We here at the Mortenson Center blog are pleased to present a series of guest posts written by Mortenson Center students.
After the (in)famous Play Pump, Lifestraw is one of the most widely known new products on the scene in drinking water development. It’s a point of use (POU) technology, which means no expensive drinking water treatment plant is necessary. Just find some water, pop out your Lifestraw, and have a drink. The same company makes a whole family of decentralized, filtration-based water cleaners, including the Lifestraw Family 2.0, a filter big enough for a whole household, and the Lifestraw Community, big enough for a whole school.
The Lifestraw, or Lifestraw Personal, is about the size and shape of big flashlight. It comes with a neck strap for convenient transport. The Lifestraw Personal doesn’t quite meet WHO standards for removing giardia or crypto bacteria, but is still plenty good at removing enough bacteria to make a health difference. The estimated useful life of the product is around 700 L or one year of drinking (Elsanousi et al. 2009). The Lifestraw Personal costs only US $3.50, which many poor households could afford (Elsanousi et al. 2009).
Sounds cool. But how do these products measure up in the field?
There was a field study of Lifestraw Personal in a village in Sudan in 2006-2007 (Elsanousi et al. 2009). Prior to the intervention, the participants were drinking directly from a canal also used for defecation. 86.5% of surveyed participants claimed exclusive use of the Lifestraw Personal (Elsanousi et al. 2009). 15.3% of participants reported diarrhea before the intervention, and only 2.3% reported diarrhea after the intervention (Elsanousi et al. 2009). However, without the presence of a control group, this improvement in gastrointestinal health could be seasonal or coincidental.
Another field study of Lifestraw Personal took place in Ethiopia (Boisson et al. 2009). The study had over a thousand participants, split into an intervention and a control group (Boisson et al. 2009). For ethical reasons, the control group was also given Lifestraws after the experiment. The intervention group had 25% fewer weeks with diarrhea, which theoretically was a statistically significant margin (Boisson et al. 2009). However, a survey at the end of the study period found that only 34% of the recipients had used the Lifestraw Personal in the past week, and only 13% claimed to use it daily (Boisson et al. 2009). Furthermore, plus or minus 25% is within the range of courtesy bias seen in similar unblinded studies (Boisson et al. 2009). The villagers who disliked the Lifestraw Personal cited that it was too difficult and uncomfortable to suck water through the filter, that it was too slow, and that the filter was too big. The participants who liked the filter said it made the water look, smell, and taste better.
The Lifestraw Personal is definitely capable of removing bacteria. However, neither of these studies firmly proved that it made a difference in the field, primarily because of inconsistent use by the intended consumers. This same problem plagues loads of other development products, from bed nets to latrines to school computers. Perhaps the most valuable impact of these interventions was providing user feedback for the Lifestraw manufacturers, so they can continue to refine the balance between cost, coolness, and cleaning power. In the end, the greatest challenge is not inventing a technology that can remove bacteria, but creating a product that people like and use.