UC Berkeley

In 2019, approximately 5 million children died before reaching age five, largely due to preventable or treatable causes. Water treatment could interrupt diarrheal disease transmission, and reduce child mortality, but 2 billion people still lack access to safe water at home. Both climate change and the COVID-19 pandemic may affect the ways in which infectious disease are transmitted. This dissertation examines water treatment and child health in rural Kenya and provides evidence of how climate change and the COVID-19 pandemic have affected infectious disease transmission.

Chapter 1 presents background information on the global burden of diarrheal diseases and other diseases associated with poverty, discusses evidence for water treatment as an intervention strategy, outlines the potential implications of climate change and the COVID-19 pandemic, and describes the study areas in rural western Kenya. Chapter 2 provides evidence for the effects of climate change on diarrheal disease transmission by quantifying the effects of extreme weather (heavy precipitation and high temperature) on bacteria levels in two key transmission pathways: drinking water and hands. We find that heavy precipitation and high temperature increase bacteria levels in drinking water but decreases bacteria levels on child hands. The relationship between heavy precipitation and bacteria in stored water holds only when households have not treated their water, suggesting that water treatment is an appropriate mitigation strategy and may be particularly important after periods of heavy precipitation or high temperature. Chapter 3 evaluates one such water treatment intervention at drinking water kiosks in Kisumu, Kenya. The Venturi chlorine doser can be attached to any pipe outflow. We evaluate the technical feasibility and kiosk and customer demand for the device. We find that the device reliably doses water with liquid chlorine. We also find that kiosks were willing to pay to lease or lease-to-own the device, and that customers reported buying chlorinated water. The COVID-19 pandemic has disrupted daily activities world-wide and may have affected infectious disease transmission. Chapter 4 examines the effects of the COVID-19 pandemic on child mortality and respiratory illness in the study area in rural Kenya. Finally, Chapter 5 concludes the dissertation by summarizing my research findings and discussing overarching themes.