The Infrastructure Team-

The Impact of Potable Water

Team leader: Lucy Jodlowska

Team members: Sky Mehringer

Melissa Summers
Adam Stieglitz
Infrastructure Team Final Report Acknowledgements

The Infrastructure team would like to thank the entire staff of La Coordinadora and
Asociación Mangle for their invaluable time, flexibility, access, information, and
logistical coordination that enabled our team to conduct our work. We are particularly
grateful to Luis Orellana, the Infrastructure Coordinator, for providing us with a
comprehensive overview of the water distribution system and all its facets. We would
also like to thank Dina (last name?), the system’s manager and administrator, for her time
and feedback, as well as for coordinating interviews with a wide variety of stakeholders,
and accompanying the Infrastructure Team on a number of site visits. David Marroquin,
our liaison and local representative, was invaluable in his facilitation of community
meetings and household introductions, which enabled our team to conduct household
interviews, for which we are very grateful. Additional thanks go to Carlos Quintalla, the
accountant overseeing the Water Distribution project, for his assistance and access to
critical financial and accounting information.

The Infrastructure team would like to thank the communities of La Amistad and La
Solidaridad for their welcoming reception, their willingness to devote time and energy to
speak with the team, as well as for the honest and frank feedback received. Community
leaders, Doña Paula and Doña Berta, were indispensible in their facilitation of access to
the community members at large.

Finally, our sincere gratitude goes to Adele Negro, our faculty and program director, as
well as our translator and interpreter, Hilda Díaz, for all of their guidance and assistance.

Executive Summary

Asociación Mangle’s Infrastructure Program, in conjunction with Engineers Without

Borders, designed, constructed, and began the implementation of a potable water
distribution system in the region of Tierra Blanca in 2007. Though the scope of the
system is to eventually provide potable water access to five rural communities, two of the
five- La Amistad and La Solidaridad- have already obtained access and have been using
potable water for over two years. The primary objective of the Infrastructure team’s study
was to develop a baseline assessment as well as determine the impact of potable water on
the two communities since its implementation, with a focus on four sectors: health, daily
life, socioeconomics, and water usage. The intent of this objective was to evaluate the
system holistically, investigate problem areas, and provide recommendations for the
improvement of the expansion of the water system to the remaining three villages.
Secondary objectives of the study included an assessment of community needs,
determining areas of community interest for technical and professional training, and
assessing the relationship of the communities with Asociación Mangle.
Project Scope

Objectives

La Coordinadora (LC) and Asociación Mangle (AM) asked the Infrastructure team for
assistance to devise a baseline assessment that would measure the impact of their project.
The Infrastructure team interviewed key stakeholders and witnessed first hand how the
water system is administered within the communities. In order to provide La
Coordinadora with a well-rounded analysis of the project, the Infrastructure team aimed
to achieve four separate objectives throughout its research:

• Measure the impact of potable water in La Amistad and La Solidaridad

• Assess the need for future community infrastructure projects
• Determine areas of interest for technical training
• Assess the knowledge of and relationship between the communities and La
Coordinadora/Asociación Mangle.

The primary objective was to measure the impact of the potable water distribution system
(PWDS). Considering the complex nature of this task, the project plan was separated into
four components: health, daily life, socioeconomics, and water usage. To measure the
health impact, the frequency of diarrhea, parasites, and fungal infections, before and after
the implementation of the water distribution system, were compared. Results of this
component were recorded separately for adults and children. Effects of the water system
on daily life and family dynamics were gauged by determining specific changes in the
quality of daily routine since receiving potable water. Examples of these indicators
include the amount of time saved from not having to retrieve water from a well and how
that newfound time is utilized. Cultural change, implementation of the system, and issues
such as cost and affordability were examined in order to gain the perspective of
socioeconomic impacts of the potable water distribution system.

The final indicator used to measure the impact of this system was usage and
administration, including the different manners in which potable water is used, how it is
disposed of, and what potential issues or problems arise throughout the administrative
system and how they are dealt with. As a whole, the aim of this objective was to provide
information that would allow for recommendations on ways to improve the water
distribution system for current and future beneficiaries.

Secondary objectives were also established in order to make recommendations in respect

to future projects. First, it was important to gain perspective from community members
about their needs. A general needs assessment was conducted in order to establish what
different areas might need improvement within the community. Also, once it was
established that the potable water distribution system created free time for its recipients,
the Infrastructure team aimed to determine the level of interest for technical training
among community members. The goal of this was to gain an understanding of ways to
diversify and create new opportunities for income generation. Both of these objectives
were accomplished by including direct, open-ended questions in the general baseline
survey. Finally, the Infrastructure team included a portion of its survey to assess the
knowledge and relationship of the community with LC/AM in order to learn more about
the local community perspective.

Goals

The team’s goals became narrower in scope once its objectives were established.
Primarily, it was important to have a full understanding of the different uses and practices
of the PWDS, because each household exemplified its own techniques. For example,
some households improvised a drainage system while others did not. It was necessary for
the Infrastructure Team to differentiate between each technique and understand why only
some households were benefiting from some sort of drainage system. This method of
research led to a diversified approach, allowing for the infrastructure team to closely
examine different areas of the PWDS, including but not limited to, system maintenance,
administration, stakeholder involvement, and community and household practices.
Gaining this inside perspective allowed for other predetermined goals to be reached.
First, it would provide more beneficial recommendations to communities who have, or
will soon have, access to the PWDS. Second, it would help identify different problem
areas and communication gaps between homes, communities, and/or organizations. Both
of these goals were fundamental areas of focus that lay within the scope of the original
project.

Background

Faced with an array of challenges throughout its turbulent history, El Salvador is a

country accustomed to dealing with hardship. Inadequate infrastructure impedes on
development, leaving rural communities marginalized with basic human needs unmet.
One example is the lack of access to clean water. According to The World Bank Group,
32% percent of the rural population in El Salvador does not have access to some
improved water source. With a government either unable or unwilling to take on this
problem, the responsibility falls onto civil society.

Initiated by La Coordinadora, a large community organization representative of many

local regions and villages, and its technical arm Asociación Mangle, the water
distribution system was constructed with the efforts of several entities and spearheaded
by the Clemson University-based Engineers Without Borders. Local decision-making
processes with regards to service and delivery to specific households has resided and
continues to reside within smaller community groups –some legal in scope- which
include the Adescos, Grupos Locales, and village leadership.

The Infrastructure Team discovered through surveys and numerous interviews that the
Salvadoran Ministry of Health of El Salvador has legal authority to approve as well as
terminate any community project that involves health implications and the usage of land.
This authority rests within the public clinics, called Unidades de Salud, which are
theoretically to be called upon to conduct an assessment of a given community project
and grant approval for the project to be implemented. With no official approval having
been granted for the water distribution system and despite threats to shut the project
down, no action has been taken to hinder or halt development of the project. This is due
to the fact that La Coordinadora and Asociación Mangle provide vital public goods and
services to a large majority of the population in the Bajo Lempa.

Before receiving access to potable water, the communities obtained water from artisanal
wells, which are manually constructed by individual families, who dig in the ground until
they reach water. Though widely used and still in existence, especially in communities
that do not have running water, the artisanal wells are often shallow, and contain water
that is undrinkable and in fact dangerous due to contamination from run-off and the
lengthy usage of unsafe agricultural fertilizers. Salvadoran families, especially those
residing in rural areas, experience high rates of kidney problems as well as death from
kidney failure, a common condition strongly associated with water contamination from
waste and animal feces, as well as from chemical run-off.

