Assessment of environmental and health impacts of water resources in Jerash Governorate and Jordan


Doctoral Thesis / Dissertation, 2014

165 Pages, Grade: PhD


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TABLE OF CONTENTS

DEDICATIONS

ACKNOWLEDGEMENT

TABLE OF CONTENTS

LIST OF TABLES

LIST OF FIGURES

LIST OF ABBREVIATIONS

LIST OF APPENDICES

I. INTRODUCTION

II. LITERATURE REVIEW

III. AIM OF THE STUDY

IV. METHODS AND MATERIALS

V. RESULTS AND DISCUSSION

VI. CONCLUSIONS

VII. RECOMMENDATIONS

VIII. SUMMARY

IX. REFERENCES

X. APPENDICES

XI. ARABIC SUMMARY

DEDICATION

To my mother’s and father’s souls, who showered my life with love, proud, and blesses. May their souls rest in peace.

To my precious sisters, Aisheh and Kholoud, who I could not finish my PhD education without their support and encouragement.

To my dearest brothers Abdullah and Mohammed, who gave me a tremendous help in collecting data and implementing the study .

ACKNOWLEDGMENTS

(Who does not thank people, does not thank Allah )

There are many people without their support this dissertation might not have been written, and to them I am greatly indebted.

My deepest appreciation to Prof. Samia Galal for her unforgettable support and great stand; to tender-hearted Prof. Linda Mekhail for her care, support and love.

My greatest gratitude to my supervisors, Prof. Samia Galal, Prof. Linda Mekhail , Prof. Mohammad Subbarini , and Dr. Ashraf Whdan for their mentorship, guidance and support. Their comments and corrections give strength and power to dissertation. Also my gratitude to Prof. Manal Ahmed for put her distinguished vision on the dissertation and to Prof. Hussein for his kindness and knowledge.

Also, I would like to express my deepest gratitude to my sisters Aisheh and Kholoud for their care and financial support; to my brothers Abdullah and Mohammed, and my sister-in-law Soad Fraij for helping me during my field work; and to my beloved brother Hesham for access to data sources while I could not and for care.

Great appreciations are extended to my colleagues Dr. Ahmed Elnour for being my brother in expatriation, and for all efforts in following the protocol approval, to Dr. Mohammed I. Tabash, Dr. Mohammed Abkar, Dr. Mohamed Fakhry and sweet Mai Badr for providing me with necessary documents; to a good-hearted and beloved character associate professor Hesham El- Naggar for nobility; to Prof. Manal Ahmed for great support; to Prof. Hassan Metwaly for noble stand; and to Prof. Ali Hasab for statistical advising.

Moreover, deepest gratitude to department of statistics for tremendous corporation; to ministry of water for water analysis and providing required data, special thanks to E. Rania Sha’ban, E. Abbas Kalbouneh, E. Refaat Bni-Khalaf, Mrs. Samer Muqattash, and to Mohammed- the driver -. Also to ministry of agriculture for kindness and corporation, special thanks to E. Areej Arabiyat, E. Omar Lahham, E. Rami Habahbeh ; to environmental police for providing me with environmental reports; and to my friends Khalik Mostafa and Suha Salah.

Finally, sincere thanks to all participants who without their participation I could not implement the study. Special thanks to dearest Nabeela Ajlouni, Arwa Ajlouni, Fatma Ajlouni, Um Abd, Hala qtaishat, to Susan Zu’bi and her mother, Emtiaz and her husband, and to Aisheh - co-worker of my brother Abdullah-.

May Allah bless you all.

LIST OF TABLES

Table 1 Population density and growth rate in Jerash governorate

Table 2 Numbers of males to females in Jerash governorate

Table 3 Distribution of population by sub-district and gender

Table 4 Distribution of non-jordanian population living by gender

Table 5 Distribution of reasons of residency of non-jordanian

Table 6 Reasons and duration of residency of non-Jordanian in 2004

Table 7 Incidence rates of amebic dysentery by some governorate

Table 8 Distribution of incidence rates of hepatitis A

Table 9 Incidence rates of diarrhea by governorates from 2000 to 2011

Table 10 Incidence rates of cancer per 10,000 by governorates

Table 11 Water demand in Jerash governorate

Table 12 Water supply and water production by governorates

Table 13 Quantities of imported water and water losses

Table 14 Age groups of husbands and wives in the study sample

Table 15 Husband’s and wife’s level of education in the study sample

Table 16 Distribution of numbers of household dwellers

Table 17 Distribution of monthly income of families

Table 18 Monthly expenditures of families in the study sample

Table 19 occupational status of wives in the study sample

Table 20 Distribution of gardens by administrative units

Table 21 Types of animals raised at houses of study sample

Table 22 Availability of sanitation system at houses

Table 23 Monthly schedule of municipal water supply

Table 24 Monthly consumption of municipal water in summer season

Table 25 Types of water tanks by administrative sub-districts

Table 26 Methods of cleaning upper tanks used for drinking

Table 27 Methods of cleaning lower tank

Table 28 Methods of cleaning underground reservoir

Table 29 Distribution of sold water types by administrative sub-districts

Table 30 Distribution of using other water resources

Table 31 Percent of compliance with Jordanian standards

Table 32 Water quality classification

Table 33 Number of laundry per week at houses in the study sample

Table 34 Type of washing machines at houses in the study sample

Table 35 Distribution of re-using of laundry water

Table 36 Distribution of re-using of dish washing water

Table 37 Distribution of re-using bath water

Table 38 Occurrence of kidney stones patients among family members

Table 39 Distribution of cancer cases by administrative sub-districts

Table 40 Types of cancer among the sample, in Jerash governorate

Table 41 Distribution of skin diseases by administrative sub-districts

Table 42 Distribution of other diseases among the sample

Table 43 Results of physical, chemical and biological parameters of water samples analysis from Qayrawan spring in 2011

Table 44 Results of physical, chemical, and biological test analysis of water 93 samples from King Talal dam

Table 45 Results of physical, chemical, and biological test analysis of water 94 samples from Zarqa stream / Jerash security point

Table 46 Results of physical, chemical, and biological test analysis of water 96 samples from Zarqa stream / agricultural nurseries

Table 47 Results of test analysis of water samples from effluent of WWTP 97

Table 48 Results of municipal water samples analysis

Table 49 Results of spring water samples analysis

Table 50 Results of truck water samples analysis

Table 51 Results of rainwater samples analysis

Table 52 Results of treated well water samples analysis

Table 53 Results of investigative water samples analysis

LIST OF FIGURES

Figure 1 Location of Jerash governorate in Jordan

Figure 2 Distribution of urbanization within specific years

Figure 3 Incidence rates of amebic dysentery in Jerash governorate and Jordan

Figure 4 Incidence rates of typhoid and paratyphoid in Jerash governorate and Jordan

Figure 5 Incidence rates of hepatitis A in Jerash governorate and Jordan

Figure 6 Incidence rates of diarrhoea in Jerash governorate and Jordan

Figure 7 Incidence rates of cancer in Jerash governorate and Jordan

Figure 8 Distribution of water uses in Jerash governorate

Figure 9 Distribution of water supply in Jerash governorate

Figure 10 Water share per capita (litre/day) in Jerash governorate and Jordan

Figure 11 Administrative sub-districts of Jerash governorate

Figure 12 Average values of nitrate in raw water at treatment plants and pump stations

Figure 13 Average values ammonia in raw water at treatment plants and pump stations

Figure 14 Values of TDS of raw water at treatment plants and pump station 84

Figure 15 Average values of pH of raw water in Jerash governorate 85

Figure 16 Average values of E. coli in raw water at treatment plant and pump station

Figure 17 Average values of fluoride, nitrate, ammonium and lead of treated water at treatment and pump stations

Figure 18 Values of TDS in treated water at treatment plants and pump station

Figure 19 pH of treated water at treatment plants and pump stations

Figure 20 Values of E. coli in treated water at treatment and pump stations

Figure 21 Treated well water bottle

Figure 22 Photos of well, tanker truck, and three springs included in investigation

Figure 23 Impacts of demographic changes on health and environment

LIST OF ABBREVIATIONS

Abbildung in dieser Leseprobe nicht enthalten

LIST OF APPENDICES

Appendix 1 Figure1: Surface and groundwater basins in Jordan, 2011

Appendix 2 Table 1: Long term average annual flow for surface water basins

Appendix 3 Table 2: Groundwater basins in Jordan and their safe yields

Appendixv 4 Figure 2: Amman – Zarqa basin location

Appendix 5 Figure 3: Water resources in Jerash governorate in 2012

Appendix 6 Table 3: Potential causes of water stress and water quality decay

Appendix 7 Figure 4: Steps of health impact assessment

Appendix 8 The questionnaire of the study

Appendix 9 Table 4: Health effects from chemical contaminants

I. INTRODUCTION

There are more than 40 countries in the world which do not have enough water to meet their escalating needs, and it is expected that the number will exceed 100 countries by the year 2025. 1 Jordan is a best example for such countries in which the current per capita consumption does not exceed 54 cubic meters per capita per year. 2, 3, 4 Actually water shortage becomes a permanent, thus meeting water demands and managing the limited water resources are major challenges. Jordan cannot rely solely on surface water and groundwater to satisfy water demands of the rapid growing population, so there is a major need to look at alternative resources, including non-renewable groundwater, and non-conventional methods like reclaimed wastewater, desalinated sea and brackish water. 5

The taps in Jordan are still running but if the current trend of over-pumping of non- renewable groundwater, continuation of leakage of public distribution networks, uncontrolled stealing water by some citizens and farmers, and unbalanced distribution in the country goes on forward, it is just a matter of time before the water scarcity encounter in the country develops into a major disaster. Almost every official and citizen in Jordan is aware that radical measures must be considered. These challenges for the Ministry of Water and Irrigation as the planning authority in the water sector, are the main focus of the National Water Master Plan for Jordan, supported by water projects. The master plan direct the attention to water sector issues in a comprehensive manner, including resource and demand management, institutional, legal, socio-economic, environmental and trans-boundary considerations. 6, 7, 8

Not only water strategies, and plans, but also projects and studies, take into account impacts of water scarcity on health, environment and socio-economic conditions.

Jerash Governorate population has developed spectacularly in the last century due to its strategic location and the growing importance of the tourism industry to Jerash city, where economy depends largely on tourists who visit this ancient city. 9 It is one of twelve Jordan governorates suffering from water resources shortage. Decreasing water resources / capita is a function of decreasing water resources coupled with population increase as depicted in all Arab Countries. Shared water resources with other neighbouring countries across political borders impact both water quantity and quality. Intensive agriculture practices in Israel with drip irrigation systems while increasing chemical fertilizers use has lead to severe nitrate concentration rise may lead to an escalation in cancer cases coupled with other intestinal health problems in Jordan. 10

In the Middle East Region many countries and Jordan is among them, are facing a rapid population growth. These growing populations compete for limited fresh water resources.11,12 Preconditions that affect availability of fresh water are like climate, geography, and vegetation, restrict people access to water. Further, human activities alter water systems, such as urbanization, agricultural practices, and over pumping of groundwater, 13 -15 Jordan is one of the countries in the world that are encountering problems of water scarcity and severe shortages as water demands far exceeds available water supply.

In Jerash governorate, which is a hilly region with fertile lands, only 60% of its needs are met, and the individual average share is only 71 litres per day, which is the lowest in Jordan.16 Moreover, about 80% of Jordan’s territories lie in arid to semi-arid areas where annual precipitation is less than 200 mm. only 4% of the whole country receives annual precipitation more than 300 mm, such as Jerash governorate in which the average annual rainfall is 400– 500 mm. Agriculture sector is suffering the most from water scarcity. 17 -19

Jordan’s water resources, mainly groundwater, are limited to support population in a sustainable manner resulting in lowered water tables and declining water quality. The situation has been intensified by the fact that Jordan shares most of its surface water resources with neighbouring countries (Israel, Syria, Lebanon, and Turkey); their control on water has partially disallowed Jordan of its fair share of water. 20, 21

With regard to "Environmental impact assessment" (EIA), it is defined as the process of identifying, predicting, and evaluating the possible positive or negative impacts of a proposed project or developmental plan on the environment. 22 -25 In case of water resources, regional impacts cannot be neglected, as Jordan receives its water resources across borders of other neighbouring countries, which impact the water quality and quantity.26 While health impact assessment (HIA), is usually not receiving the same attention as EIA though the basic focus on environmental changes is made to augment those positive impacts on human economy and wellbeing. Policies are thus needed to be judged in terms of the balance between potential negative and positive effects of development. Most applications of HIA have tended to be relatively local and limited in scope.27

The component of EIA that dealing specifically with human health is called an "environmental health impact assessment" (EHIA). 22 It is defined as a mean of assessing health- related problems deriving from the environment, and health-related impacts of policies and other interventions that affect the environment. 27 It needs a comprehensive approach to describe the delicate effects of long-term, chronic and dynamic exposure to low levels of contaminants, taking into account individual susceptibility, time-activity patterns and socio-economic disparities.28

An environmental impact assessment (EIA) study of Wadi Wala Watershed (40 km south of Amman), has been undertaken after 20 years of groundwater extraction for irrigation, showed increased in the average water salinity and potential alkalinity hazard, increased in soil salinity; and uncultivated soils were higher in salinity than cultivated soils. 18

For public health concern, pollution affecting water is a serious problem. These chemical pollutants like nitrate, iron, fluoride, and arsenic, or their mixtures and disinfection byproducts are among the sources of pollution having the attention of the policy makers. The chemical and microbial pollution is linked to events, like polluting agricultural runoff, untreated or partially treated wastewater discharged from municipal and industrial sources, accidental spills and illegal waste dumping.29 -31 Basically because of lack of investing in public wastewater treatment facilities to treat the wastewater and possible rendering it into water to be used in different uses to reduce the burden on excavating underground water.

So, finding out the causative agent has a great value in terms of prevention, controlling and management of diseases. In 1977 Bradley suggested four principal categories of communicable diseases that relate to water, which are not mutually exclusive: 1-water-borne: caused through consumption of contaminated water (like diarrhoeal diseases, infectious hepatitis, typhoid); 2 - water-washed: caused through the use of inadequate volumes for personal hygiene (e.g. trachoma, skin and eye infections); 3-water-based: where an intermediate aquatic host is required (like schistosomiasis); 4-water-related vector: that spread through insect vectors associated with water (e.g. malaria, dengue fever). 32 -35

On the other side, non-communicable diseases can result from the ingestion or absorption of contaminated water with toxic chemicals, including pesticides, minerals and heavy metals. Arsenic poisoning is an example of contamination of drinking water from wells (at a concentration of about 1 mg/litre) is associated with skin lesions, cardiovascular lesions, and bladder and kidney cancer. 31, 36

Moreover, health impacts caused by scarcity or impaired quality of biologically contaminated groundwater and surface water can be organized into three main categories. Our concern is the environment-related physical health (due to prolonged exposure to ailment causative agents) such as water-borne diseases; cancer and organs dysfunction related ailments and reproductive disorders. 29, 30

Biological and chemical contamination impacts on health are well identified in literature but it is needed to be assessed in Jerash governorate (the study area) as related to deteriorated environmental factors affected by development and population demographic changes.

Water issue is a first priority for the government, so many projects and studies had been done. However, these studies were about water quality evaluation, water resources management, water demand, environmental impact of water solutions efficiency, of wastewater treatment plant, and environmental impact of using groundwater in Wadi Wala (a master thesis). Studying impacts of using water resources on health of citizens and environment in a governorate (that distinguishes with lowest water share) is something novel, in Jordan, and Arab countries.

This will make this study a pioneer that paves the road for other studies in Jordan or similar area. In addition to, it enlightens the real situation in Jerash, and sheds the light on methods and resources people use to cope with the problem. Also, it is interesting to find out the role of the government in curbing the problem, and making balance between water demand and supply.

II. LITERATURE REVIEW

The Action Plan and Agenda 21 of the UN Rio Conference 1992, emphasized the importance of the widespread shortage, gradual destruction, and increased pollution of fresh water reserves. They specified four major world problems with fresh water, which were shortages of renewable supplies; unequal distribution of supplies; problems of health and water quality; and terrible effects of unrestrained construction of dams and reservoirs. 11

Water scarcity is a vital issue in Jordan, and has maximum priority at national level. Jordan is considered as one of the poorest fourth countries in water availability. Consequently many projects and studies tackle this problem, its effect on environment and population, how to manage water resources, and solutions to meet augmented water demand; a special care is advocated for protection against pollution, and quality degradation.

2.1 Water Resources In Jordan

Jordan lies in the eastern side of the Mediterranean. Its existing resources of water (see appendix1), 37 are hardly sufficient to cover existing demands from different water consuming sectors, requires consistent adjustments of the current situation in water demand management. Main adjustments in the past helped to cope with scarcity conditions, but are not likely to set sustainable overall solutions.

The requested sustainable overall solutions have to be found by getting along with changes in elements which determine the distribution and use of water. But, these changes will come only at costs for investments, evolution processes, and probably compensations for the disadvantaged in water re-distribution schemes.

However, economic assessments of impacts and consequences from changes in water supply and demand systems face two major challenges. The first is the interaction of tools and policies with natural and technical inhabitants on multiple layers, which requires understanding of relationships, inhabitants and realizable improvements. The second is the identification and assessment of system impacts, which may unfold on social, economic or ecological levels. 38 -44

Fresh water resources consist mainly of groundwater and surface water, while treated wastewater and brackish water are other important non conventional resources that help bridge part of the gap between supply and demand especially in agriculture. 37

Jordan Ministry of water and irrigation identified twelve groundwater basins; and considered groundwater the major source of water in Jordan, and the only source of water in some areas of the country. 9, 17

2.1.1 Surface Water

Multicultural Working Group reported that there are fifteen surface water basins in Jordan the safe yield of which varies significantly from year to year as a result of the variation in the rainfall.(The total flow in the fifteen surface water basins in Jordan shown in appendix 2).

The long term average estimated safe yield of the fifteen surface water basins in Jordan was about 692 million cubic meters /year which includes both base and flood flow. Also, the two main surface water courses are Zarqa River (currently called stream because of little quantity of water) and Yarmouk River. The catchment area of the Zarqa River watershed is 3900 km2; it has two main branches which are the Amman–Zarqa draining the higher rainfall areas of the Eastern Escarpment of the Jordan Rift Valley and parts of the Jordan highland, and the Wadi Dhuliel draining the more arid areas of the Jordan Highland and Plateau.

The working group found the mean rainfall for the watershed was 273 mm, and the median annual stream flow was 63.3 million cubic meters. 45

The Water Data Banks Project consisted of a series of specific actions to be taken by the Israelis, Jordanians, and Palestinians, designed to foster the adoption of common, standardized data collection and storage techniques among the three Parties, to improve the quality of the water resources data collected, and to improve communication among the scientific community in the region.

The project found Yarmouk River drained the basaltic highland of the Hauran in Syria, an area of strong runoff, downstream of Lake Tiberias; much of the River water was diverted and used before it reached Jordan by Syria and Israel.

It estimated that the typical monthly flows of Yarmouk River at Adasiyia (in the Jordan Valley) were between 4 and 5 million cubic meters during the dry season and between 17 and 40 million cubic meters during winter. About 75 million cubic meters per year of Yarmouk River water were diverted to King Abdullah Canal, 40 million cubic meters of which were pumped to Zai water treatment plant which supplies west Amman. The remaining 35 million cubic meters were used for irrigation in the Jordan valley.

The Wehda dam at Yarmouk River (which finished in 2006) was designed to store 110 million cubic meters, 30 million cubic meters of which was dead storage. As a result of the fact that Jordan was the downstream party, the water stored behind the dam was negligible compared to its storage capacity. 45

According to environment report of 2009, Jordan renewable water capacity became 780 million cubic meters per year, about 505 million cubic meters as surface water and 275 million cubic meters as underground water. Those renewable water resources recharged by rainfall which seeps through cracks, pores, and soil; others are non-renewable water. 17

2.1.2 Ground Water

Arabiyat in her master thesis reported that there are twelve groundwater basins in Jordan (see appendix 3). These basins have safe total renewable yields that estimated between 231 and 281 million cubic meters per year, but 275 million cubic meters per year is an acceptable number for the safe yield of renewable groundwater resources in Jordan; these data consistent with the environment report 2009. It is worth to mention that groundwater resources are the main source for domestic water supply in Jordan.

Arabiyat found in her research that almost all Jordanians receive water for domestic use from groundwater sources except west Amman where the source of its water for domestic use is King Abdulla Canal which receives its water from Yarmouk River, Mukheiba wells in addition to Taberia Lake. Due to the growing water demand, almost all groundwater resources in Jordan are over exploited which led to the deterioration of their qualities.9

Over abstraction is estimated at about 55% of the safe yield according to the 2009 water budget. Additionally, there are other non-renewable groundwater basins that are exploited to meet the growing water demand. Those are the Disi basin and portion of the Jafer basin with a safe yield ranged from 107-110 million cubic meters as estimated by BGR (2004) or 143 million cubic meters as reported by the annual water budget published by MWI. 17, 45

2.1.3 Treated Water

Remawiet. al. investigated the possibility of the reuse of treated wastewater from King Hussein Medical Center (HMC) and Queen Alia International Airport (QAA) in irrigation. This involved individual analysis of the wastewater depending on its source and the consideration of the environmental and health impacts of its reuse in agriculture. 46

Multicultural Working Group announced that As-Samra Wastewater Treatment Plant (WWTP) effluent which is the largest WWTP in Jordan, was discharged to the Zarqa River in addition to the effluent from other three WWTPs which were Abu-Nsair WWTP, Jarash WWTP, and Baqqa WWTP. However, the effluent from these three WWTPs was negligible compared to that of As-Samra.

The group recommended that Zarqa River water used for restricted irrigation within Amman Zarqa Basin upstream of King Talal Dam, and for unrestricted irrigation downstream of the dam in the Jordan Valley after mixing with King Abdulla Canal water which came from Yarmouk River. They observed that the typical monthly flows of Zarqa River of 2 to 3 MCM during the summer and 5 to more than 8 million cubic meters during the winter. 45, 47

French Agency of development, took Jordan as a case study for water demand management. It found that in 2008, around 100 million cubic meters of treated wastewater efficient was reused for irrigation and industrial purposes. Such quantity formulated around 10% of the total water resources. The Jordan's Water Strategy 2008-2022 estimated that the treated wastewater to be around 247 million cubic meters by 2022, of which 220 million cubic meters will be used for irrigation and 27 million cubic meters will be used for industrial purposes. This will raise the contribution of the treated wastewater into 15% of the total water resources. 45

European Environment Agency highlighted the problem of water shortage and recommended that harvested rainwater and greywater from showers and kitchen sinks could be used for flushing toilets and watering gardens. However, the problem with greywater was that without proper treatment it may retain increased levels of elements that are harmful to the soil and the crops or trees that grow in it. One particular concern was sodium, which in higher concentrations could damage soil permeability and structure, ultimately reducing crop yields. 48

Al-Hamaideh and Bino studied the effects of treated greywater on soil. They monitored sodium levels, and other potentially damaging elements, and found that the treated water could be used for irrigation of fodder crops and tree crops, but not vegetables that must be cooked first. For fodder and tree crops, maximum allowable limits for suspended solids and nitrates were lower. Also, the leaves and olive grains were tested, and were not found suffered from ill effects. The researchers suggested flushing soil with fresh water to reduce accumulation of salts and organic matter. 48

Arabiyat concluded in her master research that treated wastewater plays a major role in narrowing the gap between supply and demand in the agricultural sector in Jordan. In Jordan there are more than twenty wastewater treatment plants distributed spatially all over Jordan. 9, 17

However, the largest wastewater treatment plant, in the largest two cities in Jordan Amman and Zarqa, is As-Samra.

The effluent of As-Samra WWTP for the year 2008 was estimated as 63 million cubic meters. Treated wastewater from As-Samra WWTP makes about 75% of the treated wastewater effluent in the kingdom, which used for irrigation as Multicultural Work Group recommended.

The sudden increase in the volume between 2008 and 2009 was attributed to the fact that the projected water demand for the years 2009 and beyond was higher than the actual water use for the year 2008. 9, 45

2.2 Water Resources In Jerash Governorate

2.2.1 Surface Water In Jerash Governorate

Al Mahamid found that flood water (i.e. runoff) in the wadies was dependent on the unstable storms in Jerash catchment area, which occurred during the rainy season from October to May. These floods were directly discharged into King Talal Dam Reservoir; which is located at the lower reach of the catchment area. The water quality of King Talal dam was acceptable only for restricted irrigation purposes with slightly increases in TDS, BOD5, and NO3. 49

An Integrated watershed management project was implemented in Jerash Governorate. The team reported that the natural base flow in Zarqa stream had become insignificant due to over abstraction. Thus, winter floods and WWTP As-Samra effluent (and much less significant Jerash WWTP) constitute the major sources of the river flow in summer months which was stored in King Talal Dam, and mainly used for irrigation the middle and southern part of the Jordan Valley. Water flows were not monitored except for Zarqa stream and the King Talal Dam, so little was known on the annual surface runoff in the watersheds. 50

In the Fara'a and Jerash Integrated Watershed Management project Jordan Valley and its tributaries, the Wadi Al-Fara’ a area in the Nablus district on the West Bank, and the Wadi Zarqa Jerash area in Jordan, were the most potential areas of agricultural development. The project aimed at providing the Jordanian and Palestinian governments with tools and methods for selection and implementation effectively sustainable interventions to manage water resources. 45

Hammouri and El-Naqa conducted a study aimed at assessing drought by using GIS and Remote Sensing, for Amman-Zarqa basin, which is one of the important hydrological basins in Jordan. The basin is about ninety percent of this area is located in Jordan, and the rest in Syria (see appendix 4). This basin is the most densely populated area in Jordan; it comprises around 65% of the country’s population, and 80% of its industries, in addition to intensive agricultural activities.

The results obtained showed that Amman-Zarqa basin was currently facing drought conditions. Furthermore, it was concluded that the combination of various indices offer better understanding and better monitoring of drought conditions for semi-arid basins like Amman-Zarqa Basin. 51

Al Kuisi et al performed a study on Amman-Zarqa basin. The objectives were to evaluate the characteristics, distribution and seasonal variations of two pollution indicators (nitrate concentration and salinity), and to determine the impacts of land use on groundwater quality. Based upon long-term data (1970–2005) of groundwater, samples collected from 538 wells across the basin. The researchers found that inefficient wastewater treatment plants 91%, industrial activities 85%, and agricultural practices 25% were responsible for salinization of nearby wells. Nitrate pollution had reached above threshold (50 mg/L) in some cases.

Moreover, remote sensing and spatial analyses helped greatly in groundwater quality assessment not only in providing the environmental status of the Amman-Zarqa basin, but also in scheming the potential of contamination risk zones, and their correlation to human activities. Furthermore, the study suggested some environmental protection strategies that should be adopted to protect the vital groundwater resources of the basin from more deterioration. 52

Al-Qaisi carried out his study to identify the effect of climate change on the water resources in Amman-Zarqa basin, starting with precipitation distribution for long term (1950-2008). The average rainfall amount was 267.92 mm /y where it was 300 mm/y in the previous studies, which meant that, there was reducing in the rainfall amount with around 12% in the last decade. He asserted that precautionary actions should be taken to mitigate depletion in water level and water quality deterioration; and the more suitable action was water harvesting projects which fulfil water shortage and climate variations effects.

The study found rainfall decreasing the hotheadedness weather parameters would redistribute the percentage between groundwater and surface water, whereof the infiltration percentage from thunder storms was very less than infiltration from inert rainfall. So the effect of the climate change would expected to be more on groundwater, with take conceding 12% reducing in rainfall should generate 15-20% shortage in ground water recharge.

On the other hand, the surface water according to climate change expected to reduce in absolute amount and to increase regarding to rainfall percentage. The study deeply recommended water harvesting and artificial recharge constructions as mitigation and adaptation actions. 53

Ministry of water and irrigation of Jordan reported that according to the base flow measurement carried out along the main channel of wadi Jerash most of the base flow in wadi Jerash was dependent on the groundwater discharge drains mainly from the Na`ur aquifer, which was expressed by many springs and wells, and the average monthly volume of the base flow about (2.2) million cubic meters. 9

French Agency of Development implemented a study in Jordan. The main objective was to bring economic analysis into water policy and help prioritizing actions according to their cost- effectiveness. The team found that the major significant surface water resource for Jerash area was Zarqa stream, and there were numerous small wadis discharging into that stream; which is a perennial stream, but most of its base flow originates as effluent from As-Samra wastewater treatment plant. 37 (Water resources of Jerash governorate are shown in appendix 5).

Arabiyat in her study, about Jerash catchment area (which is part of Amman-Zarqa basin), asserted that the surface water resources are at present used exclusively for agriculture; while the present use of water resources is dependent on springs and pumped wells. The sewage effluent flow from Jerash Treatment Plant is considered to be another water source in the study area. These effluents should be treated to a quality that would make them suitable for unrestricted irrigation for all kinds of crops. 9

2.2.2 Ground Water Resources in Jerash Governorate

WASMAP project team found that data and information on water supply were monitored by water supply experts; which included local springs connected to distribution network (quantity & quality), wells / groundwater resources, and spring discharge connected to the water supply network 50

Saleh and Jayyousi attempted in their study to summarize the challenges facing sustainable development of a wadi system (Wadi Jerash) and to propose some solutions towards achieving that goal. They found that challenges included technical, socio-economic, environmental, institutional, political and legal aspects. The researchers found in their study that during dry periods, the dependence on the scarce groundwater resources increased, causing higher abstraction rates, thus increasingly lowering groundwater tables. 54

Given by Jordan ministry of water and irrigation the yield of wells in Jerash catchment was around 5 million cubic meters, while reached around 30 million cubic meters for the adjacent wells. However, the drawdown of these wells was about 36 million cubic meters. Furthermore, the discharge of springs was about 4.1 million cubic meters. Qayrawan spring was one of the major springs located immediately northeast of the Jerash archaeological site; pumped directly to the distribution network of Al Saru area near Jerash city.

The discharge of springs has dropped dramatically from an average of about 170 m3/ hr in 1980 into 75 m3 / hr in 2002. This could be explained by increased pumping from the Shawahed wells located upslope from the Qayrawan spring.

The other small springs (<10 m3 /hr) could be locally used both for domestic and agricultural purposes. Moreover, springs could be classified into Contact Springs which issue from permeable saturated formation overlying impermeable ones, such as El-Balad (Souf), Fawwar, and Maghasil springs; and Fissured (Faults) Springs which produced by faulting or fracturing extending to great depths in earth surface such as, Bisas El-Neil spring.

