Water Quality

Photo by Linda Khachaurian

Water may be abundant, but often it is not fit for drinking. Water-related diseases and poor sanitation still abound in Latin America despite some progress and many innovations. Some of these efforts are described in this section. 

Cooperative Sanitation in Brazil’s Favelas

Many of Brazil's favelas face a public health crisis. Community participation and affordable technology help make water accessible. Photo by Gregory Scruggs

A New Solution for the Developing World?

By Susan Leal

Many of us who live in the developed world and in urban areas in the developing world would have a hard time imagining what it would be like to live in an area with open sewers, or no formal sewer facilities whatsoever. And yet, according to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JPM), an estimated 2.5 billion people worldwide did not have access to improved sanitation as recently as 2010. Inadequate access to improved sanitation, and the resulting impacts on water quality, plague much of Latin America and the rest of the developing world.

The availability of sanitation facilities is very low throughout rural areas in several Latin American countries. Fewer than half of rural dwellers in Bolivia, Brazil, Paraguay, Peru, and Nicaragua have access to improved sanitation, and the same is true of urban residents in Bolivia.

Lack of access to sanitation has profound consequences. UNICEF reports that “[t]he combined effects of inadequate sanitation, unsafe water supply and poor personal hygiene are responsible for 88 percent of childhood deaths from diarrhea and estimated to cause over 3,000 child deaths per day.” 

The illness and deaths from tainted water supplies that result from insufficient water treatment and sanitation are not only tragic. They are avoidable. The United Nations has set an ambitious Millennium Development Goal to halve the number of people living without access to clean drinking water and improved sanitation facilities by 2015. While global access to clean drinking water has already exceeded the MDG set for 2015, it is highly unlikely that it will meet the goal set for improved sanitation in developing countries. More than two and a half billion people globally still lack access to adequate sanitation.

Urban populations have increased rapidly in Latin America and the Caribbean in recent decades. Since 1990, the proportion of Latin Americans liv-ing in cities has increased from 70 percent to 80 percent. While it is true that living in more densely populated areas improves sanitary conditions in the long run, this kind of rapid influx often leaves city governments struggling to build adequate infrastructure for those who have moved there in search of improved economic prospects. 

Success Stories in Brazil’s Favelas

When it comes to improved sanitation, there may be more than one way to provide both fresh drinking water and access to closed sewers to urban residents. Densely populated areas in cities throughout the world often rely on traditional systems of interconnected pipes buried deep underground. Some developing countries, though, are experimenting with less expensive alternatives that depend more on community participation and elbow grease. In our 2010 book Running Out of Water, my co-author Harvard Professor Peter Rogers and I explored the elements that made this approach successful—or not—in three different Brazilian communities.

Brazil faced a massive population influx into its major cities in the 1990s and 2000s. Many of these urban immigrants came from the countryside and crowded into favelas, slums that surrounded the urban core in many of the nation’s cities. These favelas often lacked sufficient access to clean water and improved sanitation, creating a dangerous mix of close quarters and increased opportunities for disease transmission. 

Recognizing the public health crisis that was developing in many of its cities, Brazil’s federal government encouraged the adoption of the condominial system that was developed by engineer José Carlos Melo. Melo’s system relied on community participation as much as it did on affordable technology that was accessible to state and local governments throughout the country. 

Unlike a traditional sewer and water system, only the mainline pipes are buried deep underground in a condominial network, and smaller pipes that connect to residences are placed much closer to the surface. Because residents were intricately involved in both designing and, in some cases, building the system, they knew where the pipes were and signed on to agreements that they were responsible for maintenance and repair of the system in their neighborhoods.

The benefits of the condominial system are manifold. First, this approach makes it much more affordable for a government to provide basic infrastructure to communities. Costs are lower because a large part of the cost involved in developing water and sewer systems rests in the deep trenching required in a traditional system. Second, in a condominial setup, the labor of residents is sometimes used to dig the trenches for pipes within a neighborhood. This resident involvement not only saves the government money, but it establishes a sense of community among neighborhood residents and creates a feeling of ownership for those who rely on the new system. 

