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PAPERS:
John A Crump, Peter O Otieno, Laurence Slutsker, Bruce H Keswick, Daniel H Rosen, R Michael Hoekstra, John M Vulule, and Stephen P Luby
Household based treatment of drinking water with flocculant-disinfectant for preventing diarrhoea in areas with turbid source water in rural western Kenya: cluster randomised controlled trial
BMJ 2005; 331: 478 [Abstract] [Full text]
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[Read Rapid Response] Moringa oleifera: a non-chemical alternative water purification
Arunachalam, Kumar, Jairaj Kumar C   (4 September 2005)
[Read Rapid Response] How sustainable is disinfection of water at household level?
Adamson S. Muula   (14 September 2005)

Moringa oleifera: a non-chemical alternative water purification 4 September 2005
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Arunachalam, Kumar,
Professor of Anatomy
Kasturba Medical College, Mangalore 575001, India,
Jairaj Kumar C

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Re: Moringa oleifera: a non-chemical alternative water purification

Pure potable drinking water is premium even in metropolitan areas in developing and underdeveloped countries. While source and storage chlorination is extensively used by city corporations and municipalities in India, in interior and rural situations, most if not all water for personal use is drawn from wells or village tanks and ponds. No attempt is ever made to by authorities at village levels to address the serious and perennial problem to health and hygiene from the consumption and use of contaminated water.

In some of the more enterprising ‘panchayats’ (locally elected five- man administrative bodies), we have seen the use of the common drumstick produce, apart from its water purification properties.

The drumstick tree, Moringa oleifera, is found all over India, its product, the drumstick, being used extensively as a constantly available source addition to add flavour, tang and spice to native recipes.

Branches of the tree are lopped and thrown into turbid and contaminated wells – where over a period of time, the once dirty water, turns clear. Desiccated drumstick seeds are known to science to clear water (about a gram to liter). We report the use of the tree product in many parts of India with hope that the simple and trusted flocculating (and probably harmless) method of water purification is adapted more widely.

As an offshoot, in our own laboratory, we are presently experimenting on the effect of drumstick seed powder as a ‘flocculant-catalyst’ to hasten the time taken for measuring Erythrocyte Sedimentation Rate in diagnostic procedures.

Competing interests: None declared

How sustainable is disinfection of water at household level? 14 September 2005
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Adamson S. Muula,
Forgraty Fellow
School of Public Health, University of North Carolina at Chapel Hill NC 25714

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Re: How sustainable is disinfection of water at household level?

The recent article by Crump et al (1) and the editorial by Tumwine (2) add to the growing literature about the available options for household disinfection of water to make it close to potable in developing countries. Other methods include solar disnfection (3), use of a sieving cloth and just letting the water stand for several hours (2).

While I appreciate the the importance of these methods, I would suggest that we consider these options of much use in emergencies such as Tsunami's, hurricanes, wars and similar situations but not really long term solutions that will ensure that the quality of life in developing countries rise. I believe it is extremely difficult, if not impossible altogether to maintain a sense of adequate hygiene and have adequate safe drinking water if people must put bottles of water on their roof daily for several hours (solar disinfection) or always remember to put in sodium hypochlorite (bleach) in order to have safe water.

Although the cost of a bottle of bottle could not be much, sustaining this in the poor, developing countries we are talking about, can be an uphill battle. Just imagine if in London, Paris or Boston, people were always reminded that; "in order to have safe water, remember to put bleach in your water daily." Not a pleasant thought and we can start seeing the diarrhoeal rates going up soon. I guess time has come when medics we need to liase with state and global agencies to ensure that more and more people in the developing countries start getting water from municipal or industrial scale water treatment plants and not rely heavily on buckets of water collected 10 to 15 kilometres from homesteads.

1. Crump JA, Otieno P, Slutsker L et al. Household based treatment of drinking water with flocculant-disinfectant for preventing dirrhoea in areas with turbid source water in rural western Kenya: a cluster randomized trial. BMJ 2005; 331: 478-83

2.Tumwine JK. Clean drinking water for homes in Africa and other less developed nations. BMJ 2005; 331: 468-9

3. Conroy RM, Elmore-Meegan M, Joyce T et al. Solar disinfection of drinking water and diarrhoea in Maasai childre: a controlled field trial. Lancet 1996; 346: 1695-7

Competing interests: None declared