These young nations inherited highlycentralized administrative systems anda professional community accustomedto a command-and-control system ofmanagement. Prolonged exposure tosuch a way of working has had a majoreffect on both professionals and thepublic. Whilst substantial energieswere expended upon, for example,monitoring of the environment andwater supplies, and while there havebeen organized systems for the evalua-tion of both environmental and healthproblems, all data were evaluated onlywithin prescribed boundaries. Notwith-standing the real quality and objectivityof the data, it was impossible for thepopulation to assess this; and becauseof compartmentalization, few profes-sionals were truly aware of the envi-ronment and health situation as awhole.

Since the changes to the administra-tive systems, therefore, many countrieshave relied on professionals with onlylimited experience of either preparingmeaningful assessments, or in usingthem to formulate policy in an increas-ingly democratic administration. Thishas been aggravated by the breakdownof systems for encounter and exchangeamongst professionals which existed inthe former Soviet Union, systemswhich have still not been fully replacedby alternatives, such as the networks ofprofessional associations commonelsewhere. Similarly, the population at

10 WATERLINES VOL. 16 NO.1 JULY 1997

Filling up at mineral springs after being cut offfor three days; water infrastructure is expensive and hard to manage.

80-95928997.5

1009982

6030-505517.595

<5045.8

Percentage coverageRural Urban

sources as is the case in both Russiaand the Ukraine for example. In theUkraine alone, around 80 per centof drinking-water is derived fromthe rivers of the Dnepr Basin; somecapacity to improve the quality of sup-ply may exist by pursuing the ground-water alternative. It should be recalledthat one of the capital cities of theregion - Budapest - is suppliedwith drinking-water through banksidefiltration from the River Danube - thelargest bankside filtration system in

systems, even where non-pumpedalternatives were available. In an erawhen energy costs were largely ignoredin system design, such decisions couldbe readily understood. Now that energycosts are being internalized by supplyagencies it has become policy to pur-sue and convert to gravity-fed supply

from protected groundwatersources, wherever possible. In someparts, there is a heavy reliance on sur-face water compared to groundwater

EstoniaKazakhstanLatviaRepublic of MoldovaSloveniaUkraineUzbekistan

Table 1: Water-supply coverage in some ofthe CEE and NIS.

legislative framework fails to supportthe changes needed to adapt to newsystems. On the other hand, someelements of legislation are highlysupportive, 'sanitary protection zones'being one important example nowthreatened in some countries becauseof rapidly evolving legislation concern-ing land tenure and owners' rightsversus land-use restrictions.

This 'unpreparedness' of States,professionals, and the public to partici-pate in water supply andsanitation within democ-ratic systems should beseen in the context ofwater supply in the Countryregion. Notwithstandingextreme diversity inmuch of the region, asTable 1 illustrateS', levelsof water-supply coveragewith centralized, pipedwater supplies areextremely high.

Such an extensivewater-supply infrastruc- Source: WHOture makes great demandsupon financial resources,organizational systems and the staffresponsible for them. Not surprisingly,therefore, problems have occurred. InArmenia, for example, it is reportedthat not one kilometre of water-supplypipe has been replaced or installedsince 1989, whilst before that datearound 100km were replaced each yearin the city of Yerevan alone.

Nevertheless, some of the changes inapproach are straightforward andalready under way. In Armenia, watersupply was often based upon pumped

large has little experience in exertingpressure upon democratic systems, orindeed, in acting as recipients of theinformation which is now increasinglyentering the public domain.

Finally, State systems may be lessthan ideal at coping with the needsand demands of a radically changedwater-supply sector. In many ways,the changes reflect the recommenda-tions of a series of major internationalmeetings, such as the New DelhiConference which concluded theInternational Drinking- Water Supplyand Sanitation Decade, the Rio Confer-ence and its follow-up at Noordwijkin the Netherlands. At all of theseevents, a major theme was that govern-ments should reduce intervention inthe provision of services and directtheir energies towards 'facilitation andregulation' .

In many ways it would appear thatthe changes now occurring in theregion do follow such recommenda-tions. But, as elsewhere, national sys-tems may be poorly adapted to playsuch roles. Common problems include:• weak regulatory agencies;• utopian standards which may be

counter-productive if slavishlyenforced without a clear understand-ing of the importance of availabilityof safe water;

• an educational system used topreparing staff for a now redundantstyle of management, and which is infrank decline; and

• little familiarity with financing prin-ciples on the part of both suppliersand government regulators.All too often, even the basic

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inefficient: this is of concern as anydecrease in efficiency of operationleads to increased pollution - often ofrivers which are then used directly orindirectly as water sources, down-stream.