In Brazil and several Latin American countries, the relative success of this approach has varied widely, often depending on the degree of resident participation in the planning and implementation process. The more time and energy a government or utility spent on educating residents about the value of their involvement, the better the results. 

In the outskirts of Brasilia, more than 57,000 residents attended 5,000 public meetings aimed at planning and implementing a condominial system that ultimately served half a million favela dwellers. The system that was adopted included elected representatives for each neighborhood, a collective design process for each block’s residents, and signed agreement with the utility from every participating household.

This level of success was not universally met. In Bahia, poor community outreach led to slow adoption of the condominial system and a much lower level of commitment among residents to maintain the system. In the northern Brazilian town of Parauapebas, the major mining company in town partnered with the local government to build a water treatment plant, and then residents contributed their labor, time, and money to bring treated waters into homes in the town. 

The condominial system has been adopted in parts of Asia, and is a prime example of the creative thinking that will be required to reduce the deaths, illnesses, and economic losses associated with insufficient sanitation in much of rural Latin America. 

Although the solutions are not always easy, in many cases they are relatively affordable. The key, as with so many challenges, is showing residents that they have the power to improve their destinies.

Susan Leal is a water utility consultant, the co-author of the book Running Out of Water. Formerly, she was the General Manager of San Francisco Public Utilities Commission and San Francisco City and County Treasurer.

El Líquido Vital

A 330 pound concrete BioSand Filter, one of about 600 being delivered in 2008-2009. The unwieldiness of this model is a major drawback. Photo by David Gullette

Solving Water Problems in Southwestern Nicaragua

By David Gullette

In global terms, ours is the troubled century of water. Expanding populations, extreme climatic events, and threatened or contested sources of “the vital liquid” are guaranteed to cause more crises—even regional conflicts—in the coming decades.

But let us tighten the focus to the strip of land in Nicaragua between the Pacific and Lake Nicaragua, south of Rivas all the way to the Costa Rican border: here folks are paradoxically both rich and poor when it comes to access to potable water.

The port town of San Juan del Sur went from sleepy fishing village to international resort in 20 years, like Provincetown on fast forward. It now gets its water (heavily chlorinated) from the big lake, pumped through a system financed by the Spanish government. Ironically, the residual taste of chlorine, plus a widespread revulsion at the very idea of drinking lake water, means that most sanjuaneños who can afford it use tap water for everything but drinking. The bottled water business is booming.

Meanwhile, in the 33 impoverished rural communities scattered around the 250 square mile township, potable water from a tap remains a distant dream.

Most rural homes get their water from hand-dug wells. And virtually all these wells are contaminated, given the omnipresence of farm animals plus the haphazard placement of porous latrines. The water contains E. coli bacteria, as well as a range of parasite cysts. Intestinal ailments are widespread, dangerous for vulnerable infants, and hard (and expensive) to get rid of.

We in the Newton (MA)/San Juan del Sur Sister City Project (www.newtonsanjuan.org) have been working with our Nicaraguan colleagues for more than a decade on a set of interlocking water solutions: home-based purification of well water; rehabilitation of wells; installation and repair of hand-operated pumps; teaching families basic hygiene; watershed preservation (partly through reducing firewood use); and introducing sealed-unit composting toilets to replace the traditional latrines. 

Our preferred method of purifying well water has been the BioSand Filter (BSF). 

Invented by a Canadian and promoted around the world by CAWST.org in Calgary, the BSF is essentially a box, usually of concrete, the size of a free-standing water-cooler, filled with carefully processed sand and gravel. Contaminated well water is poured in at the top, works its way slowly down through the column of sand, and comes out of a spout, purified. Key to the process is a “biolayer” created by the permanent two inches of water above the top layer of sand, where “good bacteria” slowly form a colony: they trap and eat much of the E. coli population that passes through.

The BSF has obvious advantages: it’s cheap (about US$50 each); home-based; and requires no chemicals or electricity.

