MEng students pursue clean water projects in Nepal and haiti, face real-world complications

   Last year a group of MEng students under the supervision of Susan Murcott, lecturer at Parsons Lab, traveled to Nepal to consider different types of water filtration techniques for removing microbial contamination caused by animal and human fecal material. The filters were deemed impractical since they couldn't clean enough water for a single person per day, let alone for a typical family of eight, and didn't decontaminate very effectively.

During January 2001, another MEng group-Tim Harrison, Jessie Hurd, Tse Luen Lee, Nat Paynter, and Meghan Smith-returned to Nepal to study alternative filters, including a Biosand filter project set in place by the non governmental organization, Hope for the Nations, Nepal. Advisors for the project were Susan Murcott and Lee Hersh, a retired chemist from the Corning Corporation. Nat Paynter explains, "Most of the water comes from springs or tube wells. Almost every water source we found, even the freshwater springs, was microbially contaminated. The people carry the water back to their house, put it through a filter to remove the contamination, and drink it.

  "I was interested in seeing if the Biosand filter was working, if people liked it, if it actually improved their health, what problems they were having, and whether it was the right technology for this area. If used correctly, the technology is very good and simple: a concrete box filled with different gradations of sand. Basically, you pour water in the top, and it swiftly flows through while the sand removes the microbial contamination."

   However, the student group quickly learned that microbial contamination occurs through many pathways, and even a supply of clean water at home doesn't necessarily cut down on the incidences of intestinal problems. Not washing one's hands before preparing or serving food can spread germs to the whole family. People don't carry filtered water when they're outside the home-a significant contamination pathway since most of the men work in distant fields or construction sites. Nobody has indoor plumbing, and toddlers wander everywhere without diapers.

   Through constant exposure, adults gradually build up their tolerance of microbial contamination. "It's a graver concern for the children," says Paynter. "The health repercussions are complex. Infant mortality in Nepal is 20% [compared to around 0.7% in the US]. Young children with frequent diarrhea don't retain essential nutrients, which results in stunted growth." Besides the anguish of seeing your children sicken helplessly before your eyes, "the economic problems include labor lost from being sick and taking care of sick children, and money spent taking kids to clinics and doctors. It's a horrible cycle, and with the lost work and medical expenses, people can't afford to pay for a filtration system."

While MEng student Tse Luen Lee examined at the technical aspects of the filter, Paynter evaluated the system to see if it was effective, and if cultural or social problems made people less likely to use it. Since people paid for the filter, Paynter concedes that it was a biased sample of those who were motivated to use it. "By and large there were no cultural/social/religious problems, and the system almost never malfunctioned. Over 150 families, each with about 8 to 10 people, had filters, so they had the potential of benefitting up to 1500 people. Filters cost about $35, which is around 15% of the annual family income, so it's a huge investment."

Even though they screened out microbial contamination effectively, the filters didn't seem to make dramatic improvements in the general public health. Paynter discovered that "about half the people reported better health and fewer incidences of diarrhea. It's a promising technology. But most of the filters were sold without educating the people about the other pathways for contaminants to enter a body, such as not washing hands after cleaning up babies, so it's not as effective against disease as it ought to be."

Back at MIT, Paynter crunched the data to find the percentages of women who collected water, average distance to reach the water (about 10 m), and the types of sources. "The basic vessel holds about 14 to 17 liters, which weighs 14 to 17 kg (31 to 37 lbs), and they might fetch water 15 times a day, so it's tough work. Traditionally the men collect water if the source is far away, but women fetch water if the source is close. There's been a big movement to provide more water sources closer to more people, so it's actually increased the workload for the women to have the water more easily accessible. They run back and forth all day hauling water, and they've got plenty of other work to do," observes Paynter.

In the course of his interviews, Paynter was grateful that "the people were extremely nice. They'll give you almost everything they have, and since they have almost nothing, it's very touching. While they were poor, it wasn't the dehumanizing poverty of urban slums. They'd bring you tea with milk and sugar, which is extremely expensive for them, so it was a real gesture of hospitality. I was nervous about being a male from the West and talking to the women, who tended to be more reticent than the men, about rather personal issues such as their rates of diarrhoea, but in general they were very willing to talk about it."

