AN ABSTRACT OF THE THESIS OF

Ashwaq Alamri for the degree of Master of Science in Environmental Science presented on June
10, 2019

Title: Water Usage and Human Health: A Preliminary Study in Riyadh, Saudi Arabia

Abstract approved: ______________________________________________________

Sunil Khanna

Saudi Arabia is one of the most arid countries worldwide with limited surface water

sources. In most areas of the country, there are no natural rivers or lakes and precipitation is

unpredictable and low. The entire region is susceptible to climate change, especially considering

that the country is experiencing unprecedented growth in population and urbanization. The

purpose of this study was to understand water usage among urban households and whether water

quality had a negative impact on the health of household members. Furthermore, the study aimed

to explore the implementation of water conservation methods in households.

The data collection took place in Riyadh, the capital of Saudi Arabia through a close-

ended household survey in addition to conducting structured interviews with a microbiologist.

The results suggest that water conservation methods were not used in 70% of the households.

Moreover, household members were not fully aware of water-related topics such as water-borne

disease, water resources, and the implication of climate change on the availability of water

resources. Further, it appears that in household’s water quantity or quality did not adversely

impact human health as 95% of the households reported no cases of water-borne diseases such as

cholera, or hepatitis.
Key Words

Water conservation method, water scarcity, health outcomes.

©Copyright by Ashwaq Alamri
June 10, 2019
All Rights Reserved
Water Usage and Human Health: A Preliminary Study in Riyadh, Saudi Arabia

By
Ashwaq Alamri

A THESIS

Submitted to

Oregon State University

in partial fulfillment of
the requirements for the
degree of

Master of Science

Presented June 10, 2019

Commencement June 2019
Master of Science thesis of Ashwaq Alamri presented on June 10, 2019

APPROVED:

Sunil Khanna
Major Professor, representing Environmental Science

Direct of the Environmental Science Program

Dean of the Graduate School

I understand that my thesis will become part of the permanent collection of Oregon State
University libraries. My signature below authorizes release of my thesis to any reader upon
request.

Ashwaq Alamri, Author

 ACKNOWLEDGEMENTS

I am overjoyed that I finished writing my thesis despite all the challenges I went through;

I was not in a good place emotionally writing it. I felt skeptical about my ability to complete this

daunting task. Fortunately, I had nice people who helped me throughout this process. I owe them

my most sincere thanks.

First, I am sincerely grateful for my advisor Dr. Sunil Khanna for accepting to be my

advisor. Also, I thank him for his feedback on this project. In addition, thanks go to my

committee members, Dr. Lisa Gaines, Dr. Susan Shaw, and Dr. Tammy Bray, who were so kind

to be willing to serve as my committee members. Also, a special appreciation goes to Dr. Gaines

for being willing to serve as PI while Dr. Khanna was out of the country, thank you very much

for that. Moreover, thanks go to Dr. Carolyn Fonyo, the director of the Environmental Science

Graduate program, for her unconditional support, thanks for all the efforts she did to

accommodate my interest in this program. Also, I want to thank Renee Freeman,

receptionist/ESGP administrative assistant CEOAS student services, who was so supportive and

helpful since the moment I stepped in this program.

Moreover, I want to thank the Graduate school and the Graduate Success center,

especially Michael Dumelle for his help with some questions regarding statistical software and

data analysis. Thank you for the Graduate Writing Center Staffs, especially, Chris Nelson and

Rachel Polisher; also, sincere thanks and appreciation goes to Valerie Goodness for her support

and assistance with checking the entire thesis. Thank for the Valley Library for providing

resources that were very helpful, thank you for Counseling & Psychological Services; I would

like to express my appreciation to Michele Ribeiro and Fernando Frias for their support.
 Also, I am so grateful to have my wonderful friend Ayat to share this journey with.

Honestly, she had the most impact on my thesis completion. She inspired me by working so hard

on her own project, sharing information with me, giving some valuable advice, sharing the good

news with me, and spending time together. Thank you so much dear Ayat, I always will be

grateful for you. Thank you very much for contacting me and introducing yourself to me in the

first place, I appreciate it.

Thanks go to my parents and my sisters who were so supportive during this journey,

especially, Nejood, Reem, and my favorite sister Zezo, who was checking on me every time I

was not ok.

I also want to thank some of my other friends who might not necessarily have had a

direct impact on my thesis, but definitely they had a very positive impact on my life in other

ways. I want to thank my friend Janet Selby, thank you for the time we spent together the last

two years, thank you for the delicious meals you made, thank you for everything. Also I want to

thank Kate, Lauri, Susan, Finn, Clara, Casey, and Andrew ( Casey, Andy, thank you so much for

inviting me to study with you guys, that was so nice of you, I owe the A I got in Julie’s class to

you). You guys were so nice and supportive in many ways, thank you very much.
 TABLE OF CONTENTS

Page

Chapter 1: Introduction...…… ……………………………………………………… 1

1.1 Research purpose……………………………………….……………….………4

1.2 Problem Statement……………………………………………….……..………4

1.3 Thesis Layout …………………………………………………………….….6

Chapter 2: Literature Review .………… ………………………………………...….. 8

2.1Water Resources …………...…..…………………………….……….…….8

2.1.1 Surface Water……………………………………………..………………9

2.1.2 Groundwater……………………………………………………….…..….9

2.1.3 Seawater Desalination ……………………………………………………10

2.1.4 Wastewater Treatment ………………………………………………….12

2.1.5 Fog Water Harvesting ………………………………………………….13

2.1.6 Rainwater Harvesting ………………………………………………….14

2.2 Climate Change Implications…………………………………………….14

2.3 Water and Human Health ……………………….......……………..…….16

2.4 Domestic Water Use……………….......…………………………………19

2.5Water Conservation Practices……………………………………….…….20

Chapter 3: Methodology …………………………………………..............………25

3.1 Study Design and Data Collection ……………………………………...25

3.2 Recruitment and Sampling Method……...………………………………28

3.3 Instruments …....………….....…………………………………………...29

Chapter 4: Results ………………….………………………………………………31

 TABLE OF CONTENTS (continued)

Page

4.1 Household’s Survey ……………………………………………………31

4.1.1 Water and Human Health ….......……………………………………..31

4.1.2 Water Conservation Impactions ………………............……….……..35

4.2 Structured Interview .........................................................................…...38

Chapter 5: Discussion …….....……………………………………………………..39

5.1 Water Conservation Implications ……………………...……………….39

5.2 Water and Human Health ………………………...…………………..…44

5.3Limitations ……………………...…………..............................................46

Chapter 6 Conclusion ………………………………………….....………………..47

6.1 Implication and Recommendation …………….............…………………...48

Bibliography ………………………………………………………………………..51

Appendices …………………………………………………………………………56
 LIST OF FIGURES

Figure Page

1. Saudi Arabia Map…………………………………………………………………..3

2. Summary of Saudi Arabia Water Dilemma ………………….…………………....6

3. Water Type ……………………………………..............................……………...31

4. Water Delivery Methods……................………………………………………….32

5. Shower Duration............………………………………………………………….32

6. Water Demand……………………………………………………….....………...33

7. Water Quality…………………………………………………………………….34

8. Health Outcomes……………………………………………………..........……..34

9. Eye/Skin Irritations …………………….…………..............................................35

10. Conservation Methods Applications……………………………………………..36

11. Knowledge of Water Resources ………………...................…………………….37

12. Knowledge of Climate Change ………………...................................…………..37

13. Conservation Methods Applications in Future……………..............................…42

14. Water Conservation Kit ........................................................................................43

 LIST OF TABLES

Table Page

1. Summary of Water Resources Production In Saudi Arabia……………..….. 8

2. Household’s Survey ………………………………………………….……. 25

3. Interview Questions……………………………………………………….. 27

4. The Estimate Water Quantity that Could be Used During a Shower with Different
Periods of Times and Different Devices …………..…………………………..40
 LIST OF APPENDICES

Appendix Page

A. Consent Form (Arabic) ………………………………………………...56

B. Consent Form (English)…………………………………………………57

C. Recruitment Flyer (Arabic) ………………………………………………58

D. Recruitment Flyer (English) …………………………………………..…59

E. Household’s Survey (Arabic) …………………………………………....60

F. Interview Questions (Arabic) ……………………………………………63

 LIST OF ABBREVATION

MANA …………………………………. Middle East and North Africa countries

TDS ……………………………………... Total Dissolved Solids
PPM …………………………………….. Parts Per Million
MCM ……………………………………… Million Cubic Meters
Mm ………………………………………Millimeters
EDCs …………………………………….Endocrine Disruptor Chemicals
GPHD ……………………………………Gallon per house per day
GPM……………………………………….Gallon per minute
UNCED …… National Report for the United Nations Conference on Environment
and Development
MOVE…………………………………….. Ministry of Water and Electricity
 1

Chapter 1: Introduction

Water is a critical resource for human beings. It is indispensable to human population

growth, land use, industrialization, agriculture, and food security (Almazroui, Islam, Balkhair,

Sen, & Masood, 2017). Groundwater and desalinated seawater are the most common sources of

water in most arid and semi-arid regions of the world, including countries in the Middle East or

North Africa (MENA) (Almazroui et al., 2017). MENA countries are currently suffering from

severe water scarcity whether in terms of water quantity or quality (Hellegers, Immerzeel, &

Doogers, 2013). Groundwater is almost depleted, the quality of water is degrading, and the water

supplies are limited. These changes are adversely affecting human health and damaging the

environment (Hellegers et al., 2013). In addition, MENA countries face an exponential increase

in population growth, which is expected to double in the next 4 decades (Hellegers et al., 2013).

This rapid population growth is exerting significant pressure on the agriculture sector to meet

food demands, which in turn needs water (Hellegers et al., 2013).

Climate change is another aspect that has serious implication on the availability of water

resources in MENA countries. According to the Fourth Assessment Report of the

Intergovernmental Panel on Climate Change (FARIPCC), climate change is causing measurable

decline in the precipitation rate and a significant increase in the temperature, which is causing

high evapotranspiration (Hellegers et al., 2013) in the near future. Changes in rainfall and

temperature would be so extreme that it might be unimaginably expensive to mitigate the adverse

of climate change. According to the World Bank, 2℃ increase in the temperature, worldwide, by

2050 would require about $ 2.5 billion - $ 3.5 billion / year to adopt or invent means to mitigate

climate change (Hellegers et al., 2013). Furthermore, MENA countries might experience more

events of drought and flood (Hellegers et al., 2013). Therefore, it is crucial to address the gap
 2

between water supply and water demand 1 in these countries (Hellegers et al., 2013) in order to

prevent the adverse impact of climate change on human health and well-being.

Hellegers et al. (2013) conducted a detailed investigation of the imbalance in the water demand

and supply in Iran, Morocco, and Saudi Arabia. Among all of the MENA countries, these three

countries are responsible for up to 42% of the total demand for water and about 50% of the

imbalance in water supply and water demand. The authors used three scenarios; average climate

forecast, dry climate forecast, and wet climate forecast, to estimate that imbalance in water

supply and future water demand in these three countries. The authors reported that these three

countries would experience more imbalance between water demand and water renewable

supplies under all these scenarios during 2040 and 2050 (Hellegers et al., 2013). Furthermore,

the agriculture sector irrigation water demand contributed most of that imbalance between water

supply and water demand (Hellegers et al., 2013).

Saudi Arabia (see figure 1) is located west of Asia (Ouda, 2013) between latitudes 16∘ 30

and 32∘15’N and longitudes 35∘00’ and 57∘30’E (Gandhidasan, Abualhamayel, & Patel, 2018).

It is classified as one of the driest countries in the world (Al-Zahrani & Baig, 2011), and the

country is facing severe water scarcity (Ouda, 2013; Gandhidasan et al., 2018). It is the second

largest (after Algeria) Arab countries in terms of the area size (Rambo, Warsinger, Shanbhogue,

Lienhard, & Ghoniem, 2017). Most of the land area in the county is arid or semi-arid 2

(Chandrasekharam, Lashin, Al Arifi, & Al Bassam, 2017). In terms of geographic area, Saudi

Arabia is also the largest country in the Arabian Peninsula (Kajenthira, Siddiqi, & Anadon, 2012;

Chandrasekharam et al., 2017), it represents up to 70 % of the Peninsula (Kajenthira et al., 2012).

Saudi Arabia is the largest producer and consumer of crude oil worldwide (Rambo et al., 2017).

1 i.e. the difference between future demand and renewable water resource quantity (Hellegers et al., 2013)
2
Mostly the coastal areas along the Red Sea
 3

Access to large quantities of water is critical to Saudi Arabia’s economic and the well-being of

its people (Al-Ibrahim, 1990).

FIGURE 1 SAUDI ARABIA MAP

The average temperature in Saudi Arabia, during summers, could be between 38℃ 3 (Al-

Ibrahim, 1990) - 50℃ 4 in some regions (DeNicola, Aburizaiza, Siddique, Khwaja, & Carpenter,

2015.). Usually, it is 49℃ 5 in the center, the west, and the east of the country (Al-Ibrahim,

1990). Rainfall, which is irregular and accompanied by thunderstorms (Tarawneh & Chowdhury,

2018), usually occurs between November and April (Al-Ibrahim, 1990), and varies considerably

across regions (Tarawneh & Chowdhury, 2018). The average rainfall could be between 20

mm/year (Al-Ibrahim, 1990) and 200 mm/year (Chowdhury & Al-Zahrani, 2013). In the north

and in the south, rainfall is 500mm (Al-Ibrahim, 1990; Chowdhury & Al-Zahrani, 2013;

3 100 ℉
4 122℉
5
120 ℉
 4

DeNicola, et al., 2015) and 550 mm in the south-western areas (Ouda, 2013) due to the

southwestern monsoons (Chandrasekharam et al., 2017).

