In peri-urban Monrovia, contaminated hand-dug wells were contributing to cholera outbreaks. Various chlorination methods were evaluated to determine their appropriateness and efficacy, both for public health emergencies and sustainable community-managed systems.
Excreta disposal in emergencies: Bag and Peepoo trials with internally displaced people in Port-au-Prince
After a series of earthquakes devastated Port-au-Prince, Haiti, on 12 January 2010, safe excreta disposal became an urgent priority. To mainstream innovative approaches to sanitation within the realities of urban humanitarian response, Oxfam GB undertook a trial from April to May 2010, of standard bag and Peepoo excreta disposal systems in two IDP settlements. Trial results demonstrate that with proper collection and removal, both bags and Peepoos are viable excreta disposal options in emergencies. A reduction was seen in ‘flying toilets’, open defecation and user reports on diarrhoea in both settlements. For in-home use, the Peepoo was preferred over bags, 84 per cent to 55 per cent (χ2 = 6.15, p=0.013) based on its ability to contain odour. Key programmatic recommendations include contingency planning for disaster-prone areas and further analysis of cost effectiveness and phase-out points for bag excreta disposal systems. Additionally, the Peepoo size should be adjusted to be more widely applicable in diverse emergency settings.
Innovative designs and approaches in sanitation when responding to challenging and complex humanitarian contexts in urban areas
As recent emergencies have shown, there are still significant challenges in the timely provision of safe sanitation in natural disasters or conflict situations. In urban emergencies or areas where it is impossible to dig simple pit latrines because of high water tables, hard rock, or lack of permission, it takes agencies considerable time to construct elevated latrines or alternative designs such as urine diversion toilets. This paper describes the challenges often faced in the rapid construction of latrines in emergencies and then looks at a number of case studies, from the Haiti earthquake and the 2010 floods in the Philippines, of how these obstacles were overcome. It also documents some of the recent innovations and improvements suppliers have made in increasing the scope of their emergency sanitation equipment.
Chlorination of drinking water in emergencies: a review of knowledge to develop recommendations for implementation and research needed
Clean water provision is a critical component of emergency response, and chlorination is widely used in emergencies to treat water. To provide responders with practical, evidence-based recommendations for implementing chlorination programmes and recommend areas for future research, we conducted a literature review of chlorination in emergencies, supplemented with a literature review on chlorination in general. We identified 106 total documents, including 7 with information on technical efficacy, 26 on chlorine dosage, 22 on technical challenges, 21 on product options, 8 on user acceptability, 33 on programmes for emergencies, and 8 on monitoring. We found that: 1) international chlorine dosage recommendations in emergencies are highly inconsistent; 2) high-quality information from the general chlorination literature on challenges of chlorination can be adapted for emergencies; 3) many chlorine products are available for use in point-of-delivery, point-of-source, and point-of-use emergency-response programmes; 4) information on the effectiveness of different chlorination programmes in emergencies varies, ranging from little data available to high-quality data that can inform programming; 5) information on user acceptability of chlorination in emergencies is lacking; and 6) monitoring data on chlorine programme effectiveness in emergencies are lacking. In this manuscript, we provide a summary of knowledge on chlorination in emergencies, recommendations for programme implementation, and recommendations for future research needed to assist communities and agencies responding to the increasing number of natural disasters and outbreaks worldwide.