The Institute for Water wants you to value the H₂0 you use

Michael Anft / Summer 2014 Posted in Health, Science+Technology Tagged institute for water

Image: Luke Best

Consider, just this once, that droplet of water forming on the lip of your kitchen faucet. Its story is likely richer than yours, and infinitely longer: It dates back at least 4.5 billion years to when the Earth was formed. It came from outer space, where the molecules that make water possible were formed in the Orion Complex, part of the Milky Way. And during its earthly existence, that one seemingly inconsequential drop has gotten around—embedding itself in clouds, drifting through oceans, alighting on flower petals, and sloshing around in the bladders of brachiosauruses—before making itself of service to you (or, more likely, before coursing its way down your sink's drain).

If you've heard one story about a drop of water, you've heard them all. Unlike the sun's rays, new water isn't being created every day. Every drop of it has been here since the Earth began—and no more. It is the epitome of recycling, going through nature's eternal washing machine with a regularity that allows it to sustain all life.

But water is not infinite. While it covers 70 percent of the Earth, making its supply seem inexhaustible, water adds up to far less than one-tenth of 1 percent of the planet's mass. Only 2.5 percent of the world's water is fresh—the kind we drink and use for flushing our toilets or greening our fields. Water makes life possible, and if humans don't manage it properly, there may not be enough clean, potable H₂0 to sustain our growing numbers. With the emergence of climate change (and the disruptive geographic changes in water distribution that come with it), more development in once-poor countries, and a new generation of harmful contaminants, the outlook for water is cloudy as hell.

So, back to that faucet: Does that drop look any different to you now?

Persuading people in the rich West that water is worth viewing through a new set of admiring eyes is one of the goals of a new venture, formed last year to tackle what is becoming a global water crisis. The Johns Hopkins University Institute for Water aims to discover the best ways to manage water at the local and regional level so that its supply will be less in question. That's the best it, or any other entity, can do. The golden age—or more appropriately, the crystal clear age—of water is over. Gone are the times when people in the developed world could turn a spigot and expect clean, fresh water to pour out, seemingly forever.

Water Institute scientists, many with research backgrounds in poor countries where water resources have always been uncertain, hope to figure out ways to recycle water that is, er, less than pure so that it is once again drinkable, or at least suitable for farming and other activities. Johns Hopkins researchers from a variety of disciplines will also explore methods for improving sanitation situations that, in many areas, have led to outbreaks of deadly disease.

While the institute's leaders may not offer eons-spanning history lessons, they do want people to think about what water means to them.

"We take water for granted," says Kellogg Schwab, director of the institute, which will be backed with up to $100 million from "Rising to the Challenge," the university's ongoing capital campaign. "In Baltimore, we pay about $50 a month for water and wastewater, and we think nothing of paying over $100 for our cable or cellphone bill. It's all too easy to overlook something as cheap as water. We have to figure out a structure where we value water and sanitation and all the infrastructure improvements we'll need to make to continue getting them," adds Schwab, who is also a professor of environmental health sciences at the Bloomberg School of Public Health and of environmental engineering at the Whiting School of Engineering.

Lest Americans believe they are immune to water shortages or contamination, they should think again. California is choked by the worst drought in 50 years. Atlanta went through its own dusty spell in 2008, and the Southwest exists amid a perpetual shortfall. Entire water purification systems were wiped out for weeks at a time in recent years by Gulf Coast hurricanes. But if you want a glimpse of the depths of the world's water future, look Down Under. Australia, among developed nations the canary in the coal mine for climate change, is ramping up its saltwater-conversion plants and wastewater-recycling efforts as it has lost much of its water capacity to drought. (The Aussies' name for that continent's changing environment: The Big Dry.)

"Sometime in the next 10 or 20 years, we might be seeing the effects of widespread water shortages" across the United States, says Edward Bouwer, a professor of environmental engineering at the Whiting School, and a member of the Water Institute. "People will be astounded, but they'll adapt too." The notion of recycling household wastewater so it reappears out of their tap may make them feel queasy—scientists call such a reaction "the yuck factor"—but people can and do change.

The question that Schwab and Bouwer pose is: How? How do Water Institute researchers get people to see water as finite, and how do they best convey that a host of innovations can save them from disease, deprivation, and the worst thirst imaginable?

