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A thought leadership piece: Where are the rural groundwater quality data for the assessment of health risks in northern Malawi?
Groundwater for Sustainable Development 7 (2018) 157–163
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Research paper
A thought leadership piece: Where are the rural groundwater quality data for the assessment of health risks in northern Malawi?
T
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Rochelle H. Holma, , Gregory Kunkelb, Laban Nyirendac a
Centre of Excellence in Water and Sanitation, Mzuzu University, P/Bag 201, Mzuzu 2, Malawi Drexel University, 3141 Chestnut St, Philadelphia, PA 19104, USA c Northern Zone WASH, World Vision Malawi, Box 610, Mzuzu, Malawi b
A R T I C LE I N FO
A B S T R A C T
Keywords: Developing countries Groundwater Malawi Rural water supply Water quality
The Sustainable Development Goals place a strong emphasis on water quality. However, what is the local capacity to ensure safe water availability in a low-income country such as Malawi where groundwater is still the primary source of drinking water for rural communities? We conducted a systematic review of peer-reviewed literature containing primary data on groundwater used for drinking water in northern Malawi published over the period from 2006 to 2016. We also interviewed district, regional, and national government representatives supporting the water quality management sector. The results showed that the government cannot tell if groundwater is safe for drinking in the northern region of Malawi. Current literature provides only minimal information on groundwater quality for the assessment of human health risks, and there are limited laboratory services. Nitrate and pH were the most commonly available data. There is evidence that the following constituents need further investigation about possible human health risks: antimony, arsenic, barium, calcium, chloride, color, cyanide (CN-), Escherichia coli and/or thermotolerant coliform bacteria, fluoride, iron, lead, manganese and turbidity. Water quality monitoring needs to especially consider mining activities, including uranium. Varied levels of engagement appear in that while there is some strengthens in the national government capacity, as this is decentralized to districts weaknesses are most evident with no laboratories and either limited data or no data in the case of the most rural districts. Malawi needs to build human capacity, laboratory infrastructure and a publicly available water quality database under national government regulatory oversight with real time monitoring data available to both district and national government decision makers, practitioners and water users to determine groundwater quality for the assessment of possible health risks.
1. Introduction
branches and practitioners make data access and transfer for decisionmaking difficult (Kayser et al., 2015). Crane and Silliman (2009) suggest, for select water quality parameters, using basic hand-held instruments or test strips in the field at a high frequency by volunteers in rural regions of developing countries. Despite its lower precision and accuracy, this approach may offer a better representation of the temporal and spatial conditions than higher quality analytical instrument data collected by technicians at limited sampling intervals. However, there have been limited efforts in Malawi on effective rural water user participation in water quality monitoring. The northern region of Malawi covers an area of nearly 27,000 km2 and has a 2008 census population of almost 1.7 million, mostly located in rural communities using groundwater for drinking water and spread over 6 districts (Chitipa, Karonga, Likoma, Mzimba, Nkhata Bay and Rumphi) (Malawi Government, 2009). Eidhammer (2017) notes that “at the time of independence [in 1964], many of the most highly
Sustainable Development Goals (SDG) 3, 6, and 12 place a strong emphasis on water quality (United Nations, 2017). While integrated monitoring and guides for best practices are available (UN-Water, 2017), the SDGs do not state what water quality constituents for analysis and what frequency of monitoring is needed to safeguard human health practically in a low-income country. The National Water Policy, set forth by the Malawi Government (2005, pp.3), states that ‘water of acceptable quality for all the needs in Malawi’ should be made ‘readily available and equitably accessible to all Malawians’. What is the local capacity to ensure safe water availability in a low-income country such as Malawi where groundwater is still the primary source of drinking water for rural communities? The absence of an open access national database of water quality results and the lack of a consistent monitoring program among water users, local and national Malawian government
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Corresponding author. E-mail address: [email protected] (R.H. Holm).
https://doi.org/10.1016/j.gsd.2018.05.004 Received 13 November 2017; Received in revised form 15 May 2018; Accepted 15 May 2018 Available online 18 May 2018 2352-801X/ © 2018 Published by Elsevier B.V.
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2.3. Ethics
educated Malawians were from the north{ern region}, educated at mission schools” (page 8). Although interest in the quality of groundwater used for drinking water is growing globally, in northern Malawi, there has been no systematic review of the currently available data and no determination of what constituents may pose a human health risk and need further investigation or what practical monitoring steps are needed for Malawi to meet the SDGs for water quality. In Malawi, the rural water supply is decentralized to districts acting as local governments, where the water office is structured identically in each district and reports to the national Ministry of Agriculture, Irrigation and Water Development. Our work will build on other work in Malawi that has looked at water quality governance (Kayser et al., 2015) and the dynamics of power and trust between development partners in the water sector providing funding and the local government (Soublière and Cloutier, 2015). It also builds on the global discussion on monitoring requirements and practices observed for other low-income countries (Crocker and Bartram, 2014). This thought leadership piece highlights the local capacity for how to ensure rural safe water availability in a low-income country such as Malawi by looking at what groundwater quality laboratory analysis has been done, where it has been carried out, indicators of possible human health risks and environmental laboratory capacity considerations. The aim of our study is to better understand the capacity for rural water quality monitoring and find lessons to share and on-the-ground implications to inform solutions for attaining the SDGs on water quality in a resource-limited environment.
Ethical clearance for this study was obtained from the Malawi Government, National Commission for Science and Technology. Written consent was obtained from respondents. All research tools and data are available from the corresponding author. 3. Results This section presents results on the national water quality guidelines for groundwater used for drinking water by rural communities, where and what existing data are available for the northern region, plus environmental laboratory capacity infrastructure and human capacity considerations to ensure safe water availability in Malawi. 3.1. What are the water quality guidelines for drinking water? In Malawi, water quality guidelines for drinking water are set by the national government. There are two drinking water quality criteria, the Malawi Bureau of Standards (MBS) MS 214:2013 (Malawi Bureau of Standards MBS, 2013), which is the drinking water specification for urban and semi-urban area piped water providers, and MS 733:2005 (Malawi Bureau of Standards MBS, 2005), which is the specification for groundwater from borehole and shallow wells used for drinking. Both of these standards differ from the World Health Organization (WHO) (2017) guidelines. While MS 214:2013 has criteria for 58 chemical and physical determinants, MS 733:2005 only has criteria for 27 determinants, while the WHO summary tables cover guideline values for 90 chemicals that are of health significance in drinking water. There are also differences in the stated levels; for example, while the WHO guideline value for fluoride is 1.5 mg/l, in MS 214:2013 it is 0.7 mg/l, and in MS 733:2005, it is 6.0 mg/l. However, for other constituents, the MS 214:2013 and WHO criteria are the same, such as that for arsenic of 0.01 mg/l, while MS 733:2005 for arsenic is five times this (0.05 mg/l). Neither MBS guideline (Malawi Bureau of Standards MBS, 2005, 2013) contains water quality criteria for uranium, yet the World Health Organization (WHO) (2017) has guidance levels for radionuclides in drinking water and for the chemical aspects of uranium. Though a uranium mine was opened at Kayelekera in northern Malawi in 2009, nationally only MS 214:2013 includes gross alpha and beta activity. This contrasts to Namibia, where there is also a uranium mine and a drinking water limit for uranium has been set at 1 mg/l (NamWater, 2017). During our interviews, four respondents mentioned the need for uranium water quality monitoring. Neither of the MBS guidelines (Malawi Bureau of Standards MBS, 2005, 2013) is available online, both are only available as paper copies from MBS offices which would be difficult for rural water users to obtain. We probed further into the water quality guidelines for drinking water during our interviews. A national ministry representative stated, “If you apply the WHO guidelines, all of our schemes would fail”. This was echoed by a government laboratory chemist interviewee who said, “if we say that it [drinking water] has to meet these stringent standards [WHO guidelines], then a lot of boreholes would be abandoned”. The interview data show that at a national level there is an awareness of water quality guidelines for groundwater used for drinking water by rural communities and of the differences between national standards (Malawi Bureau of Standards MBS, 2005, 2013) and the guidelines of the World Health Organization (WHO) (2017).
