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Diarrheal illness is a major contributor to the mortality of children under the age of five worldwide, as well as a significant burden on adult health and productivity in developing countries. Improvements in water, sanitation and hygiene (WASH) practices and infrastructure are important for decreasing the burden of infectious diseases, including diarrheal illness. The purpose of this study was to measure WASH knowledge and practices in a particularly vulnerable batey—a rural settlement of Haitian migrant workers along the Dominican-Haitian border—and to determine whether a WASH-based participatory health and hygiene education (PHHE) program would be beneficial to the community. A cross-sectional household survey of 88 homes out of an estimated 200 in Batey Altagracia was conducted to measure perceptions, knowledge and practice of WASH principles. Composite knowledge scores were calculated and analyzed for associations with demographics, social factors and WASH practices. Overall, participants demonstrated low knowledge of WASH principles. In particular, respondents lacked knowledge regarding parasitic worm prevention, skin disease prevention, protected water sources and how to make a homemade oral rehydration solution. Though water treatment and handling practices in the community were generally good, insufficient hygiene and sanitation may contribute to an increased risk of infectious disease transmission in an already economically and socially disadvantaged community. From our findings, we concluded that a PHHE program would be beneficial to improving WASH practices in the community and disrupting the cycle of poverty and disease.