Cholera in Peru : a rapid assessment of the country"s water and sanitation infrastructure and its role in the epidemic

The major measures taken to date have been increased chlorination and surveillance of existing urban water systems and distribution of home water purification chemicals and residual chlorine monitoring kits. This report assesses Peru"s water supply and sanitation infrastructure, with emphasis on the areas hardest hit by the epidemic, namely, the cities along the northern coast. Major conclusions include the following. (1) Urban water supplies are operated on an intermittent basis and are thus subject to contamination from leaks, back-siphoning, and cross- connections. (2) The majority of households have inadequate hygiene practices related to water storage. (3) In peri-urban areas (pueblos jovenes), most households are not connected to the piped water or sewerage systems. (4) Organized garbage and solid waste storage, collection, and disposal are nonexistent in the peri-urban areas and inadequate in many areas of the central city. (5) Among the poor, fundamental health and sanitation practices are often not applied. Recommendations for emergency short-term as well as for medium- and long-term programs are presented.