The answer, they believe, is predicated upon one emerging idea: Technology alone will not solve the world's water problems. Schwab is effusive in explaining that for scientists to be successful in reaching people around the world and helping them maintain water resources and stay safe from sanitary woes, the Water Institute must become a universitywide, multidisciplinary outfit that attacks the issue from a variety of angles.

"For the challenges of the 21st century, engineering and public health approaches might form the nucleus of what we'll do, but they're not enough," he says. "What we've come to realize is that human behavior is key to making water solutions sustainable." To do that, the institute will encourage relationships between businesses and nonprofit groups, researchers and local communities. It will inform policymakers about how laws and regulations can help solve water problems. So, anthropologists and sociologists from the Krieger School of Arts and Sciences will be called upon to offer advice on how people in certain regions are likely to respond to droughts and floods. Microbiologists from the Bloomberg School will study how waterborne illnesses proliferate, while other researchers at the school will attempt to find the best ways to notify people in far-flung lands about water storage safety. Schwab plans to encourage academics at the Paul H. Nitze School of Advanced International Studies to provide advice to foreign governments on water-friendly policies, while physician-scientists at the School of Medicine will investigate the best ways to provide water after natural disasters. And so on, and so on.

"The possibilities for collaboration are endless," Schwab says. "We're trying to include all 10 Hopkins schools or divisions." Even the Peabody Conservatory could get involved, he muses, with songs and tones informing people about the status of water quality and safety in their local areas via hand-held devices, such as cellphones.

If Schwab's approach works, millions of people across the dozens of countries where Johns Hopkins researchers work will enjoy, perhaps for the first time, sustainable water and sanitation. To get there, solutions need to be crafted to work at the local level—all water issues are local—and then scaled up. That means applying something other than the Western-world systems that engineers typically design to handle the needs of millions.

"It's best to start at the village level," says Bouwer. "If you have any kind of regional treatment system, you need it to be simple, energy efficient, and to use existing forces, like gravity, to help move the water around." If engineers were to devise a more complex system and there's no one in an area who has the skills to manage it, that technology might become useless once it breaks down, he adds. The idea is to find elegant solutions that can work in small areas, even within single homes.

"We talk a lot about creating 'leapfrog technology,'" adds William Ball, also a professor of environmental engineering and a Water Institute member. The idea, he says, is to eliminate steps engineers have traditionally used to connect clean water to people. "We're trying to do the opposite of what we've done in the past, which has often involved sending water to the bottom of the hill to treat it. It costs a lot of money and energy to move water around. So, we're trying to jump past that idea and see if we can cheaply get water closer to home so people can use it."

Researchers connected with the Water Institute already study a panoply of issues. With the support of institute money and the research grants it can help draw, each has ideas for broadening their investigations to reach more people. But they admit that the range of issues the institute faces is overwhelming, and not exactly overlapping. For example, while some engineers, public health researchers, and other scientists are investigating how nanoparticles, remnants of pharmaceutical drugs, endocrine-disrupting chemicals (such as bisphenol A), and other micropollutants affect water quality in the United States, people in developing nations are, as usual, suffering more from large, ongoing water-related problems than the rest of the world. "We're looking for parts per billion of nanotubes while there are hundreds of millions of people who have no water to drink," says Ball.

The numbers are indeed confounding: Worldwide, one in three people lacks access to basic sanitation, of which water is a major component. Some world health groups contend that as many as 5,000 children die daily from intestinal diseases, including cholera and dysentery, because of it. Other deadly disorders with a connection to unsafe water, such as dengue and malaria, take a huge toll as well. Experts say that delivering clean water to people on one end, and then finding ways to sanitize water once it has been used, will dampen the effects of such developing-world diseases, as will better management of irrigation systems.

Close to half of all people in developing countries suffer at any given time from a health problem caused by a lack of water or sanitation. At an international water summit held last October in Hungary, Ban Ki-Moon, the United Nations secretary general, named water sanitation as one of three areas critical to sustainable global development.

Meanwhile, one in six people in poorer nations—more than 1 billion total—lacks access to clean drinking water. It takes others, mostly women or children, one to four hours on average to trek for water each day in many regions of Asia and Africa. During many human disasters, refugee camps are often placed far from water, forcing migrants and other displaced people to traverse long distances or beg for it.

