Avital Li:  Public Health Intern

 

As a dual intern with Water Ecuador and Runa Foundation, I am co-leading a research study on water quality and community members’ perceptions of water quality in Archidona and Tena, Ecuador. In these two cities where we are working, as is the case in other regions of Ecuador and Latin America, people generally buy their drinking water in reusable 20 liter jugs, if they can afford to do so. We are conducting tests on water from six of the most popular bottled brands in the area to determine whether this water, which is supposed to be the cleanest and safest for drinking, is contaminated. The blue, translucent bottles are sold in most little tiendas or are delivered upon request to your door. When people need more water, they bring back old bottles to get a discounted price on the water (US$1.50 instead of $10.00, as we learned during our first bulk purchase of the bottles). A previous study undertaken by Water Ecuador in the coastal region of Muisne, found that while the water companies purify the water sufficiently, they don’t properly sanitise the reusable 20 liter jugs between use and over 70% of jugs tested were contaminated with coliform bacteria. However after roughly three weeks, countless 20 liter jugs, and six visits to different water bottling companies, I had started to become slightly skeptical about the relevance of the research in this particular region of Ecuador.

 

These 20 liter bottles are everywhere – in homes, offices, stores – making them an obvious target for research on water quality. What I had learned in the visits we have done and from the people I have spoken to so far, however, had me doubting that bottled water was the issue. Based on appearances, the bottling factories we visited were clean and small (hence easy to manage). The owners, who we interviewed at length about the history of their business, their thoughts about past and future trends in bottled water consumption, and the processes of purification and sanitation they use, seemed overall quite knowledgeable about the need to sanitize and cleanse the water properly. They each had an individual but similar array of complicated filters and machinery for cleansing the water. The Ministerio de Salud Nacional has strict regulations on water filtration and bottling and many of the companies prominently displayed certificates attesting that their product was clean. However what is less obvious is that guidelines for cleaning the 20 liter bottles themselves are more relaxed, and anecdotal evidence from previous Water Ecuador work suggests that water companies can choose to send in any form of bottled water for testing, meaning that the reusable 20 liter jugs have the potential to slip through unregulated.

Though some of the interns have had skin reactions when exposed to the unfiltered shower water, none of us have had severe stomach ailments (knock on wood). Through conversations I’ve had with my host family and other Ecuadorians I’ve met, it started to seem to me that the bigger water-related issue in Napo Province might be elsewhere — among people who don’t use the 20 liter jugs as their main source of drinking water or among groups that have little knowledge of sanitary household water storage and treatment practices.

After our most recent visit and sample collection from a bottling plant, we left congratulating ourselves. For once, the visit had gone by relatively smoothly – the owner was present and agreed to be interviewed, we were able to buy the 10 water bottles we needed without returning 10 empty bottles, and they asked no questions about giving us the samples we needed directly from the system (these are used to determine whether any contamination is from the treatment process or the bottling process). As per procedure, we poured the requisite four 100mL samples (two from the system and one from two bottles each) into their respective IDEXX trays and placed them in the incubator to warm for 24 hours. The next day, when we took the trays out, the samples were entirely yellow, indicating the presence of coliform bacteria. Though the extent of the contamination was higher than usual, other samples we had already tested showed high levels of coliform bacteria so this wasn’t too far out of the ordinary… at least we thought. When we passed the UV flashlight over the trays, we saw, for the first time at such an impressive scale, the telltale fluorescent blue glow of the tray cells that indicates the presence of E. coli in the samples!

Drinking water guidelines worldwide state that Total Coliforms and E. coli levels must be 0. These groups of bacteria are found in digestive tracts of humans and animals, and indicate fecal contamination of the water. While many coliform bacteria can be harmless, E. coli are typically more aggressive and likely to have negative health effects. My group members and I had previously half-jokingly shared with each other that we secretly hoped for at least one example of E. coli in the water bottles that would justify the hours of lugging heavy bottles and negotiating with less-than-willing owners. We rapidly retracted all of our previous comments when we walked into the kitchen and found one of the very same bottles in which we found E. coli on the water dispenser in the communal home where many of us interns are living.

This unfortunate discovery has convinced me that bottled water is the right, though maybe not the only, water source to be studying here at the moment. Most of the water distributors have attested to an increase in bottled water consumption as incomes in the area rise and residents become more aware about the health conditions associated with water consumption, making the quality of the water sold in 20 liter jugs an immediate and pressing matter of concern. Many coastal regions have no water infrastructure, and without the jugs the communities would be forced to rely on untreated rivers, wells, and rainwater. We will be starting community household surveys this week and I am eager to learn more about individuals’ in-home practices and conceptions about water quality and different water sources in this region.

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