The largest spring in Jerash catchment, from the discharge point of view, was El-Birkatein spring that discharges at an average flow of about 160.4 m3 /hr while the lowest spring was Basset Abeid spring, which flowed at an average of 0.1 m3 /hr, and located after Jubeh and Al Hasani. 9

According to Arabiyat the pumped water from wells is presently used for municipal and agricultural purposes. Nine wells drilled around Jerash city, to supply Jerash city and the local villages located in Wadi Jerash catchment area.The yield of these wells ranged between 7 to 77 m3 /hour.

Moreover, nine wells penetrated the Kurnub aquifer with an average yield that ranges between 16-52 m3 /hr. she found that the government owns 16 wells from the overall wells in the study area, 14 of them are in use, while the rest are private ownership.

The groundwater resources in Jerash catchment area are provided from different aquifers, comprising Kurnub sandstone aquifer, Hummar dolomitic limestone aquifer, and Na’ur limestone aquifer.

She found also that thirteen major springs are located in Jerash catchment, of which, five emerge from Hummar aquifer, seven springs from Na’ur aquifer, and two springs from Kurnub aquifer.

It is worthy to mention that, in 2003/2004, WASMAP project identified about sixty springs in Mastaba, Burma and Me’rrad watersheds (within Zarqa stream basin and Jerash governorate) with a total annual average flow of about 8.0 million cubic meters. Springs with an annual discharge of more than 20,000 m3 /hour, comprised 90% percent of the total spring discharge. Other springs were not suitable for domestic supply and were utilized by local communities for domestic and agricultural usage.

2.2.3 Treated Wastewater in Jerash Governorate

Ministry of environment of Jordan estimated in 2005 that the monthly mean effluent flow from the Jerash Treatment plant was about 106,275 m3 /month, where the method of wastewater treatment was a combination between extended aeration and aerated ponds.

The treated water from Jerash Wastewater Treatment Plant was utilized by some farms, carrying small quantities of water and then finally merges with Zerqa stream near Jerash-Amman Bridge.

2.3 Factors Affect Water Resources

Surface water and ground water are affected by many factors, which are environmental or anthropogenic. These factors have impact on water availability, in which reduce ground water and surface water supply in some areas, and increase water demand. And have impact on water quality, in which increased runoff resulting in soil erosion and sedimentation, deterioration, and contamination of water. 49

2.3.1 Climate

The major elements of climate are five: temperature, pressure, wind, humidity and rain.

Over the past decade, evidence on global warming and the accompanying changes in the earth was growing. The IPCC’s fourth assessment report (2007) concluded that it was 90–99% likely that the rise in global atmospheric temperature since the mid- 19th century has been caused by human activities. This left 1-10% to environmental origin. Intergovernmental Panel on Climate Change found that most recent assessments anticipated that arid and semi- arid regions were highly vulnerable to climate change. 37, 55

According to Kundzewicz et al., the IPCC noted that trend in groundwater systems could be directly correlated to climate change, however not in everywhere, primarily because of the lack of data. Climate change could affect groundwater resources by affecting recharge, pumping, natural discharge, and saline intrusion. Some of these effects are direct, and some were indirect.

Abdulla et al.investigated the sensitivity of the Zarqa River Watershed (ZRW) to potential climate change. The study showed that climate warming could dramatically impact runoffs and groundwater recharge in the Zarqa River Watershed. However the impact of warming could be greatly influenced by significant changes in rainfall volume. 56

Al-qaisi found assessment of vulnerability and consequent risk to water resources due to climate change impacts was necessary to work out proper adaptation and mitigation responses. The overall purpose of his study was to give a general overview of the studied impacts of the projected climatic changes in Jordan, in order to address some key points in the way of adaptation and mitigation planning.

Recent modeling studies anticipated that Jordan in general will face an increase of 2 to 5.5°C in the surface temperature by the end of the 21st century. In addition, this increase in temperature will be coupled with a projected decrease in precipitation of between 0 and 20%. The results for Jordan include shorter winters, dryer and hotter summers, a higher rate of heat waves, increased weather variability, and more frequent of extreme weather events. 51

There was a sudden change of rainfall patterns since the mid of 1950s. 57 According to Water Authority of Jordan (2007), rainfall in Jordan was between 100-500mm, and the mean monthly surplus volumes were in December, January, February and March. The average evaporation constituted approximately 90% of the total rainfall, while the average estimated infiltration rate was approximately 4-10%. 2 -4

The Jordan’s Second National Communication to UNFCCC (2009), showed decreasing trends of the annual precipitation by 5–20 % in the majority of the stations in Jordan during the last 45 years, but very few stations such as Ruwaished in the extreme east and Ras Muneef in the northwest experienced an increase in the annual rainfall amount by 5 – 10 %.

They found that larger rainfall amount with a decrease in the number of rainy days may lead to an increase in the daily rainfall intensity. On the other hand, many other stations experienced increasing number of rainy days associated with decreasing annual precipitation amounts. Moreover, they observed increasing trends in relative humidity of about 4–13% during the last three decades in the majority of locations. 55

Arabiyat concluded that the average rainfall distribution for dry year over Jerash catchment area varies from less than 195 mm as in Prince Feisal Nursery station to more than 341 mm in Kitta station. The wet hydrological year has rainfall depth varies from less than 475 mm in Prince Feisal Nursery station in the south to more than 823 mm in Ibbin station the northern parts of the study area while the average annual rainfall overall the study area for the period (2000-2010) calculated to be 432 mm. 9

Chehata and Livant showed importance of precipitation on water resources, that natural recharge of aquifer from precipitation and surface water runoff helped to maintain the water level of producing aquifers, control contamination of existing water supply by waste water and lessen or entirely avoid the degradation of fresh water resources due to mixing with adjacent or underlying brackish/saline waters. Also, extreme weather conditions such as flash floods during winter and heat waves during summer were becoming more frequent in the region.

Abdulla and Al-Omari concluded that previous studies investigated the weather records in Jordan showed an increase in the magnitude and frequency of extreme temperatures. Higher temperature and lower precipitation are expected as a result of climate change: The main results of the local climate change studies were there is a slight increase in the mean annual temperature; mean annual maximum temperature tends to increase slightly, but the mean annual minimum temperature tends to show higher increase. Their study showed that rising temperature by 2-4 °C in Jordan will reduce the flow of Zarqa river between 12 and 40 %. 37

Jubeh and Al- Hasani carried out an undergraduate project about hydrology and hydrochemistry of Wadi Jerash Catchment area. They described Jerash catchment climate in general as Mediterranean semi-arid with two distinct seasons; a long dry hot summer season extending from May to September and a moderate winter season extending from October to April. The climate of Jerash catchment area was highly influenced by elevations.

The western part which had elevations below 400 meters above sea level had low precipitation, and was dominated by hot dry weather. While the northern part of the catchment with elevations reaching 1096 meters above sea level had high annual precipitation (above 400 mm) and frequent snow falls.

The average daily minimum temperature in Amman-Zarqa basin occurred in January was about-4 °C, and about 36.25 °C as an average daily maximum temperature. The area was affected by dry wind in summer, changed from east to southeast and southwest direction. While in winter, it was affected by humid wind from west and southwest. Generally, the north-westerly wind was dominant in summer and south-westerly wind in winter. 9

According to water authority of Jordan the average daily wind speed was 10.8 km/hr. In general wind speed for the long period (2000-2010) was ranging between 7.6 and 14.6 km/hr. And the average daily relative humidity varied from 65.2 to 82.6% in winter and from 59.2 to 71% in summer.

2.3.2 Evaporization

Chehata and Livant observed that prevailing winds at Amman Airport were from the south-west in the winter, shifting to the northwest in the summer. And monthly evaporation rates were range from approximately 85 up to 90 millimeters, in December and January to 210 millimeters in April, and up to 300 millimeters in May. And the evaporation reached 567 millimeters in August. The rainfall storms shifted toward summer time, so the evaporation became more. As a result this study seems to see the potential evaporation value for Amman- Zarqa Basin increased from 90% to 91%. 51

The data of Um El-Jimal station was used by Arabiyat in order to estimate evaporation in Jerash catchment area. She found that the maximum average of evaporation was in July as 12.2 mm while the minimum was in January and December as 4.2 mm more over the average evaporation was calculated to be 8.2 mm for the study period. 9

2.3.3 Runoff

Runoff is defined as the water flow that occurs when the soil is infiltrated to full capacity and excess water from rain, melt water, or other sources flows over the land.

Al-Qaisi was interested in climate change effects on water resources. So, he analyzed the available date for rainfall-runoff events in Amman Zarqa Basin, in period from 1950 to 2008, and derived the runoff coefficient.

It was found that there was a quick response of runoff upon the rainfall, but the correlation was not found to be very high (R2= 0.123). When considering all the rainfall, the average runoff coefficient was found to be (3-5) %. According to Natural Resources Management and Environment Department/FAO (1991), the use of runoff coefficients had been derived for watersheds, in which the coefficient describes the percentage of runoff resulting from a rain storm; however it was not a constant factor. Instead its value was highly variable, and depended on catchment-specific factors and on the rainstorm characteristics. 53

There are many gaging stations in and around Wadi Zarqa, but New Jerash Bridge station data were used because it was the most representative station. The average monthly runoff recorded during the period of (2000-2010), the highest value was recorded in (2004/2005) with an average of 29.666 (m3/sec), while the lowest one was recorded in (2008/2009) with a rate of 0.012258 (m3/sec).

It was concluded that the highest averages were recorded in January while the lowest were in May. The maximum evaporation recorded in June and July due to the longest sunshine duration. Runoff maximized in winter especially in January while minimized in summer season.

It was obtained that the highest average monthly rainfall was recorded in Kitta station in February for all the period of the study while the lowest one was at Jerash station in May.9

2.4 Water Demand and Water Supply

As population increase water demand increases too. The same available water resources will be used for domestic, agricultural, and industrial purposes by more people, consequently make pressure on water supply, especially when resources are limited, and global warming increases the problem.

Savenije considered water demand management as another approach to water resources management. It differs from supply management in that it targets the water user than the supply of water, in order to achieve more desirable allocations, and sustainable use of water. Thus water demand management strategies mainly consist of economic and legal incentives, to change the behavior of water users; and creation of institutional policy environment. 58, 59

In its report 2007, the Intergovernmental Panel on Climate Change (IPCC) concluded that water availability and quality would be the main pressures on, and issues for, societies and the environment under climate change. 55

2.4.1 Jordan Water Supply

French Agency of development confirmed in its study that due to the expanding population together with the increasing per capita water demand, and the huge socio-economic developments of the last three decades, the need for sustainable use and integrated management of Jordan's scarce water resources became an outstanding condition for survival.

The Water Authority of Jordan (WAJ), is the only government authority with full responsibility and authorization of management and administration of water resources (excluding the Jordan Rift Valley). They estimated per capita share of domestic water , and found that it has decreased from 150 litres/capita/day in 1993 to 133 litres/capita/day in 1999 (i.e. a decrease of 11%), even though the supply has increased by 10%. This decreased in per capita share is expected to continue until the year 2025 due to high increase in population growth, (reaching 91 litres/capita/day).

They also found that the problem of water losses through seepage, due to aging and deterioration of distribution networks, illegal connections and robbery or inefficient billing procedures, increase the severity of water shortages problem in Jordan. 60, 61

Population and Family Health Survey estimated that the average demand in the distribution network was estimated to be 74 litres per capita per day (that is 27.05 m3 per capita per year). In reality, the demand was higher and most people buy water from tanker trucks. They also found water leakage throughout the distribution network was estimated to account for the loss of 35% of the total water distributed. Moreover, they found people who used piped water were 85.8%, Rainwater 4.5%, Tanker truck 1.7%, Bottled water 7.6%, and those use other water resources were 0.4%. 62

2.4.2 Jerash Water Supply

2.4.2.1 Domestic Water Supply in Jerash Governorate

Jerash Governorate obtains its domestic water supply from local springs, groundwater wells as well as from sources outside the Governorate. Jerash city for example is supplied from Al- Qayrawan spring, Al-Deek spring, Al-Riyyashi and Al-Shawahed wells, as well as Wadi Al-Arab water treatment plant in Irbid. Sources of domestic water supply in villages and towns of Jerash governorate are springs and wells in the area, as well as water imported from neighboring governorates Irbid, Mafraq, and Zarqa, and sometimes Ajloun and Balqa.

The water that is supplied through Ein Al-Deek drinking water station is pumped to villages and towns directly from the station through the pressure pipe network, but water supply is intermittent, so most households have storage tanks on rooftops or grounds. The spring water is first checked for turbidity, filtered, settled, and then chlorinated. The production rate was 150 m3 /hour in winter and 95 to 100 m3/hour in summer. 50

Ministry of environment conducted a project in the lower part of Zarqa stream, and found the average per capita share in Jerash governorate was 72 l/capita/day - that was nearly 50% less than the overall average for the whole of Jordan. They found that the total loss of water as a percentage of the supply was rather high, with an average of 41.3%. 45, 50

2.4.2.2 Agricultural Water Supply in Jerash Governorate

Integrated watershed management project conducted in Jerash government, found three major irrigation water sources in Jerash Governorate, which supply water to 22,000 dunnoms in total. They were Zerqa stream that supplied 5,000 dunnoms; springs, which supplied 9,000 dunnoms; and wells (private wells, and two wells operated by Jerash water authority Bab Amman well and Jerash 2 well) which supplied 8,000 donums.

Furthermore, they found that the King Talal Dam Reservoir was used exclusively for irrigation purposes in the Jordan Valley. In current days, it is also used to generate electricity.

2.4.3 Water Demand in Jordan

Water demand is influenced by several confounding factors that are varied overtime. Variation in the influential factors makes the estimation and forecast of water demand uncertain. And demand uncertainty is at the root of the water supply reliability problem. Situations of uncertainty in estimating water demand are translated into situations of risk for being incorrect or inaccurate, such as designing over capacity systems, or the opposite case where there is water deficit that becomes a restriction on the economic activities.37, 63

2.5.3.1 Factors Affecting Water Demand in Jordan

There are few studies available that assess the factors affecting on the water demand.

Demand for water has increased by 6 per cent, according to officials (2012). The rise in demand for water was due to economic and agricultural factors, in addition to population growth and an ongoing influx of Syrian refugees, which has added further complications to the Kingdom’s struggle for water security. 64

Salman et al. focused on their study on understanding the nature of household demand for water in Amman-Zarqa basin, in addition to estimation of residential demand functions for water by income classes and spatial distribution. Data from 1360 households, and instrumental variables estimation techniques were used to estimate the residential water demand function. Marginal price, rate structure premium, level of household income and other welfare indicators were examined.

The results showed that the estimated residential water demand elasticity was negative, and weakly responsive to price (-0.47) for the basin, (-0.62 for Amman and -0.004 for Zarqa). Households with lower incomes responded less to higher water prices than wealthier household groups, not as hypothesized, which means that the demand function, below certain levels became insensitive to increases in price. Other factors such as size of household, level of welfare, education, and number of bathrooms were positively correlated with water demand. 65

Another study for Salman et al. tried to make estimates of demand and supply functions for water. His study focused on understanding the nature of household demand for water, and attempted to express the household demand functions. A panel of quarterly aggregated data of 10,564 observations, was drawn from the household expenditure survey conducted by the Department of Statistics in 2003, was used to estimate domestic water demand function.

The study used two models. In the first model, the dependent variable is the household consumption of water in cubic meter and in the second model the dependant variable was the daily per capita water consumption in litre per capita.

The results showed that the estimated water demand was not flexible, and so was the income. The effect of the findings on water policy making, in regard to pricing, was quoted. Limitations of price effectiveness as a tool to shorten water consumption were highlighted. 66

1- Population Growth

Falkenmark and Midstrand put four conditions to pay attention, for balance between population and water resources, especially in areas of rapid population growth. The conditions were inadequate amount of available water, deteriorating water quality, failures in food security, and land degradation. Slow progress in water resources management, sanitation and hygiene, and family planning provoked these conditions.

They recommended steps to avert a water crisis, which were adopting management techniques to increase accessibility to water; use water more efficiently; and limiting population growth. Furthermore, cooperation and commitment of local, national, and international governments, industries, and other governments were needed for successful water management. Also, understand demographic forces to implement effective policies to reduced population growth. 14

Pech and Sunada analyzed the complex relationship between demographic changes and impacts on the natural-resource base, and confirmed that resource utilization was occurring, not only to meet growing domestic needs, but also for other rooted interests such as institutions, markets, and technology. 67

2- Urbanization

Houses in urban and rural areas have different characteristics and water consumption behavior of each. Additionally, family size is also larger in the rural areas derived by the need to have more family members help their families in their agricultural activities. Therefore, water demand and consumption behavior is expected to vary between the urban and rural areas. 37

The aggregate data on the governorate level for the year 2006 was another way to investigate the influence of urbanization on domestic water demand. There was slight trend between the increase in urban population and the increase in residential water consumption, and a weak correlation between both variables.

Conversely, the relation between the urbanization and water supply per capita provided a different opposite relation in which the correlation was also weak. This was explained by non revenue water (NRW) which increased in the governorates with higher rural population, due to longer water network in rural areas and less monitoring. 37

The minister of water and irrigation announced that the water sector in Jordan was struggling due to water scarcity, droughts, lack of funding for projects, and an inability to recover costs of ventures. He underscored that water loss has long plagued the northern governorates (Jerash, Ajlun, Irbid, Mafraq) in particular, reaching 60 per cent in Mafraq, 35 per cent in Irbid, 28 per cent in Ajloun and 24 per cent in Jerash. 64

3- Household Income

Salman et al. found that increasing household income by 10%, would expected to increase the household water consumption by 0.2-0.3%. Also, showed that showed that there was positive relationship between the total per capita water billed and the average household income increases.

4- Water Prices

There are few studies that assessed the water price flexibility on water demand in Jordan. Salman et al. showed that the estimated residential water demand elasticity was negative, and weakly responsive to price (-0.47) for the Amman-Zarqa Basin, (-0.62 for Ammanand -0.004 for Zarqa). 65 On turn, they estimated the price elasticity (in 2008) to be around -0.12 and -0.18 for the water consumption, measured in liter per capita per day, and in meter cube per household per quarter. 66

In 2008, household expenditure and income survey found that households of different income levels were buying these sources, derived by meeting their needs of potable drinking water.68

5- Seasonal Factor

French Agency for development analyzed water supply and quarterly billed water data per governorate, for the year 2009. They found clear variations during the summer and winter seasons, and among governorates; and found also that there was around 2% increase in summer season than winter.

6- Agriculture

Irrigation technologies commonly used in Jordan are furrow, drip and sprinkler. Open space, greenhouse and plastic tunnels are the most technologies used for cultivation or production. Using different irrigation and cultivation technologies are influencing irrigation water demand in requirement and efficiency. Other factors affect water demand are agricultural area, climate zone, water price, and quality of water (fresh, brackish, desalination or treated). 37

Salman et al. assessed the impact of water prices for different water qualities. The own price elasticity of surface water demand, was about -0.04 at the actual surface water price of $0.049 per m3. This was a very low elasticity, but that was very largely a consequence of the very low actual price at which it was evaluated. They concluded that an increase of 1% in the price of surface water would decrease the quantity demanded by about 0.91%, so that demand was slightly inelastic. 69

Shatanawi et al. assessed the current on-farm irrigation efficiency in the Central Jordan Valley. They found surface irrigation more efficient 70 %) than drip irrigation/open space (56%) and drip irrigation/green house (42%). 70

Wolf et. al. found an increase in farmers’ investments in greenhouses by about 15% p.a., where profitability suggested reliable water supply. Expectable benefits included higher profits through intensified cropping and high-value cropping patterns for farmers, and a simultaneous reduction of water demand due to the improved. 60

The JVA (Jordan Valley Authority) was undertaking infrastructure projects to reduce water loss, and raise the efficiency of irrigation systems to 87 per cent by the end of year 2012, according to the minister of water and irrigation, who said that these projects cost JD25 million. Majority of 114 MCM treated wastewater used for irrigation and industrial purposes per year, but the JVA plans to raise the amount to 240mcm by the year 2020. 70

7. Industry

Jordan Investment Board found a significant increase of about 73% in industrial water demand, reflecting the above average development of industrial investments. This was about tripled between 2005 and 2007. 60

According to Abel Khaleq industrial sector in Jordan used about 38.5 MCM. And this amount was expected to increase with more industries planned. 59

USAID team reviewed water policies in Jordan, in order to make its recommendations for strategic priorities. Industrial water requirements in 2010 were 40 MCM; in which water was consumed by fertilizer industries (potash and phosphate), the oil refinery, thermal power plants, cement factories, and various light- to medium-industries. Most of the larger industries were suffering from water shortage. Recycling industrial wastewater investments were, in many cases, too expensive for small industries. Moreover, the salinity problems associated with industrial effluent (especially from small, artisanal industries) could have a negative impact on the operations of the As-Samra WWTP, and the future for Jordan Valley agriculture. 56

2.5 Future Water Resources

According to Jordan-Syria treat in 1987, Jordan would utilize the water collected in the Dam .However, the construction of Al-Wehda Dam happened after 20 years in 2007, with capacity 110 CMC. But, the maximum collected quantity of water was only 16% of it storage capacity. If both governments came to an agreement on how to maintain a sustainable level of surface runoff to the dam with water, Jordan could get around 80 million cubic meters annually. 37

Jaber and Mohsen suggested two main water sources desalination: the Aqaba Gulf and the brackish deep groundwater or mineral springs flowing in some basins.71

However, the most recent large major desalination plant was Zara Ma’in constructed in 2006, which produced around 36 million cubic meters /year; while treated wastewater played a major role in narrowing the gap between supply and demand in the agricultural sector in Jordan. There were more than twenty wastewater treatment plants distributed spatially all over Jordan; As Samra WWTP made about 75% of the treated wastewater effluent in Jordan. 37, 60

The updated Master Strategy of Energy Sector in Jordan for the Period 2007-2012 (2007), set plans to start generating electricity from nuclear energy by 2020. The strategy aimed to construct Jordan’s first nuclear reactor to generate around 400 MW of electricity per year, and then construct a second reactor in 2024 with the same capacity. The nuclear reactor required huge quantity of water for cooling purposes that was estimated to be 60-100 million cubic meters per year for a reactor 1000 MW capacity.

Two sites were suggested either at Aqaba or close to As Samra WWTP, where sufficient water quantities available to meet its water demand. The water used for cooling can be condensed to produce fresh water, which could be used for other industrial, irrigation and domestic purposes. Assuming the efficiency of the condensation of the water vapor resulted from the cooling process was 80%; so about 25 million cubic meters of fresh water could be produced annually from each reactor of a capacity of 400 MW. 72

But it should take into consideration that, the overall Un-Accounted for Water (UFW) of the municipal water sector reached around 43% of total water supply. Huge investments in restructuring and rehabilitating the existing water, expected to result in overall water saving from improving the water supply efficiency was estimated to be around 62 million cubic meters in 2009. In 2022, the Jordan’s population expected to reach around 7.8 million inhabitants. Assuming a water supply of 150 litres/capita/day, this will result in supplying around 427 million cubic meters. A targeted physical water loss of 10% compared with current loss of 21.5% will result of saving around 49 million cubic meters. 37

For water harvesting, Fayez and Al-Shareef estimated in their study that if every residential rooftop in Jordan were to collect every drop of water that fell on it, the maximum quantity available would be 15.5 MCM/year, which was approximately 5 percent of domestic supply. Considering that typical rooftop systems effectively collect 60–70 percent of available water, water collected would be 9 MCM. Although this was only 3 percent of Jordan’s total annual domestic water budget, household-level rainwater harvesting provided an opportunity to meet water demand. Rainwater harvesting at the landscape- and household-scale was viewed positively by the Government of Jordan and individual stakeholders. 73

On the other hand, The World Bank estimated the increase of production costs and declining yields to poor water quality would affect farmers' income, for a share of some 40% of the 2006 cost of environmental degradation. Moreover, the cost was more likely to escalate in the future, as water tables keep declining, and as increased demand for potable use in urban areas raised the opportunity costs of the additional water required to lower salinity.61

Disi water came from Disi aquifer in the south part of Jordan, shared with Sudia Arabia. It was considered a non-renewable source, with very limited recharge rates, and almost the major remaining conventional water source that could be utilized for drinking water. The capital cost was estimated at around JD 770 million. While Red Sea Dead Sea Water Conveyance (RSDS) is a common project with Palestine and Israel, which estimated at around 6.4 billion USD. The Jordan’s share of it will be 560 million cubic meters. According to the Jordan's Water Strategy 2008-2022, the RSDSWC will be operational by 2022. 37, 56

A study conducted by CEC tried to assess the saving resulted from efficient water use, however there was not concrete estimation. The most saving was expected to come from the agricultural sector then by the domestic sector.

The study addressed that a significant amount of irrigation water was wasted due to inappropriate location of agriculture where high evaporation rates, and sandy soil with high percolation of water. Farm water used efficiency was between 40-60% depending on the irrigation system used (surface or drip irrigation), and the area where irrigation took place (water efficiency decreased as moving from north to southern part of Jordan Valley).

However, according to the historical data, it has been noticed that the best cases, irrigation water use efficiency cannot be improved more than 1-5% annually according to the geographical area.74

The same Center estimated that using rainwater harvesting by 30% of buildings in Amman could collect around 46.2 million cubic meters. By Assuming that 30% of the building in the other governorates could also collect same quantity, then rainwater harvesting could at least collected around 100 million cubic meters annually. Definitely, expanding the use of rainwater harvesting would take time, therefore collecting such quantity could be achieved reasonable after 5 years if appropriate incentives and mechanisms were put in place.

According to French Agency for development the groundwater abstraction rates were around 500 million cubic meters annually, which exceeded the safe yield by around 180%. And the total average annual runoff was around 555 million cubic meters, where around half of this quantity utilized with the total dams capacity of 315 million cubic meters.

In addition, Ministry of water and irrigation estimated the development in water demands, which would be exaggerated even more by the intended introduction of new activities in power supply industries and related mining operations after 2020, resulted in an estimated total water demand of 1679 million m³ in 2025. 60

2.6 Polluted Water Resources

Al-Kharabsheh found that the surface and groundwater nearby As-Samra wastewater treatment plant, and along the effluent path suffered from a major cause for deteriorating water quality. 47

The World Bank found that as water tables keep declining, and as increase demand for drinkable use in urban areas raised the opportunity costs of the additional water required to lower salinity. Water analysis revealed the relation between the groundwater table drawdown and the increased in the salinity levels as measure by electrical conductivity in Amman-Zarqa Basin. Also, the nitrate content in the different wells was significant and in some wells exceeded the limits for drinking water quality particularly in Amman-Zarqa basin, but was less alerting in the other basins. 61

The keys to maintaining an adequate supply of safe drinking water are proper construction and protection of supplies, licensing and monitoring of well contractors, keeping of a trained water supply operators, replacement or upgrade of aging drinking water treatment plants and facilities, and raising awareness among the consumers. 75

2.6.1 Surface Water Quality and Industrial Pollution

Farber et. al used water quality data, mass-balance calculations, and actual flow-rate measurements, to investigate possible management scenarios for the Lower Jordan River (which is between the Sea of Galilee and the Dead Sea) and their potential effects on its salinity. It was predicted that removal of sewage effluents dumped into the river (around 13 MCM/a) would significantly reduce the river water’s flow, and would increase the relative proportion of the saline groundwater flux into the river. Under this scenario, the Cl content of the river at its southern point (Abdalla Bridge) would rise to almost 7000 mg/L during the summer.

In contrast, removal of all the saline water (16.5 MCM/a) would significantly reduce its Cl concentration, to levels of 650–2600 and 3000–3500 mg/L in the northern and southern areas of the Lower Jordan River, respectively. However, because the removal of either the sewage effluents or the saline water would decrease the river’s discharge to a level that could potentially cause dryness during the summer months, other water sources must be allocated to preserve in- stream flow needs and hence the river’s ecosystem. 76

Jaar M. concluded that the increased in salinity was primarily due to industrial plants, that used reverse osmosis, and dump brine into the sewer system or natural drainage networks. He found the wastewater effluent from the As-Samra plant had a significant level of TDS. Reported levels were on the order of 1,165 mg/l. This had an impact on the TDS levels in the King Talal Reservoir, and therefore on the releases to the Jordan Valley 77 Since there was limited freshwater available to dilute the effluent, this high salinity water entered the Jordan Valley irrigation systems, resulted in lower crop yields and land degradation, which forced farmers to switch to more salt-tolerant crops. 56

According to FAD only 28% of the total industrial wastewater effluent was treated (if wastewater from potash mining was excluded, the percent became 50%); and about 25% of industrial wastewater was estimated to be discharged in the sewer network, which affected on the wastewater treatment plants performance, particularly in Amman- Zarqa Basin.

2.7 Environmental Impact Assessment (EIA)

The overall goal of an EIA is to achieve better developmental interventions via protecting the human, physical and biotic environments. EIA is one component in the environmental planning and management of development projects, in that focuses upon acceptance stage. Increasingly EIA is linked to Environmental Management Systems (ISO14001) via the use of Environmental Management Plans, or Environmental Action Plans, and to environmental auditing. The environmental impacts of projects and policies are an integral part of the project cycle, in which the identification at an early stage of environmental impacts contributes to project appraisal and project design, which combine necessary mitigation, and opposite measures. 78 -83

Jaber found in a study of water pollution in Lebanon, that water was polluted by organic materials, came from domestic wastewater and solid wastes, animal farms, slaughterhouses, agricultural fertilizers, hospital wastes, and food processing wastes. Water chemical pollution on the other hand, came from fuel and gas stations, industrial wastewater, pesticides, fertilizers, and quarries. Furthermore, this pollution had impacts which were intestinal and hepatic diseases due to drinking water or green vegetables eaten raw, irrigated with polluted water, and even through injuries to the skin; also, may raised rates of cancer and other serious or fatal diseases, due to toxic chemicals in water. 84 (Causes of water stress and deterioration of water quality in appendix 6)

2.7.1 Review of Jordan’s Environment Impact Assessment System

2.7.1.1. Assessment of the National EIA System

EIA in Jordan was evaluated by world health organization (2009). The legal basis for the EIA was the Environment Protection law #52 (EPL) for the year 2006, which replace an temporal EPL #1 of 2003, creating the Ministry of Environment, these laws were considered the framework laws. Ministry of Environment has two concurrent mandates: a classic mandate for policy and legal development and coordination; and a regulatory agency for follow up monitoring, and control, of the environmental regulations, through the Environment Rangers. 75

Procedures for Environmental Impact Assessment in Jordan were initiated in 1995 in which an EIA Directorate was established within General Corporation for Environmental Protection (GCEP). This Directorate was responsible for administering the EIA system, and for coordinating the licensing of development activities. They conducted EIA studies on an ad hoc basis, primarily under the requirements of international agencies. Since 2003 there was a remarkable progress, in order to institutionalize the EIA system in Jordan.

