Water & Human Disease in Developing Countries

Good evening and welcome to this evening's meeting of the Commonwealth Club of California. I am Karen Keefer, a member of the International Relations, Member Led forum and your Chair for this evening's program "Water and Human Diseases in Developing Countries". The Club wants to extend our gratitude to the Pacific Institute which has been sponsoring the entire month of programs in the "Cool, Clear Water Series". We want to express a special thanks to The Rotary Clubs of Belmont, Menlo Park and Woodside Portola Valley for this who are partnering with us for this evening's program. As water is one of the areas of primary interests of Rotarians which now number two million worldwide and it's increasing daily. Welcome also to our listeners on the radio. We invite our audience to visit us online at www.commonwealthclub.org. Now it is my pleasure to introduce our distinguished speakers for this evening. Dr. Vincent Resh has served as professor in the Department of Environmental Science, Policy and Management at the University of California at Berkeley since 1975. He is the author of nearly 300 articles and books mainly on the ecology of rivers and water borne and vectors disease. You may have seen his latest article, "River blindness; 'curse' lifted" in this Sunday's Chronicle. His recent encyclopedia of insects was designated as the best single volume reference in science for 2003 by the Association of American Publishers. Dr. Resh currently serves as psychological advisory to the World Health Organizations, River Blindness Control Program in West Africa and to the Mekong River Commission where he oversees ecological health monitoring in Cambodia, Thailand, Vietnam and Laos. In 1995, Dr. Resh was elected a Fellow of the California Academy of Sciences and was the recipient of the University of California's distinguished teaching award. J N or Jim Boylson began his long international development career after being nominated by professors in UCLA's African Study Center to be in the first Peace Core Group sent to Ethiopia. Since then his career in Community Economic Development or CED has taken him to 65 countries on four continents. His service includes Executive Director of the National Association for Community Development, a 300,000 member Professional Association based in Washington DC and he has provided assistance to 105 native American tribes, inter tribal counsels, bands and urban organizations throughout the US, Canada and Northern Mexico. In retirement Jim has continued service as managing principal of an international CED consulting firm, ATAC or ATAC-1 which specializes in applied appropriate technology. He is also Founder and Chief Executive Officer of two groups created to promote his current interests. Pure Water Associates Limited and H2O for Africa, serving as the primary distribution agents for a new alternative water purification solution. In his spare time Jim serves as Score a small business's a small business administration supported National Volunteer Organization providing counseling and mentoring support to area small businesses. Regarding our program the control of river blindness or Onchocerciasis in West Africa is a public health and economic development success story of that continent. 30 years ago one fourth of the adults in many West African villages were blinded by this disease. Today the area contributes food for 17 million people and the disease is no longer of public health concern. However the control of many other water borne, often killer diseases still languishes. These diseases accounts for the annual deaths of a half a million infants and 40 percent of the total mortality rate in some countries. Dr. Resh will give us a background on water borne diseases and one success story while Mr. Boylson will inform us of ongoing water purification alternatives. So let's begin with Dr Resh. Dr. Resh -. Thank you, good evening. There is a theme that you are going to hear tonight that runs through both Jim's talk and mine. And that is about the partnerships that can exist between international agencies, individual countries and the control of of diseases particularly water borne diseases. Now if you were visiting West Africa thirty years ago, one of the common scenes that you would see would be a small child may be five or six leading an adult by pulling a stick along this. Child will be leading this adult to the village or to a market; but this was a classic picture of river blindness. The adult being blinded by this disease called Onchocerciasis. Now one of the things that I want to mention is when we talk about control of river blindness we are not talking about the adult that's being lead, the adult is blind, we are talking about the child, protecting the child from river blindness so this child actually can have a life devoted to agriculture, devoted to fishing, devoted to commerce, perhaps even education. So this is one of the things that we really were not talking about curing the disease in people that already have it but preventing the disease in others. Now the disease onchocerciasis or river blindness is caused by a round worm. It's a round worm that gets in to our bodies through the bite of a biting fly that's called a black fly and if any of you have ever lived in some parts of the Mid Western Counties you know how fears black flies can be. The people that live in some areas of West Africa experience about 10,000 bites a year of black flies. So this is a very, very serious