Friday, 4 January 2013

How disaster resilient is your toilet?


Claire Beck is a child health and nutrition specialist who has been working with World Vision for 11 years. With a strong background of emergency programme management in a variety of sectors, she is currently global team leader for health, nutrition and WASH in humanitarian emergencies.

The importance of having a private place to go to the toilet or wash yourself is a pretty basic instinct for all human beings. Have you ever thought what it would be like not to have this? Even in the poorest and most under-resourced communities there are systems in place that aim for sanitary practices and allow some dignity to remain for what every human being must do every day.

In my role as a health specialist for emergency situations I often experience conditions that deny people of this basic dignity. It’s hard to imagine unless you’ve experienced it. Maybe if you’ve been camping for a few days you’ve coped with digging a hole or washing in a stream, but doing this for weeks or even months, while forced to live in cramped and crowded conditions, is a very different scenario.

Enclosed latrines and clean water supply are often used as measures to calculate development, and so the vulnerability of this infrastructure to disasters, both natural and human induced, should also be part of the calculation. Even when there are sanitation facilities available they quickly become dirty and unhygienic as lots of people use them. They can also be unsafe to use due to bad construction, poor location, the wrong type for the situation or a lack of locks and screening. As a result people will stop using them – especially women and children – and they may as well not be there at all.

Given poor sanitation and limited water for washing in these emergency conditions, I am always on the lookout for rapid outbreaks of diarrhea, skin diseases, increased malaria and dengue fevers, even pneumonia, all of which could be prevented if the displaced communities had access to enough clean water, adequate sanitation facilities, disinfectant, soap and better messaging on how these diseases are spread.

It’s not only the displaced that face this problem in emergency situations. Earlier this year I attended an emergency response based on famine and food insecurity in Niger, where the rate of latrine usage is among the lowest in the world. We noted an alarming increase in cholera in some of the areas near the massive Niger River and could only put it down to the toilet habits of local communities. So we introduced crisis sanitation into the programme, working with the community health workers to identify causes and ensuring that every household had access to enough soap for their family to ensure hand washing at the critical times and water purification sachets so they could purify their water at home. In addition village committees turned their attention to the state of public toilets and began to take responsibility for disinfecting them daily.

What the residents really wanted long-term were latrines at household level. Given the threat of a further cholera outbreak, this seemed a reasonable request and I am pleased to report that work towards that goal was ongoing when I left. In fact, I would like to see household level toilets become the normal expectation for emergency response and prepositioned supplies. Using a toilet is neither a luxury nor an option. Nor are toilets particularly difficult to build given the right forward planning on what sort, how it will work and whether it will meet standards for protection from contamination, contagious diseases and invasion of privacy.

This is the sort of thinking that should be happening in advance of a disaster situation, so that children already facing extremely challenging health conditions can at least have a safe and sanitary place to go to the toilet.

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