Obtaining water from the artisanal wells involved making at least one arduous trip per
day, though sometimes many more. Buckets of water must be pulled from the well itself,
which may be a substantial distance away for families that do no have their own wells,
any available containers are filled, and the heavy load is carried back home. This activity
is physically taxing and quite exhausting, and most frequently performed by women, who
carry containers of water on top of their heads. As a result many women suffer from
sores, chaffing and calluses on their hands, as well as neck and back problems. The
successful excavation, implementation and testing of the water distribution system in the
communities of La Amistad and La Solidaridad, have put an end to the traditional
fetching and usage of contaminated well water, at least for most members of the
communities.

Engineers Without Borders, along with a number of other organizations and the members
of the communities themselves, provided the materials for and installed the main
infrastructure of the system. La Coordinadora and Asociación Mangle purchased the well
from a community member in La Amistad, and cleaned and revitalized it in order to
connect it to the water distribution system. Individual households were responsible for
excavating the land and installing the pipelines that served as the connections to their
homes. A critical aspect of the new potable water distribution system, however, is that the
system does not include a drainage mechanism. Water that is delivered from the main
pipe and used for all household duties, including cooking, drinking, cleaning and
washing, is disposed of by the families in a variety of ways. It is either emptied directly
onto their properties, sometimes “to settle the dust,” next to their homes, or onto the lots
of neighbors. It is also sometimes thrown directly onto the road and walkways around the
houses. This factor has many health and social implications that will be addressed in
more detail.

Community Demographics

The communities of La Amistad and La Solidaridad, the first two to benefit from the
potable water distribution system, are unique in their structure and demographical
composition. La Amistad is comprised of approximately thirty households and La
Solidaridad forty, the vast majority of which are ran by women.

La Amistad, the smaller of the two communities, is divided by a single large dirt road,
with all of the families living on other side of the road. The housing units manifest
different attributes and levels of development. Some are made of brick or cement, while
others have walls made of tin slabs. Some homes have cement floors while others have
dirt floors. Some of the families have a mix of both in their living compounds. The land
is predominantly flat. La Solidaridad, on the other hand, is substantially larger, more
spread out, and is located in areas of steeper land elevation than La Amistad. The
presence of hills in this community is significant because it allows for more collection of
run-off and stagnant water, especially during the rainy season.

The lots that the families live on are modest in size, with all of the families living in close
proximity to each other. None of the roads leading to or around the communities are
paved. There is no sewage system of any kind, and the roads themselves are narrow,
uneven and contain substantial amounts of stagnant water, animal feces, and garbage.
Since there is no garbage treatment or collection, most of the families burn their trash in
self-contained fires on their properties, usually on a daily basis.

As mentioned above, the mixture of rain, especially during the rainy reason, as well
as the constant presence of waste water that is regularly disposed of into the
streets, fosters a near-constant presence of mud and stagnant water. Both, in turn, lead to
an increased infestation of mosquitoes, foul smell, conflicts between
neighbors, and general health concerns.

photo by Lucy Jodlowska

Household Demographics

Of the 35 households interviewed in the communities of La Solidaridad and La Amistad,

68.57% had a family size of 4 or more, and 80% of households had at least 1 child under
the age of 13. The average daily wage per person in these households is $3.44 and
individuals work an average of 3.55 days per week. In most households there was only
one income earner. Average household monthly income is approximately $140.62
including remittances; excluding remittances, average household monthly income is
approximately $135.91. There were only 7 households that received remittances, and
only 2 out of those 7 had remittances as their only income source. Table 1 shows the
breakdown the income generation activities by percentages of the households surveyed.

Table 1: Income Generation by Activity (Percentage)

Activity Type Percentage Households
Participating in Activity
Farm work 45.90%
Washing clothes 11.48%
Selling (vegetables, clothes, etc.) 9.84%
Small store 1.64%
Cleaning Houses 1.64%
None 14.75%
Remittances 14.29%
Other (carpentry, construction, retirement) 11.48%

Of all income generating activities, the most frequently reported was farm work at 45.9%.
The people living in the communities of La Amistad and La Solidaridad have few
opportunities for work, and primarily must find work in the sugar cane fields. Field work
is seasonal and, therefore, very unstable. Often, there is not enough work for all those
who seek it, and those who do obtain it frequently work 15 days straight, and then go
weeks or months without another job. Furthermore, the farming industry, particularly
sugarcane, is becoming much more mechanized. Due to mechanization and seasonality,
the members of these communities are increasingly finding themselves without a steady
income stream.

Public and Community Health

The issue of public health is now considered a high priority by the recently elected Funes
government. However, it has been a topic of much contention among Salvadoran
communities. Public health clinics, called Unidades de Salud, are the main centers for
medical attention available to rural communities such as La Amistad and La Solidaridad.
Operating on limited resources and providing very basic care, the health clinics are
generally open from 7am to 2 or 3pm, with doctors and medical personnel attending to a
substantial number of villagers, who form long lines and are not all able to obtain
treatment due to the sheer volume of patients.
In 2009, the new administration terminated the $1 service fee previously required from
each patient seeking medical attention in the Unidades de Salud. While an important
change and an improvement in the public health care system, the lifting of this service
charge, along with other public health changes, has overwhelmed the Salvadoran public
health care system with the increased numbers of medical-attention seekers who were
previously unable to get care due to lack of funds.

Community Health Workers

Public health workers, otherwise known as Promotores de Salud, visit most rural
Salvadoran communities, including the communities of La Amistad and La Solidaridad.
The health workers are usually from the communities or regions they service and only
have several months of training on basic medical attention. Their priorities lie in visiting
families with pregnant women and small children, distributing vaccinations for children
as well as household animals, keeping diligent records of community illnesses, birth and
mortality rates, as well as providing families with information on sanitation, basic
hygiene and trash disposal. The health workers also distribute anti-mosquito pills to be
deposited in water containers and barrels to prevent mosquito-borne diseases, particularly
malaria and dengue fever.

Health workers’ services are fairly comprehensive and address many areas of health and
household sanitation. However, due to the low ratio of community health workers per
number of families, the Infrastructure team discovered substantial discrepancies in terms
of which families were actually visited by the health workers. Some families reported
having been visited at least twice a month, while others (mostly the ones with older
children), claimed not to have been visited by health workers in months.

The Infrastructure team’s main focus in researching the area of community health trends
and health records among the rural communities was to analyze the variations in water-
borne illnesses and their frequency before and after access to potable water. It was found
that the main areas of current concern are mostly centered around other infrastructure
related issues, specifically those pertaining to a fundamental lack of garbage collection
and management.

