Our parallel publication GallonLetter has previously expressed concern about the lack of quality control of drinking water projects in developing countries. Now a scientific article in a peer-reviewed journal has echoed that concern.

Authors from The Water Institute, University of North Carolina at Chapel Hill, Southampton University, and the charity WaterAid UK, have reviewed the literature to determine whether water from “improved” sources is less likely to contain fecal contamination than “unimproved” sources and to assess the extent to which contamination varies by source type and setting. The “use of an improved source” terminology comes from the World Health Organization and UNICEF, both of which organizations use it as an indicator even though it does not take into account water quality measurements.

The study, which included data on 96,737 water samples taken from water projects in low and medium income countries, found that:

• the odds of contamination were considerably lower for “improved” sources than “unimproved” sources.
• however, over a quarter of samples from improved sources contained fecal contamination.
• water sources in low-income countries and rural areas were more likely to be contaminated.
• studies rarely reported stored water quality or sanitary risks and few achieved robust random selection.
• safety may be overestimated due to infrequent water sampling and deterioration in quality prior to consumption.

The study concluded that:

• access to an “improved source” (piped water into a dwelling, yard, or plot, or a standpipe, borehole, and protected dug well) provides a measure of sanitary protection but does not ensure water is free of fecal contamination nor is it consistent between source types or settings.
• international estimates greatly overstate use of safe drinking-water and do not fully reflect disparities in access.
• an enhanced monitoring strategy would combine indicators of sanitary protection with measures of water quality.

Many of these “improved” water projects have been completed by ngos, government and UN agencies, and others seeking to provide assistance to people in developing countries. But providing a developing country community with water from an “improved” source that is still harmful to human health because of the presence of bacterial contamination is, in GallonDaily’s opinion, unethical and should be criminal. The editors of the PLOS Medicine journal point out that  by equating “improved” with “safe,” the number of people with access to a safe water source has been greatly overstated, and suggests that a large number and proportion of the world’s population use unsafe water. This problem will not be solved by implementing more “improved” water projects that provide unsafe water. Millennium Development Goal target 7c aims to halve the proportion of the population without sustainable access to safe drinking-water but progress towards that goal is almost certainly overstated because international agencies use the “improved” water source indicator rather than a “safe” drinking water source indicator.

Many individuals and organizations provide financial and other support to organizations committed to bringing drinking water to less developed countries. However, this study shows that digging wells, providing pumps, and “improving” water sources in other ways does not mean that the provided water is fit for human consumption or that the incidence of water-borne disease is reduced. Gallondaily urges those supporting providers of water to developing country communities to make sure that the organizations are testing the water to ensure that it is fit for human consumption. If not, transfer the support to an organization that behaves in a more responsible, and ethical, manner.

An abstract and the full article are available at http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001644