Man-made lakes and man-made diseases: Towards a policy resolution

Throughout the tropical world, in Africa, Asia and Latin America, the construction of water impoundments, for irrigation and other purposes, in areas of endemic water-related diseases, has inexorably intensified community levels of infection, and also created new areas of transmission. The clearest 'indicator' disease is schistosomiasis, but others are involved such as malaria and the filariases. An assessment for the future suggests a worsening situation because of population growth, the demand for food production, and the increased technological capacity of the 'bulldozer revolution' to effect earth impoundments. The typical sectoral dichotomy in which a department of agriculture creates a disease outbreak through its development activity, leaving its counterpart department of public health to cope on a curative basis, where possible, is strongly deplored. A policy position is offered whereby disease prevention measures are integrated with development projects from the beginning, and infrastructural investment and operational costs for health maintenance are identified and incorporated in the total benefit-cost analysis. The need for a communications network on ecological and health effects is pointed out; and a typology for registration of dams is offered in support of policy implementation.