Water Distribution System

Administration

As of the first year and eight months of the implementation of the potable water system,
each household was charged $3.50 per month for water access, which was rationed based
on the time of day the water was available. In September 2009, Asociación Mangle chose
to revise the administration of the water system because the previous billing system had
become too costly for AM and was not sustainable. As such, a meter was installed in each
household to measure its monthly water consumption. Each household was now charged
for their water consumption at $0.10 per meter3 of water consumed plus a reduced base
cost (cuota base) of $2.50. However, while households were informed of this change and
of the decrease in cost, their bills, until recently, did not reflect the two charges; they only
reflected the total amount charged. As one can imagine, this caused great concern among
the households because they had been told that the base cost would go “down” but only
“saw” their bill go up. They did not understand how the charges were broken down or
why they were broken down the way they were. While 71.43% of households
interviewed knew that their bill included a base cost, only 64% of those who were aware
of the existence of the base cost knew what it was used for. As a result, a great deal of
confusion was observed among the communities about how much they were being
charged, and many began to feel discontented with the cost of water.

Installation

The main infrastructure (revitalization of the well, main pipelines, etc.) for the water
distribution system was installed and paid for by Engineers Without Borders, a number of
its partners, volunteers, and La Coordinadora and Asociación Mangle. However, each
family was responsible for installing the connection from the main pipeline to their house
and paying for the materials needed in order to do the installation. Based on the
households surveyed, the average cost to households for the installation materials was
approximately $36.89. However, this number tended vary greatly due to the fact that
some peoples purchased their materials at the local hardware store as opposed to directly
from AM, thus having to pay a marked-up price. Other families also chose to include
their purchase of an individual meter ($20) in their total cost, which created a disparity in
the numbers reported to the team. Figure 2 shows the percentage breakdown of how
households paid for the installation materials. Other payment methods included donations
or working in exchange for the materials, which amounted to only 4 out of 31
households.

Figure 2: Payment Methods for Installation Materials

Cost of Water

Initially, the households in La Amistad and La Solidaridad were charged a fixed price of
$3.50 per month for water. The households were allowed to consume as many cubic
meters of water as they desired while the water was on. AM rationed the amount of water
consumed by having it turned on only during certain times of day. However, in
September 2009, this system was changed because of exorbitant energy costs, which
were rendering the system unsustainable. AM was not able to cover its fixed costs4 by
only charging the households $3.50 per month. Furthermore, during the hours that the
water was turned on, households were not rationing their own consumption,
understandably because their monthly bill never changed.

Each household was required to purchase a small meter to be installed on their property
in order to measure the quantity of water consumed per household per month. The base
cost was reduced to $2.50 per month and the charge per meter was at $0.10. The base
cost continued to cover personnel and maintenance costs, but the amount charged per
household for consumption went directly to cover the cost of electricity. In this way,
Asociación Mangle would be able to recover all of its expenses and be able to maintain
the system. During the first month of the new system, individual households continued to
consume an exorbitant amount of water5 despite the fact that they knew they were being
charged for consumption. It was not until the first bill arrived that they began to change
their consumption habits in order to reduce the amount of their monthly bills.

As can be seen in Table 36, the average cost of water has continued to decrease for the
members of La Amistad and La Solidaridad (See Table 3).

Table 3: Average Cost of Water7

Average cost of water (November 2009) $5.09
8
Average cost of water (January 2010) $3.00

The average monthly income per household in the communities of La Amistad and La
Solidaridad was determined to be approximately $135.91. At $3.00 per month for water,
this cost represents 2.22% of household monthly income in these communities. While
this appears to be a relatively low percentage of monthly income paid for water, it must
be kept in mind that the estimations of monthly income are approximate at best, due to
the fact that most of the work available to these households is variable and unstable.
When asked whether or not they felt that the monthly charges for water were fair, the
majority of households indicated that it was a necessary expense, but that they often had
to forego buying a certain food item in order to pay for water. Additionally, a large
percentage of the households had purchased the materials for the water installation,
including the meters, on credit from Asociación Mangle and were currently also paying
those bills. Therefore, taking into account the fact that the price structure had recently
changed, the following is a distribution of the answers respondents gave regarding
whether or not they could afford water:
Figure 4: Affordability of Potable Water

Methodology

Multidisciplinary Approach

To successfully attain its objectives, it was necessary for the Infrastructure team to utilize
a multidisciplinary approach. With a variety of actors, each having a stake and a wealth
of knowledge on the status quo, it was important to learn from them before implementing
the research aspect of the project. These stakeholders included program coordinator Luis
Orellana, system administrator Dina Armina-Gómez, Carlos Quintanilla, the system
accountant, public and private health officials, and local community leaders.

Tour of Communities and Pump-House

Once the Infrastructure team had a comprehensive understanding of the scope of the
project, the team took a tour of the communities to see how the potable water distribution
system worked. Communities yet to receive potable water were easily identified by the
presence of women carrying water back to their homes. Communities with the potable
water system each had a visible faucet, usually accompanied by water in the streets or in
the patios. The team also visited the heart of the potable water distribution system, the
pump-house, which was located within walking distance of both La Amistad and La
Solidaridad.

Interviews with Administrators and Coordinators

Luis Orellana, the Infrastructure Program Coordinator, was the first administrator
interviewed. Luis explained the basics of the water project, such as the administrative
procedures and how the construction and piping system works. The second person
interviewed was Dina (insert last name), the manager of the water system, who provided
information about specific administrative procedures of the potable water system. She
also coordinated logistics and set up a number of meetings for the team. In addition, she
offered insight regarding problems, as well as ideas for topics to be incorporated within
the survey. Dina informed the team that she was at its disposal for all three weeks and
was willing to help in any way possible. For the rest of that week she set up
appointments, assisted in scheduling a community assembly, and provided important
information about the local context, history, and community dynamics. The last
administrator interviewed was Carlos Quintanilla, the accountant for the water system.
Carlos offered a comprehensive perspective on accounting and administrative procedures
along with providing the team with financial statements. These statements allowed for the
team to evaluate the system and offer sound recommendations on ways to increase
administrative efficiency.

Visits to Health Clinics and Interviews with Doctors/Health Promoters

The team visited two health clinics in order to gain a better understanding of the local
health care opportunities in Tierra Blanca and Bajo Lempa. The first clinic was privately
owned and staffed by a small team of volunteers. The doctor in charge of the clinic
advised the team of the private clinic’s preference to attend to fewer patients but to give
them better quality care and discuss illness prevention strategies. He also acknowledged
that access to potable water in the two rural communities improved the overall health
conditions of the system’s beneficiaries.

The second clinic visited was a state-run public clinic. During this visit the team
interviewed the clinic’s sole doctor; however an administrative officer working for the
government’s Ministry of Health also entered the room during the interview and
interjected his feedback. The team’s intention was to ask similar questions and compare
answers from the doctors of the private and public clinics to see how they differed, if at
all. It was the impression of the team, however, that the doctor from the public clinic was
unable to speak frankly because of the administrative official’s presence. Having
witnessed the power dynamics within the public health care clinic, the team was able to
incorporate this interview as a useful part of its research.

The Infrastructure team also interviewed local health promoters. The government assigns
a health worker to a specific region in the field to provide medical assistance for citizens
who are unable to visit the clinic. Health promoters are trained to help with basic medical
problems and are mostly accustomed to working with pregnant women and children.
They are responsible for both human and animal vaccinations, ensuring proper water
maintenance, as well as offering guidance on hygiene practices and other domestic issues.
The health promoters provided the Infrastructure team with useful information on health
problems in the communities where the team was working. This information, juxtaposed
with the information provided by the clinics, provided the Infrastructure team with an
overall impression of the most predominant health concerns in the region.
Community Assembly

The last objective of the Infrastructure team prior to drafting the initial survey was to
hold a community assembly, designed to bring together the future interviewees for a
preliminary, introductory meeting. The purpose was to introduce the team, offer
information on the study and its intended objectives, and address any initial questions or
concerns from the participants. This assembly turned out being very productive, as it
created a comfort zone and initiated a relationship between the team and the community
members. Afterwards, the team was able to interview Dona Paula, a community leader,
as well as the community plumber, who was the main contact person in case any
technical difficulties arose with the water system.

