I first visited Bommanahalli, an urbanised village with slum pockets at the outskirts of Bangalore where Swasti Health Catalyst runs an 2 program, six months ago. It’s a densely populated area where people get drinking water either from pipes buried alongside drains or from local tubewells. It seemed most of the water would be contaminated with bacteria. At the i4We centre, I was told the water was tested and found to have high levels of faecal coliforms, a bacteria that causes diarrhoea.
Typically the staff at the centre collected water samples and had it tested at a local laboratory. Results came a week later and the dense data was hard to communicate. People found it hard to believe their water was unsafe to drink or that their sickness was due unsafe drinking water. This posed a problem for Swasti’s aim to improve their health. The only solution was either changing the source of water (almost impossible) or one could insist on consistent treatment (boiling of water). Swasti had a big job of convincing the community that their water caused illness and that they consistently needed to boil it. I needed a better solution….
This solution would have to work differently. It would have to be fast, convincing and reliable. I had come across the H2S test for coliform where the water in the test vial turned black in 48 hours if bacteria was present. But this only indicated the presence of bacteria that was not necessarily harmful. I needed something better.
A French company CHROMagar had approach us recently with a different sort of water test. The water turned green or yellow depending on the type of bacteria present. It took just 24 hours. It was simple and could be carried out in the field. This seemed like the sort of test that would actually show people whether their water is safe to drink. It would make the job of convincing them to treat impure water much easier as it could be done at their homes by themselves, with results available the next day.
We started the pilot in March 2018, to test samples from 25 locations over nine months. The CHROMagar team trained our staff who collected and tested samples. A batch of water samples was sent to the laboratory to check for reliability. The day after the training, we had the results. The results were dramatic in more ways than one. Many samples turned green because of the presence of faecal coliforms, indicating that the water was unsafe to drink while other samples were yellow, showing bacteria present and few remained clear; those were safe. But more than this, I saw and felt that the women in the community felt empowered to test their own water and understand the results from themselves, no third party involved and I have to thank Alberto Lerner of CHROMagar for partnering with us on this exciting journey.
With this tool in hand, we have now the means to speak to the health outcomes of water supply. Too often the means becomes an end. The end here is to use CHROMagar to test, show and convince people of the need to treat their water before drinking, if the test turns green. If it turns yellow, the water could be safe to drink because those bacteria do not necessarily make you sick! The staff was excited with the test. They could take the green vials back to the houses where they had collected the samples, convince people that drinking water needs to be disinfected.
Going forward, this will have a tremendous impact on the way people think about water and its effect on health. Just clear, odourless and colourless water may not be safe - most of the samples were like that. We will continue this pilot for several months to understand how water quality changes through the year. This will help us design a long-term strategy for communicating with people about water that will not make them ill. It will be powerful way to simplify decisions about safe water, and put it in the hands of the community.
