Broadly, my goals is to identify practical strategies for improving health and well-being in low-resource settings. My current work focuses on passive chlorination and improving the household built environment, specifically floors.
1. Increasing access to safely managed water with passive chlorination technologies
Centralized drinking water treatment has historically resulted in enormous population health benefits, but this model has not been universally replicated, and over 2 billion people globally lack access to safe water. As an alternative to point-of-use water treatment, which requires individuals (typically women and girls) to manually treat drinking water for each household, passive, in-line chlorination technologies have the potential to automatically chlorinate and disinfect drinking water at various scales. My colleagues and I found that passive chlorination at primary (shared) drinking water points in urban Bangladesh reduced the prevalence of child diarrhea by nearly a quarter, and that the taste and odor of chlorine were not obstacles to implementation.
With a grant from the King Center on Global Development, I plan to conduct formative research on passive chlorination in healthcare facilities in 2022-2023. Lack of clean water in health facilities can lead to infections, and it also has implications for gender equity. Pregnant people may be less likely to seek care at facilities with poor WASH conditions or may be exposed to infection risks during delivery. Globally, the majority of healthcare workers are women; this is thus a gendered occupational health risk as well. This is a newer area of research for me.
2. Upgrading household dirt floors to reduce pathogen exposure
In an observational analysis of data from a trial in rural Bangladesh, my colleagues and I found that children living in households with improved (i.e., concrete, tile, or wood) floors as compared to dirt floors were less likely to have soil-transmitted helminth infections or Giardia infections. Additional analyses suggested that improved floors are protective against diarrhea, but, with the relatively small proportion of households with improved floors, the analysis had low power and thus motivates a larger study (pre-print coming soon).