Water and wellness
By Diana Schoberg
The Rotarian -- August 2009
Photography by Alyce Henson
María Magdalena Gonzalez uses filtered water for cooking. Her family’s gastrointestinal ailments have disappeared because of the filter.
L unchtime is drawing near, and María Magdalena Gonzalez, 28, hoists up a jug of water and pours some into a pot on the stove. She adds rice she’s had soaking in a bowl on the countertop. Meat and green peppers are stewing. As she works, she washes her dishes using water pulled from a pail under the sink. Gonzalez’s mother prepares to give eight-month-old Hilary a bath.
Before Rotarians gave them the bio-sand filter that now sits along one wall of the kitchen in their home near Bonao, in the center of the Dominican Republic, the family bought bottled water, which was often fetid. Three-year-old María Magdalys, who now darts through the kitchen playing, spent two weeks in the hospital with diarrhea; Gonzalez was once so dehydrated from amoebas that she was given five bottles of saline solution. Now they use filtered water for everything. Baby Hilary, who has known only clean water during her short life, is pudgy; her skin is clear. The family is healthy. “Sin agua, no hay vida,” Gonzalez says, in what becomes a common refrain I hear during a week in the Dominican Republic. Without water, there is no life.
Spend some time in the Dominican Republic, and you’ll find many people like Gonzalez whose lives were affected by bio-sand filters – and Rotary. There is Rosa Día, who had an open sore on her foot that healed only when she bathed it in water from her sister’s bio-sand filter. There is Sandra Castillo, who walks half a mile from her cousin’s house carrying filtered water, the only thing that will get rid of her skin irritations. And then there is the biggest miracle of all, the one that proved to Rotarians that this was a worthwhile venture: Marisol Hernandez, now 12 years old, for whom water from the bio-sand filter cleared up the parasites in her stomach and rashes on her skin, allowing the child’s body to fight full time the HIV infection she’d gotten from a blood transfusion.
Rotary club members have helped install 19,000 bio-sand filters in the Dominican Republic through the Rotarian-led Children’s Safe Water Alliance, reaching an estimated 100,000 people in 300 communities. For seven years, more than 200 clubs in 18 districts in Canada, the Dominican Republic, the United States, and other Caribbean countries have supported the effort, as has The Rotary Foundation, with 30 Matching Grants. In part because of the groundwork that’s already been laid, the Dominican Republic was chosen as one of three pilot countries for the new International H2O Collaboration, a worldwide alliance of Rotary International, The Rotary Foundation, and USAID.
More than 3.5 million people die from water-related diseases each year, and more than 40 percent of those deaths are due to diarrhea. (UNICEF names diarrhea as the second-leading childhood killer.) The average child in a developing country gets diarrhea three or more times a year, leading to four billion cases annually. For those who survive the dehydration, diarrhea gets in the way of nutrient absorption, which can lead to malnutrition, stunt growth and development, and reduce resistance to other infections that a child might encounter. Unsafe water – often contaminated by untreated wastewater – is a source of other infectious diseases too, such as hepatitis, typhoid, guinea worm, and cholera.
Bio-sand filters, which cost as little as US$60, reduce waterborne pathogens by more than 90 percent. With no moving parts or required maintenance, all the user has to do is pour water in. Layers of sand and gravel trap parasites, and beneficial bacteria growing on the sand kill micro-organisms.
The filters were invented in 1990 by David Manz, a former professor of environmental engineering in Calgary, Alta., Canada. When Rotarians began to apply them in the Dominican Republic, they asked a scientist from the U.S. Centers for Disease Control and Prevention to come to the country to make sure they were using the appropriate technology. They found out that although the filters were proven effective in the laboratory, the large-scale scientific field study that would be needed to push them onto the shortlist of technologies approved by the World Health Organization had never been conducted.
The Rotarians took matters into their own hands. They contacted water expert Mark Sobsey, a professor at the University of North Carolina, Chapel Hill, and consultant to WHO, to research the filters, supported in part by $85,000 in donations from Rotary clubs and districts in Colorado and Michigan, USA.
