The fact that all life depends on water makes it one of the most vital substances on our planet, with populations across the world organizing ways to access the water they need to survive. At the same time, flood, drought, and contamination mark several ways that water can also pose a threat to life. Human activity -- such as mismanagement, travel, pollution, conflict, and widening social disparities -- can also contribute to water's potential danger, including the spread of deadly waterborne diseases. Sudden or otherwise dramatic disruptions in drinking-water quality expose important ways that humans value such an invaluable resource. To develop programs, policies, and infrastructure that ensure all Americans access to safe water, it is critical to understand not only the interacting human and environmental factors that lead to drinking-water contamination, but also the ways that individuals and societies adjust to water crises.<br/><br/>The new presence of cholera in Haiti provides an exemplary case through which to study the dynamic relationship between humans and water. Cholera is a waterborne disease that causes profuse diarrhea and possible death from rapid fluid loss. The investigators, who started traveling to Haiti in 2008, have been researching the cholera epidemic there since it began in 2010, nine months after the earthquake. The investigators' extensive understanding of the local context, robust network of contacts, and previous data with which to make comparisons will foster the successful implementation and impact of forthcoming research. The research will be conducted in the coastal city and surrounding rural areas of Saint-Marc, Haiti, near the mouth of the Artibonite River, which was contaminated with cholera bacteria in October 2010, sparking one of the largest cholera epidemics in recent history. Though preventable by drinking clean water and treatable with timely rehydration, and despite significant national and international investment in relief efforts, many Haitians remain vulnerable to infection. With the disease now endemic, the presence of cholera has likely prompted substantial changes in the political economy, management, and consumption of water in Haiti. Investigators will assess the extent to which drinking-water for many Haitians has gone from a trusted common resource to a market commodity, industrialized product, or privately administered good. They will also evaluate whether these changes, driven by local and international actors, are resulting in improved access to safe water, particularly among the poor. Based in Saint-Marc, investigators will conduct interviews, archival, and participant-based research, observe and participate in everyday life, shadow clinicians, water engineers, and water entrepreneurs, and collect quantitative data about water quality and household water use. Research findings about the ways disease, the environment, and human society influence one another will illuminate factors that promote, perpetuate, or protect against water insecurity, poverty, and illness.<br/><br/>This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.