The downsides are that boxes made of concrete are extremely heavy (330 lbs. without the sand/gravel) and thus hard to deliver and move for maintenance; they also require daily use to keep the “good bacteria” in the biolayer well-fed and oxygenated. If neglected for more than a day or two, the biolayer dies and starts to stink, and the efficacy of the system is compromised. Thus the human element at the point of use is crucial. Families have to be disciplined enough to follow the “use-it-every-day rule” and keep their water storage bucket clean to avoid recontamination. 

In 2008 and 2009, grants from the Boston-based Conservation, Food and Health Foundation allowed us to manufacture and install more than 600 BSFs in twenty rural communities,and to train area promotoras and village brigadistas to troubleshoot and help villagers comply with the rules of proper filter use. 

In 2011, retired businessman Dennis St. John approached us with his design for a BSF made entirely of PVC (using a 10” drainage pipe for the column). For the 2012 pilot project we installed twelve of these in one community. We have been very pleased: the PVC filter weighs only 29 lbs. empty, and laboratory tests show that it removes contaminants as well as the concrete filters do. Plus, it’s elegant and easy to clean. We’ll build and install 36 more in January 2013. 

Our Nicaraguan colleagues also emphasize domestic hygiene, especially hand-washing and keeping animal feces out of the yard. Particularly useful in these efforts are graphic posters made available by CAWST.org. We have also paid to have wells dug deeper and re-lined, and to have the classic “rope pump” installed or repaired.

Because an occasional well runs dry early in the year, we also focus on “how to take good care of your watershed.” Since virtually everyone cooks with wood in the countryside, we point out that stripping vegetation from around the house can actually put the water supplies at risk. We explain how, when it rains, a forested hillside is like a sponge; if deforested, it’s like a zinc roof. But people still need wood to cook. So Fidel Pavón and I developed our own model stove, which uses half the amount of wood of the typical open fire with the added advantage that its chimney rids the house of the smoke that gives mothers emphysema and children asthma. As we were building the prototype, Fidel’s wife, Luzmarina, was hospitalized with emphysema, but after we replaced her open fire with our EcoStove, her symptoms disappeared. 

We’ve decided to present the EcoStoves as a reward for families who use their BioSand Filter properly. At the same time, it’s a new incentive to those who have stopped using their filters: get your filter re-installed, follow the rules, and become eligible for a stove. (Unlike the BSF program, in which we gave the filters free of charge, participants in the EcoStove program must donate sweat equity and when possible, materials such as cement, sand, and bricks, to obtain a stove.)

Demonstrably, clean lungs, clean water and healthy watersheds go hand in hand.

One obvious alternative to the use of BSFs would be to have wells professionally bored to great depths where contamination is not a problem. The issue here is cost: it’s extremely expensive to have a deep well bored, and a pump for such a well requires electricity, yet fewer than half of the villages we serve are wired. And in most villages the houses are so dispersed that piping water to each home would be an additional challenge.

But one non-electrified community did it right: Ojochal, where about twenty families live along an ascending dirt road. In 2008, the Union Church in Newton worked with local residents to take several steps toward a potable water supply. They deepened the existing, privately owned well at the top of the road that most people used and then constructed a hardwood tower to hold a 1,100 gallon water tank. They installed a set of solar panels to power a submersible pump to fill the tank and finally, they excavated a trench for a two-inch water main to run the water down the hill, with a spigot in front of each house. Eventually the mayor’s office found money to bore a deep public well. Today, all the Ojochal families have access to solar-pumped high-quality water that does not require subsequent filtration. But of course there are 32 other villages.

One other way to limit the infiltration of pathogens from surrounding soil into a well is by using composting toilets (CT). The first of our “in-house outhouses” was a twin-bin affair (one room for boys and one for girls) built next to the schoolhouse we financed in the community of Cebadilla. 

