Bridges Summer Research Report
Energy Resources Group
of Community Managed Water Systems in Rural Mexico"
The goal of my trip to Guerrero, Mexico was conduct preliminary
field research on the role of community managed potable
water systems in influencing the health and development
of the community. My long-term objective is to arrive
at an understanding of what social, cultural and political
factors make some of these water systems more effective
than others. The information I collected over the summer
will be used as a stepping stone upon which I base
much of my doctoral research. My research is part of
a larger project which also aims to quantify the effectiveness
of those water systems in reducing the incidence of
childhood diarrheal disease and conduct a cost-benefit
analysis of the impact of these water systems.
This summer, I spent two months in Guerrero Mexico together
with another graduate student whose work also contributes
to the larger study. During this time, I was involved in
a variety of activities which can mostly be divided into
three categories: collection and verification of data,
site visits, and interviews with government officials.
Collection and Verification
The process of
collecting and verifying data began immediately upon
my arrival in Mexico. The first two weeks of my
visit I spent in Cuernavaca working together with Dr.
Jorge Salmeron of the Instituto Mexicano de Seguridad
Social, who has been collecting data on the incidence
of gastro-intestinal illness for our 100 study sites.
This data, which is subdivided by age group and diagnostic
code, has been collected on a weekly basis by the majority
of health clinics in Guerrero from 1998 to the present.
I checked to see which data had already been collected
and entered into a database as well as which data was
missing. If data was missing, I tried to determine the
reason for its absence (no doctor, new or defunct health
clinic, misclassification or other.)
group on water source choice and use practices,
La Barra, Coyuca de Benitez.
Our list of 100 study sites includes 60 villages which
contain community based ultraviolet light water filters
(UVW) and 40 which do not. Those communities which do not
have water filters were included to serve as control villages
to represent the base case of the incidence of disease
which would occur were there no water purification in the
village. I investigated the appropriateness of the control
groups we had selected. I located Mexico INEGI year 2000
census data and GIS maps to compared our village location
and population data with census data and looked at socio-economic
characteristics, access to the sites, geographic location,
and other characteristics to determine whether or not the
control sites selected were good matches with our study
sites. In some cases, new control sites were selected and
data is now being collected for those sites. Later in the
summer, I managed to obtain a list from the National Water
Commission of localities in Guerrero that have registered
water systems. We are in the process of re-evaluating our
control sites again, to assure the water sources available
match those of the intervention communities.
Waterworks, Las Trancas.
Additionally, I determined whether or not the data that
had been collected could be used in the study. As a health
clinic often serves more than one locality, the location
of the health clinic had to be compared with the location
and geographic dispersion of our study sites to determine
whether or not the data collected adequately represented
the actual incidence of disease for that site. Due to distance,
time, hours of availability of services and transportation
limitations, it is possible that patients do not attend
the health clinic to which they are assigned. Furthermore,
it is difficult to disaggregate from the data collected
to which of the many localities covered a particular case
belongs. Thus there may be cases reported at a given health
clinic which belong to a location other than our study
sites. Additionally, since some of the water systems we
are studying only serve a maximum of 3000 inhabitants,
we needed to make sure that the size of the population
does not exceed that number.
Waterworks in health clinic in Tetipac.
I also contacted and solicited data from Oportunidades,
a government program that provides health education and
services in Guerrero. Data on which communities are participating
in and what percentage of each of those communities is
covered by the Oportunidades program as well as information
on the activities Oportunidades is realizing in each community
are essential to this study, as those factors will influence
the incidence of disease in the community.
The next step, once the data that had been collected was
inventoried and evaluated, was to visit the study sites
to find out if it the data accurately represents in situ
conditions. To do so, we visited 22 localities in 10 different
municipalities. The sampling scheme used was a pseudo-cluster
random sampling method. For each region, a municipality
was randomly chosen and we tried to visit as many study
villages within that municipality as time and transportation
The purpose of the 22 site visits was
to familiarize ourselves with in situ conditions, to
meet with key leaders and
community members, to understand better the historical
and socio-economic context of each locality, and to determine
the openness of community members to focus groups and
surveys. During the summer we only visited villages which
contain UVW filters.
each village, the first step was to locate the UVW filter
and as well as the person(s) responsible
maintenance and upkeep of the UVW system in that community.
In 14 localities the UVW filter was located in a health
clinic, whereas in the remaining 8 localities the UVW filter
was located in the Comisaría. Usually if the filter
was located at the health clinic, the doctors and nurses
knew who in the community took care of the water filter.
