212747 Impact of Hermetically Sealed Wells on Diarrheal Illness Among Flood-affected Rural Communities

Wednesday, November 11, 2009: 1:35 PM

Jennifer Lisa Chan, MD, MPH , Harvard University, Harvard Humanitarian Initiative, Cambridge, MA
Guillermo N. Morán O , Universidad de El Salvador, San Salvador, El Salvador
Miriam T. Aschkenasy, MD, MPH , Harvard Humanitarian Initiative, Oxfam America, Boston, MA
Lauren Rae Bateman, MPH , Oxfam America, Boston, MA
Karina Copen, MIA, MPH , Oxfam America, San Salvador, El Salvador
P. Gregg Greenough, MD, MPH , Harvard Humanitarian Initiative, Harvard University, Cambridge, MA

Frequent flooding compromises access to clean water in rural communities. Water sources are frequently contaminated potentially increasing the risk of diarrheal illness. In October 2007, widespread flooding occurred in the Bajo Lempa region of El Salvador. An international NGO provided emergency assistance followed by disaster risk reduction (DRR) interventions. The DRR programs aimed to mitigate the negative health effects of flooding and improve access to potable water by installing hermetically sealed wells in at-risk communities.

The efficacy of hermetically sealed wells on diarrheal illness is unknown. This retrospective cohort study aimed to determine the odds of diarrheal illness among communities exposed to hermetically sealed wells during flooding.


A retrospective cohort of households in exposed and unexposed flood-affected communities was chosen in a two-stage systematic random sample design. Exposed communities were defined as those with hermetically sealed wells. 85 households representing 402 individuals were surveyed during floods in October 2008.


Hermetically sealed wells demonstrated a significant protective effect among exposed individuals compared to unexposed (OR 0.18; CI 0.06-0.53). Adjusting for latrine use and hand washing the protective effect remained (OR 0.21;CI 0.06-0.72). Latrine use by type did not show a protective effect when individuals reported pit or composting latrine use compared to open defecation.


Hermetically sealed wells are protective against diarrheal illness among flood-affected communities in rural El Salvador. Further studies are necessary to evaluate sustainability of this type of hermetically sealed well. Investigating factors that maintain this protective effect will likely improve long-term DRR strategies.


Learning Objectives:
Discuss the impact of water related disaster risk reduction (DRR) programs on diarrheal illness. Demonstrate the protective effect of hermetically sealed wells on diarrheal illness in rural El Salvador

Keywords: Disasters, Water

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Doctor of Medicine, Master of Public Health, public health provider, former international emergency medicine fellow, NGO consultant for humanitarian activities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.