Water quality assessment in Ecuador

The El Tor cholera pandemic arrived in Ecuador in March 1991, and through the course of the year caused 46,320 cases, of which 629 were fatal. The majority of the cases were confined to the cities along Ecuador's coast. As part of its efforts to combat the spread of the disease, the Government of Ecuador, through its Ministry of Health, requested help from USAID/Ecuador in the form of chlorine to be used by the water utilities in the affected coastal areas. Given its earlier experience in a cholera assessment in Peru, WASH was asked to participate in a review of this request for help. It was felt that the country needed a more comprehensive approach, and that chlorine alone may not have been an adequate solution to water quality problems if there are breaks in the distribution system, intermittent supply problems, and poor handling of water in households, all factors which contribute to recontamination. The evaluation team visited three coastal cities, Guayaquil, Machala, and Esmeraldas. The evaluation concentrated on the following issues: water quality, hygiene education, and institutional issues. The recommendations given concerned both short and long term strategies for the prevention of cholera in the coastal cities of Ecuador.