groundwater iron an important source for women in Bangladesh

Iron deficiency is the most common micronutrient deficiency in the world.  Although many believe that anemia and iron deficiency are synonymous (as I did until a few weeks ago), iron deficiency is but one  cause of anemia.   Iron deficiency and anemia are both associated with increased risk of morbidity and mortality and pose a real threat to women in the developing world.

Scientists have shown that iron-fortified water and cooking with cookware can both lead to improved iron status but few believed that natural sources of iron in groundwater could offer iron in the correct state, and in high enough concentrations, to have nutritional benefits.  That is, until researchers from a large nutrition study in Bangladesh, JiVita, noted that women in their target area had much lower prevalence of anemia, iron deficiency, and iron deficiency anemia than much of the country.  They started to ask themselves what makes this population different. They failed to attribute these discrepancies to demographics, differences in dietary intake of iron, and differences in the prevalence of other infections/diseases.  Next they turned to the women’s water source.

This population almost exclusively drinks from groundwater through tubewells. Despite the high variability of groundwater iron concentration in Bangladesh, they found a median total iron concentration of 16.7 mg/L –  greater than other parts of the country with higher iron deficiency prevalence. The team estimates that women in the study ingest ~42 mg/day of total iron and expects a 6% increase in ferritin concentration for every additional 10mg/day.

So in short, it seems that groundwater iron can offer nutritional benefits to women.  These nutritional benefits may in turn reduce mortality and morbidity associated with iron deficiency and anemia.

So why do I think this is interesting?

1. This may be important to consider when treating water in areas with high concentrations of iron in their groundwater.  In Bangladesh, what is the impact on nutrition of all the technologies that remove iron at the same time as arsenic?

2. Will iron concentration in groundwater now play an important role in nutrition studies?

If you want to learn more about this, here is a great presentation by Rebecca Merrill who did a large part of this research for her doctoral dissertation.


wash and phones

With all the buzz about using cell phones in the field of development I decided to do a quick review of the different ways people have attempted to use cell phone technology to improve water sanitation and/or hygiene related access.

When we talk about cell phones for water and sanitation we are talking about a broad range of uses and technologies.  On the simple end we can use basic cell phones to transmit data through sms (text messages) or voice.  We can get more fancy and utilize smart phones that run more serious operating systems and have powerful features like internet connectivity, gps, and cameras.  Here are some examples of how people have started using cell phones to improve WASH services in Africa and Asia:

1. Community Led Total Sanitation Tracking via SMS – In a World Bank WSP funded project in Indonesia, Health Officers and Sanitarians started using SMS to report on baseline conditions and progress on the path towards Open Defecation Free Communities.  The officers text in the number of latrines contructed and other key information to a SMS server which processes the information and puts it into some sort of database.  According to WSP they will plan to replicate this in 29 districts in the Province.

2. Q&A – IRC International Water and Sanitation Center piloted an SMS based Question and Answer service to link communities and individual users with information related to their water supply.  Questions submitted via SMS are (or were) answered by one of the members a Water and Sanitation Network.  Questions ranging from the costs of spare hand pump parts to inquiries about low pressure in a piped system in Dar es Salaam have been answered by this service.  This pilot project started back in 2005 and I have not received any response by the operators whether they are still in action.

3. Water from Cell Phones – Grundfos, the Danish pump company, launched a new business model called LifeLink.  LifeLink is a small water enterprise (see previous post on SWEs) that uses cell phones to transfer “water credits” from the user’s bank account to that of the pump operator.  Lifelink constructs a solar powered water kiosk in a community and when someone wants to buy water they add credits to their account thorugh a simple text message transaction.  The kiosk displays the users balance after they swipes some sort of pass.  After that they are free to have as much water as they can afford.

4.  Information Broadcasting – A number of programs throughout Africa and Asia have attempted to use SMS to broadcast information about everything from handwashing to water conservation.

These four cases are surely not comprehensive but give good examples of what people have used phones for in the WASH sector.  I think we can break these uses down to the following:

  • Monitoring and evaluation – Cell phones can be used to collect information and relay data back to some central location.  This fucntionality can be extremly useful for tracking progress of work and maintaining transparency.
  • Information Services (to end user) – People can get information by calling or texting a specified number (in addition to the example above check out google sms in Uganda).
  • Gateway – The cell phone can act as a mechanism to enable a service (think about the Grundfos example above).

