Cholera in Haiti, Women's Saris and Occam's Razor

Thanks, "We, Beasties" for your article on cholera.

As you pointed out:

As cholera rampages through Haiti, some epidemiologists are warning that the country could face more than half a million cases over the coming year. Yet tracking and treating the disease is proving increasingly difficult as civil unrest grips the county.

While oral vaccines are an effective approach to treating such epidemics, there is another potential tool that has proven to be effective in Bangladesh. Could this approach be used in Haiti to improve health outcomes?

Flickr mckaysavage's photostream

In a pursuit of truth and striving to understand nature, scientists grapple with complex questions that often yield complicated solutions that lead to more questions. In some cases, a solution can be so simple that it may be overlooked.

Consider cholera, a scourge in developing countries, that has killed millions of people and is a major cause of death in children under the age of five. Caused by a strain of bacteria, it is typically treated with rehydration therapy and/or antibiotics. But rehydration therapy is of little use if the water is contaminated. More than one billion people worldwide do not have access to clean drinking water.

A recent study in Bangladesh shows that the common sari cloth worn by villagers can be used to filter contaminated water, resulting in a significant reduction of cholera – a striking example of “Occam’s razor” stating that the simplest solution is often the best one. Using as little as two or three layers of sari cloth can remove 99% of the disease-causing bacteria.

How does such a simple method work? The bacteria are tiny compared to the mesh size of the sari cloth and could easily pass through, but the vast majority of cholera-causing bacteria attach themselves to plankton and other larger particles that are captured by the cloth. Cholera is reduced not only in families that maintain the practice of filtering water with sari cloth, but also in their neighbors that are not filtering their water – this disease can spread rapidly.

Such an elegant solution can have far-reaching benefits since it does not rely on costly technologies and is a socially acceptable and simple practice. The women portrayed in the photograph above participate in Self Help Groups supported by micro-finance loans and organizations such as Hand in Hand. A modest amount of financial support and ingenuity can have profound impacts on local entrepreneurial and public health outcomes.

Who would have known that an approach to devastating diseases such as cholera is embedded in the same beautiful fabric that expresses tradition and cultural pride?

A version of this article was published in NJ Voices.

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Very cool. Are saris typically made of cotton, or silk, or something else? I expect the fabric's composition makes a difference to its filtering efficiency.

Also, this is not an example of Occam's razor. A simple solution means few assumptions, not simple mechanically or socially.

By TheBrummell (not verified) on 02 Dec 2010 #permalink

Expensive ones are silk; cheaper ones are cotton, though I suspect there are some very nice cotton ones out there for the Jains (who I think likely oppose boiling silkworms to harvest the silk). The fabric is a very fine mesh weave (mine, at least, is semi-see-through), so I suspect that's what's doing it.

By Mackenzie (not verified) on 02 Dec 2010 #permalink

cool. People also used to do this to combat Guinea worm when I was in the Peace Corps. btw it ain't Occam's razor that you want to describe this. That's strictly for theories and no positing extra things without evidence, it's a stretch to apply it to systems and solutions. We need another term, maybe engineers have one.

@tbell1 Yes, also used in Sales. It's the KISS principle. "Keep It Simple, Stupid".

Interesting! Like TheBrummell, I wonder how much sari cloth's composition influences the effectiveness of this technique. Would it work as well with someone's T-shirt?

Thank you for your comment. I do not believe a T-shirt would be effective, as the pore size would likely be too large. Perhaps using multiple layers for a finer mesh?