Women play a major role in domestic water management in areas where safe water and drainage are not available in the house. In these settings, women are typically responsible for collecting, storing, and using water and for disposing of wastewater (1,2). Most studies of women's water management and the health benefits of safe water and sanitation examine the effect of protected water sources, such as covered wells or pumps, and basic sanitation (3). However, water management may also be a health issue in large villages and periurban communities that are supplied with piped water but have inadequate sanitation or drainage facilities. For example, in Egypt's Nile Delta, tap water is available in most rural communities (although not in every house), and no absolute shortage of water exists. However, safely disposing of wastewater and toilet effluent often remains a problem; this problem is exacerbated by the high water table associated with the irrigation system.

We conducted a study on Schistosoma mansoni in two Nile Delta villages (each with a population of ≈8,000) from 1991 to 1998. During this period, villagers risked infection with S. mansoni when they came into contact with water in irrigation canals; women were especially at risk when washing laundry and utensils in the canal.