Despite the low precipitation, there are seasonal heavy rain events whether in the center, the

south or the north areas of Saudi Arabia that can result in a massive amount of runoff water,

which could be a source to recharge aquifers (Tarawneh & Chowdhury, 2018) or stored to be

used in the agricultural or domestic purposes (Tarawneh & Chowdhury, 2018).

Research Purpose

The purpose of this study was to understand the use of water at a household level and to

investigate water conservation practices within households. In addition, the study aimed to

explore health outcomes household members might suffer from due to either poor water quality

or water scarcity.

Research Questions

The research questions were:

Are households making any efforts to save water, for example, adopting water conservation

methods and/ or reducing the use of water?

Are there health outcomes that might occur due to a decline either in water quality or quantity?

Problem Statement

There are several issues, see figure 2, that Saudi Arabia is facing in terms of water scarcity.

The country is heavily relying on nonrenewable sources of water which are almost depleted since

the country lacks water resources such as rivers, lakes (Al-Ibrahim, 1990; Rambo et al., 2017;

Ouda, 2013; DeNicola et al., 2015; Chandrasekharam et al., 2017), or regular rain (Al-Ibrahim,

1990; Al- Zahrani & Baig, 2011; DeNicola et al., 2015; Chandrasekharam et al., 2017). In

addition to nonrenewable sources, there is a high dependence on seawater desalination which

 5

seems not to be sustainable resource due to the greenhouse gas emission that contributes to

climate change (DeNicola et al., 2015; Chandrasekharam et al., 2017). In addition, desalination

processes could create marine ecosystems damages (Aljoufie & Tiwari, 2015; DeNicola et al.,

2015; Kajenthira et al., 2012). Treated wastewater is another water resource that might affect

human health if it is not adequately treated to the standards that would be acceptable for human

health (Al-Saleh, Elkhatib, Al-Rajoudi, & Al-Qudaihi, 2017; DeNicola et al., 2015). Further, the

rapid population affects water resources; in 2019, the population was more than 34 million

(“Population of Saudi Arabia,” 2019) and it was predicted to be more than 56 million by 2050

(Rambo et al., 2017). Increase population will increase agricultural activities to meet food

demands, which will increase water demand. Agriculture is the largest user of water in the

country, where it consumes more than 85% of total water demand in the country (Kajenthira et

al, 2012). In addition, agriculture activities will lead to more green gas emissions, which will

accelerate climate change. Climate change is another factor that imposes huge pressure on water

resources (Saati & Faidah, 2013; Tarawneh & Chowdhury, 2018). Climate change will increase

temperature, which would increase evaporation that would lead to surface water loss. For

example, 20% of rainfall is lost as soon as it reaches the ground due to this high rate of

evaporation (Al-Ibrahim, 1990). In addition, evaporation could cause a water loss by up to 80%

in old wadies or dam reservoirs (Tarawneh & Chowdhury, 2018).

Despite the limited sources of water, there is wasteful water consumption among different

users whether individuals or sectors, climatic conditions such the high temperature and the low

rainfall rate, and rapid urbanization are other factors that worsen the country’s situation

regarding water security (Mohorjy & Grigg, 1995; Ouda, 2013; Chandrasekharam et al., 2017;
 6

DeNicola et al., 2015). Therefore, it is essential to address water use, water conservation

methods, and potential impacts on human health due to the quality or the availability of water.

FIGURE 2 A SUMMARY OF WATER DILEMMA IN SAUDI ARABIA

Thesis layout

This thesis is written in six chapters, the first chapter is the introduction where the research

purpose and questions are introduced. Additionally, the chapter gives some general background

about Saudi Arabia and talks about the research significance. Chapter two is a literature review

where it talks about some backgrounds of subtopics such as water use, water resources and water

potential impact on health in Saudi Arabia. Next, chapter three is about the study’s design and

the methods that this research followed. Chapter four will talk about the results of the study, and

chapter five will be a discussion of the results, and also represents the study’s limitations.
 7

Finally, chapter six will be a conclusion of this study: the purpose of the research, the methods,

and the results. In addition, it provides some recommendations according to the findings.
 8

Chapter 2 Litterateur Review

I. Water Resources:

There are four main sources of water in Saudi Arabia; two of them are conventional

sources: surface water, and renewable and nonrenewable groundwater (Chowdhury & Al-

Zahrani, 2013; Mohorjy & Grigg, 1995; Ouda, 2013; DeNicola et al., 2015; Al-Ibrahim, 1990).

The second sources are non-conventional sources: desalinated water, and treated wastewater (Al-

Ibrahim, 1990; Mohorjy & Grigg, 1995; Chowdhury & Al-Zahrani, 2013; Ouda, 2013).

However, groundwater (Al-Zahrani & Baig, 2011; Ouda, 2013) and desalinated seawater are the

main supplies of water in the country (Al-Zahrani & Baig, 2011). The production of these four

water sources is summarized in table 1 during 2010 and 2014 (Ouda, 2013). Additionally to

these four sources, there are other potential resources such as rainwater and fog water harvesting.

Table 1 Summary of water resources production in Saudi Arabia (Ouda, 2013). * million cubic meters

Water resource 2010 mcm* 2014 mcm

Groundwater 3850 3850

Surface water 1300 2400

Total conventional sources 5150 6250

Treated Wastewater 240 400

Desalination water 1050 2070

Total non-conventional sources 1290 2470

Total 6440 8720

 9

Surface Water

Irregular flash floods constitute the only source of surface water in Saudi Arabia

(Aldosari, Al-Zahrani, Al-Zaidi, Baig, Muneer, Muddassir, &Mubushar, 2017; Ouda, 2013;

DeNicola et al., 2015), which happen due to heavy rain events (Al-Ibrahim, 1990; Chowdhury &

Al-Zahrani, 2013). These events usually occur from November to April (Ouda, 2013) in the

western coast and the southern mountainous regions of the country (Al-Ibrahim, 1990; Ouda,

2013; DeNicola et al., 2015). According to Chowdhury & Al-Zahrani (2013), the south-western

area 6 has the most amount of runoff water; about 60% of the total runoff water that occur in the

country (Chowdhury & Al-Zahrani, 2013; DeNicola et al., 2015). Also, the southern area of the

western coast 7 has 40% of the runoff water (Chowdhury & Al-Zahrani, 2013). There are about

449 dams in Saudi Arabia to store runoff which are used as an additional resource for drinking

water (Tarawneh & Chowdhury, 2018).

Groundwater

Due to a dry and desert environment (Alqahtani, Asaad, Ahmed, & Qureshi, 2015), Saudi

Arabia heavily depends on groundwater (Alqahtani et al., 2015; Almazroui et al., 2017) as a

source of drinking water (Alqahtani et al., 2015; DeNicola et al., 2015). The aquifers in Saudi

Arabia are classified into two types (Al-Ibrahim, 1990; Aldosari et al., 2017); shallow aquifers

that have renewable water which comes from rainfall and runoff water (Al-Ibrahim, 1990; Ouda,

2013). The second type is deep aquifers that are between 100 and 1500 meters deep (Al-Ibrahim,

1990; Chowdhury & Al-Zahrani, 2013). Deep aquifers hold nonrenewable water 8 (Chowdhury

& Al-Zahrani, 2013) that is stored in some sedimentary rocks 9 (Al-Ibrahim, 1990; Chowdhury &

6 Constitutes 10% of the total land area of Saudi Arabia

7 Represents 2% of the total area of the country
8 Also known as a fossil water
9 Sandstone and limestone
 10

Al-Zahrani, 2013) for about 10,000 - 32,000 years (Al-Ibrahim, 1990; Chowdhury & Al-Zahrani,

2013; Ouda, 2013; DeNicola et al., 2015). The non-renewable aquifers are expanded from the

north toward the south until the Empty Quarter 10 and from the east of the central area to the

Arabian Gulf; whereas the renewable resources are mainly located in the west and the

southwestern area (Al-Ibrahim, 1990; Aldosari et al., 2017; Ouda, 2013).

In general, Saudi Arabia derives over 80% of the water from non-renewable aquifers

which are mainly used for agricultural purposes (Kajenthira et al., 2012). Most of this water is

considered brackish 11 (Al-Ibrahim, 1990; Ouda, 2013). Therefore, it is not good to be used as

drinking water or to irrigate plants that are sensitive to salt (Al-Ibrahim, 1990). However, there

are some aquifers that contain good quality water (Mohorjy & Grigg, 1995). The water in these

aquifers can be potable (Al-Ibrahim, 1990; Mohorjy & Grigg, 1995; Aldosari et al., 2017) where

the total dissolved solids (TDS) are less than 1,000 parts per million (ppm).

The low recharge rate of aquifers is attributed to the lack of permanent surface water, low

precipitation rate that could be less than 100 millimeters (mm) annually (Al-Ibrahim, 1990;

Aldosari et al., 2017), and the over-withdrawals, that is faster than recharge rate. In fact, it was

found that the decline in groundwater level is a result of over-pumping and not because of

climate change (DeNicola et al., 2015). Climate change could affect only the flow of

groundwater in shallow aquifers (DeNicola et al., 2015).

Seawater Desalination

Saudi Arabia is considered a worldwide leader for desalinated water production (Al-

Ibrahim, 1990; Mohorjy & Grigg, 1995; Aldosari et al., 2017; Rambo et al., 2017; Ouda, 2013;

DeNicola et al., 2015; Mansouri & Ghoniem, 2017; Kajenthira et al., 2012). Due to the scarcity

10 Empty Quarter (Rub' al Khali) is a desert in Saudi Arabia

11 Brackish water contains more than 1,000 ppm of TDS (Al-Ibrahim, 1990)
 11

of natural water resources (Al-Ibrahim, 1990, Rambo et al., 2017), the country has resorted to

seawater desalination as an alternative resource to meet its water need since the 1970s (Al-

Ibrahim, 1990; Rambo et al., 2017; DeNicola et al., 2015; Gandhidasan et al., 2018). Since 2005,

about 70% of the water consumption in the country has been that of desalinated seawater

(Rambo et al., 2017). In some cities such as Jeddah, Mecca, Madina, Abha, and Taif, the

desalinated water meets about 90% of the demand for water (Elhadj, 2004). As Saudi Arabia’s

population has increased by 36% in the last decade, the production of desalinated water has also

increased by 25% to meet the growing demand for water (Elhadj, 2004).

There are 36 desalination plants in Saudi Arabia that are run by the Saline Water

Conversion Corporation with 1000 million m³ of the daily production of drinking water (Al-

Zahrani & Baig, 2011). About 78% of desalinated water in the country is sourced from the Red

Sea and the Arabian Gulf (Al-Ibrahim, 1990; Chowdhury & Al-Zahrani, 2013; Kajenthira et al.,

2012). The water from the Red Sea and the Arabian Gulf have a high amount of total dissolved

solids (TDS), which could range between 40,000 and 60,000 ppm (Al-Ibrahim, 1990). Removal

of such a high amount of TDS can be expensive when compared to other countries that use the

same technique but use a water source that has lower amounts of TDS (Al-Ibrahim, 1990).

In addition to higher purification cost, there are some other disadvantages of reliance on

seawater desalination. First, the cost of desalinated water production could be about US$ 0.52

per m³ and the cost of transmission of this water through pipeline could be US$ 1.32 per m³

(Elhadj, 2004). Second, the most common method that is used in desalination plants in Saudi

Arabia is thermal flash distillation that requires a massive amount of energy, thus more

emissions (Chandrasekharam et al., 2017), that would contribute to air pollution and worsen

climate change ( DeNicola et al., 2015). Further, although the desalination process meets the
 12

water needs for humans (DeNicola et al., 2015), it negatively impacts marine life (Aljoufie &

Tiwari, 2015; DeNicola et al., 2015; Kajenthira et al., 2012) and degrades coastal water quality

(DeNicola et al., 2015; Kajenthira et al., 2012) due to the high salinity solution along with the

chlorine content that are returned to the sea (Aljoufie & Tiwari, 2015; DeNicola et al., 2015).

In recent years, Saudi Arabia has increased efforts to discontinue the use of diesel as an

energy source and increase the use of solar energy (DeNicola et al., 2015). For example, in 2010,

Saudi Arabia established a National Initiative for Water Desalination that uses solar energy

(Kajenthira et al., 2012). Then, in 2011, Saudi Arabia constructed King Abdullah City for

Atomic and Renewable Energy as a step to adopt clean energy (Mansouri & Ghoniem, 2017).

Wastewater Treatment

The production of wastewater in Saudi Arabia has considerably increased due to the

increase in population and the urbanization (Kajenthira et al., 2012). Treated wastewater could

reduce the use of groundwater and desalinated seawater (Kajenthira et al., 2012). As a result, the

energy that is required to withdraw groundwater and to run desalination plants will be reduced,

leading to less CO₂ emission (Kajenthira et al., 2012). In addition, wastewater treatment can

reduce contamination from sewage discharges into water bodies that would cause eutrophication

that would encourage algal blooms (DeNicola et al., 2015) which could affect human health.

There are about 70 treatment plants in Saudi Arabia located mostly in the eastern,

western, and central areas (Chowdhury & Al-Zahrani, 2013). It was estimated that these plants

would cover about 25% of the total use of water (Elhadj, 2004). Chowdhury & Al-Zahrani

(2013) estimated the quantity of wastewater that could be produced from domestic use to be

1500 million cubic meters (MCM), considering the population was 26 million (Chowdhury &

Al-Zahrani, 2013). However, they found that only 40% of wastewater is treated (Chowdhury &
 13

Al-Zahrani, 2013) due to the low capacity of treatment plants which cannot accommodate the

increased population and urbanization (Kajenthira et al., 2012). The remaining amount of

wastewater is discharged either into empty wadies (Chowdhury & Al-Zahrani, 2013),

groundwater, or the Arabian Gulf and the Red sea (Chowdhury & Al-Zahrani, 2013; Aljoufie &

Tiwari, 2015) which would affect the water quality, the ecosystem of marine life, or causes

overflows of sewage in the city which ultimately would impact human health ( Aljoufie &

Tiwari, 2015).