Paynter found uncomfortable moments when people assumed that since he was an American from a prestigious school, then he must know the answer to their water problems and have unlimited funds to solve it. "There were very heightened expectations of, 'OK, you're coming here to make us healthy-do it!' Then we had to reply that we didn't really know what the problem was and we certainly didn't have unlimited funds, but we're working on it."

As a token of thanks for cooperating in the interviews, Paynter brought pens for the adults and crayons for the children, with unforseen results. "The kids just loved the crayons, which they had never seen before, but I think I spawned a generation of vandals. They had no paper to draw on, but there were lots of blank walls, clothes, and other kids. I think next year's group should be really careful [about what they bring]."

Even though a $35 filter is too expensive for the most marginalized members of society "who probably need it the most urgently, it's a sound technology and very appropriate for Nepal," believes Paynter. "By our standards it's cheap, it can be made entirely with local products, and it doesn't require any chemicals or electricity. To clean it once or twice a year, you remove the top inch of sand, rinse it off, let it dry in the sun, and replace it."

Like many Westerners traveling to remote parts of the world, Paynter had "a marvelous experience, but it also makes you really appreciate what you have. When you walk around with more in your backpack than people have in their houses, it makes you evaluate what you really need. Coming from America, you forget the depths of poverty that are out there, and the repercussions of being so poor that you can't even afford to be healthy."

In addition, Paynter found himself in the unaccustomed position of being a very conspicuous minority. "I'm 6 ft 4 in. (193 cm), and the average Nepali man is about a foot (30 cm) shorter. Tim Harrison is 6 ft 7 in. (2 m), and Meghan Smith is about 6 ft (183 cm), which is especially tall for a woman in Nepal. People were fascinated with us, and they would always come up and touch us, which was a little uncomfortable. They were endlessly amused that our feet were really big, and our legs were really long, and we were always hitting our heads wherever we went."

As well as being the local equivalent of a circus parade, Paynter felt very much of an outsider in this culture "linguistically, socially, religiously, and culturally. The possibilities for causing offense were endless. Some things are so innate to them that they couldn't imagine that someone else wouldn't know that fact. Wearing leather into a temple, whether it was our shoes, belt, wallet, or watch band, was deeply offensive to them, and it didn't occur to me.

"We were lucky to get an unspoiled view of Nepal in places where tourists rarely visit. In parts of Kathmandu, people would swarm around you in the street trying to sell things or finding many brilliant ways of separating you from your money. In other parts of the country, strangers were more likely to invite you in for a cup of tea. We crashed several weddings and were treated as guests of honor."

Resigned to being flattened by all sorts of intestinal problems, the MEng group was astonished when nobody reacted badly to the local food. "However, I got sick when I returned to the US and gorged on butter and ice cream after a month of almost no dairy products. Buffalo milk is very different, especially on your cereal. But vegetables in Nepal were great, yogurt was outstanding, and we found really good coffee."

Like his supervisor, Susan Murcott, Paynter studied humanities before turning to engineering. "Susan and I had a real understanding of a different perspective on engineering and the best ways to implement it." After earning a BA from Brown Univ. in English and American literature, he worked several years in publishing before returning to school to tackle "the unholy trinity: physics, chemistry, and calculus, followed by statistics. I felt unprepared for MIT, but I wasn't as unprepared as I could have been. Also, straight science is very different from engineering in its language and approach. That took some getting used to. My classmates seemed to have different basic assumptions. However, I figured it would be so much worse not to even attempt pursuing this career than to try and fail. It's been one long year of just putting my head down and plunging ahead." Now that he has graduated, Paynter hopes to land a position with the water and sanitation division of a development organization which will use both his humanities and engineering background.

Since 1995, a non-profit organization based in Florida called Gift of Water, Inc. (GWI) has been providing household water filtration systems in Haiti. In January 2001, an MEng group including Daniele Lantagne, Farzana Mohamed, Peter Oates and Nadine van Zyl traveled to urban and rural locations in Haiti to investigate the effects of this point-of-use water purfier. Daniele Lantagne describes the system as "essentially two 15-liter buckets, stacked on top of each other. The water is chlorinated and runs through the cotton filter on top, into the bottom bucket and through a granulated activated carbon filter. The water is purified for bacteria, using the chlorine as the disinfectant. The cotton filter reduces any suspended solids, and the carbon filter on the bottom pulls out chemicals and chlorinated byproducts."

