1. Southern Lagoon and Village of Gales Point, Belize, CA: Water uses, water quality, and potential health impacts Rasmi Nair, MBBS and Ritchie D. Taylor, PhD Abstract An International Health Service Learning Program, Impact Belize 2010, was conducted by Western Kentucky University. Faculty and students worked closely with Gales Point villagers to gain an insight into the use of Southern Lagoon. The objective of the study was to assess fecal coliform levels in Southern lagoon, its primary and secondary contact use by villagers and its potential impact on health. Study methodology involved collection of water samples, both near shore and offshore, in the lagoon and incubating them using ColiQuant EZ method approved by EPA. A questionnaire was administered to villagers attending the WKU clinic to collect data regarding the use of the lagoon and associated health problems. The range of fecal coliform levels near shore was 5501 – 6284 (95% CI) Colony Forming Units (CFU)/100 ml of water and offshore was 566 – 1065 (95% CI) CFU/100 ml of surface water. Secondly, 74% of the respondents stated that they use the lagoon, of which 56%, 10% and 33% of the people used it for primary, secondary or both purposes respectively. Results indicated that 77% of the participants reported having health problems, including respiratory illnesses or skin, eye and ear problems. Preliminary data demonstrates that contamination of the lagoon may affect the health of Gales Point villagers. Introduction Objectives Evaluate water quality in the Southern Lagoon near Gales Point. Assess the primary and secondary contact use of the lagoon. Survey potential health impacts of villagers due to use of contaminated water in the Southern Lagoon. Gales Point, also known as Gales Point Manatee, is a remote coastal village in Belize. It is situated at the farthest point south in the Southern Lagoon, within the Belize District, surrounded by a 10,000 acre wildlife conservation sanctuary. With a population of 450 people, the village has 65 households. More than 80% of the people have completed elementary school and the major occupation reported in the village was subsistence fishing. It has been observed that water in the Southern lagoon is used for swimming, fishing, and waste disposal by the villagers. However, there is no quantitative data regarding the use and water quality. Previous research has indicated the probable impact of human waste disposal in the lagoon. As stated by Priest (2000), “Until quite recently, most residents used outhouses, which emptied directly into the surrounding waters”. This study hypothesized that water in the Southern Lagoon was contaminated due to human waste disposal from outhouses and poses a threat to human health. Survey Methods A survey of Southern Lagoon water use by Gales Point villagers was completed to determine primary and secondary uses. The survey was conducted among villagers that attended the WKU Health Clinic at the Gales Point Community center. Survey components followed required HSRB protocols and were approved through HSRB review. Questions in the survey were developed in English, assuming that at least one member in the family could read English. Public Health students in the Impact Belize program administered the survey to villagers. Questions in the survey pertained to use of Southern Lagoon water, human waste disposal, and health problems experienced by villagers. Data collected through the survey were tabulated and descriptive statistics were performed using SPSS software. References 1) Mallin, M. A., Williams, K. E., Esham, E. C. & Lowe, R.P. (2000). Effect on Human Development on Bacteriological Water quality in Coastal Watersheds. Ecological Applications, 10(4), p. 1047–1056. 2) Priest, S. H. (1992). Communication impact: designing research that matters. U.K &Littlefield Publishers, Inc. 3) World Health Organization. Guidelines for safe recreational waters. Volume 1. Chapter 4. www.who.int/water_sanitation_health/bathing/srwe1-chap4.pdf. Conclusions Water quality methods consisted of quantification of fecal coliform and E. coli levels in the Southern lagoon. Sampling was done for the presence of fecal coliform and E. coli with the use of the ColiQuant EZ method (LaMotte Company). The method involved the inoculation of Coliscan Easygel ® with an aliquot of water collected from each site (Figure 1). Water quality sampling in the Southern Lagoon was done in a near shore versus off shore pattern. A baseline was established from the tip of the peninsula and extending to points located via GPS at a distance of 0.5 mile intervals from the tip. Sampling sites were located using the baseline points. A grab sample of water was then collected at sites near the shore and the approximated 0.1 mile offshore determined via GPS. Water quality sampling was done in this manner to evaluate the gradient of fecal contamination that should be present near waste disposal facilities (outhouses). All samples were incubated at room temperature. The samples were analyzed for fecal coliform and E. coli colonies after 48 hours. Water Quality Methods Gales Point, Belize Belize A Path for the Future Develop and implement responsibilities of WKU, Gales Point and the Belize Ministry of Health Public Health Leadership and Systems Thinking Met with Central District, Ministry of Health, developed initial strategy Developing an agreement of cooperation Provided workshop at Gales Point for Ministry of Health Providing reports to Ministry and continued contact Provided a $100 solution that hosted a meeting with Gales Point Community and Belize Ministry of Health Developing waste disposal strategies Results The mean E. coli levels in the Southern lagoon near shore and offshore from the Gales Point peninsula were 5,892 CFU/100 ml of water (5,501 to 6,284, 95% CI) and 815 CFU/100 ml of water (566 to 1065, 95% CI), respectively. Also, the mean total coliform levels at the shore and away from the shore were 16,960 CFU/100 ml of water (16,048 to 17,872, 95% CI) and 2,815 CFU/100 ml of water (2,039 to 3,591, 95% CI) respectively. All the above values were greater than the fecal coliform primary contact standard of 200 CFU/100 ml of surface water. Survey data revealed that a majority of Gales Point households used the water in the Southern Lagoon (74%). Among the households, 57% indicated primary contact (swimming, bathing and cleaning), 11% secondary contact (fishing) and 33% of households surveyed indicated both. Of the Villagers interviewed, 77% admitted to having health problems of some kind. Data for respondents using the Southern lagoon showed that 79% specified having health problems. The most frequently reported health issues included breathing ailments, and ear and eye problems. Mean E. coli levels in the Southern Lagoon (CFU/100 ml of surface water) Type of use of the Southern Lagoon Mean E. coli levels for near and offshore sampling sites indicated a gradient that was associated with the location of outhouses, direct discharges of human waste to the lagoon. Mean E.coli levels near shore exceeded primary and secondary contact criteria for surface waters of the United Sates. Levels of E. coli measured away from the shore exceeded secondary contact criteria. Results for pathogens in the lagoon water surrounding Gales Point indicated that human waste disposal is inadequate to protect public health and water quality. A waste management strategy needs to be developed with the Belize Ministry of Health that eliminates direct discharges of human waste to the lagoon. Analysis of Water Quality Samples