Survey Design

The Infrastructure team gathered enough information to draft a household survey after the
initial interviews with the key administrative stakeholders were held. At this stage of the
project, its scope began to grow as the team became aware of all the different aspects of
the potable water distribution system. Besides asking questions directly related to water,
the team would also need to obtain personal and health information, determine socio-
cultural changes with before and after comparisons, and examine the role of women. The
survey’s first draft was very comprehensive, but a pilot interview proved it to be too
complicated. Before beginning household interviews, the Infrastructure team had to
shorten, simplify, or omit many of the questions. This turned into a very lengthy and
complex process, which included consultations with locals in order to identify and use
common, widely understood terminology, avoid misleading questions, and make sure to
include a range of both closed and open-ended questions were included.

Household Interviews

Interviews in La Amistad and La Solidaridad were conducted on a house-to-house basis.

The Infrastructure team split up and conducted interviews in groups of two. David
Marroquin, the team’s liaison with La Coordinadora, made introductions at each home
before the survey began. After ensuring that team members were welcome into the
homes, David then left the group alone, and the interview was conducted in privacy.
Before each interview began, the interviewee was reminded that all information was
confidential and anonymous. Most interviewees were willing to speak honestly and
frankly about issues regarding their personal lives and how they have been affected by
the potable water distribution system. In addition to conducting interviews, the team
documented and photographed the water system and any quasi-drainage systems, as well
as the physical landscape affected by stagnant or grey water.
photo by Ryan Gonzalez

Preliminary Report/Recommendations; Presentation to Asociación Mangle

The last days of the team’s work in El Salvador were spent preparing a preliminary report
for Asociación Mangle. This consisted of a brief summary on what was accomplished,
the methodology and process followed in order for the team to meet its goals and
objectives, general observations, and preliminary recommendations based on the initial
results from the survey. On the final day in El Salvador, the report was presented to
Asociación Mangle, board and program coordinators, and community leaders.

Assumptions and Results

Throughout the various stages of the survey process it became apparent that the team had
embarked on the project with certain assumptions and presuppositions that influenced
both the process and the interpretation of the data collected. Each of these assumptions is
highlighted below, immediately followed by the team’s findings and results.

The team assumed that beneficiaries of the potable water system would understand what
potable water meant, why it was healthier than well water, and that it was preferable to
well water. Furthermore, the team believed that the communities would not hesitate to
drink the potable water, and would harbor no doubts about the resulting differences they
observed from the chlorination. However, when the water initially became accessible,
many residents doubted its quality given the difference in color and taste resulting from
the chlorination. The majority of respondents did not understand the health implications
of potable water. While all appreciated the improved access, many did not believe that it
was healthier than untreated well water. Some individuals distrusted the chlorination
process and believed that the chlorine used to purify the water was toxic and led to
kidney failure. As indicated by the occurrence of doubt (60% of respondents had doubts
about potable water prior to installation) and the reasons causing that doubt, there
appeared to be a lack of information, or a failure in the dissemination of information
regarding potable water (See Table 5). Nevertheless, 80% of respondents now believe
that potable water is safer than well water, while 17.14% of respondents believed it is not
safer and 2.86% believe there is no difference.

Table 5: Reasons for Doubt regarding the Safety of Potable Water

Reason for Doubt Percentage of interviewees who had doubt
Different Taste 2.86%
Different Color (white at the beginning) 22.86%
Different Odor 0.00%
Fear of too much chlorine 25.71%
Potable water is unhealthy 5.71%
Well had been stagnant for a long time 3.00%

It was assumed that the health impact from the water distribution system would be easy
to distinguish from impacts caused by other factors that had changed within a similar
time frame. The consequent health impact of potable water would be dramatic, easily
observed, and easily quantifiable. While there had been a notable improvement in the
overall health of the families since the installation and usage of potable water, the team
recognized that there had been a number of other recent changes that would also have
affected their health. The residents of the two communities had been living in cardboard
houses next to train tracks, without latrines or access to potable water roughly a decade
prior to the team’s visit. After an earthquake in 2001 had demolished their homes, they
were relocated to the area that would become the communities of La Amistad and La
Solidaridad. LC and AM assisted them in building better quality homes. Within the past
four years they were given compostable latrines, followed by access to potable water. All
of these changes happened within an overlapping period and all entail a significant
impact on the quality of life and health of the people. It was therefore exceedingly
difficult to ascertain which of these changes was most influential in creating the drastic
improvement to health that was observed throughout the two communities, and what
specific impact the installation of the potable water system had.

It was assumed that water-borne diseases, specifically caused by contaminated well

water, would be the most prevalent health problems for the population in question and it
was expected that these would have decreased significantly after the implementation of
the potable water system. The team discovered a marked decrease in incidences of
diarrhea and parasites, particularly among children under the age of thirteen, as noted by
parents and health workers. However, the data did not reflect an equally significant
decrease in other water related illnesses, such as kidney failure and fungus infections.

Given the lack of available, concrete data and the uncertainty of the interviewees’
memory, the team chose to measure the impact by categorizing the changes as: “less,”
“more,” “no change,” or “not applicable/relevant.” In this way, the team was able to
gauge whether or not access to potable water had any significant impact on the health of
the families in the communities of La Amistad and La Solidaridad. As can be seen in
Figure 6, 31% of adults and 29% of children experienced no change or did not suffer
(adults – 49%, children – 51%) from fungus infections before or after potable water. In
the case of parasites, the team observed a reduction in occurrence. However, the team
expected to observe a more significant decrease in occurrence than was actually the case.
As can be seen in Figure 8, 43% of adults responded that they suffered less from
parasites, and 34% of parents responded that their children experienced fewer infections
from parasites. This also contradicted the expectation because children are generally
more susceptible to illnesses, a greater decrease in infection rates for children would be
observed. In the case of diarrhea, 49% of adults experienced fewer occurrences while
46% of children experienced fewer occurrences (See Figure 7). In all three illnesses,
fewer than half of the households had experienced a decrease in infection rates. In
particular, only 17% and 6% of adults and children, respectively, experienced lower rates
of fungus infections after having access to potable water.

Figure 6: Incidence of Fungus Infections

Figure 7: Incidence of Diarrhea

Figure 8: Incidence of Parasites

It was assumed that the beneficiaries would have a clear understanding of the water
system’s billing process. This was not the case, however. There was a considerable lack
of general understanding about the water system within the communities. The majority of
those interviewed did not understand the charges and fees on their bill or adequately
comprehend the consequences of late or defaulted payments. As previously noted, there
had recently been a number of changes to the administration of the water distribution
system and its billing structure as well as a lack of communication to the beneficiaries
about the changes.