The results were astounding. The study, carried out in 2005-06 in Bonao, found that bio-sand filters reduced diarrheal diseases by about 45 percent. A later article by Sobsey, which compared bio-sand filters with four other household point-of-use technologies, ranked them at the top. (Ceramic filters, which filter water through a clay pot, were also highly recommended.) Because the bio-sand filters are easy to use, there are no breakable parts, and the water looks and tastes good, 85 percent of households were still using them after eight years.
Manz credits Rotarians for helping to propel the technology onto the world stage. “Rotarians played a pivotal and central role, and continue to do so,” he says. “Right from their beginning, it was their response to me – they became proactive, they understood the need was there, and they had a capacity to help.”
Aguas Negras barrio, Puerto Plata, Dominican Republic
The Dominican Republic is the No. 1 tourist destination in the Caribbean, with nearly four million visitors in 2008 alone – more than double the number in Jamaica, and triple the Bahamas, according to the Caribbean Tourist Organization. During my stay, I see the rows of resorts in Puerto Plata, their arched entrances beckoning. I’m here as part of a Rotary International crew touring bio-sand filter projects with Bob Hildreth and his wife, Ysabel, and Sara Lucena, members of the Rotary Club of Puerto Plata Isabel de Torres.
Bob Hildreth moved to Puerto Plata in 1991 after a career as a U.S. Army aviator, with assignments as an attack helicopter pilot, instructor pilot, and ultimately a counternarcotics worker in South America (evident in the fearless manner in which he navigates the Dominican highways). Today, he owns collateral loan and jewelry businesses and runs his own nonprofit, Project Las Americas. It was his desire to do something about the dirty water in his community that led him to join Rotary in 1997; he found the connections that he could make through his club key in carrying out water projects.
On our first full day in the country, Hildreth takes us to Aguas Negras, a barrio of Puerto Plata where his Rotary club has been particularly active. Aguas Negras means “black waters” – so named because of the sewage treatment plant just up the road. But there’s no sewer system in this neighborhood of about 5,000 people, and a rivulet of human and animal waste flows between the patchwork of wooden shacks and into the ocean.
In Aguas Negras, an aqueduct provides water to residents; those who don’t have piped water in their homes have access to public taps located periodically along the streets. That doesn’t mean it’s always on, though. Only 10.5 percent of homes on the public water system receive water continuously, according to a 2008 report prepared for the Inter-American Development Bank. Hildreth says that the changes in water pressure when the water is turned on and off cause contaminants to be sucked into the system.
Most of the people we meet turn to other sources for their water, like rivers, rainwater, or bottled water. Tiny shops selling blue plastic jugs of water are as ubiquitous as the bancas selling lottery tickets; in fact, the Dominican Republic has the highest percentage of urban people in the world who use bottled water as their main drinking water source, according to a 2008 report by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. The problem is that you can’t trust the quality bottle to bottle. “I could remember buying a bottle of water and opening it, and it stank,” says Hildreth, who has a bio-sand filter in his own home. “You just accept you are going to get sick every once in a while.”
And then there’s the expense. In Aguas Negras, we meet Leonida Burges, 40, who dances with her 17-day-old son, Ricardo Daniel, as we talk, his knit cap refusing to stay put. Lucena installed a filter at their house, which Rotarians helped build, just two days earlier. Burges says she pays 50 pesos (about $1.40) per bottle of water. Now, with the new filter, she’ll be able to save that money so that if the baby gets sick, she can take him to the doctor. “There’s no discretionary income for the poor of the world,” Hildreth explains as he translates the conversation. “Any little bit of money is so important to them. Five dollars to buy medicine is not in the budget; they have to sell something. The economic impact – especially if people were buying water – is huge.”
Later in the week, Hildreth and Lucena lug a couple of 50-pound bags of sand and the blue plastic shell of a filter out of the back of a pickup truck and into the home of Eridanica Pimentel. It’s installation day. The six family members crowd into the tiny kitchen along with Hildreth and Lucena. Two of the young children stand along the cement brick wall, drinking cola out of silver-colored cups as they watch.
