Click here to read the related blog post: http://ryanrowe.com/2012/06/05/rotary/

1. Hi, my name is Ryan Rowe.
It’s an incredible honour to be here today, and I’d like to thank you all for giving this opportunity to
share with you what the Fellowship means to me. Today I am going to talk to you about my studies
at the University of North Carolina at Chapel Hill, where I recently completed a Master of Public
Health, and focused my research on the topic of water quality and point‐of‐use water treatment.
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2. This slide aims to describe what the Peace Fellowship means to me personally: Investing in Peace
and Taking Action.
Rotary and Rotarians invests in leaders from communities around the world, and give them the
opportunity to accumulate knowledge, skills and tools around specific topics related to
development and conflict resolution.
As Peace Fellows, our mission is then to take those new skills and collaborate with the communities
that Rotary serves.
Today I am going to tell you about some of what I’ve learned during the Fellowship and from the
organizations I’ve had the opportunity to work with. I am also going to tell you what I plan to do
going forward from here.
[Over 600 Peace Fellows around the world now, many of them working on development and peace
isssues with organizations such as the United Nations and other multilateral institutions, NGOs small
and large, and in universities, for example. Each one of them has their own personal story to tell
you about their Fellowship experience and tonight I am going to tell you mine. They are contributing
to peace, development, and process at home and abroad.]
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3. My story starts with the poorest of the poor.
All Rotary Peace Fellows are required to undertake a summer of work overseas, applying the skills we learn during our graduate studies.
I travelled to Kenya and became involved with a school located in Kibera, one of the largest slums in East Africa.
This picture makes me happy because I see all the smiles on the kids faces. As you can see, They all have their own little personalities.
This is Esther, one of the brightest kids in the class; here we have Julius the “Thinker”, and over here we have Edward, whose figured out
how to salute the camera!
But the picture also makes me very sad. This kids come from the most broken and impoverished families in the slum. These are the
poorest of the poor – folks who earn about a dollar a day. Many of them don’t know their father or mother, and are being taken care of
by “guardians” or members of their extended family. They live in 10 feet by 10 feet square shacks where as many as 10 people might
spend the night.
For example, Hanson, with his cute little smirk live in a shack which sits next to a garbage dump. This boy, Daniel, has HIV and so does his
brother Rufus. They come from a family of nine kids, who have to take care of each other because the mother is an alcoholic and often
not around. At least half a dozen more of the kids in this picture have HIV.
Most of these kids have what’s known as persistent diarrhea, day after day, as a result of being exposed to pathogens transmitted
through the water supply and the environment, which ends up on their hands, in their food, in their water, and in their stomachs
because it’s simply unavoidable. Dirty water can be fatal for kids like this living with HIV/AIDS, as it reduces the absorption of much‐
needed anti‐retroviral medication.
They make sure kids take their HIV medication daily. This is what is known as an integrated approach to health and development. Seeing
the positive impact of clean water on these kids has really reinforced the importance of working in this area. Today I’m going to talk to
you about one of the solutions that exists: household water treatment.
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4. During the summer of 2011, I travelled to Kenya to research water issues. It was my first time
working “in the field” so to speak and it was an extraordinary opportunity to learn more about how
to improve access to clean water – an experience I would not have had without Rotary’s help.
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5. I spent the bulk of my time in the capital city of Nairobi, in a very well known slum named Kibera
which you can see in this satellite shot. Half a million people live there. I was hosted by a local NGO,
Carolina for Kibera, which as some of you know has its roots right here at UNC and been strongly
supported by Rotarian Jim Peacock.
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6. This what the slum looks like from the top of a nearby hill. As you can see homes are closely
crowded together.
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7. There is no water and sanitation infrastructure in the slum – at least not the kind that you and I are
used to here in North America. Sewage and waste flow through ditches between homes and you
need to keep a careful eye on where you step. When we talk about the poorest of the poor, we are
referring to communities like Kibera.
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8. Without an adequate supply and good quality of water, people are locked into a vicious
cycle of poverty. As a result of the dirty water and environments they are exposed to,
women and young girls often travel as far as 6 kilometres each day just to collect water for
their homes and families, spending in aggregate some 200 million hours fetching water.
Sometimes that water is not even clean, and the resulting illnesses force them to miss
education and income opportunities, as well as incurring the need for treatment and
medication from local clinics, if they can afford them. Approximately 1.5 million people a
year die as a result of preventable diarrheal diseases, most of them children.
The result is a vicious cycle of poverty, which also contributes to insecurity, economic
instability, and the potential for conflict.