Essentially our CT is a pair of tall boxes on, not in the ground. Their floors are sealed with roofing cement. A tall stack carries off water vapor and whatever gases arise from the composting process, and creates a slight updraft to disperse odors. On top of the boxes sit the roofed “throne rooms.” Because San Juan del Sur is a fishing port, we were able to modify a Vietnamese-model CT, employing a “hammock” of heavy-duty nylon fish net that holds the “biomass” in the air so that aerobic decompostion can take place. The “hammock” was filled first with layers of palm fronds, zacate (a perennial fodder grass), corn husks, leaves, and sawdust from the sawmill a mile away. A bucket of sawdust is left in each stall, and the teachers are urged to throw a handful or two of sawdust into each toilet at the end of every school day. 

This system has functioned flawlessly—without strong odors or external leaks—since February 2005. Not far away is a hand-dug well that serves most of the community. The schoolyard where the well is located is livestock-free, thanks to a barbed-wire fence. As a result, the unfiltered well water registers a fairly low E. coli count, compared to similar (unfenced) wells in the region. 

Our Canadian colleagues at Project Nicaragua/NicaCan have been promoting single-family composting toilets in several other rural communities in the San Juan del Sur township. They found that often families would help build their new CT and then, when the Canadians left, revert out of habit to using the old odoriferous, well-water-polluting latrine. The donors now insist that the old latrine be dismantled before the family can receive the new CT.

This sporadic backsliding points to a key issue that we who do development work must sooner or later confront, whether we work in water purification, sanitation, alternative building materials, or something as basic as making sure kids get sent to school. The point is, people are slow to change old habits, or as we say in Nicaragua, La costumbre es la ley: old customs rule. Some people will never change. I once saw a man kneel on a rock covered with monkey feces and drink directly from the creek which ran below his knees. Maybe his intestinal system had years ago adapted to the bacterial flora of the water he and the monkeys shared. Or maybe he suffered from chronic parasitosis and simply lived with it. What is clear is that an infant or toddler would almost certainly not be as immune to infection. Worldwide, 5,000 such children die every day from contaminated water. Doubtless the parents of many of these children had been warned about microbes. But as in all types of education, including public health, steady repetition and reinforcement of basic lessons is crucial. Patience is power.

Certainly, our efforts to guarantee year-round potable water for folks in our little part of the world will never have 100 percent success. But over the years we have forged partnerships between activists in Newton and numerous Nicaraguan colleagues—in the medical community, local government, civil society, village councils, and individual families—that will at least assure that la lucha continúa: the fight for clean water goes on.

 David Gullette is Vice President of the Newton, MA/San Juan del Sur Sister City Project. He is author of Nicaraguan Peasant Poetry from Solentiname, ¡GASPAR! A Spanish Poet/Priest in the Nicaraguan Revolution, and Dreaming

Making Water Safe in Haiti

A canal in Cité Féquiére, the poorest neighborhood within the Cité Soliel slum. Photo by Linda Kachadurian

Filters and Dispensers for the Haitian People

By Linda Khachadurian 

Madame Aubry swoops through the front door of her two-story cement blockhouse in the Delmas neighborhood of Port-au-Prince to greet her guests. She is a petite bundle of cheer, with a ponytail that swings in synch to the allegro tempo of her gait. Her caramel skin is punctuated only by a beauty mark below her left eye and a few beads of sweat that have aggregated in her cupid’s bow. 

Her two visitors today are Canadian-American Chris Rolling, executive director of the Pierre Payen-based non-profit Clean Water for Haiti, and his friend Johnson Alexandre, who is a board member of the organization, and a commander with Haiti’s anti-terrorism unit. The pair has come to check-in with Aubry, who is a recipient of one of Clean Water’s Biosand water purification filters. 

An estimated four million out of the nine million inhabitants of Port-au-Prince have no access to safe water and are thus subjected to a tidal wave of waterborne diseases such as cholera, typhoid, hepatitis, and chronic diarrhea. Through Clean Water’s subsidized filter program, Haitian families are able to receive the systems, which cost $55 to make, for $5.

Rolling, who has merry, blue eyes and a curly ponytail that bounces when he laughs, speaks to Aubry in rapid-pace Kreyol. The three go inside and climb a curved staircase that opens into a spacious kitchen. The Biosand filter stands in one corner, in a shaft of sunshine that beams through the adjacent full-length window. The filter is a 32” high, by 12” wide by 12” deep concrete rectangle that has been painted an ethereal baby blue. Perched on top is a hand-carved wooden lid. 