2. Materials and methods 2.1. Systematic literature review A systematic review was conducted of publicly available groundwater data published over the period from 2006 to 2016. However, because the Malawian Government does not publish open access water quality data, we only considered peer-reviewed literature containing primary groundwater data. Google Scholar and Pub Med were used as internet search engines. Keywords for the search included combinations of the following: groundwater, aquifer, water quality, well, borehole, Malawi, contamination, pollution, Lilongwe, Blantyre, and Mzuzu. We selected these keywords based on the authors’ experiences in the field. We also searched literature known to the authors. The inclusion criteria for the systematic literature review was groundwater sample results where the water may have been used as drinking water from the 6 northern districts of Malawi. Study records were managed in Microsoft Excel. We only used full text papers, and if papers were not open access, we requested a copy of the paper directly from the authors. Selected articles were then reviewed by the corresponding author for the origin of authorship, funding source, and water quality data, after which the results were reviewed by all authors. We did not include water quality data for urban municipal piped water systems. We also did not include grey literature for consistency with accepted systematic review practices, such as unpublished data from academic laboratories. 2.2. Key informant interviews Following the systematic literature review, from June to December 2017, we conducted face-to-face or mailed structured surveys focusing on current water quality issues and capacity based on their link to World Vision Northern Zone rural water supply interventions. Interviews were conducted with local government District Water Officers (n = 6); the regional urban piped water supply system provider (n = 1); government laboratories (n = 3, located in each the northern, central and southern regions); and the national ministry in charge of water supply, the Ministry for Agriculture, Irrigation, Water, and Development (n = 1). Surveys were conducted in English. Key informant interviews with rural water users were not included.
3.2. Where and what are the groundwater data in northern Malawi? We initially identified 35 articles containing groundwater quality data for the assessment of health risks in Malawi and determined a final set of 9 that met our criteria for northern Malawi. Upon detailed review of the work by Kanyerere et al. (2012), these data were excluded from 158
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Table 1 Available groundwater data from 2006 to 2016 for northern Malawi compared to the MS 733:2005 (Malawi Bureau of Standards MBS, 2005) and World Health Organization (WHO) (2017) guidelinesa. Parameter
Units
Minimum Reported Value
Maximum Reported Value
Total n reported
MS 733:2005 standard (Malawi Bureau of Standards, 2005)
WHO healthbased guidelines (2017)
Evidence of possible human health risk needing further investigation?
Aluminum Antimony Arsenic Barium Borate Cadmium Calcium Chloride Chromium Color
mg/l mg/l mg/l mg/l mg/l mg/l mg/l mg/l mg/l Total Color Units mg/l mg/l µS/cm colony forming units/100 ml mg/l mg/l CaCO3 mg/l mg/l mg/l mg/l mg/l
0.0003 0.0016 0.0004 0.0172 0.0001 0 3.6 2.5 0.0002 –
0.0066 0.0058 0.0145 0.9701 0.0561 0.0007 412 989.7 0.0018 –
25 25 25 25 25 25 324 304 25 0
0.5 0.005 0.05 0.7 5 0.01 250 750 0.01 50
– 0.02 0.01 1.3 2.4 0.003 – – 0.05 –
No Yes Yes Yes No No Yes Yes No No data
0.0001 – 40 0
0.0145 – 3128 6225
25 0 351 351
2 0.07 3500 50
2 – – 0
No No data No Yes
0.1 25 0.0022 0.0005 0.97 0.0001 0 6 0.0011 2.4 0 24 0.1 0
56 757.8 5.336 0.0176 116.6 0.8041 30 8.7 0.0096 166 505.2 1896 740 5.1
45 305 217 25 324 197 609 609 25 304 324 304 217 45
6 800 3 0.05 200 1.5 45 6.0–9.5 0.01 500 800 2000 25 15
1.5 – – 0.01 – 0.4 50 – 0.04 – – – 1 –
Yes No Yes Yes No Yes No No No No No No Yes No
Copper Cyanide (CN-) Electrical conductivity Escherichia coli and/or thermotolerant coliform bacteria Fluoride Hardness Iron Lead Magnesium Manganese Nitrate as NO3 pH Selenium Sodium Sulfate Total dissolved solids Turbidity Zinc
mg/l mg/l mg/l mg/l NTU mg/l
-No value available. a Groundwater data are from: Chidya et al. (2016); Holm et al. (2016a); Holm et al. (2016b); Mapoma et al. (2016); Msilimba and Wanda (2013); Rieger et al. (2016); Wanda et al. (2011); Wanda et al. (2013).
Chinese, European and American researchers. Each (8/8) of the articles had multiple authors and most (7/8) had authors from more than one institution. In addition, data for only two rural water supply practitioners, Pump Aid and Wells for Zoe, were available, despite there being more than 20 non-governmental organizations (NGO) and dedicated private sector providers supporting water, sanitation and hygiene in the northern region (Water and Environmental Sanitation Network, 2017). Most of the existing groundwater data in northern Malawi are from grab samples (not depth discrete samples) from boreholes and shallow wells in rural areas. The depth at which the water samples were taken was not typically provided in the available data, though whether the water source was a drilled well versus a shallow dug well was generally provided. No time series monitoring data were found. The largest water quality study identified (Holm et al., 2016a) had a sample count of 285 wells and was funded by the practitioner who installed the rural community handpumps. While all districts in our study would be considered rural, no water quality data were found for Likoma or Chitipa Districts, the two most difficult and furthest districts to reach in relation to the capital city of Lilongwe where the national ministry is based. Likoma District is in the middle of Lake Malawi, and consists of two islands. Some rural water supply collaborations have tried to facilitate the creation of sector databases to share data. One of these is the openaccess WPDx (Water Point Data Exchange) database (https://www. waterpointdata.org) managed by a global working group of water, sanitation and hygiene partners. Most (99%) of the data for Malawi in WPDx were input by six organizations. Another of these databases is the Madzi Alipo database (https://www.madzialipo.org) managed by Fisherman's Rest, Malawi. However, the data were again primarily
the analysis based on errors in the reported constituent units; the errors were verified by the authors (personal communication, Levy, 14 December 2017). Table 1 provides a summary of available groundwater data from 2006 to 2016 for northern Malawi compared to the MS 733:2005 (Malawi Bureau of Standards MBS, 2005) and Health Organization WHO (2017). While the ‘maximum’ for a few parameters being over the guideline value is not a clear indicator of health risk nor for groundwater quality, when only limited data is available it provides targeted areas that need further investigation. Of the 27 determinants in MS 733:2005, most (25/27) had some available data. Nitrate and pH were the most commonly reported data. There is evidence that the following constituents need further investigation about possible human health risks: antimony, arsenic, barium, calcium, chloride, color, cyanide (CN-), Escherichia coli and/or thermotolerant coliform bacteria, fluoride, iron, lead, manganese and turbidity. If n is small, how can human health risks be assessed? In the case of arsenic, the sample size (n = 25) shows the maximum reported value is 0.0145 mg/l, which is from a single report (Mapoma et al., 2016) with 3 of 25 samples exceeding the WHO guideline. However, this is too limited of evidence without further investigation. While Mapoma et al. (2016) provided the raw water quality data of each sample, not all authors offered this level of detail to allow review (Fig. 1). Only one (1/8) full article was published with open access, for others only the abstract was accessible. The journal Physics and Chemistry of the Earth, which is linked to the WaterNet Community of Practice, was the most common source of data (4/8). Half (4/8) of the studies had foreign author affiliations, involving partnerships with 159
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Fig. 1. Location of groundwater quality data by district: northern region, Malawi.