Once the buckets are set up, the only necessary maintenance is to change the cotton filters about once a year, and switch the carbon filters about every six months. However, Lantagne discovered that the carbon filters often weren't being replaced. "The oldest one we saw was four years old, and it wasn't doing much good. The GWI provides all the equipment and trains the technicians. They claim that there are 90% fewer intestinal diseases among children who use the filter, but we didn't see any epidemiological studies to back up that number."

Lantagne examined four different chemicals in the THM (trihalomethane) group which are created when chlorine reacts with the natural organic matter in the unfiltered water supply. "I looked at THM production in the filter based on different variables, such as water temperature and turbidity. I found out that THM production depended on how old the carbon filter is, because a fresh carbon filter removes it. Also, more THMs will form if there is more bromine in the water. Bromine is naturally occurring in the ocean, and it's everywhere in an island nation like Haiti."

Only one out of the 17 filters which Lantagne tested had THM concentrations above the World Health Organization standards. "There really isn't a THM threat, and the situation would be completely avoided if the carbon filters were changed every six months. In any case, the World Health Organization stresses that disinfection is much more important than eliminating traces of THMs, given the high mortality of diarrheal diseases in children compared to a small increase of cancer likelihood over a lifetime exposure."

GWI hires Haitian technicians in each community with a water system to provide maintenance. "Each Catholic church in Haiti is paired with a Catholic church in the US that supports them," Lantagne says. "The Catholic church in the US supplies the funding to GWI to put the filters in, train and pay Haitian technicians. They walk around to all the houses and check that everything's working, and they're supposed to change the carbon and make sure that the family uses the device properly."

The essential chlorine for the system must be imported from the US or the Dominican Republic. Nadine van Zyl recommended a system for manufacturing chlorine locally, figured out how much it cost, and translated the directions into French and Creole. Locally manufactured chlorine would be distributed at a lower cost, would be fresher, more readily available, and would be a better disinfectant. Gift of Water is planning to implement this system to produce their own chlorine.

In some communities, international NGOs have installed wells or erected captages, which are stone structures above groundwater springs to protect them from surface contamination. People also make strenuous efforts to fetch what they perceive as cleaner water, says Lantagne. "They'll walk uphill 30 minutes to go to a river source that's cleaner upstream. However, even the best point-of-use disinfection technologies will have a limited impact without public education. People don't realize all the sources of bacterial contamination. It's an imperative part of community education to let people know that they'll get sick if they drink out of puddles or streams away from home, even if they only drink filtered water at home."

Given identical equipment, some communities are more receptive and conscientious about using the new water purifiers than demographically similar communities a few miles away. Lantagne and Farzana Mohamed looked at reasons why the program succeeds or fails, and found three deciding factors. "First, it is extremely helpful when the program is well organized and effective, with competent technicians in charge. Second, it's more effective when the purifiers are distributed in a small area. Thinking about where to locate the purifiers in a community is actually a big issue. If a small number of purifiers are distributed over a huge area, the technicians have to walk long distances making sure everything is functioning. Third, the purifiers should be part of an overall community education program, not just dumped into the community," lists Lantagne.

"In one case where the purifiers were poorly used, the village priest was very interested in having a radio station, rather than in emphasizing public health. The water program was imposed on him, and it didn't fit in with his radio station. But in another community, a nun had been stressing maternal and public health, breast feeding, and the need to wash hands. When the water program came in, the rest of the community was prepared for it and understood its importance."

Because this specific type of filtering system loses effectiveness if no chlorine is available or if the THM level gets unacceptably high, group member Peter Oates investigated solar disinfection (SODIS) as an alternative technology to purify water. He explains, "It's very simple. We fill a two-liter PET plastic bottle with water, paint the bottom half black, and let it sit out in the sun. The sun has a three-fold synergistic effect where the ultraviolet portion of the sunshine forms thymine dymers. It produces highly reactive oxygen species, such as hydrogen peroxide, which oxidizes the microorganisms. Also, the black painted bottle heats up in the sunlight and the microbial proteins fall apart. The SODIS bottle provides an appropriate depth that allows the UV to penetrate."

Oates tested for the presence of indicator organisms E.coli, total coliform, and hydrogen sulfide-producing bacteria. He studied exposure periods of one to two days in different types of weather, and found that a one-day exposure inactivated about 50% of the three types of microbial species being testing for, while a two-day exposure killed 100% of the indicator species.

