Since 2011, Dr. Christine Moe and the Center for Global Safe WASH at Emory University have been evaluating the impact and sustainability of water treatment systems donated by General Electric Foundation to health facilities in Honduras, Ghana, and Rwanda.

In Ghana and Honduras, the research team have focused their work on monitoring performance and use of the treatment system, water quality, and issues of sustainability.  In collaboration with Assist International, the team has worked to identify and document the most important elements necessary for the sustained provision of safe water in GE-sponsored water treatment hospital sites. From field observations and data collection activities, the research team developed a comprehensive sustainability metric that provides a scoring system to assess and track four main domains of sustainability:  technical feasibility, onsite capacity, accountability, and institutional engagement.  The metric has been field tested and deployed in four district-level hospitals in Honduras and six hospitals in Ghana.  Recent funding from the GE Foundation will allow for the reconfiguration of the metric into a more rapid tool that can be used to assess the sustainability of any central water treatment intervention in a hospital setting.

In Rwanda, CGSW conducts ongoing monitoring of GE water treatment systems by evaluating system performance, water availability and quality in ten healthcare facilities.  The Rwanda program has also developed a unique safe water delivery strategy via water kiosks at the ten healthcare facilities.  A business operation plan and community mobilization campaign has been launched to support this market based strategy that purposes to increase the scale of safe water provision and provide a source of income to help sustain the hospitals water treatment system.  Extensive training and collaboration with government partners have been done to ensure appropriate governance and accountability for the water systems.

Safe Water for Healthcare Facilities in Cambodia and Uganda: Establishing Sustainable Safe Water Solutions and Building the Evidence Base for Advocacy

In 2013, Dr. Moe and the CGSW received another award from the GE Foundation for a four-year global research and advocacy program for safe water access in healthcare facilities. Similar to the previous projects, the research team will evaluate the performance, use, and sustainability of water treatment systems donated by GE Foundation in healthcare facilities in Cambodia and Uganda. The team will also conduct targeted research on the role of safe water and improved hygiene on healthcare outcomes for mothers and children. A distinguishing feature of this award is the plan to work collaboratively with UNICEF Headquarters on a global advocacy campaign to increase awareness and action on the issue of improving water, sanitation, and hygiene conditions in healthcare facilities around the world.

The SaniPath Study: Assessment of Fecal Exposure Pathways in Low Income Urban Settings.

Funded by the Bill and Melinda Gates Foundation, the SaniPath study is a multidisciplinary investigation to quantify the consequences of a broken sanitation chain in Accra, Ghana, a city of four million people without a functional municipal sanitation system. One goal of the SaniPath study was to examine sources and movement of fecal contamination in four diverse, low-income urban communities and quantify the risks of exposure to fecal contamination in public (beaches, public latrines, schools, urban agriculture products, drinking water, and open drains) and private (households and childcare centers) domains.

Using a mixed methods approach and state-of-the-art environmental microbiology and behavioral science techniques, the research collected and tested almost 2,000 environmental samples and conducted over 500 hours of structured observation. The results indicate widespread and often high levels of fecal contamination in the environment and the food supply. This contamination has consequences for health and well-being both for low-income communities within the city and for the whole city population.

Based on the results of this study in Accra Ghana, the SaniPath team has developed a rapid assessment tool. The tool aims to assess exposure to fecal contamination in urban, low-income settings. The tool guides users in collecting much needed data on exposure to fecal contamination in low income, urban neighborhoods, and synthesizes these data for community, government, and service providers’ decision-making. The tool will be publicly available and is intended for non-governmental organizations, funders, and government institutions. For more information about the SaniPath tool, please click here.

The Moe Laboratory

For more information about the Moe Laboratory and ongoing projects in environmental risk assessment, surface and water disinfection, and norovirus epidemiology, please click here.