While simple, the filter has several key features. A diffuser plate gently disperses the water poured in, like rain. The water hits several inches of water on top of a layer of beneficial bacteria, called a schmutzdecke, which kills harmful micro-organisms. Below that are layers of sand and gravel, which remove parasites that are too big to make it through. After the water is filtered into other containers, families are trained to add chlorine to finish the purification.
Lucena sticks a Rotary sticker on the outside of the filter, and using a permanent marker helps four-year-old Eric Antonio Polcaco write his family members’ names on it. (“Tu nombre,” she tells him, “tu filturo.” Your name, your filter.) Then she pulls out a pamphlet and explains to the family how to use and care for the filter: Don’t put chlorine in it because it will kill the bacteria, and don’t store food inside. Together, the installation and training take less than an hour.
Grand Rapids, Michigan, USA
Bio-sand filters got their start in the Dominican Republic in 2000, when inventor David Manz and Canadian doctor Jan Tollefson trained technicians to build the filters in a project sponsored by the Rotary Club of Calgary Chinook, Alta., Canada, with support from The Rotary Foundation. But it was in 2002, when in a chance meeting Tollefson showed Hildreth and Jim and Susan Bodenner, of the Rotary Club of Rockford, Mich., USA, a bio-sand filter in action that the technology really took off. Intrigued by the simplicity of the design, they decided to try the filters out in a small project in Puerto Plata.
When they got back to Michigan, the Bodenners recruited clubs to go in on a $10,000 bio-sand filter project, with the caveat that each participating club would send a Rotarian to the Dominican Republic to see the filters for themselves. They’ve since led nearly 200 Rotarians and 14 trips, each creating Rotarian advocates who return home evangelizing the virtues of the filters and then raising the money to install even more of them. “Every time after that first time, people coming back who hadn’t been on the trip before had the same feelings that Jim and I did: I wish others from our club would see it, I’ve changed, I totally understand,” Susan Bodenner says.
Meanwhile, Hildreth spread the bio-sand filters to other Rotary clubs in the Dominican Republic, which went on to lead their own projects once they tried out the technology and saw how communities embraced it. Today, he’s the District 4060 water resources chair and works closely with other Rotarians such as David Crow, who coordinates water project grants for the district.
One offshoot of the Bodenners’ involvement in the Dominican Republic was their initiation in 2005 of the annual Thirsting to Serve conference, which brings together water experts and Rotarians to talk about water issues. It’s at the most recent one, held in February in Grand Rapids, Mich., that I meet up with the Bodenners and other Rotarians who work in the Dominican Republic.
Terry Allen and Charles Jespersen are two of them. Nicknamed “the Water Boys,” they met when Jespersen, a member of the Rotary Club of St. Joseph & Benton Harbor, gave a talk about the filters at Allen’s club, the Rotary Club of Lakeshore (Baroda-Stevensville-Bridgman). Only acquaintances before, they now share a business card. Allen and Jespersen have built foam replicas of the bio-sand filters, prepared PowerPoints and DVDs, and given more than 120 presentations to Rotary and Interact clubs, schools, and church groups. “If we can save kids, whatever is involved, we’ll save kids,” Allen says.
The original bio-sand filters used in the Dominican Republic and elsewhere have been made of concrete. Manz, who made the cement filter technology available free to anyone for humanitarian purposes, also held a patent on a plastic version, and the nonprofit International Aid acquired the license. (Jim Bodenner is director of water initiatives for the organization.) There are benefits and drawbacks to each. The cement filters can be made through local microenterprises, providing jobs in the country. But there are few people who make them in the Dominican Republic, limiting the speed at which the project can expand, and therefore the number of people who have access to clean water. The cement filters also weigh 300 pounds, which makes them difficult to transport into remote areas. Rotarians working in the Dominican Republic through the Children’s Safe Water Alliance have been turning increasingly to the plastic version because of its portability and mass production potential.