The institute's reach—from the smallest microparticles to the ongoing macrodisaster surrounding human water needs—is ambitious. But there are signs that the institute might be originating at the right place and at the right time, Ball and others say. For one thing, the supply of safe drinking water has been made available to more people in the last 20 years, an indication that new technologies and programs can make a dent in the world's water inequities. For another, global groups, including the World Health Organization, are making water and sanitation top health priorities as the risks of climate change and breakneck development bring the problems of water purity and scarcity into higher relief.

What's more, science has already done a fair bit of "leapfrogging" regarding water, especially in the last 100 years or so. Prior to that, clean water and sanitation were part of an uneasy dialectic. From the Romans up till 1850, societies merely worried about delivering enough water via aqueducts and pipe systems. Often, as was the case in Baltimore, once the nation's typhoid capital, drinking water supplies shared space with de facto sewers, breeding disease.

Once germ theory was discovered, water system leaders tried to keep potable water entirely separate from wastewater. Johns Hopkins scientists and others found ways to eliminate the germs in drinking water, perhaps one reason why mortality rates in the United States fell by 40 percent from 1900 to 1940. For the past century, developed nations have made it a priority to treat wastewater as well, building sewage plants and devising new methods for sending effluent to waterways without polluting them.

Abel Wolman, A&S 1913, Engr 1915, pioneered a standardized system for water chlorination in Baltimore nearly 100 years ago, a process that has been emulated in several other cities. His son, M. Gordon "Reds" Wolman, A&S '49, a longtime Johns Hopkins engineering professor, was an expert on water flow, creating the Wolman Pebble Count, a method for determining how sedimentation in waterways can influence currents and flooding. (Leaders of the Water Institute originally considered calling it "The Wolman Initiative" but eventually dropped the idea.)

During the middle of the last century, engineering professors and students at Johns Hopkins conducted the first quantitative, longitudinal study of the Chesapeake Bay. And the university's immersion in water has been augmented by connections the Bloomberg School has maintained for decades in poor regions worldwide wracked by disease and drought. Such links, Schwab and others hope, will continue to bolster the institute's ability to work in many water-stressed parts of the world. "We are at a critical point with water," says Ball. "A lot of our success will be measured by how well we learn to reuse it."

The future of water won't look anything like the cheap and plentiful era we've enjoyed for the past century. The pressures of a booming global population and a changing environment will force us to be more ingenious. The new Johns Hopkins initiative has stirred some hope among researchers that there will be more opportunities for them to get there. Institute-affiliated scientists are gearing up investigations to learn how a changing environment will skew age-old patterns of rainfall and evaporation. Some, like Ball, have written grant proposals to study how farmers react to climate change. Because farmers typically adapt very quickly to climatic or economic forces, they could serve as a bellwether for how people behave in a new, warmer world.

Other researchers are already working to learn how much water each part of the world holds and then projecting whether it will have enough to sustain future populations.

Benjamin Zaitchik, an assistant professor of earth and planetary sciences, scours and compiles the best information on the ongoing water challenges of the Nile region, where most of the river's water originates in the highlands of Ethiopia. That country has never developed its water resources— until now. Ethiopia is building a hydroelectric dam slated to open in 2017. It will be massive and transformative enough that it will immediately account for 7 percent of that country's gross domestic product. Perhaps more importantly, the lake that the project will create will hold much more of the water seeping down from the highlands into the Blue Nile, water that may be in dispute because of treaties Egypt and Sudan have maintained for decades regarding the flow of the Nile. Such a scenario involves a thicket's worth of environmental, health, and political thorns—ones that the institute's leaders hope it can one day encompass. For now, Zaitchik is content to determine how "climate resilient" the region, which is home to more than 400 million people, will be in the coming decades. Water availability is key.

The countries of the region won't readily share information, and few weather stations monitor the highlands. So, Zaitchik mines satellite data to estimate how much water is evaporating from irrigated fields and reservoirs, how much groundwater the region may hold, and how quickly water sources may be winding down.

