New Jersey-based group digs wells to fight disease and malnutrition in Malawi

Today’s post comes from Seton Hall Law LL.M candidate and former long time Newark Star Ledger reporter, Robert Schwaneberg, J.D.

Health Reform Watch is truly pleased to welcome a reporter of such great renown to our blog.

The well at Zowe. Photo by Robert Schwaneberg

By ROBERT SCHWANEBERG

The road to Euthini in northern Malawi is a narrow dirt path through fields of gourds, maize and peanuts, known locally as groundnuts. The delegation from WorldHope Corps arrives, by four-wheel-drive vehicle, to find the village leaders waiting under a tree. They are sitting in straight-backed wooden chairs with velveteen cushions that seem strangely elegant in this poor African community that lacks electricity, modern sanitation and any source of clean water.

According to the World Health Organization, 38 percent of rural Malawi lacks access to improved water sources.[i] Along with high rates of HIV infection, lack of clean water is a leading reason “Malawi’s health indicators are among the worst in the world.”[ii] Water-borne diseases such as diarrhea and cholera are “common in Malawi”[iii] and are among the top three killers of children under five.[iv] A survey done in 2000 found 18% of children under five had experienced diarrhea in the preceding two weeks.[v]

Euthini Children. Photo by Robert Schwaneberg

WorldHope Corps is trying to change that. Working with other non-governmental organizations, churches and private donors, it has arranged the installation of six hand-pumped wells in Malawi in the past two years and has plans for more.

“Wells are the water of life,” said the Rev. Michael Christensen, who teaches at Drew University in Madison, N.J., and founded WorldHope Corps in 2007. “If we can provide clean water to villages without water, we can save hundreds of lives because one out of five children dies under the age of five of water-borne diseases like cholera, dysentery and malaria.”

Drilling wells in northern Malawi is expensive. Holes have to be bored deep — 50 to 100 meters — to get below the groundwater contamination that pollutes shallow wells. Heavy rigs must be brought in from the southern part of the country, where the only drilling companies are located, and transported over primitive “roads” like the dirt path to Euthini. There are additional costs for having a government official inspect the work and certify the well is deep enough to provide safe water.

“All in all, it’s about $10,000, give or take $500,” Christensen said. He hopes to cut the cost by helping one of WorldHope Corp’s partners, CitiHope International, form a well-drilling business in northern Malawi.

“The prospects are very good,” Christensen said. “I think by this time next year we’ll have the beginnings of a well business that will cut the cost of a well in half.”

Last month, Christensen led a team of 10 volunteers on a 12-day mission to inspect existing well sites in Malawi and scout locations for new ones. Michael Bond of Basking Ridge, N.J., did not go with the idea of funding a well. He decided to do so after observing the stark differences between Euthini, where women haul water from a stream about a kilometer away, and Zowe, which got a deep well through WorldHope Corps in 2007.

“The life of a village, the life of a people changes dramatically once they get fresh, clean water,” Bond said. At Zowe, which also has a part-time medical clinic, Bond learned from the health surveillance officer that a remarkable thing happened after it got its well: No child died during 2008.

“The ah-hah moment for me was the difference a 20-minute drive down that trail (from Zowe to Euthini) made,” Bond said. “The difference was night and day. The kids were in dirty clothes; they were dirty because they weren’t bathed. Some showed signs of malnutrition.”

Malnutrition results not just from poor agricultural yields, but also from dirty water. About half the cases of underweight children are due to repeated bouts of diarrhea and intestinal infections from unsafe water and substandard sanitation and hygiene, according to W.H.O.’s 2008 report, “Safer Water, Better Health.”[vi] Globally, W.H.O. estimates that each year 860,000 children under five die from malnutrition induced by unsafe water, inadequate sanitation and insufficient hygiene.[vii]

Michael Bond (left) and villagers of Euthini break ground for new well. Photo by Robert Schwaneberg

The visit to Euthini ended with Christensen calling for a village youngster to fetch a shovel to break ground for its new well. But first, as he does with all his projects, Christensen enlisted the villagers in a partnership. He asked what they would contribute; they replied they would supply bricks, rocks and labor to construct the spillway and sinks for washing clothes. He asked how they would use overflow water; they said they would divert it to a community garden. He asked how they would pay for spare parts and repairs; they promised to take up a collection from all the villages drawing water from the new well.

“It’s not just about a bore hole,” Christensen said. “It’s about promotion of human rights, gender equality, community action, power of the people to make change.”

More information about WorldHope Corps is online at http://www.worldhopecorps.com/index.htm

[ii] WHO Country Cooperation Strategy, Malawi, 2005-2009 at page15. Online at

http://www.who.int/countryfocus/cooperation_strategy/ccs_mwi_en.pdf

[iii] Id. at page 12.

[iv] The others are pneumonia and all neonatal causes, including diarrhea. World Health Organization, Country System Fact Sheet 2006 - Malawi.

[v] WHO Country Cooperation Strategy, Malawi, 2005-2009 at page 12.

[vi] World Health Organization, “Safer Water, Better Health: Costs, benefits and sustainability of interventions to protect and promote health,” at page 7. Available online at http://www.who.int/water_sanitation_health/publications/safer_water/en/print.html

[vii] Id.

Surgical Checklist Said to Save Lives & Money

The use of a basic checklist was shown to be associated with a substantial decrease in surgical deaths and complications. In what the A.P. referred to as a “a large international study of how to avoid blatant operating room mistakes,” researchers found a 47 per cent decrease in death and a more than one third decrease in complications-from 11% to 7%– concomitant with the use of a 19 point checklist designed by the World Health Organization.

A.P reports that regarding the elements on the list (many of which concern matters such as verifying the patient’s identification, marking the area to be incised with a magic marker, discussing patient allergies and surgical team member responsibilities, and accounting for all needles, sponges and instruments after the surgery)

U.S. hospitals have been required since 2004 to take some of these precautions. But the 19-item checklist used in the study was far more detailed than what is required or what many institutions do.

The researchers estimated that implementing the longer checklist in all U.S. operating rooms would save at least $15 billion a year.
The study, which was conducted in both “wealthy” and “poor” nations in eight city hospitals across the world (including Seattle, Washington), was published in the New England Journal of Medicine; its results were said to have “startled the researchers.”