Dr. Joan Rose is not only the world’s leading expert on cryptosporidium, but also well known for her work in water microbiology. She’s one of the few scientists who successfully navigate the intersection of research and policy, and for her body of work, she received the prestigious Stockholm Water Prize, this year, presented at World Water Week in Stockholm. She was felicitated by the King of Sweden for her “tireless contributions to global public health; by assessing risks to human health in water and creating guidelines and tools for decision-makers and communities to improve global wellbeing.” Chhavi Sachdev caught up with her for a chat about her tremendous career.

There are still relatively few women in science and engineering, but your work straddles both realms. What led you to where you are today?

There’s a handful of scientists that are part of the engineering world – I think the engineers are always surprised I’m a microbiologist. All my degrees are in microbiology. Before getting my PhD, I worked at a wastewater plant, in a micro lab testing to see if the water was safe to discharge into the river. As I started working at full scale and when I went back to do my PhD, I started taking classes in engineering, environmental law and hydrology and I think I learned the language of engineers. In 2011, I was inducted into the National Academy of Engineering.

I think I got where I am because I served a special niche they needed at that time. In water and water quality, especially on the biological side we’d relied on certain indicators and E. coli, the workhorse of water quality. But suddenly they weren’t enough. We were having outbreaks of cryptosporidium, norovirus; we were seeing different organisms that are not spotted by the E. coli indicator. And because I was testing for those pathogens, they needed me.

Now we have standardized tests for parasites, viruses, worms but back then it was rare.

The general view of scientists, especially in academia, is that they are comfortable in their ivory tower, at most stepping out to do field research. You are involved not only in those but also in advocacy, lobbying and framing policy. How did you move into the policy realm?

I was studying viruses in drinking water originally and then got involved in wastewater reuse. Florida gets a lot of rain but it’s like many parts of India where the rain is uneven. So you have drought conditions if you don’t get rain in the rainy season, reclaimed water was important, but it needed to be safe. We started with testing for Giardia – a water borne protozoan that causes diseases; there were brand new methods for testing it in water (rather than just feces, to catch it at source).

Then all of a sudden, in the early 80s, cryptosporidium started showing up in humans.Crypto had been restricted to livestock before but it was starting to show up in AIDS patients. Initially it was thought that it was jumping from animals into humans; there had not been a documented outbreak yet so no one linked it to water. I said it’s fecal-oral, it’s got to be like Giardia so along with a veterinary scientist, an immunologist, I started looking to see if we could use the same methods to look for crypto in the water. So I went around the United States testing for water and I published my first paper – I think it’s the very first publication on crypto, actually – in 1988. I went to my first water engineers’ conference and told them I thought this was going to be a problem for the water industry and I said, “I think you’re going to have worry about it”. Then there was a large outbreak in Carrollton, GA (in 1987). We investigated that and then Milwaukee happened.

I was invited up to Milwaukee directly after the outbreak started in 1993, where the Centre for Disease Control and the local utilities were working on it. It was my first experience with such a large outbreak. In auditoriums full of people, 70% people said they’d been affected. For the average person, they can recover in about 5 days but for immuno-compromised people like AIDS patients, they couldn’t. So people were finally recognizing that they were having deaths from their tap water. In the US we’d had deaths from tap water before but not at this scale. People and the media were saying, “What do you mean, people are dying from tap water?”

Dr. Joan Rose and fangirl Chhavi Sachdev at Stockholm. Photograph: Chhavi Sachdev
Dr. Joan Rose and fangirl Chhavi Sachdev at Stockholm. Photograph: Chhavi Sachdev

I think that moving to policy and advocacy was a progression. You learn as you go. You don’t just jump from science into the policy arena, but I was interested and when there are opportunities, you take them. I’d already interacted a little bit with state agencies, I’d met them at some conferences where policy makers were talking about writing new policies around new virus data. I took a summer-long science and policy program to work with the Environmental Protection Agency through the American Association for the Advancement of Science. I learned more about that framework, the ability to take that framework and apply it to science and policy, the economics, how to decide what’s safe, how to look at engineering and public health messaging, especially in recreational waters, to reduce risk. And I could incorporate all those into my science. And then when I was in conferences with regulatory people, I could speak to them, understand their issue and bring my science to the table to create something of value together. I learned to turn my data into knowledge that could be shared and used.

I’ve heard you say over World Water Week that outbreaks are the car crashes that snag our attention, but we really need to be paying attention to the daily traffic flow. How do we do this? Where has this worked?

I first realized that looking for the pathogen itself was so much more added value in terms of knowledge and decision making during my work in the Florida Keys.