It was assumed that the women in the communities would occupy a social role that was
secondary and subservient to the males, and that the community would be largely male
dominated. However, in a large majority of the homes that the team visited the men were
absent. The women were the sole wage earners and the heads of the household. Due to
the considerable absence of men, or the lack of participation by those present, the women
ran and maintained the community. They had built their own community centers, dug
their own drainage ditches and installed the pipes for the water system in their own
homes. They worked in the fields, raised the animals, and cared for the children. The
women held community leadership roles and were undeniably the authority when it came
to making decisions for the community as a whole. During the community meeting that
was held to introduce the team and the project, the gathering was comprised entirely of
women, while a few men lingered outside the building.
Community meeting with families from La Solidaridad and La Amistad.
photo by Lucy Jodlowska

The team assumed there would be a general understanding of the connection between
hygiene practices and the resulting health effects. Yet, there was considerable variation in
both the hygiene practices and the level of understanding about the consequences of such
practices. In many cases either the children or the adults, or both, in a household were
walking around the house and the yard without shoes during the interview. This posed a
health problem due to the unsanitary conditions in which the majority of the people live.
The floors of the homes were often made of dirt, and it was not uncommon for animals
such as chickens, pigs and dogs to also wander freely around the house. Outside the
house, in the yard, there was invariably a mixture of used water and animal feces. Some
households maintained their yards more vigilantly than others so that the water and feces
were confined only to a specific part of the yard, but others showed evidence of little
maintenance. There seemed to be a lack of understanding about the health consequences
of this exposure to dirty water and excrement.
 Hens and other animals are seen
feeding and walking freely through
families’ homes and sleeping
quarters.

photo by Lucy Jodlowska

The team’s understanding of a water distribution system was based upon the assumption
that it would include a drainage mechanism. The most striking aspect observed was the
lack of and dire necessity for a drainage system to evacuate the water used by each
household. The used water was routinely collected in open ditches or receptacles where it
became a potential breeding ground for mosquitoes. In some households, when the ditch
or receptacle was full, it was emptied onto the patio or into the street. For some homes
this is not a problem during the dry season because the water quickly evaporates.
However, many homes and sometimes whole communities are plagued by puddles of
stagnant water that run through their yards or in front of their houses, mixing with animal
excrement and trash. The problems caused by this runoff and the lack of a drainage
system is significantly exacerbated during the rainy season. When asked what they do
with their used water, given the lack of a drainage system, 65.7% of the respondents
indicated they throw it on their yard to control the dust (See Figure 9). It should be noted
here that the survey was conducted during the summer season in El Salvador, which is a
very dry time of year. The respondents did comment that, during the rainy season,
disposing of the used water becomes a much more difficult process due to ground
saturation and the lack of outlets for the water. Problems associated with stagnant water,
such as dengue fever and malaria, are much more common and worrisome during the
winter months. Given the problems associated with stagnant water and lack of drainage,
the infrastructure team chose to survey respondents regarding their opinion with respect
to the necessity of a drainage system.
Figure 9: Disposing of Grey Water

The significant variation among the personal water distribution and drainage system of
the households was correlated with the amount of effort and funds that were dedicated to
the installation and maintenance of the system. Most households accessed the water in a
similar fashion. They would fill a large water basin directly from the tap and use it for all
of the household needs, though sometimes there was a second tap in the yard used for
showering. While this was fairly standard, the team observed far more variation in how
the used water was disposed of. There were cases where the water simply ran off from
wherever it was used in the yard, and cases where it flowed through a shallow open ditch
to a hole dug at the edge of the yard. Often there were chickens, pigs and excrement
mingling with the stagnant, soapy water in the ditches and the catch holes. Some houses,
however, had used plastic tubing to create a rough-made drainage system that transported
the water in a contained manner to a catch ditch that was covered and well maintained. In
the communities where the majority of households regularly maintained their personal
drainage systems there were minimal problems with standing water around the houses
and in the streets.
The team assumed that services and support from Asociación Mangle would be provided
to people in the communities according to their needs, and that these needs would be the
only deciding criteria. Throughout the interview process, it remained unclear what
criteria were used in selecting who was to receive donated materials for the installation of
the water system, who was considered for leniency in regards to late payments and
termination of services, and who received other amenities and services such as new
kitchens, stoves and home expansion/improvement. While some families with few young
children and adequate income had received special hardship consideration when unable
to pay their bills, other families who demonstrated obvious hardship - a lack of funds and
insufficient means to provide for their families - were not given special consideration.
Some families seemed to live in relative comfort, having received the majority of services
and materials offered by Asociación Mangle, while other families lived in obvious need
of assistance, yet had not received the same materials and services.

It was expected that the greatest change reported by respondents in terms of the water
system’s impact would be substantial health improvement. The most prevalent response
that was highlighted by the majority of the households, however, was that the
beneficiaries now had much more free time and their quality of life had improved.
Prior to the implementation of the water distribution system, the families of La Amistad
and La Solidaridad spent approximately 90 minutes per day (1.25 times per day)9
gathering water from either a personal or neighbor’s well.10 All households surveyed
were very happy and satisfied with having access now to clean, potable water, and felt
that it had a significant impact on their lives. Among the specific impacts mentioned,
reduced stress received the most frequent mention at 31%, followed by more free time
and more accessibility at 29% each, and not having to bother the neighbors anymore at
17% (See Figure 10).

The concept of having more free time has a multitude of implications, none of which was
lost on these communities. As can be seen in Figure 11, having potable water, and
therefore more free time, has had a significant impact on the daily lives and incomes of
the households surveyed. The members of these households now have more time to do
housework and gather firewood for cooking (43% of respondents), more time to rest
(37%) and more time to work and generate income for their families (31% of
respondents).

------------------
9
90 minutes and 1.25 times per day are the median times for water gathering based on an average time per
day of 84.43 minutes and an average number of times per day of 1.97. The median was selected as the
measurement in place of average, given the number of outliers existing in the data. With a large number of
outliers, the median is considered to be a better measure of centrality in the data than a calculation of the
average.
10
Majority of households gathered water from a neighbor’s well, which could either have been right next
door, down the street or in another community
Figure 10: Greatest Impact of Potable Water

Figure 11: Use of Free Time

Recommendations

Income Generating Skills Workshops

The team recommends that Asociación Mangle offer a series of workshops to the
communities in order to teach new income-generating skills that water recipients may
utilize during their increased free time. When asked what the biggest impact to their lives
had been since the installation of the water distribution system, the overwhelming
majority of respondents reported that it was the increased accessibility of water and the
resulting increase in free time. Many of those interviewed expressed great interest in
learning new skills that would allow them to use this additional time in order to earn
more money, given the opportunity to do so. Both men and women, whether they were
heads of household or not, were asked what sort of skills or training they desired. The
majority of the women (31%) said that they would be interested in learning how to sew,
in order to make clothes not only for their family members but also to sell (See Figure
12). The majority of men (33%) said that they would be interested in learning how to be
an electrician and 22% said they would like to learn anything that would allow them to
earn more money (See Figure 13).