However, if the filter was located in the Comisaría,
the person responsible for maintenance was either the Comisario
or a member of the health committee. We then interviewed
those individuals in order to determine the historical
functionality of the filters, the maintenance history,
the use patterns, the approximate costs, and the community
organization regarding the system. Furthermore, we asked
questions regarding illnesses, nutrition, and education
levels in the community as well as how those have changed
over time. We also asked what other sources of water are
available to community members, what use patterns and practices
exist, how much water is available, and what treatments
are given to the water prior to consumption. In the rare
instances in which the UVW filter was functioning and water
was available, we took samples of the water and tested
for the presence of coliform bacteria.
Summary of Sites Visited:
The UVW filter was not operational in 50% of the villages
visited. This was either due to mechanical failures, water
scarcity, dismantling of the system due to planned relocation,
or community disinterest. The other interesting finding
was that in many of these villages, other sources of purified
water are available.
with Health Promoter walking to Ciulutla.
with Government Officials
The Ministry of Health
plays an active role in rural communities via the provision
of health care and health education
services as well as via the provision and vigilance of
water purification. In order to gain an understanding
of the context (historical, cultural, and socio-economic)
in which the UV water systems have been put in place
and are maintained, we interviewed government officials
working in the central state health department office.
Beyond using these interviews to understand context,
I wanted to use these interviews to inform the design
of my research project so as to actualize a project that
will provide useful information to the Health Department.
We spent three days meeting with and interviewing various
officials. First, we spoke with two representatives in
the Area de Fomento de Agua y Saneamiento. They told us
about the activities in which their department has been
involved, namely, water quality improvement, water quality
testing, and monitoring and inventorying of water systems.
The UVW systems were originally under the jurisdiction
of another department within the Ministry of Health; however,
they have been maintained and supervised by the Area de
Fomento de Agua y Saneamiento for the past year and a half.
The representatives from the Area de Fomento de Agua y
Saneamiento provided me with a copy of the maintenance
reports from the past year which were sent to the Secretaria
de Salud by engineer contracted to supervise all 60 UVW
systems. Furthermore, I was given a copy of the original
inauguration papers which listed the names of the villages,
the population, and a description of any problems that
were present at the time of installation. I also received
information about which municipalities seem to have the
most difficulty ensuring an adequate level of chlorination
in its water systems and the plans the Area de Fomento
de Agua y Saneamiento has for future improvements to infrastructure,
monitoring and water quality assurance.
Additionally, we were able to talk with Dr. Memeje, from
the Programa de Accion Salud de Infancia. Dr. Memeje is
responsible for the training of doctors and for child healthcare
services. He explained to us the training process for doctors
who are performing their year of social service, the process
of record keeping, (key to understanding the GI data already
collected) and the standard healthcare treatments and programs
Promoter and Comisarios (current and previous)
in front of UV waterworks in Ciulutla.
We also met with Licenciado Diego Diaz, Secretaria Personal
de la Secretaria de Salud. He is one of the top officials
in the Ministry of Health and a key person both in terms
of access to information as well as approval for collaboration.
I explained to him the purpose of our study, talked about
collaboration for future work and discussed with him the
needs of the Department of Health. He expressed an interest
in the project and said he would like to collaborate with
us in the future.
Many of the in-site conditions that
I encountered were different than I expected: a much
smaller portion of
the UVW filters were technically functioning and actually
used by community members. Additionally, the sites in
which they were functioning were not those I would have
originally expected based on socio-economic and geographic
characteristics. Furthermore, more communities have access
to piped chlorinated water or other sources of purified
water, and lower incidences of diarrheal disease than
I had presumed. Although this might thwart some of my
original research plans, I feel that 1) these are positive
findings in terms of quality of life for the inhabitants
of the study sites and 2) these findings suggest other
questions regarding the role of common property management,
the impact of state led health initiatives and the choices
and constraints families make with respect to the source,
quantity, and quality of water used. Moreover, the original
premise of my research, to understand what social, cultural
and political factors make some of these systems more
effective than others still holds, as the UVW filters
were working in some communities and yet totally dismantled
summer visit provided an excellent introduction to the
research site, allowed for the meeting of key contacts,
re-evaluation of the proposed project to make it better
suited to on the ground reality and a productive data
collection. During the course of the next few months
I hope to analyze in depth the data we collected, write
a paper on my preliminary findings, and develop more
clearly the methods (and questions) which I will be using
for future research.