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9. But global access may be improving. WHO and UNICEF released their latest update on the global
water and sanitation picture two weeks ago. According to the report, the United Nations
Millennium Development Goals, a set of targets for eradicating poverty and improving global
health, announced that the drinking water target had been met, one of the first targets to have
been achieved
For those who are not familiar with the goal, the aim was to halve the proportion of people living
without access to an improved source of water at baseline (1990) by 2015. So we wanted to move
from 24% to about 12% of the world’s population, and according to this latest report we achieved
that target at the end of 2010. While this is good news, we can see from this gap here, that
hundreds of million will still not have “access to clean water” even if the goal is met.
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10. Furthermore, the numbers at the global level hide the reality at regional and country levels.
For example, the coverage in Africa is only 61% compared to 94% in Latin America. In six of these
African countries, the coverage rate is below 50% (Congo, Malawi, Ethiopia, Somalia, Madagascar,
Niger). And in Kenya, the coverage rate is only 59%.
Within countries, there is further inequality. Urban areas usually have more access than rural areas.
And rich people have greater access than poor people. So those who need it most are least able to
access it and afford it.
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11. The Millennium Development Goals as they relate to water and sanitation use what’s known as a
water/sanitation “ladder” that goes from unimproved sources to improved sources to piped source.
In this picture, there are unimproved sources which include water sources such as an unprotected dug well,
an unprotected spring, a cart with small tank or drum, a tanker truck, surface water sources (e.g river, dam,
lake, pond, stream, canal, irrigation channel) [and even bottled water if the source is unknown]. As of the
2010 JMP update, 41% of Kenyans were drinking water from unimproved sources, and this figure would
include the kids shown in the picture on the previous slide. This number breaks out to about 17% of the
urban population and 48% of the rural population. The water quality of an unimproved source cannot be
counted upon – as animal and human waste often runs into the water during rainstorms or as a result of
people using the stream to wash.
At the second level, we have “improved” sources which include a public tap or standpipe, tubewell or
borehole, a protected dug well, a protected spring, and rainwater collection. An improved drinking water
source is one that by the nature of its construction adequately protects the source from outside
contamination, in particular with faecal matter. But quality is often not assured because protection is
inadequate or in disrepair. We hear stats coming from Africa that as many as 50% to 60% of water projects
are not in functioning order.
Finally, we have piped water into dwelling, yard or plot. But even the water quality of piped sources is not
guaranteed. Utilities often underinvest in their water networks, which leads to leaks, or contamination.
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12. If you lived in Kibera, your water situation would look something like this.
First of all, you’d have to deal with Cartels: Many water enterprises are operated by entrepreneurs or CBOs but locals
widely report “cartels” often steal or vandalize water connections to set up their own water kiosks. This destructive
activity can cause water shortages or service outages, increase prices, decrease water quality, and affect the cost of doing
business.
Secondly, issues of cost: Most residents do not have household supply and buy water on an as‐needed basis from local
water vendors at rates much higher than Nairobians connected to the grid. And the poorer you are, the less likely you are
to be able to pay the connection fee to the municipal water network, have a bank account to pay your bill.
Thirdly, Water access for your daily needs: Water use among Kibera residents is often below the minimum daily
requirements for basic human activities such as bathing, washing clothes, cooking and drinking. Frequent shortages /
rationing are also an issue in Nairobi and this can disrupt water supply. If you were living on one dollar a day and had to
spend 4 cents for every 20 litres of water, how would you choose to spend it?
Fourthly, Water quality will be suspect: Kibera water is generally clear in color, but may be contaminated with
pathogens invisible to the eye. Deep inside Kibera, water quality may worsen even further due to conveyance through
damaged / leaky pipes. One of the toughest issues of all is convincing people that they should pay to treat their water
even when it looks safe to drink. Residents may believe it is safe to drink but a recent study showed that approximately
8% of water samples tested from water vendors in Gatwekera were contaminated. [Based on informal conversation with
director of local NGO. Sample size approx. 200 water points in Gatwekera village of Kibera. Unpublished.]
Finally, there are Environmental and Behavioral risks: And finally, if that weren’t enough, if your water wasn’t
contamined to begin with, it’s likely to be so once you bring it home because of the conditions in which you live and
because it’s so difficult to keep things free of germs, especially your water supply. As individuals transport, store and use
their water, contamination levels are likely to increase due to unsanitary environmental and household conditions, and
poor hygiene practices.
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13. This is a picture of a local water vendor, the type of kiosk where the vast majority of people living in
Kibera will purchase their water. The container you see here holds about 5 gallons of water and will
cost about 4 cents during the wet season. In the dry season, that price will rise to about 20 shillings
(25 cents). 5 gallons is about the same amount of water you would use during 60 seconds in the
shower.