Treated water could contain different types of contamination such as pharmaceuticals,

personal products, or endocrine disruptor chemicals (EDCs) (Al-Saleh et al., 2017). Further,

wastewater treatment systems are not well equipped to remove antibiotics which can lead to so-

called the perfect microbial storm that could promote infectious diseases to spread (DeNicola et

al., 2015). Therefore, Kajenthira et al. (2012) found that the treated industrial and municipal

wastewater has fewer health risks than treated domestic wastewater. Furthermore, industrial and

municipal wastewater require lower levels of treatment (Kajenthira et al., 2012). They concluded

that the utilization of reclaimed municipal and industrial wastewater along with the reduction of

agricultural activities would lead to freshwater sustainability in the country (Kajenthira et al.,

2012).

Fog Water Harvesting

Fog water harvesting is an example of a sustainable resource of water which is already

recognized worldwide (Gandhidasan et al., 2018). In Asir province in the south of Saudi Arabia
12
where the highest mountain peak is located, fog-harvesting has been adopted (Gandhidasan et

al., 2018). During November and February, fog is formed due to the high humidity, high -speed

12 About 3,000 meters (Gandhidasan et al., 2018)

 14

wind, and the low temperature (Gandhidasan et al., 2018). Additionally, during October and

March, Indian Ocean monsoons result in 300 mm of rainfall in the Asir region (Gandhidasan et

al., 2018). Gandhidasan et al. (2018) concluded that the Asir region possesses a plentiful amount

of fog water that should be effectively collected to supply that region with water, especially

during the tourism season when water demand rapidly increases (Gandhidasan et al., 2018).

Rainwater Harvesting

The Fourth Assessment Report of the Intergovernmental Panel for Climate Change (2007)

suggested that rainfall in the Arabian Peninsula was predicted to increase (Almazroui et al.

2017). Almazroui et al (2017) investigated rainwater harvesting possibility under climate change

impacts during 2006-2099 This study was done at Wadi Al-Lith which is located in Tihamat, 200

km away from the southeast of Jeddah, Saudi Arabia (Almazroui et al. 2017). The average

rainfall in this area is about 100 -300 mm, and the area is affected by monsoon from the Indian

Ocean (Almazroui et al. 2017). The study found that under climate change, there will be an

excessive amount of rainfall in the distance future (2070-2099) than near future (2020-2049) in

Wadi Al-Lith (Al-Mazroui et al. 2017). Therefore, it was found that rainwater harvesting is an

auspicious strategy for climate change adaptation to support water availability in that area

(Almazroui et al. 2017).

II. Climate Change Implications

Climate change may exacerbate the water scarcity for the future (Saati & Faidah, 2013).

According to the United Nations, Gulf Cooperation Council countries are an example for

countries with scarce water resources, which would be more vulnerable to climate change

implications (DeNicola et al., 2015). Despite the efforts that the Saudi Arabian government has
 15

done, some of these efforts are not sustainable and could exacerbate climate change or cause

water stress on other countries (DeNicola et al., 2015) such as seawater desalination.

In addition, precipitation rate (Aljoufie & Tiwari, 2015; DeNicola et al., 2015) and

temperature could be tremendously affected by climate change that would lead to a water

shortage (Aljoufie & Tiwari, 2015). It was found that that the temperature has increased by 1.8

℃ -4.1 ℃ in different areas of Saudi Arabia ( Saati & Faidah, 2013; Tarawneh & Chowdhury,

2018), imposing an increase in agricultural demand for water by 5 to 15 % (Saati & Faidah,

2013). Furthermore, Tarawneh & Chowdhury (2018) found that the temperature would increase

by 0.65 ℃ per decade. Therefore, as a consequence of temperature increase, the evaporation rate

will increase, which cause runoff water loss in Saudi Arabia (Al-Ibrahim, 1990; Rambo et al.,

2017; Tarawneh & Chowdhury, 2018). For instance, 20% of rainfall is lost as soon as it reaches

the ground due to this high rate of evaporation (Al-Ibrahim, 1990).

Regarding precipitation, climate change would cause 10 mm (on average) decline in

precipitation in the north of Saudi Arabia each year (DeNicola et al., 2015). On the other hand,

rainfall is projected to increase in the central areas by 15 to 25 mm/year and by 109.7 to 130.4

mm /year in the south of the country by 2050 (DeNicola et al., 2015; Tarawneh & Chowdhury,

2018). However, the evaporation as mentioned above was predicted to increase during the same

period (DeNicola et al., 2015); therefore huge amounts of rainwater could be lost through

evaporation. Also, it was estimated that the length of rain events would be short and intense,

resulting in flash floods (DeNicola et al., 2015) which already had happened in Jeddah twice.

Additionally, Climate change can create a fertile environment for some pathogens such as

boosting pathogens’ metabolism and increasing their productivity (DeNicola et al., 2015).

Further, increasing the growth size, the length of the transmission season, and severity of
 16

infections of some pathogens, such as Vibrio, Cryptosporidium, noroviruses, and Campylobacter

which react very quickly to climate change (DeNicola et al., 2015). Therefore, climate change

can increase the morbidity and mortality, epidemic, the spread of infectious diseases, and

respiratory diseases (Tarawneh & Chowdhury, 2018).

As the literature review showed, water resources in Saudi Arabia are limited, some of

these resources such as seawater desalination are expensive (Elhadj, 2004), and can cause marine

system damage (Aljoufie & Tiwari; DeNicola et al., 2015; Kajenthira et al., 2012). Other

resources such as wastewater could affect human health when it is poorly treated (DeNicola et

al., 2015). Groundwater is almost depleted and rainwater harvesting is not reliable due to the low

rainfall rate (Mohorjy & Grigg, 19957; Al-Zahrani & Baig, 2011; DeNicola et al., 2015;

Chandrasekharam et al., 2017). In addition, climate change has serious implications on water

shortage and water quality (Saati & Faidah, 2013; Tarawneh & Chowdhury, 2018). Thus, it is

important to understand the water availability in the country and also to understand climate

change impacts on water resources. Our study will examine households’ comprehension

regarding the country’s water resources and climate change impacts. Households’ knowledge

about these two topics would encourage them to control their water consumption and conserve

water as much as possible, that would lead to water sustainability.

III. Water and Human Health

The extent of drinking water quality and safety has been one of the most essential issues

from the public health perspective (Alqahtani et al., 2015). Climate change would impact the

rainfall pattern and cause more floods in some areas, so the runoff water during these heavy

precipitation events could carry contamination, pathogens (DeNicola et al., 2015), and sewage,
 17

which is a resource of fecal coliforms and E.coli ( Saati & Faidah, 2013), into water resources

(Saati & Faidah, 2013; DeNicola et al., 2015).

In addition, sewage can be carried to the water body through pipes that are used

simultaneously to drain sewage and rainstorm, and/ or agricultural discharge (Saati & Faidah,

2013). Fecal contaminations, which are not detected in chlorinated tanks, contribute many of

bacterial and viral diseases when they get into water resources (Saati & Faidah, 2013) that can

cause enteric diseases (Alqahtani et al., 2015).

The safe water access in Saudi Arabia is 93% and the sanitation access is 100 %

(DeNicola et al., 2015) which has improved since the establishment of the National Water

Company (Kajenthira et al., 2012). However, the increase of urbanization and the population

growth rate in Saudi Arabia have aggravated the demand for water and sanitation service

(Elhadj, 2004).

A study conducted in different zones in the Riyadh area, that aimed to assess drinking

water quality, found that the microbial levels in some of their samples were higher than the US

Environmental Protection agency’s standard for is which 500 colonies forming unit/mL (Al-

Omran, Al-Barakah, Altuquq, Aly, & Nadeem, 2015). Further, Saati & Faidah (2013) conducted

a study about the prevalence of pathogens in 36 drinking water wells and another 36 non-

drinkable sources in Makkah city, Saudi Arabia( Saati & Faidah, 2013). They found E.coli in

seven of the wells that contained potable water and in five of the wells that had non-drinkable

water (Saati & Faidah, 2013). The presence of E.coli was due to poor maintenance and/or

treatment of the water in tanks or sewage contamination (Saati & Faidah, 2013).

Additionally, they found Pseudomonas. aeruginosa, which was the highest

microorganism found in the study among other microorganisms (Saati & Faidah, 2013).
 18

Pseudomonas. aeruginosa bacteria can cause infection in some body systems such as the urinary

tract, the respiratory system, and the central nervous, also causes gastrointestinal and bones and

joint infections (Saati & Faidah, 2013). All these infections are caused by the toxins released by

this pathogen resulting in tissue damage (Saati & Faidah, 2013). Moreover, Aspergillus was

found in four drinkable wells and in one non-drinkable well (Saati & Faidah, 2013). Aspergillus

fungi can cause infections, spread by water, in the respiratory system which is responsible for

about 40% of deadly infections that originate in hospitals (Saati & Faidah, 2013).

Saati & Faidah (2013) concluded that the safest water can be used as drinking water was

the private desalinated water (Saati & Faidah, 2013). According to the microbiological guideline

and standards for drinking water, the standards for E.coli, Pseudomonas. aeruginosa, and

E.faecalis are zero colony /100 m of drinking water (Saati & Faidah, 2013), which was not the

case for this study where these contaminations amounts were way more than zero.

Moreover, Alqahtani et al. (2015) conducted another study to investigate the water

quality in Najran where many of wells were used as a potable water source that had not been

treated. Additionally, water tankers were frequently used there, where 96% of the participants

stated that they used roof tanker to store water (Alqahtani et al., 2015). They found 15% of well

samples, 30% of tanker samples, and 62.5% of roof tanker samples were contaminated with

coliforms (Alqahtani et al., 2015). In addition, 22.5% and 10% of roof tankers contained E.coli

and S.faecalis, respectively. Moreover, Pseudomonas aeruginosa was found, as an isolated

organism, with the largest percentage (32.1%) (Alqahtani et al., 2015). The presence of microbes

in roof tanker, which contained a higher number of bacteria than any guideline values whether

national or international level, were due to irregular cleaning of the tankers, also the water was

not treated with chlorine (Alqahtani et al., 2015).

 19

Further, a study in Khamis Mushait examined 33 wells and found that 87.9 % of wells

samples were contaminated with fecal coliform and 57% of the samples contained fecal

streptococci (Alqahtani et al., 2015). Another study in Makkah stated that about 68.8% of

sampled tankers were contaminated with coliform and 37.5% of these samples were positive to

fecal coliform (Alqahtani et al., 2015). Another study in Shebaa found 2.6 % of 39 samples form

tankers contained coliform (Alqahtani et al., 2015).

According to this literature, it seems that there was a decline in water quality that could

cause water-borne diseases; thus, we want to explore that in our research. This research aims to

understand how prevalent water-borne diseases are through an structured interview. In addition,

the households will examine water quality and the overall health outcomes among households.

IV. Domestic Water Use in Saudi Arabia

Saudi Arabia was ranked as the third largest consumer in regard to water use per capita

after the United State and Canada despite its scarce resources of water (DeNicola et al., 2015).

Rambo et al. (2017) found that the daily average water use rate in urban area was about 100 -350

liters per capita and about 15-20 liters per capita in rural areas. In Riyadh, which where our study

took place, the per capita use is more than 300 liters/day (Al-Zahrani & Baig, 2011). The

domestic water demand has increased by 6% between 1970 -2010 (Ouda, 2013).

A study conducted in China found that as households get access to more improved water

delivery system such as receiving tap water, the water consumption increases (Tong, Fan, and

Niu, 2017). Another study in Australia came to a similar conclusion where they found that hot

water system in households; for example, has resulted in an increase in water use which could

contribute to water resources depletion (Lindsay & Supski, 2017). In the case of Saudi Arabia,

the safe water access in Saudi Arabia is 93% (DeNicola et al., 2015); also, there has been rapid
 20

improvement in lifestyle (DeNicola et al., 2015) which has caused in water demand increase (Al-

Zahrani & Baig, 2011; DeNicola et al., 2015).

This improvement in water accesses could be blamed regarding the massive quantity of

water was used by some individuals for unnecessary purpose, for example, using a lot of water to

wash cars, or houses which were common practices in the country (Al-Zahrani & Baig, 2011).

Our study will look at the household’s water consumption to examine whether it has increased or

decreased. By understanding domestic water consumption, policymakers might able to address

the increase of water use among households to mitigate water shortage.

Water consumption among household, both indoor or outdoor consumptions, contribute

to water sustainability whether negatively or positively. Regarding indoor demand, there are

three components that consume most of the household water: toilets that consume 26.7% of the

total household water demand, showerheads, and washers that are responsible for 16.8% and

21.7% of the total water demands in households, respectively (Lee, Tansel,& Balbin, 2011). In

urban areas, domestic water use contributes the most of water demand; therefore water

conservation practice can be a key to reduce water demand, especially in these areas. In Saudi

Arabia, the urbanization rate is exponentially increasing (Ouda, 2013; DeNicola et al., 2015),

thus, it is urgent to execute water conservation practice among households.

