| When disasters strike, safe water is one of the first
and most basic needs that must be met. The Centers for
Disease Control and Prevention Safe Water System Project
has been successfully deployed in a number of recent
disaster situations, including the tsunami of December
2004.
Unsafe drinking water is a major contributor to
childhood morbidity and mortality worldwide. Until
universal access to safe piped treated water is attained,
point-of-use treatment and safe storage of drinking
water in homes, schools, clinics, marketplaces and
other locations can prevent many waterborne illnesses
and deaths. With the support and collaboration of
many public and private sector partners, tools for
point-of-use water treatment, safe water storage and
hygiene education (known collectively as the Safe
Water System) have been developed and implemented
in more than twenty countries. Implementation through
social marketing, most often by Population Services
International (PSI) and community mobilization (by
CARE and other NGO's) has been the most successful
model. The simplest treatment is a chlorine bleach
disinfectant, while a more advanced home water treatment
product (PuR, developed by the Procter & Gamble
Company) removes mud and chemical contaminants, as
well.
Safe Water System programs using these simple and
inexpensive tools have dramatically reduced the incidence
of endemic waterborne disease where they are adopted,
have begun to achieve economic sustainability, and
have proven extremely valuable in responding to emergencies,
including the recent tsunami. The US Government has
promoted the Safe Water System Program at the 2002
World Summit on Sustainable Development in Johannesburg,
South Africa, the 2003 World Water Forum in Kyoto,
Japan, and the 2003 G8 Summit Meeting in Evian, France.
The Safe Water System in Disasters
In 2004, the US Centers for Disease Control and
Prevention (CDC), CARE and USAID initiated a Safe
Water System program in Indonesia. The program relies
on locally-produced and bottled dilute sodium hypochlorite
(bleach) and on culturally-sensitive behavior change
materials describing safe water storage and improved
hygiene practices in the Indonesian language. In early
2004, soon after the program began, a typhoon spawned
catastrophic flooding in West Timor which contaminated
local drinking water sources and forced the evacuation
of thousands of families. A CARE/CDC team responded
immediately with 30,000 bottles of water treatment
solution, sufficient to meet the needs of households
in the most affected areas. A rapid evaluation of
300 households in 14 villages showed that Safe Water
System users experienced 56% fewer episodes of diarrhea
than non-users. A follow-up evaluation 6 months later
demonstrated utilization rates of 60-94% and a greater
than 70% reduction in diarrheal disease risk. This
dramatic success laid the foundation for CARE's vigorous
response to the December 2004 tsunami.
Immediately after the tsunami, CARE mobilized teams
and supplies; within the first week, 20,000 bottles
of water treatment solution were distributed to affected
populations. Because of existing in-country capacity
to scale-up the response, CARE is now on schedule
to provide 200,000 bottles per month to the affected
populations in Aceh, Indonesia.
Indonesia was not the only beneficiary of the Safe
Water System. PSI India, which is running a Safe Water
System Project in India, supplied 5,000 bottles of
water treatment solution to tsunami victims in Tamil
Nadu.
The recent tsunami was not the first time that safe
water system programs have been a vital component
of disaster response efforts. Previous experience
with disaster response includes responses to flooding
in Nepal (2003), Kenya (2003), Malawi (2002), and
Bolivia (1998, 2003), response to earthquakes in Bolivia
(1999), and response to landslides in Bolivia (2000).
The Safe Water System has also been deployed to
respond to epidemics of cholera in Zambia (1999 and
2004), Madagascar (2000), and Bolivia (1996).
Where Safe Water System programs exist, they are
routinely incorporated into disaster response with
good results. Introducing the elements of a new Safe
Water System program during a disaster is a far greater
challenge, and effectiveness is greatly limited for
two reasons. The necessary materials (solution, bottles,
instructions) need to be imported or created in-country;
and local implementing agencies (governmental, non-governmental
and community-based) need time to become familiar
with the elements of the program and to integrate
them into their disaster response activities. The
impact of Safe Water System programs, however, goes
far beyond the immediate disaster response period.
These programs have consistently been shown to reduce
diarrheal diseases, particularly in children, by an
average of 50%, and have proven themselves to be attractive
to local populations, cost-effective and sustainable
over the long-term in Africa, Asia, and Latin America.
Despite this success, there are no Safe Water System
programs in many countries that need them, and many
existing programs are not yet at national scale. Initiation
of new programs and expansion of existing ones would
yield tremendous health benefits for relatively little
cost, and put in place an important tool for disaster
and epidemic response.
If you have any questions, please feel free to contact
us at safewater@cdc.gov. |