The situation there was bad. There were algal blooms, the coral reef was dying, and they knew they had poor wastewater treatment. It was an example of how, historically, we don’t think of the water cycle as a cycle. We think about it linearly, separating fresh water and wastewater management.

The Keys didn’t really have any fresh water. Fresh water pipes were laid, infrastructure was built, people moved there. Wastewater was being disposed of in cess pits, septic tanks, onsite systems, package waste water plants that weren’t doing a very good job. So with a microbal ecologist and our student teams, we set up an experiment where we were staying. We took a virus, a bacteriophage to use as an indicator to do a tracer study, and we flushed the virus down our own toilet. Then every four hours, teams went out in every direction, in the reef, in the canals and sampled, sampled, sampled. Our tests showed that within eight hours of flushing, it showed up in the canal and then it proliferated and moved around the canal system. We could plot it with the tide, we could see how far it was going out to the reef. And that demonstrated what was happening with human waste, too.

Then the news media got wind; I got in as “news of the weird.” People wanted to know if they couldn’t swim in the canals anymore and we said we wouldn’t recommend it, you’d be swimming in what was in your toilet just eight hours ago. When they understood that, there was a sort of a movement. The state of Florida had to think about building new wastewater treatment plants, upgrading septic tanks, property values. That value of that data led to more research. It was not just nutrients (from untreated waste) and E. coli, but there was also rotavirus and hepatitis A in the water and it was making people sick. That data helped in policy planning and decision making.

The other important thing, of course, is to know what you’re looking for. And you’ve been working on this. Could you tell me more about your database?

It’s called the Global Water Pathogen Project. I was chairperson of the Health-Related Water Microbiology group for about 8 years. We run labs all over the world, using new techniques, metagenomics, and people are out sampling water. I met Blanca Jimenez from UNESCO many years ago – she was doing wastewater reuse. She and I are of the same generation and we grew up using this book, Sanitation and Disease Health Aspects of Excreta and Wastewater Management, published by the World Bank in 1983, and we wanted to update it. There are viruses we didn’t know of before, fresher, newer case studies. So, Blanca and I partnered up, I reached out in my network to found dedicated editors for each chapter, and also secured funding because we wanted to use the new methods of communication, share access to our updated knowledge through the Internet, on phones and tablets. The mandate from the Food and Agriculture Organization of the United Nations (FAO) and UNESCO is to create knowledge and disseminate it globally for public access.

It’s a big project. We have to think about which organisms do we need to add? Which do we subtract? Which techniques work? What are the new technologies – such GIS, mapping, source tracking. What are the new tests? We got data from underrepresented areas in Africa and India. We’ve got case studies for massive river basins like the Ganges and the Mekong, and with that information, we could do water diagnostics and treatment in a way that would save so much money and energy than going in and randomly sampling like we had to back in the Florida Keys.

The database is consistent and verified and deep; one chapter in there has 200 references – and it’s not a literature review, it’s the best science summarized. It’s rich. It’s going to be tremendous.

As a woman in a field that is still dominated by men, what would your advice be for other women following in this career path?

In real life, find good mentors. In my first job, when I experienced some issues – sexism, unequal salaries – I met a woman in the philosophy department. And every time she’d see me, she’d ask me “How are you doing? And if you have any problems with the university, I don’t care what it is, you just call me.” And this is something I learned from her and now I do. Because you need that. When I had my problem I almost didn’t call her – because part of me was wondering, why am I having this problem? What’s wrong with me? I was partly embarrassed. But I said, “What do I do? I need your help.” She was supportive, she advised me, and she was prominent enough to talk to the provost, the president, and the matter was overturned. Now I do that. When I meet women in committees or go to conferences I tell young women to call me. Because now, I’m in the position to help someone else. I couldn’t walk in the president’s door back then, but I can now.

Join professional organizations. Be fair to everybody. Follow your own honest interest. When you need help, ask. And when you get to those positions where you can help, offer it.

Finally, when you’re not collecting water samples, teaching, or shaking hands with Swedish royalty, what do you do for fun?

I love the outdoors. I go hiking. I love to be with my family – which is scattered in Alaska, New York, California. If I’m not on vacation, I like to be planning vacations. I read books, I enjoy history and I especially love the history of cities and water. I was fascinated in India by the (Mughal) forts and how they’d built storage tanks to harvest rain water, thousands of years ago. So I’m often taking photos of drains and tanks; My family will even find and point stuff out for me to look at.

This interview has been edited for clarity and length. Read more about the Stockholm Water Prize here.