Access to Safe Water in Rural Artibonite, Haiti 16 Months after the Onset of the Cholera Epidemic

Abstract

Haiti has the lowest improved water and sanitation coverage in the Western Hemisphere and is suffering from the largest cholera epidemic on record. In May of 2012, an assessment was conducted in rural areas of the Artibonite Department to describe the type and quality of water sources and determine knowledge, access, and use of household water treatment products to inform future programs. It was conducted after emergency response was scaled back but before longer-term water, sanitation, and hygiene activities were initiated. The household survey and source water quality analysis documented low access to safe water, with only 42.3% of households using an improved drinking water source. One-half (50.9%) of the improved water sources tested positive for Escherichia coli. Of households with water to test, 12.7% had positive chlorine residual. The assessment reinforces the identified need for major investments in safe water and sanitation infrastructure and the importance of household water treatment to improve access to safe water in the near term.

“Improved” But Not Necessarily Safe: An Assessment of Fecal Contamination of Household Drinking Water in Rural Peru

“…These results are consistent with the findings of other studies that demonstrated improved sources are not necessarily safe. 5,6,8,[25][26][27][28] Although transporting water to the home from an offpremises source has been associated with contamination in other studies, 15,17 in this population, microbiologic quality of stored water tended to be similar to, or better than, source water. Under conditions of relatively high-quality source water as in this study, microbial settling and time-related die-off are unlikely to yield significant improvement in water quality.…”

Microbial Diversity of Source and Point-of-Use Water in Rural Haiti – A Pyrosequencing-Based Metagenomic Survey

“…Access to safe water is a serious public health concern in Haiti, the nation with the poorest water and sanitation infrastructure in the Western Hemisphere [1]. The World Health Organization (WHO) estimates only 62% of Haitians have access to “improved water” sources [2].…”

“…Taking into consideration the fact that improved drinking water is not necessarily safe water [6, 7] the proportion of the country’s rural population at an elevated risk of poor health due to exposure to contaminated drinking water is probably much higher than estimates indicate. In fact, the majority of those living in the countryside must rely on drinking untreated or unimproved water at least part of the time [1, 7]. …”

“…Waterborne diseases, mostly infectious in nature, caused several thousand deaths in Haiti in recent years [1]. It is further estimated that the diseases spread by contaminated water are major causes of death of Haitian children under the age of five [8].…”

Cholera Elimination in Hispaniola

“…Evaluation of access to water and sanitation services has identified the continuing and large unmet needs, and helped to inform efforts to improve these services 16. Sustained efforts will be necessary to achieve long-term improvements 9…”