We began our work in Ghana where water sources in villages (including boreholes, rivers, and streams) are often contaminated with dangerous levels of fecal E. coli bacteria.  Almost invariably, sanitation facilities are not available, which contributes largely to the problem of water contamination.  Per World Bank 2016 data (https//: data.worldbank.org), approximately 45% of the population of Ghana is defined as rural.

Many of the Western world’s clinical experts and the media have noted staggering and alarming degrees of morbidity and mortality in the young (age 5 and under) due to severe contamination of drinking water in rural areas of third world countries.  Significant data are available now indicating that diarrheal disease is a major cause of morbidity and mortality among children in Ghana (chosen as the country in which we initiated our work) and in many other developing countries.  In recent years, extensive efforts have been made to improve the quality of drinking water in countries such as Ghana, but the success of these undertakings has been greater in cities and large towns, (“urban” being defined by the Ghana Statistical Service as localities with a population of 5,000 or more).  However, to date, these efforts have required electricity or other power and/or a relatively easy delivery route for already purified water.  Therefore, the problem of having quality drinking water still exists for the rural population lacking power or the presence of uncontaminated boreholes.

A wide range of nursing and medical services from isolated small clinics to reference hospitals deal with the clinical outcomes of drinking contaminated water.  These include diarrhea, consequent dehydration, and acute kidney failure, with high mortality, especially in babies and young children. Just weaned children are probably at highest risk.  These services have a vital role in the overall scope of medical treatment in this environment but cannot resolve the major source of the problem, polluted drinking water, which is almost always combined with poor sanitation and hygiene.  

According also to the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, in Ghana in 1990, only 37% of water sources were “improved” in rural areas providing drinking water but by 2015 the number of improved water sources had increased to 81%.  However, as indicated in the “UNICEF, The Millennium Development Goal (MDG 7)” improved drinking water sources targets have been met, but marked disparities between urban and rural areas persist: “Questions also remain about the safety of ‘improved’ drinking water sources that may not always be free of contaminants and may not provide a reliable supply of water throughout the year.”   Further it states,” … the ‘improved’ source” indicator is based on classification of water supplies by facility type and does not include direct measurements of water quality.”  (https://www.unicef.org/wash/3942_4456.html)   This report indicated that post-2015 plans were to examine the issue of quality of source water.

Examining the current website of WHO/UNICEF Joint Monitoring Programme for Water Supply & Sanitation, the commitment to pursue determination of quality of the ‘improved’ source has come to fruition. The previous classification of improved and unimproved now is based on 5 divisions called “ladders”. The top ladder is colored dark blue which is defined as free from fecal and chemical contamination. This fits perfectly with NUF500 (the device currently used by Easy Water for Everyone (EWfE)) as the once used, repurposed hemodialyzers (filters) have a pore size of .03 microns which prohibits bacteria, viruses or parasites from passing through it, thus achieving the top ladder, dark blue free from fecal contamination.

https://washdata.org/sites/default/files/documents/reports/2018-01/JMP-2017-report-final.pdf

During the period that the prototype purifier device (named NUF500) was being developed in Israel, two major questions were studied.  The first was the source of “seed” money for practical application and evaluation of the device, and the second was which country would be the best selection for the first (pilot) installations. The initial source of the money for support of this endeavor has been funds given as a grant from a not for profit research foundation.

For the site selection, two African countries, Ghana and Tanzania were analyzed for need, both having large rural populations with a widespread lack of drinkable water and of electrical power.  It was necessary for the success of the work that a local physician(s) specifically interested in this type of project would participate in major aspects of the required medical and administrative activities.  Ghana was selected, as previously mentioned because of our connection with Dr. Sampson Antwi. Dr. Antwi had been dealing with these related clinical issues for years in his hospital practice, supporting a significant rural population in the hospital catchment area.  He has already identified several villages/hamlets for that were in great need of pure drinking water.

With this resource in place, the first water purification devices were installed in Ghana in May 2015.   Installations were placed in village/hamlets of Kumi and Boahenkwaa, all within 2 hours driving distance of the city of Kumasi (using appropriate heavy-duty vehicles).  The second installations were placed in January 2016 in 3 sites in Big Ada close to Accra, which are on several of the various estuarial islands in that area (the Volta river enters the ocean there): Kputsukpanya, Alorkpem, and Pediatorkope are the names of the villages.  The third group of installations was placed during the week of June 2016 on three villages on the estuarial islands of Big Ada; Kewuse, Aflive and Ajiem.  The next four estuarial islands to have NUF500 devices installed (July 2018) were: Anazome, Baitrenya, Alewusedekorpe, and Agamakorpe. In November of 2018, four more devices will be installed. Villages will be chosen from the estuarial islands of the Volta River. Click here to view a chart of the villages and map of the island area.

Routine laboratory testing had shown that the drinking water used at the time was highly contaminated with E. coli, while purified water from the NUF500 output was free of infectious agents.  In all areas, the quality of life of the villagers was changed dramatically by having pure drinking water.  In all our return visits, after device installation, the mothers have come to tell us what a difference the pure water has made in their lives, particularly in reducing or eliminating diarrhea in their small children.  It is very heart-warming to see this level of appreciation for the  NUF500 produced water.