Water supply and diarrhea : Guatemala revisited

To demonstrate this phenomenon, two communities in Guatemala, Florida Aceituna and Guanagazapa, were selected for study due to their similar population, environment, and health characteristics. The former, which obtained water from shallow wells and rivers, served as a control to establish a norm for diarrheal incidence without project assistance. The latter was provided with a piped chlorinated supply system. Data from both communities were analyzed independently. Halfway through the project, a program to alter sanitary behavior and encourage latrine construction was instituted in Guanagazapa, allowing changes in diarrheal incidence to be ascribed either to water alone or to both water and the new program. The mean amount used per person over the project was 26 liters daily for each person in Florida Aceituna and 68.4 liters in Gaunagazapa. Eighty percent washed their clothes and bathed at home in Gaunagazapa compared to less than 1/3 who did laundry and 1/5 who bathed in the control village. Gaunagapaza showed a significant improvement in sanitary awareness over the project period and 79 new latrines were installed. Latrines continued to be built at a rate of two per month following the project. Almost no construction occurred in the control village. Data suggest that water alone was a sufficient condition to reduce diarrheal rates. Diarrhea declined substantially among the 1-45 age group in Guanagazapa, with children 1-7 benefiting the most. The health program and the increased use of latrines did not appear to decrease diarrhea notably. Data also indicate that water quantity rather than quality was responsible for improved health -- the amount of water used at home was three times greater in the experimental than in the control village. Water quality, however, while good at the tap, deteriorated in the transfer to domestic containers. Analyses determined that half of the samples from domestic containers had fecal coliform bacteria and three quarters had some coliform bacteria. Three appendices and a 17-item bibliography (1948-79) are appended.