Figure 12: Female Respondents’ Interest in Learning New Skill

Figure 13: Male Respondents’ Interest in Learning New Skills

Communication Between Asociación Mangle and Water System Beneficiaries

Given the considerable lack of understanding the team encountered in the communities
regarding the water services, the fees, and the administrative procedures entailed, it is
highly recommended that efforts be made to improve communication between
Asociación Mangle and the beneficiaries of the services. While a letter of agreement was
signed upon implementation of services, the beneficiaries frequently reported not
knowing or understanding the details and facts that were stated in the agreement. It is
therefore recommend that upon signing any future agreements, a member of Asociación
Mangle meet down with the beneficiary to ensure that the agreement and the details of
service are understood, including payment dates and processes, rates and fees, and the
nature of the cuota base (baseline fee). Asociación Mangle should devise a checklist that
would be used during this information session to ensure that all aspects of the service and
the person’s responsibilities are covered in this meeting. Since many of the beneficiaries
do not read, the agreement may need to be read and further explained to them.

Additionally, it is recommended that recipients of the water distribution services be kept

apprised of changes to the system and the functioning of the administration as it pertains
to them. The recent and current changes taking place within the administration have
caused confusion within the communities, especially among those who had an
understanding of the original agreement and arrangement. In order to ensure that the
people understand what happens with the system and what their duties and
responsibilities are it is recommended that they be notified of changes in the
administration that will affect them. While it may be too time-consuming to inform
people individually, this information could be imparted at a community meeting, or to a
community representative whose responsibility it would then be to pass the information
along.
Drainage System and Eventual Water Treatment System

The team highly recommends the implementation of sanitary wastewater disposal

practices, the installation of individual drainage systems, and eventually the pursuit of a
mass drainage system for the communities that have access to potable water. One of the
most salient needs the team observed during the evaluation of the water system was that
of an accompanying drainage system. As a first step in addressing this necessity, it is
recommended that during the installation process the beneficiaries be given help to install
a drainage system and instruction on how to maintain it. The most functional personal
systems observed simply employed a hose or tube that carried the wastewater from the
place it was used to a catch basin or hole that was kept covered to protect it from
mosquitoes. As long as the wastewater was transported in this contained fashion, and as
long as the catch basin was emptied regularly, there were minimal problems with
standing water around the house. However, while this solution may prove effective
during the dry season in small communities, it provides no remedy for problems caused
during the rainy season and will not suffice as a means of disposal for wastewater as the
number of people using the system increases.

In order to mitigate the problems caused by the mingling and inundation of rainwater and
wastewater during the rainy season, it is recommended that Asociación Mangle help the
communities to create a more extensive and comprehensive drainage system. Considering
the current funds and resources available to Asociación Mangle and the communities, the
team recommends as an immediate remedy, the adoption of simple, cost-effective
approaches, such as a French Drain system.11 This system could be used to transport the
community’s used water to an appropriate drainage site. If the funds or resources are
available, the water from the drains could be channeled to a storage unit or area where the
community or a designated representative could oversee and manage the disposal.

11
A French drain is a ditch covered with gravel or rock that redirects surface and ground water away from
an area. A French drain can have hollow, perforated pipes along the bottom to quickly vent water that seeps
down through the upper gravel or rock. Diagram above.)
As a long-term objective Asociación Mangle should investigate the possibility of
installing a more effective and permanent drainage system, as well as water treatment
system. The construction and implementation of such a system would require the
collaboration of several agencies, the means to build the infrastructure, and likewise the
means to maintain it. However, as the communities continue to grow and as the water
distribution system expands, the consequences of having inadequate drainage will
become increasingly detrimental to the health and sanitary conditions of the people.

Overwhelmingly, 82.86% said that a drainage system was absolutely necessary, while
only 17.14% said it was not.

Education About Potable Water

It is recommended that that there be a community focused informational session about

potable water to inform the beneficiaries about how the system functions and what
potable water is, and what the health consequences of drinking untreated water are. This
information will help the people to understand the importance of following the hygienic
practices necessary to reap the full health benefits of their access to treated water. Many
of the respondents the team spoke to did not fully understand the concept of potable
water. They did not all understand that the water they were receiving from the system
was healthier, or that the chlorine added to purify it did not have detrimental health
consequences.

Education About Water Treatment

In order to avoid confusion over water treatment, the community should receive some
sort of education or training about the procedures involved. The health care workers
provide families with pills to put in their water that prevent it from becoming a breeding
ground for mosquitoes. However, they also supply chlorine pills to some families so that
they may purify their own water when needed (as in the case of a power outage or other
disturbance in the delivery of potable water that would lead them to use water from
artisanal wells again). The team encountered confusion in the communities over which
pill was to be used and when. This confusion and lack of understanding have potentially
hazardous consequences that could be avoided if explanation and training were provided
along with the pills.

Proactive Education and Preparation in Communities Awaiting Water System

The team further recommends that education about potable water, hygienic practices,
water treatment and drainage systems begin taking place in those communities that do not
yet have access to the water system. Proactive education about these issues could help to
avoid complications or confusion once the people have access to the system and become
beneficiaries with obligations to Asociación Mangle. Additionally, imparting the
information prior to service delivery could potentially alleviate some problems associated
with sanitary practices and lack of drainage that those communities may be currently
experiencing.
Strengthening of communication between LC/AM and public health clinics

During interviews with potable water system administrations as well as the public health
clinic, which is run by the Ministry of Health, it was noted that there exists a lack of
communication and coordination between the two bodies with regards to the potable
water distribution system as well as previous community projects. Though historical and
political circumstances may have influence on the relationship between the two
stakeholders, LC/AM provides the service delivery while the Ministry of Health, through
the public health clinics, has legal authority over projects that affect community health.
As it was conveyed to the Infrastructure Team, the public health clinics have knowledge
of health trends, terrain and geological information relevant to ground water and wells,
along with other demographical and technical data which they feel is essential to such
development projects. Citizens and associations such as Asociación Mangle allegedly do
not directly consult the public health clinic prior to initiating such projects and it is feared
this could lead to potentially negative environmental impacts. On the other hand,
community project organizers allege experiencing roadblocks, bureaucratic obstacles, and
the imposition of being charged lofty fees when attempting to initiate community
projects, all of which prove to be detrimental to the projects themselves. It is
recommended that the stakeholders communicate an understanding of each others’ needs
in an open forum or through a series of focus groups, where the two sides could discuss
and communicate concerns and grievances to each other via a neutral facilitator.

Suggestions for Additional Services

During the survey and household interview process, the Infrastructure Team asked the
families what improvements or modifications they would like to see in their
communities. A large portion of the respondents (31%) said that, first and foremost, they
would like improvements to be made to their homes. These included new walls, flooring,
roofing, as well as additional rooms. Additionally, 14% of respondents would also like a
park or recreation area for their children to play in (See Figure 14). Other suggestions
included improvements in infrastructure, such as paved roads and a drainage/sewage
system, as well as new financial and entrepreneurial opportunities.
Figure 14: Suggestions for Other Services

Needs-Based Distribution of Services

Finally, it is recommended that Asociación Mangle assess household need as a basis to

determine eligibility for services and consider hardship when dealing with an inability to
pay (or to pay on time) for water services. Selection for receipt of services and
consideration for leniency in application of penalties should be assessed strictly
according to the circumstances the recipient is facing, his/her willingness to cooperate
with Associación Mangle, and the ability of the association to provide aid or services.
Eligibility for services and special consideration should be equitable and offered based on
need, not on any other criteria.

