The Tibetans of Sama village must trek five or six days to reach any modern health care. Nestled in the Himalayas, still in Nepal but near the Tibetan border, the village is so remote that mortality rates for appendicitis and childbirth are alarmingly high. Poor access to clean drinking water breeds even more illness, and dysentery is a major problem. My younger son and I plan to travel to Sama in two weeks for a medical mission and to help out in whatever way we can. We are working with others to secure resources to bring a water purification system along with medicines by helicopter from Kathmandu.

According to the current edition of Science, nearly 1 in 4 nearby stars, similar to our sun, may have earth-size planets, many of which could have liquid water, the prerequisite for life as we know it. Closer to home, NASA scientists announced this month that a man-made explosion on the moon’s surface released 342 pounds of ice and water vapor in a cloud of mineral dust. This is the first confirmation of water on the moon.

While this is great news for the heavens, on earth, clean water is becoming increasingly scarce. In many places it costs even more than oil. While contaminated water in the Himalayan village of Sama causes dysentery, in Haiti, the poorest country in the Western Hemisphere, cholera has just reappeared for the first time in 100 years.

Securing sources for clean water is a gripping priority for underdeveloped regions and during any natural disaster whether from hurricane, earthquake or flood. Yet, increasingly, concerns about the ability to secure adequate amounts of potable water have begun to create tensions within stable, developed societies. The Dead Sea continues to shrink as Jordan and Israel struggle with rights over water from the Jordan River. There is an ongoing rift between water-rich Northern California and the great metropolis of Southern California that basks in semidesert.

Water quality among industrialized nations with established infrastructure carries additional risks: heavy metals from pipes, plastics, pesticides and pharmaceuticals that have been flushed down the toilet. Even bottled water isn’t always what it’s cracked up to be. Increasingly, people are using personal water purifiers. My family uses a system that boils, distills and filters the water, which works quite well. Unfortunately, the best ones often use the most energy. While this is a good solution for the wary and the fortunate, it is not in the interests of sustainability or public health.

Even Oahu, which supports the largest population in the Hawaiian Islands, is under strain because of its water wealth. Ancient Hawaiian "laws of the water," kanawai, enforced water conservation and explicitly prohibited damage to irrigation systems. Bathing and washing were allowed downstream, and pure water was collected upstream. Today, water use is up, our watersheds are strained and the island’s basal aquifers are not recharging as they should.

The state water commission, responsible for managing these resources, is facing a budget crisis, and more than one-third of its positions are not staffed. Adequate funding, in concert with political, public and private will, must be brought to bear to ensure skillful oversight and enforcement of policy and regulations.

Investment must be made at every level to support optimal efficiency from our toilets and showers to water catchment and the appropriate use of gray water. A collective sense of personal social responsibility is also essential. Each of us, in our daily life, has an opportunity to cherish this precious resource and bear in mind that good water is not an endless commodity.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit questions to info@manakaiomalama.com.