Long-Term Sustainability of Using Hemodialyzers to Inexpensively Provide Pathogen-Free Water to Remote Villages Lacking Electricity

The provision of clean water to remote communities is a major goal of both the World Health Organization and the United Nations. We report on the long-term sustainability of filter-sterilizing polluted water in remote villages in Ghana that lack electricity. Contaminated water pumped several times a week via a gasoline pump into a 1000 L elevated tank is filtered through polysulfone hemodialyzers on demand. The 3 nm fiber pore size rejects all bacteria, parasites, and viruses. Villagers flush organic matter from the dialyzers thrice daily to maintain a flow of up to 250 L/h. Having previously reported a 73% reduction in diarrheal episodes, we now address system sustainability. After passing through the hemodialyzer filters, a fecally polluted water source remains consistently free of pathogens even after the system has been in place for >1 year in most villages. Filters are easily replaced when needed. Daily cost for unlimited clean water is less than USD 2.22 per village over five years. Villagers have continued to independently fill the tank and flush the system, because they appreciate the clean water and health benefits. We demonstrate that over 2–6 years this system providing pathogen-free drinking water can be maintained independently by villagers for long-term sustainability. It does not require electricity nor disinfectants to be added to the product water and is ready for far broader application in similarly remote settings.