Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

Danielle Medgyesi,John Brogan,Laura Kwong,Daniel Sewell,Kelly Baker,Jean Creve-Coeur

doi:10.3390/ijerph15081646

Abstract

Globally, gastrointestinal (GI) infections by enteric pathogens are the second-leading cause of morbidity and mortality in children under five years of age (≤5 years). While GI pathogen exposure in households has been rigorously examined, there is little data about young children’s exposure in public domains. Moreover, public areas in low-income settings are often used for other waste disposal practices in addition to human feces, such as trash dumping in areas near households. If young children play in public domains, they might be exposed to interrelated and highly concentrated microbial, chemical, and physical hazards. This study performed structured observations at 36 public areas in an internally displaced persons community that has transitioned into a formal settlement in Haiti. We documented how often young children played in public areas and quantified behaviors that might lead to illness and injury. Children ≤5 years played at all public sites, which included infants who played at 47% of sites. Children touched and mouthed plastic, metal and glass trash, food and other objects from the ground, ate soil (geophagia) and drank surface water. They also touched latrines, animals, animal feces and open drainage canals. Hand-to-mouth contact was one of the most common behaviors observed and the rate of contact significantly differed among developmental stages (infants: 18/h, toddlers: 11/h and young children: 9/h), providing evidence that children could ingest trace amounts of animal/human feces on hands that may contain GI pathogens. These findings demonstrate that water, sanitation and hygiene interventions could be more effective if they consider exposure risks to feces in public domains. Furthermore, this research highlights the need for waste-related interventions to address the broader set of civil conditions that create unsafe, toxic and contaminated public environments where young children play.

Highlights

1.7 billion episodes of diarrhea and around half a million diarrhea-related deaths occur in children under five years of age (≤5 years) living in low-to-middle income countriesInt
Given the multitude of hazardous scenarios in public areas, our study aimed to describe how often young children are observed playing in public areas and to measure the rate at which children practice behaviors, such as hand and mouth contacts with objects that could lead to illness and injury
This study study found found that that infants, infants, toddlers toddlers and and young young children children living living in in aa LMIC

Summary

Methods

Reflective of global humanitarian trends, Corail has transitioned to a permanent formal settlement of over 2500 families in the Croix des Bouquets commune, necessitating the need for development of permanent water and sanitation infrastructure. Corail’s provisional sanitation infrastructure (109 dry pit latrine blocks of four to six toilet cabins) was established as part of humanitarian relief efforts. Blocks of toilets were located on the periphery of rows of housing, with one toilet being shared by five to eight families. At the time of the study, most septage pits were full and in urgent need to be emptied and many latrines were in a state of disrepair. According to the residents of Corail, no routine waste management services were available and/or affordable to the community

Results

Discussion

Conclusion