Leptospirosis was one of the causes of death after Hurricane María. The disease, which is transmitted by the bacteria Leptospira found in the urine of infected animals, rats, dogs, cows, pigs and other wild animals, can live in water and soil for weeks or months, according to the U.S. Centers for Disease Control and Prevention.
Once a person is infected with the bacteria it can be deadly as it can lead leads to kidney and liver damage and meningitis. However, the disease can be treated effectively with antibiotics if caught early on, according to Leslie Maas, Director of the Clean Water Project of the Puerto Rico Science and Technology Trust. Maas explained the disease often goes untreated until too late because the symptoms can be easily mistaken for other diseases such as dengue, chikunguya and zika among others.
The risk of this disease as well as others transmitted by unsafe water prompted the Science and Technology Trust of Puerto Rico to establish the Clean Water Project in the aftermath of Hurricane Maria. This initiative started out small last October with the distribution of 320 Kohler water filters to homes with donations made a group from California called Puerto Ricans in Action.
Before launching the initiative, the Clean Water Project wanted Kohler to conduct tests. “We needed to make sure that the filters could be effective against leptospirosis,” explained Maas. Kohler certified the filter as 99% effective in eliminating the leptospirosis bacteria.
For months on end after Hurricane Maria, hundreds of communities around the island lacked a safe water source since there was no electricity to distribute water from treatment plants in many of the hilly parts of Puerto Rico. People began to collect water from springs and rivers. Compounding the risks faced by the population at the time, the health system was overburdened and lacked basic resources that may have led to the misdiagnosis of several reported cases of leptospirosis in the first weeks after the hurricane struck the island last September.
No one knows for certain the number of leptospirosis cases that may have existed after the hurricane or how many of them ended in death. Maas pointed to data from the World Health Organization that indicates that in the aftermath of a hurricane or massive flooding leptospirosis cases tend to spike.
The initial concern was leptospirosis, yet as the Project’s volunteers encountered the first affected communities, they understood that the risk of unsafe water sources went beyond infection with leptospirosis, said Mari Olga Mendoza, Project Manager for the Clean Water Project. They looked for additional funding and submitted a grant proposal to United for Puerto Rico.
Understanding the need for such a project, the board of United for Puerto Rico approved a $1.9 million grant to expand the Clean Water Project’s reach. “Access to clean and safe water is a priority for United for Puerto Rico. The grant made to the Clean Water Project ensures that these families will have a source of clean water regardless if another hurricane hits us. And even if it does not hit us, there are still communities in which water service has not been restored, nearly a year after the hurricane struck,” said Mariely Rivera, Executive Director of United for Puerto Rico.
With the additional funds, Maas and Mendoza explained that the Clean Water Project will be able to impact more than 30,000 households with filters, providing potable water for approximately 180,000 citizens of Puerto Rico. Beyond distributing the filters, project volunteers and employees are also educating communities about safe water use, the use of the filters and in some cases collecting water samples and conducting surveys of water borne diseases. To expand their reach, they have also joined forces with 330 Primary Health Centers, the Corporación de Servicios Médicos and H2O Worldwide.
As soon as they received the funds from United for Puerto Rico, they were able to hold the first massive event in February in the town of Utuado, in Puerto Rico’s mountainous center. Word of the event spread quickly and by 6 am, there were 100 people waiting in line for the filters. At the time, five months after the hurricane, most of the community lacked a safe and reliable water supply and had no power service. Six hundred water filters were distributed that day, according to Maas.
The work continues. “We have a list of 239 community non- PRASA systems on which we are focusing as a priority,” explained Maas. These are community run systems that are not served by the Puerto Rico Aqueduct and Sewer System (PRASA) and which historically have been known for higher counts of fecal coliforms and other contaminants.
Mendoza explained the process of reaching residents in those communities is time consuming. They first contact the community leader who runs the system, then they organize an event in the community to explain the importance of safe water and distribute the water filter and explain how to use it. Often, they find they need to go from home to home.
“With this grant, we will now be able to provide a safe alternative to thousands of people through the Clean Water Project,” said the Executive Director of United for Puerto Rico.
The concern is warranted, according to Maas. The first tests made by the Clean Water Project indicate high levels of fecal coliform in samples collected so far. For more information, you can access www.prsciencetrust.org. The Clean Water Project is part of the Brain Trust for Tropical Disease Prevention Program of the Trust.