1. To extend previous research and models of water resources in the study locations, by considering the effects of a) ranges of predictions of climate change, and b) development and demographic changes; on surface water supply and groundwater quality. 2. To evaluate how climate change, by shifting reliance on different sources of water, could affect the long-term health impacts of exposure of rural communities to central Rift Valley groundwater with elevated levels of fluoride, arsenic, and other toxic naturally occurring contaminants. 3. To assess how climate change could alter local reliance on surface water sources for drinking water, and to examine the relationship between the prevalence of water-borne diseases and short-term or seasonal fluctuations in precipitation and water availability. 4. To evaluate household, community, and regional resilience and coping mechanisms for dealing with the health effects of inadequate water quality, and to consider the extent to which climate change could challenge existing management capacities.

Two manuscripts, one of which has been published: Rango, T.; J. Kravchenko; A. Vengosh; P. McCornick; B. Atlaw; M. Jeuland & B. Merola (2012). Groundwater quality and its health impact: an assessment of dental fluorosis in rural inhabitants of the Main Ethiopian Rift. Environment International 43: 37-47; doi:10.1016/j.envint.2012.03.002. An active collaboration on Duke's campus spanning the Medical Center, the Sanford School, DGHI, the Nicholas School and the Nicholas Institute.

May help develop policies to help people cope with poor water quality and climate variability in the Rift Valley.