V. Water Conservation Practices

Water conservation appliances can reduce water use, especially since some appliances

such as showers and clothes washers consume most of households water demand (Lee, et al.,

2011). Moreover, water conservation practices have been proven to be effective regarding saving

water (Lee, et al., 2011). For example, low-flow toilets (1.28 gallon/flush, GPF) can save 23.8
 21

gallons/household/day (GPHD), low-flow showerheads (1.5 gallons/minute, GPM) can save 12.1

GPHD, and Front-loading clothes washers can save 27.9 GPHD (Lee et al., 2011).

Regarding outdoor water consumption such as yards irrigation, rain can reduce outdoor

water use (Lee, et al., 2011. However, as the literature review mentioned, rainfall is low in Saudi

Arabia (Mohorjy & Grigg, 19957; Al-Zahrani & Baig, 2011; DeNicola et al., 2015;

Chandrasekharam et al., 2017). One study found that controlling outdoor irrigation systems

along with the adoption of water conservation practices indoor had a significant impact on water

demand (Lee et al., 2011). Also, considering drought-resistant plants could contribute to water

reduction (Abdulrazzak & Khan, 1990). Therefore, addressing water conservation application in

households whether indoor and outdoor activities is very important. Our household survey will

look at some activities both indoor, such as taking shower, and outdoor such as irrigation

methods to water yards.

Water conservation methods are essential regarding planning a strategy to achieve a

balance between the increase in water use and the increase in water demand (Al-Ibrahim, 1990).

There were two types of water conservation means; first, those means that aim to effectively

utilize water such as water recycling and minimizing water leakage (Al-Ibrahim, 1990). The

other type means that reduce water consumption such as water metering, water saving tools, and

reasonable pricing (Al-Ibrahim, 1990). Both of these types are essential to be applied in Saudi

Arabia to meet water demand based on the available resources (Al-Ibrahim, 1990).

A study was conducted in China found that water consumption was higher by female

users than male users (Tong, Fan, & Niu, 2017). Nonetheless, Females practiced more water

conservation methods than males because they want to reduce water bills. Whereas male chose

to use water conservation methods to mitigate water shortage (Tong et al., 2017). Our study
 22

targets women as they are responsible for most households’ activities such as cooking, dishes,

and laundry.

There has been progress in terms of improving water management in Saudi Arabia

according to the National Report for the United Nations Conference on Environment and

Development (UNCED) (Mohorjy & Grigg, 1995). This progress was done by the Ministry of

Agriculture and Water that made regulations such as monitoring system for groundwater, the

compulsion of water-saving methods in large establishments, providing housing complexes with

information, and guidance to irrigate their lawns with treated wastewater (Mohorjy & Grigg,

1995).

Moreover, Water and Electricity (MOVE) established a strategy called National Water

Strategy (NWS) to address water sustainability. This strategy included a Four-Stage program as a

step toward water conservation practices (Ouda, Shawesh, Al-Olabi, Younes, & Al-Waked,

2013). The first stage, of the four-stage program, aimed to distribute water conservation tools, for

free, among households. There were about 34 million conservation tools which included water-

saving showerheads and faucets, replacement bags for toilet-tank-bank, and pills to detect water

leaks. The second stage focused on the installation of water conservation in public places such as

schools, mosques, and airports. The third and the fourth stages were concerned with water

conservation application in private sectors, such as hotels and rental apartments (Ouda et al.,

2013). Additionally, the government established an exhibition for women to educate themselves

about water conservation practices and their importance in terms of water sustainability (Ouda et

al., 2013). This step is very important since women in this culture are more responsible for the

household’s resources.
 23

In addition, the Council of Ministries passed regulations to conserve more water, such as

the reduction of wheat and fodder for local productions (Ouda et al., 2013). According to the

Saudi Arabia’s Ninth Development Plan, the reduction in agricultural activities had resulted in

less groundwater consumption, for instance, in 2004, water consumption decreased from 20.3

billion m³ to be 18.5 billion m³ in 2009 (Kajenthira et al., 2012). In order to provide wheat

without cultivation inside the country, the Saudi Agricultural and Livestock Investment Co

(SALIC), which was constructed to address sustainable food security, had an agreement with the

Canadian Wheat Board to export a certain amount of its crop to Saudi Arabia (DeNicola et al.,

2015). Furthermore, agreements have been considered with other countries (DeNicola et al.,

2015; Hellegers et al., 2013) Ukraine and other countries, in South America and Asia, to allow

the Saudi government to grow its own food in these countries and then export it back as a plan to

fully outsource food production (DeNicola et al., 2015). This practice is known as virtual water

where water is imported in a form of food (DeNicola et al., 2015).

Despite all these efforts, it seems that there is still underachievement regarding water

conservation practice in Saudi Arabia at the household level.

Household’s water use in Saudi Arabia tends to be inefficient (Al-Ibrahim, 1990). Many of

these households lack water meter instruments despite the efforts that have been done by the

government in terms of providing pipes and installing these meters (Al-Ibrahim, 1990). The use

of water meters enables households to use 50% less water than households that have no access to

this instrument in their homes (Al-Ibrahim, 1990). Moreover, the household’s water leakage

caused a massive loss of water (Al-Ibrahim, 1990; Chowdhury & Al-Zahrani, 2013). In Saudi

Arabia, there was a loss of about 50 % of water due to leakage in Madinah, more than 50% in

Riyadh and Jeddah (Al-Ibrahim, 1990), and about 70% loss of water in other cities (Al-Zahrani
 24

& Baig, 2011). Maintenance of pipe and leakage monitoring tools should be improved,

especially since the climate in Saudi Arabia could cause more corrosion of water pipes (Mohorjy

& Grigg, 1995). Lee et al., 2011 found that the application of high-efficiency toilets save water

significantly while also can reduce water leaks since toilets could contribute to water leakage in

households.

As the literature review suggested, it seems that water conservation is poorly applied by

different users, due to this, it became very important to investigate water methods application.

Expanding knowledge about water conservation practices could provide recommendations to

policymakers to establish regulations regarding the importance of water conservation and

enforcement of these regulations. Our study will focus on households’ adoption of water

conservation methods.
 25

Chapter 3: Methodology

I. Study Design and Data Collection

The data collection took place in Riyadh city, the capital of Saudi Arabia during

December- January 2018/2019. Riyadh is located in the center of Saudi Arabia and it is the most

populated city in the country. In 2017, the population was 8.2 million (Al-Ibrahim, 1990);

additionally, most of the water-related organizations are located at Riyadh.

Quantitative data for this study was collected through a household survey. It comprised of

fourteen closed-ended questions (see table 2). The survey was written in both Arabic and

English; however, all the participants chose to take the survey in Arabic. The translation was

done by the graduate student author as she was an Arabic native speaker.

The survey questions focused on understanding participants’ views on the use of water,

the type of water that households could access, water conservation methods, the knowledge of

household members regarding water resources in their area, knowledge of impact of climate

change on water resources, and health outcomes that were related to water use in the households.

The target population was women between 18 - 89 years old. A focus on the women in this study

is justified considering that women in the community are primarily responsible for the use of

water in the household. Women also play an important role in preparing food and taking care of

household members during sickness.

Table 2: Household Survey.

1. How many people do live in your house?

• 2-5
• 5-8
• Up to 8
 26

2. Do you have a different type of water for each use, for example, do you have water for
Drinking and water for bathing, or do the water in your house is used for everything?
• I have different type of each use.
• I have one type that is used for all things (e.g., bathing, drinking... etc.)
• I do not know

3. How is water delivered into your house?

• Municipal tap water system
• Water truck
• Go and fetch water
• I do not know

4. Do you have any water-conservation methods such as low-flow showerheads or water-

efficient appliances? If no, why
• Yes, one or two
• Yes, I always consider all kind of water-save appliances / devices
• No, because I am not aware of them
• No, because they are expensive
• No, I do not know why I did not think of them.

5. If you answer was No for the previous question, would you consider any water-saving
devices/appliances in the future?
• Yes
• No

6. On average, do members in the household take shower in

• 10 minutes or less
• 20 -40 minutes
• More than 40 minutes.

7. Do you think your water use in the household has decreased or increased in the last five
or ten years? if yes, why?
• Decreased, because the use of water conservation method
• Decreased, because the number of residuals decreased
• Increased, because the number of residuals increased
• Increased/decreased no idea why.
• I have not noticed if it was decreased or increased.

8. Do you use water to grow plants or vegetables in your backyard? if yes, how do you
water them? Do you practice any water conservation methods for this purpose?
• Yes, I use the tradition liberal irrigation, but I do not practice any water
conservation methods
• Yes, I use sprinkles/ drip system
• Yes, I collect the water that is used to wash vegetables/fruit
• No, I do not have a garden or a backyard that need to be watered.

9. Are you aware of the limited are water resources in your region or the entire country?
• Yes
• No

10. Are you aware of climate change and its potential impacts on water resources in the
country?
• Yes
 27

• No
• Not much

11. Have you been taught at school about water-related disease, water resources in Saudi
Arabia, water scarcity, or water-conservation methods?
• Yes
• No

12. What do you think of the quality of the drinking water that you have access to, is there a
chlorine taste, for example?
• Good
• Has a distinctive odor / taste
• I do not know

13. Do you or any member of your family suffer from skin / eye irritation frequently
especially after washing your/their face?
• Yes
• No
• I have not noticed

14. Have you or any member of your family suffered from water-borne diseases such as
cholera, Hepatitis, or polio last two months?
• Yes, many times
• Yes, once
• No
• I do not know

In addition, the researcher used structured interviews to collect data from a doctor at the

King Faisal Specialist Hospital & Research Center. The interview with the doctor was meant to

qualitatively understand the history of water-related diseases in the country, what most common

diseases were, and what kind of intervention the Health Ministry provided in regard to water and

its impact on human health. However, the doctor wanted to only answer the question on her own

without being interviewed. The interview questions were listed in table 3 below.

Table 3 Interview questions.

Can you talk about water-related diseases history in the kingdom?

Have you seen cases that were a result of poor water quality or scarcity recently?

What are some waterborne diseases you anticipate that could be seen in the?
kingdom in the coming years?
 28

What are some interventions that might be considered by the health ministry when?
it comes to water and its impact on health?

II. Recruitment and Sampling Methods

The recruitment method was via flyers 13 that were supposed to be posted on the bulletin

boards in King Saud University for Female and Al Ghad International Colleges for Applied

Medical Science in Riyadh. However, King Saud University did not post anything on the bulletin

boards, instead, they posted it through email to all the students who enrolled in this school while

Al Ghad International Colleges for Applied Medical Science allowed the flyer to be posted on

their bulletin boards. The flyer included information about the study and participation eligibility

criteria: participants should be female aged 18 -89, and participants should answer all fourteen

questions. In addition, the flyer included the title of the study and the purpose of it, the

predictable time that participants might need to take the survey, and the contact information of

the researchers: the principal investigator and the graduate student.

It was mentioned in the flyer that participants could take the survey in person at their

preferred places; however, all the participants only wanted to take the survey via email and

emailed it back to the graduate student. The participants were asked to answer all the questions,

as it was mentioned above, in order to include their answers in this study. Therefore, one

participant was excluded because she did not answer all fourteen questions.

The King Saud University was chosen due to its popularity and also it was a government

school, whereas Al Ghad International Colleges for applied Medical Science was a private

school, so the data would include different socioeconomic statuses.

13 See Appendix
 29

The sampling method that was used was non-probability samples, where no guarantee

that the population would have non-zero chance to be chosen. In addition, the non-probability

sampling method was a voluntary sample where participants selected themselves to be a part of

this study. Not all people were willing to participate due to some misconception about

participating in research. Therefore voluntary sample seemed the best method for this study and

seemed to be the most familiar method to the public who feels comfortable participating in this

kind of method.

The total sample size was 20, although there were 21 participants, one of them was

excluded as mentioned earlier, therefore, the sample size in total was 20. Before the participants

took the survey, a consent form 14 was emailed to them and they were asked if they understood

the content to ensure their comprehension, then the survey was emailed to them. The consent

was written in Arabic and also in English, however, again, all participants signed the Arabic one

and emailed it with the answered survey. The consent included information such as the purpose

of the survey, what they would be asked and for how long, the potential benefit, that it is

voluntary, confidentiality, and the contact information for the principal investigator, the graduate

student, and the institutional review board (IRB) at OSU.

III. Instrumentation

All data were tabulated into an Excel spreadsheet. The data was then summarized into

percentages for effective comparison. Considering the small sample and the use of a non-random

sampling strategy, no statistical tests of significance (e.g., t-test, z-test, or ANOVA test) were

performed. RStudio was used to visualize data producing bar graphs. The interview with the

14 See appendix
 30

doctor from the hospital also was summarized and no graph was needed to visualize it since it

was only one participant.

 31

Chapter 4: Results

I. Households Survey

A total of 20 households voluntarily participated in this survey that consisted of fourteen

close-ended questions. All the participants were women; however, not all of them were Saudi,

some of them were Egyptian and Sudanese, some of them were professors from Al Ghad

International Colleges for applied Medical Science.

The results were grouped into main categories: water use and human health and water

conservation implication.

Water and Human Health

In response to the first question of the survey about how many people lived in

households, 80 % of the answers were two to five residents, and 20% were five to eight people.

In regard to the water type 15 that families had access to, 90% of the households reported that

they had different types of water for different uses, for example, cooking, bathing, drinking...

etc.; whereas 10% said that they had only one type that was used for all purposes, figure 3.

FIGURE 3 WATER TYPE

15 Water sources such as tap water or bottled water.

 32

The results showed that there were different ways to get water delivered to households

(see fig 4): 60% of the households answered that they got their water by municipal tap water

system, 25% of households had to go and fetch their water themselves, 5% said that water was

delivered by water truck, 5% got access to the municipal tap water system and also by water

truck, and another 5% got water by municipal tap water system and also had to go to fetch water.

