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Water Quality in Roma Populations

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Dear Friends, 

Before I get into details, allow me to tell you a bit about myself. I am a 33 year old Master of Public Health student at Virginia Tech University in Blacksburg, VA. I've recently returned to school after a six year hiatus, during which I used my PhD in immunology to conduct laboratory research in hopes of benefiting those with traumatic injury or severe infection. Dissatisfied with the pace of bench to bedside, I've embarked on a new path in public health. I hope to bring my scientific understanding of infectious disease and immunology to bear on my new field to increase the rate in which ideas that may be of benefit to thousands or millions of people make it to market for public use. 
During my first semester at Virginia Tech, I began taking classes for global development. During this time, I focused my class research in the area of my family's origins, Eastern Europe. As classes continued and interest grew, I began to develop an initiative that would take me beyond my coursework and into the field.  My research focused on the health disparities that exist for Roma (you may know them as Gypsies) populations across Europe. I now hope to take my learning outside of the university setting and to fulfill my required practicum through the implementation of this initiative, the details of which are below. Please know that any monies collected for this endeavor will NOT be used for 'salary', but rather for room, board, and necessary resources while in the host country. As my budget was constructed with current exchange rates and travel pricing, it is subject to change slightly. If money remains, it will be donated to the organization (non-profit) with whom I partner or, if requested at the outset, returned to the donor. Please know this initiative is a labor of passion and the result of a need to be of real use in the world. I hope you will join me in bringing basic necessities to some of the world's most marginalized peoples. 

World Water Day gives additional info and a great overview here.

Clean Water Access in Roma Populations

Background: The Roma people in Eastern Europe disproportionately face substandard living conditions and unreliable housing. This leads to extreme difficulties maintaining access to clean water and, as such, the Roma face illness from water-borne disease at much higher rates than non-Roma throughout Europe. In collaboration with Drs. Ralph Hall and Stephen Eubank at Virginia Tech University, I have developed a targeted project to address the issue of clean water access and sanitation. Dr. Hall has extensive experience in multiple use water systems throughout the globe and has generously shared a validated survey used previously in other countries to determine the level of need and satisfaction in target communities in regard to water access, cleanliness, and disease prevention. Dr. Eubank is a computer modeling expert and has developed a program that allows researchers to model the effects of a given public health intervention on a target population or region. I am an experienced research scientist with a background in immunology, with an emphasis on infectious diseases and immunology, currently pursuing a Masters in Public Health degree and certificate in global planning and international development at Virginia Tech.
I am interested in conducting a survey within the Roma population, based on Dr. Hall’s validated survey in conjunction with a World Health Organization (WHO) survey, in order to address the connection between clean water and the spread of communicable diseases in Roma settlements and camps. A great deal of research exists in the literature about these two concepts independently, but very little has been done in terms of combining the two and identifying the connection. In addition to demographic, educational, and housing information, my survey covers a range of topics related to clean water access, including perceived need, satisfaction, belief in government support, and questions addressing illness and the spread of disease. Following the survey data collection, Dr. Eubanks’ modeling system will allow us to leverage the data from the survey questions to evaluate the cost/benefit and cost/effectiveness of any proposed intervention to address the cross-over issues of water, sanitation, and the spread of disease. These data and subsequent analysis can then be utilized by ERTF, ERRC, or other collaborators to inform public policy, aid advocacy initiatives, and enhance the published literature.
In addition, the Roma people have often been left out of research initiatives and advocacy that targets them. My survey is unique in that it will address the level of satisfaction that the Roma have with their current circumstances. Further, we will engage the principles of community-based participatory research and identify leaders within the Roma community to assist with our data collection, analysis and review of our conclusions to ensure any interventions developed are addressing the needs of the Roma rather than our interpretation of those needs. These individuals will be invited to participate in focus groups and one-on-one interviews to offer their thoughts and ideas regarding how best to implement any interventions that result from this work.

Method: This study has been designed for conduct over the course of a four to six-week period in the summer of 2016 in the communes of Vâlcele, Covasna and Slobozia, Bradului, Romania. Each commune in Romania has been selected for the presence of a large Roma community. Five villages will be chosen at random, and fifty participants (25 Roma and 25 non-Roma) in or near each village will be invited to complete the survey, in either English, French, Romanian, or Romani, for a total of 250 participants.  The survey consists of approximately 30 questions, including demographic information, and should take no more than 25-30 minutes to complete. Once the surveys are administered, the data will be analyzed for differences in water quality, water access, expectation of sanitation services, satisfaction with existing services, rate of communicable diseases in the populations, understanding of communicable diseases, and healthcare access between Roma and non-Roma participants.
More importantly, the information collected from the surveys will be entered into the computer modeling system in the Eubank lab at Virginia Tech in the US and a variety of potential interventions will be tested within the model to determine how effective each might be alone or in concert with other programs in improving any of the aforementioned variables. These interventions include, but are not limited to, access to a community well, improvements in indoor plumbing, educational initiatives regarding hand washing and water treatment, and the establishment of additional primary care facilities in the area.

Outcome: The modeling system will allow us to identify the interventions that may be most useful in improving the circumstances in the targeted villages, and it can be readily updated as circumstances and populations change or progress. This study should be considered a pilot to determine whether the modeling system can accurately identify the best course of action regarding clean water access and inhibition of communicable disease through a population. If successful, a more widespread study should be conducted to ensure the statistical power of the conclusions. Furthermore, our results will be used by our partner organizations to advocate for the implementation of the interventions we identify as most beneficial.

Room, Board, Travel (6 weeks) ……... …….......…$3000
Translator Services and Participatory Incentives…............................................................................$3350
 Miscellaneous and Emergency funds…...………$1500



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Rebecca Powell Doherty
Blacksburg, VA

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