Moreover, the EIA regulations #37 of 2006, and its five annexes, were legislated, to require that the project supporter would contract with a national consulting firm, to conduct the EIA and prepare an EIA report. It provided full authority to the Ministry of Environment via its department of Licensing and Guidance to arrange for screening, control, and follow up on the EIA process, and its implementation. The approval of an EIA was a pre-requisite for any subsequent license or permit, by any or all other relevant authorities that may be required prior to construction. Thus, all development projects, regardless of EIA classification, must adhere to the air emission, water, wastewater reuse; industrial and municipal discharges set by the Jordanian Institute for Standards and Metrology.

EIA procedures in Jordan are screening, scooping, technical review, and decision. An Inter- ministerial Central Licensing Committee reviews the PIF (Project Information Form), and after conducting site surveys, determines if the project require EIA report, initial EIA, or no environment analysis. If the EIA was rejected, there are 15 days to appeal to the Minister of Environment, who establishes a three person independent committee, to review the decision. Monitoring is required, to follow up on the implementation. 85, 86

Furthermore, in parallel to the national EIA system, a similar EIA system was for the Aqaba Special Economic Zone Authority (ASEZA) which established by Law No. 32 of the year 2000, to manage the economic and social development of the that region. This Law assumed the powers of the Ministry of Environment, for the protection of the environment, and a special environmental protection regulation No 21 of 2001, was developed with the assistance of the World Bank. ASEZA EIA procedures are similar to the national, except that there was Environment Regulation Directorate instead of the Central Licensing Committee and the Technical Review committee, and the ASEZA Commissioner for the Environment who gave approval. 61, 86

2.8.1.2 Diagnostic Review of the National EIA System

A comparison between the EIA system in Jordan and ASEZA system with the World Bank and the European Commission systems showed that, many features of the Jordanian EA system were compatible with the World Bank EA Policy (OP 4.01) and EC 97/11. The most important difference was in the public consultation during the EIA process, and in publicly disclosing the EIA reports. 61, 87

2.8 Health Impact Assessment (HIA)

WHO defined HIA as a combination of procedures, tools and methods by which a policy, project or programme may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population. As known, policy decisions made outside of the health sector, influence many determinants of health. Thus, HIA works with a range of decision-makers and stakeholders, to support healthy public policy. So, the overall objective of HIA is to provide decision-makers with logic and true information on the health implications of a policy, programme or project. 87 While Strategic Environmental Assessment (SEA) directed towards plans, policies, and programs to support the decision-making process. 88

Chen et al. proposed a methodology for SEA, in which both positive and negative impacts on ecology, society, and economy were considered at the same time in the planning (including policy generation and evaluation), implementation, and control phases of the procedure. 89

All of article 152 of the Amsterdam Treaty, the new Strategic Environmental Assessment protocol, in 1997, Organisation of African Unity Harare Declaration on Malaria Prevention and Control in the Context of African Economic Recovery and Development, health21 – The health for all policy framework, the Strategic Environmental Directive, and environmental impact assessment, are international policies that supported HIA. Similar to HIA, EIA explores the effect of policies, programmes and projects on the environment. 90

CDC (Centers for Control Diseases and prevention) considered HIA as providing recommendations to increase positive health outcomes, and minimize negative health outcome; to the decision-making process for subjects that fall outside the traditional public health fields, such as transportation and land use. Thus policies concerned with enhancing the human condition through maintain and improve access to environmental benefits; and reducing risks. HIA needed to be judged in terms of the balance between potential negative and positive effects. 36

Human Impact Partners used HIA as a tool, for training how to live healthy. The major steps in conducting an HIA (see appendix 7) were:

1. Screening (deciding if an HIA necessary).
2. Scoping (reviewing the issue in more detail, setting the boundaries for the HIA, and considering how the HIA appraisal stage should be undertaken).
3. Assessing risks and benefits (identifying which people may be affected and how they may be affected).
4. Developing recommendations (suggesting changes to proposals to promote positive health effects or to minimize adverse health effects).
5. Reporting (presenting the results to decision-makers).
6. Monitoring and evaluating (determining the effect of the HIA on the decision). 91

Gulis et al. showed the relationship between SEA, EIA and HIA. HIA was supported within the EU context, through the Protocol on Strategic Environmental Assessment. Strategic Environmental Assessment (SEA) was a development on Environmental Impact Assessment. While EIA focused on the physical environment (air, water and soil issues for instance), the SEA Protocol promotes a broader view by focusing on both environment and human health. 92

2.8.1 Health Impact of Water Resources

Water is a remarkable solvent, however a medium (for human exposure) for a large number and variety of carcinogens. Moreover, drinking water may serve as a route of exposure for contaminants like iron, fluoride, asbestos and arsenic; or for mixture of contaminants. ( 93 - 95

According to Luciana impaired or scarce groundwater caused health impacts that organized into three main categories:

1-environment-related physical health, like communicable and non-communicable (chemical contamination) diseases; poor hygiene; and contamination-related diseases with effects on coming generations (e.g. sterility and impaired juvenile development).
2- Health care services in which increase in health care needs and laboratory costs.
3- Social well-being, like effects on socioeconomic status and employment; more resettlement and investment seeking for water. 30

Cervigni and Naber suggested that questionable water quality was likely one factor that attributed to waterborne disease, which has been found to be the cause of 47 child deaths per year in Jordan, or about 1 percent of total child deaths. 86

According to the World Health Organization in 2004, the diarrheal disease burden in Jordan as measured in Disability-Adjusted Life Years of 282 per 100,000 was like other regional countries, such as Lebanon (257) and Oman (226), and much better than others such as Yemen (1,545) and Iraq (2,121). 56

In quantitative assessments, the results were generally expressed in terms of in morbidity or mortality, usually for each endpoint separately – aggregation was left to the user. It also relied on modelling, to determine likely exposures and epidemiological knowledge to translate these into estimation of potential health effects. Veerman et al. concluded based on a review of 98 prospective (i.e. prognostic) assessments, that quantification was so far relatively rare, and the validity of the methods and results uncertain. 37

2.9 Environmental Health Impact Assessment

Briggs defined Integrated environmental health impact assessment as means of assessing health-related problems deriving from the environment, and health-related impacts of policies and other interventions that affect the environment, in ways ,taking into consideration complexities, interdependencies and uncertainties of real circumstances.36

Luciana, Aertgeerts and Angelakis in the same year, discussed types of environmental health impact assessment of a policy, that could be performed as a:

1- Prospective assessment of the proposed new policy, so as to identify possible impact
2- Retrospective assessment of effects, following policy implementation
3- Concurrent assessment, where the policy was assessed at the same time as implemented.

Once a project chosen, the focus will be on physical health, particularly the potential health impact on the surrounding population. Health professionals have a significant role, in that they contribute to implement risk communication to stakeholders, and to determine (potential or actual) health costs that are supposed to be an integral part of the overall cost–benefit evaluation.(30, 96)

Environmental health impact assessments require epidemiological studies, which are mostly observational studies, carried out along cohort, case-control, or cross-sectional approaches.

Luciana described the three types when addressed the challenges posed by health impact assessment related to aquifer recharge by means of recycled water. Cohort studies answer the question “What are the health effects of exposure to?” The measure of the effect was the risk ratio or relative risk; and incidence of mortality rate ratio.

While the most commonly used environmental health investigation is Case–control studies (which also known as case-referent studies). They are used when there is a need to assess the contribution of environmental causes to a given disease, but not suitable for direct measurement of risk.

Whereas in a cross-sectional study investigate at a single time-point (or over a relatively short period of time) the prevalence of a particular disease, set of symptoms or other indication of ill- health. Then Comparisons can be made between the frequency of ill-health and those not exposed. 30, 96

In a summary, the previous studies and researches highlighted the significance of water shortage, showed the size of the problem, and identified factors affecting (directly or indirectly) on this problem, in Jordan in general, and Jerash governorate specifically.

They studied possible mitigation measures, conventional and non conventional solutions; made cost analysis of strategies and plans for water management; put scenarios for water demand; and investigated the impacts of agriculture and industries on water quality, soil, and crops; in addition to impacts of using new water resources (such as treated wastewater, greywater, desalination, …) on soil and health.

Furthermore, they provided ideas for methodology and expectations of this study, major points for research, and were good baseline for implementing the study. Moreover, they were beneficial for comparison and explanation of the findings.

This study (EHIA of water resources uses in Jerash governorate) can be considered as a combination of studying water demand and supply; water quality, quantity, and management. Increasing number of Population, socio-economic status of citizens, and effect of season were the understudy factors which affecting water demand; sources of water supplies used for domestic and agriculture purposes in Jerash governorate were identified, as well as how people in this governorate managed limited quantities of water.

It also concerns with roles and efforts of government in increasing quantities of water, protecting sources of water supply, raising awareness among people, and controlling water-borne diseases. The novel understudy factor of this study is the health impacts of water shortage on jerash community.

III. AIM OF STUDY

The specific objectives of this study are:

1. Characterization of the demographic population changes in Jerash governorate from 2000 to 2011.
2. Evaluation of water quality (groundwater, surface water) in Jerash governorate from 2000–2011, according to Jordan National drinking water standards.
3. Assessment of environmental and health impacts of water usage for irrigation, industry, and drinking in Jerash governorate during 2000-2011.
4. Assessment of the current applied plans for sustainable water resources management in Jerash governorate within 2000-2011.

IV. MATERIALS AND METHODS

4.1 Study Design

The study consisted of two designs, which were retrospective assessment and cluster survey, applied in the three sub-districts of Jerash governorate (Jerash, Mastaba, Burma). Retrospective data for health problems, those citizens suffered from, and for records during 2000-2011.

4.2 Sampling Design

Jerash governorate was divided into clusters. Based on a previous study applied in Jordan by WHO and UNICEF, each cluster contained 2500 persons. 97 The total clusters was 65, thus seven clusters were selected by probably proportionate to size.

Number of houses included in the study was according to the equation: 97

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n= number of houses

P = assumed proportion of households with enough water quantity and good quality=0.5 D = design effect

e = acceptable precision- expressed as a proportion- = 0.05

Then n was divided by 7 (clusters) to specify number of houses in each cluster. Within each Cluster, houses were drawn randomly. For drinking water samples, they were 10% of n, thus 80 water samples. However, number of houses actually included was 810 and water samples were 81 distributed as follows:

Jerash sub-district, 5 clusters: 578 houses, 58 water samples

Mastaba sub-district, 1 cluster: 116 houses, 12 water samples

Burma sub-district, 1 cluster: 116 houses, 10 water samples

4.3 Data Collection Method

The study was done on three stages, which were reviewing records, interviewing people, and collecting water samples.

1. Reviewed Jerash governorate’ records (from 2000 to 2011), of the following ministries and departments:
1-1. Ministry of Planning and International Corporation / General Statistical Department provided statistical data about population size, density, growth rate, number of households, family size, non-Jordanians, to characterize the demographic changes. Also provided maps of Jerash governorate for residential houses, and water resources.
1-2. Ministry of water and irrigations provided data about municipal water, springs and wells controlled by Water Authority of Jordan, before and after treatment, in order to evaluate water quality, and methods of water management.
1-3. Ministry of environment had data relevant to water resources in Jerash governorate, like reports of watershed projects, studies about environment, and annual reports, needed to evaluate environmental impact.
1-4. Ministry of agriculture provided available data and studies relevant to water management and demand, in addition to annual reports, so as to evaluate environmental impacts on soil, land, and agriculture.
1-5. Ministry of health had data about morbidity of water-borne diseases like typhoid, and hepatitis A, needed to evaluate health impact.
2. Interviewed heads of all household owners in the selected clusters (using an interviewer-administered questionnaire).

Tool of study: questionnaire

The questionnaire of the study was interviewer-administered; consisted of five sections (see appendix 8), aimed to identify water resources used by citizens of jerash Governorate for drinking and domestic purposes; identify the effects of water shortage on both their health and health community; and how they adapt with water cut-off or scarcity. Furthermore, aimed to identify ways of water consumption and methods of conservation; and how they clean water tanks to prevent contamination.

Credibility of the instrument: validity and reliability

Validity

The questionnaire validity was tested using a jury of academic professors, who revised the questionnaire and all necessary changes were done till approved.

Reliability

Some questions were deliberately repeated to assure same answers. When answers were different, the questionnaire was rejected.

Pilot study

To check the design of the questionnaire, and to identify problematic questions and refine them, pilot study was done. The design of questionnaire was tested twice in Irbid city and as- Sarih town before implementing the study in Jerash governorate.

Collected drinking water samples, and analyzed them using standards methods for water to determine (Coliforms, faecal streptococci, lead, nitrogen group, fluoride) from 10% of houses included in the study representing different water recourses, so as to evaluate quality of drinking water.( 93, 97)

For water samples, houses were selected, took appointment to come and took the sample by a qualified employee from water authority of Jordan, who made arrangement with his co-workers at quality lab in Amman, to receive the samples.

He used two test tubes for each water sample, one for biological testing and the second for chemical testing. The latter contained nitric acid HNO3 since there were heavy metals would be tested. Also, he used to test level of chorine in chlorinated water. Moreover, the samples were taken between January and April (2013), in order to take collected rainwater samples.

Number of water samples drawn from each sub-district was in proportion to number of households in each sub-district, and according to source of water. Attention was paid for water sources not controlled by water authority, like springs, rainwater and tanker trucks, because of more probability of contamination.

Ten samples of municipal piped water distributed as:

- Two samples from each Burma and Mastaba
- Six samples from Jerash sub-district Twenty samples of spring water distributed as:
- Three samples from Burma
- Two from Mastaba
- Fifteen from Jerash sub-district

Another twenty samples of tanker truck water distributed as samples of spring water with similar distribution:

- Three samples from Burma

- Two from Mastaba

- Fifteen from Jerash sub-district Eleven samples from water coolers distributed as:

- Two samples from Burma
- Three samples from Mastaba
- Six samples from Jerash sub-district

And finally twenty samples of collected rainwater, distributed as:

- Two samples from Burma
- Three samples from Mastaba
- Fifteen samples from Jerash sub-districts.

Moreover, five samples were taken from a private well, tanker truck, and three popular springs, so as to investigate high level of nitrate.

In the lab, they used for chemical analysis ion chromatography (ref: CHI:NO3 IC) for measuring NO3; ion chromatography for NO2; ammonia selective electrode for measuring NH4; colorimetric (ref: CHI:F) for flouride; and inductively coupled plazma/atomic emission spectro for measuring Pb; in addition to DPD colorimetric/field analysis for municipal and tanker truck water only. While used for biological analysis multiple tub fermentation (ref: MIC-TFC) for examining total Coliforms and Esherichia coli.

4.4 Statistical Analysis

Data was analyzed with SPSS version 19.0, and Microsoft EXCEL 2010. Descriptive frequency, Chi Square, in addition to charts and figures, were used to describe the sample, test association between variables, and to describe the relationship between them.

4.5 Eligibility

Eligible households were residential, for Jordanian family living (not for students, or non- Jordanian workers), and within the selected cluster. And eligible interviewee was the head of the household.

V. RESULTS AND DISCUSSION

5.1. Jerash Population

5.1.1 Population Parameters

Jerash governorate is a hilly region with fertile lands, located north of Amman (Jordan's capital) as seen in figure 1 below. It has the smallest area of the 12 governorates of Jordan, yet it has the second highest density in Jordan (447.5 / km2) after Irbid Governorate is ranked 7th by population. 16

Governorate. Jerash

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Figure 1: Location of Jerash governorate in Jordan

Table 1: Population density and growth rate in Jerash governorate during 2000-2011

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Source: General statistical department

As shown in table (1), over the last eleven years (2000-2011), the population of Jerash governorate has increased normally. Also, the growth rate on the last six years (2006-2011) was stable (2.2), 98 however the density of population was slightly increased.

The growth rate of Jerash was similar to National growth rate over the period 2007-2011, which could reflect good family planning program and awareness, or reflect impact of economic factors on family size.

Table 2: Numbers of males to females in Jerash governorate during the period 2000-2011

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Source: General statistical department

Proportion of males to females was steady over the period 2000-2011.

On the average, proportion of males to females was (51:49). This trend is general in the whole country. 98

Table 3: Distribution of population by administrative sub-district and gender within specific years

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Source: General statistics department (GSD)

As shown in table (3), males over years are more than females in the three sub-districts. There is Slight decrease in males in Jerash sub-district, corresponding to slight increase of females in the other sub-districts. However, the last trend is changeable, and not steady.

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Source: General statistics department (GSD).

Figure 2: Distribution of urbanization in Jerash governorate within specific years

Rural to urban migration has become an essence fact in Jordan; and the number of people living in urban zones almost doubled from 40% to 72% between 1952 and 2004.

This is related to rural-to-urban migration, and due to the fact that immigrants usually prefer cities rather than rural zones.

Combined, the three largest cities (Amman, Zarqa and Irbid) make up 71.4% of Jordan population in the year 2009.

Urban area according to department of statistics is settlements of over 5000 persons.

Thus, as shown in figure (2), as years passes in Jerash governorate urbanization increases, but in less degree than Jordan as a whole. This can be attributed to attraction of large cities, which resulted in migration from Jerash Governorate to these cities (Amman, Irbid, and Zarqa).

Table 4: Distribution of non-jordanian population living in Jerash governorate by gender in 2004

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Based on the latest population and housing census performed in 2004, the majority of non- Jordanians (98.3%) were Arabs. This can be explained by good level of tourism, or good reputation of medical services level, better chances of working for non-Jordanian neighbour countries, study exchange programs, or coming to Jordan as refugees like Iraqis.

As shown in the table (4), percent of males among non-Jordanians were more than females, in 2004. The difference could be due to coming to Jordan as a worker or a student.

Table 5: Distribution of reasons of residency of non-jordanian in Jerash governorate by gender in 2004

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Source: Department of statistics. Population and housing census 2004

According to population and housing census in 2004, accompaniment (could be with a patient, a tourist, a student, or a worker) was the most reason for residency, especially among females; followed by work especially for males, which was commonly agricultural works. Tourism and study had close percent (0.26%, 0.33 %), which was very low percent.

Number of females was as one time and a half as males in accompaniment category, which showed that they came to Jordan as accompaniment, while males came for work or study or other causes than accompaniment.

For the reason “others”, though the percent was 77.2 % but no details were available.

As shown in the table (6), 17.7% of people of accompaniment reason had been stay between 1 to 4 years in Jerash governorate, followed by 16.5% had been stay from 5 to 9 years; 14.6% and 14.4% had been residing 10-14 years and more than 14 years, respectively.

For people at work group, 41.4% had been stay in Jerash Governorate for less than one year; followed by 25.6% had been stay 1- 4 years. Those who had been in Jerash for 15 years and more were 7.3% (142 out of 1955). According to ministry of labour, 84% of workers being Egyptians who work overall in the agricultural sector, and in construction and unskilled production. ([99]) For “others” category, though the numbers were high no details available, which could be due to variety of different reasons, with low numbers in each reason, resulted in moved them to “others” category.

Table 6: Reasons and duration of residency of non-Jordanian in Jerash in 2004

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Source: Department of statistics. Population and housing census 2004

5.1.2 Health Problems in Jerash Governorate during 2000-2011

Water shortage in Jerash governorate has direct effects as water-borne diseases via contaminated water used for drinking or irrigation; and indirect effects like less personal hygiene which result in skin problems, and gastrointestinal diseases.

For comparison between Jerash and other governorates, it was found that Jerash, Ajloun, and Tafela governorates were similar in low quantity of water supply and water production compared with the rest of other governorates of Jordan. Thus comparison will be between these three governorates and governorate with highest incidence rate of the disease.

Over of the period 2000-2011 incidence rates in Jerash Governorate were lower than Mafraq governorate except in 2006-08; and higher than Ajloun and Tafela governorates. This could be real or due to under reporting of the disease in Tafela and Ajloun, misdiagnosed or patients take medications without medical diagnosis, or use home treatment.

Table 7: Comparison of incidence rates of amebic dysentery by some governorates from 2000 to 2011 (in 100,000) Source: Annual reports of ministry of health (100, 101-106)

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Source: Annual reports of ministry of health 100, 101 -106

Figure 3: Incidence rates of amebic dysentery in Jerash governorate and Jordan during 2000-2011

Abbildung in dieser Leseprobe nicht enthalten

As shown in the figure (3) that jerash governorate has higher incidence rates than the national most of time between 2000- 2011.

However, rates in Jerash fluctuated, from 1.6 per 100,000 in 2010 to 33.4 per 100,000 in 2002.Based on the average of incidence rates during 2000-2011, Mafraq was the highest (44.5), then Jerash governorate (17.8).

Moreover, the national incidence rates (10.1 in 2001 to 1.3 in 2009, the average was 5.7 per 100,000) affected by extreme values like that in Tafela (0.0).

No accurate global prevalece data were exist for E histolytica infection and amoebic dysentery, however, the estimates on the prevalence of Entamoeba infection range rom 1-40% of America, Africa, and Asia, and from 0.2-% in endemic the population in Central and Sout areas of developed countries. 107

In Egypt, a survey conducted in 2002, found that 38% of people with acute iarrhoea in an outpatient clinic had amoebic dysentery. 108

By comparison, Jerash Governorate’s rate (17.8 per 100,000) two times less than Egypt, but more than developed countries.

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Source: Annual reports of ministry of health 100, 101 -106

Figure 4: Incidence rates of typhoid and paratyphoid in Jerash governorate and Jordan during 2000-2011

During most of the years the incidence rates in jerash were lower than the national incidence rate. Typhoid and Para-Typhoid are not a problem in Jordan, over the last 12 years old, the average cases were 41 cases.

In 2004 an epidemic of typhoid happened in Balqa in which 112 cases occurred, otherwise cases ranged from 0 to 18. In Jerash governorate there were no reported cases in 2005-2010, only one case in 2000, 2001, and 2011. The highest number of cases was in 2003, which were 7 cases.

As shown in the table (8), that Jerash had higher incidence rates of hepatitis A over the period 2000-2011 than Ajloun and Tafela governorates, except in the years 2000 and 2004.

Compared to other governorates, it has been found that the highest number of cases were in Jerash governorate in the last three years (2009-2011) plus in year 2005. In general, Mafraq governorate had the highest average incidence rate over the period 2000-2011 (22.0 per 100,000 persons), followed by Jerash (21.0 per 100,000), Balqa (14.8) and Ajloun (14.1) governorates.

According to WHO, Geographic areas can be characterized by high, intermediate, or low levels of endemicity patterns of hepatitis A virus infection. The levels of endemicity correlate with hygienic and sanitary conditions of each geographic area. High incidence occurs in developing countries, where poor sanitation and hygienic conditions, may reach 150 per 100,000 per year. This rate is seven times of Jerash Governorate’s rate (21 per 100,000).

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Source: Annual reports of ministry of health 100, 101 -106

Figure 5: Incidence rates of hepatitis A in Jerash governorate and Jordan during 2000- 2011

Hepatitis A incidence rates in Jerash governorate were mainly higher than the national incidence rate, except in the years 2000, 2002, and 206.

The average number of cases of hepatitis A over the 12 years, in whole Jordan, was 496 cases. The number of cases range from zero case (as in Aqaba governorate in six years, M’aan in four years) to 246 cases (as in Irbid governorate in 2002).

Furthermore, the average incidence rate (21 per 100,000) of Jerash governorate over the 12 years was more than double of the average incidence rate of Jordan (9 per 100,000 persons).

According to WHO definition, diarrhoea is the passage of 3 or more loose or liquid stools per day, or more frequently than is normal for the individual. It is usually a symptom of gastrointestinal infection, which can be caused by a variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene.109

Table 9: Comparison of incidence rates of diarrhea by governorates from 2000 to 2011, per 1000

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Source: Annual reports of ministry of health (100,101-106)

As shown in the table (9), diarrhoea cases are more in Ajloun and Balqa governorates than in Jerash governorate except in 2001.

The average incidence rates of diarrhoea were 40.5 and 36.5 per 1000 persons in Ajloun and Balqa consequently. In return cases in Jerash governorate are more than in Tafela governorate except in the last three years (2009-2011); in which 17.7, 17.6, 17.3 corresponding to 19.4, 48.9, 19.2 per 1000. However, the average incidence rates of diarrhoea, were 28.6, and 24.5 in Jerash and Tafela consequently.

Globally, it was found that the overall incidence rates of diarrhoea among children less than 5 years old, lived in 139 low and middle income countries, in 2010, each child experienced an estimated 2.9 episodes , resulting in nearly 1.7 billion diarrhoea episodes among children less than 5 years of age in low- and middle-income countries. Moreover, globally the incidence rate of diarrhoea among children less than 5 years old was 3.2 episodes. 110

In Jordan, A cross sectional study in 2012 estimated that the overall diarrhea prevalence in Jordan Valley was 21.3%, and among children less than 5 years old was 19.1%. When the last percent turned to per 1000, it became 191 per 1000, which is about seven times higher than Jerash Governorate (28.6 per 1000). The study found that factors had significant relationships with diarrhoea were age and level of education of mother, index of house crowdedness, type of family, the income, family size, cleanness of kitchen and toilet, water availability, cleanness of water tank and surrounding area of the house, compliance of septic tank with standards. 111

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Source: Annual reports of ministry of health 100,101 -106

Figure 6: Incidence rates of diarrhoea in Jerash governorate and Jordan during 2000-2011

Despite incidence rates of diarrhoea in Jerash governorate were not steady over time, in which increased and decreased, but most of the time are higher than the national incidence rate, about one and half times as Jordan’s.

The average incidence rates were 19.6, 28.6 in Jordan as a whole, and in Jerash governorate consequently.

The top three governorates with average incidence rate were Ajloun in north, Madaba and Balqa in central region (40.5, 37.5, and 36.5 per 1000 persons consequently).

On the other hand, the lowest three governorates in Jordan were Amman, Zarqa, then Irbid (8.6, 16.7, 21.2 per 1000 persons consequently).

Incidence rates of cancer in Jerash governorate ranged from 3.0 to 4.6 per 10,000 persons; which were higher than incidence rates of its neighbour Ajlouni governorate, and Tafela governorate -except in the last four years (2007-2010) plus in 2005-.

However, Amman governorate (the capital) had the highest incidence rate all over the period 2000-2010, followed by Zarqa and Irbid governorates. Incidence rates in Amman (the capital) ranged from 10.3 to 12.4 per 10,000 persons.

Table 10: Comparison of incidence rates of cancer per 10,000 by governorates from 2000 to 2010

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Source: Ministry of health (100,101-106)

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Source: Annual reports of ministry of health 100,101 -106

Figure 7: Incidence rates of cancer in Jerash governorate and Jordan during 2000-2010

As shown in the figure (7) that the national incidence rate of cancer in about twice as Jerash.

Incidence rates in Jerash governorate ranged from 3.0 to 4.6, while in Jordan it was from 6.7 to 8.0 cases per 10,000 persons.

Jordan is among Arab countries which had high incidence rates of cancer, especially among females. 112

5.1.3. Water Supply in Jerash governorate during 2000-2011

Fresh water resources in Jordan consist mainly of groundwater and surface water, while treated wastewater and brackish water are other important non conventional resources. There are fifteen surface water basins which vary significantly from year to year as a result of the variation in the rainfall. Besides, there are twelve groundwater basins in Jordan. 9, 37

Water production helps to overcome shortage of water in Jordan as a whole, and specifically in jerash. But there are lost quantities due to different reasons, which reduce quantities of water supply to population. Thus, Jerash governorate imports more quantities from neighbour governorates (Mafraq, Irbid, and Zarqa).

Jerash catchment area is part of Amman-Zarqa basin, and considered as the most important basin in Jordan that suffers from acute water shortage. 9, 42, 47, 64 As shown in the table 12, Jerash is one of the top three governorates (Ajloun, Tafela, jerash) which have least water supply; while the top four governorates with high quantities of water are Amman (the capital) and Zarqa in the central region of kingdom, Irbid and Mafraq in the northern region of kingdom.

Generally, Jerash governorate water requirements are mainly domestic and agriculture. Table 11 shows total water requirement for different sectors, 50 while figure 8 presents graphically distribution of water uses in the governorate, in which only 35% of water for domestic purposes.

Table 11: Jerash governorate total demand (in million cubic meters), in 2005 and 2010

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Source: Integrated watershed management project 50

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Source: Ministry of agriculture

Figure 8: Distribution of water uses in Jerash governorate, in 2013

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Table 12: Comparisons of Water supply and water production by governorates during 2004 – 2010.

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Source: Ministry of water and irrigation 3, 4

Figure 9: Distribution of water supply in Jerash governorate during 2004-2011 (in million cubic meters (MCM))

As shown in the figure (9), that Quantity of water supply in Jerash governorate started increasing since 2007, this could be better water resources management, more good projects for sustainable water resources, in addition to, better non-conventional water techniques, and importing water from neighbour governorates.

Also, there was a sharp decline in 2005, which could be a calculation error in the year 2004.

In general water supply quantity in Jerash governorate was small when compared with other governorate, and people in Jerash governorate mainly used water for domestic and agricultural purposes, and not for industrial and touristic purposes. 37

Table 13: Quantities of imported water and water losses in jerash governorate during 2000-2003

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Source: Integrated watershed management project (2005) 50

As mentioned before that, Jerash governorate used to import water from neighbour governorates (Irbid, Zarqa and Mafraq) to overcome its shortage of water.

It can be seen that Irbid contributed more than Mafraq and Zarqa in exporting water to Jerash governorate.

In addition to the general problem of water shortages is the problem of water losses, through seepage due to aging and deterioration of distribution networks, illegal connections and robbery. 50

Efforts to control water losses could be seen through decreased in values since 1998 (52.6% to 25.2 % in 2001).

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Source: Ministry of water and irrigation, 3, 4 general statistics department 113

Figure 10: Water share per capita (litre/day) in Jerash governorate and Jordan during 2004-2011

The average per capita share in Jerash governorate during 2000-2011 is 71 L/capita/day - that was nearly 50% less than the overall average for the whole of Jordan. 50

According to the Falkenmark Water Stress Indicator, there is water scarcity when water supplies drop below 1,000 cubic meters per person per year,14, 114, 115 which applies on both Jordan and Jerash governorate.

Jerash governorate was among the top three governorates with lowest average water share per capita (Jerash 71, Ajlouni 75.1, and Irbid 96.1 litre/day); on the other hand, the top three governorates with highest average water share were Aqaba 326.1, M’aan 212.6 and Tafela 132.4 litre/day.

As shown in the figure (10), that water share varied over the years, which can be explained by the change of rainfall, climate change, population growth, implementing projects and rainfall harvesting.

5.2 The Sample Population

Jerash governorate consists of three sub-districts, as shown in figure (11) below. Jerash sub- district is obviously much larger than both Burma and Mastaba sub-districts.