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use in rural communities, there is unpublished (personal communication with USAID, May 12, 2014) evidence in Malawi of possible environmental interferences being common. This further complicates data interpretation because the presence or absence of these environmental interferences is sometimes not known when a method is selected due to the limited publically available historical water quality data. In the case of colorimetric arsenic testing, sulfide may interfere positively (yielding false-positive test results) at concentrations greater than 5 mg/lS2-. Other interferences may include selenium, antimony, and tellurium (personal communication with Hach). Despite these possible interferences, colorimetric arsenic analysis was the method used by one of the laboratories interviewed. While distillation can be carried out to remove environmental interferences prior to arsenic analysis, this is often not logistically possible when doing on-site field analysis. Additionally, spiked samples (such as for arsenic) are not available from local suppliers at known concentrations to determine problems with field methods. None of the government laboratories in our study was observed to be climate controlled, with doors and windows observed by researchers to be open at the time of the survey. Each of the laboratories is challenged by intermittent municipal power and water supplies. One laboratory interviewed reported that when fees are charged for water quality analysis, such as for support of an NGO project, instead of funds being invested back into the laboratory, they are deposited in the general national government account. Some NGOs worked around this and were reported to procure the consumable supplies and then depend on the human resources and infrastructure of the government laboratories for analysis. Another laboratory reported that fees sometimes do not cover the materials and labor, so when analytical services were provided, the laboratory is operating at a loss. In this case, there is no incentive for government laboratories to provide fee-for-use services. Nonfunctional laboratory equipment was also repeatedly reported as a gap, in both necessary parts and technical knowledge to conduct repairs.
uploaded by a few organizations. The Madzi Alipo database includes aspects of spare parts and maintenance, and targets sharing Fisherman's Rest organizational data. The Madzi Alipo database and WPDx upload data to each other, which means that the data are not unique and are duplicated. Moreover, the Malawian government laboratories are not uploading data into either system, and neither of these databases includes water quality data. Another database is the Eawag Groundwater Assessment Platform (GAP) (www.gapmaps.org), which targets water quality results but only includes predictions for arsenic and fluoride levels in northern Malawi. During interviews, one respondent indicated that their government laboratory does not keep a consolidated water quality database and when further probed about data sharing said that results were communicated, but not necessarily all the way to the rural water user. Instead, reports are issued depending on the sampling objective of the client, such as an NGO. As well, there does not appear to be a practical mechanism or regulatory demand with which to share results between the government laboratory and the rural water user. District respondents indicated that communities reporting unsafe water for remediation were rarely cited. One district water office representative reported political problems related to water quality monitoring: “We have seen some councilors [ward level politicians] allowing people to start accessing water at a newly drilled borehole before water quality testing is done.” The additional gap in the linkage between the local government and NGOs sharing data to the local government is evidenced by another district water office representative, which reported, “NGOs do not test water here,” despite our study finding water quality results from an NGO available in that district (Table 1). Additionally, some major partners in the water supply sector who require water quality monitoring as part of their rural water supply infrastructure projects have non-disclosure agreements with the analytical laboratory. This means additional water quality data may be available but are not being shared, nor is there regulatory oversight demanding public access.
3.4. Human capacity
3.3. Laboratory infrastructure and accessibility
On a limited scale, districts are using field kits for basic physical and chemical parameters. There was a wide range of qualifications for District Water Development Officers, the personnel in charge of the rural water supply. Some of these personnel were working on a Master's degree, while in other districts, they held a Malawi School Certificate of Education (MSCE), which denotes the completion of secondary school (high school). When asked how rural communities are able to determine if their water is safe, one district representative said this:
None of the districts surveyed reported regular or systematic rural groundwater testing for water quality in the northern region of Malawi based on the full MBS guidelines (Malawi Bureau of Standards MBS, 2005). Additionally, no smaller decentralized laboratories within districts were reported. What water quality testing is performed is almost entirely carried out in reaction to increases in water-borne diseases at health centers, which requires people to get sick before the problem is realized. The government laboratory in the northern region of Malawi can analyze only 4 of 27 determinants from the MS 733:2005. The southern and central regions have fixed water quality laboratories that are able to do much more, at 14 and 23 determinants respectively. The Northern Region Water Board also has a fixed water quality laboratory. No NGOs or private providers in the northern region are running fixed water quality laboratories, though there are academic laboratories at two Universities (Mzuzu University and the University of Livingstonia). However, some communities in remote districts in the northern region are over 6 h away from the Central Water Quality Laboratory in Lilongwe, far exceeding the holding time for microbial sample analysis. Likewise, the transport and processing of rural water samples is expensive. In addition to laboratory analysis, a sample that requires 6 h of travel time to reach the Central Water Quality Laboratory may nearly cost MK50,000 (USD$68) in fuel and an additional MK50,000 (USD $68)/per day for hiring the required 4-wheel-drive vehicle suitable for the rural road network. Some donor organizations require testing for arsenic in the potable water supply. Arsenic does not impart a color or taste to water, it can only be detected through chemical analysis. While commercially available colorimetric test kits are relatively inexpensive and easy to
They are able, but not really, because water is a difficult thing. If they look at it and it's clear, they cannot easily determine that it's not safe. But when it's turbid, that's when they say this water is not good. Even myself, if it is clear from a borehole, I would say it's good. If it has no smell, it's good. - District Water Officer interview on 27 June 2017 Such a response indicates that communities of the district cannot be expected to appreciate the intricacies of water quality. None of the districts interviewed reported having volunteers within communities analyze rural water quality using field kits. It was observed there was a generally low level of understanding of national and WHO (2017) water quality guidelines for drinking water by district water personnel interviewed. While the Northern Region Water Board focuses on urban piped water supply systems and does not supply rural water services, they also said that “we understand there are some areas in the region where we don’t have information of water quality on groundwater.” The representative interviewed was also well qualified, holding a Master's 161
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but also the technical capacity to know what chemicals or supplies are needed and where they can be obtained. There is also a high import tax and lengthy importation procedure for consumable laboratory supplies that would need to be overcome. In comparing responses by different levels of engagement, the strongest link is at the national government but practical factors limiting the water quality monitoring in northern Malawi are evident moving incrementally down this chain. Having MS 733:2005 (Malawi Bureau of Standards MBS, 2005), with guidelines for rural water supply less stringent than WHO (2017), in place is a good first step to acknowledge local capacity to ensure safe water availability in a lowincome country such as Malawi where groundwater is still the primary source of drinking water for rural communities. Considering the current capacity at the district government level, salinity, turbidity, E. coli and/ or thermotolerant coliform bacteria, and pH should be prioritized as core standards for community health surveillance at appropriate times (at a minimum on a seasonal basis for all drinking water supplies). Each of these can be assessed with either test strips, handheld meters, or basic field kits, but these still must be imported. However, field kits are not always the best option due to environmental interferences and may have a short lifespan in rough field conditions. Practically speaking, at a district level, action level thresholds can be developed to send samples to the government laboratories if results are near human health guideline criteria. There are also partnership opportunities that are not happening for water quality analysis with rural water supply and the regional urban piped water supply system provider. The government capacity to analyze all MBS constituents is a key limitation of the national laboratory infrastructure, including a backup electrical system and reserve water storage tanks. The financing required to set up a new regional water quality laboratory in line with every constituent in MS 733:2005 (Malawi Bureau of Standards MBS, 2005) would likely require an infrastructure investment in the ballpark of USD$1,000,000. Most importantly, lack of groundwater quality data sharing is driving this problem. Malawi needs human capacity dedicated to data sharing. Considering the responsibilities, it is recommended that District Water Development Officers have a Bachelor of Science degree as a minimum qualification. The northern region has historically been known for its high level of education, and there are two regional Universities that may allow the water office personnel to study while maintaining other duties. During the time of the first Malawi president, Banda repressed academic and scholarly writing and publication (Eidhammer, 2017); however, nearly 25 years later, the publication and open access data culture is still limited. Efforts to create a nationwide database for water quality can only work if all stakeholders are dedicated to data sharing, including the governmental laboratories. In protection of water users, we would argue that the national government should sets rules and enforce a publically available database available to all water users, local and national Malawian government branches and practitioners. There are limitations to this research. Not all relevant published studies may have used common water quality terms, and thus some studies may have been missed by the systematic review. However, we used a variety of search terms to address this concern. The systematic review process was based in Malawi and may not have had access to additional databases requiring a subscription that Mzuzu University did not have, but this review presents a realistic picture of the data publicly available to users, practitioners and decision makers.