"The results were pretty encouraging. However, I don't know whether all the microbes would be killed after two days of exposure on overcast days. I only saw two stormy days in my entire time in Haiti, and both were followed by sunny days." Water temperatures in the SODIS bottle must reach 45° C (113° F) to trigger the synergistic thermal effects. On particularly steamy days, Oates found that water temperatures sometimes climbed to 55° C (131° F).

Even though Haiti is a tropical country, Oates doesn't know how effective SODIS technology would be in the country's cloudier and cooler mountain regions. "I worked in Dumay Santo, a suburb of Port-au-Prince. People there told me that in general that you can count on your hands the number of days that Haiti receives zero sunshine. Considering that the investment cost in this project is a plastic bottle, it warrants further investigation. It's so cheap, and it inactivated all the microorganisms that we tested for. You put it in the sun and pick it up the next day. You don't have to measure out chlorine or worry about the granule-activated carbon having saturated sorption sites, and there are no carcinogenic by-products. This SODIS technology can only improve conditions."

Many years of political strife have left Haiti with little organized government above the community level, and even there the organizations are through the church. The visiting students were astonished to find no government body providing the most basic infrastructure needs such as roads, water or sewer pipes.

As representatives of a completely foreign world of unbelievable wealth compared to the communities they worked in, the MEng students constantly encountered situations which are not covered in engineering textbooks. Lantagne recounts, "Pete got a few marriage proposals. There were excessive thank-yous at times." While she found that people in the villages tended to be very polite and helpful, Oates discovered the complicated flip side of this desire to cooperate. "I always felt that people were trying to make us happy. They just told us what they thought we wanted to hear, which was a problem." Many questions, Lantagne concurred, "were answered with responses that we wanted, and there was a whole subset of questions that we just couldn't ask."

The local eagerness to please skewed any hopes of doing accurate epidemiological studies on the effectiveness of GWI filters, says Oates. A sample interview would end up with him asking, "'Are you sick with the filter?" and the respondent reassuring him, "Oh, no, your filter's great, I'm never sick." Other questions, "such as how many times do you use the filter in a day or a week, would get answered more honestly. There's no stigma if your family of three drinks less water than the family of 15 next door."

Oates and Lantagne recoiled from the idea of providing little presents as token of appreciation for all the patient explanations by the community members. "There's already too many handouts from people working in Haiti." Distributing cookies or treats to the children disturbs community dynamics, continues Oates. "It upsets the parents to have visitors come in from other countries providing things for their kids that they can't afford." Lantagne paid the children who carried her water bottles because "they'd offer to carry gallons of water for a half-hour walk, and I felt it was appropriate to give them money for doing a job."

Compared to the squalor and degradation of Port-au-Prince slums, Lantagne feels that the people in the rural areas where she worked were happier and less desperately poor. "They had roofs, friendships, food. There's a real sense of community which you didn't see often in Dumay, and definitely not in Port-au-Prince. Looking at statistics for income, one might conclude, 'People must be miserable here,' but you can see that it's not true. Kids who had lived in the US and returned to Haiti were miserable because they had seen everything that is available here. But the people who have no frame of reference are just happy, which brings up the question, How involved should we be in Haiti? While everyone should be entitled to clean water, are we helping, or would they figure out their own filtration systems if we weren't there? And then when you bring in the whole history of US military and political interventions in Haiti, it's all so complicated that you don't know what's right." Which, Oates and Lantagne both agreed, was one of the reasons which attracted them to the project in the first place.

After graduating in June '01, Oates will remain in academia for a PhD. Lantagne is working on another filter project in Nicaragua, on a dissolved oxygen study with the Ipswich River, and is supervising this year's group of students going to Haiti.

Those working on different aspects of water in Haiti besides Oates and Lantagne were Farzana Mohamed and Nadine van Zyl. Lantagne thanks "our amazing group leader" Peter Shanahan, a lecturer in CEE. Lantagne's second advisor was Prof. Phil Gschwend, and Oates' advisor for the microbiology work was Prof. Martin Polz. Mohamed worked with Paul Levy, formerly with the Mass. Water Resources Authority. The project was initially organized by Susan Murcott.