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Small island nations in the Pacific face water supply and sanitation problems amongst the most critical in the world. This is especially so in the Republic of Kiribati where shallow, fresh groundwater is the major source of water. It is extremely vulnerable to natural and human- induced changes. Storm surges, droughts and over-extraction cause seawater intrusion. Settlements and agricultural activities can extremely rapidly pollute the shallow groundwater. The incidence of illnesses and deaths from water-borne diseases, especially amongst children, are unacceptably large.