disease both in terms of the annoyance and the pain and then of course of the of the ultimate blindness that results. Now when you have a disease that's vectored by a biting fly and it caused by a parasite you really have two ways you can control it. One is you control the vector; in this case the biting fly or the other is that you control the parasite. Now the biting fly itself is really fascinating, the black fly is a day time feeder. And what happens with these worms the worms during the day actually migrate from the skin up to the surface to enable them to be picked up by the biting flies where as at night they migrate and feed deeper in to the tissues. So they are increasing their chances by evolutionary selection of getting picked up by a biting fly by having this, this daily migration. The larval stages of the black flies you know they are like the the thing of the butterfly egg larvae crysalis adult; the larva stages actually live in water. They live in fast moving water such as as typically found in these West African streams that have very, very complex wet dry cycles with a monsoon type type climate. Now one of the things that I think is interesting to to realize is that the like all biting fly disease and we have now one of the biggest killers in the world in malaria where one to two million people in a good year dies from malaria, where its not too serious. If an infected person is bitten and the parasite in the case of malaria the protozoan and in the case of the of river blindness this round worm is taken in to their body and gradually it migrates to certain areas for example in Africa it tends to migrate around the pelvic bones, in South America the river blindness worm tends to cause lumps that are located on the head. And there is a gradual series of symptoms. So the initial symptoms as these that this level of worms increase in the body as you start getting this terrible itchiness and you start getting rashes and discoloration of the skin eventually to the point that you go, you go blind. We never have found a way to control the adult worms. The adult worms are about 15 inches long. But we have ways to control the larval worms and of course we concentrate on that and the control of the the larval black flies. Now one of the things that happens is that this disease is also called as African lion stare because we typically see the person with river blindness having this opaqueness of their eyes, the bluish color like you see if you ever stared at a lion, they have this color as well and typically as was said you know 30 percent of the adults in a village can be blind but actually this going to happen to young people as well because the blindness itself results from an immune response and immune response of scar tissue forming around the activity of the worms. Now, one other things that is of course happened is that there was the curse of river blindness if you were living in a village where 30 percent of the people were going blind and you expected blindness to be part of your lifecycle you migrated out of the village, you left these villages. These villages were in really the most fertile valleys of West Africa. One of the things that is interesting if you go back probably 500 years ago before the colonists and missionaries arrived that these villages actually were located about a kilometer or little over a half a mile away from the rivers and they had strict habits about going to the rivers during the daytime. Well the missionaries and the colonists arrived, they said "you know this is crazy, you are talking a chance of getting you know stump by a hippo or eaten by a lion by going down to the rivers early in the morning and late at night and you are spending all this extra time" and within a few generations these taboos that actually kept river blindness from reaching the population really disappeared. So what we see now was this abandoning of this villages cause tremendous economic problems because this was the most fertile parts of West African valleys and West Africa this time was the poorest country in the world. Well, the Sahelian region is region below the Sahara experienced a severe drought in the 60s going into the 70s a long period of drought and Robert McNamara who you remember from the secretary of defense during the Vietnam war. When he left as this post of secretary of defense he went to the World Bank as the president. One of the first things he did just as Wolfowitz he took over his press he made a tour of countries that needed development and he went to west Africa and he met a French animalologist that convinced him if you can control river blindness, you can bring west Africa up to the level of west Africa. So today in other words this would be from about 250 dollars household in come to about maybe 400 to 500 dollars a year but that you could actually bring economic development to this area. The goal was never to control the disease for public health purposes. It was to provide economic development. Now, what is interesting about this is that if you sort of think of this strategy that you use, the idea was that you basically stop the transmission of the parasite to humans by killing the black flies and you remember the most expectable stage is when they are in the water. So that you basically think of ways that you are going to break this parasite life cycle, this transmission, the parasite life cycle is actually about ten to eleven years old. It is a quite long life cycle that they live which in terms of