Management of rainwater harvesting and its impact on the health of people in the Middle East: case study from Yatta town, Palestine.

Water-related diseases are a primary problem in Palestine where many residents revert to harvested rainwater as their primary water source due to water shortages within the area. From an environmental engineering perspective, it is already well known that certain situations (e.g., cross contamination) reduce drinking water quality and ultimately cause diseases in a population. In this study, we investigated the social practices and situations that may lead to lower disease occurrence. Towards this goal, we surveyed 382 residents in Yatta to collect data on the water-related diseases that they experienced and the specific situations that might affect the disease occurrences such as the residents' practices (i) for maintaining a high quality of cistern water, (ii) for maintaining the environment around the cistern, and (iii) for managing the wastewater. In addition, we measured the physicochemical and microbiological parameters in cisterns to support the qualitative survey data. The measured parameters, including turbidity, salinity, free available chlorine, total Coliforms, and fecal Coliforms, were above Palestinian Standard Institution (PSI) and World Health Organization (WHO) guideline levels, suggesting a potential infectious hazard. The poor quality of the water was also observed by residents based on change in taste and by visually noting floating impurities, turbidity, and green coloration. Survey results showed that observations of the poor quality in cisterns and surrounding environment had statistically significant correlation with most of the water-related diseases. Additionally, frequently emptying the septic tank contributes to improving the observed water qualities. Therefore, residents should be encouraged to continue to observe the water quality in the cistern, improve the surrounding environment of cistern, and empty their septic tank frequently, to keep the water diseases away from their households.