Conclusion

Implementing a potable water distribution system that reaches a number of communities

is a logistical and administrative challenge, and various elements have to be considered in
order to guarantee the system’s success. Some of the most critical aspects include
educating the communities with respect to the benefits of potable water, dispelling any
preexisting health myths that may exist, and ensuring that the communities understand
the administration and billing structure of a new system. Any changes to such a system,
especially those involving financing or payment structures, must be clearly and
expediently communicated to the beneficiaries.

Furthermore, a cost/benefit analysis should be conducted to assess the dynamics of an

increased number of water recipients, the necessity and numerical value of the cuota base
and whether current administrative practices should remain the same, and whether hiring
and training additional staff or plumbers to maintain the water system in the three
additional communities would be necessary.

Other important considerations include ensuring proper maintenance of the water system
and water-related hygiene practices, as well as the critical issue of how to address the
lack of drainage. The problem of stagnant water and increased possibility of mosquito-
borne diseases must be addressed, either via improved draining strategies or communal
decisions on where to dispose of wastewater.

Nevertheless, the impact of potable water on the two studied communities has been
overwhelmingly positive. Though still modest in health improvements, the quality of life
has vastly improved, along with a decrease in stress and an increase in free time as a
result of not having to make daily trips to gather well water. Also observed in many
households was the desire to acquire new skills and improve the family’s income
generation options. Many women expressed an interest in learning how to sew, make
bread, and set up their own micro enterprises, while men expressed interest in carpentry,
electrical work, and construction. Both sexes acknowledged that they would welcome
learning just about anything “to earn money”.

What the Infrastructure team’s findings point to is a series of socio-economic dynamics

which present a picture of communities that desire and need further improvements in
infrastructure and living conditions just as much as they need new income generating
opportunities to further improve their quality of life. It is strongly recommended that
future infrastructure projects focus on garbage and waste treatment and collection efforts.
These are critical for community and family health as is the need for water drainage, an
area that sooner rather than later should be addressed.

Having said that, the Infrastructure team sees the above two areas, waste treatment and
collection and an expansion of the water project to address water drainage and
administrative improvements, as areas of future collaboration and continued partnership
between La Coordinadora and Team Monterey. Should agreement on either or both of the
above project proposals be mutually shared, Team Monterey is prepared to effectively
transition into the next phase of project work.

Appendix 1
Schedule of Activities

Week One:
Monday, January 4, 2010:
9:30 AM – 11:30 AM: Meeting with the Junta Directiva of La Coordinadora and
Asociación Mangle
11:30 AM – 1:00 PM: Meeting with Luis Orellana, Director of Infrastructure Program
2:30 PM – 6:00 PM: Tour of La Amistad, La Solidaridad and other communities in
Tierra Blanca
Met with Paula and Berta, community leaders for La Amistad and La Solidaridad
Tuesday, January 5, 2010:
9:00 AM – 5:00 PM: Day spent defining project objectives and infrastructure program
needs.
Created work plan and timeline
Began working on survey questions

Wednesday, January 6, 2010:

9:00 AM – 12:00 PM: Meeting with Dina, water program administration supervisor.
2:00 PM- 6:00 PM: Worked on developing survey for meeting with the health clinics and
doctors.

Thursday, January 7, 2010:

8:30 AM – 2:00 PM: Visited the private medical clinic and the Unidad de Salúd (public
health clinic).
Met with the doctors from both clinics as well as the Inspector of the Unidad de Salúd.
3:00 PM – 6:00 PM: Prepared for community meeting in La Solidaridad on Friday.
Developed interview questions for Paula and Alex (the plumber).

Friday, January 8, 2009:

2:00 PM – 5:30 PM: Community meeting in La Solidaridad with the community
members from La Solidaridad and La Amistad.
Requested permission to visit each family in their homes the following week to interview
them.
Interviewed both Paula and Alex

Week Two:
Monday, January 11, 2010:
8:30 AM – 12:00 PM: Completed household survey
2:00 PM – 6:00 PM: Visited La Amistad and conducted first interview
Interview last 1 ½ hours
Team determined that the survey was too long and needed revision
7:30 PM – 9:30 PM: Debrief and began re-writing survey

Tuesday, January 12, 2010:

9:00 AM – 12:00 PM: Re-wrote survey, deleted unnecessary questions and added new
ones.
12:00 PM – 1:30 PM: Tested survey by interviewing our host mothers
2:00 PM – 6:00 PM: Conducted 8 interviews in the community of La Amistad
7:30 PM- 9:30 PM: Debrief and designed template for inputting data

Wednesday, January 13, 2010:

9:00 AM – 12:00 PM: Inputted data from surveys
1:30 PM – 5:30 PM: Conducted 9 interviews in the community of La Solidaridad
7:00 PM – 10:00 PM: Debrief and data input

Thursday, January 14, 2010:

9:00 AM – 12:00 PM: Inputted data from surveys
1:30 PM – 6:30 PM: Conducted 9 interviews in the community of La Solidaridad
7:30 PM – 10:00 PM: Debrief and full team meeting

Friday, January 15, 2010:

Parque Nacional El Impossible

Week Three:
Monday, January 18, 2010:
9:00 AM – 12:00 PM: Inputted data from surveys
1:30 PM – 6:30 PM: Conducted 4 interviews in La Solidaridad and 5 interviews in La
Amistad.
7:30 PM – 10:00 PM: Inputted data from surveys

Tuesday, January 19, 2010:

9:00 AM – 5:00 PM: Inputted data from surveys and began outline for
preliminary report.

Wednesday, January 20, 2010:

9:00 AM – 12:00 PM: Met with Luis, Dina and Carlos (accountant)
1:00 PM – 5:30 PM: Assisted with the release of baby turtles on the Bay of Jiquilisco
7:00 PM – 9:00 PM: Completed outline for preliminary report and began writing
preliminary report.
 Thursday, January 21, 2010:
9:00 AM – 12:00 PM: Completed preliminary report.
Two team members met with the health promoter from San Hilario
12:30 PM – 6:00 PM: Visit to sugar cane mill in San Vicente
7:00 PM – 11:00 PM: Edited and revised preliminary report in Spanish

Friday, January 22, 2010:

9:30 AM – 11:30 AM: Final meeting with the Junta Directiva of La Coordinadora and
Asociación Mangle
Presentation on preliminary report and initial findings/recommendations

Appendix 2 - Master Copy of Final Survey (Spanish)

Full Survey questions

Información personal
¿Cuántas personas viven en su casa?
1ª> Hay ninos de 13 anos o menos en su casa?
¿Qué tipos de trabajos hace usted para ganar dinero? Y su pareja?
2ª> hay otras personas en su casa que ganan dinero? (info on all working adults)
¿Cuántos días (promedio) trabaja por semana? Y su pareja?
¿Cuánto dinero gana usted (promedio) por día? Y su pareja?
Usted recibe remesas? If yes – cuanto?
Uso del agua
¿Tiene acceso a agua potable? S/N
¿Para qué utiliza el agua potable?
Cocinar
Agua para tomar
Lavar ropa
Limpieza del hogar
Bañarse/ducharse
Cepillarse los dientes
Lavarse las manos
Lavar los platos
Regar las plantas
Para los animales/ganado
No utilizaba el pozo communal
Antes de que tuviera agua potable en su casa, ¿dónde iba a traer el agua?¿Cuántas
veces al día iba a traer agua?
¿Cuánto tiempo le tomaba ir a traer agua (ida y regreso)?
¿Tiene un pozo artesanal en su casa?
Si tiene un pozo artesanal en su casa, ¿todavía lo ocupa? ¿para qué?
 ¿Qué hace usted con el agua sucia (ya utilizada)?
Tirarla a la calle
Tirarla a la par de la casa o en el patio
La ocupa de nuevo
Si utiliza el agua de nuevo, ¿cómo es que la utiliza?
Para regar las plantas
Para los animales
Otras_____
¿Los charcos o agua estancada es un problema en su casa? S/N
Si su respuesta es si, que problemas son los que causa?
Explain the drainage system a little bit, then ask question.
¿Piensa usted que un sistema de drenaje es necesario? S/N
Los adultos en su casa llevan/usan zapatos o chanclas fuera y dentro de su casa?
(observe what kind of floor is present: wood, tile, dirt)
Los ninos en su casa llevan/usan zapatos o chanclas fuera y dentro de su casa?