the original models that were developed, it look like about 20 years of control of application of insecticides to these streams would be needed and in this case when we think about when this start in the early 1970s, or mid 1970s what was available DDT and other chlorinated hydrocarbons. So this is really you know a potential as you can imagine environmental disaster especially when you think that you are applying these pesticides through helicopters to vast stretches of rivers. Literally, at the height of the program we were applying insecticides to 35,000 miles of river a week, unbelievable amount of control area. Now, one of the things of course that when you do this as you have to think about the fact that you are dealing with areas that have very severe protein limitation, protein anemia and of course it is the main source of protein is the fish and when you think about the fish, you know we intent to think about large fish but it is actually the little tiny fish that are dried and cut up and mixed in a pour age that are really quite important for people's diets. And what we basically right from the beginning started to look at both the fish and the fish foods, the insects which of course are these excellent indicators of water quality that we use throughout the developing world or the developed world today. We monitored what effects that we would have and we do these by doing very very small scale laboratory studies and we would do very large scale rivers studies that really basically looked at what the effect of these pesticide applications would be on the fish communities because we don't want to cure river blindness and then at the same time reduce the protein sources of these these rivers. Well while we ended up doing what was absolutely amazing in terms of of really reducing to the point of of extremely minor impact was, we used a pesticide that's a bacterial insecticide, it's called Bacillus thuringiensis israelensis, it's the same when we used in the San Francisco bay area for controlling mosquitoes, of the use in Minnesota to control marshes very very specific on biting flies, doesn't have any other effect. But there are two things one of which is that this insecticide really only works very is very effective when there is low water levels. It's not effective during floods and the other thing is we were terrified that what if got resistance, pesticide resistance to Bacillus thuringiensis, this would have world wide implications in terms of this resistance spread because this is one of the most effective environmentally safe pesticides we have available. So what we actually did was we came up with a schedule where every week we would decide which pesticides we would use. 75 percent of the time we would use this very very safe Bacillus thuringiensis, but about four times a year we would use a very very strong insecticide that we would loose some organisms that were non target that we didn't want to control but then we would allow recovery to occur before we used these heavy insecticides again and we were managing not just to control the black flies but to make sure we didn't get resistance because if it's spread, the effects would have just been been devastating. Now the second strategy we used and this came late late this was the strategy that we could use chemotherapy. And there was a drug that was around that Merck produced called ivermectin it was a drug that if any of you were had a pet dark hard worm, this is the drug that you use and in the late 80s it was listed as being safe to use for humans to control for worms. And what ended up happening was that we used this drug and it is a microfilariasis, it just kills the larvae it doesn't kill kill the adult worms. And we decided that we should try to give a dose annually to every child that was an adult, everybody over five years old in terms of controlling this disease. The drugs were donated by Merck, they were donated for free and to this day in all of the river blindness control programs that are operating in Africa and in South South America, the drugs are given away by Merck for free. So this is really this beginning of this industry industry country internationally to seek partnership. The drugs were distributed by 22,000 volunteers these community based health workers that we had and one of the things that I think was kind of mind last lasting memory of this program is the Dutch government had given us some money to give to them as a thank you for what they were doing is not not payment but as a reward you know we approach them about you know so you know how - what form do you want this money and do you want any local currency do you want it in food, coupons or some thing equivalent. And what they wanted was soap to reduce infection and salt to add preservation. That's what they wanted and who thought that one of the major things that may be a less than I have learned from this, that's that was the things that are important, you reduce infection and you provide some preservation for your food. Now the way we did this, this was really kind of interesting you know every drug is listed based on you know the dosage per vain of course you can't correct scales around West Africa. So we came up with a way of measuring people in terms of how many drugs they should use at a certain size, we will give them one pill and another size two pills in another size three pills, and you know based on this size dosage we would decide how many they they should take. And this was extremely