Steps toward clean water

Communities across the globe are seeing an uptick in access to water, sanitation and hygiene (WASH) facilities as efforts ensuring safe water and sanitation for all progress. Despite the increase in piped-water, handwashing stations and latrines, exposure to fecal pathogens often through contaminated water kills hundreds of thousands of people – particularly children – each year. As governments and aid organizations continue working toward Sustainable Development Goal 6, a better understanding of whether such infrastructure leads to improvements in household health can help inform future efforts.

James Winter, a PhD student in the Civil & Environmental Engineering Department at Stanford presented research to over 140 scholars at the University of Colorado, Boulder WASH Symposium recently. Entitled “From Tank to Tap (and Beyond): Impact of Piped Water Systems on Hand and Water Contamination in Zambia,” his work focuses on examining how installing piped-water systems affect contamination of household water used for cooking or drinking. Here, he outlines his work and findings. 

Can you describe the work you presented at the symposium?

My research is broadly trying to answer the question of what happens to a household's well-being, quality of life and health when you move their primary water source radically closer to their home. My focus is on the impact that an installed piped-water system in rural Zambia has on household water quality and microbiological contamination of people’s hands. This is important because when you provide people with high-quality water close to their home, there are wide ranging benefits to hygiene, hand washing and disease transmission, in addition to the time averted from fetching water from distant sources. And when you consider to whom these benefits accrue, these systems disproportionately benefit women and girls, because they are most frequently responsible for water fetching, water storage and household cleaning. 

What are the main findings of your research?

I found that the piped systems successfully delivered water free of fecal contamination to the home. When households obtained access to improved water at home, they washed their hands more often, leading to a 60% reduction in fecal contamination on the hands of female heads of household. This is important because, as we’re reading about in the news these days, hands are one of the most important vectors of illness transmission. My study also found that increasing access to water resulted in a much larger reduction in hand contamination than previous programs that promoted better handwashing practice but didn’t improve water supply infrastructure at the same time. Those studies found impacts ranging between 0 and 30 percent reduction in hand contamination.

At the same time, households in Zambia who got a tap near their homes still reported storing their water for about the same duration of time before drinking it. This was surprising to me – I expected households living so close to the water source would store their water for shorter periods of time. However, because the water system didn't deliver water 24 hours per day, households continued to store water. This at least partially resulted in the introduction of fecal contamination into their water before the water was consumed. Although this is disappointing, because these households are now receiving their water from a centralized storage tank, this presents the WASH field with an opportunity. Centralized chlorination, even in small, rural systems is something that has received more focus in recent years. For example, Lotus Water – a joint effort led by Jenna Davis and Stephen Luby – showed that centralized chlorination can lead to large reductions in fecal contamination in drinking water in the home. 

How does this work fit into the bigger picture of the WASH community?

The United Nations’ new Sustainable Development Goals target providing reliable, on-plot water service to all households by 2030. These are ambitious targets, and they are particularly costly in rural areas where households live relatively far from each other. Governments and external donors who will be funding these projects need to know what benefits can be expected from such large capital investments. This study makes an important contribution in that regard. 

Specifically, the findings suggest large reductions in the time women are spending fetching water, increases in the amount of water that is being consumed and large reductions in the fecal contamination found on the hands of female heads of household. These are compelling results that can help justify the installation of these higher-cost water supply systems, even in rural areas.  

What are you interested in exploring next?

This study was generously funded by Stanford SEED and the King Center on Global Development – however I was only able evaluate the impact of these piped systems on two villages. Therefore, some of my confidence in the findings would be increased if we were able to do this study on a larger scale in maybe a few different provinces at the same time. Zambia is twice the size of California, so we’re talking about a huge area, and culturally the tribes are very different. 

I’m also growing increasingly interested in two things. One is the impacts these systems have on household wealth and asset accumulation. There is some evidence on how these systems can improve household wealth, but it is not currently being integrated into proposals for new piped systems in sub-Saharan Africa. I would like to help generate additional evidence to help local governments and planning departments make informed decisions about the impacts these systems have on incomes and the ability of communities to participate in the financing of the systems. Secondly, I would like to learn more about how these systems are sustained. All too often you see beautiful piped water systems constructed without a robust plan in place for operation and maintenance. I’d like to understand more about the determinants of how and why these systems are breaking down and learn more about the systems of accountability that can support these large capital investments.