"It's incredibly complex terrain," Zaitchik says. "There's a remarkable amount of variability. We've looked at data from the past 30 years, and then compared it with models from the Intergovernmental Panel on Climate Change." The goal, he says, is to help Nile nations plan for a variety of scenarios—each of which brings its own water resource challenges. The one found in the largest number of models involves a few wet decades, followed by an inevitable aridness. "After 2050, rainfall will decrease and we'll see it become hotter there, which will mean more evaporation," says Zaitchik. Besides aiding Zaitchik in making such crucial projections, the Water Institute will aim to link together other Johns Hopkins scientists working to improve Ethiopia's water quality, just one of many signs that the institute can develop some meaningful synergies, Zaitchik says. Already, it has connected him to David Sack, a professor of epidemiology and infectious disease at the Bloomberg School, whom Zaitchik calls "a living legend in the world of cholera."

The two have started work on a project to create a system that can predict where cholera will mostly likely strike, even before a first case is identified. "The institute will be great for helping us run workshops here, educate people around the world about water issues, and for us to do more research," says Zaitchik. "It's coming together at an important time."

Other researchers say the institute can help them in more prosaic, though no less important, ways. Maria Elena Figueroa, SPH '97 (PhD), hopes that the institute can support research like hers to deepen understanding of human behavior in order to help people in far-flung areas affected by a lack of water and unsafe sanitary conditions. Figueroa, director of research and evaluation for the Bloomberg School's Center for Communication Programs, has spent years working in Guatemala, India, Nicaragua, Pakistan, and elsewhere to achieve what has become one of the institute's overarching goals: changing how humans act when dealing with water issues. CCP has researched how best to improve water, hygiene, and sanitation programs in developing nations, and how to make those programs sustainable at the local level. "A key goal of our research is to find out how people think and feel about water," Figueroa says. "Do they think water treatment is a good idea? Do they have some misconceptions or concerns about water treatment methods that need to be dealt with?"

In Indonesia, for example, most people boil their water for drinking, as they have done for generations. That includes areas where the national government provides chlorinated water. Boiling it eliminates chlorine that protects the water from pathogens—a problem when people then don't store it safely. Much of it can become infected.

"We had to get the word out to people, to explain to them that boiling isn't the only way to make water safe," Figueroa says. "We also worked to increase their understanding of how water can get recontaminated," often from a lack of soap for hand-washing, as well as open defecation. "Our work influenced the development of a new water policy in Indonesia," she adds.

The institute will afford the center more opportunities for social and behavioral research in developing nations, where a lack of sanitation continues to place a burden on too many people in needy areas, she adds. "You have to reach into the spaces where people and water come together. As the institute grows, we'll be able to make stronger connections between behavior and technology, and work with communities and offer them more solutions that fit their contexts and needs."

Others at the university say that some solutions should start as early as possible—even as soon as the day each human is born, especially in the thousands of small villages worldwide where an infant's first sip, often given as part of a ritual to connect the child to its place in the world, is of contaminated water.

Lori Edwards, SPH '89, '12 (DrPH), an instructor in the School of Nursing, says that years of working in Central America and Haiti have taught her how crucial water is. "Being in places where clean water is limited was an epiphany for me," she says. "Seeing what dehydration in children looks like in remote areas of Guatemala or isolated mountain villages in Mexico was a shocker."

The Water Institute will, Edwards hopes, bring together the right people at Johns Hopkins to make her dream of a project, which she calls Baby's First Sip, come to life. The idea came from Peace Corps nursing students Edwards has taught and worked with at the School of Nursing. "They know intimately well the challenges of clean water and sanitation and are thirsty for more knowledge about them," she says. Edwards would like to develop a baby bottle with a filter—something that could be disseminated in places where sanitation and changing community behavior are ongoing challenges. With millions of people dying annually from water-related diseases, most of them children, a bottle that successfully weeds out microbes could have a profound impact in developing countries, Edwards says.

"The idea is great, but we don't have the money or bioengineering know-how yet to get it done," she adds. "We need to bring in engineers and others from Hopkins and elsewhere to put together technology that could work in the field. We'd also have to work closely with the local culture to create a system people will adopt."

Such a device, she says, would make sure that babies in even the most remote, poverty-stricken areas have safe water—water that is good from the first drop.

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