degree in Chemistry and had a strong knowledge of national and WHO (2017) water quality guidelines for drinking water. At the Ministry for Agriculture, Irrigation, and Water Development, staffing was raised as one of the primary issues, by the respondent, towards completing the mission and vision of the ministry both in terms of the number and qualifications of staff. This respondent held a Master's degree and had a strong knowledge of national and WHO (2017) water quality guidelines, and also mentioned the Northern Region Water Board capacity for analysis within the northern region. This triangulates that at one of the government laboratories it was reported having a staff vacancy rate of 80%. Another challenge to effective water quality analysis is represented by the following quote from one of our interviews with a government laboratory representative: “From my observations, with time I have spent in the division, in the sector itself, very few individuals really understand how the laboratory operates.” One of our surveys revealed an example of this in that donations of water quality monitoring equipment were reported to have been received by the Ministry of Health, whose responsibilities do not include water quality and therefore the equipment was reported to have gone unused. The challenge with human capacity and operations was reinforced during several of our interviews. The district water offices are dependent on the regional and national government for water quality analysis and monitoring, which itself has as gaps. From the interviews conducted, the Northern Region Water Board had the highest qualified staff for water quality monitoring in the northern region; however, their work does not focus on rural groundwater used for drinking. But, this strong laboratory human resources and infrastructure capacity could be collaboratively leveraged. 4. Discussion Although rural water supply in Malawi is decentralized to district responsibilities, water quality monitoring remains a function and oversight provided by the national government. In addition to limited data, no time series monitoring data was available which would have allowed tracing the water quality history of a specific water source. McNicholl et al. (2017) reports “Rumphi District Council is updating its waterpoint mapping database, updating its District Sector Investment Plan, ensuring that NGO activities align with district priorities, and hosting learning forums and quarterly meetings. This success has not gone unnoticed by other stakeholders.” While Rumphi District has a reportedly strong stakeholder network, McNicholl and colleagues are silent on aspects such as the local capacity for water quality analysis. At a district level, water monitoring assistants (technicians from the water office) are placed within rural areas, but their main focus is on maintenance and not water quality testing. Importantly, within the northern region, the Rumphi District Water Development Officer had one of the highest academic qualifications of the districts surveyed, and while it has the highest human capacity, it still did not have water quality monitoring or evaluation infrastructure in place. Our findings are similar to those of Crocker and Bartram (2014), in that the national government relied on a few fixed laboratories in Malawi. Chowns (2015) reports on the problems in Malawi with the decentralized rural water supply system and how local ownership of water point functionality and financial performance under community management is weak and compounded by district water offices with no resources to support coordination and supervision. If rural communities cannot manage to keep their water source flowing, efforts to promote local water analysis are also likely to fail. Our findings on the limited laboratory infrastructure capacity in northern Malawi are also supported by Kayser et al. (2015), who noted that the technical capacity for water quality laboratory analysis is limited in the central and southern region also. The inability of decentralization to determine whether rural water supply is safe is especially evident in rural areas, where supplies for analysis must be imported, requiring not only financial resources
5. Conclusion This study has shown that the government cannot tell if rural groundwater is safe for drinking in the northern region of Malawi, with currently available data providing only minimal information for human health risks. However, capacity varied by different levels of engagement, while there are some strengthens in the national government capacity, as this is decentralized to rural areas weaknesses in local 162
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capacity are most evident with no laboratories and limited data. Our study found that key limitations lie within the lack of laboratory infrastructure and gaps in human capacity. The remote nature of a majority of the rural water supplies require district, or at least regional, fixed environmental laboratories. There may be some role for field tools as an effective screening tool for some constituents at the district level. Water quality monitoring needs to especially consider mining activities, including uranium. Malawi needs a publicly available water quality database under national government regulatory oversight and enforcement with real time monitoring data available to both local and national government decision makers, practitioners and water users for decision-making based on groundwater quality for the assessment of possible health risks in northern Malawi.
Holm, R., Wandschneider, P., Felsot, A., Msilimba, G., 2016b. Achieving the sustainable development goals: a case study of the complexity of water quality health risks in Malawi. J. Health, Popul. Nutr. 35 (20). http://dx.doi.org/10.1186/s41043-0160057-x. Kanyerere, T., Levy, J., Xu, Y., Saka, J., 2012. Assessment of microbial contamination of groundwater in upper Limphasa River catchment, located in a rural area of northern Malawi. Water SA 38 (4), 581–596. http://dx.doi.org/10.4314/wsa.v38i4.14. Kayser, G.L., Amjad, U., Dalcanale, F., Bartram, J., Bentley, M., 2015. Drinking water quality governance: a comparative case study of Brazil, Ecuador, and Malawi. Environ. Sci. Policy 48, 186–195. http://dx.doi.org/10.1016/j.envsci.2014.12.019. Madzi Alipo. Database. 〈https://www.madzialipoapp.org/〉 (Accessed 5 October 2017). Malawi Bureau of Standards (MBS), 2005. Malawi standard; Borehole and shallow well water quality– specification. Malawi Standards Board, MS 733:2005. Malawi Bureau of Standards (MBS), 2013. Malawi standard; drinking water – specification. Malawi Standards Board, MS 214:2013. Malawi Government, 2005. National Water Policy. Ministry of Irrigation and Water Development, Lilongwe, Malawi. Malawi Government, 2009. 2008 Malawi Population and Housing Census. National Statistics Office, Zomba, Malawi. Mapoma, H.W.T., Xie, X., Zhu, Y., Liu, Y., Sitolo-Banda, G.C., 2016. Trace element geochemical evolution and groundwater origin in North Rukuru–Songwe alluvial aquifer of northern Malawi. Environ. Earth Sci. 75, 877. http://dx.doi.org/10.1007/s12665016-5682-6. McNicholl, D., McRobie, A., Cruickshank, H., 2017. Characteristics of stakeholder networks supporting local government performance improvements in rural water supply: cases from Ghana, Malawi, and Bolivia. Water Altern. 10 (2), 541–561. Msilimba, G., Wanda, E.M.M., 2013. Microbial and geochemical quality of shallow well water in high-density areas in Mzuzu City in Malawi. Phys. Chem. Earth 66, 173–180. http://dx.doi.org/10.1016/j.pce.2013.07.002. NamWater, 2017. Namibia Water Corporation Ltd. Guidelines for the evaluation of drinking-water for human consumption with regard to chemical, physical and bacteriological quality. Rieger, K., Holm, R.H., Sheridan, H., 2016. Access to groundwater and link to the impact on quality of life: a look at the past, present and future public health needs in Mzimba District. Malawi Groundw. Sustain. Dev. 2–3, 117–129. http://dx.doi.org/10.1016/j. gsd.2016.07.002. Soublière, J.F., Cloutier, C., 2015. Explaining levels of local government involvement in service delivery: the dynamics of cross-sector partnerships in Malawi. Public Adm. Dev. 35 (3), 192–205. http://dx.doi.org/10.1002/pad.1715. United Nations, 2017. Sustainable development goals. 〈https://sustainabledevelopment. un.org/sdgs〉 (Accessed 25 October 2017). UN-Water, 2017. Integrated monitoring guide for sustainable development goal 6 on water and sanitation - Good practices for country monitoring systems. 〈http://www. unwater.org/publications/good-practices-sdg-6-monitoring/〉. Wanda, E., Monjerezi, M., Mwatseteza, J.F., Kazembe, L.N., 2011. Hydro-geochemical appraisal of groundwater quality from weathered basement aquifers in Northern Malawi. Phys. Chem. Earth 36, 1197–1207. http://dx.doi.org/10.1016/j.pce.2011. 07.061. Wanda, E.M.M., Gulula, L.C., Phiri, A., 2013. Hydrochemical assessment of groundwater used for irrigation in Rumphi and Karonga districts, Northern Malawi. Phys. Chem. Earth 66, 51–59. http://dx.doi.org/10.1016/j.pce.2013.09.001. Water Point Data Exchange. Database. 〈https://www.waterpointdata.org〉 (Accessed 5 October 2017). Water and Environmental Sanitation Network, 2017. Directory 2017 for the water, sanitation and hygiene sector actors in Malawi. Lilongwe. World Health Organization (WHO), 2017. Guidelines for Drinking-water Quality, Fourth Edition Incorporating the First Addendum. URL: 〈http://apps.who.int/iris/ bitstream/handle/10665/254637/9789241549950-eng.pdf;jsessionid= 054D53AD5EE1CCD6C897ED3194E1EB80?Sequence=1〉 (Accessed 22 April 2018).
