Recommendations for Action

Objective (6), the final objective of this research, is to make culturally, economically, and environmentally appropriate recommendations for dealing with possible contamination of water drawn from Pitcher Pump systems. Therefore, based on field observations, interviews with pump users and manufacturers, the conclusions made in Section 5.1, the successful history of the Pitcher Pump as a sustainable Self-supply water technology, and the need to ensure its future success and sustainability in coastal Madagascar, I recommend the following:

(1) Pump users should be taught to flush pumps before collection for direct consumption, especially after long periods of pump inactivity such as first-draw times in mornings. A reasonable amount to flush might be 2.5–3 times the well volume, which will vary in total volume pumped (i.e., buckets) depending on well depth.

(2) Pump users should be educated that flushed water remains suitable for household water needs other than cooking and drinking such as washing clothes, cleaning, and hygienic behaviors, and should not be “wasted.”

(3) Pump manufacturers should receive training on the ability to use Fe components to fabricate valves in lieu of Pb components, and on the public health considerations that

establish this need. Graduates of this training should be eligible to train other manufacturers locally and in other coastal areas of Madagascar.

(4) Pump manufacturers should be taught that the use of Fe in place of Pb has the potential to make the manufacturing process more profitable through use of less expensive materials, and that the service of retrofitting existing pumps for valve replacement can be advertised as an improvement to water quality, perhaps creating business. Along these lines, pump manufacturers should be trained at a basic level in marketing to support new business practices and promote pump retrofitting.

Taken together, these recommendations can be part of a holistic intervention to promote the most effective use of the Pitcher Pump by improving water quality. Recommendations made to pump users and manufacturers should fit within the context of urban Tamatave, and the means of the parties involved. These water points are not centrally managed, nor is water quality monitored by a government entity. These circumstances are not likely to change in the near future. As such, guidance for improving water quality and mitigating the potential threat from elevated Pb exposure must be affordable and appropriate for a household or an independent manufacturer and small business owner to implement.

Accordingly, Recommendations (1) and (2) aimed at pump users do not seek to drastically change the existing behaviors of the public, hopefully only the order in which water is drawn for certain purposes. The Pitcher Pump has proven to be a culturally acceptable technology, in large part due to its convenience. If the general process of flushing pumps before use is promoted—without the auxiliary message of continuing to make use of that flushed water—not only might the public refuse to change behaviors (e.g., adopting longer pumping times and exerting more work), significant amounts of water could be wasted. The repurposing

of first-draw water to household activities, rather than merely flushing the pumps and disposing of flushed water, attempts to address the potentially negative environmental trade-off of flushing pumps. However, personal behavior change in any form is notoriously difficult to achieve; often education is not enough to sustainably influence to adoption of new behaviors (Abrahamse et al., 2005; Panter-Brick et al., 2006; Mihelcic et al., 2009; Greenwell et al., 2013). Therefore, interventions to limit Pb exposure might be most effective at the manufacturing level.

Recommendations (3) and (4) seek to change the manufacturing process as simply as possible (e.g., changing out the predominant material for valve weights and thereby eliminating the largest contributor to soluble Pb). These recommendations attempt to facilitate this change with an emphasis on the economic benefit, which is naturally occurring in material costs. In fact, as noted previously in Section 4.2, one manufacturer encountered in Tamatave—outside of the sampling campaign—had altered his fabrication process to utilize Fe in place of Pb two years prior (Appendix II). The manufacturer claimed to have changed his practices purely for economic reasons, as he was unaware of any health problems associated with Pb. This anecdotal evidence provides a positive sign that Recommendations (3) and (4) have the potential for adoption. Additionally, replacement of Pb materials in Pitcher Pump systems decreases the spread of Pb to the local environment and exposure to users. These recommendations can also protect the health of the manufacturers and other artisans who work with Pb on a regular basis.

Some artisans spend significant amounts of time harvesting Pb from plating in old car batteries, melting it down for repurpose and resale. Pump manufacturers melt the Pb to cast it for valves, which could lead to airborne Pb exposure.

Another consideration for these recommendations is the existing market for Pitcher Pumps in Tamatave. This technology has successfully supplied water to thousands of families for

over half a century, organically growing in scale over time. Any interventions taken by the government, by NGOs, or by other entities must be mindful of the potential to damage the existing market for must be mindful of the potential to damage the existing market for Self-supply water in Tamatave. Steps should be taken to frame messages in a way that encourage the use of pitcher pumps while stressing the importance of flushing before drawing water for drinking and cooking and valve replacement. Any intervention should benefit both users and manufacturers, and current users should be encouraged to demand improvements to Pitcher Pump systems (e.g., new materials and services) from the local manufacturers.