Globally, more than 1 million children under 5 die each year from diarrheal disease. Contaminated drinking water, poor hygiene, and the lack of sanitation facilities are leading causes of this problem.
Diarrhea is the second largest cause of mortality in children under 5 after respiratory infections, accounting for almost 19% of child deaths in developing countries. Even when episodes are not fatal, chronic diarrhea in early childhood can contribute to malnutrition, reduced resistance to infection, stunted growth, and worse performance in school.
Improving water sources is insufficient, as unhygienic water collection and unsafe storage practices often lead to recontamination, making it difficult to ensure that water is actually safe when people drink it. Therefore the need for chlorine dispensers in dealing with water borne diseases has arisen as an innovation which will go a long way in alleviating these diseases.
Why Chlorine dispensers?
An early study evaluated the effectiveness of protecting springs in rural areas where piped water is not feasible or cost-effective. This study found that spring protection reduced source contamination by 66%, but that contamination of household drinking water only decreased by 24% as a result of unsanitary water collection and storage. The researchers, then, sought a solution that would protect drinking water from recontamination.
The research team next investigated strategies to encourage household chlorination. Chlorine kills 99.99% of harmful bacteria, keeps water free from contamination for up to 72 hours, and reduces the incidence of diarrhea by 40%. A randomized controlled trial was conducted in Kenya to compare chlorine dispensers to other chlorination options.
The researchers found that 50-61% of people adopted the chlorine dispenser system compared with only 6-14% in the control group, or an approximately 40 percentage point increase. Adoption was sustained over time.
How do Chlorine dispensers work?
The diagram below illustrates the external features of an Express Drainage Solutions Kenya Limited chlorine dispenser;
Further, the diagram below illustrates the mechanisms and the principles behind the functioning of an Express Drainage Solutions Kenya Limited chlorine dispenser;
As illustrated in the diagram above, as the water flows through the pipe into the jerrican, it experiences changes in diameters of the entry pipe and exit pipe hence creating a high pressure zone and a low pressure zone. This change in pressure causes the chlorine delivery tank valve to open and deliver a specific amount of chlorine to the flowing water and into the jerrican, hence the water of the villagers jerrican becomes chlorinated.
There is also in the mechanism, a chlorine recharge inlet lid for adding more chlorine to the chlorine recharge tank. When chlorine flows out of the chlorine discharge inlet valve into the jerrican a flush toilet floater system closes the delivery tube from the recharge tank.
How does Express Drainage Solutions Kenya Limited implement such a chlorine dispenser project in the community?
Costs to implement dispensers for safe water; We break down the direct implementation costs into 2 parts:
- Initial implementation (from the decision to install dispensers through the installation, including materials, community education, transportation, staff time, etc.) costs almost $200/chlorine dispenser; this will go down over time.
- Ongoing operations (ensuring that the dispensers continue to function and increasing the rate at which they are used) are projected to cost almost $65/dispenser/year at scale. This includes chlorine supply, maintenance, hardware replacement after its projected lifespan, M&E, management costs and all overheads.
Express Drainage Solutions Kenya Limited implementation process
- Choose areas in which we work using data on diarrhea rates/waterborne disease, prevalence and type of water sources, and population density.
- Meet local stakeholders from the district to location-level governments.
- Meet with local leaders (e.g., church leaders, village elders) to discuss the possibility of installing dispensers. These officials provide lists of all water points in the areas they represent.
- Select the water points at which we will work.
- Host community meetings in areas that we have selected. The meeting is advertised by calling village elders, posting notices, announcements by megaphone, and by meeting with a couple villagers initially and asking them to tell others about the meeting. Community meetings serve to sensitize the community members to the program and inform them of the benefits of chlorine, as well as to ask if they are ready to have the program (to formally secure their buy in). At community meetings, our staff explain how to use the chlorine dispensers to treat water, address any problems people raise, and collect phone numbers of community members for use when we sends text messages to promote the use of the dispensers. We also ask for a small contribution of sand and other materials needed to install the dispenser, as well as a mason from the community who can help install it.
- Choose water points for dispensers. Our criteria for placing a dispenser near a water source: the water source must have low to moderate turbidity (because chlorine is less effective in treating highly turbid water); the source must have at least 10 households using it; the source must be working for at least 9 months out of the year; and, in situations where the water point is located on privately-owned land, the land-owner must be amenable to the dispenser. About 65-75% of water points in an area meet these criteria.
- Install the dispensers.
- Host a smaller meeting at each water point where a dispenser was installed so that people can see it and be reminded of how to treat their water.
- Attendees of this meeting elect a person from the village to be the official chlorine dispenser promoter by show of hands or secret ballot. The promoters are charged with refilling dispensers with the chlorine supplies that we deliver, ensuring the dispenser is in working order, communicating any issues to our staff, and reaching out to people to encourage them to use the dispenser. Promoters are given chlorine dispenser promoter T-shirts, and are sometimes given a small gift such as $1 of phone credit per month, but in the past have otherwise been unpaid.
We are studying variations on the incentives it offers promoters: it is experimenting with offering cash incentives, such that the promoter earns a reward for each household with chlorine present in their collected drinking water. It is also trying out a non-linear model in which the promoter is rewarded when the community reaches a certain percentage of households with chlorinated water.
- Provide services for ongoing operation of each water point: chlorine supply, fixing malfunctioning dispensers, marketing to increase uptake, monitoring and evaluation (We conducts 2-month, 4-month and 12-month evaluations for the dispensers installed)
Our field work is done by field associates who collect data, hold community meetings, etc, and by community field assistants who deliver the chlorine. We also have an area coordinator and associate area coordinator, to whom the field staff report. They in turn report to the Operations Manager.
Field visits for chlorine delivery currently occur about every 3 months, but we are exploring reducing visits to 2-3 times per year.
The field associates visit a sample of households using the chlorine dispenser, and test for levels of chlorine present in stored household drinking water. We also collect survey data in addition to monitoring chlorine levels.
Who are the Target Beneficiaries?
- Residential households using tapped water in villages in rural areas.
- Residential households using tapped water in slum areas in suburban areas.
- Schools relying on tapped water from such places as subsurface dams, springs and wells.