With more than 3,000 homes in rural Alaska lacking piped water systems, sanitation remains a serious challenge in many remote communities. As COVID-19 reached Alaska, residents in these unserved communities became even more vulnerable to the spread of the virus.
“Those communities that lack basic services have higher rates of skin infections, infectious diarrhea and acute respiratory infection among children and elders,” said Troy Ritter, water subject matter expert for the Centers for Disease Control and Prevention (CDC). “There is a striking difference in health outcomes between served and unserved communities.”
In coordination with CDC, the CDC Foundation approached the Alaska Native Tribal Health Consortium (ANTHC) to see how they could help. As a nonprofit agency with deep ties to Alaska Native and American Indian communities across the state, ANTHC began exploring ways to address the critical sanitation needs.
The answer was the Mini Portable Alternative Sanitation System (PASS). Comprised of a simple gravity fed 20-gallon handwashing station and ventilated toilet, the Mini PASS is an iteration of a larger PASS unit designed by ANTHC engineers and used in rural homes across the state. Smaller in size than the original PASS system, the Mini PASS was ideal for smaller homes and easier to transport to remote Alaskan communities. The newly designed unit also has a low-flow faucet that enables household members to use fresh water, rather than reusing water from a basin—a critical improvement in sanitation. Because it uses no seepage pit, which requires digging in summer months, the Mini PASS can also be installed at any time of year.
“With these CDC Foundation funds, there was flexibility, so we could use the funding to provide systems that were a bit different than what had been used in the past,” Ritter said. “We had this unique infrastructure sitting on the shelf, and we knew it worked.”
Working first with tribal regional health associations who chose the most vulnerable communities, ANTHC then coordinated with community elders to identify the residents most in need. Once the homes were identified, ANTHC staff visited the homes to make sure the units would fit, and to educate the homeowners on proper use of the system.
“The project can only be successful if the homeowner embraces the technology,” said Jacqualine Schaeffer, community development manager for ANTHC, who conducted the home visits. “If it’s too difficult, chances are that system is going to fail because we didn’t use the correct communication method.”
Though the initial target was to provide 100 Mini-PASS units in 10 selected communities, ANTHC staff looked carefully at the costs and logistics of the project and determined the target might be better lowered to 75 homes. Wanting to reach as many homes as possible with the funding available, they looked hard at solutions.
“We went to the CDC Foundation with the issue, and they asked how much we would need to hit that 100 mark,” said Charissa Williar, sanitation facilities program manager for ANTHC. “They were able to come through with additional support, so at that point we were full steam ahead.”
Through CDC Foundation funding and the generosity of a private CDC Foundation donor, ANTHC was able to install 100 Mini-PASS units within six months, and additional installs will take place in 2022. The funding also provided for the hiring of a local champion in each of the 10 communities to support the unit recipients and troubleshoot any problems that arise.
While the Mini-PASS system is still an intermediate solution, because it does not solve the bigger challenge of piped water and sewage, the unit does create a far healthier environment, a critical point in homes often crowded with extended family in unsanitary conditions, said Schaeffer.
“Imagine 10 people living under one roof without running water or any sanitation,” Schaeffer said. “They use a 5-gallon bucket for human waste, so there is a risk factor there that communities live with every day. But this system helps alleviate that risk.”
This project will serve as a model for other hard-to-reach communities. “Our work with ANTHC and CDC highlights how innovation supports the needs of communities,” said Ramot Adeboyejo, MPH, emergency response officer for the CDC Foundation. “The Mini-PASS unit is an example of one mechanism that can be scaled to serve many other communities who face unique challenges similar to the recipient families in Alaska. It has truly been an honor to work with ANTHC and CDC on this project.”
Troy Ritter, water subject matter expert, CDC
Charissa Williar, sanitation facilities program manager, ANTHC
Header photo: Jacqualine Schaeffer, community development manager, ANTHC