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Source:Jordan ministry of tourism and antiquities. 99

Figure 11: Administrative sub-districts of Jerash governorate

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5.2.1 Demographic Data of sample population

Table 14: Age groups of husbands and wives in the study sample, in Jerash governorate 2012/2013

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Mean ±SD for Husbands = 43.28 ± 14.6 years, Median=43.0 Mean ±SD for Wives = 39.53 ± 11.68 years, Median =39.0

Ages of husbands ranged from 23 to 87 years old with a mean of 43.28 years and a standard deviation of 14.6 years. More than half (62.7%) of husbands were aged from 30 to less than 50 years old; 4.5% of them were less than 30 years old; while 4.2% were 70 years or older.

On the other hand, ages of wives ranged from 18 to 78 years old, with a mean of 39.53 and standard deviation 11.68 years. While (65.7%) of them were 30 to less than 50 years old. On the other hand, 16.4% of the wives were less than 30 years old, while in turn around 2% were 70 years or older.

In 2004, the percentage of the husbands in the age group 60 years and over, was almost 3 times that of the wives data (17.8to 6.9) respectively, 116 but the percent decreased in the study sample to more than double (13.9 to 6.3) respectively. This can be explained with rising age of marriage for females, less difference in age between wife and husband due to economic reasons (they prefer working females), or parents attitude to encourage their daughters to continue education (at least high school –Tawjehe-).

Table 15: Husband’s and wife’s level of education in the study sample, in Jerash governorate 2012/2013

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For level of education: 35.8% of husbands were secondary educated, followed by university educated (23.5%); and the least percent was illiterate (5.8%).

While level of education of wives varied between illiterate (10.1%) to university (31.0%). Secondary education (21.4%) was the second high level among these wives. As noticed that percentage of university education among wives was higher than among husbands, which can be attributed to social factor (to avoid spinsterhood, or parents and bride no longer pay attention to level of education of groom), and it may be to secure better income.

In 2004, the percentage of illiteracy in females was three fold higher than in males and this was compatible with the mode in the whole country, 116 but now percentage of illiteracy in Jordan dropped to 6.7%, and it was twofold higher in wives of the sample than husbands (10.1% to 5.8%).

Table 16: Distribution of numbers of household dwellers, by administrative sub-districts of Jerash governorate in 2012/2013

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Mean ± SD = 6.16 ± 2.4 persons, Median =6.0

Number of household dwellers ranged from 1 to 15. In all administrative sub-districts of Jerash Governorate, 59.3% of the families (480 families out of 810) had less than 7 persons.

According to data collected 35.1% of families (284 families out of 810) had 5 or 6 persons in the house, which is consistent with family size in 2006 and 2008 (according to housing and expenditure survey 2008, and 2010). However there was 40.7% of the sample had 7 or more members. The mean of the sample was 6.16, and the median 6.0 (with standard deviation 2.4).

In 2005 the average family was 6.95 with (standard deviation 3.15) persons. ([116]) Whereas within the sub-districts (Burma, Mastaba, and Jerash), the average of household dwellers in 2005 was 6.7, 6.4, and 6.9 respectively.

But in 2012/2013, the average of family size in Burma was 6.67, and in Mastaba was = 6.45, while in Jerash was 5.99. This put two sub-districts (Burma, Mastaba) above the mean of the sample population (which was 6.16).

Table 17: Distribution of monthly income of families, by administrative sub-districts of Jerash governorate 2012/2013

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Mean = 379.26 JD

In all administrative sub-districts (Burma, Mastab, and Jerash) 41.98% of families had as low as monthly income between 100 and less than 300 JD, 2.96% had less than 100 JD, and 1.7% had more than 900 JD monthly incomes.

According to Anbat newspaper (February 18th, 2013), based on the financial report, the poverty line in Jordan in 2012 was 366 JD per month, for a standard family (consist of 4-5 members), which put more than 45% of the sample population under poverty line. The value is logic, but according to the World Bank, in 2004, the average total poverty line in jerash governorate has been set at 373 JD per capita (compared to the national level of 392 per capita). (98) The latter value was not logic and could be a typing mistake, in which typed per capita instead of per household or per month.

On the other hand, the poverty line published by department of statistics, based on the household income and expenditures survey of 2008, was JD57 per person per month and JD3876 per household (5.7 people). That was, the monthly household income 325 JD. The value coped with poverty line in 2012.

Moreover, it had been reported in 2004 that Jerash was the fourth lowest income of families in Jordan, and it was also below the Jordan median income of 5118 JDs/year. 116 This was supported with results of household income and expenditure surveys2006 and 2008, in which the average annual household’s income in Jerash Governorate was estimated to be 5060.7, and 6669.6 respectively (which was below Jordan average value in that year).

However, in 2010, Jerash had the third highest income of households (7945.5 JD) in Jordan, which could be attributed to dealing with stock exchange that attracted thousands of people that year; or could be a data entry error.

Table 18: Monthly expenditures of families in the study sample, in Jerash governorate 2012/2013

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Monthly expenditures of most families in the sample (64%) were more than monthly income, 29.6% of households had equal income and expenditure, and only 6.4% of families had higher income than expenditures. This reflects a general trend in all governorates.

There was no significant difference between the three sub-districts. (χ[2] = 3.311, P = 0.507)

Table 19: Occupational status of wives and husbands in the study sample, in Jerash governorate 2012/2013

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With respect to employment status of husbands and wives, 56.0% of husbands in the sample were employed, 36.6% retired, while 7.4% are unemployed; while 63.7% of the wives in the sample are unemployed, 35.3 employed, and 1% retired.

Within the sample, 63.7% housewives were unemployed although educated, because they work as full household wife. Moreover, 21.7% of the sample population have at least one unemployed person (male or female) who was 18 years old or over, and finished or left studying.

On general, there was a high significant difference between the three sub-districts with regard to unemployment among the family members (χ[2] = 31.705, P = 0.00).The highest unemployment was in Burma (36.2%), and the least was Mastaba (13.8%) followed by Jerash (20.4%). In a report issued by department of statistics the rate of unemployment in Jordan was estimated at 12.9% in the year 2011. So unemployment in Jerash governorate was about double higher than the national one. 117 -119 This could be a real state, or overstated by respondents due to misunderstanding of unemployment term though it was clearly defined, or deliberately gave false data to get help from government, although it was declared on the cover page that the study was for scientific purpose only.

5.2.2 Water Resources Consumptions among sample population in 2012/2013

Table 20: Distribution of home gardens by administrative units of Jerash governorate in 2012/2013

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As shown in the table (20), 43.7% of the studied houses had a garden. Jerash sub-district had more home gardens (47%) than Mastaba (39.7%) and Burma (31%).

The range of home gardens area was from 1 square meter to 25000 square meters. In Burma it ranged from 4 square meters to 1200 square meters, in Mastaba from 4 square meters to 25000 square meters, and in Jerash from 1 square meter to 9000 square meters.

Furthermore, Fruit, herbs, trees, vegetables, and flowers were planted in the three sub- districts. The most dominant was olive trees, this data consistent with the fact that over 1.25 million olive trees is planted in the Governorate, 120 followed by decoration trees and flowers, then grapes. Only in Jerash sub district some household members planted apple, pistachio and nuts.

Table 21: Types of animals raised at houses of study sample 2012/2013

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Raising livestock / birds at houses, was common, in among 25.19% of the studied houses (that is 204 houses)

Among those raising animals/birds, 38.2% of families raised more than one type of livestock and domesticated birds; while 16.7% had goats, 12.7% had sheep, and 7.8% had cows.

The low percent of raising cows attributed to high cost of buying cows, which require large space too; on contrast to high percent of raising chickens which are not costly.

Though raising livestock/birds had advantages and benefits to their owners, but they competed with house dwellers on water, and would increase water consumption of those houses.

On sub-districts level, it was found that 53% of the families ( 62 families) in Burma were raising (livestock, birds) in their houses, while families in other sub-district were less common to raise animals Mastaba (26%, i.e. 30 houses) and Jerash (19%, i.e. 112 houses) respectively.

In a summary, 43.7% had gardens with different plants and trees, while quarter of them raised livestock and/or domestic birds. This supported their living conditions but simultaneously consumed water on their expense of water share.

Table 22: Availability of sanitation system at houses by administrative sub-districts of Jerash governorate in 2012/2013

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According to the Ministry of Water and Irrigation report 2010, the general percent of houses in Jordan, connected to public sewerage network was 65%. 4

As shown in the table (22) that 71.6% of households in the sample were not connected to public sewer network.

Only 2% of houses in Burma and 9% in Mastaba were connected to public sewer network. The situation was better in Jerash sub-district where 38% of the houses were connected to public sewerage network.

By using chi square test, it was found that there was high significant difference between the three sub-districts (χ[2] =87.705, P = 0.00).This implies significant relationship between sanitation and geographic location.

In 2005, sewerage public network was not as prevalent in Jerash governorate, reaching 21% of the government households, while 79% use cesspools. 99

5.2.3 Water Resources for the sample population

Table 23: Monthly schedule of municipal water supply by administrative sub-district in 2012/2013

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As shown in table (23), half of houses in the sample population got municipal water twice per month. During this period, it was found that residual chlorine solution in pipes had the ability to control biological contamination.

Thus those who got piped municipal water twice per month were potentially protected. While those got it once per month or less were on more danger if they used municipal water for drinking.

It was found that 9.38% of the sample was not connected to municipal water network or connected but did not get municipal water. Thus this category was susceptible to biological and chemical contamination if had to use unsafe substitute, like springs and Zarqa stream; in addition to financial burden if have to buy water for drinking or other domestic purposes.

On contrast, 29.9% of the sample got municipal water three times per month or more. Among this category 12 houses (6 in Mastaba, and 6 in Jerash) got municipal water twice per week.

At sub-districts level, there is high significant difference between them (χ[2] = 63.204, P =0.00). Burma had the highest percent of no municipal water supply, while Mastaba had the highest percent of got it three times per month or more.

According to household income and expenditure survey (2002/2003), almost all households had access to public water network, yet around 60% suffer from water cut-off. 97 However, this is common all over the kingdom.

Table 24: Monthly consumption of municipal water in summer season in Jerash governorate in 2012/2013

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It has been found that families in the sample consumed in summer from 1 m3 to 21 m3 per month. While in winter the consumption decreased, which ranged from 1m3 to 16 m3 of municipal water per month. The highest consumption in both summer and winter was 5 to 6 m3 of municipal water per month.

There is high significant difference between the three sub-districts with regards to municipal water consumption both in summer and winter (in summer χ2 =76.466, P = 0.00; in winter χ2 =34.089, p = 0.00).

As shown in table (24), the highest consumption of municipal water in both summer and was in Burma, and least in Jerash.

Table 25: Types of water tanks by administrative sub-districts in 2012/2013

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Table 26: Methods of cleaning upper tanks used for drinking, by administrative sub-district in 2012/2013

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As concluded from table (25) that only 6 houses did not have upper water reservoirs, 99.26% of the studied houses had at least one upper tank, and came on the second place underground tanks (41.98%).

It was found that 70.6% of the studied houses had one or two tanks. In general, number of upper water tanks for the household ranged from 1 to 7 tanks. Also, 2.5% of the households in the sample had five and more upper water tank. However, this percent was low and five tanks for one house is not common, and might be the interviewee calculated all upper tanks on their roof though not all of them for his house. The common was one to three upper tanks.

In Table (26), 502 households (62%) used upper tank for drinking or drinking and domestic purposes; more than half of them (56.6%, i.e. 284 out of 502 houses) cleaned the upper water tank by emptying the dirty water, removing calcification and any other precipitations by scrubbing and abrasion, rinsing with water, then drying by a clean towel or by air drying.

Others (12.4%, i.e. 62 out of 502) used detergents like serf and golden which is accepted by WHO,121 and rinse with water and let it dry by air. Finally, those who added chlorine solution as disinfectant against bacteria, protozoa, and may be viruses, were 4.4% only.

There is significant difference between the three sub-districts. (χ[2] = 17.794, P = 0.007 for drinking purpose; and for drinking and other purposes χ[2]= 45.632, and p = 0.000).

Burma was the least that used upper tanks for just drinking, while Jerash was the highest that used the upper tank for drinking (52.5%, i.e. 42 out of 80) and for both purposes (64%, i.e. 270 out of 422). Mastaba was the least (13.7%, i.e. 58 out of 422) that used it for drinking and other purposes.

Table 27: Methods of cleaning lower tank by administrative sub-districts in 2012/2013

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With respect of lower water tank, 75.5% of households (612 out of 810) in the sample did not have lower water reservoirs.

Among those who had lower water tank (24.5%), number of tanks was from 1 to 6 tanks; 17.5% (of those had lower tank) had one tank, and 6.5% had three tanks and above.

By using chi square test, there is no significant difference between the three sub-districts with regards to drinking, and both drinking and domestic purposes (χ2 = 1.50067 and P = 0.221, χ2 =15.067, and p = 0.058 respectively).

For the purpose of drinking only, the two houses in Mastaba cleaned their water lower tanks without detergents, while in jerash the two houses cleaned their water lower tanks by chlorine solution, and the other two lower tanks cleaned without detergents like goblin.

For the purpose of both drinking and domestic uses, 51.6 % (48 houses out of 93 houses with lower tanks) cleaned their lower tanks with water only.

On contrast 4.3% (4 out of 93 houses) used chorine solution for cleaning, which was very low percent. This could be explained with chlorine taste, that affect water and people do not like it.

Table 28: Methods of cleaning underground reservoir by administrative sub-district in 2012/2013

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58% of houses (i.e. 470 houses) did not have underground reservoir, and among those who had underground reservoir (340 hoses), around 9% shared the underground reservoir with other houses in the same building.

Based on chi square test, there is no significant difference between the three sub-district for drinking purpose (χ2 = 3.642, P = 0.888), but for both purposes (drinking and domestic uses) there is significant difference among them (χ2 =20.770, P = 0.002).

In Burma only 6 houses used their underground reservoir for drinking, in which 4 houses cleaned them without using detergent, and the other two houses did not clean them.

While in Mastaba just two houses used underground reservoirs for drinking, in which cleaned them without adding detergent. And in Jerash 80 houses (13.8% of 578 houses) used their underground reservoir for drinking, in which only 4 houses added chlorine solution, 8 houses used detergents, 37 houses (46.3% out of 80) cleaned their underground reservoirs without using detergent, while the rest (30 houses) did not clean them.

For respect of both drinking and domestic purposes, both Burma and Mastaba did not add chlorine for cleaning underground reservoir, while 16 houses in Burma and 18 houses in Mastaba cleaned their underground reservoir without using detergents. On the opposite in Burma 10 houses did not clean their underground reservoir, while in Mastaba 4 houses did not clean their underground reservoirs.

For Jerash sub-district, as shown in the table (28), 86 houses used their underground reservoirs for both purposes, but among those 30 houses (34.9%) did not clean their underground reservoirs. Only 4 houses (4.7 %) added chlorine tablets after cleaning the underground reservoir, two houses used detergent, and other houses (50 houses) neither used detergents nor chlorine tablets for cleaning their underground reservoirs.

In a summary, the majority cleaned water reservoirs without using detergents (like serf and golden) or chlorine (as solution or pills). According to WHO when water is stored, it is extremely important to protect it from contamination. Washing tankers with a bleach solution like chlorine, rinsed with safe water and disinfecting of tanks should be carried out at least once every six months; and should be provided with a tap and a cover to prevent insects, dust and other possible contaminants from entering. 121, 122

Table 29: Distribution of sold water types by administrative sub-districts of Jerash governorate 2012/13

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Burma bought more water (69% - 80 houses out of 116 houses-) than Mastaba (53.4% -62 houses out of 116 houses) and Jerash (53.6% -310 houses out of 578). On the other hand, Mastaba and Jerash buy bottled treated well water more than Burma.

Bottled treated well water is a drinking water supply technology, in which the source of water is a safe water tanker truck, treated by filtration, ozone and ultra violet in small scale Water Company, which is widely common in Jordan. For tanker truck, they bring water from licensed private or governmental well.

As shown in the table (29) that while citizens in Burma (50%) bought water tanker trucks, both Mastaba (25.9%) and Jerash (30.8%) bought bottled treated well water.

By using chi square test, it was found that there is high significant difference between the sub-districts (χ2 = 45.406, P = 0.00).

Table 30: Distribution of using other water resources by administrative sub-districts of Jerash governorate in 2012/2013

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As shown in the table (30), Burma depends on other resources more than two times of Mastaba, and around six times than jerash (42%, 21%, and 8% respectively).This could be explained by presence of springs in Burma more than in Mastaba,50 and although Jerash has lot of springs but not all of them safe and protected from contamination.

By using chi square test, it was found that there is high significant difference between the administrative sub-districts (χ2 = 125.160, P = 0.000).

38% of households in Burma depended on springs as additional water resources, while 17% in Mastaba and 4% in Jerash used them as additional water resources.

However, water stream (Zarqa stream which is known previously as Zarqa river) and borrowing rainwater from relatives or friends had similar percent among the three sub-districts.

In a summary, there was schedule for municipal water distribution and intermittent periods of water, so people searched for other resources than municipal piped water. Many bought water from water treatment shops and tanker trucks; some harvested rainwater, and use springs. By experience they located safe springs and used them for domestic purposes.

5.2.4 Water Quality in the Sampled Area

Many factors play a role leading to deterioration of water quality. Some factors have direct effects, others have indirect effects; such as absence of sanitation, adequacy of water, availability of water resources, methods of water handling and treatment, etc.

Globally, improving water quality, sanitation and hygiene has the potential to prevent at least 9.1% of the disease burden, or 6.3% of all deaths. 20% of children up to 14 years of age, particularly those living in developing countries, suffer more from deterioration of water quality, because of low immunity. Millions of children die every year from diarrhoeal diseases transmitted by water and food. 35

Sanitation in Jordan is 65 % that is medium, 4 while in jerash governorate it is poor (21%). 99

According to Jordanian standards for drinking water, it was found that 74.07% of the analyzed water samples, from households at the three sub-districts, comply with the standards for chemical tests, and 80.25% of them comply with the standards for biological tests.

Furthermore, as shown in the table (31) municipal water, rainwater, and treated water were 100% chemically comply with the standards; while spring water and tanker truck water were 45%, 50% respectively chemically complying with the standards. This is attributed to the high level of nitrate in the raw ground water.

On the other hand, municipal water and tanker truck water were 100% biologically complying with the standards; while spring water (55%), rainwater (75%), and treated water (81.8%) ranged from medium to very good biologically in compliance. This is logic since chlorine is added to both municipal and tanker truck water; while spring water and rainwater were neither treated nor disinfected with chlorine.

At level of sub-districts, the water in Jerash sub-district was biologically and chemically better than Mastaba and Burma. While chemically Mastaba sub-district water (83.3%) was more complying with standards than Jerash (77.19%) and Burma (50%); it was found that biologically both Jerash (84.2%) and Burma (83.3%) were more in compliance with the standards than Mastaba (58.3%).

Marginal quality was dominant in Burma (50%), with regards to chemical standards, because 50% of them used tanker truck water and 38% used spring water for drinking. These sources are potentially not safe.

Moreover, by using the classifications of water quality shown in table (32) – derived from Canadian water quality designations, the overall chemical quality of the governorate was medium, while the overall biological quality was good.

These findings were less than the values of results of RADWQ project in Jerash governorate (2005) which found more than 99% of drinking water samples in a compliance with National and WHO standards. In real fact, this study included samples of springs, collected rainwater, and samples from coolers, whereas the project did not include them.

Table 31: Percent of chemical and biological tests complying with Jordanian standards for drinking water, at Jerash governorate sub-districts, 2012/2013

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Table 32: Water quality classifications

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5.2.5 Methods of water Conservation in households

Many methods and tactics are used in houses to conserve water, and reduce used quantities. Such as saving water utilities, reusing wastewater, maintaining water pipes and taps, cleaning floors with mops, washing cars by bucket, etc, which all are acknowledged conservation techniques in Jordan.

Table 33: Number of laundry run per week at houses in the study sample, in Jerash governorate 2012/2013

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Mean ± SD = 2.17 ± 1.284 (Median = 2.00)

Table 34: Type of washing machines at houses in the study sample, in Jerash governorate 2012/2013

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Number of laundry per week, and type of washing machine were significantly different between the sub-districts (χ2 = 28.329, P = 0.029, χ2 = 11.879, p = 0.018 respectively).

Households in Mastaba washed clothes twice per week (44.8%) more than in Jerash (42.9%) and in Burma (39.7%); but households in Burma used automatic washing machines (44.8%) more than Jerash (36.3%) and Mastaba (34.5%). In general, 61.7% of houses used ordinary washing machine.

Table 35: Distribution of re-using of laundry water by administrative sub-districts of Jerash governorate 2012/2013

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People in Burma were reusing laundry wastewater (62%) slightly higher than Mastaba (59%) and Jerash (55%), mainly for flushing toilet, and then cleaning floors.

On the other hand, those who did not reuse laundry wastewater were more in Jerash (45%) than Mastaba (41%) and Burma (38%). However, this difference was not significant (χ2 = 2.445, P = 0.294).

It is worth to mention that using laundry wastewater for irrigation should be used with cautious, for laundry products can be harmful to plants. Most soaps and detergents - including baking soda - contain sodium compounds.

High levels of sodium can cause discoloration and burning of leaves, and can contribute toward an alkaline soil condition. Acid-loving plants may experience some chlorosis or yellowing of the foliage, due to the alkaline nature of the greywater. 123 -126

Table 36: Distribution of re-using of dish washing water by administrative sub-districts of Jerash governorate 2012/2013

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As shown in table (36) around half of households in Burma (48%), as well as one third of Mastaba (33%) reused dish washing wastewater mainly for garden irrigation.

In Jerash sub-district 37.7% (i.e. 218 houses) reused the dish washing wastewater; mostly (18.3%) reused it for flushing toilet.

By using chi square test, it was found that there is significant difference between the three sub-districts (χ2 = 6.446, P = 0.04).

However, the percent of reusing dish washing wastewater (38%) was less than reusing laundry wastewater (56.3%), may be because of less amount of wastewater, or high amount of lipids resulted from food residues, or it may need installing fixtures specifically for colleting dish washing wastewater.

Usually the dish washing wastewater contains detergent, organic matter, oils, and chlorine solution, which have negative effects on home garden 124, 126, floor or toilet.

Table 37: Distribution of re-using bath water by administrative sub-districts of Jerash governorate 2012/2013

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As shown in table (37) the least percent of people who reused body wash wastewater was in Mastaba (21%), than in Jerash (29%) and Burma (38%), in which the main use of body wash wastewater was toilet flushing.

Using chi square test confirmed this significant difference between the three sub-districts (χ2 = 8.421, P = 0.015).

Furthermore, there are other domestic uses for water at houses. Such as body washing and flushing toilet.

With respect to method of washing body, using full tub would consume much quantity of water than shower. In turn shower would consume more water than using bucket.

Mastaba had the highest percent of using the shower (84%), than Jerash (65.1%) and Burma (45%). This reflected more quantities of consuming water in Mastaba, and less concern with conserving water, since shower consumes more water than bucket or similar tools.

With respect to flushing toilets, it is known that more number of toilets means more consumption of water. Moreover, type of toilet also determines degree of consuming water, such as flush latrine consumes more water than pit latrine.

Numbers of toilets in the studied houses, varied from one to more than three toilets. 45.9% of houses had one toilet, followed by 40% of them had two toilets. This finding is consistent with a pervious study done in Al-Me’rrad (in Jerash governorate 2005). 117

Furthermore, pit latrine was the most dominant type (79.3%), while 29.1% had both pit and flush latrine.

On the other hand, there are other methods to reduce water consumption, such as fixing the leakage of water taps which will save much water from wasting. However not all people take such action; the highest percent (80%) of householders who usually fixed it, and only 2.0% did not care when there was slight leakage, as in Mastaba and Jerash; while 18% of householders collected dropping water in buckets.

Moreover, using mop to clean floor does not consume much water in comparing to rinsing. For those who did not have rugs or something alike to cover floors of the house, only six houses in Jerash sub-district did not rinse the floors. The highest percent of rinsing floors was in Mastaba (87%) then Burma (83%).Based on chi square test, the difference between the three sub-districts, with regard to using mop, is highly significant (χ2 = 30.259, P = 0.000)

Furthermore, for those who had motor vehicles, in all sub-districts, 71.8% used bucket for cleaning their vehicles, or hose (20.2%); only 6% went to car washing stations.

Most Owners of motor vehicles in Burma (60%) used bucket for cleaning; in Jerash (47%) and Mastaba (36%) they used mainly bucket but in less degree than Burma.

The difference between the sub-districts is highly significant, according to chi square test (χ2 = 29.403, P = 0.000).

In a summary, as seen from comparison between the sub-districts, people in Burma took better action of conserving water than in Jerash and Mastaba.

This can be explained by their water status. They suffered more from inadequate water, and had less monthly income than the others, which result in more appreciation for the water value.

5.2.6 Health Problems among sample population

Inadequate water supply will force people to use unsafe water resources, with high risk of biological contamination; in addition to less personal hygiene. This increase the probability of water-borne diseases, and diseases related to water like skin diseases, cancer 29, kidney problems, etc.

Kidney stones

Table 38: Distribution of occurrence of kidney stones patients among family members by administrative sub-districts of Jerash governorate during 2000-2011

Abbildung in dieser Leseprobe nicht enthalten

As shown in the table (38), percent of kidney stones cases was 14.0%, and in all administrative sub-districts cases are more among husbands. The percent was not high, for Jerash governorate is a hilly region with a mild Mediterranean climate.

The lifetime risk of kidney stones is about 10 to 15% in the developed world, but can be as high as 20 to 25% in the Middle East.127 Moreover, higher cases among husbands concordantly with a common fact , that about 65-80% of those with kidney stones are men; most stones in women are due to either metabolic defects or infection.128

Mastaba had the highest percent of kidney stones cases (26.7%), followed by Burma (22%), and the least was Jerash sub-district (9.7%). This difference is high significant (χ2 = 25.475, P = 0.000).

Moreover, there were only two nephritis cases in the sample, during the same period, but no kidney failure cases. The average cases of kidney failure in Jerash governorate over last seven years (2005-2011) was 51, i.e. around 3 cases per 10,000 persons. This could explain absence of kidney failure cases among the sample which consist of 810 households (about 4860 persons).

Hepatitis A

For Hepatitis A, during the period 2000 – 2011 there was only 8 cases (1%) in the sample; they were sons, and in jerash sub-districts. This can be explained by the low incidence of Hepatitis A in Jordan as general, or because some cases were asymptomatic (i.e. no visible symptoms).

This is consistent with statistics from ministry of health, in which the average cases over 2002 to 2011 in the whole Jerash governorate was 34 cases.100

Cancer

Table 39: Distribution of cancer cases by administrative sub-districts of Jerash governorate during 2000-2011

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Table 40: Types of cancer among the sample, in Jerash governorate during 2000-2011

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As shown in the table (39), percent of cancer cases (2%) was similar in all administrative sub-districts. This is lower than general percent of Jerash Governorate over the period 2000- 2011 (range from 3.0% to 4.6%).

During 2000 – 2011 only 16 household dwellers in the sample suffered from cancer. Though the number seems very low, but it is reasonable, since on the average, during 2000-2011, every 10,000 Jordanian persons 7 had cancer. Among those who had cancer, wives percentage was 25% while husbands, daughters and sons had equal percentage 12.5%. This is consistent with cancer statistics in 2009, in which 52.5% were females and 47.5% were males. 100

In table (40), Leukemia cancer (25%) was the dominant type among cancer patients, followed by similar percent (12.5%) of types related to bones, digestive system, neuroblastoma, and skin cancer.

The most dominant types of cancer among females in northern part of Jordan in 2009 were breast, leukemia, thyroid, colo-rectal, and skin; while among men the dominant types were prostate, lung, colo-rectal, leukemia and skin cancer. 127

The difference in types order between the sample and northern part can be explained by that the northern part of Jordan consists of four governorates Irbid, Jerash, Ajloun, and Mafraq, and not Jerash only; and also type order changes over years.

Even the order of cancer in overall Jordan varies from year to year, except the highest two types which are breast followed by colo-rectal. 100

Skin diseases

Table 41: Distribution of skin diseases by administrative sub-districts of Jerash governorate during 2000-2011

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Only 5.7% of people in the sample had skin diseases, and there were no problems among husbands during 2000 – 2011.

Skin fungi problem (4.2%) was the main skin problem among cases, followed by hair lice (1.2%). It had been found that cases of skin diseases in the sample were higher among daughters (52.2%) and sons (39.1%).There were 18 cases among sons, aged 6-26 years old; and 16 cases among daughters, aged 4-43 years old.

Moreover, all cases of hair lice were females, aged 4 -11 years old, and all cases in Jerash; while the highest percent of skin fungi cases (10%) were in Mastaba.

There is significant difference between skin problems in the three sub-districts, (with χ2 = 8.124, P = 0.017). Skin diseases were most in Mastaba (10.3%), then Jerash sub-district (5.5%), and the least cases were in Burma (1.7 %).

Other diseases

Table 42: Distribution of other diseases among the sample, by administrative sub-districts of Jerash governorate during 2000-2011

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92.47% of people (in 749 out of 810 families) in the sample did not have other health problems related to water, which could be attributed to their age, in which the average was 40s; or people forgot or tried to undercover their health problems.

Heart problems (67.20%) were the most health problem among patients of other diseases related to water, then both amebiasis and intestinal worms (13.12%).

It has been found that husbands (70.4%) suffered from other health problems, mainly heart problems, more than other members of the family.

Heart problems, hypertension, and diabetes are interrelated; and there is intimate relationship between diabetes and hypertension, while hypertension increases the risk of heart attacks, strokes and kidney failure.

Also, uncontrolled hypertension can also cause blindness, irregularities of the heartbeat and heart failure. Heart diseases and stroke accounted for 35% of deaths in Jordan, in 2005.

During 2004, both diabetes and hypertension patients accounted for 15% of the population in Jordan. 129

In Jerash governorate, the average of amebic dysentery over 2000-2011 was 26 cases; and on the last three years (2009-2011) cases were 7, 3, and 6 respectively.

In the sample, cases of Amebiasis were the whole members of two households, which means that one of them infect the others, or all eat or drink same contaminated source.

Another health problem was found, which was Intestinal worm. All cases of abemiasis and intestinal worms were in Jerash sub-district, while most of heart problems were in Jerash (38.5%) then Mastaba district (15.4%).

5.3. Results of Water Analysis

5.3.1 Results of raw water from springs and ground water analysis during 2000-2011

Jerash Governorate has many springs, and wells (artesian, shallow, and collective), in addition to public water networks. Water authority controls some of these springs and wells.

As shown in the following figures (13 to 17), that treatment plant of Ain Deek and Ain Teis springs do not perform chemical tests to raw water, but biological tests only.