Acknowledgements We would like to recognize the contributions of the World Vision Malawi WASH team, Mzuzu University, as well as Dr. Shannon Marquez, Dr. Emmanuel Opong, Mr. Silvester Kunkeyani, and Mr. Wongani Mkandawire. We also appreciate the technical editing by Dr. Kip McGilliard and valuable comments by the editor and reviewers. Funding source This work was supported by World Vision International and Drexel University's Dornsife Global Development Scholars Program. Both funding organizations contributed feedback on this report prior to submitting this article for publication. World Vision International also provided logistical support throughout data collection. References Chidya, R.C.G., Matamula, S., Nakoma, O., Chawinga, C.B.J., 2016. Evaluation of groundwater quality in rural-areas of northern Malawi: case of Zombwe Extension Planning Area in Mzimba. Phys. Chem. Earth 93, 55–62. http://dx.doi.org/10.1016/ j.pce.2016.03.013. Chowns, E., 2015. Is community management an efficient and effective model of public service delivery? Lessons from the rural water supply sector in Malawi. Public Adm. Dev. 35 (4), 263–276. http://dx.doi.org/10.1002/pad.1737. Crane, P., Silliman, S., 2009. Sampling strategies for estimation of parameters related to ground water quality. Ground Water 47 (5), 699–708. http://dx.doi.org/10.1111/j. 1745-6584.2009.00578.x. Crocker, J., Bartram, J., 2014. Comparison and cost analysis of drinking water quality monitoring requirements versus practice in seven developing countries. Int. J. Environ. Res. Public Health 11, 7333–7346. http://dx.doi.org/10.3390/ ijerph110707333. Eidhammer, A., 2017. Malawi, a place apart. Logos−Open Culture, Malawi. Holm, R., Stroud, R., Msilimba, G., Gwayi, S., 2016a. Functionality and water quality of Elephant pumps: implications for sustainable drinking water supplies in rural Malawi. Groundw. Sustain. Dev. 1, 129–134. http://dx.doi.org/10.1016/j.gsd.2016. 02.001.
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Research paper
A thought leadership piece: Where are the rural groundwater quality data for the assessment of health risks in northern Malawi?
T
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Rochelle H. Holma, , Gregory Kunkelb, Laban Nyirendac a
Centre of Excellence in Water and Sanitation, Mzuzu University, P/Bag 201, Mzuzu 2, Malawi Drexel University, 3141 Chestnut St, Philadelphia, PA 19104, USA c Northern Zone WASH, World Vision Malawi, Box 610, Mzuzu, Malawi b
A R T I C LE I N FO
A B S T R A C T
Keywords: Developing countries Groundwater Malawi Rural water supply Water quality
The Sustainable Development Goals place a strong emphasis on water quality. However, what is the local capacity to ensure safe water availability in a low-income country such as Malawi where groundwater is still the primary source of drinking water for rural communities? We conducted a systematic review of peer-reviewed literature containing primary data on groundwater used for drinking water in northern Malawi published over the period from 2006 to 2016. We also interviewed district, regional, and national government representatives supporting the water quality management sector. The results showed that the government cannot tell if groundwater is safe for drinking in the northern region of Malawi. Current literature provides only minimal information on groundwater quality for the assessment of human health risks, and there are limited laboratory services. Nitrate and pH were the most commonly available data. There is evidence that the following constituents need further investigation about possible human health risks: antimony, arsenic, barium, calcium, chloride, color, cyanide (CN-), Escherichia coli and/or thermotolerant coliform bacteria, fluoride, iron, lead, manganese and turbidity. Water quality monitoring needs to especially consider mining activities, including uranium. Varied levels of engagement appear in that while there is some strengthens in the national government capacity, as this is decentralized to districts weaknesses are most evident with no laboratories and either limited data or no data in the case of the most rural districts. Malawi needs to build human capacity, laboratory infrastructure and a publicly available water quality database under national government regulatory oversight with real time monitoring data available to both district and national government decision makers, practitioners and water users to determine groundwater quality for the assessment of possible health risks.
1. Introduction
branches and practitioners make data access and transfer for decisionmaking difficult (Kayser et al., 2015). Crane and Silliman (2009) suggest, for select water quality parameters, using basic hand-held instruments or test strips in the field at a high frequency by volunteers in rural regions of developing countries. Despite its lower precision and accuracy, this approach may offer a better representation of the temporal and spatial conditions than higher quality analytical instrument data collected by technicians at limited sampling intervals. However, there have been limited efforts in Malawi on effective rural water user participation in water quality monitoring. The northern region of Malawi covers an area of nearly 27,000 km2 and has a 2008 census population of almost 1.7 million, mostly located in rural communities using groundwater for drinking water and spread over 6 districts (Chitipa, Karonga, Likoma, Mzimba, Nkhata Bay and Rumphi) (Malawi Government, 2009). Eidhammer (2017) notes that “at the time of independence [in 1964], many of the most highly
Sustainable Development Goals (SDG) 3, 6, and 12 place a strong emphasis on water quality (United Nations, 2017). While integrated monitoring and guides for best practices are available (UN-Water, 2017), the SDGs do not state what water quality constituents for analysis and what frequency of monitoring is needed to safeguard human health practically in a low-income country. The National Water Policy, set forth by the Malawi Government (2005, pp.3), states that ‘water of acceptable quality for all the needs in Malawi’ should be made ‘readily available and equitably accessible to all Malawians’. What is the local capacity to ensure safe water availability in a low-income country such as Malawi where groundwater is still the primary source of drinking water for rural communities? The absence of an open access national database of water quality results and the lack of a consistent monitoring program among water users, local and national Malawian government
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Corresponding author. E-mail address: [email protected] (R.H. Holm).
https://doi.org/10.1016/j.gsd.2018.05.004 Received 13 November 2017; Received in revised form 15 May 2018; Accepted 15 May 2018 Available online 18 May 2018 2352-801X/ © 2018 Published by Elsevier B.V.
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2.3. Ethics
educated Malawians were from the north{ern region}, educated at mission schools” (page 8). Although interest in the quality of groundwater used for drinking water is growing globally, in northern Malawi, there has been no systematic review of the currently available data and no determination of what constituents may pose a human health risk and need further investigation or what practical monitoring steps are needed for Malawi to meet the SDGs for water quality. In Malawi, the rural water supply is decentralized to districts acting as local governments, where the water office is structured identically in each district and reports to the national Ministry of Agriculture, Irrigation and Water Development. Our work will build on other work in Malawi that has looked at water quality governance (Kayser et al., 2015) and the dynamics of power and trust between development partners in the water sector providing funding and the local government (Soublière and Cloutier, 2015). It also builds on the global discussion on monitoring requirements and practices observed for other low-income countries (Crocker and Bartram, 2014). This thought leadership piece highlights the local capacity for how to ensure rural safe water availability in a low-income country such as Malawi by looking at what groundwater quality laboratory analysis has been done, where it has been carried out, indicators of possible human health risks and environmental laboratory capacity considerations. The aim of our study is to better understand the capacity for rural water quality monitoring and find lessons to share and on-the-ground implications to inform solutions for attaining the SDGs on water quality in a resource-limited environment.