FIGURE 4 WATER DELIVERY METODS

The duration of taking a shower was relatively high in most of the households where 70%

of the households spent on average about 20 to 40 minutes to take a shower, 25% spent 10

minutes or less, and 5% spent more than 40 minutes as figure 5 shows.

FIGURE 5 SHOWER DURATION

 33

To have an idea about whether water use, in general, had increased or decreased (figure

6), 35% of the households responded that their water use had increased due to the increase in the

number of families’ members. Additionally, 10% thought that their water use had increased but

they did not know what caused that increase. On the other hand, 20% of the households reported

that water consumption had decreased because the families members had decreased, 5%

answered that the water use decreased because the use of water conservation method, and finally

30% of the households said that they did not notice if their use of water had increased or

decreased.

According to this finding, it seemed that there was an association between the increase or

decrease of family members and the water consumption in the households, where 55% reported

an increase/ decrease in their use of water due to the increase/decrease of families’ members.

FIGURE 6 WATER DEMAND

 34

In response to the water quality in households, it seemed that water quality was relatively

good in most of them; for example, 70% of participants reported that the quality was good, 15%

found that the water had distinctive odor /taste, and another 15% did not have any idea about

water quality in their households, see figure 7

FIGURE 7 WATER QUALITY

Regarding negative health outcomes that occurred during the last two months (October

and November 2018) due to the water quality in the households such as cholera, or hepatitis,

95% (see figure 8) of the households reported no cases of such diseases; while 5% did not know

whether such diseases had occurred.

FIGURE 8 HEALTH OUTCOMES

 35

Despite that there were no serious cases of illness due to the quality of water, there were

few cases of eye or skin irritation. 20% of the households suffered such outcomes that occurred

frequently especially after washing their faces with water, 75% had not experienced such

irritation, and 5% had not noticed any irritation as it is shown in figure 9.

FIGURE 9 EYE/SKIN IRRITATION

Water Conservation Implication

In terms of water conservation methods 16, 70% of the households did not use any of

these methods for different reasons. Moreover, 30% answered with yes, 67% of them said that

they always considered all kind of water-save appliances/devices, for example, as means to

conserve water in the households, and 33% used one or two of these appliances /devices.

There were some reasons that households did not use any methods to conserve water

(figure 10), out of the 70% of households who did not use water conservation methods, 57% of

them answered that they did not know why they had not thought about them. Furthermore, 36%

16 See table 2
 36

said that their reason was that they were not aware of such methods, and 7% answered that water

conservation methods were expensive.

In response to the possibility of future consideration of adopting conservation methods,

79% of the households who did not use conservation methods answered that they would consider

these methods in the future, whereas 21% reported that they would not consider utilizing any of

these methods in the future.

FIGURE 10 CONSERVATION METHODS APPLICATION

In regard to what kind of irrigation methods were practiced to water garden/lawn, the

result showed that 75% of the households had neither a garden nor a lawn, and only 25 % had a

garden. 60 % of those who had a garden reported that they used the traditional liberal irrigation 17

methods and they did not use any of water conservation methods, whereas 40% used

sprinkle/drip irrigation methods.

17Water is pumped from wells, artesian wells or spring and then water runs through open ditches (Al-Ibrahim,
1990)
 37

The knowledge of the available water resources in an area could encourage the rational

use of water. In this study, 85% of the households did not have any knowledge about the water

resources in their area, while only 15 % had knowledge of the available resources, figure 11.

FIGURE 11 KNOWLEDGE OF WATER RESOURCES

In addition to the knowledge of the available water resources, participants were asked

about their apprehension of climate change and its potential impacts on the water resources. The

research results showed that there was not an adequate knowledge of such topic (figure 12),

where 45 % answered not much, and 20 % of them did not know anything. On the other hand,

35% did have knowledge of climate change and its possible implications on water resources.

FIGURE 12 KNOWLEDGE OF CLIMATE CHANGE

 38

The study showed that there was apparently some focus on water-related topic in school

curriculum where 75% participants said that were taught about the water-related topics and

water-related disease at school while 25 % were not taught any of that at school.

II. Structured Interview

The second part of this study was a structured interview with a doctor form King Faisal

Specialist Hospital & Research Center, this interview meant to be a structured interview;

however, the doctor that was interviewed preferred to answer the question on her own due to her

tight schedule. In response to the question about the history of water-related diseases in the

country, the doctor said that she had not seen a lot of water-borne diseases cases that occur due

to either poor water quality or water scarcity across the country.

In response to potential waterborne diseases that might be seen in the country in the

future, the doctor did not think that there would be such diseases cases soon due to the clean

water that people could access to and also due to the continuous government improvements of

the water service such as water conservation and water sterilization. The doctor reported that

there were some interventions by some organizations such as the Health Ministry, for instance,

some campaigns that aimed to raise awareness about these disease among patients and their

families. In addition, the provision of outreach to raise awareness about any water-related issues

and provision of some possible solutions.

 39

Chapter 5: Discussion

The objectives of this study were: 1. to understand the use of water at the household

level. 2. To examine water conservation practice within the household. And 3. To understand

health outcomes that household members might suffer from due to either poor water quality or

water scarcity. The research focused on understanding water conservation strategies that the

households may be adopting and the health consequences of poor water quality and quantity.

I. Water Conservation Implication

The Saudi Arabian government has been trying to secure water to meet the needs of the

people. Efforts in this regard suggest that the national government recognizes water scarcity as

an important policy issue and focused on new water resources such as seawater desalination,

wastewater treatment, and fog/rain harvesting. However, and in order to achieve more success

and sustainability, in terms of water security in Saudi Arabia, residents of the country will need

to be more cooperative with the government efforts. People could reduce their water use, or

adapt water conservation strategies, including the use of 81/min faucets instead of a 151/min

faucet, 121/flush toilets with 61/ flush toilets, or 221/min shower heads with 101/min ones.

Further, People should consider replacing their 50 gallons/load washing machines with 22

gallons/load washing machines, all these devices could save about 50% of water (Chowdhury &

Al-Zahrani, 2013). Additionally, manual taps should be replaced with sensorial taps to save more

water (Chowdhury & Al-Zahrani, 2013). Households should be checked for any water leaks and

fix water pipes, which would reduce water wastage by 20% (Kajenthira et al., 2012). According

to the US Environmental Protection Agency (EPA), a daily loss of one gallon of water can occur

due to small leaks (“Start Saving,” n.d).

 40

This study suggests that families were not making sufficient efforts to conserve water.

Nearly 70 % of the households who participated in the study, did not any method for water

conservation, which is higher than a study was conducted in Al-Khobar where 43% of

participant did not practice water conservation methods (Ouda et al., 2013). Majority of the

households spent 20-40 minutes taking a shower. This shower time is about three-fold to five-

fold longer than the average shower time in the United States, which is 8.2 minutes (“Residential

Shower,” n.d).

Although we did not calculate the predicted quantity of water that would be used during

a long shower, the Alliance for Water Efficiency conducted a study in the United States to

calculate the amount of water that could be used during different duration and methods as table 1

shows. The duration of 20 - 40 minutes ranks between wasteful to extreme wasteful, mostly

extreme wasteful, regardless of the device types except for the tub half-full type. Also, it shows

that the quantity of water that could be used during 20 minutes of a shower with 6.0 GPM

showerhead is 120 gallons and 180 gallons for 30 minutes shower. Furthermore, the Alliance for

Water Efficiency study found that taking a shower was the third indoor activity that consumed

the most of water in households (“Residential Shower,” n.d).

TABLE 4 THE ESTIMATE WATER QUANTITY THAT COULD BE USED DURING A SHOWER WITH DIFFERENT PERIODS OF
TIMES AND DIFFERENT DEVICES, (“RESIDENTIAL SHOWER,” N.D).
 41

As the results showed that 70% of households did not use water conservation methods

for different reasons. About 57 % of them said that they did not know why they did not consider

these method, 75% of them were not aware of how limited the water resources are in their area.

Further, 50% of them reported knowledge of climate change; however, 75% of them were taught

in school about water-related diseases, water resources in the country, water scarcity, or water-

conservation methods.

Another reason was the lack of awareness of water conservation methods. Nearly, 36%

of the household members who did not use water conservation methods were not aware of these

methods. In addition, all of these households had no idea about the water resources in their area.

Furthermore, 60 % of them said they had all of them had zero knowledge about climate change

and its potential impacts on water resources and 40 % said they did not know much about such a

topic. However, 60% of them said that were taught in school about topics such as water-related

diseases, water resources in Saudi Arabia, water scarcity, or water-conservation methods.

Therefore, it is possible that the material they were taught might not cover or inadequately cover

the water conservation methods, climate change, and water resources.

On the other hand, 30 % of households said they did use water conservation methods;

about 67% of them reported that they always considered all different types of water-saving

appliances/devices as methods to conserve water. Members in these households learned about

water conservation in school, especially about water-related diseases, water resources in Saudi

Arabia, water scarcity, or water-conservation methods. However, household members expressed

little knowledge about climate change and its impacts on the available water resources in their

area. Therefore, one can argue that the variation between those who did not use any methods and

those who always used them in terms of being taught at school, might be attributed to different
 42

curriculums that different schools offered, or maybe those who always used methods to save

water were self-taught in addition to what they were taught in school. Further, 33% of those who

utilized water conservation methods reported that they used one or two methods. A study in

China found that when households used more types of water conservation, their water

consumption decreased significantly than those households who used one type (Lee et al., 2011).

Thus, the number of water conservation methods practiced could play a huge role in water

demand.

Results of this study indicated that among 70 % of the participants who did not use water

conservation, 21 % of them said they would not consider using water-saving devices/appliances

in the future (see figure 13). Those participants were not aware of the water resources in their

area and all of them spent 20 - 40 minutes taking a shower. That could mean that the wastage of

water would continue in the absence of any intervention or water conservation

education/programs. This is a critical issue considering that water resources are extremely scarce

in Saudi Arabia. A fully understanding of water resources in the country would reinforce water

sustainability which is an essential aspect to consider in future management in the country

(Chowdhury & Al-Zahrani, 2013).

FIGURE 13 WATER CONSERVATION METHODS APPLICATION IN FUTURE

 43

The Saudi Arabian government has made efforts to recognize the importance of water

conservation. For example, the National Water Company (NWC) offers a free water

conservation kit, including showerheads, tap heads, and toilet tank-bank as figure 14 shows.

These tools could be installed by household individuals (“Water Conservation,” 2017). However,

it seems that there has been a failure by households where our study showed that about 5% of the

households did not use any water saving tools due to high cost. In addition, this research found

that 25% of the households had a garden/lawn; 60% of them used the liberal irrigation method

while 40 % used the sprinkle/ drip irrigation method. These findings are similar to the findings

by other researchers that liberal irrigation methods were more popular among farmers where

35% of lands were being irrigated by using this method (DeNicola et al., 2015). Liberal irrigation

leads to more water use than the crops/plants actually need, resulting in water wasting and

potential damage to crops/plants growth due to the excess amount of water (Al-Ibrahim, 1990).

FIGURE 14 WATER CONSERVATION KIT (“WATER CONSERVATION,” 2017).

 44

It is evident from this study that the households are not making enough efforts to

conserve water or use it more efficiently. The lack of cooperation by individuals would expand

the gap between the available water and water demand in the country. Especially, since Saudi

Arabia is one of the driest regions in the world (Al- Zahrani & Baig, 2011), where there are no

major water resources such as lakes or rivers (Al-Ibrahim, 1990; Rambo et al., 2017; Ouda,

2013; DeNicola et al., 2015; Chandrasekharam et al., 2017). In addition, Saudi Arabia has been

designated as a region of the world that is most vulnerable to climate change (DeNicola et al.,

2015). Therefore, it is imperative that the country’s government and people engage in water

conservation activities and consider water as a finite natural resource.

Furthermore, this study suggests that the public is depending on the government and

assumes that the government is capable of providing enough water to meets all household water

needs. A comprehensive awareness program that is focused on ensuring the sustainability of

current water resources in Saudi Arabia is more critical than ever. So the public can take the

initiative and cooperate more with governmental efforts.

II. Water and Human Health

Much of the literature (Elhadj 2004; Al- Zahrani & Baig, 2011; Ouda, 2013; DeNicola et

al., 2015) suggests that the domestic use of water in Saudi Arabia has increased for many reasons

such as the increase in the population growth (Chowdhury & Al-Zahrani, 2013; DeNicola et al.,

2015). The results of this study concurred with that finding, where 45% of the households

reported an increase in their water consumption. 77% of those households attributed that increase

to the increase in the number of members per household. Furthermore, there was a lack of

knowledge of available water resources among most of the households where 85% of them

answered “No” to the question “Are you aware of the limited water resources in your region or
 45

the entire country?” Moreover, households were not adequately aware of climate change and its

impacts on water availability, 45% of them had a relative knowledge of this topic and 20 % did

not know anything. Sufficient comprehension of the available water resources and climate

change might encourage people more towards rational use of water and/or use water-saving

tools, especially since Saudi Arabia is part of the Gulf Cooperation Council countries that are the

most countries that are vulnerable to climate change according to the United Nations (DeNicola

et al., 2015).

Regarding the health outcomes and water scarcity, the results of this study suggest that

household members did not consider the health impact of water scarcity as a serious issue.

Nearly 95% of the households reported no cases of diseases, such as cholera or hepatitis. This

serves as a proxy indicator of the good quality of household water. Additionally, the results from

the interview concurred with the households’ survey in terms of health outcomes. A doctor from

King Faisal Hospital, who participated in the study, reported that she had not seen water-borne

cases and that is due to the water quality improvement. There were a few cases of eye/skin

irritations (about 20%); however, the study did not investigate whether water was a causal or

associated factor of those skin/eye irritation cases. Some participants in our study reported that

household water had a distinctive odor/taste, none of them experienced eye/skin irritation.