5.3.1.1 Results of chemical analysis

1)Nitrate

Abbildung in dieser Leseprobe nicht enthalten

Source: Ministry of water and irrigation

Figure12: Average values of nitrate in raw water at treatment plants and pump stations in Jerash governorate within selected years.

Nitrate in raw water is a major concern at Qayrawan treatment plant and Shawahed pump station, but not at Ain Deek and Teis treatment plant.

Values at Qayrawan treatment plant decreased over years (68.5 to 38.9), while at Shawahed values increased between 2003 and 2006 (31.7 to 37.0).

However, Shawahed pump station discontinued analyzing nitrate in raw water since 2008, may be due to values below the national standards over years.

2) Ammonia

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Source: Ministry of water and irrigation

Figure 13: Average values ammonia in raw water at treatment plants and pump stations in Jerash governorate within selected years.

Ammonia is used in fertilizer and animal feed production and in industry, and as a starting product for many nitrogen-containing compounds.

Natural levels in ground waters are usually below 0.2 mg of ammonia per litre; surface waters may contain up to 12 mg/litre. 130

As shown in the figure (13), Ammonia in raw water analyzed at Qayrawan treatment plant in some years but not continuously, so do Shawahed pump station, while Ain Deek and Ain Tees treatment plant do not perform such test. This is because Ammonia is not of direct importance for health in the concentrations to be expected in drinking-water. 130

3) TDS

Salinity is a measure of the amount of dissolved salts in water. There are several different ways to measure salinity; the two most frequently used analyses are Total Dissolved Solids (TDS), and Electrical Conductivity (EC).

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Source: Ministry of water and irrigation

Figure 14: Values of TDS of raw water at treatment plants and pump station in Jerash governorate during selected years

The palatability of water with a total dissolved solids (TDS) level of less than about 600 mg/l is generally considered to be good; drinking-water becomes significantly and increasingly unpalatable at TDS levels greater than about 1000 mg/l. 95

TDS was not performed at Ain Deek and Teis treatment plant, and was not measured in other plants in 2008 and 2011. The shown TDS values of raw water are complying with national standards (1000 ppm).

At Qayrawan plant values were 556.1, 541.36 in 2003, 2006 consequently, and station values were 534 and at Shawahed 507.86 in 2003 and 2006.

4) Raw water pH

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Source: Ministry of water and irrigation

Figure 15: Average values of pH of raw water in Jerash governorate during the selected years.

Although pH usually has no direct impact on water consumers, it is one of the most important operational water-quality parameters. The optimum pH will vary in different supplies according to the composition of the water and the nature of the construction materials used in the distribution system, but is often in the range 6.5–9.5. ([131])

Values of water pH at Qayrawan treatment plant (7.37, 6.64, 7.44 in 2003, 2006, 2008 consequently), and Shawahed pump station (7.58 in 2003, and 7.57 in 2008) are acceptable according to national standards of drinking water supplies (6.5 - 8.5); While Ain Deek and Teis did not perform measurement for pH of raw water over those years.

5.3.1.2 Results of biological analysis during 2000-2011

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Source: Ministry of water and irrigation

Figure 16: Average values of E. coli in raw water at treatment plant and pump station in Jerash governorate in selected years.

All values of raw water in the three locations are highly above the national standards (less than 1.1 MPN/100 ml).

Microbial contamination is highest at Qayrawan treatment plant (36, 146, 86, 293 consequently over 2003-2010).This can be attributed to location of Qayrawan plant, near houses with cesspools, and possibility of leakage.

As shown in figure (16) there is fluctuation in values of E. coli at Qayrawan treatment plant, and shawahed pump station (9, 94, 66, 127 consequently), but number of E. coli are lowest at Ain Deek and Ain Teis springs (22, 94, 53, 42 consequently) except in 2003.

5.3.2. Results of Treated Water from Springs and Wells during 2000-2011

5.3.2.1 Results of chemical analysis during 2000-2011

1)Fluoride, Nitrate, Ammonia, and Lead

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Source: Ministry of water and irrigation

Figure 17: Average values of fluoride, nitrate, ammonium and lead of treated water at treatment and pump stations in Jerash governorate during 2000-2011.

Fluoride is one of the very few chemicals, which causes significant effects in people through drinking-water. It has beneficial effects on teeth at low concentrations but excessive exposure can give rise to adverse effects. 132 In 2006, an exhaustive 500-page review of fluoride’s toxicity had been published. The report concluded that fluoride is an “endocrine disruptor” and can affect many things in the body, including the bones, the brain, the thyroid gland, the pineal gland, and even blood sugar levelsAll values of fluoride in the three locations (0.23, 0.32, 0.27 consequently) were in compliance with national standards (less than or equal 1.5 mg/l).

Lead is a strong neurotoxin in the unborn, newborn and young children, toxic to both the central and the peripheral nervous system, thus causing cognitive and behavioural effects. However, Lead is rarely found in source water, but enters tap water through corrosion of plumbing materials, 132 dissolution from such materials strongly depends on chemical properties of the drinking-water, with soft, acidic water dissolving the largest amount. 133

In Ain Deek and Ties, Qayrawan, and Shawahed locations, values of lead were zero, while ammonia values were 0.1 ppm; and nitrate values (29.26, 34.59, 29.22 consequently) were below WHO, and nationals standards (Pb 0.01 mg/l, NH4 0.2 mg/l, NO3 ≤ 50 mg/l). However, Qayrawan treatment plant had higher average values than others.

2) TDS

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Source: Ministry of water and irrigation

Figure 18: Values of TDS in treated water at treatment plants and pump station in Jerash governorate during 2000-2011.

According to WHO guidelines for drinking water, 4th edition, water with TDS less than 600 ppm considered good. The values of TDS were highest in Qayrawan treatment plant (515.90, and 422.1 for maximum, and minimum values), and lowest at Ain Deek and Teis treatment plants (505.18, and 246.56 consequently).

At Shawahed pump station values were 469.00, and 423.44 as maximum and minimum values. All values are complying with national standards, and considered good according to WHO guidelines.

3) pH

Abbildung in dieser Leseprobe nicht enthalten

Source: Ministry of water and irrigation

Figure 19: pH of treated water at treatment plants and pump stations in Jerash governorate during 2000-2011

The pH of the water entering the distribution system must be controlled to minimize the corrosion of water mains and pipes in household water systems. Failure to do so can result in the contamination of drinking-water and in adverse effects on its taste, odour, and appearance,131 as well as heavy metals concentrations.

All values of Qayrawan, and Ain Deek and Teis treatment plants, and Shawahed pumping station are complying with national standards (6.5-8.5), however Qayrawan readings (7.61 for maximum, and 7.38 for minimum) had lower value compared to both Shawahed’s (7.78, 7.44 ) and Ain Deek and Teis’s readings (7,7.46 as maximum and minimum values consequently).

5.3.2.2 Results of biological analysis during 2000-2011

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Source: Ministry of water and irrigation

Figure 20: Values of E. coli in treated water at treatment and pump stations in Jerash governorate during 2000-2011

E. coli are naturally occurring fecal Coliforms, the only species in the Coliforms group that is exclusively found in the intestinal tract of humans and other warm-blooded animals and it is excreted in large numbers in feces. Most strains of E. coli are relatively harmless; and easily treated with chlorine. Total Coliforms counts in treated drinking water are an indicator of how well the disinfection process is working.95

As shown in the figure (20) that there was a problem at Qayrawan treatment plant during 2000-2011.The maximum value in a year was 1553.

This can be explained by the defect of the disinfection process, wrong data, or extensive microbial contamination occurred. But the real fact that there was a contamination after rain shower in the washout sample , which do not used for drinking purpose, so this value should be excluded due to unexpected event.

Only Shawahed pump station (1.1) was free from biological contamination, while Ain Deek and Teis was slightly contaminated (8 maximum, and 1 minimum) and Qayrawan plant was highly contaminated.

5.3.3 Other Water Resources Analysis

5.3.3.1 Qayrawan Spring in 2011

Table 43: Results of physical, chemical and biological parameters of water samples analysis from Qayrawan spring in 2011

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Source: The annual report of national project for monitoring water quality in Jordan. 134

There has been information about biological contaminations in Qayrawan spring, in April, July, and October 2011, in addition to January 2012. 134

As shown in the table (43), according to Jordanian standard for drinking water number 286/2008, there was a microbiological contamination (E.Coli 3.31E+01); which required treatment before drinking.

This is consistent with microbiological standards for water quality of surface and ground water, issued in July 2001, in which Qayrawan spring water can be used for drinking after disinfection and filtration.

5.3.3.2 King Talal Dam

In the following table (44), as biological test results shown (E.Coli 3.4E+01), and according to WHO guidelines, that water of King Talal Dam can be used for unrestricted agriculture. While according to FAO guidelines, Physical and chemical results revealed that water of the dam can be used for moderate and tolerable salinity (pH 8.05), Boron (1.0 mg/l) and Sodium crops; and can be used for tolerable Chloride crops.

Also, high level of Bicarbonate (337 mg/l), Sodium (286 mg/l), and Chloride (444 mg/l) restrict sprinkles usage in irrigation, but drip irrigation can be used. Moreover, cautious should be taken when using nitrogen fertilizers because of moderate level of nitrate (39.3 mg/l) in dam water.

Chemical and biological characteristics of water of King Talal Dam made it used for unrestricted agriculture, while water of Zarqa stream suit restricted agriculture only because of deterioration of water quality due to wastewater discharged from factories and As-Samra wastewater treatment plant. This is consistent with Multicultural Working Group report (1998), (50, 47) and Al Mahamid research (2005). 49

Table 44: Results of physical, chemical, and biological test analysis of water samples from King Talal dam, 2011

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Source: The annual report of national project for monitoring water quality in Jordan. 134

5.3.3.3 Zarqa Stream / Jerash Security Point

Table 45: Results of physical, chemical, and biological test analysis of water samples from Zarqa stream / Jerash security point in 2011

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Source: The annual report of national project for monitoring water quality in Jordan. 134

As biological test results shown, and according to WHO guidelines, that water of Zarqa stream/ Jerash security point can be used for restricted agriculture only. While according to FAO guidelines, Physical and chemical results revealed that water of Zarqa stream, at Jerash security point can be used for moderate and tolerable salinity (pH 8.28), Sodium, and Boron (1.0mg/l) crops; and can be used for tolerable Chloride crops.

In addition, high level of Bicarbonate (285mg/l), Sodium (266mg/l), and Chloride (402mg/l) restrict sprinkles usage in irrigation, but drip irrigation can be used; and cautious should be taken when using nitrogen fertilizers because of level of nitrate (the average value is 52.6).

5.3.3.4 Zarqa stream / agricultural nurseries in 2011

In the following table (46), as biological test results shown, and according to WHO guidelines, that water of Zarqa stream/ nurseries can be used for restricted agriculture only. While according to FAO guidelines, Physical and chemical results revealed that water of Zarqa stream, at nurseries, can be used for tolerable salinity (pH 7.39) and chloride crops; for moderate and tolerable Sodium and Boron (0.9mg/l) crops.

Furthermore, high level of Bicarbonate (720 mg/l), Sodium (365mg/l), and Chloride (569mg/l) restrict sprinkles usage in irrigation, but drip irrigation can be used after water treatment. Also, because of level of manganese (83 ppm) and iron (11.6 ppm) impose restriction of irrigation purposes.

5.3.3.5 Jerash wastewater treatment plant in 2011

Jerash wastewater treatment plant started working in 1983, using activated sludge-extended aeration system, with capacity 800 cubic metres per day.

In 2010 the daily effluent reached 3680,8 cubic meter, which run into Jerash valley, mix with running water in the valley, thus dilute the effluent and improve its quality, then can be used in restricted crops.134

As shown in the table (47), quality of effluent water did not comply with Jordanian Standard number (893/2006) / discharge to valleys and streams. Levels of BOD (222 mg/l), COD (543 mg/l), phenol 0.06 mg/l), T-N (148mg/l), PO4 (56 mg/l), Cl (465 mg/l), HCO3 (1039 mg/l), Na (312 mg/l), and E.coli (2.19E+05) exceed the standards.

Thus, necessary precautions should be taken to protect health and environment due to large number of E.Coli.

Table 46: Results of physical, chemical, and biological test analysis of water samples from Zarqa stream / agricultural nurseries in 2011

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Source: The annual report of national project for monitoring water quality in Jordan. 134

Table 47: Results of physical, chemical, and biological test analysis of water samples from effluent of Jerash wastewater treatment plant, in 2011

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Source: The annual report of national project for monitoring water quality in Jordan. 134

5.3.4 Water sample analysis in 2012/2013

Eighty one samples were taken from different sources: public network, rainwater reservoirs, springs, tanker trucks, and treated groundwater bottles. Then analyzed and compared with Jordanian drinking water standards.

5.3.4.1 Samples of municipal water in 2012/2013

Table 48: Results of municipal water samples analysis

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All readings are complying with national standards for drinking water. Nitrate level in all samples is within the national standards, and so as the fluoride. WHO states that nitrate-nitrogen should not exceed 10 mg/L, because this high level can induce cancer in intestine as well as blue babies syndrome. This high level of nitrate-nitrogen suggests that the water pollution is coming from far distances like Israel, due to their excessive use of fertilizers in agriculture.

Extensive epidemiological data support the current guideline value for nitrate-nitrogen of 10 mg/litre. However, this value should not be expressed on the basis of nitrate-nitrogen, but on the basis of nitrate itself. Nitrate is the significant chemical, and control it in drinking water is an effective preventive measure. WHO's Guideline Value for nitrate in drinking water is 50 mg /litre and for nitrite is 3mg/litre.94,135,136

Compliance with national standards of drinking water reflected effective water treatment and control. And this is consistent with results of USAID review team, 56 and a study about rapid assessment of drinking water quality by WHO and UNICEF. (97)

5.3.4.2 Samples of spring water in 2012/2013

Table 49: Results of spring water samples analysis

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30% of samples (6 samples) were contaminated with E. coli, and 55% of samples (11 samples) had nitrate above the national standards. This left 70% of the samples not biologically contaminated, and 45% of the samples free from nitrate.

Water quality is determined on the basis of an indicator of faecal contamination, namely the concentration of Escherichia coli (E. coli).137 Some spring water was contaminated with E. Coli, either because not protected thus exposed to animal and birds excreta, or due to septic tanks of nearby houses. This is consistent with results of RADWQ pilot project, conducted in 2004-2005, in Jordan household samples; that showed some contamination in the network pipes and household taps, due to break in some points of sewer pipe system that was close to municipal water pipe system. 97

Moreover, nitrate in groundwater has increased greatly over the years, and the demonstration of endogenous nitrosamine formation among highly exposed subjects raises concern of elevated cancer risk. But the epidemiologic data are not yet sufficient to draw a conclusion. 138, 139

5.3.4.3 Samples of tanker truck water in 2012/2013

Table 50:Results of truck water samples analysis

Abbildung in dieser Leseprobe nicht enthalten

35% of samples (Seven samples) had high level of nitrate, while the rest of samples (65%) comply with the national standards with regard to all parameters.

Nitrate is a widespread contaminant of drinking water, but its potential health effects are unclear. Inside the human body, nitrate is reduced to nitrite, which reacts with amines and amides to form N-nitroso compounds, known animal carcinogens. Luckily, N-nitroso compound formation is inhibited by certain nutrients, such as vitamin C. 140 -143

5.3.4.4 Samples of harvested rainwater in 2012/2013

Table 51:Results of harvested rainwater samples analysis

Abbildung in dieser Leseprobe nicht enthalten

People usually collect rainwater in January, after many times of raining, and not from the first flush, to get sure of clean roof, however, 25% of the samples (five samples) had been found bacteriologically contaminated, but not to a high level. Microbial contamination of collected rainwater indicated by E. coli is quite common, particularly in samples collected shortly after rainfall.

Mainly the origin source was birds, passing over the roof, or from domestic animals like cats. This is consistent with An American researcher (Doug Pushard) who performed a set of water quality tests for Rain Water from a cistern and an adjacent well in Lamy, New Mexico, and found that cistern water was better or equal to the well water; except that the cistern had a presence of coliform.

Pathogens such as Cryptosporidium, Giardia, Campylobacter, Vibrio, Salmonella, Shigella and Pseudomonas have also been detected in rainwater. However, the occurrence of pathogens is generally lower in rainwater than in unprotected surface waters. Higher microbial concentrations are generally found in the first flush of rainwater, and the level of contamination reduces as the rain continues.136

5.3.4.5 Samples of Treated Well Water Bottles in 2012/2013

Table 52: Results of treated well water samples analysis

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27.2% of the studied houses used treated Well water bottles for drinking, in which small scale companies bring water from tanker trucks; used filters, ozone, and ultra violet for treatment; then fill it in PET bottles –as in the figure (21)-; to be used in bottled water coolers.

Surprisingly it has been found that 18.2% of the samples (two samples) were slightly contaminated (<1.8 total Coliforms), however there was no E.Coli, which indicated inadequate treatment.

It is known that total Coliforms are a less reliable index of faecal contamination than E. coli, and are not an index of faecal contamination or of health risk, but can provide basic information on source water quality. They have long been utilised as a microbial measure of drinking water quality, largely because they are easy to detect and enumerate in water. 144, 145

Presence of E. coli mostly causes diarrhoea; but may cause death in immunocompromised individuals, the very young, and the elderly if dehydration last for prolonged time. 146 It can come from the wastes of any warm-blooded animal, including humans, cattle, and many other animals including wildlife. Fecal wastes from humans are the greatest health concern since they carry the most human pathogens.

According to USA Food and Drug Administration, safety of bottled water depends on its origin. Artesian well water usually from deep underground aquifer layers of porous rock, sand and earth; can be very pure because the confining layers of rock and clay; however, there is no guarantee that they are any cleaner than ground water. While mineral water comes from an underground source that contains at least 250 parts per million total dissolved solids.

Spring water derived from an underground formation from which water flows naturally to the earth's surface; while well water comes from a hole bored or drilled into the ground, which taps into an aquifer. So, the type and extent of treatment needed, depending on the intended use of the water (whether for drinking, or other domestic uses). (Fact Sheet)

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Figure 21: Treated well water bottle

Moreover, all samples have nitrate which is within the standards. Nitrate contamination of both surface water and ground water due to increased use of chemical fertilizers, changes in land use and increased waste from livestock production. 147

5.3.5: Water Samples for Investigation in 2013

Level of nitrate in spring and tanker truck samples was a good motive to make investigation, to search for the reason. Five samples were taken from a private well, tanker truck, and three popular springs (Ain Al-Deek in Jerash, Um Rabee’ in Mastab, and Souf in Jerash).Below the results of analysis.

Table 53: Results of investigative water samples analysis in 2013

Abbildung in dieser Leseprobe nicht enthalten

The private well has high level of nitrate (88.01ppm) beyond the national standards (50 ppm), due to agricultural lands around it; and the tanker truck using that private well has higher level of nitrate (99.95 ppm) than the well itself, may be due to accumulation of nitrate after many times of transporting high-nitrate water.

Both Souf (19.09 ppm) and Um Rabee’ (65.55 ppm) springs are protected, but that was not enough to protect Um Rabee’ spring from effect of fertilizers used in surroundings lands. Moreover, Ain al-Deek spring (58.11 ppm), which is controlled by water authority, in which treated and piped, has nitrate higher than national standards.

This could be due to fertilizers in the surrounding agricultural lands –shown in figure (22) -, in addition to natural quantities of nitrate in groundwater.

Abbildung in dieser Leseprobe nicht enthalten

Private well, and tanker truck (Jerash)

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Um Rabee’ spring (Mastaba)

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Ain Al-Deek spring (Jerash)

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Souf spring (Jerash)

Figure 22: Photos of well, tanker truck, and three springs included in investigation

5.4 limitations

There were limitations which affect the results and consequently the conclusions too.

The study was a retrospective type, which depended on memories of interviewees; some had weak memories and probably gave incomplete information or missing some facts related to health problems during 2000-2011. Some participants had limited education or low level of intelligence, and might misunderstand some questions, thus gave wrong or non logic answers, so 38 questionnaires (which is 4.7%) were rejected due to contradiction of answers.

Also, ministry of health was not cooperative at all, and could not get any piece of information from there, and all data about diseases in Jerash governorate and Jordan were from their web site, and annual statistical reports –which were downloaded from their web site-.

Moreover, high cost of water samples analysis restricted number of parameters to be tested.

Finally, Lack of data about soil tests in Jerash governorate negatively affected the third objective of the study, that concerning with environmental impacts of water shortage. So, little data were available for discussion.

5.5 Findings

1) Findings of this study can be summarized as the following:

Though there was shortage in water, people were able to adapt with this strenuous situation. All citizens conserved water by using roof and/or ground tanks; many used water wisely at their houses; and reused greywater (laundry wastewater more than dishwashing wastewater, and bath wastewater), for mainly flushing toilet and watering garden. In addition, they installed water saving utilities.

They had poor sanitation, which negatively affected soil and water resources like springs and wells, and sometimes caused their contamination. However, awareness and good hygiene practices generally protected the people from waterborne and food-borne diseases.

The most dominant health problem was kidney stones. On the other hand, there were no cholera, Malaria, typhoid, and Para-typhoid during 2000-2011. In Jordan cholera is an extinct disease, vanished since the past century, but refuges from Syria these days, Iraqis before, and out comers from epidemic countries threatens emerging it again; while Malaria is not common due to absence of the disease vector. Both strict monitoring on boarders, and continuous medical test analyses used by government, aimed to prevent these diseases, and actually succeeded.

2) Findings regarding Jerash governorate can be summarized as the following:

Although the average yearly rainfall was in the range of 400–500 mm considered among the highest in Jordan, 16, 50 water share per capita in Jerash governorate was the lowest (71 litre/day) in Jordan, 3, 4, 113 due to water losses for many reasons, both low water supply and water production. However, according to Gleick scarcity index, the water share was exceeding the daily amount for life needs (drinking, bathing, food, sanitation, and preparing food), which is 50 liters (per capita per day). On contrast of Falkenmark Water Stress Indicator which set 1000 cubic meters per capita per year as threshold for water scarcity (1 cubic meter =1000 liters), that is 2740 liters per person per day. 148

Compared with other governorates, typhoid and Para-typhoid, diarrhoea, and cancer were not major problems in Jerash governorate during 2000-201; while amebic dysentery and hepatitis A came in the second place in Jordan. Low rates of water-borne diseases can be explained by improved management of diarrheal disease in Jordan and the large and growing proportion of persons having access to safe water. 108

3) Findings of water quality in Jerash governorate can be summarized as the following:

There was high level of nitrate in some tanker truck water, private well, and springs, above the national standards for drinking water, due to natural existence of nitrate in ground water, in addition to nitrogen-fertilizers used excessively by farmers.

This is expected because Jerash governorate is an agricultural area, and almost one-fourth of the total area is covered with olive groves; in which the number of olive trees about two million trees. 63 Also, this finding is consistent with World Bank study (2009), 61 Al Kuisi et al, study (2009), 52 and integrated watershed management project in Jerash (2005). 50

For ammonia, in all water resources it was in compliance with national standards for drinking water. Ammonia in drinking water does not pose health hazards; it may be present in drinking-water as a result of disinfection with chloramines; taste and odour problems as well as decreased disinfection efficiency are to be expected if drinking-water containing more than 0.2 mg of ammonia per litre, as up to 68% of the chlorine may react with ammonia and become unavailable for disinfection. 144, 130

On the other side, fluoride, lead, pH and salinity, all were in compliance with both national and WHO standards for drinking water.

5.6 Study Objectives

5.6.1 First Objective: “Characterization of the demographic population changes in Jerash governorate from 2000 to 2011.”

Data over the period 2000-2011, showed a normal increase of population in Jerash governorate, and constant ratio between males to females. This normal and stable growth rate was close to the national growth rate, especially in the last five years. 98, 149

Non-Jordanians as tourists, workers, visitors, students, and companions stayed days to years in this governorate. However, general department of statistics do not include non-Jordanians who lived in Jerash governorate, when calculated number of population.

For example, in 2004 there were 19,496 non-Jordanians, who lived in the governorate for different reasons, some for more than 14 years. Also Palestinian camps were not included. There are two camps: Souf (established in 1967), on 500 donums, with 8,000 original population, which became 19,051in 2003; the other camp is Jerash (also called Gaza) established in 1968, on 750 donums, with 11,500 original population, and became 27,916 in 2003. (16)

In addition, Jerash ancient city attracted many people to come annually, especially at time of the annual festival, which made pressure on water, for example, in 2010 and 2011 there were 354,608 and 179,700 non-Jordanian tourists consequently.150

Furthermore, non-Jordanians are included in separate tables from population of governorate; number of tourists at time of Jerash festival reaches the peak, estimated hundreds of thousands of people from inside and outside Jordan.

According to housing and population census in 2004, Jerash governorate got the fifth place among all governorates with regard to number of non-Jordanians (19,496 persons out of 392,273 persons, i.e. 5%), but, it got 10th place with respect to non-Jordanian workers (1,955 workers out of 166691 workers, i.e. 1.2%).

Since the start of the war in Iraq in 2003, increasing numbers of Iraqi nationals had taken residence in neighboring countries, particularly Jordan and Syria.

A study in collaboration and cooperation between the Norwegian Research Institute Fafo, Department of Statistics and the Jordanian government technical team was conducted in 2007 to estimate Iraqis community in Jordan, and their needs. The study concluded that there were between 450,000‐500,000 Iraqi residents in Jordan as of May 2007. Seventy seven of Iraqis arrived in 2003 and later, with the highest volume of movement of population taking place in 2004 and 2005. The majority of them resides in Amman, and had originally come from Baghdad.

According to housing and population census 2004, only 0.3% of Iraqis lived in Jerash governorate. Larger difference between the genders was found among Iraqis, but on average there were a small overweight of women in the Iraqi population, this is particularly true for the middle aged part of the population (25-60). The Iraqi population was on average older than the Jordanian population, the mean age for Iraqis was 29.5 years whereas it was 24 for the Jordanians.

The majority of the Iraqi population was 25 years of age and above (56 percent), 26 percent of the population was below 15 years of age and the remaining 18 percent was between 15 and 25 years of age. Close to 70 percent of the Iraqi population in Jordan was in working age (15 years old and older); of these, about 30 percent were participating in the work force; but the participation rate was particularly low for women. The large number of Iraqis in Jordan represents big challenges to Jordan in various sectors, especially water sector. 151

These large numbers of refugees and tourists increased demand on water resources. A study conducted in Jordan (2011), to show the relationship between population growth and water demand. By drawing the population growth verses the total billed water change for each governorate over 2001-2009, it was found that there was a good correlation (which was 0.81) between population growth and water demand. Nevertheless, water demand was not increasing in the same manner of population growth. There was a positive relation between population growth and water demand increase.

However, there was no correlation between both variables which supports that the demand change did not increase in the same manner of the population growth.

This could be explained by the variation in NRW (non revenue water, i.e. lost before reaching the costumer), by allocating in many cases the same share of water supply on a larger number of inhabitants due to limited water availability in Jordan, and by consuming the same quantity of water inside household even with increasing the number of members living in the same household such as cleaning household, irrigation the garden, etc. In conclusion, population growth has clear influence on water demand that drives its increase. 37

This is consistent with Abdulla and Al-Assa`d (2006), who concluded that due to the increasing demand, the withdrawal from aquifers is almost double that of the safe yield. And this would eventually lead to the depletion of water resources and deterioration in the water quality in soon future. 9

Also consistent with Salman (2008), who analyzed data sets of Jordan, over the period from 2001 to 2009. Data indicated that the development in municipal water demand, which comprised water demand by the domestic sector and tourism, was sufficiently explained by the number of inhabitants, the billed water per capita, and the percentage of unaccounted-for water (UFW). 60

Salman et al. (2008), carried out an analysis of water consumption, and concluded that those living in a flat or apartment consumed less water per household and per capita, compared to those living in an individual houses. This analysis also showed that there was a positive relation between household size and water consumption based on the household model. This relation was negative based on per capita model, as the household size gets bigger, the per capita water consumption decreases. The per capita model estimated that the increase of the household size would reduce the water consumption by 13% per capita. 66

5.6.2 Second Objective: Evaluation of water quality (groundwater, surface water) in Jerash governorate from 2000 – 2011, according to Jordan National drinking water standards.

It was found that the agricultural practices and solid waste management in Jordan were sources of pollution that contributed to a lesser extent to contamination of water resources. The French Agency (2011) found that per-hectare use of fertilizers and pesticides was relatively low (around 12 kg/ha of pesticides) in comparison to international averages. Also, water quality analysis did not provide any strong evidence of residues of pesticides in surface- and ground- water. 37

On the other hand, USAID team in Review of water policies in Jordan and recommendations for strategic priorities, (2012), asserted that Jordan provided a reliable supply of water to petroleum refineries, power plants, mining operations, and small and medium industry. However, the main concern in the industrial sector was the point-source pollution.

While biological and microbiological treatment has improved in Jordan, industrial disposal of saline brine, derived from industrial processes or in-plant desalination, was degrading reclaimed wastewater quality. They found that conventional wastewater treatment options had effectively reduced microbiological contamination of sewage effluent, making wastewater reuse more acceptable; however, conventional treatment did not remove salts. 56

For water resources, the latest Household Expenditure and Income Survey of 2008 carried out by DOS (2010), estimated that around 19.2%, 4.7% and 2.3% of Jordan’s household considered the mineral water (from water shops), wells and water tankers as the main source for drinking water; which were more expensive than the public water network. 68

The Jordan Water Authority’s central lab directorate (2012), indicated that more than 98 % of its water samples collected during the year from all water resources, networks and end users’ tanks were safe and matched local and international standards.64

With regard to this study, based on the results of analysis of domestic water samples from Burma, Mastaba, and Jerash sub-districts (2012/2013), supported with results of previous studies and researches, quality of water was defined. Then evaluation of water resources was used, result in about three quarters of the households in Jerash governorate had chemically medium quality. And on the other side, most houses had biologically good quality, which is safe to be used. This can be attributed to continuous monitoring of municipal water, tanker truck water, and treated water. In addition to, good awareness of people in harvesting rainwater and selecting springs.

At level of houses in Jerash governorate (2012/2013), lead, fluoride, nitrite, and ammonium in different water resources were in compliance with both WHO and Jordan national standards for drinking water, which assure efficient water treatment at water treatment plant, and indicate freeness from chemical contamination. These findings are consistent with results of a study of WHO and UNICEF in 2004-2005; in which there was high drinking-water quality in the distribution network, and the overall compliance with WHO guideline values and national standards was 97.8% (including data for chemical contaminants). 97

Municipal water and bottled treated underground water in the three sub-districts were free from E. coli which is a good sign of safe water. This is consistent with RADWQ pilot project conducted in 2004-2005 in Jordan, in which water was analysed with portable field kits and in local laboratories for the parameters: thermo-tolerant coliforms, pH, turbidity, faecal streptococci, appearance, conductivity, free/total chlorine, arsenic, nitrate, fluoride, and iron.