Ethical clearance for this study was obtained from the Malawi Government, National Commission for Science and Technology. Written consent was obtained from respondents. All research tools and data are available from the corresponding author. 3. Results This section presents results on the national water quality guidelines for groundwater used for drinking water by rural communities, where and what existing data are available for the northern region, plus environmental laboratory capacity infrastructure and human capacity considerations to ensure safe water availability in Malawi. 3.1. What are the water quality guidelines for drinking water? In Malawi, water quality guidelines for drinking water are set by the national government. There are two drinking water quality criteria, the Malawi Bureau of Standards (MBS) MS 214:2013 (Malawi Bureau of Standards MBS, 2013), which is the drinking water specification for urban and semi-urban area piped water providers, and MS 733:2005 (Malawi Bureau of Standards MBS, 2005), which is the specification for groundwater from borehole and shallow wells used for drinking. Both of these standards differ from the World Health Organization (WHO) (2017) guidelines. While MS 214:2013 has criteria for 58 chemical and physical determinants, MS 733:2005 only has criteria for 27 determinants, while the WHO summary tables cover guideline values for 90 chemicals that are of health significance in drinking water. There are also differences in the stated levels; for example, while the WHO guideline value for fluoride is 1.5 mg/l, in MS 214:2013 it is 0.7 mg/l, and in MS 733:2005, it is 6.0 mg/l. However, for other constituents, the MS 214:2013 and WHO criteria are the same, such as that for arsenic of 0.01 mg/l, while MS 733:2005 for arsenic is five times this (0.05 mg/l). Neither MBS guideline (Malawi Bureau of Standards MBS, 2005, 2013) contains water quality criteria for uranium, yet the World Health Organization (WHO) (2017) has guidance levels for radionuclides in drinking water and for the chemical aspects of uranium. Though a uranium mine was opened at Kayelekera in northern Malawi in 2009, nationally only MS 214:2013 includes gross alpha and beta activity. This contrasts to Namibia, where there is also a uranium mine and a drinking water limit for uranium has been set at 1 mg/l (NamWater, 2017). During our interviews, four respondents mentioned the need for uranium water quality monitoring. Neither of the MBS guidelines (Malawi Bureau of Standards MBS, 2005, 2013) is available online, both are only available as paper copies from MBS offices which would be difficult for rural water users to obtain. We probed further into the water quality guidelines for drinking water during our interviews. A national ministry representative stated, “If you apply the WHO guidelines, all of our schemes would fail”. This was echoed by a government laboratory chemist interviewee who said, “if we say that it [drinking water] has to meet these stringent standards [WHO guidelines], then a lot of boreholes would be abandoned”. The interview data show that at a national level there is an awareness of water quality guidelines for groundwater used for drinking water by rural communities and of the differences between national standards (Malawi Bureau of Standards MBS, 2005, 2013) and the guidelines of the World Health Organization (WHO) (2017).
2. Materials and methods 2.1. Systematic literature review A systematic review was conducted of publicly available groundwater data published over the period from 2006 to 2016. However, because the Malawian Government does not publish open access water quality data, we only considered peer-reviewed literature containing primary groundwater data. Google Scholar and Pub Med were used as internet search engines. Keywords for the search included combinations of the following: groundwater, aquifer, water quality, well, borehole, Malawi, contamination, pollution, Lilongwe, Blantyre, and Mzuzu. We selected these keywords based on the authors’ experiences in the field. We also searched literature known to the authors. The inclusion criteria for the systematic literature review was groundwater sample results where the water may have been used as drinking water from the 6 northern districts of Malawi. Study records were managed in Microsoft Excel. We only used full text papers, and if papers were not open access, we requested a copy of the paper directly from the authors. Selected articles were then reviewed by the corresponding author for the origin of authorship, funding source, and water quality data, after which the results were reviewed by all authors. We did not include water quality data for urban municipal piped water systems. We also did not include grey literature for consistency with accepted systematic review practices, such as unpublished data from academic laboratories. 2.2. Key informant interviews Following the systematic literature review, from June to December 2017, we conducted face-to-face or mailed structured surveys focusing on current water quality issues and capacity based on their link to World Vision Northern Zone rural water supply interventions. Interviews were conducted with local government District Water Officers (n = 6); the regional urban piped water supply system provider (n = 1); government laboratories (n = 3, located in each the northern, central and southern regions); and the national ministry in charge of water supply, the Ministry for Agriculture, Irrigation, Water, and Development (n = 1). Surveys were conducted in English. Key informant interviews with rural water users were not included.
3.2. Where and what are the groundwater data in northern Malawi? We initially identified 35 articles containing groundwater quality data for the assessment of health risks in Malawi and determined a final set of 9 that met our criteria for northern Malawi. Upon detailed review of the work by Kanyerere et al. (2012), these data were excluded from 158
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Table 1 Available groundwater data from 2006 to 2016 for northern Malawi compared to the MS 733:2005 (Malawi Bureau of Standards MBS, 2005) and World Health Organization (WHO) (2017) guidelinesa. Parameter
Units
Minimum Reported Value
Maximum Reported Value
Total n reported
MS 733:2005 standard (Malawi Bureau of Standards, 2005)
WHO healthbased guidelines (2017)
Evidence of possible human health risk needing further investigation?
Aluminum Antimony Arsenic Barium Borate Cadmium Calcium Chloride Chromium Color
mg/l mg/l mg/l mg/l mg/l mg/l mg/l mg/l mg/l Total Color Units mg/l mg/l µS/cm colony forming units/100 ml mg/l mg/l CaCO3 mg/l mg/l mg/l mg/l mg/l
0.0003 0.0016 0.0004 0.0172 0.0001 0 3.6 2.5 0.0002 –
0.0066 0.0058 0.0145 0.9701 0.0561 0.0007 412 989.7 0.0018 –
25 25 25 25 25 25 324 304 25 0
0.5 0.005 0.05 0.7 5 0.01 250 750 0.01 50
– 0.02 0.01 1.3 2.4 0.003 – – 0.05 –
No Yes Yes Yes No No Yes Yes No No data
0.0001 – 40 0
0.0145 – 3128 6225
25 0 351 351
2 0.07 3500 50
2 – – 0
No No data No Yes
0.1 25 0.0022 0.0005 0.97 0.0001 0 6 0.0011 2.4 0 24 0.1 0
56 757.8 5.336 0.0176 116.6 0.8041 30 8.7 0.0096 166 505.2 1896 740 5.1
45 305 217 25 324 197 609 609 25 304 324 304 217 45
6 800 3 0.05 200 1.5 45 6.0–9.5 0.01 500 800 2000 25 15
1.5 – – 0.01 – 0.4 50 – 0.04 – – – 1 –
Yes No Yes Yes No Yes No No No No No No Yes No
Copper Cyanide (CN-) Electrical conductivity Escherichia coli and/or thermotolerant coliform bacteria Fluoride Hardness Iron Lead Magnesium Manganese Nitrate as NO3 pH Selenium Sodium Sulfate Total dissolved solids Turbidity Zinc
mg/l mg/l mg/l mg/l NTU mg/l
-No value available. a Groundwater data are from: Chidya et al. (2016); Holm et al. (2016a); Holm et al. (2016b); Mapoma et al. (2016); Msilimba and Wanda (2013); Rieger et al. (2016); Wanda et al. (2011); Wanda et al. (2013).
