In an emergency, water, sanitation and hygiene are all key determinants to life. People affected by an emergency often do not have access to sufficient water supply or sanitation services and, as a result, have poor hygiene practices. Lack of these three elements makes people more susceptible to illness and death. These three elements are often known collectively as the WASH (water sanitation hygiene) to denote their interdependence.
Access to water is a basic human right, essential to life and human dignity. Lack of access to sufficient and safe water is a key contributor to health problems in an emergency. All people have the right to sufficient and safe water for consumption, personal hygiene, cooking and other domestic uses. All people have the right to adequate water storage facilities such as containers to ensure that water can be stored safely (without risk of contamination) until needed. Local and international standards should be adhered to with regard to the regular testing and monitoring for quality of water from the source, transport, and central and household storage.
Access to adequate sanitation facilities in an emergency reduces the likelihood of illness within an affected population. It especially reduces the likelihood of faeco-oral diseases (such as cholera) and exposure to disease-bearing vectors which can result in large numbers of deaths in relatively short time frames. It also establishes conditions that allow people to live with dignity and comfort. Sanitation programmes in an emergency usually concentrate on four key areas: drainage, excreta disposal, vector control, and solid waste collection and disposal.
The combination of good water and sanitation programmes in an emergency will protect the health of people through the promotion of good personal and environmental hygiene. Hygiene promotion utilises the people’s existing knowledge, practices and resources supported by humanitarian organization’s knowledge and resources.
As a humanitarian worker you need to ensure all emergency WASH interventions are measurable and accountable to people affected by the emergency. Particular attention needs to be paid to the equitable participation by women and men in the planning, design and management of water facilities. Consideration also needs to be given to ‘vulnerable’ groups and their access to services and facilities. Vulnerable groups often include, but are not limited to, elderly people, children, women, disabled and people living with HIV/AIDS and other chronic illnesses such as tuberculosis. Careful reflection and consideration of these issues will contribute to ensuring all the affected population has safe and easy access to water and sanitation services.
Sphere provides the most appropriate and user-friendly checklist for assessing needs, identifying local resources and describing local conditions.
Sphere WASH checklist
- How many people are affected and where are they? Disaggregate the data as far as possible by sex, age, disability, etc.
- What are people’s likely movements? What are the security factors for the people affected and for potential relief responses?
- What are the current or threatened water- and sanitation-related diseases? What are the extent and expected evolution of problems?
- Who are the key people to consult or contact?
- Who are the vulnerable people in the population and why?
- Is there equal access for all to existing facilities?
- What special security risks exist for women and girls?
- What water and sanitation practices were the population accustomed to before the emergency?
- What is the current water source and who are the present users?
- How much water is available per person per day?
- What is the daily/weekly frequency of the water supply?
- Is the water available at the source sufficient for short-term and longer-term needs for all groups in the population?
- Are water collection points close enough to where people live? Are they safe?
- Is the current water supply reliable? How long will it last?
- Do people have enough water containers of the appropriate size and type?
- Is the water source contaminated or at risk of contamination (microbiological or chemical/radiological)?
- Is treatment necessary? Is treatment possible? What treatment is necessary?
- Is disinfection necessary, even if the supply is not contaminated?
- Are there alternative sources nearby?
- What traditional beliefs and practices relate to the collection, storage and use of water?
- Are there any obstacles to using available supplies?
- Is it possible to move the population if water sources are inadequate?
- What are the key hygiene issues related to water supply?
- Do people have the means to use water hygienically?
- What is the current defecation practice? If it is open defecation, is there a designated area? Is the area secure?
- What are current beliefs and practices, including gender-specific practices, concerning excreta disposal?
- Are there any existing facilities? If so, are they used, are they sufficient and are they operating successfully? Can they be extended or adapted?
- Is the current defecation practice a threat to water supplies (surface water or groundwater, or living areas?
- Do people wash their hands after defecation and before food preparation and eating? Are soap or other cleansing materials available?
- Are people familiar with the construction and use of toilets?
- What local materials are available for constructing toilets?
- Are people prepared to use pit latrines, defecation fields, trenches, etc.?
- Is their sufficient space for defecation fields, pit latrines, toilets, etc.?
- What is the slope of the terrain?
- What is the level of the groundwater table?
- Are soil conditions suitable for on-site excreta disposal?
- Do current excreta disposal arrangements encourage vectors?
- Are there materials or water available for anal cleansing? How do people normally dispose of these materials?
- How do women manage issues related to menstruation? Are there appropriate materials or facilities available for this?
- What are the vector-borne disease risks and how serious are these risks?
- What traditional beliefs and practices relate to vectors and vector-borne disease? Are any of these either useful or harmful?
- If vector-borne disease risks are high, do people at risk have access to individual protection?
- Is it possible to make changes to the local environment (by drainage, scrub clearance, excreta disposal, refuse disposal, etc.) to discourage vector breeding?
- Is it necessary to control vectors by chemical means? What programmes, regulations and resources exist for vector control and the use of chemicals?
- What information and safety precautions need to be provided to households?
Solid waste disposal
- Is solid waste a problem?
- How do people dispose of their waste? What type and quantity of solid waste is produced?
- Can solid waste be disposed of on-site, or does it need to be collected and disposed of off-site?
- What is the normal practice of solid waste disposal for the affected population? (compost/refuse pits? collection system? bins?)
- Are there medical facilities and activities producing waste? How is this being disposed of? Who is responsible?
- Is there a drainage problem (e.g. flooding of dwellings or toilets, vector breeding sites, polluted water contaminating living areas or water supplies)?
- Is the soil prone to waterlogging?
- Do people have the means to protect their dwellings and toilets from local flooding?