Inside his shack, this vendor may have a meter monitoring his connection to the network. If he does
not, he is likely illegally connected.
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14. This is an example of the piped network through Kibera. It runs right through the sewage trenches
that go through the community. These pipes are usually made of plastic instead of metal as metal
pipes are more subject to theft. The problem is that plastic pipes break more easily and are often
vandlized by competing water vendors. So as you go deeper into Kibera, the more likely that water
running through such pipes has become contaminated due to leaks or breakage. Once those
pathogens get into the water supply, you’ll spread disease very very quickly.
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15. Household water treatment is a possible solution. It can be used to improve the quality of water
consumed in the home. A series of meta‐analyses by Fewtrell (2005), Clasen (2006), and
Waddington (2010) showed that HWTS could reduce the incidence of diarrheal disease by between
35% and 47%. But while it’s shown to work it can be very tricky to implement because it is so
inherently behavioral.
Use of an effective, appropriate HWTS option is really important – it needs to work in the local
context. For example, if you’re trying to use solar disinfection at a certain latitude, it won’t work as
effectively. Correct use is making sure that the method or technology is used in the right way and
improves the quality of the water. Consistent use means it is done every time the user is consuming
water so that clean water is always being used. It only takes one exposure to a pathogen to trigger
diarrhea. Long‐term and sustainable use is about long‐term behavior change. Children are
especially important – to inculcate a culture of appreciate for good water, good sanitation, and
good hygiene.
Reaching a vulnerable population is about reaching those who need the intervention the most and
about improving equitable access to clean water. HWTS can help improve access to clean water for
the most vulnerable groups of people. Public health programs need to be vigorously focused on
their primary beneficiaries, instead of a blanket approach that reaches all kinds of secondary
audiences. Finally, HWTS needs to be integrated with other WASH and health programmes so as to
realize the financial and health synergies from a multi‐pronged development intervention.
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16. Here are five examples of accepted and proven HWTS methods. Each has its advantages and
disadvantages and the choice of which one to use depends on the local context. Some methods
protect against re‐contamination such as through a chlorine residual or a safe storage mechanism
(i.e. solar disinfection in a plastic bottle). Boiling is not ideal due to a range of factors: sub‐optimal
performance, no protective factor against recontamination risk, creates smoke in the household,
heightens the risk of burn injuries, environmental issues.
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17. As I move forward beyond the fellowship, there are a number of activities that I will be working on
to scale up household water treatment.
For the last two years I have been working with the WHO and UNICEF and over 100 members
globally, including Rotary to scale up the use of household water treatment!
I am going to continue this work going forward.
During my studies, my role has been to facilitate the sharing of the latest news from the sector,
such as upcoming events, recent publications, and jobs and funding opportunities.
I link our organizational members with some of the latest literature on household water treatment
and also help organize and implement our webinars, capacity‐building workshops, and open
working groups which anyone can join.
Going forward, I will be using my public health skills and newly acquired water knowledge to help
communities build up their capacity to implement their own water and sanitation projects.
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18. One of the products of the WASRAG activities is a set of online learning modules for Rotarians who
would like to learn more about health and hygiene. I will be developing the module on safe water.
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19. This is a project I started over the summer, in collaboration with a Kenyan NGO and a US NGO using
GPS technology to map one organization’s network of treated water points in the Kibera
community. Imagine it like Google Maps for water. The idea is to bring together the work of several
NGOs onto a map like this so as to identify points of the community that are already being served
and thus duplicating efforts and identify portions of the community in need. It will also hopefully
allow some residents to identify points vending treated water, if posted on local notice boards and
made available via SMS or online.
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20. In this project, we are looking to include water, sanitation, hygiene in the curriculum, where 30
minutes a day of instruction will be added every day for 12 weeks (4 weeks, 4 weeks, 4 weeks for
each of the three topics). We’ll conduct a pre‐test and a post‐test survey to determine the extent to
which knowledge has been transferred from the kids to the parents. We’ll validate it using
observation. The survey has been reviewed by CARE Kenya. The central idea is that kids can be
change agents.
The school where this project will be based is an example of an integrated development project –
as it combines education, nutrition, and water/sanitation/hygiene, as well as other elements, such
as a safe place for the kids to play and learn.
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22. Improving the quality and supply of water can break the cycle of poverty.
There is a great quote from the book The Alchemist by Paulo Coelho. It goes: “If you follow
your dreams, the entire universe will conspire to help you achieve them”. For me, Rotary
represents that universe.
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