Chinese, European and American researchers. Each (8/8) of the articles had multiple authors and most (7/8) had authors from more than one institution. In addition, data for only two rural water supply practitioners, Pump Aid and Wells for Zoe, were available, despite there being more than 20 non-governmental organizations (NGO) and dedicated private sector providers supporting water, sanitation and hygiene in the northern region (Water and Environmental Sanitation Network, 2017). Most of the existing groundwater data in northern Malawi are from grab samples (not depth discrete samples) from boreholes and shallow wells in rural areas. The depth at which the water samples were taken was not typically provided in the available data, though whether the water source was a drilled well versus a shallow dug well was generally provided. No time series monitoring data were found. The largest water quality study identified (Holm et al., 2016a) had a sample count of 285 wells and was funded by the practitioner who installed the rural community handpumps. While all districts in our study would be considered rural, no water quality data were found for Likoma or Chitipa Districts, the two most difficult and furthest districts to reach in relation to the capital city of Lilongwe where the national ministry is based. Likoma District is in the middle of Lake Malawi, and consists of two islands. Some rural water supply collaborations have tried to facilitate the creation of sector databases to share data. One of these is the openaccess WPDx (Water Point Data Exchange) database (https://www. waterpointdata.org) managed by a global working group of water, sanitation and hygiene partners. Most (99%) of the data for Malawi in WPDx were input by six organizations. Another of these databases is the Madzi Alipo database (https://www.madzialipo.org) managed by Fisherman's Rest, Malawi. However, the data were again primarily
the analysis based on errors in the reported constituent units; the errors were verified by the authors (personal communication, Levy, 14 December 2017). Table 1 provides a summary of available groundwater data from 2006 to 2016 for northern Malawi compared to the MS 733:2005 (Malawi Bureau of Standards MBS, 2005) and Health Organization WHO (2017). While the ‘maximum’ for a few parameters being over the guideline value is not a clear indicator of health risk nor for groundwater quality, when only limited data is available it provides targeted areas that need further investigation. Of the 27 determinants in MS 733:2005, most (25/27) had some available data. Nitrate and pH were the most commonly reported data. There is evidence that the following constituents need further investigation about possible human health risks: antimony, arsenic, barium, calcium, chloride, color, cyanide (CN-), Escherichia coli and/or thermotolerant coliform bacteria, fluoride, iron, lead, manganese and turbidity. If n is small, how can human health risks be assessed? In the case of arsenic, the sample size (n = 25) shows the maximum reported value is 0.0145 mg/l, which is from a single report (Mapoma et al., 2016) with 3 of 25 samples exceeding the WHO guideline. However, this is too limited of evidence without further investigation. While Mapoma et al. (2016) provided the raw water quality data of each sample, not all authors offered this level of detail to allow review (Fig. 1). Only one (1/8) full article was published with open access, for others only the abstract was accessible. The journal Physics and Chemistry of the Earth, which is linked to the WaterNet Community of Practice, was the most common source of data (4/8). Half (4/8) of the studies had foreign author affiliations, involving partnerships with 159
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Fig. 1. Location of groundwater quality data by district: northern region, Malawi.
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use in rural communities, there is unpublished (personal communication with USAID, May 12, 2014) evidence in Malawi of possible environmental interferences being common. This further complicates data interpretation because the presence or absence of these environmental interferences is sometimes not known when a method is selected due to the limited publically available historical water quality data. In the case of colorimetric arsenic testing, sulfide may interfere positively (yielding false-positive test results) at concentrations greater than 5 mg/lS2-. Other interferences may include selenium, antimony, and tellurium (personal communication with Hach). Despite these possible interferences, colorimetric arsenic analysis was the method used by one of the laboratories interviewed. While distillation can be carried out to remove environmental interferences prior to arsenic analysis, this is often not logistically possible when doing on-site field analysis. Additionally, spiked samples (such as for arsenic) are not available from local suppliers at known concentrations to determine problems with field methods. None of the government laboratories in our study was observed to be climate controlled, with doors and windows observed by researchers to be open at the time of the survey. Each of the laboratories is challenged by intermittent municipal power and water supplies. One laboratory interviewed reported that when fees are charged for water quality analysis, such as for support of an NGO project, instead of funds being invested back into the laboratory, they are deposited in the general national government account. Some NGOs worked around this and were reported to procure the consumable supplies and then depend on the human resources and infrastructure of the government laboratories for analysis. Another laboratory reported that fees sometimes do not cover the materials and labor, so when analytical services were provided, the laboratory is operating at a loss. In this case, there is no incentive for government laboratories to provide fee-for-use services. Nonfunctional laboratory equipment was also repeatedly reported as a gap, in both necessary parts and technical knowledge to conduct repairs.
uploaded by a few organizations. The Madzi Alipo database includes aspects of spare parts and maintenance, and targets sharing Fisherman's Rest organizational data. The Madzi Alipo database and WPDx upload data to each other, which means that the data are not unique and are duplicated. Moreover, the Malawian government laboratories are not uploading data into either system, and neither of these databases includes water quality data. Another database is the Eawag Groundwater Assessment Platform (GAP) (www.gapmaps.org), which targets water quality results but only includes predictions for arsenic and fluoride levels in northern Malawi. During interviews, one respondent indicated that their government laboratory does not keep a consolidated water quality database and when further probed about data sharing said that results were communicated, but not necessarily all the way to the rural water user. Instead, reports are issued depending on the sampling objective of the client, such as an NGO. As well, there does not appear to be a practical mechanism or regulatory demand with which to share results between the government laboratory and the rural water user. District respondents indicated that communities reporting unsafe water for remediation were rarely cited. One district water office representative reported political problems related to water quality monitoring: “We have seen some councilors [ward level politicians] allowing people to start accessing water at a newly drilled borehole before water quality testing is done.” The additional gap in the linkage between the local government and NGOs sharing data to the local government is evidenced by another district water office representative, which reported, “NGOs do not test water here,” despite our study finding water quality results from an NGO available in that district (Table 1). Additionally, some major partners in the water supply sector who require water quality monitoring as part of their rural water supply infrastructure projects have non-disclosure agreements with the analytical laboratory. This means additional water quality data may be available but are not being shared, nor is there regulatory oversight demanding public access.
3.4. Human capacity
3.3. Laboratory infrastructure and accessibility
On a limited scale, districts are using field kits for basic physical and chemical parameters. There was a wide range of qualifications for District Water Development Officers, the personnel in charge of the rural water supply. Some of these personnel were working on a Master's degree, while in other districts, they held a Malawi School Certificate of Education (MSCE), which denotes the completion of secondary school (high school). When asked how rural communities are able to determine if their water is safe, one district representative said this:
None of the districts surveyed reported regular or systematic rural groundwater testing for water quality in the northern region of Malawi based on the full MBS guidelines (Malawi Bureau of Standards MBS, 2005). Additionally, no smaller decentralized laboratories within districts were reported. What water quality testing is performed is almost entirely carried out in reaction to increases in water-borne diseases at health centers, which requires people to get sick before the problem is realized. The government laboratory in the northern region of Malawi can analyze only 4 of 27 determinants from the MS 733:2005. The southern and central regions have fixed water quality laboratories that are able to do much more, at 14 and 23 determinants respectively. The Northern Region Water Board also has a fixed water quality laboratory. No NGOs or private providers in the northern region are running fixed water quality laboratories, though there are academic laboratories at two Universities (Mzuzu University and the University of Livingstonia). However, some communities in remote districts in the northern region are over 6 h away from the Central Water Quality Laboratory in Lilongwe, far exceeding the holding time for microbial sample analysis. Likewise, the transport and processing of rural water samples is expensive. In addition to laboratory analysis, a sample that requires 6 h of travel time to reach the Central Water Quality Laboratory may nearly cost MK50,000 (USD$68) in fuel and an additional MK50,000 (USD $68)/per day for hiring the required 4-wheel-drive vehicle suitable for the rural road network. Some donor organizations require testing for arsenic in the potable water supply. Arsenic does not impart a color or taste to water, it can only be detected through chemical analysis. While commercially available colorimetric test kits are relatively inexpensive and easy to
They are able, but not really, because water is a difficult thing. If they look at it and it's clear, they cannot easily determine that it's not safe. But when it's turbid, that's when they say this water is not good. Even myself, if it is clear from a borehole, I would say it's good. If it has no smell, it's good. - District Water Officer interview on 27 June 2017 Such a response indicates that communities of the district cannot be expected to appreciate the intricacies of water quality. None of the districts interviewed reported having volunteers within communities analyze rural water quality using field kits. It was observed there was a generally low level of understanding of national and WHO (2017) water quality guidelines for drinking water by district water personnel interviewed. While the Northern Region Water Board focuses on urban piped water supply systems and does not supply rural water services, they also said that “we understand there are some areas in the region where we don’t have information of water quality on groundwater.” The representative interviewed was also well qualified, holding a Master's 161
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but also the technical capacity to know what chemicals or supplies are needed and where they can be obtained. There is also a high import tax and lengthy importation procedure for consumable laboratory supplies that would need to be overcome. In comparing responses by different levels of engagement, the strongest link is at the national government but practical factors limiting the water quality monitoring in northern Malawi are evident moving incrementally down this chain. Having MS 733:2005 (Malawi Bureau of Standards MBS, 2005), with guidelines for rural water supply less stringent than WHO (2017), in place is a good first step to acknowledge local capacity to ensure safe water availability in a lowincome country such as Malawi where groundwater is still the primary source of drinking water for rural communities. Considering the current capacity at the district government level, salinity, turbidity, E. coli and/ or thermotolerant coliform bacteria, and pH should be prioritized as core standards for community health surveillance at appropriate times (at a minimum on a seasonal basis for all drinking water supplies). Each of these can be assessed with either test strips, handheld meters, or basic field kits, but these still must be imported. However, field kits are not always the best option due to environmental interferences and may have a short lifespan in rough field conditions. Practically speaking, at a district level, action level thresholds can be developed to send samples to the government laboratories if results are near human health guideline criteria. There are also partnership opportunities that are not happening for water quality analysis with rural water supply and the regional urban piped water supply system provider. The government capacity to analyze all MBS constituents is a key limitation of the national laboratory infrastructure, including a backup electrical system and reserve water storage tanks. The financing required to set up a new regional water quality laboratory in line with every constituent in MS 733:2005 (Malawi Bureau of Standards MBS, 2005) would likely require an infrastructure investment in the ballpark of USD$1,000,000. Most importantly, lack of groundwater quality data sharing is driving this problem. Malawi needs human capacity dedicated to data sharing. Considering the responsibilities, it is recommended that District Water Development Officers have a Bachelor of Science degree as a minimum qualification. The northern region has historically been known for its high level of education, and there are two regional Universities that may allow the water office personnel to study while maintaining other duties. During the time of the first Malawi president, Banda repressed academic and scholarly writing and publication (Eidhammer, 2017); however, nearly 25 years later, the publication and open access data culture is still limited. Efforts to create a nationwide database for water quality can only work if all stakeholders are dedicated to data sharing, including the governmental laboratories. In protection of water users, we would argue that the national government should sets rules and enforce a publically available database available to all water users, local and national Malawian government branches and practitioners. There are limitations to this research. Not all relevant published studies may have used common water quality terms, and thus some studies may have been missed by the systematic review. However, we used a variety of search terms to address this concern. The systematic review process was based in Malawi and may not have had access to additional databases requiring a subscription that Mzuzu University did not have, but this review presents a realistic picture of the data publicly available to users, practitioners and decision makers.
