Women Expanding the Boundaries of Wastewater Monitoring

Dr. Farjana Jahan in front of her office. (Photo Courtesy of Dr. Jahan)

Familial expectations nudged her toward a different path. “My parents said the character traits required for being a scientist were not ideal for a woman,” she recalled. Dutifully, she earned her medical degree. She started her post-graduation to specialize in pediatrics.

Still, she couldn’t relinquish that childhood dream. So she added on to her degrees as an epidemiologist. Now, as a scientist at the Environmental Health and WASH group in International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), she is helping lead wastewater monitoring in Cox’s Bazar, where nearly one million displaced Myanmar Nationals live in the world’s largest refugee camp.

“We are developing this prediction model in a vulnerable area. But our goal is to have it adopted broadly and streamlined into the government system,” Jahan said.

“With climate change, we need to monitor traditional diseases that may spread in new ways and places, as well as brand new diseases that may appear.”

As part of her holistic approach to health, Jahan is simultaneously piloting climate-resilient refugee housing made of Jute, a fiber that can be spun into coarse threads, to replace poorly ventilated shelters often constructed with plastic tarpaulins. “The Jutin shelters are cooler in the summer and allow air and sunlight in,” she said.

Being the mother of two young children contributes to the fact that “I often think in a longer timeframe than some of my male colleagues,” she said. “I worry about 2100. Climate change – and the diseases it will bring – is the biggest threat facing the next generation. Prioritizing this work has to be our shared responsibility.”

“Wastewater surveillance can be a really impactful solution for those of us who live in low-resourced countries,” says Fatma Guerfali.

Guerfali grew up in Tunisia and Morocco with a passion for art and archaeology. Neither, her father persuaded her, made for a practical career choice. So she began her professional life as a biologist.

She quickly discovered that “people weren’t speaking the same language when they belonged to different fields, even different fields within science.” She also discovered the gap that often exists between scientists and policy implementers, and that can make it difficult to bring transformative work to scale.

“Wastewater surveillance used in this way is a relatively new field, and we are still learning and creating. Many of us live in places where clinical data are scarce, which makes this very important,” she said. “Covid-19 was a hard lesson, but it taught us we cannot move forward one by one. We have to empower and collaborate.”

She and her team had to figure out when to collect samples and deliver them to the lab so that public health officials could get usable results weekly on a consistent, timely, and reliable basis – something she identified as critical to make the work jump from lab to communities.

They also prioritized training lab technicians, initially partnering with six university labs – four of them historically disadvantaged institutions with equity as a goal.

Then in May 2023, with a Covid-19 routine in place, a cholera outbreak hit the country. “We pivoted, and focused on detecting that,” Street said.

Already this year, they have pivoted again, introducing a multi-pathogen panel that looks at 24 different pathogens, many of which are worsening due to climate change.

Street, who got her start studying natural resources and the environment, has demonstrated the ability to shift her focus as health gaps arise.

For women scientists, particularly mothers like herself or other caregivers, “managing the work-life balance can be challenging,” she said. “I sometimes get it right, but not always. Women in science need more mentors who understand the balance.”

Dr. Kwanrawee Joy Sirikanchana collecting water samples from the Chao Phraya River. (Photo Courtesy of Dr. Sirikanchana)

The Thai government is especially excited about implementing the research she directs at the Chulabhorn Research Institute in Bangkok in the field of antimicrobial resistance (AMR), which has been a government-endorsed strategic priority since 2017.

The World Health Organization (WHO) has called AMR one of the top global public health threats, putting many of the gains of modern medicine at risk.

WHO says misuse and overuse of antibiotics in humans, animals, and plants is a key driver of AMR, which contributes to almost 5 million deaths annually.

Focusing on government priorities is key to maintaining funding for wastewater surveillance, noted Sirikanchana, who got her undergraduate degree in her native Thailand and then post-graduate degrees in the United States.

The mother of two children, Sirikanchana said women often have less time to develop their careers because of family responsibilities. “But women bring particular experiences and viewpoints to research, as well as particular restraints and circumstances,” she said. “They should be given full support for the best outcomes.”