One unexpected development - andcurrently limited to one country - is adecision to change sources fromgroundwater to surface water. Thismay seem odd to those accustomed toregarding the generally superior qualityof groundwater sources - especiallywith regard to microbiological quality- as of paramount importance. InMoldova, however, where at presentaround 80 per cent of the population issupplied from groundwater sources,official policy is to pursue such achange, apparently because of the com-bined effects of high levels of fluorideof natural origin (5 to 12 mg/l), stron-tium (12 to 14mgll), and selenium.

Rural areasAs is common when systems are underpressure, groups with the least repre-sentation are the ones most affected.During this process of change one suchgroup has been the rural population. Insome of the countries concerned, therural population is a significant per-centage of the total, around 50 per centof the total in Romania, for example.Much of the rural population dependsupon private wells in household plotswhich enclose the family home, someform of latrine or septic tank, and anallotment or smallholding. Most of thewells lack sanitary protection and arehighly polluted with faecal microbesand nitrate. In small piped water sup-plies to rural areas, intermittent supplymay be the norm, sometimes becauseof the cost of pumping, as is the case inArmenia - a country otherwise rich insprings. Similarly, in Moldova, overallrates of piped water supply are some55 per cent. In urban areas, this figureis some 98 per cent, but are very lowelsewhere. In rural Russia around onethird of the population uses water from'non-centralized' sources, of which anestimated 30 per cent fails microbio-logical quality criteria.

DisinfectionOne consequence of the centralizedplanning of the former Soviet Unionrelates to the availability of materials.To provide one small but graphicexample, Armenia is home to a largefactory producing chlorine gas. Thatcountry is unable, however, like manyothers in the region, to reliably supplychlorine to its own water supplies.In light of the desperate need for

infectious water-borne disease havealso occurred in St Petersburg(Leningrad), across Armenia and in theRomanian town of Sebes, associatedwith some 180 cases of acute diarrhoeaand 565 cases of infectious hepatitis.

Overall, very significant sections <;>fthe population rely on water whichfails prevailing national standards.

Not all badBut not all of the short-term conse-quences of the process of change havebeen negative. Probably because ofeconomic constraints, there has been amarked drop in the application of inor-ganic fertilizers, especially in house-hold plots, and the levels of nitrate ingroundwater have decreased. What-ever, the number of reported cases of

methaemoglobinaemia('blue baby syn-drome') - for exam-ple, have decreaseddramatically, from 95recognized cases in1986, to 52 in 1995for the District ofDolj, Romania, wherearound 83 per cent ofsamples from wells inagricultural areasfailed the standard of50mg/1. In Hungary,methaemoglobinaemiacases peaked in 1977with 300 cases and 7deaths, a figure whichwas steadily reduced,so that, by 1993, therewere only 20 cases,and no deaths.

Europe and one which has proven areliable technology for many years.

Not only are the water-supplysystems under stress but, in someareas, the water resources on whichwater supply depends are in a perilousstate. Perhaps the most notoriousexample is that of the Aral sea, referredto above. As a consequence of whatcan only be described as an unprece-dented environmental disaster, the eco-nomic basis of life in a 'disaster zone'near to the Sea has been entirelyeroded. Whilst the claimed effects ofenvironmental pollution on the healthof the population in this region receivewide coverage, it should be recalledthat the combined effects of unemploy-ment, migration, social upheaval andincreasing poverty are the fundamentalhealth issues in the area.

Outbreaks of diseaseDespite the experience and qualifica-tions of staff across the region, noteven capital cities have escaped theconsequences of the process of change.Outbreaks of hepatitis A have beenreported from Riga and Latvia, associ-ated with the use of contaminatedsource waters, problems of treatment,and failure in continuous chlorinationof the city water-supply system: andsimilar reports have come from othercountries in the region. Outbreaks of

IndustrialpotlutionIt is possible that simi-lar trends affect pesti-cides, although stocks

The legacy of recent neglect: two women take water of older and possiblyfrom a broken standpipe in Konasub, Uzbekistan. more harmful pesti-

---- ---- - cides are said to bemitigating against this

in some areas. It is also likely thatdecreased industrial activity will havereduced water-resource contamination,as has been reported from Slovenia, forexample.

