Trust is an important part of this process. Who is regarded as a credible source of information varies across cultures and may include medical providers, traditional healers, family members, friends, religious leaders, and political leaders. In many communities there is often the blending of folk wisdom and experience with formal education, which together provide a stronger sense of the culture. Finally, there is often a trust barrier with outsiders that needs to be overcome. As a first step, researchers need to understand the patterns of authorities—the first contact in a community. This first contact may not be the person with the greatest amount of measurable power, but it may be the person with the greatest level of influence and authority in the system. Understanding the patterns of authority can help to determine who the community gatekeepers are, so that community members may be more likely to accept interventions when promoted by people in authoritative roles.

In conclusion, successful interventions will not only recognize but also understand the local culture. Researchers should not see culture as a barrier, but rather as an opportunity to ensure the sustainability of their interventions. Recognizing the importance of water and culture and their intersection opens opportunities to begin to address the Millennium Development Goals.

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