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Lessons Learned in Providing 2 Billion Liter of Clean Drinking Water in the Developing World with Point-of-Use Flocculent-Disinfectant Technology

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While household water treatment technologies have been shown to be cost-effective and efficacious in reducing diarrheal illness, there are few examples of reaching large numbers of people with household water treatment. Recent evidence has indicated that large coverage may be possible by focusing on providing safe drinking water during emergencies, through nutrition feeding programs, to people living with HIV/AIDS, through school and clinic programs, and through community-based and social marketing efforts. An advantage of this strategy is that it can rely on existing infrastructure and thereby reach scale at a reduced cost of intervention. Since 2004, P&G and partners have provided more than 2.5 billion liters of clean water via a flocculent–disinfectant technology in a not-for-profit program called the P&G Children's Safe Drinking Water Program. Laboratory evaluations in test waters demonstrate that the flocculent-disinfectant product, called PUR Purifier of Water, meets the requirements and is approved by the US Environmental Protection Agency as a microbiological purifier of water by effectively killing more than 6 log of pathogenic bacteria, killing more than 4 log of viruses, and removing more than 3 log of chlorine resistant parasites. In addition, the product reduces turbidity and removes a variety of chemical contaminants such as arsenic making it suitable for treating a wide variety of water sources in developing countries. Because the technology significantly reduces water turbidity, it provides superior microbial reduction compared to disinfection alone in highly turbid waters and provides a strong visual signal to consumers that the treatment is effectively cleaning the water. Five randomized, controlled, health intervention trials (n=25,000 people) demonstrated that the combination system reduces the incidence of diarrhea by an average of 50%. The not-for-profit effort to provide the flocculent-disinfectant product is now reaching about 4 million people a year with plans to scale-up in the next few years to reach 10 million a year by providing more than 2 billion liters of clean water each year. Emergency relief efforts are a significant part of the program including providing clean drinking water to survivors of floods, tsunamis, earthquakes, and cholera outbreaks. The product has been used in more than 60 countries for providing emergency drinking water and a standard operating procedure and other communication tools have been developed and refined based on field experience. Providing clean drinking water in schools is a significant part of the effort and school programs conducted by PSI, CARE, World Vision, UNICEF, CFW Shops, Aga Khan Foundation, and others have reached more than 1.5 million students. Monitoring of school programs in Malawi and Kenya demonstrated that children are positive change agents leading to adoption of positive habits within the broader community. In addition to reduced diarrheal illness, monitoring of school programs found a 26-50% decrease in school absenteeism associated with providing clean water and hand washing stations in schools. Clean drinking water is particularly important for people living with AIDS and monitoring of the use of flocculent-disinfectant technology showed decrease in diarrhea in patients and improved retention in medical follow-up. Malnourished children need clean drinking water and several programs are underway to provide the flocculent-disinfectant product along with nutrition therapy to speed recovery by preventing loss of nutrients because of diarrhea. Providing clean drinking water has been shown to be synergistic with other water and sanitation program efforts resulting in improvements in efforts to gain community acceptance of latrines and improved hand washing behaviors.

Keywords: diarrhea; flocculent-disinfectant; household water treatment; point-of-use

Document Type: Research Article


Publication date: 2011-01-01

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