Practices surrounding water use among community members in the Dominican Republic: Implications for social justice and public health

BACKGROUND: Despite significant population growth in recent years, many communities in the Dominican Republic have not experienced a corresponding investment in infrastructure, such as sanitation. Therefore, access to water is critical for everyday life, for the sustainability of established and emerging economies, and for social justice. METHODS: A convenience sample of 88 households throughout the Constanza municipality was selected. Interviews with heads of households and ethnographic observations were conducted to obtain information about access to safe and clean water and to observe cultural practices surrounding water. A household survey was administered to examine self-reported diarrheal morbidity, water handling practices, and healthcare-seeking behavior. Survey questions were selected from the Dominican Republic DHS. Communities were GPS tagged. Water samples were collected from households and selected environmental sources (e.g. aqueducts) were analyzed for E. coli and coliform bacteria. RESULTS: Despite governmental potable water treatment recommendations, the majority (60.2%) of households reported not taking any measures to sanitize their water, which accounted for the majority of individuals self-reporting diarrheal disease (59.8%). Logistic regression analysis indicates that adults aged 65+ are at highest risk for diarrheal disease. Although aqueducts carrying potable water to the communities lacked measurable coliform bacteria contamination, most households (90.1%) had some contamination in the drinking water. CONCLUSIONS: This study revealed poor water quality and sanitation practices surrounding drinking water. Findings from this study will be utilized for an education program to encourage proper water storage and sanitation with the goal of reducing diarrheal disease and increasing potable water sanitation.