Additional 10% samples from the sites visited were taken, to analyse the deterioration of water quality from network to consumer’s tap. The results confirmed the validity of routine national monitoring data, which showed that drinking-water quality was generally high in the distribution network.

99.9% of those water samples were in compliance with WHO guideline values and national standards for bacteria, and overall compliance was 97.8% (including data for chemical contaminants).In some areas, the results for nitrates, conductivity and iron indicated a need for concern. Moreover, household samples showed some contamination between the network pipes and household taps. 97

Also data were consistent with USAID review team (2012), who confirmed that municipal water supplies were treated effectively, and water quality at the household level, was within compliance levels. The team found that 99.96% of municipal water samples were within international World Health Organization drinking water guidelines for microbiological water quality.

However, due to non-continuous supply, many residents used tanker truck water, which came from untreated groundwater wells and purchased drinking water from water-treatment shops. 56

Moreover, consistent with CDC (Centers for disease control and prevention), that bottled water with unbroken seals and canned/bottled carbonated beverages are safe to drink and use.

On turn, spring water and collected rainwater in the three sub-districts (2012/2013), sometimes had E. coli. Presence of E. coli was expected in collected rainwater and springs because both are exposed and easily contaminated. This is consistent with the baseline report of a project on watersheds in Jerash governorate (2005), in which it was found that natural springs suffered from pollution from cesspits or olive oil extraction mills. 50

On the other hand, in general, rainwater is relatively free from impurities except those picked up by rain from the atmosphere, but contamination may occur during harvesting, storage and household use. Rainwater is slightly acidic and has very low dissolved minerals; but can dissolve heavy metals and other impurities. In most cases, chemical concentrations in rainwater are within acceptable limits. 152, 153

This is supported by WHO (2004) where the first flush of rainwater carries most contaminants into storages; 136 whereas Doug Pushard found Coliforms in rainwater collected in a cistern.

Tanker truck water in the three sub-districts (2012/2013) was free from E. coli which indicates efficient monitoring by concerned ministry. Health law number 54 for the year 2002 states that ministry of health is the official body responsible for monitoring water sold by tanker truck or by small-scale companies for treated water.

USAID review team (2012) found that many residents use tanker truck water, 56 while Population and Family Health Survey (2002), estimated 1.7% of Jordan population buys water from Tanker truck. 62

Moreover, some tanker truck water in the three sub-districts of Jerash governorate (2012/2013) had nitrate above national standards of drinking water due to high level of nitrate at the original source of that water. Even protected spring water sometimes had high level of nitrate more than national standards of drinking water due to leaching of fertilizers. This is consistent with USA Food and Drug Administration, in which safety of water depends on its origin.

According to WHO Nitrate is not carcinogenic in laboratory animals; and in general, vegetables will be the main source of nitrate intake when levels in drinking-water are below 10 mg/litre. Experiments suggest that neither nitrate nor nitrites act directly as a carcinogen in animals; however there is some concern about increased risk of cancer in humans from the endogenous and exogenous formation of N -nitroso compounds, which mentioned previously as carcinogenic in animals. Suggestive evidence relating dietary nitrate exposure to cancer, especially gastric cancer, as a result of geographical correlation or ecological epidemiological studies, but these results have not been confirmed. Moreover, it must be recognized that many factors in addition to environmental nitrate exposure may be involved.(94, 95)

At level of water treatment plants and pumping stations in Jerash governorate during 2000- 2011, which result in municipal water used by citizens for domestic purposes like cleaning, irrigation home gardens, and sometimes for drinking and watering livestock raised at homes.

The pH and conductivity for both raw and treated water were in compliance with national standards for drinking water, which indicate that no chemical leaching is attributed to industries or solid wastes dumping. 56, 97

Careful attention to pH control is necessary at all stages of water treatment to ensure satisfactory water clarification and disinfection. For effective disinfection with chlorine, the pH should preferably be less than 8. The pH of the water entering the distribution system must be controlled to minimize the corrosion of water mains and pipes in household water systems. Failure to do so can result in the contamination of drinking-water and in adverse effects on its taste, odour, and appearance. Also, exposure to extreme pH values (greater than 11, and below 4) results in irritation to the eyes, skin, and mucous membranes. 154

Jordan water demand management study (2011), found that fresh water (which has salinity of less than 1000 ppm) was used in Northern Jordan Valley and uplands; while brackish water has salinity of more than 1000 ppm. Desalinated water (which is a desalinated brackish water), was used in different locations in Jordan Valley and uplands; while treated wastewater & mixed with fresh water was major water source for irrigation particularly in Middle Jordan Valley.

The study (2011) concluded that quality and salinity of water affected water requirement, as well as type of crops that could be planted. For example, Alfalfa was moderately sensitive, wheat was moderately tolerant and barley was tolerant respectively. 37

Concentrations of TDS in water vary considerably in different geological regions owing to differences in the solubilities of minerals. However, drinking-water becomes significantly and increasingly unpalatable at TDS levels greater than about 1000 mg/l. The presence of high levels of TDS may also be objectionable to consumers, owing to excessive scaling in water pipes, heaters, boilers and household appliances. But no available reliable data on possible health effects associated with the ingestion of TDS in drinking-water, thus no health-based guideline value is proposed. 95 The World Bank (2009) expected rising of the opportunity costs of the additional water required to lower salinity.61

Values of fluoride, ammonium, and lead in treated water in Jerash governorate during 2000- 2011 were below Jordan national standards for drinking water. This is consistent with Rapid assessment of drinking water quality study. 97 On the other hand, number of E. coli and level of nitrate in some treated underground water were not within standards.

World Bank (2009) revealed that the nitrate content in the different wells was significant, and in some wells exceeded the limits for drinking water quality particularly in Amman-Zarqa basin, but was less alerting in the other basins. 61

It is important to note that some labs may report nitrate-nitrogen (NO3-N) or total nitrate (NO3). The following equation can be used to compare the two reporting systems: 10 mg/L nitrate-nitrogen (NO3-N) = 44.3 mg/L nitrate (NO3). 95, 155

For EPA (environment protection agency), the Maximum Contaminant Level (MCL) for nitrate-nitrogen in a public water supply is 10 mg/L, based on acute health effects specifically the risk of methemoglobinemia, that result from ingestion of a contaminant over a short period of time. The acute health hazard associated with drinking water with nitrate occurs when bacteria in the digestive system transform nitrate to nitrite.

The nitrite reacts with iron in the hemoglobin of red blood cells to form methemoglobin, which lacks the oxygen-carrying ability of hemoglobin, resulting in methemoglobinemia (sometimes known as “blue baby” syndrome). Infants under one year of age have the highest risk, and older persons who have a gastrointestinal system disorder causing increased bacteria growth may be at greater risk than the general population. Also, individuals who have a genetically impaired enzyme system for metabolizing methemoglobin may be at greater risk. 155

Nitrate in groundwater may result from point sources such as sewage disposal systems and livestock facilities, and from nonpoint sources such as fertilized cropland, parks, golf courses, lawns, and gardens, or from naturally occurring sources of nitrogen (the natural sources originated either from biology or deposits of nitrates produced by atmospheric reactions).

Some studies have shown a correlation between long-term ingestion of elevated nitrate and increased incidence of certain cancers, and increased birth defects. However, uncertainty exists in nitrate risk assessment, and the connections between the level of nitrate in drinking water, volume ingested, duration of exposure, and possible chronic risks are not fully understood. 155

Other water resources used by citizens of Jerash governorate during 2000-2011, like King Talal dam, Zarqa stream, and wastewater treatment plant, based on results analysis can be used in agriculture under certain conditions. King Talal dam has good quality of water so suits unrestricted agriculture; while Zarqa stream water has low quality of water attributed to contamination by wastewater of factories and effluents discharged from wastewater treatment plants, so can be used for restricted agriculture only; and effluent of Jerash wastewater treatment does not comply with the national standards of water discharged into valleys and streams, in which elevated levels of BOD, COD, phenol, PO4, HCO3, Na, Cl, SAR, and E. coli, so had low quality of water.

Thus used for restricted crops not eaten raw. This is consistent with Multicultural Working Group findings, who recommended that Zarqa River water used for restricted irrigation within Amman Zarqa Basin upstream of King Talal Dam, and for unrestricted irrigation downstream of the dam in the Jordan Valley after mixing with King Abdulla Canal water. 47

As well as Al Mahamid, who found that the water quality of King Talal dam was acceptable only for restricted irrigation purposes with slightly increases in TDS, BOD5, and NO3. 49

In summary, water quality put pressure on water resources, people, and government too. This is supported by study of Bakir, who concluded that water quality was a key issue that might generate pressure on the water resource, and thus reduce the fresh water available for use. The level of water quality varied by water source, and by geographical location.

Bakir found that the limited presence of surface water and shallow groundwater helped in protecting the water resources in Jordan. Overall, water quality was declined due to different causes of pollution. These were poor management of domestic wastewater; uncontrolled disposal of industrial wastewater into sewer, land and water; leachate from landfills; seepage of fertilizers and pesticides; and over-pumping of water. 156

5.6.3 Third Objective: Assessment of environmental and health impacts of water usage in Jerash governorate during 2000-2011.

5.6.3.1 Health Impacts

The study found kidney stones the major health problem. A kidney stone, known as a renal calculus, is a solid concretion or crystal aggregation. 157, 158 And Urinary stones are typically classified by their location in the kidney (nephrolithiasis), ureter (ureterolithiasis), or bladder (cystolithiasis), or by their chemical composition (calcium-containing, struvite, uric acid, or other compounds).

The formation of Urinary stone is a process involving multiple factors, i.e. not only intake of liquids, but also genetic predisposition, eating habits, climatic and social conditions, gender, etc.

(158) Several studies documented that higher water hardness is associated with higher incidence of urolithiasis among the population supplied with such water.

It is worth to mention that Jordanian standard for total hardness in drinking water is 300 mg/l, with maximum allowable 500mg/l; and Urolithiasis is a condition in which crystals in the urine combine to form stones found anywhere in the urinary tract. These stones cause irritation and discomfort and mostly end up in the bladder).(Canadian standard for calcium in drinking water is 200 mg/l, and for magnesium is 50 mg/l).

In contrast, more studies found softer water to be associated with higher risk for urolithiasis; while any correlation between water hardness, or the drinking water calcium or magnesium level, and the incidence of urolithiasis was not found in a vast USA epidemiological study with 3270 patients performed in the year 2002.

Japanese studies did not find that the water calcium or magnesium levels alone had an effect on the incidence of urolithiasis, but found that the Mg to Ca ratio had: a study in 1989 reported the lower Mg to Ca ratio to be associated with a higher risk for urolithiasis, another study in 1993 found a correlation between the higher Mg to Ca ratio and higher incidence of infectious phosphate urolithiasis. 159 -161

A cross sectional Italian study (2010) of 688 male workers aged 21-68, conducted as part of the 10 year follow up of a nationwide survey of the prevalence of cardiovascular risk factors. It was found that an independent clinical association exists between the occurrence of urolithiasis and hypertension. The increased urinary calcium excretion commonly detected in hypertension may be the pathogenetic link. 161 Furthermore, a prospective study found that Hypertension in middle-aged men is a significant predictor of kidney stone disease rather than a consequence of renal damage caused by kidney stones. 128

Also, this study found other health problems in the three sub-districts of Jerash governorate during 2000-2011, like heart diseases, and skin fungi problems, which both related to life style and believes, affected by socio-economic situations, in addition to quality / quantity of water. Numerous epidemiologists throughout the world have studied the relationships between drinking water hardness and cardiovascular disease mortality, mostly based on ecological studies. (Calcium is the major mineral causing hardness in water)

During 1957 to 1979, many, but not all, of the epidemiological studies reported an inverse association between cardiovascular mortality and water hardness.

Lower cardiovascular death rates were among populations using water supply contained relatively high levels of calcium and magnesium, compared to populations in areas with low levels of calcium and magnesium. Limited information was available about the magnitude of causality or the association. Several reviewers estimated that population use soft water may have, at best, a 25% more cardiovascular disease mortality risk than populations using hard water. 162

Consumption of drinking water even moderately high in magnesium (at least 10 ppm and up to 40 ppm and higher) can be expected to reduce cardiovascular mortality by 30 – 35%. Giving drinking-water with added magnesium to experimental animals (which show sub cellular markers due to low magnesium food), lessens these markers even at such low magnesium levels as 15 ppm, while water magnesium levels of 100 ppm can completely reverse some of these markers.

Similarly, human population studies show that those with less than 3 ppm to 6 ppm Mg drinking water have very high rates of mortality from heart disease, and that rate of mortality goes down as the level of magnesium in the water goes up, the higher the better. Experts in this field say that total magnesium daily intake must be at least 450 to 500 mg, and drinking water should contain a minimum of 25 – 50 ppm magnesium. 162

A study investigated the importance of magnesium and calcium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Cases were men and women 50-74 years of age living in 18 Swedish municipalities who had suffered an acute myocardial infarction between October 1, 1994, and June 30, 1996. For calcium, this study was inconclusive, but data suggested that magnesium (≥ 8.3 mg/litre) in drinking water is associated with lower mortality from acute myocardial infarction, but not with the total incidence. 163

Other health problems found in Jerash governorate during 2000-2011, but in less incidence rates, were cancer, hair lice, hepatitis A, amebiasis, and intestinal worms. Percentages of these health problems were low, and cannot claim that there is a serious health situation in Jerash governorate relating to water, neither attributes them to water shortage.

In general, Diarrhoeal diseases are caused mainly by the ingestion of pathogens, especially in unsafe drinking-water, in contaminated food or from unclean hands. Inadequate sanitation and insufficient hygiene promote the transmission of these pathogens. 164, 165

The category “diarrhoea” includes some more severe diseases, such as cholera, typhoid and dysentery—all of which have related “faecal–oral” transmission pathways. 35

Cholera

With regard to Jerash governorate, data showed no cholera cases during 2000-2011, since it is an extinct disease in Jordan. Health status in Jordan is good compared to other developing countries, in which the infant mortality rate 22.1 per 1000 live birth (during 2001-2011). According to WHO the risk of infant mortality rate was highest in the African region (63 per 1000 live births), more than six times higher than that in the European region (10 per 1000 live births). Globally, the infant mortality rate has decreased from an estimated rate of 63 deaths per 1000 live births in 1990 to 35 deaths per 1000 live births in 2012.

Provision of safe water and sanitation is critical in reducing the impact of waterborne diseases.137, 166 Global Task Force On Cholera Control (2003), estimated 3–5 million cholera annual cases and 100,000–120,000 deaths per year due to cholera. About 75% of people infected do not develop any symptoms, although the bacteria were present in their faeces for 7–14 days after infection, and potentially infecting other people. Among people who develop symptoms, 80% have mild or moderate symptoms, while around 20% develop acute watery diarrhoea with severe dehydration, which could be deadly.Global Task Force encouraged Oral cholera vaccines as an additional means to control cholera. 167

In 2011, according to WHO, 589,854 cases of cholera reported to WHO from 58 countries from all continents, of which 32% were reported from Africa, and 61.2% from the Americas where a large outbreak that started in Haiti at the end of October 2010, which affected the Dominican Republic too. Between the years 2001–2009, 93% to 98% of total cases worldwide were reported from Africa. Globally, cholera incidence has increased steadily since the year 2005 with outbreaks persisting in Sub-Saharan Africa, Asia and more recently in Hispaniola. Cholera continues to pose a public health problem among developing world populations without access to adequate water and sanitation resources.

Typhoid

Typhoid and Para-typhoid (0.8 per 100,000 persons) incidence rate in Jerash governorate during 2000-2011, were in the middle among governorates’ incidence rates. It is interesting to find high incidence rates in Balqa (lies in the middle region, with high share of water), in Karak and Ma’an (both lie in southern region, with high share of water per capita). This suggests other factor to attribute with incidence rate of enteric fever other than water shortage, which could be food, geographic location, or climate. Enteric fever is typhoid and paratyphoid fever, in which Paratyphoid is similar in its symptoms to typhoid fever, but tends to be milder, with a lower fatality rate.168

Many studies found that 2–5% of untreated patients will become permanent, lifelong carriers of the bacteria in their gall-bladder. In a case-control study (in Tajikistan) of 45 patients and 123 controls, typhoid was associated with drinking unboiled water. Of tap water samples, 97% showed fecal coliform contamination. Samples were taken from water treatment plants revealed that fecal coliform contamination occurred both before and after treatment. Lack of chlorination, equipment failure, and back-siphonage in the water distribution system led to contamination of drinking water. After chlorination and coagulation were begun at the treatment plants and a water conservation campaign was initiated to improve water pressure, the incidence of typhoid fever declined dramatically.169

Hospital-based studies and outbreak reports from India indicated that typhoid and Para- typhoid are major public health problems. Although the disease is not common in industrialised countries, it remains an important and persistent health problem in developing nations. With regard to Risk factors such as poor sanitation, lack of a safe drinking water supply and low socio economic conditions in resource-poor countries are amplified by the evolution of multidrug resistant salmonellae. Thus, treatment failure cases had been reported in India, which is associated with increased mortality and morbidity.161

Crump et. al (2003), conducted a household survey in Bilbeis District, Egypt, estimated that the incidence of typhoid fever was 13/100,000 persons. 170 Moreover, Crump and Mintz (2010), found Typhoid and paratyphoid fever an important causes of illness and death, particularly among children and adolescents in south-central and Southeast Asia, where enteric fever was associated with poor sanitation and unsafe food and water. 171

While Parry (2004), found polluted water was the most common source of typhoid transmission. In addition, shellfish taken from sewage-contaminated beds, vegetables fertilized with night-soil and eaten raw, contaminated milk and milk products had been shown to be a source of infection. 168

In addition, Connor and Schwartz (2005) concluded that the risk to travellers, who went to endemic areas, appeared to vary by geographic region visited. They found two vaccines were licensed and others were being developed, but neither licensed vaccine was used in endemic areas as a public health measure.(172)

Amebic Dysentery

Jerash governorate got the top second rank in amebic dysentery (17.8 per 100,000 persons) and hepatitis A (21 per 100,000 persons) incidence rates after Mafraq (44.5 per 100,000, 22 per 100,000 persons)). This could be related to the fact that Mafraq governorate imports water to Jerash governorate per year to overcome water shortage in the latter governorate.

Generally, in areas where poor sanitation allows contamination of drinking water and food with faeces, up to 40% of people with diarrhoea may have amoebic dysentery. Amoebic dysentery is most common in developing countries although it is occasionally seen in industrialized countries, and not just in travellers. It can be considered equivalent to intestinal amoebiasis. This is consistent with Dans and Martínez (2007), Mackey-Lawrence and Petri (2011), who found Amebic dysentery transmitted in areas where poor sanitation allowed contamination of drinking water and food with faeces. 107, 173

A ten year retrospective study (1999-2008)of amebiasis in patients admitted to University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, was conducted. A total of 34 cases were analyzed. The most common was amebic liver abscess 22(65%) and the rest was amoebic dysentery 12(35%). Majority of the cases occurred among Malaysians 29(85%), with Chinese 14(41%), followed by the Malays 9(26%) and the Indians 6(18%). Males 24(71%) were more commonly affected. Most of the cases occurred between the age group of 40-49 years (23%), and 60 years and above (23%) too. Age group of 20-50 years constituted 20(60%) of the cases. (174)

Hepatitis A

Tens of millions of individuals worldwide are estimated to become infected each year with Hepatitis A. In developing countries, and in regions with poor hygiene standards, the incidence is high, and the illness is usually in early childhood.

In May 2012, an outbreak of viral hepatitis A was reported to the Guangxi Center for Disease Control and Prevention from a middle school in Liujiang County. A cohort study showed that students who reported using well water daily were 5.2 times more likely to be ill than those that reported using the pipeline water daily. Eighteen cases were confirmed as hepatitis A. This outbreak was potentially caused by a contaminated school well. 175

Ciocca (2000), Ryan and Ray(2004), Wheeler et al. (2005), Brundage and Fitzpatrick (2006), Wasley et al. (2006), Nothdurft (2008), and Irving at al. (2012) were interested in Hepatitis A (formerly known as infectious hepatitis), which is an acute viral infectious disease of the liver, transmitted from person-to-person via ingestion of contaminated food or water, or via direct contact with a patient. They found Hepatitis A infection caused no clinical signs and symptoms in over 90% of infected children, and of no special significance to those infected early in life. Hepatitis A produced a self-limited disease without result in chronic infection or chronic liver disease. However, 10–15% of patients might experience a relapse of symptoms during the 6 months after acute illness.176 -182

In countries highly endemic for hepatitis A, large-scale vaccination programmes are not recommended; while in countries of intermediate disease endemicity, large-scale childhood vaccination may be considered as a supplement to health education and improved sanitation. But in regions of low disease endemicity, vaccination against hepatitis A is indicated for people with increased risk of this infection, such as traveller. 180 -182

It was found that as incomes rise and access to clean water increases, the incidence decreases. In Europe, the United States and other industrialized countries the infection is more among susceptible young adults, most of whom went trips to countries with a high incidence of the disease, or through contact with a patient. 177, 179

Diarrhoea

Furthermore, the average incidence rate of diarrhoea in Jerash governorate during 2000- 2011, was 28.6 per 1000 persons, while its neighbour Ajloun governorate had 40.5 per 1000 persons as average incidence rate, this could be real or under reporting, or citizens ask medical care when diarrhoea is part of a serious disease.

Eighty-eight per cent of cases of diarrhoea worldwide are attributable to unsafe water, inadequate sanitation or insufficient hygiene. These cases result in 1.5 million deaths each year, most being the deaths of children. 35

In 1990, Guerrant RL et al reviewed diarrheal diseases in all countries, and found that in developed and developing countries, diarrheal diseases with attack rates ranging from two to 12 or more illnesses per person per year. In addition, diarrheal illnesses account for an estimated 12,600 deaths each day in children in Asia, Africa, and Latin America. While enterotoxigenic Escherichia coli and rotaviruses predominate in developing areas, Norwalk-like viruses, Campylobacter jejuni, and cytotoxigenic Clostridium difficile are seen with increasing frequency in developed areas; and Shigella, Salmonella, Cryptosporidium species, and Giardia lamblia are found throughout the world. 110

WHO stated that as much as 29% of the global burden of disease attributable to unsafe water and poor sanitation and hygiene, is probably due to the secondary health effects of diarrhoea. However, Diarrhoea can be a symptom of many diseases and health problems, and not due to contaminated water.

Cancer

Finally it is worth to mention that the relationship between cancer and water is not confirmed. However, the incidence of cancer in Jerash governorate, during 2000-2011, was 3.8 per 10,000, which is about half of Jordan national incidence rate.

An American study showed Age-specific and age-standardized rates (ASR) of registered cancers for nine communities in the U.S.A. (21.8 million inhabitants, mainly white) were obtained (1978-82, 1983-87, 1988-92).

People supplied with "optimally" fluoridated drinking water (FD) were used for regression analysis of incidence rates of cancers at thirty six sites. About two-thirds of sites of the body were associated positively with FD, but negative associations were noted for lip cancer, melanoma of the skin, and cancers of the prostate and thyroid gland. In digestive organs the stomach showed only limited and small intestine no significant link.

However, cancers of the oral cavity and pharynx, colon and rectum, hepato-biliary and urinary organs were positively associated with FD.

This was also the case for bone cancers in male, in line with results of rat experiments. Brain tumors and T-cell system Hodgkin's disease, Non-Hodgkin lymphoma, multiple myeloma, melanoma of the skin and monocytic leukaemia were also correlated with FD (fluorinated drinking water). Of the 36 sites, 23 were positively significant (63.9%), 9 not significant (25.0%) and 4 negatively significant (11.1%).

This may indicate a complexity of mechanisms of action of fluoride in the body, especially in view of the coexisting positive and negative correlations with the fluoridation index. The likelihood of fluoride acting as a genetic cause of cancer requires consideration. 183

5.6.3.2 Environmental Impacts

Studies of EIA concern with effects on air, water, and soil; which in turn affect human, aquatic creatures and crops.

In 1999, an epidemiological study was implemented in the area of Kherbit As-Samra stream, to evaluate the environmental and health effects of establishment of wastewater treatment plant, which located near Hashemia town beside Zarqa city. The effluent discharged into Dhuliel valley, passed through Zarqa stream, ending in Talal King dam.

The study included evaluation of health status in the study area, and health care services, in addition to evaluation of health surveillance programs performed by health ministry, and level of coordination between government agencies and departments. As well as assessment of impacts of using treated wastewater in irrigation via studying irrigation water quality and level of bacteriological contamination of crops using the treated wastewater.

Another area was chosen for comparison, which was similar in soci-economic and agricultural aspects, except not using treated wastewater for irrigation, but instead using groundwater. It was found that treated wastewater were not used for vegetables (either cooked or raw); but used for fodder, forest, and fruitful trees.

The results indicated that people who contacted with treated wastewater; agricultural workers or their families, were exposed to diseases like diarrhea, intestinal warms, and bacteriological infections. Moreover, the results showed many faults in the mechanism of documentation of epidemic status, how physicians at health centers diagnosed cases.

As well as, showed difference between study and comparison area. With regard of level of bacteriological contamination of vegetables, it was higher in the study area more than comparison area. (184)

Water

With respect to environmental impact of using groundwater in Jerash governorate, data showed slight or no impact. Total dissolved salts had been decreased from the year 2003 to 2006, for both Shawahed pump station and Qayrawan spring; while pH of groundwater at the shawahed pump remained the same from the year 2003 to 2008. This could be attributed to rainfall, which recharge groundwater, so dilute water and reduce pH. Qayrawan spring had been contaminated several times, which affect the pH of its water.

On contrast, a Jordanian study (2007) showed that due to overpumping from the shallow groundwater aquifers, the water level dropped dramatically and signs of salinization and depletion are starting to occur. The severe drawdown in the Azraq well-field caused a reverse in the hydraulic gradient, and consequently the saltwater in the center of the basin (Qa-Azraq) started to move in the direction of the well-field. 150

Luciana (2003), assessed the health risks associated with groundwater recharge option, and recommended an integrated approach to groundwater management in general, and a health impact assessment of management options in particular, especially where regional limitations for water use. Example of factors that had impact on groundwater quality were air deposition of small particles, contaminated rainfall, polluted agricultural runoff, untreated or partially treated wastewater from municipal and industrial resources, accidental spills and illegal waste dumping. Some types of chemical pollution (see appendix 9) are irreversible; result in prohibiting use of the aquifer for many decades. 30

Luciana expected that increasing use of bottled water (much of which from spring water) in poorer countries or regions, and recommended setting a new exposure scenario that required appropriate environmental health assessment and surveillance. Also, recommended a preliminary environmental health impact assessment as the first step during the initial evaluation of a new water option for water resource management, so as to assess all realistic policy options like natural recharge or artificial recharge. In addition to assess the potential health benefits as well as the health risks, to maximize benefits and reduce costs. 30

Soil

On the other hand, TDS and pH of soil in Jerash governorate during 2000-2011were, unfortunately, not available at ministry of agriculture or national centre for agricultural research and extension so the real situation of soil could not be shown. Soil analysis data found in labs of ministry of agriculture were upon request of farmers to check quality of their lands or to find out the problem of the soil. For comparison over years, soil samples should be taken from same location, because each spot of the land has own characteristics.

In 2000 a master thesis about environmental impact assessment of using Wadi Wala (south of Amman, near Madaba) groundwater after twenty years, indicated average water salinity and medium potential alkalinity hazard, increased soil salinity and medium alkalinity hazard. In many uncultivated farms soils reported higher salinity than cultivated soils due to salts leaching of soil surface. Exhausted springs and stream flow in the Wadi Wala were attributed to groundwater overpumping in the high lands. This had a negative impact on desertification, and land deterioration due to soil salinization and improper irrigation management. 18

Also, a Jordanian paper presented in Vienna (EGU General Assembly 2013) reported that unsustainable land use practices, recurrent droughts and climate change are the main causes of land degradation in the Highlands (including jerash governorate) area of Jordan. Unsustainable land use practices include improper plowing, inappropriate rotations, inadequate or inexistent management of plant residues, overgrazing of natural vegetation, forest cutting, land fragmentation and over-pumping of groundwater. In addition, Jordan's rapid population growth (2.8% per year) is exerting considerable pressure upon its limited arable land through uncontrolled and random urbanization activities.185

There are indirect indexes can be used to assess environmental impact of water shortage on soil, such as types of plants grow in the area, like salinity tolerant plants; and effects of treated greywater and wastewater on soil, like increase pH, TDS, and types of metals.

A study in 2011, used mixed greywater (that is laundry, kitchen, and bathroom) sourced from household for irrigation plants, compared with tap water irrigation and hydroponic nutrient solution. The results indicated that soil irrigated with mixed greywater showed increased electrical conductivity and increased concentrations of metals over time, coupled with an increase in sodium and metal concentrations in crops. 186

It was found that, those who reused greywater for irrigation either manually or via installed collecting system, in Jerash governorate (2012/2013), were 20.8% used laundry wastewater, 16.5% used dishwashing wastewater, and 3.7% used bath wastewater. The percent was not high because there are disadvantages for reusing domestic greywater, such as unpleasant view, bad smell, staining toilet, effort and time are needed for collecting wastewater manually, and clogging of mesh –if the mesh used for filtration-; in addition to harmful effects on plants and soil.

This is consistent with a study conducted in South Africa, aimed to show the effects of laundry greywater irrigation on soil characteristics and growth of specific plants. It is found that the combination of high electrical conductivities, high sodium concentrations and high sodium adsorption ratios in greywater and in greywater-irrigated soils suggested that prolonged application of laundry greywater may cause adverse physicochemical change in soils.

Values of soil specific hydraulic conductivity (Ks) indicated that the application of liquid laundry detergent to soil caused severe soil hydrophobicity (i.e. the property of being water-repellent; tending to repel and not absorb water). The observed effects of laundry greywater on soil

characteristics suggested that chronic application would require steps to mitigate deterioration of soil. (187)

There are documented applications of reusing greywater in the Hashemite kingdom. Jordan government provided over 750 low-income households in 2003 with greywater treatment units. However, without proper treatment of greywater, it may retain increased levels of elements that are harmful to the soil and crops or trees that grow in it. The most concern is sodium, in which high level of sodium concentration can damage soil permeability and structure, ultimately reducing crop yields. 124

Researchers monitored sodium levels, and other potentially damaging elements, to establish whether water produced by the treatment units and used for irrigation compliance with Jordanian standards. They found that the treated water complied with standards for irrigation of fodder crops, and tree crops like olive trees.

However, it did not meet standards for uncooked vegetables. It is worth to mention that sodium levels were within the allowable limits, although the researchers did notice that concentrations of sodium and organic matter increased over time. The leaves and fruits of olive trees were tested, and there were no negative effects from recycled water.

