By Rob Stein
Washington Post Staff Writer
Saturday, January 16, 2010; A01
Port-au-Prince, Haiti's densely populated capital, is home to more than 2 million people, each of whom, under normal circumstances, needs to drink about a gallon of clean water every day, just to survive. Basic needs such as washing and cooking add another three gallons or so per person each day.
Those numbers illustrate the stark crisis looming as international relief agencies race to blunt the next phase of the disaster in Haiti -- a shortage of clean water that threatens survivors with potentially fatal dehydration and massive outbreaks of water-borne diseases.
"Once water supply is disrupted or contaminated, this could complicate the situation," said Jon K. Andrus, deputy director of the Pan American Health Organization, an arm of the World Health Organization that is helping orchestrate the response. "Water is top on our list."
The agency has established a makeshift headquarters near the airport and opened a field office in the Dominican Republic, about 90 minutes from Port-au-Prince, to "serve as a bridge for the management of supplies and medical relief teams," Andrus said.
But clean water is perhaps the highest priority because water is more important than food for human survival.
"The human body lives a lot longer without food than without water," said Thomas Kirsch, co-director of the Center for Refugee and Disaster Response at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "Without food, we have fat stores we can cannibalize. But there is no water store."
Four gallons a day usually suffice if temperatures are moderate and there is no unusual stress. In less favorable conditions, an individual's need can be greater.
"Water is one of the basic necessities for drinking and cooking and sanitation to maintain appropriate hygiene in situations where you can have rampant infectious disease," said Kellogg J. Schwab, director of the Hopkins Center of Water and Health.
In addition to causing death from dehydration, a lack of clean water can trigger outbreaks of dysentery, cholera, typhoid fever and other illnesses.
"Diarrheal outbreaks could pose a huge problem," Andrus said.
The water purification and sanitation systems of an impoverished nation such as Haiti are typically old, poorly maintained and reliant on aging pipes and trucks for distribution. After the earthquake, the fragile system that existed was probably devastated as pipes broke, bathrooms were destroyed, pumps lost power and existing water supplies were contaminated.
"They don't have a good system in place. It has a lot of problems in the normal situation," said Luiz Galvao, PAHO's manager of sustainable development and environmental health. "Now it will be worse -- much worse."
Other nations are rushing to provide supplies. In addition to private donations of bottled water, the U.S. Agency for International Development was readying an estimated 100,000 10-liter containers for potable water.
But such efforts will have limited impact, especially given the monumental logistical obstacles of transporting large numbers of heavy water containers over wrecked roads. Each gallon of water weighs about eight pounds. "It's really hard to move around, to say the least," Schwab said.
U.N. agencies and other groups are supplying water treatment chemicals and tablets that people can use to purify small amounts of water. But experts said they are difficult to consistently use correctly and cannot provide large amounts. So rescue efforts also include sending water purification equipment
U.S. officials, for example, plan to send four major purification systems soon by ship, and six more might be brought to Haiti later from elsewhere in the world. Each can produce enough water for 10,000 people a day.
Water Missions International, a Charleston, S.C., charity that provides clean water in Haiti and 39 other countries, sent 10 water filtration systems to Port-au-Prince by plane on Friday and was rushing to assemble as many additional systems as quickly as possible.
The 1,700-pound, $25,000 systems, which can run on diesel fuel or solar power, can purify water from ponds, lakes, streams, springs, wells and other sources to produce 10 gallons of water a minute -- enough to supply up to about 5,000 people a day.
"They're kind of like small municipal water treatment plants," said Patrick Haughney, the group's director of international programs.
Although some water purification systems, including those on ships anchored offshore, could turn seawater into drinking water, such desalination systems tend to be much more complicated and expensive to run.
"If fresh water is available, it's much easier to do that," Haughney said. "We think there's an adequate available supply of fresh water."
The USS Carl Vinson arrived in Haiti on Friday with desalinization equipment able to produce about 35,000 gallons of water a day. Four additional U.S. Navy ships carrying desalinization equipment that can produce 20,000 to 22,000 gallons of water a day are expected to arrive within days.
But even after such systems are operating, many logistical challenges remain, including having enough fuel to power them, personnel to run them and then transporting the clean water long distances to those who need it.
"It's not as straightforward as dropping something off and hoping it will work," Schwab, of the Hopkins center, said.
Even carrying the water to those who need it can be difficult.
"How do people carry it?" Schwab said. "In many cases, it will be in open buckets. But that's not ideal. If someone's hands are contaminated with waste and they put their hands in the bucket, then it's contaminated all over again."
In the long term, workers will need to repair whatever water purification system was in place before the earthquake.
"We need to act very, very fast to make the treatment plant work again so we can distribute water for people in large amounts," Galvao, of PAHO, said.
Staff writer Carol Leonnig contributed to this report.