Household Chlorination Program to Improve Drinking Water Quality in Rural Haiti

Local creation of sodium hypochlorite solution in Haiti (http://www.cdc.gov/safewater/chlorination.html) 

This is an interesting article on a long-term program in Haiti using household chlorination to improve drinking water quality by Harshfield and colleagues. They evaluated the utility of a Safe Water System (SWS) program that was established in a rural part of Haiti in 2002. In 2010 they conducted a survey with concurrent water testing of 201 SWS program participants as well as 425 control households. These authors found that 56% of participants were correctly treating their water with chlorine (as opposed to 10% of controls) with a 59% odds reduction in diarrheal illness in children under 5 (OR 0.41, 95% confidence interval 0.21-0.79). The interesting thing about this study is the SWS program was sustainable and was having a positive impact 8 years after its creation.

We have been working in the Yoro area of northern Honduras since 2008, with our efforts focused in and around the remote, mountainous village of La Hicaca (find out more about our work here). Our public health work is primarily focused on improving access to clean drinking water via a water filter program. The above study is intriguing in that it could provide an alternative, potentially sustainable mechanism to improve access to safe drinking water for the population we serve. However, Gaby Halder conducted a large survey on access to technologies to treat drinking water in 2011 of our population and found very few people used chlorine. This was largely due to poor chlorine access due to financial and geographic barriers. If a SWS program is to be employed in a rural, remote setting such as the one we practice in, addressing these key barriers will be critical.