WASH Cluster – Water in Emergencies W W1 1 Water in Emergencies Session 1 Water Supply Linkages

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WASH Cluster – Water in Emergencies

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Water in Emergencies

Session 1

Water Supply Linkages

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Terminology• WASH• WATSAN• WES• Water & Habitat• Public health engineering• Public health promotion • Hygiene promotion• Environmental health

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Water Supply Linkages

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Transmission RoutesTransmission

routeInfection Prevention strategies

Water-borne Diarroheas and dysenteries (including cholera)

Hepatitis A

Improve quality of drinking water

Prevent casual use of unprotected water sources

Improve sanitation

Improve hygiene

Water-washed Infectious skin and eye diseases

Louse-borne typhus

Increased quantity of water used

Improved accessibility & reliability of supply

Improve hygiene

Water-based Schistomiasis

Guinea worm

Reduce need for contact with infected water

Control snail populations

Reduce contamination of surface waters

Water-related insect vector

Filariasis

Malaria

River blindness

Yellow fever

Improve surface water management

Reduce need to visit breeding sites

Use mosquito netting (for malaria)

Personal protection repellent

Cairncross & Feacham (1999, 2nd edn) Environmental Health Engineering in the Tropics

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0 10 20 30 40 50

% reduction in diarrhoea

Water Supply (quality& quantity)

Water Quality Source

Water QualityHousehold

Sanitation

Hand washing

Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis, Fewtrell et al

(2005)

Data leads to some controversy, partly due to the difficulty of splitting impacts of interventions. For example:

• Hand-washing is not possible without a water supply, so ‘hand-washing’ is in fact ‘water supply and hand-washing’

• Water quality at household will have involved some hygiene promotion when setting up the household water treatment processes

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% Reduction in diarrhoeal disease(Data compiled in Fewtral et al, Lancet Infect Dis 2005: 5: 42-52)

05

101520253035404550

Mul

tiple

inte

rven

tions

Wate

r & sa

nitatio

n San

itatio

n

Wate

r sup

ply (

qual

ity &

quan

tity)

Wate

r qua

ntity

Wate

r qua

lity (m

easu

red

at s

ourc

e)

Wate

r qua

lity (m

easu

red

at h

ouseh

old)

Hygien

e Han

d-was

hing

Specific WASH interventions

% r

ed

uc

tio

n in

dia

rrh

oe

al d

ise

as

e

Esrey, all studies

Esrey, rigourous studies

Curtis & Cairncross

Few trell et al meta-analysis

Data analysis is contentious

Difficult to split components

Agreement on the importance of hygiene, sanitation & hand-

washing

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Providing learning opportunities

Participation, gender& representationPublic Health

Promotion /Water & Sanitation

E.g. piped waterhand pumpswater filterschlorine tablets

Participatory education

Improve HealthPrevent Epidemics

Providing water of adequate quality

Providing adequatequantity of water

Appropriate sanitation

Ensuring adequatemaintenance of

facilities

Ensuring accessto essential items

e.g. soap, ORS, buckets

Action forchange

Ownership &responsibility

Technical capacityaccess to spare partsfinancing

Privacy &safety

Acceptable design

Advocacy

Public Health Promotion ModelPublic Health Promotion Model

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WASH Linkages

Health

Nutrition

Logistics

Shelter

Protection

Early recovery

?

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WASH Linkages

Health

Nutrition

Logistics

Shelter

Protection

Early recovery

Water is life - without water, we dehydrate & die

Hygiene is difficult without water, increasing diarrhoeal diseases

PLWHA may have increased WASH needs

Children who are malnourished are more susceptible to dying from diarrhoea

People with diarrhoea cannot absorb the food they eat and hence this contributes to malnourishment

Efficient logistics are essential for effective WASH programmes in emergencies – value your logistician!

The siting of shelter and WASH facilities need to be coordinated effectively to enable equitable use and access

Poorly sited WASH facilities, can lead to increased vulnerability and attacks on women or children including rape and can inhibit use

Women and children who have to walk long distances for water can be vulnerable to attack

Good WASH services at community level aids early recovery

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The Importance of Context• Fast onset - slow onset

• Conflict – war, civil war

• Natural disasters – flooding, landslides, drought

• Complex

• Different geographical areas and hydro-geological conditions – mountains, tropical, arid, low-lying, island etc

• Different cultures and social groups

• Urban - rural

• Refugees or IDPs – concentrated camps or dispersed over large areas

• Post conflict

• Structural deterioration or political crisis

What is appropriate in one context may not be appropriate in the next

ZaireS House / WEDC

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Local authorities, community leaders, affected populations, vulnerable people

Cross-sectoral, Cross-Cluster, Cross-WASH

CommunicationCommunication

CoordinationCommunication

effective responses, best use of resources

magnified benefits for, and increased accountability to the affected populations

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Documents

WASH Cluster – Water in Emergencies W W1 1 Water in Emergencies Session 1 Water Supply Linkages