Olive trees are known to be able to tolerate slight increases in salinity, thus suitable for irrigation by greywater. According to the researchers, occasional leaching with fresh water may reduce build up of salts and organic matter in soils irrigated with greywater. 48

In addition, a study conducted in Amman, analyzed laundry water before and after storing in a barrel for four weeks, found boron (before and after storage), and sodium (before storage) above national standard number 1995/893, for irrigation fruit trees by treated wastewater; and found high level of fecal coliform (before, after storage), too.

The national standard number 1995/893 does not pay attention to fecal coliform, thus did not set the allowable limit. Moreover, TDS, pH, chloride, SAR, and BOD were complied with national standard number 1995/893. 124

Another study was conducted in a rural house, in North Ghor (in Irbid governorate), in which the clay soil which irrigated by output greywater (come from kitchen, sinks, and laundry), and stored in a tank, which was analyzed. It was found that TDS, chloride, sodium, boron, and SAR complied with national standard number 60 for agriculture, while pH (8.6) and fecal coliform (was more than 1600) were above the standard. 124

Not only greywater affected soil, but also treated wastewater too. Al-Lahham et al. (2007), conducted a field experiment to investigate the extent of translocation of heavy metals to tomato fruit, in an open field, near to Abu-Nusair wastewater treatment plant (in Amman). Seeds were irrigated with different mixtures of potable water to treated wastewater. It was found an increase in the concentrations of Cu, Mn, and Fe, in the soil, correlated with high concentration in the wastewater; and an increase in the pH and EC in the soil with increasing the proportions of wastewater. Heavy metals in the fruit were below the Jordanian standard limits, thus, might use treated wastewater for irrigation. 48

There were more studies which were concern about using treated wastewater on soil.

Manasreh et al., Assessed the treated wastewater, produced from Al-Lajoun collection tanks of wastewater treatment plant, in Karak governorate (in Jordan), for both influent and effluent; and soil samples were collected from Al-Lajoun valley where the treated wastewater drained, to measure the heavy metal and total organic carbon concentrations.

The study showed that there were low heavy metals in the treated wastewater, during both winter and summer seasons, which was attributed to high pH value enhancing their precipitations. Some of the major ions like Cl-, Na+, HCO3 -, Mg2+, biological oxygen demand and chemical oxygen demand were higher than the Jordan standards for drained water in valleys.

The treated wastewater also contained some organic compounds of toxic type like polycyclic aromatic hydrocarbons. Moreover, it has been shown that, the soil had low heavy metal contents and total organic carbon, which attributed to adsorption of heavy metals, total organic carbon, and sedimentation of suspended particulates. The researchers concluded that the treated wastewater should be used for irrigation animal fodder only, and prohibited contact with the surface and groundwater resources in the area, especially Al-Mujeb dam. 188

While Batarseh found in his master research that there were nitrate in wastewater. This may originated from many sources, inorganic (mineral) as well as organic, like fertilizers, and sewage sludge.189

5.6.3.3. Predictions of demographic changes health impacts

Though water share per capita in Jerash governorate is the lowest all over the kingdom, but the health problems are still under control. However, if the population growth rate goes on, negative impacts will occur in the very near future. Figure (24) summarizes these impacts on environment and society.

Abbildung in dieser Leseprobe nicht enthalten

Figure 24: Impacts of demographic changes on environment and society

As population increases, water demand will increase and so ground water withdrawal by pumping. This will deteriorate the quantity and quality of ground water. In addition, the soil will be affected by low quality of ground water, resulting in low or no growth of fragile plants which do not tolerate high salinity or pH of agriculture soil, or high level of certain chemicals like sodium, boron, etc. Principal items like wheat will fail to grow with economic return, then food security will be affected seriously. Also, certain birds and wild animals will disappear from the area because of scarce water which creating unsuitable living environment.

Moreover, more water-born or related –water diseases will increase, due to low or contaminated water. In addition to, increase in illegal connections of water networks, tension and violence among people.

Furthermore, development in all sectors will decrease; result in more unemployment and migration to larger cities, creating an added stress on their scanty water resources as they will be seeking more job opportunities and better living conditions

It is worth to mention that industries in Jerash governorate are not consuming water, however, people in the near future will rely more on types of industries using minimal water, ranging from hand crafts, furniture, carpentry to electronic and communication network services, that needing skilled labors with minimal water

Also, the tourism industry does not consume water too except during festivals, for flushing toilets. However water scarcity will put pressure on touristic activities too.

5.6.3.4 Mitigation measures and plan of action

1- Individuals, private companies and public institutions should take great efforts to conserve in their water consumption and should continuously seek added resources of fresh water with due care to all possible negative environmental impacts of water desalination and their mitigation measures
2- Utilizing non-conventional methods to produce more quantities of water.
3- Safeguarding water resources, specially networks and wells, in order to reduce water leaking losses, stealing and Non-Revenue Water quantities.
4- Regulating groundwater resources by installing water meters and allowing fixed amounts of water to be withdrawn /year in order to allow the underground water recharge.
5- Promoting effective water use efficiency and water conservation at houses.
6- Implementing strict various penalties on the illegal use of water and sewer network, polluting any water resources, drilling unlicensed groundwater wells, and carrying any work related to water or wastewater without obtaining the licenses, permits or approvals required
7- Raising farmers’ awareness of standards, testing and enforcement of standards, training and certifying drip system designers, and institutional responsibilities.
8- Building farmers’ water management skills, and using reclaimed water
9- Coordination in the integrated planning approach between the water sector organizations and other organizations related to infrastructure and economic development.
10- Proper communication both among sectors and between initiative levels (from government to the grassroots) in order to coordinate programs and create a stronger, comprehensive plan for addressing water scarcity problems.
11- Religious leaders as community leaders should cooperate with the government in increasing the value of conserving water among people and re-using greywater at houses.

5.6.4 Fourth Objective: Assessment of the current applied plans for sustainable water resources management in Jerash governorate within 2000-2011.

Jordan water strategy addresses water resource development, resource management, legislation and institutional set-up, shared water resources, public awareness, performance, health standards, private sector participation, financing, researches and development. The strategy states “resource management shall continually aim at achieving the highest possible efficiency in the conveyance, distribution, application and use of water resources.” New Water strategy (2008- 2022) foresees a decreased reliance on groundwater from the current 32% to 17%, increased use of treated wastewater in agriculture from 10% to 13%, and increased use of desalination from 1% to 31%. (3, 4, 190)

This is consistent with a study done by Al-Weshah (2008), who confirmed in his study that the temporal and spatial variability of freshwater resources was very sensitive to changes that may occur due to climate change. Hazards like floods and droughts affected many regions of the world, but most heavily on the poor in developing countries. 37, 74

In order to coordinate domestic, industrial, irrigational, and touristic activities which use water, and to ensure sustainable resources, a common planning framework is needed. This framework is given by the Water Master Plan. In Jordan, the Formulation of a Water Master Plan is a principal task performed by the Ministry of Water and Irrigation.

Thus sustainable management of water resources was a must as in Jordan, for water scarcity was becoming a big development constraint, which hindered the economic growth of the country.

While Hadadin et al. (2010) concluded that a true foundation of sustainable water solution required population awareness, and involvement of a number of governmental and non- governmental organizations. Elements of sustainable water resources were standing under, the development of new supplies of water, water harvesting, reuse of wastewater in the agricultural sector, desalination, and reduction of water demands. 20

With assistance of the German Government, the national water Master plan is a Digital Plan (developed in 2004) based on an extensive Water Information System (WIS). In close cooperation with the Ministry of Water and Irrigation and GTZ (the Deutsche Gesellschaft für Technische Zusammenarbeit), the German consulting company AHT International has developed the Digital software Planning Tools. These tools were database applications with a GIS (digital mapping) interface that were applied to:

1- Assess the present availability, withdrawals, losses and uses of the water resources; 2- Formulate alternative development scenarios for water resources and demand/use at various planning horizons;
3- Perform the balancing of resources versus demands for the recent past as well as for the alternative development options;
4- Identify technical and operational options in order to bridge the gap between resources and demands.191

An interesting note worth to mention, which is that, Falkenmark Water Stress Indicator (in 1989, the most widely used measure of water stress, and adopted by the World Bank) is using cubic meter per capita per year, while Jordan ministry of water and irrigation uses litre per capita per day. This makes some confusion, and result in mistake in official reports as in the final report of USAID (2012) “Review Of Water Policies, In Jordan And Recommendations For Strategic Priorities”. In which wrote 147 m3 per person per year in 2010, whilst it was 147 liters/person/day.

Anyway, when converting litre/day into m[3]/year figures become so low, and in best situation was in Aqaba governorate in 2004, where water share per capita per year was 137 m[3]. At national level (2011), the figure 145 liters/capita/day turned to 52.93 m[3]/year/person, about one tenth times of absolute scarcity according to Falkenmark indicator (absolute scarcity if water share is <500 m[3]/year/person). 192

5.6.4.1. Ministries Manage Water Resources

Water Authority of Jordan (WAJ), linked with ministry of water and irrigation (MWI), is the official body responsible for monitoring and management of the water supply, water sector, and wastewater system. Ministry of water and irrigation includes: Water Authority of Jordan, which is in charge of water & sewerage systems; and Jordan Valley Authority (JVA), which is responsible for the socio-economic development of Jordan Rift Valley, including water development and distribution of irrigation.

Ministry of water and irrigation established also Water Demand Management Unit (WDMU) to provide knowledge and increase awareness on reducing water consumption and better demand management issues. This unit is responsible for monitoring misuse of water and recommending regulatory measures. It introduced and promoted concept of water demand management, promoted water saving technology and water saving devices, participated in introducing new water laws and regulations, studied the possibility of greywater reuse in areas with no sewer systems, promoted and supported studies on rainwater harvesting.

While Ministry of Health taking care of monitoring water quality and monitoring the standards of drinking water provided by WAJ; also monitors public and private wastewater facilities to assure its compliance with national standards and regulations. Regulations are issued in coordination between the two ministries to regulate the use of treated wastewater for irrigation.

Moreover, Ministry of Agriculture (MOA) is authorized to exploit surface water resources through construction and operation of small dams and other facilities for agricultural production and livestock. Policies of MOA have great effect on water policies, as well as the planning and management of water resources. The National Center for Agricultural Research and Extensions (NCARE) is affiliated with the MOA, which concerns with farmers and researches.

Furthermore, Ministry of Environment (MOE) is responsible for protecting natural resources in Jordan, through making EIA (environmental impact assessment) for new projects and industries. (37, 50, 113)

5.6.4.2 Responsibility For Water Supply And Sanitation

Ministry of Water and Irrigation is officially responsible for the formulation of national water strategies, policies, and planning, but subject to approval by the Council of Ministers. It is supported by several donor organizations which assisted in development of water policy and water master planning as well as restructuring water sector. The Project Management Unit (PMU) – in Water Authority of Jordan- carried out major investment projects such as the water loss reduction program in Amman.

In early 2008 King Abdullah II created a Royal Water Committee to develop policies and programs in light of the kingdom's scarce water resources, chaired by Prince Faisal bin Al Hussein. The Committee produced the new Water Strategy in 2009. 44, 63, 113

5.6.4.3 Water Service providers

Aqaba Water Company (AWC), the public company established in 2004 as Jordan's first semi-autonomous water utility; owned by WAJ (85%) and the Aqaba Special Economic Zone (ASEZA) which owns 15%.

The second public water company, Miyahuna, was set up in 2006 for the Governorate of Amman. The company, which was created to take over service responsibility from a private operator, is a 100% subsidiary of WAJ.

The third public company, the Northern Governorates Water Administration (NGWA), set up in 2010, also as a 100% subsidiary of WAJ; currently serves the Governorates of Irbid, Jerash, Ajloun and Mafraq. 37, 193

Northern Governorates Water Administration (NGWA)

Water Authority of Jordan analyzed and evaluated various options for the Northern Governorates Water Administration (serves Jerash, Ajloun, Irbid, and Mafraq governorates) and finally, decided that NGWA has to undergo a process of commercialization that consists of two stages:

1- NGWA corporatization, throughout the establishment of a limited liability company (Yarmouk Water Company YWC). So that it will be an independent legal entity with its own separated finances and management.
2- YWC to go for a full Performance Based Management Contract, in which the main objectives of the Management Contract are:
A) To improve the water and wastewater services provided to the customers in the Northern Governorates
B) To improve the financial position of YWC through the achievement of cost efficiencies and improved revenue management.
C) To establish, for Yarmouk Water Company, the foundation for sustainable operational and business effectiveness and efficiency;
D) To reduce the amount of water lost or unaccounted for through, among other things, leakage and unauthorized connections to the water facilities.

Though the time interval for NGWA achievement is short, however evaluation can be done through certain indexes.

Indexes of performance for NGWA are:

1- Quantity of available water supply in million cubic meters: was 62 MCM in 2007, became 73 MCM in 2011, and planned to be 75 in 2012 but in real fact it was 68 MCM.
2- Percentage of water lost: it was 41% in 2007, became 38% in 2011, and planned to be 36% in 2012 but in real fact it was 37%.
3- Percentage of compliance of water samples with national standards: it was 98% from 2007 to 2012. (water authority of Jordan, 2012)

5.6.4.4 Public, Users and Private Sector Participation In Water Management

Jordan government considers the participation of the private sector (in all governorates) in managing the water sector as a major step. The government needs to increase private sector participation through transferring infrastructure and services from the public to the private sector in order to improve the performance and ensure the delivery of services to the population.

Thus, legislation related to private sector investments in the water sector need to be updated and continually assessed in relation to the benefits and satisfaction of end users; and the role of water tariffs should be considered as a tool to attract private investment in water projects aiming for recovery of the capital costs, and costs of operation and maintenance. The role of the private sector in agricultural projects should also be encouraged and expanded too.

An example, in 1999, a Management five-year Contract between WAJ and the private joint venture Lyonnaise des Eaux - Montgomery Watson – Arabtech Jardaneh (LEMA) was signed. According to the contract, LEMA was responsible for operating and managing water and wastewater services in the Greater Amman area on behalf of WAJ. It was intended to strengthen the technical structure, and management capability, as well as to develop the skills and knowledge of the staff.

LEMA treated water received from a number of WAJ sources, and delivered it to Amman population; it also collected wastewater from citizens and transported it to treatment works. The company was able to achieve 12 out of 15 performance targets; access to supply increased from 90% in 2000 to universal access in 2005. At the same time, sewer connections increased from 69% to 80%. In 2007 the Jordan Water Company Miyahuna replaced LEMA after its contract had been extended one final time for an extra six months.

Another example in the Madaba Governorate a different model of private sector participation, called Micro PSP has been carried out starting in 2006. The Micro PSP involved outsourcing customer service operations to Engicon, a local operator hired on a three-year performance-based contract. Aims of the project were to improve water and wastewater revenue, to increase the billing rate and to develop the customer management organization thereby improving efficiency.

To achieve this, Engicon trained staff, surveyed and mapped all subscribers and regulated routes to meter readers (so as to eliminate reader monopoly). As a result, the Madaba Water Administration could start issuing its own bills instead of having to rely on WAJ structures. The accuracy of meter reading improved and net billed water increased by 75%. Net collections increased from 0.9 million in 2005 to 1.9 million in 2008.

The levels of non-revenue water (NRW) initially dropped from an average of 45% to 34%, but in 2009 they were back at 40% due to an increase in water pumping pressure. (Non-revenue water is water that has been produced but “lost” before it reaches the customer. Losses can be real (through leaks) or apparent losses (for example through theft or metering inaccuracies)

Advantages of the Micro-PSP model include the fact that WAJ maintained asset ownership and that all revenue collected went to WAJ, so that investment costs could be fully recovered within 13 months of operation. The performance-based contract set strong incentives for the private operator to deliver concrete results. 37

In addition, there are more than 15 non-governmental organizations (NGOs) like the Jordan Environment Society and the Royal Society for the Conservation of Nature, works (directly or indirectly) on water issues in Jordan, such as water quality assessments and wastewater management. Several water management projects have been conducted by NGOs, and funded by international organizations and donors, especially in water harvesting, water reuse and sustainable agriculture issues. 193

A community-based water management is always promoted and is part of the Jordanian water policies. In fact, there are several initiatives and programs promoting optimal water use at community level are advancing all over the country, in which women are bearing the responsibility of household water management, with a basic reliance on water gathering and utilization. 190, 194

The idea of water conservation is not new to Jordanian people, because low rainfall leads them to survive by harvesting rainwater and minimizing water usage. In Jerash governorate, as well as other governorates, citizens tend to reduce consumption of water quantities used for cleaning house, washing dishes, and washing bodies; use water saving utilities which installed on taps and showers; fixing leakage as soon as possible; re-using greywater for toilet flushing, garden, and cleaning floor (if possible); and collecting rainwater.

An ongoing public awareness and outreach activities and school educational programs are implemented in Jerash governorate, as well as other governorates, to increase and maintain high levels of public awareness of the importance of water efficiency.

5.6.4.5 Water Projects in Jerash Governorate during 2000-2011:

1- Upgrading water network and house connections in Souf/ Jerash. (66% accomplished in 2010)
2- West Jerash project; which include construction of treatment plant to serve Me’erad municipality in Jerash, Construction of Ain Deek lifting plant, lifting line, conveyor line, and wastewater networks for Haddaheh, Mansheyeh, Sakeb, Remon, Ketteh, and Nahla. (98% achieved in 2010)
3- Study Amman/Jerash gate wastewater project. ( 90% accomplished in 2010)
4- Qayrawan/Souf wastewater conveyor line project. (5% accomplished in 2010). ([4])
5- Integrated watershed management -in Jerash- project (2005-2008). (done) 6- Extending Jerash wastewater treatment project. (ongoing)
7- SCADA project for north Jordan, aim to monitor well from distance. (new) 8- Water loss reduction project at northern governorates WLRP . (done)
9- Project of conveyers from Um lolo/ Jerash to Hofeh/Ajloun, 2008. (ongoing)
10- Rehabilitation of water networks and maintenance in Jerash and Ajloun governorates. Funded by KFW (The German Development Bank) and WAJ. (done)
11- Project of rehabilitation of network of northern governorates. (ongoing)
12- Project of conveyers for northern governorates. (ongoing) 3
13- Protection from contamination project (Qayrawan spring: treated 120 m[3]/hour, during 2003-2008; Shawahed wells: treated 120 m[3]/hour, during 2006-2009). 2
14- Project of exploiting wells of Faisal nursery/ Jerash. (ongoing)

5.6.4.6 Tariffs, Pricing and Cost Recovery

Currently, water valuation is used by the Ministry of Water and Irrigation as an economic tool for better efficiency in water allocation, and to full cost recovery, considering water quality, and end users. The Ministry states that the marginal cost of water is high based on world standards, the investments for water and wastewater projects are high and are increasing, and old water networks need rehabilitation which is costly.

Domestic piped water (i.e. municipal water) prices are affordable for poor citizens, but the supply is not continuous (in Jerash governorate and other governorates), and the water prices for bottled water and tanked water are 8-10 times that of piped water. Luckily Water supply is still subsidized by the government, and the price paid by the consumer does not reflect the full cost of its demand management. At the same time, it has been argues that privatization of the water supply network and utilities had a minor impact on the affordability of water for consumers, but with increasing population growth and decreasing resources a bigger impact could be expected in the future.

This is consistent with studies conducted by Salman et al. In 2001, they concluded that demand was slightly inelastic, an increase of 1% in the price of surface water would decrease the quantity demanded by about 0.91%. 69 In 2006, they showed that the demand function, below certain levels became insensitive to increases in price. Other factors such as size of household, level of welfare (like swimming pool, etc), education, and number of bathrooms were positively correlated with water demand. ([65]) Another study for Salman et al., in 2008, showed that the estimated water demand was not flexible, and so was the income. 66

Furthermore, the Irrigation Water Policy sets some principles for the pricing of irrigation water. The water price at least covers the cost of operation and maintenance, and recovers part of capital cost of the irrigation water project. The tariff system is an increasing-block system, under which users pay a higher tariff per cubic meter if they consume more water. The tariff system distinguishes between Amman, where tariffs are higher, and jerash governorate (as well as the rest of other governorates); also differentiates between domestic and commercial uses. 37, 56,194

VI. CONCLUSIONS

Based on results of this study, it can be concluded that:

1- Citizens of Jerash governorate cope well with water shortage, with the help of government which continuously monitor water resources, increase health awareness about water contamination, and protect springs used by people.
2- Based on basic human needs index, 50 litres per day per person is enough. This put Jerash governorate above danger of water scarcity.
3- Although water share per capita in Jerash governorate is globally very low, but health situations still under control.
4- The quantity of water decreases over time due to increase in population, but the quality of drinking water is acceptable for municipal, and treated bottled water. Tanker truck water and wells (both are undergrounded water) are within national standards except high level of nitrate, whereas protected springs are potentially not safe because of fertilizers and many septic tanks around them; while harvested rainwater is free from nitrate but susceptible to biological contamination, thus using disinfectant is preferable.
5- Poor sanitation plays an important role in polluting springs, even controlled ones. Better sanitation will reduce pollution, thus increase safe water for drinking.
6- Neither gastric cancer nor colo-rectal cancer was found in the study although high level of nitrate in some water resources. This suggests presence of other factors that play role in incidence of these types of cancers.
7- With regard to water TDS and pH, data did not show increment over 2000-2011, in Jerash governorate.
8- Though direct impacts of using water resources on soil are not obvious due to other strong factors like climate change and agricultural practices, but indirect impacts can be measured through impacts of water management methods and technologies. For example effects of greywater and treated wastewater on soil and crops.

VII. RECOMMENDATIONS

Based on study findings and results, recommendations were drawn as follows:

1- Government should pay attention to high level of nitrate in tanker truck water, continuous monitoring tanker truck water and put solutions to reduce it to acceptable level.
2- Conduct similar study in Ajloun and Irbid governorates, which have low water share per capita (75.1, 96.1 litre/day respectively), and compare results with Jerash’s.
3- Additional researches are needed to correlate kidney stones cases and myocardial infraction with level of magnesium and calcium in water.
4- Government is recommended to establish monitoring systems for all water resources mentioned in this study.
5- Incentives provided by Water provider (currently NGWA Water Company for northern governorates) to households who consume less water quantities, and who re-use greywater successfully (like for irrigation).
6- Do not use Falkenmark Water Stress Indicator for countries with limited water resources, because Falkenmark levels are so high, and much far beyond the real situation of human needs. Whereas, Basic Human Needs index instead is much realistic and a better substitute.
7- Ministry of water and irrigation is recommended to use cubic meter per year in its annual reports instead of litre per day, to avoid confusion among researchers.
8- There is only one study about soil in Jordan, where Jerash governorate was included, done in 1995. So, Ministry of Agriculture is recommended to make another study on soil characteristics, to show changes over time, 1996-2014.
9- It is highly recommended that Department of Statistics includes non-Jordanians in Jordan and Palestinians in the two camps in Jerash governorate, in its annual reports.
10- Ministry of Education is recommended to increase sense of responsibility among students at all levels, through competitions about saving water, water shortage issue, and innovative solutions to control shortage or contamination of water, not in Jerash governorate only, but in all over the kingdom.
11- Since underground aquifers are recharged by rainfall leakage only, the government is highly recommended to recharge water aquifers by using reliable and suitable technology.
12- Prohibit privatization of wells, so as to control overpumping
13- Enforce more hard penalties for those who steal water
14- Establish collecting system of domestic grey water from houses, and treat them.

"Assessment of Environmental and Health Impacts of Water Resources uses in Jerash Governorate/ Jordan During 2000-11, Based on Demographic Change"

SUMMARY

Jordan is one of the countries in the world that are encountering problems of water scarcity and severe shortages as water demands far exceeds available water supply. In Jerash governorate, only 60% of its needs are met, and the individual average share is only 71 litres per day, which is the lowest in Jordan.

Jerash Governorate population has developed spectacularly in the last century due to its strategic location and the growing importance of the tourism industry in Jerash city. These growing populations compete for limited fresh underground and surface water resources. Human activities such as urbanization, agricultural practices, and over pumping of groundwater, alter water systems. Impacts on Health and environment and socio-economic conditions caused by scarcity or impaired quality of biologically contaminated water can be organized into categories, most concern is the environment-related physical health such as water-borne diseases; cancer and organs dysfunction related ailments and reproductive disorders.

The main objective of the study was the assessment of the environmental and health impacts of consuming water resources in Jerash governorate during 2000-2011 based on demographic changes. Through characterization of the demographic population changes in Jerash governorate; evaluation of water quality (groundwater, surface water) , according to Jordan National drinking water standards; assessment of environmental and health impacts of water usage for irrigation and drinking in Jerash governorate; and assessment of the current applied plans for sustainable water resources management in Jerash governorate within 2000- 2011.

There were two designs for this study, which were retrospective assessment and cluster survey, applied in the three sub-districts of Jerash governorate (Jerash, Mastaba, Burma). Retrospective data for health problems, those citizens suffered from, and for records during 2000- 2011.

The tool of study was interviewer-administered questionnaire; which consisted of five sections aimed to identify water resources used by citizens of jerash governorate for drinking and domestic purposes; identify the effects of water shortage on both their health and community health; and how they adapt with water cut-off or scarcity. Furthermore, aimed to identify ways of water consumption and methods of conservation; and how the community clean water tanks to prevent contamination. In addition to analysis of drinking water samples, drawn from resources.

Data collected was analyzed with SPSS version 19.0, and Microsoft EXCEL 2010. Descriptive frequency, Chi Square, in addition to charts and figures, were used to describe the sample, test association between variables, and to describe the relationship between them.

Results obtained were represented by tables and figures, describing the sample and the population of Jerash governorate, showing water resources and their management used to reduce water consumption by dwellers in the three districts of Jerash governorate. Also, were presenting distribution of water-borne diseases and water-related diseases, showing relationship between water quality and other variables. Moreover, results were presenting water supply of Jerash governorate and their analysis of water samples from different resources, in addition to investigative samples from a private well, a tanker truck and three springs.

It had been found that though there was scarcity in water, people were able to adapt with this strenuous situation. All citizens conserved water by using roof and/or ground tanks; many used water wisely at their houses; and reused greywater (laundry wastewater more than dishwashing wastewater, and bath wastewater), for mainly flushing toilet and watering garden. In addition to, they installed water saving utilities. They had poor sanitation, which negatively affected the soil and water resources like springs and wells, and sometimes caused contamination. However, awareness and good hygiene practices generally protected them from waterborne and food-borne diseases. The most dominant health problem was kidney stones.

Furthermore, although the average yearly rainfall in Jerash governorate was considered among the highest in Jordan, water share per capita was the lowest (71 litre/day) among the twelve Jordan governorates, due to water losses for many reasons, low both water supply and water production. Also, registered water analysis found high level of nitrate in some tanker trucking water, a private well, and springs, above the national standards for drinking water, due to natural existence of nitrate in ground water, in addition to nitrogen-fertilizers used excessively by farmers. On the other side, Ammonia, fluoride, lead, pH and salinity, all were in compliance with both national and WHO standards for drinking water.

It was concluded that Citizens of Jerash governorate cope well with water shortage, with the help of the government which continuously monitor water resources, increase health awareness about water contamination, and protect springs used by people. Also, this concluded that the health situations still under control. The quantity of water decreased over time due to increase in population, but the quality of drinking water was acceptable for municipal, and treated bottled water. Tanker truck water and wells (both are undergrounded water) were within national standards except high level of nitrate, whereas protected springs are potentially not safe because of fertilizers and many septic tanks around them; while harvested rainwater was free from nitrate but susceptible to biological contamination. Moreover, poor sanitation played an important role in polluting springs, even controlled ones. So better sanitation would reduce pollution, thus increase safe water for drinking.

It was recommended not to use Falkenmark Water Stress Indicator for countries with limited water resources, instead use Basic Human Needs index should be applied. Also, to pay attention to high level of nitrate in tanker truck water, and to level of magnesium and calcium in water; conduct similar study in Ajloun and Irbid governorates to compare results with Jerash. Furthermore it was recommended to recharge water aquifers by using reliable and suitable technology for recharging.

REFERENCES

1. NIC. Global Trends 2025: A Transformed World. Washington DC: US government printing office; 2008. 120 p. ISBN 978-0-16-081834-9

2. Ministry of water and irrigation (JO). Annual report of water authority 2006. Amman: MWI; 2007.

3. Ministry of water and irrigation (JO). Annual report of 2007. Amman: MWI; 2009.

4. Ministry of water and irrigation (JO). Annual report of 2010. Amman: MWI; 2012.

5. Dougherty P. Planning Jordan’s Water Future: Lessons Learnt from the Water Sector Planning Support Project. Jordan: (GTZ) GmbH, German Technical Cooperation (GTZ Jordan); (2006).

6. MWI, GTZ. National Water Master Plan 2004. Amman: MWI; 2005. 97 p.

7. Ministry of Water and Irrigation (JO). National Water Master Plan, Water Uses and Demands (digital information system). Amman: MWI; 2009.

8. Ministry of Water and Irrigation (JO). National Water Master Plan. Amman: MWI; 2004.

9. Arabiyat A. Evaluation and Management of Groundwater using MODFLOW Model in Jerash Catchment Area. Master thesis. Sult: Balqa' Applied University; 2013.

10. Abu Salem O. Colon cancer in North Jordan. RMJ. 2010; 35(2): 129-132.

11.Saeijs HL, Van Berkel MJ. Global water crisis: the major issue of the 21st century, a growing and explosive problem. Eur Water Pollut Control. 1995; 5(4):26-40.

12. Abu-Rumman G. Environmental impact assessment of demographic changes on water resources in Jordan. Master thesis. Amman: University of Jordan; 2002.

13. Shah T. Groundwater and human development: challenges and opportunities in livelihoods and environment. Water Sci Technol. 2005; 51 (8):27-37.

14. Falkenmark M, Widstrand C. Population and water resources: a delicate balance. Popul Bull. 1992; 47(3):1-36.

15. No authors listed. Population and water. Interview: Genady Golubev. People Planet. 1993 ; 2 (2) :34.

16. General budget department (JO). Jerash governorate. Amman: GBD; 2010. 28 p. (Arabic)

17. Ministry of environment (JO) . Environment status report of Jordan. Amman: MOE; 2009. 211 p. (Arabic)

18. Estebanez F. Environmental impact assessment of the usage of Wadi Wala groundwater Master thesis. Amman: University of Jordan; 2000.

19. Makhamreh Z. Aggravation of drought and desertification problems in Jordan. In: Conference of climate change impacts in the Arab regions: water scarcity, drought, and population mobility; 2010 September 15-16; Syria.

20. Hahadin N, Qaqish M, Akawwi E , Bdour A. Water shortage in Jordan — sustainable solutions. Desalination. 2010; 250(1):197-202.