Areas, such as Kachetia regionin Georgia, where there isconsiderable contamination of ground-water resources from oil productionand transport, are less fortunate; in"general, groundwaters, once polluted,recover only very slowly because oftheir large volume and low throughput.Wastewater-treatment plants are often

12 WATERLINES VOL. 16 NO.1 JULY 1997

A brother and sister drink water in a village near Tashkent. The lack of effective disinfection means that childrenare at greater risk of contracting an infectious water-borne disease.

disinfection to control the real andimmediate risk of infectious disease,this is a significant problem.

Technically, the decreased attentionto operation, maintenance, rehabilita-tion and extension in recent yearsleaves a challenging legacy. Manycountries report frequent problemsrelated to microbiological recontamina-tion in distribution, presumably causedby the combined effects of poornetwork maintenance and intermittentsupply or low pressures. Rates ofleakage from distribution systemsare reportedly extremely high - 70per cent has been claimed in Armeniafor example; while in some largeRomanian towns such as Constanta andNavodari, the figure is around 40 to 60per cent.

The need to prioritize disinfection,and the use of a residual disinfectant toprovide some protection against rein-forced-contamination in distribution is,therefore, clear. Nevertheless, in Rus-sia, 22 per cent of water 'suppliesbelonging to public utilities, and 20 percent of those belonging to officialestablishments, provide water withoutdisinfection. Whilst both experts andthe general public sometimes expressconcern regarding the risks associatedwith disinfectant by-products such astrihalomethanes, it is clear that muchgreater risks of infectious water-borne

disease are posed by the absence ofeffective disinfection.

Monitoring systemsMany of the countries beingdiscussed have extensive networks ofexperts, facilities for monitoring ofdrinking-water quality, and vast experi-ence in monitoring and control, but,in some countries at least, these activi-ties seem to be on the wane. Giventhe overall state of water supplies, thisis a matter of concern. Where the mon-itoring effort has decreased, thisappears to be related, to a large degree,to the non-availability of materials forroutine testing. But a critical review ofpractice, such as undertaken by theauthorities in Latvia with WHOassistance, for example, highlightedthe feasibility of effective monitor-ing through targeting high-priority 'critical parameters' (suchas microbiological indicators, disinfec-tant residuals, turbidity and nitrate) forrelatively intensive monitoring; andbeing highly selective with other ana-lytical efforts - targeting them inareas of greatest need. It should alsobe recalled that much effectivemonitoring can be undertaken withno analytical effort whatsoever,through, for example, sanitary-inspection programmes.

ReferencesI. WHO, Guidelines for Drinking- Water Qualit)\Volume I: Recommendations, Second Edition,WHO, Geneva. 19932. WHO, Guidelines for Drinking- Water Qualit)·,Volume Ill: Small community supplies, WHO,Geneva, 1984 (second edition to be published1997)3. WHOIEURO, 'Concern for Europe'sTomorrow: Health and environment in the WHOEuropean Region', Wiss VerI Ges, Stultgart,]995.4. 'Report of a national workshop on drinking-water supply and quality, Sinaia, Romania,1996' ,WHOIEURO, Copenhagen, 1996.5. 'Report of the Joint WHO/German RegionalSeminar on Drinking-Water Quality, Bad E]ster,Germany, ]994', WHOIEURO, Copenhagen,1995.6. 'Report of the National Workshop onImp]ementation of the WHO Guidelines forDrinking-Water Qua]ity for Latvia, Riga, Latvia,March 1994', WHOIEURO, Copenhagen, 1994.7. 'Report of a nation a] workshop on Drinking-Water Supply and Quality, Tzakadzor, Armenia,]996.' WHOIEURO, Copenhagen, 1996.8.'Report of a national workshop on Drinking-water Supply and Quality, Tbilisi, Georgia, 1996.WHOIEURO', Copenhagen, 1996.

Jamie Bartram is the Manager. Water andWastes, European Centre for Environmentand Health, World Health Organization,Via Francesco Crispi 10, 00187 Rome, Italy.Fax: +39 64 877 599. E-mail: JBA@who.itJens Jacob is based at the Institut fur Wasser-,Boden- und Lufthygiene des BGA (WaBoLu),Heinrich-Heine Strasse 12, 08695 Bad Elster.Germany. Fax: +49 37 4377 6219. E-mail:hoI769@hofbaynet.de

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