Aubry can’t seem to sing its praises enough: the system keeps her family in good health, and it saves them money because they no longer need to buy expensive bottles of purified water. Instead, they can go the more economical route of having a water truck fill their large cistern with water for the Biosand system. Although she can’t articulate exactly why, she also insists that water from the filter has a more pleasing taste than bottled water. “I don’t know,” she says, “it’s just better.” 

She glides over to the filter, and removes the lid. She cradles it in her arms and sets it down on the kitchen table, where Alexandre is sitting—a solemn column in a black silk suit—adjusting his necktie. Aubry and Rolling peer into the body of the filter. “Everything looks good,” he proclaims.

Each system is filled with 90 pounds of fine, washed sand that filters 99 percent of all microbes, such as bacteria, protozoa, viruses, and worms, through a combination of biological and physical processes that take place within the sand column’s biolayer. 

Earlier in the day, Rolling and Alexandre, who both use Biosand filters in their own homes, were exchanging stories about small creatures that had paid visits to them through their running water. Alexandre gave a dramatic re-enactment of the day that worms came through the faucet of his bathroom sink. Rolling countered with a tale of baby shrimp that some of the more resourceful neighborhood children had wrapped in cheesecloth and dropped into a tasty vegetable stew. 

The Port-au-Prince chapter of another non-profit, Pure Water for the World, also opts for the Biosand method. Every day, their factory produces 14 filters that are painted amped-up pastel hues—neon pistachio, electric ballerina pink, and psychedelic cerulean blue—to match the color schemes of the walls of the schools and health clinics in which they are installed. Each year, the organization provides Biosand systems to over 2,400 homes, schools, health clinics, and orphanages. 

Like Clean Water for Haiti, Pure Water for the World is meticulous about the quality of sand that goes into their filters. On a Saturday morning, project coordinator, Rony Seraphin, is inspecting the goods at his organization’s factory. “The premium stuff is here,” he announces. With a flourish of the wrist, he pulls back the corner of a tarp that is covering a mound of silky, beige sand. He scoops up a handful and gives an approving nod as it streams through his fingers like water.

Both organizations also place a heavy emphasis on educating the recipients of the Biosand filters on proper implementation and maintenance. For water systems that are installed in schools, Pure Water requires that teachers attend 2½ day-long workshops that also cover hygiene education, so that they can, in turn, train their students. 

Some economists resist the idea of the human right to safe water—made official by the United Nations General Assembly in 2010—because they claim that it is difficult to calibrate which type of right (i.e. education, healthcare, etc.) should take priority. Harvard professor Michael Kremer thinks otherwise. The Gates Professor of Developing Societies in the Department of Economics, Senior Fellow at the Brookings Institution, and research affiliate for Innovations for Poverty Action, rallies for the relative importance of the right to safe water by pointing out the cost-effectiveness of purifying water, thereby preventing health problems that would be even more expensive to treat. He believes that within the existing government budget—and with a little help from the Ministry of Education, endowment funds, and private firm developers—it is feasible, financially, to have virtually universal access to safe water.

According to Jeremy Hand, managing director of the safe water program at the New Haven-based non-profit, Innovations for Poverty Action, it was Kremer’s 2005 research in Kenya, studying rural water sources, that was the genesis for the organization’s Chlorine Dispenser System. 

The dispensers have three primary components: they must be installed near communal water sources; following installation there must be community education; and the chlorine used to purify the water must be delivered in a reliable and sustainable manner. Hand, who refers to the professor as “a champion of our dispensers program,” says that so far 400 of IPA’s cost-effective and easily maintainable water treatment systems have been installed throughout Haiti.

Marcel Jean, the community coordinator for the Port-au-Prince-based non-profit, People in Need Partnership, says that although he doesn’t know a lot about economic theory, he is, nevertheless, grateful to anyone who advocates a cause that is so crucial to the well-being of his countrymen. 