Therefore, it is possible that instead of water there was another cause of skin and eye irritation,

especially that all of the households who experienced that kind of irritation reported a good

quality of water.

Finally, Our study was conducted in the capital Riyadh, and as the research results

showed, the overall quality was good, however, a study in Nijran, showed a poor quality of water

where people rely on well water and also use roof tankers as a method to store their water
 46

(Alqahtani et al., 2015). The water services in Riyadh are usually more advanced than other

cities, so it is possible that water quality would not be as good as what our study found among

other cities and it is possible that there would some health outcomes due to water quality.

III. Limitation:

This study had many limitations such as difficulties to interview officials from some

organizations such as Environment, Water and Agriculture Ministry, and National Water

Company due to time constraints. Additionally, the study was designed to get more data about

the prevalence of water-borne diseases to understand how water impacts health. However, we

could not access the database where the graduate student had to have an appointed hospital

advisor which was not feasible, again due to the time constraints.

Furthermore, the study design did not guarantee that all people had the same chance to be

included. Initially, simple random sampling was considered by accessing household lists to

assign them with numbers, then choose randomly every 5th households, for example, to be asked

to participate. However, an official accessing to the households list was not easy to be obtained

due to time constraint. Moreover, the flyer was posted at a school environment, therefore, it is

possible we missed women who did not go to school or had no connection to the school. .

Additionally, since the graduate student was not able to interview officials, the household survey

was changed to include more questions, thus, there were two data collections, and only the

second data collection was used for this research. The first data took place during summer 2018

in Riyadh city
 47

Chapter 6: Conclusion

The purpose of this study was to explore the water use among households and whether

they apply water conservation methods. In addition, the study looked at humane health outcomes

in regard to water-borne diseases due to the exposure to households’ water. The research

questions were: 1) Are households making efforts to save water, for example, adopting water

conservation methods and/ or reduce the use of water? 2). Are there health outcomes that might

occur due to poor water quality or water shortage?

The results showed that there were not enough efforts were made by most of the

households to conserve water. This research showed the most of the households did not use

methods to save water for several reasons. Further, the study showed that there was some

resistance to water-saving methods where some households answered “No” to the question

“Would you consider any water-saving devices/appliances in the future?” In addition, a large

portion of participants reported that their shower time could be 20 -40 minutes.

Regarding water use impact on human health, our study found that households’ health

was good where there were no water-borne diseases cases such as cholera, or Hepatitis cases due

to the exposure to water. Despite good overall health, the results found that there were some

eye/skin irritation cases that a few of the households suffered from. The study did not look if the

water was the cause of these irritations or not, thus it could be concluded that there could be

another reason for these eye/skin irritation cases. Moreover, we found that water use had

increased among many households, where some of them said that increase was due to the

increase in family’s members. Likewise, some of the households reported a decrease in their

water consumption due to the family’s members’ decrease. Furthermore, the study found that the
 48

overall water quality was good, where a large percentage of households stated that the quality,

however, a handful of households said there was a distinctive odor /taste in their water.

Implications and Recommendations

This study opens many possibilities for future research that could be conducted in other

cities that have similar circumstances in terms of climatic condition, availability of renewable

water resources, or /and rapid population growth. Broader implication for water conservation

applications is an important research possibility in connection to this research. As the results

showed that there was not an application of water conservation method by most of the

participants, thus, these methods should be mandatory in every household, organizations, and

public places in this survey area.

As the study showed that most households reported a lack of knowledge regarding the

available water resources in the country. Furthermore, while some households had some

knowledge of climate change and its influence on water resource, there were those who did not.

Therefore, schools curriculum should be improved to cover more topics such as water resources

in the country, how climate change and other factors impact these resources, the need of rational

use of water, the potential diseases that could occur due to the exposure to water, and the

possible negative impacts of other alternative water resources such as seawater desalination

whether on the marine life and/or the environment. Our study suggests that there should be

further future research on the education system and awareness campaigns improvement.

Moreover, the literature and our study (Chowdhury & Al-Zahrani, 2013; Aljoufie &

Tiwari, 2015; Rambo et al., 2017, and DeNicola et al., 2015) indicate that the population growth

rate is increasing which would lead to Overpopulation. Overpopulation impacts many aspects

while there has been a strong association between human activities and environmental issues
 49

such as climate change, contamination, and shortage of water, and air pollution (Peacock, 2018).

Therefore, this study recommends future research on controlling overpopulation as a solution for

many environmental issues such as water shortage which might trigger wars or conflicts over

water resources which were anticipated to happen in the future at a local level if no interventions

are performed (DeNicola et al., 2015).

Further, some of the participants in our study reported that they did not consider

practicing water conservation methods in the future. However, our study did not investigate the

rationale behind that; thus, future research is recommended to navigate the reasons and provide

solutions. This research results showed that more than half of participants who had yard/lawn

used a liberal irrigation method which is an extremely wasteful method. Also, our study did not

explore the agricultural use of water; however, the literature stated that it is the largest user of

water in Saudi Arabia (Chowdhury & Al-Zahrani, 2013; Kajenthira et al., 2012). Thus, further

research on irrigation methods whether at agricultural sector level or household level is

necessary.

Additionally, there should be more studies done to investigate water quality, especially

Riyadh has frequent dust storm events. Our study did not examine the impact of these dust

storms on water quality. However, dust and leaves can serve as organic matter that would

nourish some enteric bacteria in water tanks such as Salmonella spp, and E.coli (Saati & Faidah,

2013). Therefore, there should be more research on dust impact on water quality. In addition, the

eye/skin irritation cases were not proved to be due to water quality in our study; therefore, future

research is recommended to investigate the cause of these eye/skin irritation cases.

Finally, although we did not investigate the impact of fossil fuel, the literature showed

many of these consequences (Aljoufie & Tiwari, 2015; Chandrasekharam et al., 2017).
 50

Therefore, more renewable energy research should be considered to reduce the use of fossil fuels

to alleviate climate change, especially, Saudi Arabia’s location is suitable for generating solar

energy where there are about 3,245 sun shines received in the country per year ( Rambo et al,

2017). Furthermore, the impacts on marine life due to the desalination process has not been

further investigated, thus, it is essential to conduct more research in this regard.

 51

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receiving improved water supply: A gender-based analysis. ScienceDirect. Retrieved

from https://www.sciencedirect.com/science/article/pii/S0959652616315104

Water conservation tools. (2017). Ministry of Environment, Water, & Agriculture Twitter.

Retrieved May 25, 2019 from

https://mobile.twitter.com/MEWA_KSA/status/829388026598060033
 ‫‪56‬‬

‫)‪Appendix A: Consent Form (Arabic‬‬

‫ﻋﻨﻮان اﻟﻤﺸﺮوع‪ :‬اﺳﺘﺨﺪام اﻟﻤﯿﺎه ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﯿﺔ اﻟﺴﻌﻮدﯾﺔ وﺗﺄﺛﯿﺮھﺎ ﻋﻠﻰ ﺻﺤﺔ اﻹﻧﺴﺎن‬
‫ﺑﺎﺣﺚ رﺋﯿﺴﻲ‪ :‬ﺳﻮﻧﯿﻞ ﺧﺎﻧﺎ‬
‫ﺑﺎﺣﺚ طﻼﺑﻲ‪ :‬اﺷﻮاق اﻟﻌﻤﺮي‬
‫‪ 2018‬ﺗﺎرﯾﺦ اﻹﺻﺪار ‪ 3‬دﯾﺴﻤﺒﺮ‬
‫________________________________________‬

‫اﻟﻐﺮض ﻣﻦ اﻟﺪراﺳﺔ‪ :‬أوﻻ ھﺬه دراﺳﺔ ﺑﺤﺜﯿﺔ ﻹﻛﻤﺎل رﺳﺎﻟﺔ ﻣﺎﺟﺴﺘﯿﺮ‪ .‬اﻟﻐﺮض ﻣﻦ ھﺬه اﻟﺪراﺳﺔ ھﻮ ﻓﮭﻢ اﺳﺘﺨﺪام اﻻﺳﺮ ﻟﻠﻤﯿﺎه‬
‫وﺗﺄﺛﯿﺮھﺎ ﻋﻠﻰ ﺻﺤﺔ اﻹﻧﺴﺎن ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﯿﺔ اﻟﺴﻌﻮدﯾﺔ‪ .‬ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ‪ ،‬ﻟﻔﮭﻢ ﻛﯿﻒ ﺗﻤﺎرس اﻟﻨﺴﺎء أﺳﺎﻟﯿﺐ اﻟﺤﻔﺎظ ﻋﻠﻰ‬
‫‪.‬اﻟﻤﯿﺎه ﻓﻲ ﻣﻨﺎزﻟﮭﻦ‪ ،‬وﺧﺎﺻﺔ ﻓﻲ أوﻗﺎت ﻧﺪرة اﻟﻤﯿﺎه‬

‫اﻷﻧﺸﻄﺔ‪ :‬ﺗﺸﻤﻞ أﻧﺸﻄﺔ اﻟﺪراﺳﺔ اﻹﺟﺎﺑﺔ ﻋﻠﻰ ‪ 14‬أﺳﺌﻠﺔ ﺗﺮﻛﺰ ﻋﻠﻰ اﺳﺘﺨﺪام اﻟﻤﯿﺎه‪ ،‬وﻧﻮﻋﯿﺔ اﻟﻤﯿﺎه‪ ،‬وطﺮق ﺣﻔﻆ وﺗﻮﻓﯿﺮ‬
‫اﻟﻤﯿﺎه‪ ،‬وﻛﻢ ﻋﺪد أﻓﺮاد اﻷﺳﺮة‬

‫اﻟﻮﻗﺖ‪ :‬ﺳﺘﺴﺘﻤﺮ ﻣﺸﺎرﻛﺘﻚ ﻓﻲ ھﺬه اﻟﺪراﺳﺔ ﺣﻮاﻟﻲ‪ 5‬اﻟﻰ ‪ 10‬دﻗﺎﺋﻖ‬

‫اﻟﻔﺎﺋﺪة‪ :‬ﻧﺤﻦ ﻻ ﻧﻌﺮف ﻣﺎ إذا ﻛﻨﺖ ﺳﺘﺴﺘﻔﯿﺪ ﻣﻦ وﺟﻮدك ﻓﻲ ھﺬه اﻟﺪراﺳﺔ‪ .‬وﻣﻊ ذﻟﻚ‪ ،‬ﯾﻤﻜﻦ أن ﺗﻜﻮن ھﺬه اﻟﺪراﺳﺔ ﻣﻔﯿﺪة ﻟﻠﺒﻠﺪ‬
‫ﺑﺄﻛﻤﻠﮫ‪ ،‬ﺑﻤﺎ ﻓﻲ ذﻟﻚ أﻧﺖ‪ ،‬ﺣﯿﺚ ان ھﺬه اﻟﺪراﺳﺔ ﻗﺪ ﺗﺴﺎﻋﺪ ﻓﻲ ﺗﺤﺴﯿﻦ ﻧﻈﺎم اﻟﻤﯿﺎه ﻓﻲ اﻟﺒﻼد وﻧﺸﺮ اﻟﻮﻋﻲ ﻓﯿﻤﺎ ﯾﺘﻌﻠﻖ ﺑﺄﺳﺎﻟﯿﺐ‬
‫‪.‬ﺣﻔﻆ اﻟﻤﯿﺎه ﺑﯿﻦ اﻷﺳﺮ اﻟﺘﻲ ﻗﺪ ﺗﻔﯿﯿﺪك ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ‪.‬‬

‫اﻟﺪﻓﻊ او ﻣﻜﺎﻓﺌﺎت‪ :‬ﻟﯿﺲ ھﻨﺎك أي ﻣﺒﻠﻎ ﺳﯿﺘﻢ دﻓﻌﮫ ﻟﻚ ﻣﻘﺎﺑﻞ ﻣﺸﺎرﻛﺘﻚ ﻓﻲ ھﺬه اﻟﺪراﺳﺔ اﻟﺒﺤﺜﯿﺔ‪.‬‬

‫ﺳﺮﯾﺔ اﻟﻤﻌﻠﻮﻣﺎت‪ :‬ﻗﺪ ﯾﻌﻠﻢ أﺷﺨﺎص آﺧﺮون أﻧﻚ ﺷﺎرﻛﺖ ﻓﻲ ھﺬه اﻟﺪراﺳﺔ وﻟﻜﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﺗﻘﺪﻣﮭﺎ ﺳﺘﻈﻞ ﺳﺮﯾﺔ إﻟﻰ اﻟﺤﺪ‬
‫اﻟﺬي ﯾﺴﻤﺢ ﺑﮫ اﻟﻘﺎﻧﻮن‪ .‬ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ‪ ،‬ﻟﻦ ﻧﻀﻊ اﺳﻤﻚ ﻋﻨﺪﻣﺎ ﻧﻘﻮم ﺑﻨﺸﺮ اﻟﻨﺘﺎﺋﺞ إذا ﻛﻨﺖ ﻻ ﺗﺮﻏﺐ ﻓﻲ اظﮭﺎر ھﻮﯾﺘﻚ‪،‬‬
‫ﯾﻤﻜﻨﻨﺎ اﺳﺘﺨﺪام أﺳﻤﺎء ﻣﺴﺘﻌﺎرة ﺑﺪﻻً ﻣﻦ ذﻟﻚ‪ .‬ﺳﺘﺘﻢ إزاﻟﺔ اﺳﻤﻚ وﻛﻞ ﻣﻌﻠﻮﻣﺎت اﻟﺘﻌﺮﯾﻒ اﻷﺧﺮى ﻣﻦ ﺟﻤﯿﻊ اﻟﺒﯿﺎﻧﺎت ﺑﻤﺠﺮد‬
‫‪.‬اﻛﺘﻤﺎل ﺟﻤﻊ اﻟﺒﯿﺎﻧﺎت‪ .‬ﻟﻦ ﯾﺘﻢ اﺳﺘﺨﺪام أو ﺗﺠﻤﯿﻊ اﻟﻤﻌﻠﻮﻣﺎت اﻟﺘﻲ ﺗﻢ ﺟﻤﻌﮭﺎ ﻣﻨﻚ ﺧﻼل ھﺬا اﻟﺒﺤﺚ ﻓﻲ اﻷﺑﺤﺎث اﻟﻤﺴﺘﻘﺒﻠﯿﺔ‬