effective, like wise we developed a patch test that with out because initially what we have to do is was take skin snips, these were very very painful unless you are you are really good at doing this which none of us ever seem to be very good at. So you would take these dispatch, you would put it on and simply by leaving it on for a day you will be able to tell if the person had been exposed to worms and this was our way of monitoring whether in fact in a certain village or a certain area we worked in reducing the concentration of worms and we can then be able to be able to use in our models to predict what kind of control we are getting and likely to get in terms of transmission. What we just to again to to kind of summarize that, the extend of this program was enormous, probably the largest insect control program or disease control program that's been attempted since the the polio vaccine. We were spraying with insecticides 35,000 miles of rivers a week, we were using 22,000 community based distributors of ivermectin to make sure we got drugs to the people. We were distributing these drugs to all most seven million people in ten countries and today in a program that we have expanded to central and east Africa, we are in 19 countries where we have over 35000 distributors and we are hoping to reach almost a 160 million people. The reason we can do this with this less with just drugs and not with not with insecticides is because the disease has a much, much lower prevalence there and a much lower rate of blindness. It's not like it was in West Africa. Now, kind of let's look at the benefits of this. If we look at what we got out of this control program that lasted almost 30 years, I was involved for 15 years and it is that over 65,000 acres are now being resettled. There are problems with this resettlement that I will come to in a minute. Food production in this area now supports 17 million people. In other words food for 17 million people in Africa are being grown in these areas free to river blindness that were not grown before. The problem of course is what is the sustainability of this food production? One of the things that we had as a big problem is that when the resettlement occurred in these abandoned villages, the resettlement was occurring with traditional type tribal tenure. What was happening was people were moving in from these war torn areas, Sierra Leone, Guinea-Bissau, Guinea, now Ivory Coast and so there was no traditional land tenure based system. So what happened was people were taking the largest possible area they could to occupy for agriculture and there was no infrastructure, there was no soil erosion, no water conservation, nothing was done. So this was really a very, very big problem that we had and of course one of the big fears we had was increased erosion which would of course we spent all these time trying to protect the fish and then we cut down the gallery forest, allowed erosion to occur from the increased agriculture and we lose the fish from that; so this has been a very, very big concern in these follow up areas. Of how do you maintain the sustainability of agriculture? Now, I think one of the things that I would like to leave you and I am sure Jim is going to bring this up too, is when you deal in developing countries the geopolitical issues are just sometimes overwhelming. Throughout the whole time we were doing this, we had war in Sierra Leone; we had some of our people working in this program killed in Sierra Leone in the civil war. There was a major civil war in the former Portuguese colony of Guinea-Bissau. In terms of distributing we had to deal with four different health ministers in the Ivory Coast; when the Ivory Coast went unsettled during a six month period. And of course there are problem areas, there are movements of people, there are miners and fishermen that move around there. Women that live in closed societies that you know when they are 13 they enter a compound and they never leave that compound until they die. How do you get drugs into them? You can't just give them to the man were he will just 12 or 15 pills as opposed to giving them to the people in the compound. So all of these sociological problems; it wasn't just a problem of coming up with a disease control program. It was a problem of really sociology as well. One of the the kind of fascinating things as what we were trying to do now, we are still through TDR which is the Tropical Disease Research Centre of World Health Organization, we are still trying to find a drug that can work as a Macro Filarial side. In other words they would kill the adult worms. We have no backup if we get resistance to the drug that we use to kill a larva. We have no backup at all. So this is a big problem in disease resistance just like it is in pesticide resistance. One of the things that's very interesting is that following Merck SmithKline Beecham, which has changed its name I think to welcome Glaxo now; is also giving drugs away for free for the control of Lymphatic Filariasis, or Elephantiasis, a disease very much like river blindness, transmitted by mosquitoes but caused by worms. And one of the other things that we are hoping to do is we are using our distribution system of 22,000 workers in West Africa and we eventually hope 35,000 workers in the East and central Africa to use this distribution system for the to get pesticide impregnated bed nets out to release malaria. I think one of the big accomplishments that we have done in talking to the Gates Foundation; which