In 2010, Jean was put in charge of creating a community water system in Cité Soleil—the capital city’s poorest slum-—for his organization, which works to alleviate extreme poverty in Haiti by connecting Haitian women and children with global partners, who not only help them financially but also connect to them on a personal level. Like IPA, People in Need Partnership chose the chlorination method of water purification. Because the organization was working with a budget of $1,000, Jean and two of the neighborhood bricklayers constructed a model by themselves that consisted of a 125-gallon plastic tank that had a mesh filter and a valve for dispensing chlorine. They installed the system in the enclosed backyard of Lalane Marie-ange, one of the women being helped by the organization’s partnership program. 

Jean admits that the water system wasn’t a perfect solution, but that it was “better than nothing.” The dispenser, which was filled with water by a commercial delivery truck every two weeks, was able to accommodate Marie-ange and 15 of her neighbors. Things went smoothly for several months, but then Marie-ange broke her leg and sold the tank for $300 in order to have her limb set at a local clinic by a man who may or may not have been a real doctor.

A year-and-a half later, Jean decides to pay another visit to her to see how she is doing. Marie-ange, who has almond-shaped eyes that tilt downward, giving her a perennially sleepy look, greets Jean at the front door of her tin hut with a hug, and a small, sad smile. 

Her substantial legs—one of which bows dramatically to the right—taper to dainty feet clad in metallic mauve flip-flops. The polish on her toenails matches the color of her sandals perfectly. Jean’s eyes are large somber pools as he scrutinizes her crooked leg. He utters a cluck of dismay. “That is not right. I don’t think that man was a doctor. I think he was a toy.”

Marie-ange explains that she still experiences pain and has problems walking with the leg that had been injured. She also says that she is sorry that her neighbors no longer have free, “good” water available to them. When asked about the importance of having pure water, she raises her hands in the air and sings out: “For life, for life! What else is there?”

It may be a while before Marie-ange and her neighbors have ready and affordable access to pure water. The National Bureau of Water and Sanitation of Haiti’s (DINEPA) 2012 report, which documents progress in drinking water and sanitation, reveals that water sanitation in Haiti has improved by 24 percent in urban areas and 10 percent in rural ones. In spite of these lackluster figures, Harold Florentino Latortue PhD, an advisor to President Michel Martelly and director at BAIN Consulting, remains cautiously optimistic: “We’re on the right path, but we need to work more extensively to rehabilitate the water system so that it can be more efficient and sustainable.”

Jean and Marie-ange have stepped outside and started walking along the bank of a canal that is overrun with hundreds of smashed cans, plastic bottles, and empty cardboard containers. An occasional stray shoe dots the heaps of debris. A wild boar is wading in the murky water. 

A couple of yards away, someone has turned on a faucet that is attached to a thin, rusty pipe. Jean goes over to inspect. “Look at that!” he exclaims, as he watches water gush into the five-gallon plastic bucket that has been placed below. “Look at those dirt pieces.”

Six-year-old Celian is standing in front of the bucket, mesmerized by the flow of water. She is draped in a ripped “Surfer girls rule” t-shirt, and her head is adorned with cornrows, one of which hangs over her forehead at a 75-degree angle to the ground. Eight-year old Sophie, standing beside Celian, has a belly that juts out several inches past her bony ribcage. Her shoulders curve forward with exhaustion, as if the weight of her abdomen is too much to bear. A teenage boy, hovering nearby in a crisp white oxford shirt that has somehow managed to defy the humidity, explains that she has “maladies” from drinking “bad” water.

On an adjacent patch of paved road, a young boy peddles past on a bicycle. He rings the bell on its handlebars in three-second increments. The bell’s rhythmic clangs synch with the boar’s snorts. Together, they harmonize with the melody of the gurgling water, and form a beautiful, cacophonous symphony that flows through the heavy, gray air.  

Linda Khachadurian is a medical and educational editor and founder of the non-profit, Charitable Confections, which raises awareness and funds for educational programs in third-world countries. She is working on a book about unsung humanitarians, entitled The Extraordinary Doings of an Ordinary Man