VCU GH2DP Honduras Trip Update: Days 3-4

Sharing data with the Health Minister, Olanchito

Yesterday morning we got up early and met with the Health Minister in Olanchito. We shared data from the projects we undertook on our June 2012 trip, including our water filter testing project, anemia point prevalence survey and indoor air quality project. We discussed current health issues facing the communities we serve in and around La Hicaca, and discussed ways we can support the Ministry of Health improve the health of the communities we serve.

Dr. Patrick Mason doing an impromptu
clinical consultation 

We then traveled up to La Hicaca where we had a busy day; we visited with local community leaders where we shared the results of the aforementioned projects, and also did a few impromptu clinical visits, inspected the local cistern (a fairly sophisticated structure that pipes in water from two or so hours away, but that has fallen into disrepair) and also inspected several indoor stoves and water filters.

Sharing data with local community
 leaders in La Hicaca

Examining the cistern above La Hicaca

Inspecting water filters

We found out some very interesting things in our conversations with the Health Minister and local community leaders. In our indoor air quality survey we identified that, in general, there was poor understanding about the connection between smoke inhalation and respiratory problems. Our in-country contacts confirmed this, and also helped us identify that indoor smoke is often generated by poorly maintained stove chimneys. This is important as these chimneys can be repaired relatively cheaply and be made to more efficiently ventilate smoke. We were asked to conduct an educational campaign during our next brigade highlighting the relationship between indoor smoke and respiratory health.

School in La Hicaca

We also visited the school where we typically set up our clinic and learned the roof has fallen into disrepair.

Here is an example of a well-connected
chimney entering a stove; we found that
many chimneys were not attached
to the stoves at all, allowing smoke to
freely enter into the home 

We were welcomed into local homes to spend the night and then traveled on to an even more remote village, Lomitas, today. I will blog more on today’s events in a future post. 

You can learn more about the VCU Global Health and Health Disparities Program (GH2DP) and our work in Honduras here. 

Household Chlorination Program to Improve Drinking Water Quality in Rural Haiti

Local creation of sodium hypochlorite solution in Haiti (http://www.cdc.gov/safewater/chlorination.html) 

This is an interesting article on a long-term program in Haiti using household chlorination to improve drinking water quality by Harshfield and colleagues. They evaluated the utility of a Safe Water System (SWS) program that was established in a rural part of Haiti in 2002. In 2010 they conducted a survey with concurrent water testing of 201 SWS program participants as well as 425 control households. These authors found that 56% of participants were correctly treating their water with chlorine (as opposed to 10% of controls) with a 59% odds reduction in diarrheal illness in children under 5 (OR 0.41, 95% confidence interval 0.21-0.79). The interesting thing about this study is the SWS program was sustainable and was having a positive impact 8 years after its creation.

We have been working in the Yoro area of northern Honduras since 2008, with our efforts focused in and around the remote, mountainous village of La Hicaca (find out more about our work here). Our public health work is primarily focused on improving access to clean drinking water via a water filter program. The above study is intriguing in that it could provide an alternative, potentially sustainable mechanism to improve access to safe drinking water for the population we serve. However, Gaby Halder conducted a large survey on access to technologies to treat drinking water in 2011 of our population and found very few people used chlorine. This was largely due to poor chlorine access due to financial and geographic barriers. If a SWS program is to be employed in a rural, remote setting such as the one we practice in, addressing these key barriers will be critical.