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Assessing the PoUWT Response in the Haiti Earthquake: Preliminary Findings

Assessing the PoUWT Response in the Haiti Earthquake: Preliminary Findings. Daniele Lantagne, PE LSHTM. Note - Preliminary Data. All data in this presentation is preliminary unless otherwise noted in the notes section.

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Assessing the PoUWT Response in the Haiti Earthquake: Preliminary Findings

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  1. Assessing the PoUWT Response in the Haiti Earthquake:Preliminary Findings Daniele Lantagne, PE LSHTM

  2. Note - Preliminary Data • All data in this presentation is preliminary unless otherwise noted in the notes section. • Data is being released in this presentation to help inform the ongoing response in Haiti, and any use of data for that purpose is authorized. • The author does NOT grant use of this data for reference or written publication unless specifically approved via email at danielelantagne@earthlink.net.

  3. Who am I? • Public health engineer (MIT ‘96, ‘01) • 1/2 time with CDC • 1/2 time with LSHTM • Worked on PoUWT for 10 years • At CDC, provide technical assistance on implementing and evaluating PoUWT programs • At LSHTM, research PoUWT in emergencies

  4. LSHTM Research Project Supported by UNICEF and Oxfam to answer: • What role, if any, should PoUWT play in emergency response? • What are the factors associated with feasible, and potentially sustained, implementation of PoUWT in response to emergencies?

  5. Haiti Earthquake • January 12, 2010 • 7.0 on the Richter Scale • 222,517 fatalities • 3 million affected • Immediate impact • Extensive shelter damage • Internal displacement

  6. Existing PoUWT in Haiti • Existing products in Haiti prior to earthquake • Chlorine: Aquatabs, Gadyen Dlo, Dlo Lavi, Klorfasil, Klowoks, Jif • Filters: Biosand filters (two organizations), Kado Dlo • Discontinued: PuR, ceramic filters

  7. Decision to Deploy Selection criteria • High diarrhea risk emergency • Flood, outbreak, displacement • Multiple PoUWT options used • Water supply options used • Populations have various levels of exposure/training • Logistically feasible Met criteria, decided to deploy

  8. Research Plan • Information gathering • Spatial analysis • Household surveys • Water quality testing • Qualitative interviews • Costs/logistics

  9. Information Gathering - Acute PoUWT Response • Actually distributed in first 5 weeks • 2,880 Gadyen Dlo buckets with Aquatabs in Leogane • Aquatabs in 48 Camps in PaP and others in rural areas • ~350 ceramic filters in Jacmel • 238 biosand filters across Port-au-Prince • 70 Klorfasil bottles in spontaneous settlement in Canape Vert

  10. Spatial Analysis • Google Earth maps • Existing from DSI • Emergency from CDC • GPS points collected • All households surveyed

  11. Households Surveyed

  12. Leogane Communes - DSI Distribution

  13. Questionnaire • Survey • Developed by primary investigator • Translated into Kreyol and printed in Atlanta • Enumerators trained (18/19-Feb-2010) • Enumerators back-translated, edits written in • Administrated 19-Feb-10 to 11-Mar-10 • Questions • 30 questions on family, SES, water, known PoUWT methods • 12-20 questions on each PoUWT option received • Summary questions on current water supply/water testing • Minimum 31 questions (no products received) • Maximum 103 questions (all products received)

  14. Survey Implementation

  15. Did not vary significantly by program • Average known per family: 2.01 options • Average chlorine known: 1.28 options

  16. Water Sources

  17. Water Sources - HRC Spontaneous Settlements

  18. Inappropriate Targeting

  19. Chlorine Knowledge By Program

  20. Reported Treated Water at Unannounced Visit

  21. Reported Treated Water at Unannounced Visit - HRC Spontaneous Settlements

  22. Source Turbidity (n=316) • n=316 • 10/316 (3.2%) over 10 NTU • No need for filtration prior to disinfection

  23. Turbidity Testing

  24. Chlorine Residuals in Treated Water

  25. Microbiological Contamination - Source

  26. Micro Contamination - Tanker Truck Water Tested 22 samples for chlorine residual: 17/22 (77%) had 0 mg/L free chlorine, remainder 0.1-0.5 mg/L

  27. Micro Contamination - Tanker Truck Water

  28. Treated-Untreated Water Pairs: DSI Aquatabs Treated Water E. coli

  29. Treated-Untreated Water Pairs: DSI program

  30. Treated-untreated Water Pairs: HRC

  31. Treated-untreated Water Pairs: Klorfasil

  32. Treated-untreated Water Pairs: Gadyen Dlo

  33. Treated-Untreated Water Pairs: All Chlorine Options

  34. Treated-untreated Water Pairs: All Chlorine Options (only FCR>=0.2)

  35. Treated-untreated Water Pairs: Ceramic

  36. Treated-untreated Water Pairs: BioSand

  37. Treated-Untreated Water Pairs: Clean Water for Haiti

  38. Summary of Microbiological Effectiveness

  39. Summary - Water Quality Improvement

  40. Summary - Water Quality Improvement

  41. Qualitative Interviews • Due to the constraints of geography and time in the Haiti earthquake, the qualitative work was conducted as follows: • Recorded interview with DSI • Informal interview with notes with • Klorfasil • HRC • Pure Water for Haiti • Email interviews • FilterPure • Results are summarized in the following slides

  42. Cost Portion of the Study • To be very frank, • The primary investigator has been (like many of you) a touch busy lately and hasn’t done this yet. • But, • She feels that cost is probably not the critical factor for decision making of using PoUWT in response to the Haiti earthquake. • She’d love if you could email her the cost of providing any water supply options or PoUWT options if you have any data that might be of interest (and she might email you to bug you as well). danielelantagne@earthlink.net

  43. Overall Lessons Learned • Confirmed distribution reached very small percent of affected population • However, high adoption when: • Appropriate targeting • Community mobilization • Low, but noticeable uptake in random AT camp distributions • Poor microbiological quality of BSF

  44. Future Work • Recommend continuing targeted, appropriate PoUWT as supplement to water supply activities for rural / unreached areas • Assist with tanker truck water quality assessment • Enter and analyze survey data • Write formal paper and deliver • Mid 2010 • Complete follow-up in March 2011

  45. Very Special Thanks - The Survey Team Christophe, Thibert, Nancy, Denys, Marie-Gabrielle

  46. Also Thanks To:Deep Springs InternationalClean Water for HaitiHRC, FilterPure, KlorfasilThe GoW Baudin Water TechnicianUniversity of Notre Dame / CDC / Gates Filiarisis Eradication Guest House For graciously assisting the survey. For providing a bit of lawn to pitch my tent, and so much more.

  47. Thank you. Meci anpil. I am happy to take questions, and please feel free to email me with any questions, thoughts, requests for data, additional information, etc. daniele.lantagne@lshtm.ac.uk

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