‫اﻟﺘﻄﻮﻋﯿﺔ‪ :‬اﻟﻤﺸﺎرﻛﺔ ﻓﻲ ھﺬه اﻟﺪراﺳﺔ اﺧﺘﯿﺎرﯾﺔ‪ ،‬وﻣﻊ ذﻟﻚ‪ ،‬ﺳﻮف ﺗﺤﺘﺎج إﻟﻰ اﻹﺟﺎﺑﺔ ﻋﻠﻰ ﺟﻤﯿﻊ اﻷﺳﺌﻠﺔ اﻻرﺑﻌﺔ ﻋﺸﺮ ﻟﻜﻲ‬
‫ﯾﺘﻢ ﺗﻀﻤﯿﻦ ﺑﯿﺎﻧﺎﺗﻚ‪ .‬ﯾﺮﺟﻰ ﻣﻼﺣﻈﺔ اﻧﮫ ﻓﻲ ﺣﺎل إﻧﻚ رﻓﻀﺖ اﻟﻤﺸﺎرﻛﺔ‪ ،‬ﻓﻠﻦ ﺗﻜﻮن ھﻨﺎك أي ﻋﻘﻮﺑﺔ‪ ،‬ﻛﻤﺎ ﯾﻤﻜﻨﻚ اﻟﺘﻮﻗﻒ ﻋﻦ‬
‫‪..‬اﻟﻤﺸﺎرﻛﺔ ﻓﻲ أي وﻗﺖ دون أي ﻋﻘﻮﺑﺔ‪.‬‬

‫ﻣﻌﻠﻮﻣﺎت اﻻﺗﺼﺎل‪ :‬إذا ﻛﺎن ﻟﺪﯾﻚ أي أﺳﺌﻠﺔ أو اﺳﺘﻔﺴﺎرات ﺣﻮل ھﺬا اﻟﻤﺸﺮوع اﻟﺒﺤﺜﻲ‪ ،‬ﻓﻼ ﺗﺘﺮدد ﻓﻲ اﻻﺗﺼﺎل ﺑﻨﺎ‪ .‬ﯾﻤﻜﻨﻚ‬
‫‪.‬اﺳﺘﺨﺪام إﻣﺎ اﻟﺒﺮﯾﺪ اﻹﻟﻜﺘﺮوﻧﻲ أو رﺳﺎﺋﻞ ﻧﺼﯿﺔ أو ﻣﻜﺎﻟﻤﺔ ھﺎﺗﻔﯿﺔ‪.‬‬
‫‪541-737-6405 Sunil.Khanna@oregonstate.edu‬‬
‫)‪ (CALL OR TEXT‬أو )‪+1 541-829-2437 (WHATSAPP‬‬ ‫‪،ALAMRIAS@OREGONSTATE.EDU‬‬

‫إذا ﻛﺎﻧﺖ ﻟﺪﯾﻚ أﺳﺌﻠﺔ ﺣﻮل ﺣﻘﻮﻗﻚ أو رﻓﺎھﺘﻚ ﻛﻤﺸﺎرك‪ ،‬ﻓﯿﺮﺟﻰ اﻻﺗﺼﺎل ﺑﻤﻜﺘﺐ ﺣﻤﺎﯾﺔ ﺣﻘﻮق اﻹﻧﺴﺎن اﻟﺘﺎﺑﻊ ﻟﺠﺎﻣﻌﺔ وﻻﯾﺔ‬
‫‪:‬ﻋﻠﻰ اﻟﺮﻗﻢ )‪ 8008-737 (541‬أو ﻋﺒﺮ اﻟﺒﺮﯾﺪ اﻹﻟﻜﺘﺮوﻧﻲ ﻋﻠﻰ اﻟﻌﻨﻮان اﻟﺘﺎﻟﻲ )‪ (HRPP‬أورﯾﻐﻮن‬
‫‪IRB@OREGONSTATE.EDU‬‬
‫ﺗﻮﻗﯿﻊ اﻟﻤﺸﺎرﻛﺔ ‪..............................‬‬
 57

Appendix B : Consent Form (English)

EXPLANATION OF RESEARCH

Project Title: Water Use in Saudi Arabia and its Impact on Human Health
Principal Investigator: Sunil Khanna
Student Researcher: Ashwaq Alamri
Version Date: December 3, 2018

Purpose: You are being asked to take part in a research study that is being conducted by a student for the
completion of a master thesis. The purpose of this research study is to understand water use in
households and its impact on humane health in Saudi Arabia. In addition, to understand how women
practice water-conservation methods in their houses, especially in times of water scarcity.

Activities: The study activities include answering 8 questions that focus on the use of water, quality of
water, conservation methods, and the numbers of household member.

Time: Your participation in this study will last about 5-10 minutes.

Benefit: We do not know if you will benefit from being in this study. However, this study could be
beneficial for the entire country, including you, in term of improving water system in the country and
spread awareness regarding water-conservation methods among households that would benefit you in the
future.

Payment: You will not be paid for being in this research study.

Confidentiality: Other people may learn that you participated in this study but the information you
provide will be kept confidential to the extent permitted by law.. Your name and your all other identifying
information will be removed from all the data once the data collection is complete. The information
collected from you during this research will not be used or distributed for future research.

Voluntary: Participation in this study is voluntary, however, you will need to answer all the 14th
questions in order for your data to be included Please note that if you refuse to participate, there will be
no penalty, also you can discontinue participation at any time without any penalty.

Study contacts: If you have any questions or concerns about this research project, please do not hesitate
to contact us. You can use either email, text, or call.
541-737-6405 Sunil.Khanna@oregonstate.edu
+1 541-829-2437 (WhatsApp) or (call or text), alamrias@oregonstate.edu
If you have questions about your rights or welfare as a participant, please contact the Oregon State
University Human Research Protection Program (HRPP) office, at (541) 737-8008 or by email at
IRB@oregonstate.edu

Participant Signature --------------------------------

 ‫‪58‬‬

‫)‪Appendix C: Recruitment Flyer (Arabic‬‬

‫اﺳﺗﺧدام اﻟمﯾﺎه ﻓﻲ اﻟﻣﻣﻠﻛﺔ اﻟﻌرﺑﯾﺔ اﻟﺳﻌودﯾﺔ‬

‫ﻗﺎدرا ﻋﻠﻰ اﻟﻣﺷﺎرﻛﺔ ﻓﻲ ھذا اﻟﻣﺷروع اﻟﺑﺣﺛﻲ‬
‫ﺣﺗﻰ ﺗﻛون ً‬
‫ﯾﺟب أن ﺗﻛون‪:‬‬
‫• إذا ﻛﻧﺗﻲ أﻧﺛﻰ ﺑﯾن ‪ 89 - 18‬ﺳﻧﺔ‪ ،‬ﻓﺄﻧت ﻣؤھﻠﺔ ﻟﻠﻣﺷﺎرﻛﺔ‬
‫ﻓﻲ ھذا اﻟﺑﺣث‪.‬‬
‫أﺳﺋﻠﺔ‪ •14.‬اﻟﻣﺷﺎرﻛﺔ ﻓﻲ ھذا اﻟﺑﺣث ﯾﺗطﻠب اﻹﺟﺎﺑﺔ ﻋﻠﻰ‬
‫• ﯾﻤﻜن اﺧﺘﯿﺎر اﻟﻤﻜﺎن اﻟﺬي ﺗﺸﻌﺮﯾن ﻓﯾﮫ ﺑﺎﻻرﺗﯿﺎح‪ ،‬وﻣﻊ‬
‫ذﻟك‪ ،‬ﺳﯾﻛون ھذا اﻷﻣر اﺧﺗﯾﺎرﯾًﺎ‪ ،‬وﯾﻣﻛﻧك رﻓض ذﻟك ﺑدون‬
‫أي ﻋﻘوﺑﺔ‪ ،‬وﯾﻣﻛﻧك اﻟﻣﺷﺎرﻛﺔ إذا أردت ذﻟك‪.‬‬
‫• ﻗد ﯾﺳﺗﻐرق وﻗت اﻟﻣﺷﺎرﻛﺔ ‪ 5‬دﻗﺎﺋﻖ اﻟﻰ ‪10‬‬
‫• ﺑﻣﺟرد أن ﺗﻘررﯾن اﻟﻣﺷﺎرﻛﺔ أو ﺗرﻏﺑﯾن ﻓﻲ ﻣﻌرﻓﺔ اﻟﻣزﯾد‬
‫ﻣن اﻟﻣﻌﻠوﻣﺎت‪ ،‬ﯾرﺟﻰ اﻻﺗﺻﺎل ﺑﻧﺎ ﻋﻠﻰ‬
‫أو ‪alamrias@oregonstate.edu 15418292437+‬‬
‫(‪ text.‬أو ‪) call‬أو )‪)WhatsApp‬‬
‫وﺗﺄﺛﯾره ﻋﻠﻰ ﺻﺣﺔ اﻹﻧﺳﺎن‬
‫اﺳﻣﻲ أﺷواق‪ ،‬أﻧﺎ طﺎﻟﺑﮫ ﻣﺎﺟﺳﺗﯾر ﻓﻲ ﺟﺎﻣﻌﺔ وﻻﯾﺔ أورﯾﻐون‪.‬‬
‫أﻧﺎ أﻗوم ﺑﮭذا اﻟﺑﺣث ﻟرﺳﺎﻟﺔ اﻟﻣﺎﺟﺳﺗﯾر واﻟﻐرض ﻣﻧﮫ ھو‬
‫دراﺳﺔ ﺗﺄﺛﯾر ﺷﺢ اﻟﻣﯾﺎه ﻋﻠﻰ ﺻﺣﺔ اﻷﻧﺳﺎن‪.‬‬
‫اﻟﺑﺎﺣث اﻟرﺋﯾﺳﻲ‪:‬‬
‫ﺳوﻧﯾل ﺧﺎﻧﺎ‪ ،‬ﺟﺎﻣﻌﺔ وﻻﯾﺔ أورﯾﻐون‪ ،‬اﻟوﻻﯾﺎت اﻟﻣﺗﺣدة‬
‫اﻷﻣرﯾﻛﯾﺔ‪.‬‬
‫ﻣﻌﻠوﻣﺎت اﻻﺗﺻﺎل ﻟﻣوظﻔﻲ اﻟدراﺳﺔ‪:‬‬
‫(‪PI:‬اﻟدﻛﺗور ﺧﺎﻧﺎ )‬
‫‪،Sunil.Khanna@oregonstate.edu‬‬
‫‪541-737-6405+‬‬
‫اﺷواق اﻟﻌﻣري )طﺎﻟﺑﮫ(‪:‬‬
‫‪۱٥٤۱۸۲۹۲٤۳۷+‬‬
‫‪Ashwaq.s.alamri@hotmail.com‬‬

Appendix D: Recruitment Flyer (English)
Water Use in Saudi Arabia and its
Impact on Human Health
My name is Ashwaq, I am a master student at Oregon
State University. I am doing this research for my master
thesis. The purpose of this research is to study water use
and its impact on human health and understand the water-
conservation methods in households.
The Principal Investigator:
Sunil Khanna, Oregon State University, U.S.A.
Contact information for study personnel:
Dr. Khanna (PI):
541-737-6405, Sunil.Khanna@oregonstate.edu
Ashwaq Alamri (student):
+1 541-829-2437
Ashwaq.s.alamri@hotmail.com
59
To be able to participate in this
research project you should
be:
• If you a female between 18 – 89
years old, then you are eligible to
participate in this research.
• The participation process is taking a
survey that has 14 questions.
• You can choose the place where you
feel the most comfortable to take the
survey,
• The participation time could take 5-10
minutes
• Once you decide to participate or
want to know further information,
please contact us on
alamrias@oregonstate.edu or
+15418292437 (WhatsApp) or (call
or text).
 ‫‪60‬‬

‫)‪Appendix E: Household’s Survey (Arabic‬‬

‫‪ .1‬ﻛﻢ ﺷﺨﺺ ﯾﻌﯿﺶ ﻓﻲ ﻣﻨﺰﻟﻚ؟‬

‫• ‪5-2‬‬
‫• ‪8-5‬‬
‫• ﯾﺼﻞ إﻟﻰ ‪8‬‬

‫‪ .2‬ھﻞ ﻟﺪﯾﻚ ﻧﻮع ﻣﺨﺘﻠﻒ ﻣﻦ اﻟﻤﺎء ﻟﻜﻞ اﺳﺘﺨﺪام‪ ،‬ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل‪ ،‬ھﻞ ﻟﺪﯾﻚ ﻣﺎء ﻟﻠﺸﺮب وﻣﯿﺎه ﻟﻼﺳﺘﺤﻤﺎم‪ ،‬أو‬
‫ھﻞ ﯾﺴﺘﺨﺪم اﻟﻤﺎء ﻓﻲ ﻣﻨﺰﻟﻚ ﻟﻜﻞ ﺷﻲء؟‬
‫• ﻟﺪي ﻧﻮع ﻣﺨﺘﻠﻒ ﻣﻦ ﻛﻞ اﺳﺘﺨﺪام‪.‬‬
‫ي ﻧﻮع واﺣﺪ ﯾُﺴﺘﺨﺪم ﻟﺠﻤﯿﻊ اﻷﺷﯿﺎء )ﻣﺜﻞ‪ ،‬اﻻﺳﺘﺤﻤﺎم‪ ،‬اﻟﺸﺮب ‪ ...‬إﻟﺦ(‬
‫• ﻟﺪ ّ‬
‫• أﻧﺎ ﻻ أﻋﺮف‬

