Lessons learned from fifteen drinking water treatment program evaluations in Haiti

Providing safe drinking water is a priority in emergencies. The 2010 earthquake in Haiti and subsequent cholera outbreak thus led to the implementation of numerous point-of-collection (PoC) and point-of-use (PoU) water treatment programs. We propose to present a synthesis of lessons learned from fifteen evaluations conducted in Haiti between 2010 and 2016, including four PoC and eleven PoU water treatment programs, to better understand which strategies have helped make programs effective and sustainable. Overall, it appears that PoU water treatment technologies were more effective than PoC water treatment programs in the Haitian context. Additionally, evaluation results suggest that programs achieving sustained effectiveness were those that:1) promoted technologies that were effective and familiar to beneficiaries; 2) had reliable supply chains for water treatment products; 3) worked with local partners; and, 4) included monitoring

Characteristics of the Ebola virus and of the selected test organisms.

<p>Characteristics of the Ebola virus and of the selected test organisms.</p

Approach for the selection of a bacteriophage surrogate for the Ebola virus to evaluate surface disinfection efficacy.

<p>Approach for the selection of a bacteriophage surrogate for the Ebola virus to evaluate surface disinfection efficacy.</p

Observed average first-order inactivation constants (k, min^-1) and log inactivation (LI) at 0.1% and 0.5% NaOCl.

<p>Observed average first-order inactivation constants (k, min^-1) and log inactivation (LI) at 0.1% and 0.5% NaOCl.</p

Behavior of bacteriophages MS2, M13, Phi6, and PR772 and of the Ebola virus (results from Cook <i>et al</i>. [24]) when exposed to 0.1% and 0.5% NaOCl for 1, 5, and 10 minutes.

<p>The units are [log₁₀ PFU/mL] for the bacteriophages and [log₁₀ TCID50 units/mL] for the Ebola virus. The error bars represent the standard error of the mean of triplicate experiments (3 biological replicates of 3 technical repetitions for the Ebola results). The asterisks indicate that concentrations were under the detection limit (for PR772 at 1, 5, and 10 minutes, and for the Ebola virus at 5 and 10 minutes).</p

Experimental design.

<p>Experimental design.</p

Benefits and drawbacks of commonly used handwashing protocols.

<p>Benefits and drawbacks of commonly used handwashing protocols.</p

<i>E</i>. <i>coli</i> handwashing results.

<p>Error bars represent standard error of log reduction.</p

Phi6 rinse water results.

<p>Error bars represent standard error of log reduction.</p

<i>E</i>. <i>coli</i> rinse water results.

<p>Error bars represent standard error of log reduction.</p