Cholera outbreaks have occurred repeatedly throughout the islands of the Federated States of Micronesia (FSM). Outbreaks occurred in Chuuk in 1983 and in Pohnpei State in April 2000. The Pohnpei outbreak resulted in 20 deaths, and over 3,000 people were infected with the disease. The rapid spread of this disease was attributed to lack of proper water and food sanitation especially in villages that are being served by small community water supply systems. There are 24 municipal water supply systems around Pohnpei that provide untreated and non-potable water to the rural communities. These small systems provide water to more than 50% of Pohnpei's population. The other islands, Yap, Chuuk, and Kosrae, have very similar situations. Since 1999 the principal investigators of this project have been exploring the use of slow sand filtration technology as a means of improving the water provided by the small community system throughout the FSM. Results indicate that it is feasible to use local materials for filter media. These studies have also determined optimum filter loading rates for the local filter media. What was needed next was to pull together the results of the pilot studies and to develop design plans, cost estimates, and operational manuals for slow sand filtration systems designed appropriately for the rural water systems of the FSM. Site visitations were made to community water supply systems in Pohnpei and Kosrae States. Information was collected on: daily water demand, the turbidity level of the source water, and possible location for installing slow sand filters. From this information, complete facility drawings for three different sizes of slow sand filters with capacities of 20, 60, and 150 gallons per minute (gpm) of flow were developed. The three sizes reflected the demands of the smallest, largest, and medium sized community water supply systems. The drawings that were developed show inflow and outflow pipes to the plant, the under drain systems beneath the filter media, and the required flow controls. The estimated cost of each plant has been included in this study. The total project costs vary from $148,525 to $307,630 for a filter with a capacity of 150 gpm depending on the types of filter media that are used. Recommendations on filter operation and maintenance also have been made.