To date none of these projects have really gone to scale.  As you could imagine there are some huge barriers to success including poor cell phone networks (including poor coverage and a lot of system downtime).  I have a few ideas of my own on how to enhance WASH service delivery with cell phones and hope to post them in the coming weeks.
Any other interesting cell phone based projects?  Post them in the comments section.

football and poop?

Taking advantage of the football (read soccer for the us’ians reading this) craze in Africa leading up to the World Cup, a few European Governments have started an initiative called WASH UNITED. I couldn’t find too much information about what they specifically plan to do but it seems like they want to get high profile footballers to promote water sanitation and hygiene topics throughout Africa.  They are now hiring country coordinators so I’m sure we will hear more as soon as they get to work.  Football sure does have some serious fans in Africa, and not only in urban areas like many other sports.  This could have some serious impacts if done correctly.  Let’s see what happens.

Does anyone know more about this?



As many of you probably know, the theme at the American Public Health Association’s Annual Meeting, taking place in Philadelphia next week, is “Water and Public Health.” The speakers look great as and if you haven’t already checked out the line up I suggest you do.

hygiene and sanitation falling through the cracks?

Just thought someone would enjoy this photo I doctored up for a presentation a few weeks ago.  What does it all mean?

the safe water biz

What do PepsiCo, GE, Rotary Club, Harvard, Johns Hopkins, ARD, and Tata Trust all have in common?

An interesting group of academics, private sector representatives, and people from Governmental/International Organizations came together last week to discuss the Small Water Enterprises (SWEs). What is an SWE? SWE refers to the management of water as a business, for or non-profit, by non-state entities. SWEs provide opportunities for supplying safe water to many underserved populations throughout the world but also raise ethical challenges.

Donkey Cart SWE (Photo Taken by WhiteAfrican)

A small water entrepreneur at work

From a company in Ghana packaging and distributing drinking water sachets to a community owned high-tech membrane treatment plant kiosks in India, SWEs come in many forms. Small water enterprises illustrate one solution where governments fail in providing safe water to communities. Where do governments fail? We find examples everywhere, from far away hard to reach rural areas to urban slums…Who will supply water to an “illegal” squatter settlement? Will a government fulfill their duty of providing water while in the same action recognizing and investing in an illegal settlement ?

By definition, SWEs do not require economic viability on their own. Some models rely on subsidies while others are run for profit. The users of SWEs often pay more for their water than those served by public utilities (think economies of scale). While paying more for their water, these users may also receive an inferior product. Recent reviews of existing SWEs (see links below) cite the lack of regular water quality monitoring as a serious barrier to successful growth.

In thinking about what would happen if SWEs take off (some would argue they already have), my continually reverts back to two realities:

Reality #1: SWEs gain traction throughout the world through financing schemes and recognition by governments. They end up serving the majority of people in previously underserved in communities but the most vulnerable are left out (or they are taken care of in some communities with stronger cohesion and social mechanisms).

The people with any political capital in places served by SWEs are probably able to afford the water. Is it likely that they would continue to lobby for water if their needs are met? Will politicians really see the needs in these communities or will it be masked by the coverage of SWEs? Will the government have any real incentives to invest in water utilities in these areas after most of the people are covered by an SWE?

Reality #2: SWEs gain traction throughout the world and communities are slowly lifted out of poverty. This leads to a wealthier community with few people who cannot afford the water and stronger communities that will take care of their poor. (a bit too simplistic and reductive but it will work for this blog)

What concerns me the most is SWEs leaving the most vulnerable behind. Pro-poor policies within certain governments who choose to recognize the legitimacy of SWEs could help with this – but do you really think it could happen?

SWEs can provide some amazing opportunities to get safe (not just “improved”) water to people who need it, but in the long run will this come at a cost to these very same people? As SWE popularity increases with entrepreneurs, international organizations, and private companies , we will just have to wait and see (hopefully set up some useful studies too).

If you want to learn more about SWEs check out these resources:

Also, check out some of the work of EcoTact Ltd. in Kenya who applies this model to sanitation…Pretty interesting and promising stuff!

Golden Poo Awards

PooP Creative (yep that is POOP creative) and the London International Animation Festival joined forces in creating the Golden Poo awards. The objective was to create short and funny animation videos about key hygiene and sanitation issues. Well – some of the contestants did a really great job. Check out these two: