After the flood: an evaluation of in-home drinking water treatment with combined flocculent-disinfectant following Tropical Storm Jeanne - Gonaives, Haiti, 2004

Tropical Storm Jeanne struck Haiti in September 2004, causing widespread flooding which contaminated water sources, displaced thousands of families and killed approximately 2,800 people. Local leaders distributed Pu P(u) over bar RR (R), a flocculent-disinfectant product for household water treatment, to affected populations. We evaluated knowledge, attitudes, practices, and drinking water quality among a sample of Pu P(u) over bar RR (R) recipients. we interviewed representatives of 100 households in three rural communities who received Pu P(u) over bar RR (R) and Pu P(u) over bar RR (R)-related education. Water sources were tested for fecal contamination and turbidity; stored household water was tested for residual chlorine. All households relied on untreated water sources (springs [66%], wells [15%], community taps [13%], and rivers [6%1). After distribution, PGRO was the most common in-home treatment method (58%) followed by chlorination (30%), plant-based flocculation (6%), boiling (5%), and filtration (1%). Seventy-eight percent of respondents correctly answered five questions about how to use Pu P(u) over bar RR (R) 81% reported Pu P(u) over bar RR (R) easy to use; and 97% reported that Pu P(u) over bar RR (R)-treated water appears, tastes, and smells better than untreated water. Although water sources tested appeared clear, fecal coliform bacteria were detected in all sources (range 1 - > 200 cfu/100 ml). Chlorine was present in 10 (45%) of 22 stored drinking water samples in households using Pu P(u) over bar RR (R). Pu P(u) over bar RR (R) was well-accepted and properly used in remote communities where local leaders helped with distribution and education. This highly effective water purification method can help protect disaster-affected communities from waterborne disease.