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Water and Health Management



"Contribute to a better management of adverse health issues, linked to poor management of water and wastes for communities and at a provincial level"


Solid wastes are a major problem in Thailand, in fact according to the Pollution Control Department’s statistics in 2013, the amount of solid waste all over Thailand was 26.77 million tons with 6.93 million tons which are not properly managed or disposed. Moreover the number of solid wastes seems to increase with 2 million tons more between 2012 and 2013.



When solid wastes are not well managed, it can have an important impact on human health and environment with problems like:

  • Unpleasant smell,irritating residents in the neighbouring area
  • Water and soil contamination, especially when rubbish are dumped in sites near agricultural area such as rice farming area or irrigation area 
  • Carrier of bacteria contamination causing widespread epidemic (for example :diarrhoea) 
  • Impact on climate change (due to the decomposition process of organic waste in landfill or unsanitary landfill)  

ComAcross project has conducted a survey and collected preliminary data in Phra Nakhon Si Ayutthaya by Participatory Epidemiology method. In fact, Phra Nakhon Si Ayutthaya has been chosen to be a pilot model for proper waste management and will be a role model for other provinces in the future. (Public Affairs DivisionOffice of the Permanent Secretary,2015)

The first phase of investigation that has been conducted March-May 2015 in parallel of the participatory epidemiology capacity building activities has been implemented in collaboration with the government officers at municipality level in Chiang Rak Noi Sub-District, Bang Pa-In District. 2 stakeholders workshop aiming at the restitution of our findings with the local stakeholders have been organized (14th May, 29th May). It has been followed by the organization of 2 stakeholders’ case study workshops involving agents operating at provincial and district and municipality level in Ayutthaya (3rd July and 9th October).

As a result of the participatory assessment of health risks perception at municipality level, the focus of the case study has been set on waste management (both livestock farming wastes and solid waste) and their impacts on animal health, human public health and the environment.


Several researches have been done, in 2016, in the framework of this case study in order to assess the risk of bio-physical contamination due to poor coordination in waste management at the municipality and provincial level. These results will feed the participatory process involving provincial and municipal stakeholders and aiming at the improvement of cross-sectorial collaboration in a One health perspective. Feedback meetings have already been organised, the last one was in November 2016.



The main results of 2016 studies are listed here below:

  • Assessment of zoonotic bacterial contamination in wastewater & soil from small holder pig farms (Faculty of Veterinary Medicine, Kasetsart University)
  • Assessment of fungal burden in contaminated water & soil from livestock excreta, a potential risk to immunocompromised population (Faculty of Tropical Medicine, Mahidol University)
  • Assessment of pollution status of landfill in Chiang Rak Noi Municipality, Ayutthaya Province (Faculty of Veterinary Medicine, Kasetsart University)
  • Human health hot spot and risk area assessment surrounding communities from landfill in Chiang Rak Noi Municipality, Ayutthaya Province (Faculty of Environment and Resource Studies, Mahidol University)

The zoonotic bacterial analysis, done so far, demonstrated the presence of Escherichia coli and strains of streptococcus in the faeces, floor swabs and water of house sewage, farm sewage and cesspool from the 3 pig farms analysed. Salmonella strains were also found in the cesspool of every farm.

The assessment of pollution was done by collecting samples from 6 different landfills. It established the presence of heavy metal (Fe, Mg, Al) in every landfill analysed, the presence of Salmonella in 4 of them and Clostridium Perfringens in 2 of them. The water from these landfills was characterized by a contamination with Coliforms bacteria and a high level (but not above the recommended limit) of iron (Fe).

The study of risk area for solid waste landfill or open dumb in Ayutthaya province combined the data from flood’s frequency, distance from residential area, soil drainage, distance from water body streams and wells, and the position of the main cities. It determined that 84% (2138.44 km2) of the Ayutthaya province are risk areas to set a waste landfill and 16% (406.93km2) could be potential areas.




Cross-sectoral collaboration on adverse health issues management in Phra Nakhon Si Ayutthaya in Thaïland :

  • Improve communities' wellbeing and public health trough Cross-sectoral approach, and taking into account social and environmental aspects
  • Improve stakeholders' cross-sectorial collaboration (interactions between stakeholders at the scale of the preparedness/response system; cross-sectoral integration at local level)
  • Better understand waste management impact on human diseases and health problem
  • Better understand waste and water management at the province level and propose tools for actions

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