What quality standards are appropriate for rural water supplies?

The paper by Welch et al. entitled " Microbial quality of water in rural communities of Trinidad " (1) discussed aspects of water quality testing and expectations of safety of rural water supplies, and it affirmed similar observations of unpotability in developing countries that my colleagues and I described in a study in sub-Saharan Africa (2). The hazard of increased contamination of stored water supplies in the home must be emphasized (3). Consumers expect that delivered water, whether by truck or pipe, and that is reported to be saniti-zed, should be free of total coliforms and Escherichia coli. That expectation is in line with guidelines published by the World Health Organization (4). Finding concentrations of these indicator bacteria in treated water supplies implies that treatment procedures are inadequate, quality control measures have lapsed, or a breach in the integrity of the delivery or distribution system has occurred after treatment , as well as that there is a possibility of postde-livery contamination. Respectfully, I suggest that several assumptions by the authors beyond this observation miss the mark. Applying in rural areas the potability standards of the United States Environmental Protection Agency (EPA)—that is, an absence of microbial indicators—is a misleading, untenable, unrealistic, and unnecessary goal for water delivery schemes in many developing countries. Providing drinking water free of coliforms is an admirable and idealistic aspiration. However, EPA guidelines, while appropriate in locations with adequate resources, ought not to be applied to civil infrastructure in geographical settings where neither technical expertise nor resources are available to guarantee delivery of safe drinking water. In addition, the authors do not place in perspective the reality of developing countries, where people may not understand concepts of pathogenicity and most rural water " systems " rely on surface sources or shallow wells. Our research, conducted in Lesotho in the early 1990s, was able to distinguish potability markers and engineered solutions that practically and realistically indicated whether a water supply was likely to be safe or to be potentially hazardous. Gravity feed water system configurations that had been implemented by development projects in pre-The Revista Panamericana de Salud Pública/Pan American Journal of Public Health publishes letters from readers for the purpose of stimulating dialogue on various aspects of public health in the Americas and of constructively clarifying, discussing, and critiquing the ideas expressed throughout its pages. Letters should be signed by the author and include his or …