Feasibility of implementing the US Centers for Disease Control and Prevention's (CDC) Safe Water System (SWS) in rural Gambia

The Latin American cholera epidemic of 1992 led to the development of the Safe Water System (Point-of-Use intervention). The US Center for Disease Control (CDC) along with the Pan American Health Organization (PAHO) responded to the epidemic with a household-based intervention to meet the immediate need for improved water quality that is inexpensive, easily disseminated, and has the potential for recovering implementation costs. The Safe Water System (SWS) project has never been implemented in The Gambia; meanwhile there are areas of the country that could benefit from a SWS project. However, we don't know the challenges associated with implementing the SWS or similar interventions in Gambian communities.

Consequently, this pilot project was designed to assess the feasibility of implementing a SWS Project (a Point-of-Use intervention) in a rural Gambian village. The study was conducted prospectively with three main study activities: baseline survey and introduction of intervention (disinfection with sodium hypochlorite); residual chlorine detection at day 7 of the intervention; and post-intervention survey/assessment by participants, residual chlorine measurements, and fecal coliform testing at two weeks after the intervention.

Among other things the survey found that 100% of participating households used the intervention; detectable levels of chlorine residuals were some households; fecal coliform testing revealed contamination. The survey found that acceptance of the full SWS intervention would be successful if it was affordable and if appropriate health education strategies were used to inform the community of the importance of improving their water handling practices.