At the Thirsting to Serve conference, Jim Bodenner announces plans for the first distribution center for these plastic filters (called HydrAid filters) in the Dominican Republic, which will make them accessible in-country to Rotary clubs, churches, and others carrying out bio-sand filter projects. District 6360 (Michigan) committed to donating $40,000 of the projected $125,000 cost of the center; Interact District 5170 (California), is committing another $50,000. “We need to scale up this technology,” Bodenner says. “You’re going to have 8,000 kids die today from waterborne diseases. And there’s no organization in the world that can reach out and have a global reach to do this besides Rotary. Who else is going to do this?”
La Grúa, Dominican Republic
They file in, pile in, filling the wooden pews of the small church to hear the gospel of water. There are about 75 people, mostly women, residents of La Grúa, about 15 miles southwest of Puerto Plata. Hildreth explains Rotary International, why everyone’s here today: “Sin agua, nosotros morimos .” Without water, we die.
The Rotarians launch into their presentation. Lucena asks people about the needs of this community. Agua , a few say. Water. Salud , says another. Health. Comida . Food. Hildreth takes over to explain the specifics of the filters. He asks for volunteer facilitators who will receive two full days of training and payment of 200 pesos (about US$7) for their labor and follow-up work. Each family will put in 100 pesos toward the project, which will pay for transporting the filters here. “¿Hay gente interesada en este proyecto aquí?” he asks. Are there people interested in this project here?
A roomful of hands shoot into the air.
After the workshop, we drive into the batey, a place where Haitian and Dominican sugarcane laborers live. The brightly colored homes are perched on the steep bank of the Río Bajabonico; a bad flood a few years back swept away about 30 of them. We see girls carrying buckets of water up the bank to their houses, and a woman bathing in the river. Scabs and sores pock the skin of many of the children.
One man stops Hildreth to talk about the possibility of converting a dirt-floored shed into a classroom. Everywhere we go during our stay it is like this – people come up to Hildreth and Lucena to talk about the filters and other needs, or just to chat. Hildreth leads a group of children in the national anthem of the Dominican Republic and jokes with them about his hair. (With his shaved head, it’s a regular shtick of his.) Lucena, a 30-year-old social worker originally from Galicia, Spain, rounds up a group of children to play a game akin to Duck, Duck, Goose. “They treat you like their family,” she says. “They treat you like a sister or mother.”
Victoria Pichardo, the president of a federation of more than 40 neighborhood associations and community groups, helped coordinate the workshop. She says the federation has been working in the area for 16 years, and at this point it knows the needs of the communities. In this one, it’s water. The federation has been educating residents about how their health problems stem from the contaminated water they use. “For them, taking kids to the doctor is normal,” adds Lucena, who has been translating the conversation. “We are opening eyes. It is not normal.”
A big part of this project is creating demand. When generations have been raised on the same poor-quality water, people don’t realize that it is what’s making them sick. “If this is all you’ve got to drink, you’re going to drink it regardless,” Hildreth remarks.
The model Rotarians use for the bio-sand filter projects around the country works much like this: They identify local leaders in a community, people who are credible, and get them on board with the project. They then train a few residents as facilitators who spread the filters throughout the area. “We can channel the resources of Rotary into the community via advocates already doing good for the community, instead of trying to reinvent the wheel,” Hildreth explains.
Earlier that day, we met one of these advocates: Sandra Natividad Tineo, 33, a pastor in Aguas Negras and founder of a faith-based community organization that runs a school where Rotarians have installed a filter and provide daily breakfast for the students. Tineo says the Rotarians’ work reaches far beyond health benefits. Hildreth translates: “In the end, it brought dignity to the community because people from the outside took an interest. It helped to lose the shame of living in an impoverished community.”
In this country of postcard-perfect beaches, clean water is new life. Healthy children can attend school more regularly and focus more while they’re there, educating themselves for a better future, Lucena says. Their fathers are stronger and able to find better jobs. And their mothers, because they don’t have to stay home with their sick children, can work or go to school themselves. “What I see in the filter project is more than health, it’s more than money,” she says. “The filter is a tool for changing their lives.”
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