Evaluation of a Silver-Embedded Ceramic Tablet as secondary Point-of-Use Water Purification Technology

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1 Evaluation of a Silver-Embedded Ceramic Tablet as secondary Point-of-Use Water Purification Technology UNC Water and Health conference 2 nd Oct 2018 Dedicated to Safe Water and Sanitation for All

2 Study area

3 Study area

4 Does Honduras Disinfect? Honduras Population: 9,012,229 people 46% living in Rural Areas Instituto Nacional de Estadística Trojes Population: 51,979 people 82% living in Rural Areas Disinfection levels on drinking water in Honduras 60% 50% 40% 30% 20% Disinfection Levels on Drinking Water in Trojes URBAN RURAL 10% 0% 50% 36% URBAN RURAL Source: MAPAS II (Sistema de Información de Prestadores del ERSAPS y registros del SANAA)

5 Does Haiti Disinfect? 28% 5% 72% 95% Say they Chlorinate Say they don't Chlorinate Chlorinate at home Do not chlorinate at home 49% 86% 68% 59% 14% 32% Did not accepted a test Accepted a chlorine test Tested negative Test were positive Said they did not chlorinate (public system) Were actually chlorinating

6 Objectives Assess user satisfaction and compliance with current protocols Assess the effectiveness of MadiDrop in removal of pathogens (E. coli) Assess the usability, acceptance of MadiDrop in community groups, and behavioral adaption of community members.

7 Disinfection Ag +

8 Methods 1. Field survey on the current practises Current use of the filter Current use of desinfectant in safe storage bucket Willingness to try another desinfection method Water quality testing : Source, filter and bucket

9 Methods 2. Laboratory study : efficiency of the Madidrops over a 6 months period Filter + chlorine in safe storage bucket (3) Filter + Madidrop in safe storage bucket (3) Filter + Nothing (control) (3) Water quality testing (E.coli) after fitration AND after 24hours spend in the safe storage bucket

10 Methods 2. Laboratory study : efficiency of the Madidrops over a 6 months period 9 FILTERS WORKING 3 Buckets for Control 3 Buckets for Chlorine 3 Buckets for Silver 8 Times Over 6 months 19 SAMPLES PER ROUND Source 3 B.Control (No Treatment day 1) 3 B.Chlorine Pre-Treatment 3 B. Silver Pre-Treatment 3 B. Control (No Treatment day 2) 3 B. Chlorine 24h later 3 B. Silver 24h later

11 Methods 3. Field survey : user acceptability of Madidrops Current use of the filter Current use of the Madidrop Perception of the desinfection method Willingness to pay for the Madidrop (9 USD) Water quality testing : Source, filter and bucket

12 Methods 3. Field survey : user acceptability of Madidrops 50 silver tablets installed on Househols Monitored before installation Monitored after 6 months 14 Tablets installed on Schools Filtered and Storaged monitored Pre-installation July 17 February 18 Post-installation February 18 July 18

13 E.COLI Results Current practises Homes in haiti (N=117) 95 % filter use Water source Filter Safe storage bucket 1.7

14 E. COLI Results Current practises Honduras schools (N=14) Water source Filter Safe Storage Bucket

15 Results Current practises Chlorine usage : 3 Group of users: 1. Do not appreciate the taste of Chlorine 2. Chlorine is not available anywhere in the community 3. Never used Chlorine due to its health impact 87% of respondent are willing to try Madidrop

16 E.COLI Results Lab study Source water DAYS

17 E.COLI Results Lab Study After Filtration (T=0) Chlorine1 Chlorine2 Chlorine3 Madidrop1 Madidrop2 Madidrop3 Control1 Control2 Control DAYS

18 E.COLI Results Lab Study 120 Safe Storage bucket (T=24h) Chlorine 1 Chlorine 2 Chlorine 3 Madidrop1 Madodrop2 Madidrop 3 Control 1 Control DAYS Control 3

19 Results Field study N=50 40% 35% 37% Madidrop use 30% 25% 20% 26% 23% 15% 10% 5% 9% 5% 0% Does not used it Current User Used during 6 months Less than 6 months More than 6 months

20 Results Field study 74% satisfaction 60% reported improved family health 70% 60% 50% 40% 30% 20% 10% 0% User Taste perception 65% 33% 2% Worse The same Better

21 Results Field study 93% would like to receive another Madidrop 65% Reported a willigness to pay 9USD for a Madidrop (1year usage time) Water quality madidrop None

22 Conclusions Efficiency : Madidrop proved its efficiency removing E.coli in Safe storage buckets and preventing for recontamination Usage : Only 50% used it correctly 26% did not used it at all Significant willingness to pay regarding the price

23 Comparison of Rural and Urban Biosand filter projects UNC Water and Health conference 2 nd Oct 2018 Dedicated to Safe Water and Sanitation for All

24 Study context 722 filters in Rural areas 244 filters in slum setting Monitoring a year after installation 2 3 1

25 Water sources 100% 90% Rural Water sources Urban 0% 7% 7% 80% 70% 60% 50% 40% <0.4 l/m l/m l/m >0.8 l/m 30% 86% <0.4 l/m l/m l/m >0.8 l/m Rural Urban 20% 10% 0% Handpump Spring Other Rainwater Canal River St

26 Quantity of water used 80% Number of Buckets/day in filter 75% 70% 60% 50% 40% 30% 20% 10% 0% 47% 40% 22% 10% 0% 1% 2% 1% 2% Rural Urban

27 Filter parameters 100% 91% 88% 80% 41% Rural Urban 28% FLOW RATE WITHIN RANGE FILTER USED DAILY FILTER PASS 9 PARAMETERS

28 Hygiene and uses of filtered water 84% 93% 99% 89% 90% 91% 87% 72% 40% 47% Rural Urban 22% 2% 3% 11% HAND WASH TIME/BEFORE EATING HAND WASH TIME/AFTER BATHROOM PRESENCE OF LATRINES FILTERED WATER USE/TO DRINK FILTERED WATER USE/TO COOK FILTERED WATER USE/TO WASH HANDS FILTERED WATER USE/TO BATH

29 User perceptions 100% 99% 100% 99% 79% 86% 87% 86% Rural Urban WATER TASTE AFTER FILTRATION WATER ODOR AFTER FILTRATION WATER COLOR AFTER FILTRATION HEALTH STATUS SINCE FILTER USE

30 Conclusions Filter use is higher in rural areas Filter parameters are better respected in urban areas mostly due to the quality of source water Uses of filtered water in urban areas is more diverse due to the availability and closeness of water sources but also other choices available Hygiene knowledge and practises are higher in urban areas exposed to messages since the cholera outbreak Urban users who have the choice prefer other water tastes

31 Mesi anpil! Thank you!