Point of Use Water Systems: Solutions that meet water quality
challenges
Jo BarnesDivision of Community HealthFaculty of Medicine and Health SciencesUniversity of StellenboschTygerberg
Policy Dialogue: DST/EU Sector Budget Support, HSRC and the WRC2 October 2012
Two broad categories of users of POU devices in South Africa - the well-off and the poor:
Well off people only use POU devices to improve water taste (or are neurotic about health)
Poor people use (need?) POU devices to make water safe
REALITY - There is wide overlap of reasons for use distributed over many income classes.So-called high income families do not necessarily have access to safe, acceptable water
2
Some questionable assumptions
"POU's are usually simple, inexpensive technologies which positively affect the health of rural households by reducing the prevalence of water borne diseases".
REALITY: POU devices do not necessarily positively affect health simply by delivering cleaner water to households .
Correlation between water pollution level and occurrence of diarrhoea in household about 0.3
3
Some questionable assumptions
Contamination occurs in two different domains: Public Domestic
To realise maximum and sustainable benefit, prevention of disease should occur in both domains
Assessments often carried out too soon after implementation
Hawthorne effect causes initial improvement that does not last
4
Reasons for the mismatch
Confounders present in studies announcing reduction of diarrhoea.
Such studies did not adequate take into account: Home hygiene behaviour - recontamination Domestic sewage disposal Food storage and preparation practices Quality of irrigation water used for fresh produce Availability of soap and drying material for handwashing Vector transmission (flies, rodents, cockroaches ...)
In addition, low water sampling frequency gave wrong impression of water quality used in homes.
5
Reasons for the mismatch
40 - 60 persons per toilet
Standpipes also disposal points for dirty water
No safe place to discard wash water - runs into stormwater drains
Animal and human feet bring contamination into homes
Poor solid waste removal causes contamination
Drains running over due to stormwater intrusion
Example of "backyard shacks"
12
• 58% of RDP type houses in our study had non-operational toilets at time of visit
• 100% of houses had visible serious structural damage (leaking roofs, leaking walls, broken taps...)
• 40% of RDP houses had one or more persons who had diarrhoea in the previous two weeks
• 61% of households dispose of dirty water and wet waste by flushing it down the toilet
• 100% of inhabitants said they did not know how to maintain their houses
• Only two households paid for water
Problems in low-cost housing settlements:
The “kitchen” in many low cost houses
14
Improved kitchen in RDP house
Tap in toilet with no connection to drain
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No place to discard washing water - runs into storm water drains
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Evidence of alcohol misuse
18
The large number persons living with of HIV/AIDS increases the already considerable number of persons who are particularly susceptible to waterborne diseases
What is often forgotten is that HIV/AIDS sufferers also secrete millions of pathogens into their environment - they act as 'incubators'
19
The HIV/AIDS complication
POU devices are reported to have low uptake in communities needing clean water the most.
This occurs even where they are distributed for free.
Filter devices are more popular than chemical treatment because of complaints of off-taste.
Effective implementation ("marketing") will have to go beyond standard messages about water and health.
Active and sustainable teaching of home hygiene will go a long way towards realising the benefits of POUs
20
POU devices have low uptake
WATER:We understand it,
but we do not respect it.
The hosts of the meeting for the opportunity to speak Flemish Government, Water Research Commission, Harry
Crossley Foundation, German Academic Exchange (DAAD), National Research Foundation and Stellenbosch University for research assistance
Stellenbosch University for ethical clearance Stellenbosch University Water Institute
Acknowledgements
Thank you for your interest22