degree in Chemistry and had a strong knowledge of national and WHO (2017) water quality guidelines for drinking water. At the Ministry for Agriculture, Irrigation, and Water Development, staffing was raised as one of the primary issues, by the respondent, towards completing the mission and vision of the ministry both in terms of the number and qualifications of staff. This respondent held a Master's degree and had a strong knowledge of national and WHO (2017) water quality guidelines, and also mentioned the Northern Region Water Board capacity for analysis within the northern region. This triangulates that at one of the government laboratories it was reported having a staff vacancy rate of 80%. Another challenge to effective water quality analysis is represented by the following quote from one of our interviews with a government laboratory representative: “From my observations, with time I have spent in the division, in the sector itself, very few individuals really understand how the laboratory operates.” One of our surveys revealed an example of this in that donations of water quality monitoring equipment were reported to have been received by the Ministry of Health, whose responsibilities do not include water quality and therefore the equipment was reported to have gone unused. The challenge with human capacity and operations was reinforced during several of our interviews. The district water offices are dependent on the regional and national government for water quality analysis and monitoring, which itself has as gaps. From the interviews conducted, the Northern Region Water Board had the highest qualified staff for water quality monitoring in the northern region; however, their work does not focus on rural groundwater used for drinking. But, this strong laboratory human resources and infrastructure capacity could be collaboratively leveraged. 4. Discussion Although rural water supply in Malawi is decentralized to district responsibilities, water quality monitoring remains a function and oversight provided by the national government. In addition to limited data, no time series monitoring data was available which would have allowed tracing the water quality history of a specific water source. McNicholl et al. (2017) reports “Rumphi District Council is updating its waterpoint mapping database, updating its District Sector Investment Plan, ensuring that NGO activities align with district priorities, and hosting learning forums and quarterly meetings. This success has not gone unnoticed by other stakeholders.” While Rumphi District has a reportedly strong stakeholder network, McNicholl and colleagues are silent on aspects such as the local capacity for water quality analysis. At a district level, water monitoring assistants (technicians from the water office) are placed within rural areas, but their main focus is on maintenance and not water quality testing. Importantly, within the northern region, the Rumphi District Water Development Officer had one of the highest academic qualifications of the districts surveyed, and while it has the highest human capacity, it still did not have water quality monitoring or evaluation infrastructure in place. Our findings are similar to those of Crocker and Bartram (2014), in that the national government relied on a few fixed laboratories in Malawi. Chowns (2015) reports on the problems in Malawi with the decentralized rural water supply system and how local ownership of water point functionality and financial performance under community management is weak and compounded by district water offices with no resources to support coordination and supervision. If rural communities cannot manage to keep their water source flowing, efforts to promote local water analysis are also likely to fail. Our findings on the limited laboratory infrastructure capacity in northern Malawi are also supported by Kayser et al. (2015), who noted that the technical capacity for water quality laboratory analysis is limited in the central and southern region also. The inability of decentralization to determine whether rural water supply is safe is especially evident in rural areas, where supplies for analysis must be imported, requiring not only financial resources
5. Conclusion This study has shown that the government cannot tell if rural groundwater is safe for drinking in the northern region of Malawi, with currently available data providing only minimal information for human health risks. However, capacity varied by different levels of engagement, while there are some strengthens in the national government capacity, as this is decentralized to rural areas weaknesses in local 162
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capacity are most evident with no laboratories and limited data. Our study found that key limitations lie within the lack of laboratory infrastructure and gaps in human capacity. The remote nature of a majority of the rural water supplies require district, or at least regional, fixed environmental laboratories. There may be some role for field tools as an effective screening tool for some constituents at the district level. Water quality monitoring needs to especially consider mining activities, including uranium. Malawi needs a publicly available water quality database under national government regulatory oversight and enforcement with real time monitoring data available to both local and national government decision makers, practitioners and water users for decision-making based on groundwater quality for the assessment of possible health risks in northern Malawi.
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Acknowledgements We would like to recognize the contributions of the World Vision Malawi WASH team, Mzuzu University, as well as Dr. Shannon Marquez, Dr. Emmanuel Opong, Mr. Silvester Kunkeyani, and Mr. Wongani Mkandawire. We also appreciate the technical editing by Dr. Kip McGilliard and valuable comments by the editor and reviewers. Funding source This work was supported by World Vision International and Drexel University's Dornsife Global Development Scholars Program. Both funding organizations contributed feedback on this report prior to submitting this article for publication. World Vision International also provided logistical support throughout data collection. References Chidya, R.C.G., Matamula, S., Nakoma, O., Chawinga, C.B.J., 2016. Evaluation of groundwater quality in rural-areas of northern Malawi: case of Zombwe Extension Planning Area in Mzimba. Phys. Chem. Earth 93, 55–62. http://dx.doi.org/10.1016/ j.pce.2016.03.013. Chowns, E., 2015. Is community management an efficient and effective model of public service delivery? Lessons from the rural water supply sector in Malawi. Public Adm. Dev. 35 (4), 263–276. http://dx.doi.org/10.1002/pad.1737. Crane, P., Silliman, S., 2009. Sampling strategies for estimation of parameters related to ground water quality. Ground Water 47 (5), 699–708. http://dx.doi.org/10.1111/j. 1745-6584.2009.00578.x. Crocker, J., Bartram, J., 2014. Comparison and cost analysis of drinking water quality monitoring requirements versus practice in seven developing countries. Int. J. Environ. Res. Public Health 11, 7333–7346. http://dx.doi.org/10.3390/ ijerph110707333. Eidhammer, A., 2017. Malawi, a place apart. Logos−Open Culture, Malawi. Holm, R., Stroud, R., Msilimba, G., Gwayi, S., 2016a. Functionality and water quality of Elephant pumps: implications for sustainable drinking water supplies in rural Malawi. Groundw. Sustain. Dev. 1, 129–134. http://dx.doi.org/10.1016/j.gsd.2016. 02.001.
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