Gastroenteritis; F-Diagram; Transmission; Barriers; Pathogens


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Water borne diseases in the Marshall Islands contribute to one of the heavy burdens on the government’s medical expenses for hospitals in the country. These diseases are preventable. Expenses are therefore unnecessary as these can be eliminated or reduced dramatically if proper education and awareness is done regarding water and sanitation issues. These are common issues that government in developing and poor countries take for granted. Little is provided and supported in terms of finance, infrastructure and political commitment.

Gastroenteritis is listed as the highest recorded cases among all other water borne related diseases such as typhoid, amebiasis, giardiasis and diarrhea. The Majuro hospital recorded almost two thousand (1770) cases in 2004 and gradually decline to lower rates about 200 cases recorded in 2012. The trend increases again in 2013 and drop to about 200 cases in 2015.

This study will try to address and promote a proactive and probably the most effective learning tool to teach about water, sanitation and hygiene. These issues are not at all reflected in any school or awareness campaign systems especially with regards to sanitation and hygiene issues. If this tool is incorporated into the schools and community health education systems, the impacts will be better health for children and people in communities and little expense on medical bills. This is called the “F-Diagram.”

The F-Diagram is a very simple tool to use and educate people. “F” represents key words like feces, flies, field and fluids. It is a visual and easy diagram to follow the arrows from the source of contamination (the pathogen) to the next person.