is spending a lot of money on malaria control, is that we have convinced them you know; high tech solutions are not the only way to go, is that you have got in the mean time do low tech solutions and pesticides impregnated bed nets are really a good low tech solution in terms of the [0:24:48] ____ vaccines until we have genetically modified solutions. And of course the overall is this reduction in parasitic anemia. So you know West Africa is not a place that you hear a lot of success stories. It's one where it's been civil wars there are always about four countries at war at the entire time I was there in you know getting caught in revolutions eh I was sort of part of the the game plan that we had in mainly about how to how to get out and one of the things I want to end with is just the idea that people in that would do development work and do it aid work talk about the people that live at the end of the road. These are the world's poorest people. And I think one of the things that was marvelous about this control of river blindness because I remember was a it's a public health success but it started as an economic success is that it was devoted to people that had no voice. The people that literally were at the end of the road. So now Jim will talk to you about drinking water which of course is another big problem in developing countries. Thank you Good evening and thank you very much for taking time for your busy lives to be here this evening, great to be honored, thanks to rotary. The last time I was in Africa, east Africa just the day before I left I was invited by the combine - rotary clubs to speak to them about why I was there introducing a new non chemical, non toxic, no health side effects water purification and germicide and when I had been around the country meeting with old friends, new friends former students, I was a teacher there many years before. That was magnificent to talk to them because people in developing nations are natural skeptics and they are natural skeptics not just because it's inherent in there nature but my native American friends used to have a saying "once bitten twice shy". They have been count and used and abused by so many people particularly during the colonial years that there are really quite reluctant to get in bed quickly for particularly with new technology, new ideas from outside. Fortunately I had some standing with them, they knew that I had great interest in the country and the people that I have devoted many years in my life to helping and doing things even here I work with ex patriot Ethiopian and East Africans and their non profit organizations, one of them collects surplus medical equipments, send it over, we have opened 18 new world health centers in formally unserved un-served areas that we feel yeah while I was there in January and February, I visited some of those centers but what you have heard, heard here from doctor Resh and what rotary did in suppressing the resurgence of polio, are examples of what you can do by good organizing, by good planning, by good thinking, by determination in trying to deal with problems that seem like they are over whelming like they are monumental. Let me give you a couple of statistics all of you know you read the paper you have heard you know what water borne diseases are nasty things. A couple of figures that I would like for you to stay keep in your mind to put this whole thing in perspective is that in many - if not most parts of Africa and other parts of the developing world, 70 percent of the total population is dependent on what they call good traditional water resources, what are traditional water resources, lakes, rivers, ponds, once in a while if they are lucky an under ground spring shallow wells and now we have a lot of NGOs who are putting in rain water catchments systems which are now really part of the original tradition water systems well these just happen to be the sane watering sources that their life stalk and wild animals share with them and use as their private bathrooms, so naturally the water is full of a lot of germs we call pathogens not just bacteria but encapsulated parricides in cystic forms. And so these people will go to the sources because they have nothing else and women that are tiny little women that don't look like they would really be capable of carrying a barrel or a bag of of potatoes or something like that put these huge earthenware jugs strapped to their back, I had some pictures to show you I think somebody was unkind enough to relieve them or be of them by taking my briefcase out of my trunk last week. But the thing is that they walk for miles miles with these earthenware jugs in their back to get to one of these court traditional watering house to fill it and then walk back to their village and that is their water for depending on the size of the family a couple of days maybe a week something like that. There are now a lot of countries, a lot of NGOs are putting in water systems. What they are doing is they are creating a shallow wells and they are once in a while I visited one where they had tapped into a spring and as I said there are a lot of them are putting in rainwater catchments systems which is simply to put extra wide gutters around the roofs. The usually metal roofs over there and to catch the rain water and then have it go down through a gully into some sort of a container. Well, the other tradition of or the other statistic rather that I wanted to impress on you is that particularly in the counties I am working in now which is mostly I am starting with east Africa, eventually I will get allover Africa, 40 percent of their total mortality rate is due to water born diseases. 