Instalación/mantanimiento del sistema de agua

¿Quién participo en la instalación del sistema de agua en su casa?
la familia
los vecinos
el fontanero
representantes de Asociación Mangle
otras delegaciones
¿Cuánto dinero costaron los materiales y la instalación del sistema de aqua en su
casa?

¿Cómo pago por los materiales para la instalación?

Efectivo
Crédito (ya pagado o todavía lo paga)
Otras maneras____________
 De acuerdo a sus ingresos actuales, ¿le alcanza el dinero para tener agua potable?
(Si o No)

23A> Si usted no paga el recibe al tiempo, que ocurre?

23B> Alguna vez le han cortado el aqua? (Si o No) If yes- Por que?
23C> Tuvo que pagar para prenderla de nuevo? (Si o No) If yes- Cuanto?

¿Sabe usted que su recibo incluye una cuota base? ¿Sabe para que se utiliza esta
cuota?
24A> Alguien vino para explicarle para que se usa la cuota base? If yes- Quien?

¿Cree usted que lo que usted paga por el aqua en su casa es razonable?
Si o No. If the answer is no- Por que?

¿Qué tan seguido tiene los siguientes problemas relacionados con el sistema de
agua?
Fugas: nunca rara vez algunas veces a menudo
Quebradura de tubería: nunca rara vez algunas veces a menudo
Presión de agua: nunca rara vez algunas veces a menudo
Problemas de medidores: nunca rara vez algunas veces a menudo
Falta de luz: nunca rara vez algunas veces a menudo
¿Otros? S/N, si su respuesta es si ¿qué es? y ¿qué tan seguido? _______ n r av am

Si tiene problemas con el sistema de agua, ¿a quien llama para que le ayude?
Nadie – yo o mi familia lo arreglamos
Mi vecino
El fontanero
El representante de la comunidad
Otros_______________
Información sociocultural (hábitos de higiene, vida diaria, recibos y pagos del agua)
¿Cuál ha sido el cambio más grande en su vida desde la implementacion del agua
potable?
¿Ha cambiado su dieta alimenticia con el agua potable? S/N Si su respuesta es si,
explique como?
 ¿Cree usted que el agua potable es más saludable que el agua de pozo? S/N , ¿por
qué?
¿Tuvo usted dudas sobre el agua potable por ser diferente en color, olor y sabor?
Por que? Que tipo de dudas? Such as chlorine, water being white, etc.
Información sobre salud
Adultos (14 años de edad o mayores)
Desde que se instalo el sistema de agua , ¿qué tan seguido se han enfermado los
miembros de su hogar de las siguientes enfermedades?
Diarrea: S/N? Más, menos o lo mismo que antes del agua potable?
Parásitos: S/N? Más, menos o lo mismo que antes del agua potable?
Infecciones de hongos: S/N? Más, menos o lo mismo que antes del agua potable?
Otras enfermedades Crónicas S/N? Más, menos o lo mismo que antes del agua
potable?
Niños (13 años de edad o menores)
Antes de la instalación del sistema de agua potable , ¿qué tan seguido se enfermaban los
niños de su hogar de las siguientes enfermedades?
Diarrea: S/N? Más, menos o lo mismo que antes del agua potable?
Parásitos: S/N? Más, menos o lo mismo que antes del agua potable?
Infecciones de hongos: S/N? Más, menos o lo mismo que antes del agua potable?
Otras enfermedades Crónicas? S/N? Más, menos o lo mismo que antes del agua
potable?
¿Existen otras enfermedades crónicas en su familias? Si su respuesta es si ¿cuáles?
¿Estas enfermedades surgieron después o antes de que tuviera agua potable?
¿Cuándo uno de los miembros de su familia se enferman que hace?
A cual clínica va cuando se enferma? (Publica, privado, fondo de emergencia)
¿Cuántas veces al año visita al medico?
38A> Le visitan promotores de salud? If yes, ask when/how often.
38B> Los promotores de salud visitan/vienen mas ahora que antes del cambio del
gobierno el ano pasado?
39. ¿Hay transporte para ir a la clínica? Que tipo?
40.¿Sabe usted de que con el cambio de Gobierno del año pasado, la atención
medica y la medicina es gratis?
¿Ha cambiado la salud de su familia en los últimos dos años? Si su respuesta es si,
¿cómo?
Papel de la mujer (or head of household)
Desde que tiene agua potable, tiene usted más tiempo libre? S/N
42A> Si su respuesta es si, ¿qué hace usted con su tiempo libre?
Si usted tuviera la oportunidad de aprender otro oficio ¿qué sería?

Preguntas sobre Asociacion Mangle

Aparte del proyecto de la distribución del aqua, ha tenido contacto con Asociacion
Mangle? If yes- que tipo de contacto?
Ha tenido una experiencia positiva o negativa con Asociacion Mangle?
Sabe usted que hace Asociacion Mangle? (que tipo de proyectos tienen?)
Si pudiera cambiar algo o recibir mas ayuda o servicios de Asociacion Mangle, que tipo
de servicios le gustaria?

Average daily wage was determined by surveying all respondents on the amount they earn per day
working and taking an average of all answers given.
Average number of days per week was determined through surveying all respondents on the average
number of days per work that they work and taking an average of all answers given.
Average monthly income was determined using the following equation: daily wage multiplied by days per
week = income per week multiplied by four = monthly income divided by the number of respondents =
average monthly income. Average monthly income with remittances was calculated in a similar manner.
4. Fixed costs included: electricity, personnel (accountant and plumber), and general maintenance and
materials.
5
Though data is unavailable on exact numbers, we were able to reach this conclusion based on interviews
with the individual households as well as with the administrators of the water distribution system.
6
Note: The change from a fixed pricing structure to a variable pricing structure is relatively new in these
communities, and therefore conclusions can only be based on a few months of information and are mainly
based on observations and interviews. Furthermore, three new communities are in the process of being
added to the current distribution system, and through this process Asociación Mangle is continuing to
decrease the base cost included on the monthly water bills.
7 No data is available for October or December. Requested data sheets were not provided by Asociación
Mangle.
8 Base cost (cuota base) charged per household per month was decreased from $2.50 (October-December)
to $2.00.
11
A French drain is a ditch covered with gravel or rock that redirects surface and ground water away from
an area. A French drain can have hollow, perforated pipes along the bottom to quickly vent water that seeps
down through the upper gravel or rock.