A key step to preventing the spread of diseases like COVID-19 or influenza is simple: washing hands. But lack of piped water in parts of rural Alaska has made that simple practice not so easy to carry out.
Now a technological innovation has boosted rural Alaskans’ ability to do that important disease-fighting task.
The Miniature Portable Alternative Sanitation System, or Mini-PASS, a portable water station that does not require connection to any piped water system, proved effective at helping people wash their hands properly, and there are signs that its use is fending off contagious diseases among children, according to a recently published study.
The Mini-PASS is a stripped-down version of the full Portable Alternative Sanitation System that was also designed by Alaska Native Tribal Health Consortium and its partners.
The full PASS units typically store 50 to 100 gallons of water, and the units include connections to septic tanks, allowing for flush toilets to take the place of “honey buckets,” the plastic-bag-lined buckets commonly used in rural Alaska areas lacking water and sewer systems. The Mini-PASS units lack those septic connections, and they typically allow for storage of 20 gallons of water. Storage tanks are placed above sinks, and used water drains into collection buckets.
The Mini-PASS units are much cheaper than full PASS systems, costing a little over $10,000 for construction and delivery, according to ANTHC. A full PASS system can cost about $50,000 per household, according to ANTHC. That sum is vastly lower than the cost of extending piped water and sanitation service, which can total $400,000 or more per household in parts of rural Alaska.
Simplicity had its virtues during the COVID-19 pandemic. At the time, there was urgency for distributing Mini-PASS units to several rural communities — places where people living in unpiped homes were hauling water, often in difficult circumstances, then using and reusing it in germ-spreading basins.
The consortium, with the help of partners, distributed hundreds of Mini-PASS units to rural households during the height of the COVID-19 pandemic. At least 350 units had been distributed as of 2021, and more have gone out since then.
“The idea was people were not going to be reusing the water, that it was free flowing, that you’d wash your hands, and then it would go into the wastewater bucket, the gray water bucket,” said Laura Eichelberger, an ANTHC research consultant and co-author of the study.
“And because the pandemic was this urgent situation of crisis, they needed to get as many of these units in as they possibly could. And so they took the idea of the PASS and just made it as simple and cheap as possible,” she said.
The recent study used interviews to measure the effectiveness of mini-PASS. In all, there were 163 interviews from 52 households.
Water use is considered an indicator of public health, and the Mini-PASS units led to an increase in water use that expanded over time, the results found. Average water use per person increased by 0.08 gallons per month in households that used the units, meaning that after a year, water use was up by 0.96 gallons a day per person, or 3.6 liters per day, the results found.
Additionally, people with Mini-PASS units reported that children 12 and under had fewer symptoms of contagious diseases.
There was a “statistically significant decrease in the reported symptoms, respiratory in particular, for households who were actively using the Mini-PASS as their primary hand- washing method, compared to those that were still using wash basins,” said Amanda Hansen, the study’s lead author and another ANTHC health researcher.
Prior to the distribution of Mini-PASS units, water use in unpiped villages in Alaska averaged only 5.7 liters per person per day, according to a 2021 study by researchers at Canada’s McGill University. That was well below the World Health Organization standard of 20 liters per person per day, according to that study.
Parts of rural Alaska continue to face daunting challenges in securing adequate water and sanitation services.
Parts of rural Alaska continue to face daunting challenges in securing adequate water and sanitation services. According to the Alaska Department of Environmental Conservation, more than 30 communities were considered “unserved” as of 2020. The category applied when less than 55% of homes are served by piped, septic and well or covered haul systems.
Still, there has been significant progress in recent years. According to the Environmental Protection Agency, the number of rural Alaskan homes without water, sewer or both has decreased by a notable 70% over the past two decades.