40 percent, nearly half of all deaths from all causes are related to water borne diseases and the first statistic out through out is one is really near and dear to my heart, 2.2 million infants and children every year die from one basic, just one of the many forms of water-borne diseases which is diarrheic dehydration. I don't know if you have ever seen a child suffering or dying from diarrheic-dehydration but it is a horrible thing to see. When you see it, and you are looking at death directly in the face in your own sense of mortality, it really shakes you to your core because that baby, that innocent infant is dying of starvation and dehydration at the same time it is a long lingering death, it's not a quick death and there is no turning back. There is no medicine, there is no recourse, it just has to go to its final end and you know what, that is the simplest of all the water-borne diseases to cure. It doesn't require a medicine, it just requires one thing-pure uncontaminated, no pathogen water. Now, we have had chlorine as the default of water purification and everybody over there that is putting in these systems that is putting any water purifier and some are not assuming falsely that the water that they get from the earth is already been purified, they are all using chlorine and you know what those infants and those little children know instinctively something that the adults don't know and that is that stuff isn't good for you and they don't drink it and they won't drink it because of the smell and the taste and some of it is very heavily chlorinated water because some of the raw water they draw from is particularly turbid. It is full of all kinds of stuff and so the parents in frustration and not knowing in not being educated, not having water health education provided to them are giving them tainted water and that is why they are getting diarrheicdehydration and that is why they are dying in large numbers. 2.2 million is the W.H.O s figure worldwide one half million in Africa alone. So those are some of the raw figures that we were dealing with and the question that I immediately raised when I got into this is wow!, we had three basic ways of purifying water dating back several hundred years ago and the 1800s they started first using chlorine in our water systems and by the early 1900s every body, every metropolitan system was on was almost chlorinated. Is the default chlorine and most of the NGOs are - already weathered to not just using but weathered to very difficult to get the meat - consider any alternative, chlorine as the default. So why after all those years of having a standard, accepted, well known purification agent like chlorine do we still have all these deaths? Do we still have all these problems? Well I have to tell you and this is not not on chlorine, was the only act in town until we heard it recently. But chlorine is now one and non carcinogen, well known and if any body has any doubts I made up a little sheet which I was hoping to hand around but I have it for reference points of all the studies that have been used showing one of them the scariest to me says that some where between 84 and 93 percent of people who drink chlorinated water on a regular basis are most likely to to develop some form of cancer in their life, to contact some form of cancer in their life that's how bad it is. The second thing about chorine that we are now discovering is it really isn't all that good as a purification agent. The way it works is is is that we put it in the water chlorine being heavier than water, a lot of it sinks to the bottom in - wells and holding tanks and the chlorine contacts a pathogen, it may kill the pathogen but it dies too so you have to constantly keep putting chlorine in that holding tank full of water and since it is heavier, it sinks down and so but pretty soon that water at the bottom of that well or that holding tank gets really really wrench. All right so that when the water gets low in the tank the person dipping down in the bottom is getting more chlorine and they are water almost and it is pretty bad stuff. The other thing is it that chlorine doesn't kill a lot of water borne pathogens, it does not kill encapsulated parasites, it does not kill cystic forms and now we are finding it doesn't even kill some forms of bacteria that are mutating or morphing and some how another, they are changing forms and they are getting by the the chlorine. Well, a lot of people are discovering that chlorine is not the be all end all that we thought it was for so many years; it's matter of fact the European Union last year passed law converting all of their central water systems away from use of chlorine and in to using silver coated filters. And a lot of people in this country are now starting to look that same way. So this brings me to what is the solution for all this. Twelve years ago, a company rediscovered one of the oldest best known most effective natural germicide and antiseptics that man has ever known. It was used by the ancient Egyptians, Greeks and Romans in their days. I am not sure that they knew why but they put their water that one going to afforded in silver pictures or put a sliver spoon in the water. Silver is the best, most natural germicide that is known of the phase of the earth, it is natural it has no toxicity that's that's contrary