Many fundraising appeals for water charities are very compelling. For example:

However, after investigating this cause, we believe that building wells is likely to fail to reduce water-related illness, and that there are better options for donors looking to change lives.

Why wells may not work

Diarrhea is caused by bacteria, which can be passed through water, but can also be transmitted through hand to hand contact, by flies, or through food.4

In the best case scenario, clean water addresses only one of the many ways diarrhea could be contracted.

But water infrastructure projects may fail even to provide clean water. Wells can break down if not maintained; a recent World Bank survey found that more than one third of rural water infrastructure in South Asia wasn't functional.5

Second, even if water is clean while it's in the well, it can become contaminated before an individual eventually drinks it.

Evaluations of the success of water quality programs at reducing diarrhea deaths have confirmed the existence of these problems, presenting a history of unsuccessful projects. (For details, see our full report on water programs.)

What programs should you support?

1. If you're committed to reducing water-borne illness, you should consider programs such as point-of-use water purification (i.e., purifying water immediately before drinking it) and hygiene education. Though we have not completed formal writeups on these interventions, sources including the Copenhagen Consensus6 imply that they can be more cost-effective than focusing on water infrastructure.

2. If you just want to help people as much as possible, we recommend our top-rated charities.
3. Finally, if you're committed specifically to providing clean water, we recommend that you contact charities and ask them:
   • What was the community's access to water like before the water improvement in terms of distance and cleanliness?
   • How do you ensure that the wells you construct remain operational over the long term? Can I see the reports that come from your process?
   • Do you address other sources of waterborne disease? Do you track the impact of your programs on disease incidence and prevalence over time and can you share technical reports on this impact?

   Of the 13 water-related charities whose websites we reviewed, we only found one -- Water.org (website) -- that published reports assessing the condition of its wells over time.7

Full list of water charities we considered

The table below shows the 13 water-related charities whose websites we have reviewed. Most of them focus on providing infrastructure improvements, such as wells.

For each, we checked whether they published reports on their website that monitored the long term condition and utilization of wells they had built.8

Sources

• Water.org. Impact evaluation of urban and rural water and sanitation projects, Bangladesh (PDF).
• Water.org. Water Partners International community water systems sustainability evaluation, Lempira, Honduras (PDF).

1. 1.

   http://www.givewell.net/international/diseases#Diarrhea

2. 2.

   See our full report on water infrastructure programs at http://www.givewell.org/international/technical/programs/water-infrastru...

3. 3.

   Water for People. 2010. Water Crisis & Solutions. http://www.waterforpeople.org/extras/crisis/water-crisis-and-solutions.h... (accessed May 7, 2010). Screenshot available at http://www.givewell.net/files/ExternalWebsites/WaterForPeople/watercrisi....

4. 4.

   Image source: UNICEF. 2010. Keep it clean! http://www.unicef.org/voy/explore/wes/explore_1929.html (accessed May 7, 2010). Screenshot available at http://www.givewell.net/files/ExternalWebsites/Unicef/diarrheadiagram.pn....

5. 5.

   http://www.givewell.net/node/377#Whydontwatersupplyprogramswork

6. 6.

   Whittington, Dale, et al. 2008. Copenhagen Consensus 2008 Challenge Paper: Sanitation and Water (PDF).

7. 7.

   Note that Water.org was formerly known as Water Partners International.

   1. Water.org, "Impact Evaluation of Urban and Rural Water and Sanitation Projects, Bangladesh."
   2. Water.org, "Water Partners International Community Water Systems Sustainability Evaluation, Lempira, Honduras."

8. 8.

   Note that we checked these websites during the Spring of 2009 and this table is up-to-date as of that time.

9. 9.
   • Water.org, "Impact Evaluation of Urban and Rural Water and Sanitation Projects, Bangladesh."
   • Water.org, "Water Partners International Community Water Systems Sustainability Evaluation, Lempira, Honduras."