21. Abu al-Foul BM. Water consumption and economic growth in Jordan: an input-output analysis. PhD thesis. Ann Arbor: The University of Utah; 1994.

22. Fehr R. Environmental health impact assessment. Evaluation of a ten-step model. Epidemiology. 1999 September; 10(5): 34.

23. Canter LW. Environmental impact assessment. 2nd ed. New York: McGraw Hill; 1996.

24. Sadar MH. Environmental impact assessment. 2nd ed. Ottawa: Carleton University press for the impact assessment centre; 1996.

25. Jain R, Urban JV, Stacey GS, Balbach H. Environmental assessment. 2nd ed. New York: McGraw-Hill; 2002.

26. Majdalawi M. Environmental impact assessment of the applied water resources management techniques at Humart El-Sahn. watershed master. Amman: Jordan University; 2003. 115 p.

27. Briggs D. A framework for integrated environmental health impact assessment of systemic risks. Environ Health. 2008;7:61.

28. Smolders R. Human biomonitoring and environmental health impact assessment: spatial implications. Begium: Vitro; 2009.

29. Cantor KP. Drinking water and cancer. Cancer Causes and Control. 1997; 8: 292-308.

30. Luciana S. Impact assessment of aquifer recharge. In: Aertgeerts R , Angelakis A, editors. State of the art report health risks in aquifer recharge using reclaimed water. Geneva: WHO press; 2003. p. 154-69.

31. Skudarnov SE, Kurkatov SV. Incidence of non-communicable diseases and health risks due to potable water quality. Gig Sanit. 2011 Nov-Dec; (6):30-2.

32. Howard G, Bartram J. Domestic Water Quantity, Service Level and Health. Geneva: WHO Document Production Services; 2003. 39 p.

33. WHO, World plumbing council. Heatlh aspects of plumbing. Switzerland: WHO press; 2006.

34. Waite M, Ronchi E. Drinking Water and Infectious Disease. Florida:CRC Press; 2003. 221 p.

35. Prüss-Üstün A, Bos R, Gore F, Bartram J. Safer water, better health: costs, benefits and sustainability of interventions to protect and promote health. Spain: WHO press; 2008.

36. Birley MH, Lock K. The health impact of peri-urban natural resource development. Trowbridge: Cromwell Press;1999.

37. French Agency Of Development. Jordan water demand management study water demand management in Mediterranean countries: thinking outside the water box! Jordan case study. AFD: Amman; (2011). 122 p.

38. Abu-Shams I , Rabadi A. Commercialization and Public–Private Partnership in Jordan. Water Resources Development. 2003; 19, 2: 159–172.

39. Al-Assa’d, T, Sauer J. The Performance of Water Utilities in Jordan, Water Science and Technology. 2010; 62(4): 803-809

40. Al-Habbab M S, Al-Absi K. Economic evaluation of introducing water user's association in Karama area (Jordan Valley). Dirasat, Agricultural Sciences. (2003); 30 (3): 319-329.

41. Al-Jayyousi O. Scenarios for Public–Private Partnerships in Water Management: A Case Study from Jordan. Water Resources Development. 2003;19, 2, 185-201.

42. Al-Karablieh E, Salman A, Al-Omari A. The Residential Water Demand Function in Amman-Zarka Basin in Jordan. The 3rd International Conference on the Water Resources in the Mediterranean Basin. 2006.

43. Al-Zu’bi Y. Water Sector Privatization in Jordan, World Journal of Agricultural Sciences. 2006; 2( 3): 326-332.

44. Denny E, Donnelly K, McKay R, Ponte G, Uetake T. Sustainable Water Strategies for Jordan, International Economic Development Program. USA: University of Michigan. 2008

45. EQA. The Fara’a and Integrated Watershed Management Project, Inception Report. Jordan : HWE; 2008.

46. Rimawi O, et. al. Wastewater Reuse in Irrigation at King Hussein Medical Center and Queen Alia International Airport. Results of a three years research project. Amman:University of Jordan University of Jordan; 1988. 140 p.

47. Al-Kharabsheh A. Ground-water quality deterioration in arid areas: a case study of the Zerqa river basin as influenced by Khirbet Es-Samra waste water (Jordan). Journal of Arid Environments. 1999; ( 43): 227–239.

48 H. Al-Hamaiedeh M. Effect of treated grey water reuse in irrigation on soil and plants. Desalination. 2010; 256:115–119.

49. Al Mahamid J. Integration of Water Resources of the Upper Aquifer in Amman-Zarqa Basin Based on Mathematical Modeling and GIS. Ph.D Thesis. Germany: Freiberg University. 2005

50. Ministry of environment of Jordan. Integrated watershed management project: Jerash study area baseline report. MOE: Amman; 2005. 117 p.

51. Hammouri N, El-Naqa A. Drought Assessment Using GIS and Remote Sensing in Amman- Zarqa Basin, Jordan. Jordan Journal of Civil Engineering. 2007;1(2).

52. Al Kuisi M, Al-Qinna M, Margane A, Aljazzar T. Spatial assessment of salinity and nitrate pollution in Amman Zarqa Basin: a case study. Environ Earth Sci. 2012 April; 59(1):117-129

53. Al-Qaisi B. Climate Change effects on Water Resources in Amman Zarqa Basin – Jordan. MWI: Amman; (2010). 39 p.

54. Saleh W, Jayyousi A. Towards Sustainable Management of Jerash Watershed: The (SMAP) Project. Arab Gulf Journal of Scientific Research. 2008; 26 (112): 107- 114.

55. Ministry of environment of Jordan, United nations development programme. Jordan’s second national communication to the United Nations framework convention on climate change (UNFCCC). Amman: MOE. 164 p.

56. Humpal D, El-Naser H, Irani K, Sitton J, Renshaw K, Gleitsmann B. Review Of Water Policies In Jordan And Recommendations For Strategic Priorities. Final Report. USAID: Amman; 2012.

57. Smadi M, Zghoul A. A sudden change in rainfall characteristics in Amman, Jordan during the mid 1950s. American Journal of Environmental Sciences. US: BNET Business Library, CBS Interactive; 2006.

58. Savenije H, Van der Zaag P. Water as an Economic Good and Demand Management - Paradigms with Pitfalls. IWA, Water International. 2002; 27(1): 98–104.

59. Abdel Khaleq R. Water Demand Management In Jordan. Amman: WEPIA; 2008.

60. Wolff H, Al-Karablieh E, Al-Assa'd T, Subah A. Jordan Water Demand Management Study. Amman: MWI; (2011).

61. World Bank. Hashemite Kingdom of Jordan Country Environmental Analysis, Sustainable Development Sector Department, Middle East and North Africa Region, Report No. 47829-JO. 2009.

62. Department of Statistics (JO). Population and Family Health Survey 2002. Amman: DOS; 2003.

63. Hijazi J. Water Demand Management in Jordan Case Study. In Fifth Partner Forum on Water Governance in the MENA Region. Tunisia 31 May- 4 June 2010.

64. Namrouqa H. Demand for water rises 6% in 2012 as deficit reaches 400m cubic metres. The Jordan Times. 27 Dec, 2012.

65. Salman, A, Karablieh E, Wolff HP, Fisher FM, Haddadin MJ. The Economics of Water in Jordan. In: Haddadin MJ (ed.) "Water Resources in Jordan". Washington D.C: Resources for the Future; 2006.

66. Salman, A, Al-Karablieh E, Haddadin M. Limits of Pricing Policy in Curtailing Household Water Consumption Under Scarcity Conditions. Water Policy. 2008;10:295-304.

67. Pech S, Sunada K. Population growth and natural-resources pressures in the Mekong River Basin. Ambio. 2008 May; 37(3):219-24.

68. Department of Statistics (JO). Household Expenditure & Income Survey 2010. Amman: DOS; 2011.

69. Salman A, Karablieh E, Fisher F. An Inter-Seasonal Agricultural Water Allocation System (SAWAS). Agricultural Systems. 2001; 68: 233-252.

70. Shatanawi M, Fardous A, Mazahrih N, Duqqah, M. Irrigation systems performance in Jordan. Options Méditerranéennes : Série B. Etudes et Recherches; n. 52. 2005: 123-131.

71. Jaber J, Mohsen M. Evaluation of Non-conventional Water Resources Supply in Jordan, Desalination. 2001; 136: 83-92.

72. National Energy Research Center. Updated master strategy of energy sector in Jordan for the period 2007-2012. Amman: NERC; 2007.

73. Fayez AA, Al-Shareef AW. Roof rainwater harvesting systems for household water supply in Jordan. Desalination. 2009; 243: 195–207.

74. EPA’s Watershed Academy Web. The Effect of Climate Change on Water Resources and Programs. USA: EPA; 2010. 40 p.

75. Minnesota Department of Health, Community Health Division (USA). SPECIAL REPORT: Is Minnesota Gaining or Losing Ground: A Progress Report on Minnesota’s Public Health Improvement Goals 2004. 2004: 33-43.

76. Farber E, et al. Management scenarios for the Jordan River salinity crisis. Applied Geochemistry. 2005; 20: 2138–2153.

77. Jaar M. Industrial pollution and salinity risk assessment in Jordan Valley. Tu International. 2009; 63: 22–24.

78. World Bank. Environmental Assessment Sourcebook. Volume II. Sectoral Guidelines. Technical paper number 140. Environmental Department. Washington, D.C.: The World Bank; 1998.

79. Petts J. Handbook of Environmental Impact Assessment. Volume II. Environmental Impact Assessment in Practice: Impacts and Limitations. UK: Blackwell Science Ltd; 1999.

80. El-Fadel M, Zeinati M, Jamali D. EIA procedure Framework for environment impact assessment in Lebanon. Environ Impact Assess Rev. 2000; 20:579-604.

81. Randall J, Jowett E. Environmental impact assessment tools and techniques. USA: WWF; 2010.

82. Betey CB, Godfred E. Environmental Impact assessment and sustainable development in Africa: A Critical Review. Environment and natural resources research. 2013; 3(2). ISSN 1927- 0488

83. Fouracre P. Environmental impact assessment and management. Rural travel and transport program 2001. UK: TRL; 2001.

84. Jaber B. Water pollution in Lebanon: Proposed solutions and case studies. joint WHO/UNEP first regional conference on water demand management, conservation and pollution control. (Ceha)Amman, Jordan United Nations Environment Programme Regional Office For West Asia (Rowa) Manama, Bahrain Amman, Jordan. 7-10 October 2001.

85. Sustainable Development Sector Department (MNSSD). Middle East and North Africa Region. Hashemite Kingdom of Jordan Country Environmental Analysis. Report No. 47829-JO. WHO: Geneva.

86. Cervigni R, Naber H. (eds.). Achieving sustainable development in Jordan: Country environmental analysis. U.S. : AID and WB; 2010.

87. WHO. Health impact assessment methods and strategies: methods and tools for health impact assessment. Rome: World Health Organization Regional Office for Europe; 2001.

88. Scott-Samuel A, Birley M, Ardern K. The Merseyside guidelines for health impact assessment. Liverpool: International Health IMPACT Assessment Consortium; 2001.

89. Chen CH, Wu RS, Liu WL, Su WR, Chang YM. Development of a methodology for strategic environmental assessment: application to the assessment of golf course installation policy in Taiwan. Environ Manage. 2009 Jan;43(1):166-88.

90. WHO, European Centre for Health Policy. Gothenburg Consensus Paper, Health Impact Assessment- main concepts and suggested approach. Sweden: Brussels; 1999.

91. Human Impact Partners. Health impact assessment. USA: Oklahoma; 2010.

92. Gulis G, Soeberg M, Martuzzi M, Nowacki J. Strengthening the implementation of health impact assessment in Latvia. Denmark: WHO; 2012.

93. Eaton AD, Franson MH. Standard Methods for the Examination of Water & Wastewater. 21st ed. New York: American Public Health Association; 2005. 1200 P.

94. WHO. Guidelines for Drinking-Water Quality. 2nd edition. Geneva: WHO; 1993. ISBN 92 4 154460.

95. WHO. Guidelines for drinking-water quality. 4th ed. Malta: Gutenberg; 2011. 541 p. ISBN 978 92 4 154815 1

96. R. Aertgeerts and A. Angelakis. State of the Art Report Health Risks in Aquifer Recharge Using Reclaimed Water. 2003. WHO Regional Office for Europe: Copenhagen, Denmark. 222p

97. Properzi F. Rapid assessment of drinking-water quality in the Hashemite Kingdom of Jordan: country report of the pilot project implementation in 2004-2005. Geneva: WHO press; 2010. ISBN 978 92 4 150057 9

98. Department of statistics. Statistical yearbook of Jordan 2011. Amman: DOS; 2012.

99. Jordan ministry of tourism and antiquities, the world bank. Third tourism development project secondary cities revitalization study: jerash economic profile. Amman: MTA; 2005.

100. Information and researches directorate/ Ministry of Health. 2012. Annual statistical book for the year 2011. MOH: Amman.

101. Information and researches directorate/ Ministry of Health. Annual statistical book for the year 2010. Amman: MOH; 2011.

102. Information and researches directorate/ Ministry of Health. Annual statistical book for the year 2009. Amman: MOH; 2010.

103. Information and researches directorate/ Ministry of Health. Annual statistical book for the year 2008. Amman: MOH; 2009.

104. Information and researches directorate/ Ministry of Health. Annual statistical book for the year 2007. Amman: MOH;2008.

105. Information and researches directorate/ Ministry of Health. Annual statistical book for the year 2006. Amman: MOH; 2007.

106. Information and researches directorate/ Ministry of Health. Annual statistical book for the year 2005. Amman: MOH; 2006.

107. Dans LF, Martínez EG. Amoebic dysentery. Clin Evid. 2007: 0918.

108. Abd-Alla M, Ravdin J. Diagnosis of amoebic colitis by antigen capture ELISA in patients presenting with acute diarrhoea in Cairo, Egypt. Trop Med Int Health . 2002;7:365–370.

109. Wilson ME. "Diarrhea in nontravelers: risk and etiology". Clin. Infect. Dis. December 2005;41(Suppl 8): S541–6.

110. Walker C , Perin J , Aryee M , Boschi-Pinto C, Black R . Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review. BMC Public Health. 2012; 12:220 .

111. Okour A, Al-Ghazawi Z, Gharaibeh M. Diarrhea among children and the household conditions in a low-income rural community in the Jordan Valley. Jordan Medical Journal. 2012; 46 (2).

112. Elattar I. Cancer in the Arab World: Magnitude of the Problem. UICC : March 21-25, 2005.

113. Mohsen M. Water strategies and potential of desalination in Jordan. EuroMed 2006 - Conference on Desalination Strategies in South Mediterranean Countries. Desalination. 2007; 203: 1-3.

114. Chartres C, Varma S. Out of water. From Abundance to Scarcity and How to Solve the World’s Water Problems. USA: FT Press; 2010.

115. Asheesh M. "Allocating the Gaps of Shared Water Resources (The Scarcity Index) Case Study Palestine Israel." IGME. 2003: 797-805.

116. Hailat N. Socio-economic, Agricultural, Health and Environmental Study for Watershed Management in Al-Me’raad - Jerash/Jordan. Irbid : JUST; 2005.

117. Department of Statistics/economic statistics directorate/work statistics department. Work statistics in Jordan during 2007-2011. Amman: DOS; 2013. 99 p.

118. Department of Statistics/economic statistics directorate/work statistics department. Work statistics in Jordan during 2006-2010. Amman: DOS; 2011. 112 p.

119. Department of Statistics/economic statistics directorate/work statistics department. Work statistics in Jordan during 2005-2009. Amman: DOS; 2010. 99 p.

120. Chiahin H, et al. 28 thousand tons of oil production expected in the kingdom with 50% increment than last season. Addustour Newspaper. 2011 Nov 21; 15932: 14.

121. Davis J, Lambert R. Engineering and Emergencies a practical guide to fieldworkers. 2nd Edition. UK: ITDG Publishing; 2002.

122. WFP, UNESCO, WHO. School Feeding Handbook. Rome: World Food Programme; 1999.

123. Qaqish LM. Effect of Grey Water Irrigation on Soils and Crops. Master Thesis. Irbid: Jordan University of Science and Technology; 2003.

124. Macllwaine S. Greywater use in Jordan. Amman: CSBE; 2003. 40 p.

125. MacIlwaine S, Redwood M. Greywater Use in the Middle East: Technical, Social, Economic and Policy Issues. Amman : CSBE; 2010. 200 p. ISBN: 978-1-85339-698-4.

126. McIlwaine S. Greywater Reuse in Other Countries and its Applicability to Jordan. Amman: CSBE ; 2003.

127. Tarawbeh M, Nimri O, Arkoob K, Al Zaghal M. Jordan cancer registry: cancer incidence in Jordan 2009. Amman: MOH; 2011.

128. Cappuccio FP, Siani A, Barba G, Mellone MC, Russo L, Farinaro E, et al. A prospective study of hypertension, and the incidence of kidney stones in men. J Hypertens. 1999 Jul; 17(7) : 1017-22.

129. Brown DW, Mokdad AH, Walke H, As’ad M, Al-Nsour M, Zindah M, et al. Pojected burden of chronic, non communicable diseases in Jordan. Prev Chronic Dis. 2009;6(2):A78.

130. WHO. Ammonia in Drinking-water. Background document for development of WHO Guidelines for Drinking-water Quality. Geneva: WHO; 2003.

131. World Health Organization. pH in Drinking-water: Background document for development of WHO Guidelines for Drinking-water Quality. Geneva: WHO; 2003.

132. Bailey K, Chilton J, Dahi E, Lennon M, Jackson P, Fawell J. Fluoride in Drinking-water. Geneva: WHO press; 2006. ISBN 92 4 156319 2.

133. Schmoll O, Howard G, Chilton J, Chorus I. Protecting Groundwater for Health: Managing the Quality of Drinking-water Sources. ISBN: 1843390795. London: IWA Publishing; 2006.

134. Ministry of environment of Jordan and royal scientific society. Annual report of national project for monitoring water quality – 2011. MOE: Amman; 2012.

135. WHO. Guidelines for drinking-water quality.Vol. 1, Recommendations. 3rd ed. Geneva, WHO press; 2006.

136. WHO. Chemical safety of drinking-water. Guidelines for Drinking-water Quality, Volume 1: Recommendations. 3rd ed. Geneva: WHO press; 2004.

137. Davison A, Howard G, Stevens M, Callan Ph, Fewtrell L, Deere D, et al. Water, Sanitation and Health Protection and the Human Environment . Geneva: WHO press; 2005.

138. Van Grinsven HJ, Rabl A, de Kok TM. Estimation of incidence and social cost of colon cancer due to nitrate in drinking water in the EU: a tentative cost-benefit assessment. Environ Health. Oct 2010; 6(9): 58.

139. Cantor KP. Drinking water and cancer. Cancer Causes Control. May 1997;8(3):292-308.

140. Lee YW. Risk assessment and risk management for nitrate-contaminated groundwater supplies. PhD thesis. Lincoln: University of Nebraska; 1992.

141. De Roos AJ, Ward MH, Lynch CF, Cantor KP. Nitrate in public water supplies and the risk of colon and rectum cancers. Epidemiology. Nov 2003;14(6): 640-9.

142. Forman D. (1989). Are nitrates a significant risk factor in human cancer? Cancer Surv.1989; 8(2):443-58.

143. Knekt P, Järvinen R, Dich J, Hakulinen T. Risk of colorectal and other gastro-intestinal cancers after exposure to nitrate, nitrite and N-nitroso compounds: a follow-up study. Int J Cancer. 1999 Mar 15;80(6):852-6.

144. WHO. WHO Guidelines for Drinking water Quality. Addendum: Microbiological agents in drinking water. Geneva: World Health Organization press; 2001.

145. Ainsworth R .Safe Piped Water: Managing Microbial Water Quality in Piped Distribution Systems. London: IWA Publishing; 2004. ISBN: 1 84339 039 6.

146. Ishii S, Sadowsky MJ. "Escherichia coli in the Environment: Implications for Water Quality and Human Health". Microbes Environ. 2008; 23 (2): 101–8.

147. Weyer PJ . Municipal drinking water nitrate level and risk of non-Hodgkin's lymphoma, colon cancer and GI tract cancers: The Iowa women's health study . PhD thesis. Iowa: The University of Iowa; 1998.

148. Asheesh M. Allocating the Gaps of Shared Water Resources (The Scarcity Index) Case Study Palestine Israel. IGME, 2003: 797-805.

149. Department of Statistics and ICF Macro. Jordan Population and Family Health Survey 2009. Amman: DOS; 2010.

150. El-Naqa A, Al-Momani M, Kilani S, Hammouri N. Groundwater Deterioration of Shallow Groundwater Aquifers Due to Overexploitation in Northeast Jordan. Clean 2007,35(2),156 – 166.

151. Fafo and Jordan department of statistics . Iraqis in Jordan Their Number and Characteristics. Amman: DOS; 2008. 116 p.

152. Stockholm Environment Institute. Rainwater harvesting: a lifeline for human well-being. Sweden: UNEP; 2009. ISBN: 978 - 92 - 807 - 3019 - 7

153. Abu-Zreig et al., Rainfall harvesting using sand ditches in Jordan, Agricultural Water Management. 2000; 46 (2): 183–192.

154. Ng KL, Obbard JP. Strategic environmental assessment in Hong Kong. Abst Environ Int. 2005 May; 31(4):483-92.

155. Skipton H, Woldt W, Dvorak B, Pulte R . Drinking Water: Nitrate-Nitrogen. The Institute of Agriculture and Natural Resources. Nebraska: The University of Nebraska; 2008.

156. Bakir H. Water Demand Management and Pollution Control: Key to Securing and Safeguarding the Water Supplies of MENA in the 21st Century. Amman: CEHA; 2001.

157. Parmar MS. "Kidney stones". British Medical Journal. 2004; 328 (7453): 1420–4.

158. Preminger GM. "Chapter 148: Stones in the Urinary Tract". In Cutler, RE. The Merck Manual of Medical Information Home Edition (3rd ed.). Whitehouse Station, New Jersey: Merck Sharp and Dohme Corporation; 2007.

159. Pearle MS, Calhoun EA, Curhan GC. "Chapter 8: Urolithiasis". In Litwin, MS; Saigal, CS.Urologic Diseases in America (NIH Publication No. 07–5512). Bethesda, Maryland: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, United States Public Health Service, United States Department of Health and Human Services; 2007: 283–319.

160. Cavendish M. "Kidney disorders". Diseases and Disorders 2 (1st ed.). Tarrytown, New York: Marshall Cavendish Corporation; 2008:490–3. ISBN 978-0-7614-7772-3.

161. Johri N, Cooper B, Robertson W, Choong S, Rickards D, Unwin R. "An update and practical guide to renal stone management". Nephron Clinical Practice. 2010; 116 (3): c159–71.

162. Rebecca L. Calderon, Gunther F. Craun. chapter 10: Water hardness and cardiovascular disease:a review of the epidemiological studies, 1957-78. In WHO. Calcium and Magnesium in Drinking-water: Public Health Significance. Spain: WHO; 2009.

163. Rubenowitz E, Molin I, et al. Magnesium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Epidemiology. 2000 Jul;11(4):416-21.

164. Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis.The Lancet Infectious Diseases, 2005; `1`5(1):42–52.

165. Clasen T, Roberts I, Rabien T, Schmidt W, Cairncross S. Interventions to improve water quality for preventing diarrhoea. Cochrane Database of Systematic Reviews, 3; 2006.

166. WHO, UNICEF. Meeting the MDG drinking water and sanitation target. The urban and rural challenge of the decade. Geneva: World Health Organization; 2006.

167. WHO. Global Task Force On Cholera Control. cholera unveiled. Geneva: WHO press; 2003.

168. Parry CM. Typhoid Fever. Curr Infect Dis Rep. 2004 Feb; 6(1):27-33.

169. Mermin JH, Villar R, Carpenter J, Roberts L, Samaridden A, Gasanova L, et al. A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water. J Infect Dis. 1999 Jun;179(6):1416-22.

170. Crump JA, Mintz ED. Global trends in typhoid and paratyphoid Fever. Clin Infect Dis. 2010 Jan 15; 50(2):241-6.

171. Crump JA, Youssef FA, Luby SP, et al. Estimating the Incidence of Typhoid Fever and Other Febrile Illnesses in Developing Countries. Emerg Infect Dis. 2003 May; 9(5): 539–544.

172. Connor BA, Schwartz E. Typhoid and paratyphoid fever in travellers. Lancet Infect Dis.

173. Mackey-Lawrence NM, Petri WA Jr. Amoebic dysentery. Clin Evid (Online). 2011 Jan 13;

174. Farhana F, Jamaiah I, Rohela M, Abdul-Aziz NM, Nissapatorn V. A ten year (1999-2008) retrospective study of amoebiasis in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Trop Biomed. 2009 Dec; 26(3):262-6.

175. Ye-Qing X, Fu-Qing C, Jia-Tong Z, et al. An outbreak of hepatitis A associated with a contaminated well in a middle school, Guangxi, China. Western Pac Surveill Response J. 2012 Dec 20; 3(4):44-7.

176. Ciocca M. Clinical course and consequences of hepatitis A infection. Vaccine 2000; 18:71–4.

177. Ryan KJ, Ray CG (editors). Sherris Medical Microbiology (4th ed.). New York: McGraw Hill; 2004. pp. 733–8. ISBN 0-8385-8529-9.

178. Wheeler C, Vogt TM, Armstrong GL, et al. An outbreak of hepatitis A associated with green onions. N. Engl. J. Med. 2005 September; 353 (9): 890–7.

179. Brundage SC, Fitzpatrick AN (2006). "Hepatitis A". Am Fam Physician 73 (12): 2162–8.

180. Wasley A, Fiore A, Bell BP (2006). "Hepatitis A in the era of vaccination". Epidemiol Rev 2006; 28: 101–11.

181. Nothdurft HD. Hepatitis A vaccines. Expert Rev Vaccines 2008 July; 7 (5): 535–45.

182. Irving GJ, Holden J, et al. Hepatitis A immunisation in persons not previously exposed to hepatitis A. Cochrane Database Syst Re v 2012; 7: CD009051.

183. Takahashi K, Akiniwa K, Narita K. Regression analysis of cancer incidence rates and water fluoride in the U.S.A. based on IACR/IARC (WHO) data (1978-1992). International Agency for Research on Cancer. J Epidemiol. 2001 Jul;11(4):170-9.

184. El-Khandaq H. Health effects of using treated wastewater in Zarqa stream and Khirbet As- Samra stream rural areas. Amman: MOH; 1999.

185. Khresat S. Soil erosion and land degradation in the Highlands of Jordan. EGU General Assembly 2013, held 7-12 April, 2013 in Vienna, Austria.

186. Rodda N, Salukazana L, Jackson S, Smith M. Use of domestic greywater for small- scale irrigation of food crops: Effects on plants and soil. Physics and Chemistry of the Earth. 36(14): 1051-1062.

187. Taylor GT, Pammenter NW, Rodda NH. The Effects Of Laundry Greywater Irrigation On Soil Characteristics And Growth Of Swiss Chard (Beta Vulgaris) And Sweet Pepper (Capsicum Annuum). Westville: School Of Biological And Conservation Sciences, University of KwaZulu- Natal (Westville Campus); 2008.

188. Manasreh W, Alzaydien A, Malahmeh M. Analysis Of Treated Wastewater Produced From Al-Lajoun Wastewater Treatment Plant, Jordan. E-Journal Of Chemistry 2009; 6(S1): S287- S303.

189. Batarseh M.I. Environmental impact of the rehabilitation of the leaky water network in Amman on the Groundwater resources of the area using Trihalomethane,s (THM _s). Master Thesis. Amman: University of Jordan Amman; 1999.

190. National Technical University of Athens (NTUA), Jordan University of Sciences and Technology (JUST). Project Development and implementation of an innovative, self-sufficient, brackish water treatment pilot plant for the production of drinking water for a Jordan Community. Jordan: Brawa; 2011.

191. GTZ. Water Management in Irrigated Agriculture (WMIA), Jordanian-German project. German agency for Technical Cooperation. Jordan Valley. Amman: GTZ; 2004.

192. Brown A. A review of water scarcity indeces and methodologies. Fayetteville: Arkansas University; 2011.

193. Abedel Kahleq R. Water Demand Management in Jordan. Ministry of Water and Irrigation (MWI). Amman: MWI; 2008.

194. Japan International Cooperation Agency(JAICA), Ministry of Water and Irrigation –Jordan. The Study on Water Resources Management in The Hashemite Kingdom of Jordan. Amman: WMI; 2001.

APPENDECES

APPENDIX 1

Abbildung in dieser Leseprobe nicht enthalten

Source: Jordan water demand management study. ([37])

Figure1: Surface and groundwater basins in Jordan, 2011

APPENDIX 2

Table 1: Long term average annual flow for surface water basins in Jordan

Abbildung in dieser Leseprobe nicht enthalten

Source: Jordan water demand management (2011). ([37])

APPENDIX 3

Table 2: Groundwater basins in Jordan and their safe yields (BGR, 2004)

Abbildung in dieser Leseprobe nicht enthalten

Source: Jordan water demand management (2011). ([37])

APPENDIX 4

Abbildung in dieser Leseprobe nicht enthalten

Source: Drought assessment using GIS and remote sensing in Amman-Zarqa basin study ([51])

Figure٢: Amman – Zarqa basin location

APPENDIX 5

Abbildung in dieser Leseprobe nicht enthalten

Source: Ministry of water and irrigation

Figure٣: Water resources in Jerash governorate in 2012

APPENDIX 6

Table 3: Potential causes of water stress and water quality decay

Abbildung in dieser Leseprobe nicht enthalten

Source: Impact assessment of aquifer recharge. ([30])

APPENDIX 7

Abbildung in dieser Leseprobe nicht enthalten

Source: Strengthening the implementation of health impact assessment. ([92])

Figure 4: Steps of health impact assessment

APPENDIX 9

Table 4: Health effects from chemical contaminants

Abbildung in dieser Leseprobe nicht enthalten

Source: State of the art report health risks in aquifer recharge using reclaimed water. ([96])

DDT = dichloro diphenyl trichlorethane

PAHs = polycyclic aromatic hydrocarbons;

PCBs = poly chlorinated biphenyls a Examples only

[...]

165 of 165 pages

Details

Title
Assessment of environmental and health impacts of water resources in Jerash Governorate and Jordan
College
University of Alexandria  (High Institute of Public Health)
Course
Environmental Health
Grade
PhD
Author
Year
2014
Pages
165
Catalog Number
V501535
ISBN (Book)
9783346037428
Language
English
Tags
environmental impact, health impact, water resources, Jordan, Jerash, demographic changes
Quote paper
Eham Al-Ajlouni (Author), 2014, Assessment of environmental and health impacts of water resources in Jerash Governorate and Jordan, Munich, GRIN Verlag, https://www.grin.com/document/501535

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