to healthy, it's been approved by world health organization EPA every thing like that, it is sold in health food stores as a tonic. But a group of men and by the way there is a very very interesting history of the use of silver as a health solution and up until the late 1930s that is just before world war 2 when the pharmaceutical companies started turning out artificial chemicals in large quantities they were using colloidal silver in different forms and even in the hospitals as an antiseptic and a germicide. Well some people that I know connected with found away to take colloidal silver and get it to remain in suspension and that's the only way that it can pass the test for it to be used and certified as a water purification agent. What it has to do is has to - you have to tell the testing agency how many drops is needed and they put that in water that they have added certain pathogens to and the acid test is it must kill the pathogens in that water with that dosage within 30 minutes to a rate of 99.9 percent. Well, only colloidal silver that can remain in suspension has that capacity to do that and these folks that I am associating with now have that solution and it is called Silverdine and it is a multi-purpose type of solution that is it is not only good for purifying water but if you wash fruits and vegetables in it, it kills all the amoeba and other things that made a lot of people sick here in this country that remember the spinach and the salmonella and things like that, not only that - not only does it purifies those but it extends the shelf life of fresh fruits and vegetables by three to five times. Take a few drops of it and put it in a little - squeeze it like this, I use one of these, you wake up in the morning you have a raw throat or you have been traveling you put some of these in your throat and it will all be gone. I haven't had a cold or anything like a cold since last September one I started using this and I have traveled thousands of miles in closed airlines. We went into hospitals in south East Asia and we said give us the worst cases of sours, surgical cuts or other things that don't heal and we put this solution directly on it and with in three to four days they were healing like they weren't healing with another medicine. So it has many many applications, many many uses I just finished the series testing at university of California Davis were they had sprayed this one great wines to kill a fungal form powdery mildew and it was the only solution that they had, the only spray they had that was non toxic and had no health side effects and usually what they use for to kill are chemicals, very -very toxic chemicals and the workers in the field have to breath those, so it has environmental advantages and a lots of other things. Now, the big problem that we face is how do you get one, pass the skepticism how do you get through the beaurocracies that you have to get to approve this before you can bring in the end to start distributing, how do you get people to accept and understand it. It's very simple. One drop and two liters of normal water, wait 30 minutes and you have got water ready to drink and for people who have chlorinated water, one drop this is water out of the tap now, it is golden, ordinarily this has no color, no taste, no smell to it. This is golden because there was a little spilled in here and when they had filled it up any way so you can see it. But the test for this is if you have any doubts is to fill a picture, two or three liters, full of tap water, put a drop in let it set for 20 or 30 minutes, then go over and get a cup full of that same tap water, drink that and then drink this. My son in law who is a mountain climber, tells me that this water with this drop and a chlorinated water tasted like sweet spring water out of the mountain that he climbs. So there is no reason and in fact children do not resist it, they think that they are drinking good sweet water. It has no taste and absolutely no health side effects. So if we can find a way to get this out to a network through establishing distribution networks, now it is not expensive. The first thing the NGOs ask how much is it. Okay, This is a 30ml vile, it has 600 drops in it. This is enough to purify 1200 liters of water or enough for a couple or with a small family for up to a year and we can make this available to NGOs and foundations and things for somewhere in the range of three to four dollars depending on the laid in cost. That is less than a penny a day for pure water. They put a few drops in the baby's bath and the baby will not have to worry about getting infected by water in bath some case he has any cuts or openings. If you get a bite, a burn, a scratch, an itch any kind of irritation, any kind of skin opening, you put a drop on it, my granddaughter had mosquito bites and they just put this on, it not only stopped it from any infection but it stopped the itching too. So it has a lot of different purposes and one of the things is the last thing I leave with you is even if we can make it as low as three or four dollars, somebody earning 50 cents or a dollar a day, that is three days of food, a fuel, they have to it's got to be subsidized to deliver to them. So we are going to be calling on people in this county and throughout the world foundations, aid agencies and stuff like that to help subsidize deliver this because we need to get it into the hands of those at most risk and neediest as soon as possible. Thank you very much for your attention.