Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 families and 42 schools in Lower Nyakach, Kenya. From February to May, 2015, adjacent districts had serious cholera outbreaks, but in Lower Nyakach, where education and the use of chlorine were nearly universal, there were no cases of cholera and steadily decreasing rates of diarrhea. A cross-sectional study was conducted to verify self-reported water treatment practices with evidence-based microbiological testing. A random sample of 377 households revealed that 95% treat their water each and every time they collect. Microbiological verification found 96% of household safe water storage vessels were low risk compared to their very high risk source water. A strong association (p < 0.001) existed between the observed decrease in diarrhea trends from health facilities in Lower Nyakach and exposure to the novel training. The strategy used by FOTO could be replicated to empower communities worldwide to identify contaminated drinking water sources and to reduce the incidence of waterborne disease.

AHEAD (Adventures in Health, Education, and Agricultural Development) is a small grass-roots non-governmental organization working in the rural Meatu, District in Northern Tanzania. The AHEAD project employs Tanzanian nurses who provide health education, child weighing and nutritional counseling, family planning, and antenatal services. AHEAD has recently developed a water quality testing initiative in order to combat unsafe water supplies using solar pasteurization. Dr. Robert Metcalf, an AHEAD volunteer offers "expertise" to Meatu through transfer of solar cooking technology. Each summer, AHEAD takes volunteers into this setting who bring with them both "altruistic" and non-altruistic reasons for volunteering, economic and social capital, and a taste of the world beyond Meatu. This thesis looks at the Summer 2001 AHEAD experience ethnographically from three perspectives: 1) as public health practice, 2) in relation to the contested domain of international "development" , and 3) situated within the larger literature of non-profit and volunteer action research. These three snapshots of AHEAD suggest a project of globalization, theorized as the flow of people, goods, and information across boundaries. / Master of Science