Families install water filters in Occupied Palestinian Territories (oPt)

Finally, we distribute the filters in Masafer Yatta. In the Occupied Palestinian Territories (OPT), a permit regime for WASH infrastructure limits on water abstraction, and the political situation and institutional framework have curtailed the authorities’ ability to deal with the challenges of an increase in population of more than 50% since 1995. Average water consumption is considerably below the optimum of the World Health Organisation and basic water services are an important staying factor in communities at risk of displacement.

While an estimated 150,000 people in Area C are disconnected or receive inadequate service, 35,000 face water shortage alongside a high cost of trucked water, requiring assistance in summer. Rainwater collected as surface run-off is frequently used and stored in underground cisterns. The quality of water is poor, leading to high risk of infectious diseases. Cesvi has operated in Massafer Yatta area (Hebron Governorate, Southern West Bank) for some years, especially in communities unconnected to the water system.

I used to think that there is always more than one solution for any problem. And I never thought I would ever say this: household water treatment seems to be the only option at the moment to improve the water quality for the families in the Masafer Yatta. In August 2016, 11 communities with a total of about 1,000 people were pre-selected for the study. In September 2017, the identification and assessment process of the 150 households from these communities started.

Baseline data collection includes the submission of a questionnaire to each family (household) about its knowledge, attitudes and preferences related to water use, sanitation facilities and hygiene practices. We enter answers into a mobile-app called ODK. Interviewees give informed consent, and thus better understand the project and the level of involvement if they accept to participate. If they do, they have to approve and sign the consent. To date, Cesvi has finalized the baseline data collection with all 150 households and distributed 130 out of 150 filters to the families so far. A further 72 households were fully assessed and discarded before the distribution for various reasons.

We want to understand which features of the filters are appreciated by the households and which are not; what products they perceive as easy to use and which core technologies provide sufficient level of protection, and cover water demand in households, and not only in the lab. When we bring the filter to the family, we give it to them and… do nothing. Just observe and film if the family allows. Some of the things we focus on are:

• Do they like the filter?
• Can they install it alone and how long does it take?
• Is the housing/bucket placed correctly?
• Has the filter been contaminated on the clean side during installation?
• Where do they get the water to fill in the filter?
• Does they understand how to clean it?

These and others are the questions in a mobile phone based check list which helps us to record what we see. This is called a structured non-participatory observation.

Of course we do not let people drink water if the filter isn't assembled correctly. After installation, we train people on how to use it properly. And now an important question: does the filter actually work? A flight, handling at customs, a long drive over the desert and finally handling at the household might have affected its integrity. To be sure that the product given is functional, we do an integrity test. We add water to the filter which has been spiked with probiotic Enterococci bacteria, "good" probiotic bacteria also called harmless enterococcus faecium. They are found in human intestines or are available in pharmacies as drugs for the restoration of intestinal flora (e.g. Bioflorin). The integrity test requires the collection of 2 samples: untreated water and filtered water. The Enterococci microorganisms in the samples are measured in the laboratory of the Hebron Polytechnic University. If there are too many microorganisms in the filtered water, we repeat the test and eventually - replace the filters. Some filters are equipped with sensors recording filter use and flow.

The families will keep the filters with them for four months, and after that they will receive another filter type to have a comparison of two randomly chosen products. During the six monitoring visits we measure water quality, flow, observe use, ask about experiences in structured and open ended interviews, and answer any questions the users may have.

Then, focus group discussions are planned to receive additional feedback from the users, and a co-design workshop will help us to involve users in the process of optimising the products and sharing information with manufacturers. The final comparison of filters and their features will be a triangulation of technical performance indicators, qualitative and quantitative handling and operation indicators for each site. OPT is only one of the sites. Informal Refugee Camps close to Mogadishu in Somalia and pastoral drought-affected communities in Marsabit County in Kenya are the other two. More about them - in our next blog.