MSF are using a multi-pronged approach to combat cholera and other water-borne diseases in the Lake Chilwa region of Malawi.
"Water, water, every where,
Nor any drop to drink." - Rime of the Ancient Mariner
Lake Chilwa is a vast expanse of water. In fact, it is Malawi's second largest water body. It supplies 20% of all the fish caught in the country and supports 50% of Malawi's rice crops.
But the water that gives life also presents a grave and present danger: a gradual decline in water levels has placed great strain on the communities that live on and around the lake, and water borne diseases such as cholera have become rife.
The paradox of Lake Chilwa shows that having a plentiful supply of water is only half the battle, the other half is in making it safe to drink, something that was made all too clear to us on a recent fact-finding mission to this unique region.
Over the coming days we will be sharing some of the amazing discoveries that we made and will also be showing how Grifaid® filters are helping to make sure that Malawi's mariners have plenty of safe water to drink.
"Turbid - deriving from the Latin turba, meaning turmoil."
The people that take their drinking water from Lake Chilwa do so at their peril. In addition to the numerous diseases that are present in the water, the high turbidity of the water makes it very difficult to treat or filter.
The measure of turbidity is the NTU or Nephelometric Turbidity Unit and the World Health Organization (WHO) has established that the turbidity of drinking water should not be more than 5 NTU, and should ideally be below 1 NTU.
At Lake Chilwa, the turbidity of the water is often as high as 300 NTU and sometimes even higher.
Even under these extreme conditions, the Grifaid® Family Filter can deliver safe drinking water provided the daily backwash procedure is followed.
This simple procedure takes less than two minutes (a demonstration video can be found here) but is crucial to keeping the filter in good working order.
All of this means that for the people who rely on the imperfect waters of Lake Chilwa, high turbidity doesn't always have to equal turmoil.
The fisherman's tale
Lake Chilwa produces up to 24,000 metric tons of fish per year and much of this catch is made possible by the approximately 6,000 fisherman who live on the lake for up to 3 months of the year in floating huts called Zimboweras.
But the remoteness of the fishermen's huts and the limited access to water disinfectants and health facilities combine to make this community particularly vulnerable to outbreaks of diseases such as cholera.
Cholera was first recorded here in 1973, but the latest outbreak was confirmed in December 2015. In less than three months a total of 920 cases had been reported n the three districts surrounding Lake Chilwa with 25 deaths.
The current shoreline is 30km distant from the high water marks of 150 years ago and as the water recedes so the risk of contamination increases.
These fisherman provide a crucial supply of food for the surrounding population, but without a sustainable means of obtaining safe drinking water, basic sanitation and hygiene education, or improved healthcare facilities - their way of life and those of the communities they support, is very much under threat.
Few people would argue that one of the fundamental ingredients of a good cup of tea is clean water.
This hut is constructed on a bed of floating reeds on a remote part of Lake Chilwa serves the hot beverage to up to 100 customers per day - all of whom are local fishermen. The water for the tea is collected from the lake, but the scarcity of fuel means that although the water is heated on a rudimentary stove, it is unlikely that it is to a sufficient temperature or duration to kill off all the pathogens that may be
In situations such as these, water filtration can make all the difference.
The owner of this tea hut manages to filter up to 100 litres of water per day using a single Grifaid® Family Filter, ensuring that all his customers won't be getting more from their daily cuppa than they bargained for.
The difference that teamwork can make.
Here in the village of Gingama, about 1 kilometre from the shores of Lake Chilwa, the situation is a stark reminder of how the fight against diseases like cholera often require the coming together of many people and ideas, one of which is the essential need for safe and clean drinking water.
The village suffers from a paradox - despite a plentiful supply of water, both from the lake and from a nearby river, it is the water that is making people sick.
Because the water from the Lake is too turbid and further away, the villagers instead take their water from a nearby river. But the river water is contaminated and is a known source of the germs that cause cholera.
A large a small cholera treatment centre has been established in the village, which has a population of about 1000 people and one of the tools that they use is a Grifaid® Community filter.
In order to filter sufficient quantities of water, the filter is manned by 10 people working shifts and together, they produce about 45,000 litres a month of clean safe drinking water.
There is still a long way to go in the battle against cholera, but with more teamwork like this, the chances of a successful outcome are getting better all the time.