Haiti is the poorest country in the Western Hemisphere. Located in the Western Caribbean, Haiti is populated by more than 10 million people, sharing the island of Hispaniola with the Dominican Republic. More than 75% of Haitian residents are living on less than two dollars a day and almost 56% on less than one dollar a day. Haitians have limited access to resources such as health care, food, and clean water. The country lacks adequate infrastructure and is highly dependent on non-governmental organizations (NGOs) for public health, schools, and roads. Every year, Haitians die from diseases associated with inadequate water supply, especially with the high prevalence of cholera with mortality rates ranging from 19.1 to 39.4/1,000 person-years between 2010-2011 from the cholera epidemic.
The Gatineau villages in Haiti are composed of several communities in the southwestern mountanous region, where access to basic resources such as food, durable shelter and clean drinking water remains scarce. With only 69% of the population having access to an improved water source, Haiti is the most underserved country in the western hemisphere in terms of water and sanitation infrastructure. The purpose of this presentation is to describe the current state of water sanitation and hygiene (WaSH) in communities surrounding Gatineau, to identify gaps in knowledge for researchers, and to inform feasible interventions to improve water sanitation for residents these areas.
Methods:
Our multidisciplinary team, consisting of faculty and students from a school of nursing, public health, and a water institute, have been working collaboratively with a local NGO and community members to address two critical components to community health: sustainable sanitation and water resources. Our team has initiated a three-pronged approach to review the literature surrounding hand washing treatment, hygiene and sanitation. We have conducted data collection through community assessments to better understand some of the barriers and opportunities for sustainable WaSH projects to improve health. All of these initiatives are expanding on the work that the local NGO has been conducting with their Sanitation Community Development Project. Currently the NGO that serves the Gatineau villages has a community promoter program in operation. In this program, two members from each community receives training and reinforcement in basic WaSH practices based on the Center for Affordable Water and Sanitation Technology (CAWST) education materials. All community promoters reside within the communities they serve. The promoter program employs the “train-the-trainer”model for community education. Promoters attend classes at the NGO headquaters where they receive instruction on the 32-page booklet, wirtten in 5th grade level written in their native language of Haitian Kreyol.
Results:
After visiting seven water sources in the Gatineau villages, we discovered that small streams were the only type of water sources supplying the villages. One stream would serve as the main water source for up to five communities. Water came from various sources, most of which were not clean. Most started at the side or opening of the river and few rivers were full enough to create a current. . There seemed to be three designated functional sections for the water sources. At the top of the stream, women and children collected water with jugs and buckets. Some were washing their feet, bathing and laundering in the inferior section. Cattlemen would allow their livestock to urinate and defecate from the same water source even though they are fenced off to prevent eutrophication and pollution.
Conclusion:
We found that water sources in this area are scarce. Community members, usually women and children, commute anywhere from 15 minutes to one hour from their home to retrieve water multiple times a day and transport jugs and heavy containers on their heads. Research has shown that domestic water carrying is associated with detrimental health effects. During the assessment, we rapidly discovered a connection between poor water access and WaSH practices in Gatineau including: common (and uncommon) water treatment methods, and sanitation and hygiene beliefs and practices among Haitians living in these rural villages. Further research is necessary to improve water quality, sanitation, and health in low-resource countries like Haiti.