‫‪ .3‬ﻛﯿﻒ ﯾﺘﻢ ﺗﻮﺻﯿﻞ اﻟﻤﯿﺎه إﻟﻰ ﻣﻨﺰﻟﻚ؟‬

‫• ﻧﻈﺎم ﻣﯿﺎه اﻟﺼﻨﺒﻮر اﻟﺒﻠﺪي‬
‫• ﺷﺎﺣﻨﺔ ﻣﯿﺎه‬
‫• اذھﺐ وﺟﻠﺐ اﻟﻤﺎء‬
‫• أﻧﺎ ﻻ أﻋﺮف‬

‫‪ .4‬ھﻞ ﻟﺪﯾﻚ أي طﺮق ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻟﻤﯿﺎه ﻣﺜﻞ رؤوس اﻟﺪش ذات اﻟﺘﺪﻓﻖ اﻟﻤﻨﺨﻔﺾ أو اﻷﺟﮭﺰة اﻟﻤﻮﻓﺮة ﻟﻠﻤﺎء؟‬
‫إذا ﻛﺎن اﻟﺠﻮاب ﻻ‪ ،‬ﻓﻠﻤﺎذا‬
‫• ﻧﻌﻢ‪ ،‬واﺣﺪ أو اﺛﻨﺎن‬
‫• ﻧﻌﻢ‪ ،‬أﻧﺎ أﻓﻜﺮ داﺋ ًﻤﺎ ﻓﻲ ﺟﻤﯿﻊ أﻧﻮاع اﻷﺟﮭﺰة ‪ /‬اﻷﺟﮭﺰة اﻟﺘﻲ ﺗﻮﻓﺮ اﻟﻤﺎء‬
‫• ﻻ‪ ،‬ﻷﻧﻨﻲ ﻟﺴﺖ ﻋﻠﻰ ﻋﻠﻢ ﺑﮭﺎ‪،‬‬
‫• ﻻ‪ ،‬ﻷﻧﮭﺎ ﺑﺎھﻈﺔ اﻟﺜﻤﻦ‬
‫• ﻻ‪ ،‬ﻻ أﻋﺮف ﻟﻤﺎذا ﻟﻢ أﻓﻜﺮ ﻓﯿﮭﺎ‪.‬‬

‫‪ .5‬إذا ﻛﺎﻧﺖ اﻹﺟﺎﺑﺔ ھﻲ ﻻ ﻟﻠﺴﺆال اﻟﺴﺎﺑﻖ‪ ،‬ﻓﮭﻞ ﺳﺘﻔﻜﺮ ﻓﻲ أي أﺟﮭﺰة ‪ /‬أﺟﮭﺰة ﻟﺘﻮﻓﯿﺮ اﻟﻤﯿﺎه ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ؟‬
‫• ﻧﻌﻢ‬
‫• ﻻ‬

‫‪ .6‬ﻓﻲ اﻟﻤﺘﻮﺳﻂ ‪ ،‬ﻛﻢ اﻟﻤﺪة اﻟﺘﻲ ﯾﺴﺘﺤﻢ أﻓﺮاد اﻷﺳﺮة؟‬

‫• ‪ 10‬دﻗﺎﺋﻖ أو أﻗﻞ‬
‫• ‪ 40-20‬دﻗﯿﻘﺔ‬
‫• أﻛﺜﺮ ﻣﻦ ‪ 40‬دﻗﯿﻘﺔ‬

‫‪ .7‬ھﻞ ﺗﻌﺘﻘﺪ أن اﺳﺘﺨﺪاﻣﻚ ﻟﻠﻤﯿﺎه ﻓﻲ اﻟﻤﻨﺰل ﻗﺪ اﻧﺨﻔﺾ أو زاد ﻓﻲ اﻟﺴﻨﻮات اﻟﺨﻤﺲ أو اﻟﻌﺸﺮ اﻷﺧﯿﺮة؟ إذا‬
‫ﻧﻌﻢ‪ ،‬ﻟﻤﺎذا؟‬
‫• اﻧﺨﻔﺾ‪ ،‬وذﻟﻚ ﻷن اﺳﺘﺨﺪام طﺮﯾﻘﺔ اﻟﺤﻔﺎظ ﻋﻠﻰ اﻟﻤﯿﺎه‬
 ‫‪61‬‬

‫اﻧﺨﻔﺾ‪ ،‬ﻷن ﻋﺪد اﻻﺳﺮة اﻧﺨﻔﺾ‬ ‫•‬

‫زﯾﺎدة‪ ،‬ﻷن ﻋﺪد اﻻﺳﺮة زاد‬ ‫•‬
‫زاد ‪ /‬اﻧﺨﻔﺾ‪ ،‬ﻟﯿﺲ ﻟﺪي ﻓﻜﺮة ﻋﻦ اﻟﺴﺒﺐ‪.‬‬ ‫•‬
‫ﻟﻢ أﻻﺣﻆ ﻣﺎ إذا ﻛﺎن ﻗﺪ اﻧﺨﻔﺾ أو زاد‪.‬‬ ‫•‬

‫‪ .8‬ھﻞ ﺗﺴﺘﺨﺪم اﻟﻤﺎء ﻟﺰراﻋﺔ اﻟﻨﺒﺎﺗﺎت أو اﻟﺨﻀﺎر ﻓﻲ اﻟﻔﻨﺎء اﻟﺨﻠﻔﻲ؟ إذا ﻛﺎﻧﺖ اﻹﺟﺎﺑﺔ ﺑﻨﻌﻢ‪ ،‬ﻛﯿﻒ ﺗﻘﻮﻣﯿﻦ‬
‫ﺑﺴﻘﯿﮭﺎ؟ ھﻞ ﺗﻤﺎرس أي طﺮق ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻟﻤﯿﺎه ﻟﮭﺬا اﻟﻐﺮض؟‬
‫• ﻧﻌﻢ‪ ،‬أﻧﺎ أﺳﺘﺨﺪم اﻟﺮي اﻟﺘﻘﻠﯿﺪي اﻟﻤﺘﻘﻦ‪ ،‬ﻟﻜﻨﻨﻲ ﻻ أﻣﺎرس أي طﺮق ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻟﻤﯿﺎه‬
‫• ﻧﻌﻢ‪ ،‬أﺳﺘﺨﺪم ﻧﻈﺎم اﻟﺮﺷﺎت ‪ /‬اﻟﺘﻨﻘﯿﻂ‬
‫• ﻧﻌﻢ‪ ،‬أﻗﻮم ﺑﺠﻤﻊ اﻟﻤﺎء اﻟﻤﺴﺘﺨﺪم ﻟﻐﺴﻞ اﻟﺨﻀﺎر ‪ /‬اﻟﻔﺎﻛﮭﺔ‬
‫• ﻻ‪ ،‬ﻟﯿﺲ ﻟﺪي ﺣﺪﯾﻘﺔ أو ﻓﻨﺎء ﺧﻠﻔﻲ ﺑﺤﺎﺟﺔ إﻟﻰ اﻟﻤﺎء‪.‬‬

‫‪ .9‬ھﻞ ﺗﻌﺮﻓﻮن ﻣﺤﺪودﯾﺔ اﻟﻤﻮارد اﻟﻤﺎﺋﯿﺔ ﻓﻲ ﻣﻨﻄﻘﺘﻜﻢ أو اﻟﺒﻠﺪ ﺑﺄﻛﻤﻠﮫ؟‬

‫• ﻧﻌﻢ‬
‫• ﻻ‬

‫‪ .10‬ھﻞ أﻧﺖ ﻋﻠﻰ ﻋﻠﻢ ﺑﺘﻐﯿﺮ اﻟﻤﻨﺎخ وﺗﺄﺛﯿﺮاﺗﮫ اﻟﻤﺤﺘﻤﻠﺔ ﻋﻠﻰ اﻟﻤﻮارد اﻟﻤﺎﺋﯿﺔ ﻓﻲ اﻟﺪوﻟﺔ؟‬
‫• ﻧﻌﻢ‬
‫• ﻻ‬
‫• ﻟﯿﺲ ﻛﺜﯿﺮا‬

‫‪ .11‬ھﻞ ﺗﻢ ﺗﻌﻠﯿﻤﻚ ﻓﻲ اﻟﻤﺪرﺳﺔ ﻋﻦ اﻷﻣﺮاض اﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻤﺎء‪ ،‬أو اﻟﻤﻮارد اﻟﻤﺎﺋﯿﺔ ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﯿﺔ‬
‫اﻟﺴﻌﻮدﯾﺔ‪ ،‬أو ﻧﺪرة اﻟﻤﯿﺎه‪ ،‬أو طﺮق ﺣﻔﻆ اﻟﻤﯿﺎه؟‬
‫• ﻧﻌﻢ‬
‫• ﻻ‬

‫‪ .12‬ﻣﺎ رأﯾﻚ ﻓﻲ ﻧﻮﻋﯿﺔ ﻣﯿﺎه اﻟﺸﺮب اﻟﺘﻲ ﯾﻤﻜﻨﻚ اﻟﻮﺻﻮل إﻟﯿﮭﺎ‪ ،‬ھﻞ ھﻨﺎك طﻌﻢ اﻟﻜﻠﻮر‪ ،‬ﻋﻠﻰ ﺳﺒﯿﻞ اﻟﻤﺜﺎل؟‬
‫• ﺟﯿﺪ‬
‫• ﻟﮫ ذوق ‪ /‬طﻌﻢ ﻣﻤﯿﺰ‬
‫• أﻧﺎ ﻻ أﻋﺮف‬

‫‪ .13‬ھﻞ أﻧﺖ أو أي ﻓﺮد ﻣﻦ أﻓﺮاد أﺳﺮﺗﻚ ﯾﻌﺎﻧﻲ ﻣﻦ ﺗﮭﯿﺞ اﻟﺠﻠﺪ ‪ /‬اﻟﻌﯿﻦ ﺑﺸﻜﻞ ﻣﺘﻜﺮر ﺧﺎﺻﺔ ﺑﻌﺪ ﻏﺴﻠﮫ؟‬
‫• ﻧﻌﻢ‬
‫• ﻻ‬
‫• ﻟﻢ أﻻﺣﻆ‬

‫‪ .14‬ھﻞ ﻋﺎﻧﯿﺖ أﻧﺖ أو أي ﻓﺮد ﻣﻦ أﻓﺮاد ﻋﺎﺋﻠﺘﻚ ﻣﻦ ﺟﺮاء اﻟﻘﻼﻗﻞ اﻟﺘﻲ ﺗﻨﻘﻠﮭﺎ اﻟﻤﯿﺎه ﻣﺜﻞ اﻟﻜﻮﻟﯿﺮا أو اﻟﺘﮭﺎب‬
‫اﻟﻜﺒﺪ أو ﺷﻠﻞ اﻷطﻔﺎل ﺧﻼل اﻟﺸﮭﺮﯾﻦ اﻟﻤﺎﺿﯿﯿﻦ؟‬
 ‫‪62‬‬

‫• ﻧﻌﻢ‪ ،‬ﻋﺪة ﻣﺮات‬

‫• ﻧﻌﻢ‪ ،‬ﻣﺮة واﺣﺪة‬
‫• ﻻ أﻧﺎ ﻻ أﻋﺮف‬
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‫)‪Appendix F: Structured Interview Questions (Arabic‬‬

‫‪ .1‬ھﻞ ﯾﻤﻜﻨﻚ اﻟﺘﺤﺪث ﻋﻦ ﺗﺎرﯾﺦ اﻷﻣﺮاض اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﻤﯿﺎه ﻓﻲ اﻟﻤﻤﻠﻜﺔ؟‬

‫‪ .2‬ھﻞ رأﯾﺖ ﺣﺎﻻت ﻧﺎﺗﺠﺔ ﻋﻦ ﺳﻮء ﻧﻮﻋﯿﺔ اﻟﻤﯿﺎه أو ﺷ ّﺤﮭﺎ ﻣﺆﺧﺮاً؟‬
‫‪ .3‬ﻣﺎ ھﻲ ﺑﻌﺾ اﻷﻣﺮاض اﻟﻤﻨﻘﻮﻟﺔ ﺑﺎﻟﻤﺎء اﻟﺘﻲ ﺗﺘﻮﻗﻌﮭﺎ واﻟﺘﻲ ﯾﻤﻜﻦ رؤﯾﺘﮭﺎ ﻓﻲ اﻟﻤﻤﻠﻜﺔ ﻓﻲ اﻟﺴﻨﻮات اﻟﻘﺎدﻣﺔ؟‬
‫‪ .4‬ﻣﺎ ھﻲ ﺑﻌﺾ اﻟﺘﺪﺧﻼت اﻟﺘﻲ ﯾﻤﻜﻦ أن ﺗﻌﺘﺒﺮھﺎ وزارة اﻟﺼﺤﺔ ﻋﻨﺪﻣﺎ ﯾﺘﻌﻠﻖ اﻷﻣﺮ ﺑﺎﻟﻤﯿﺎه وأﺛﺮھﺎ ﻋﻠﻰ‬
‫اﻟﺼﺤﺔ؟‬