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Santatonin EmergencyStuatons

Proceedings of anInternational Workshop,held In Oxford, December 1995

Edited by John Adams

3696SA13802

An Oxfam Working Paper

ibraiyIRC Interr~atjonatWaterand Sanitatjon CentraTel. +3170306898r3Fax: +31 7035 899 64

Sanitation inEmergency Situations

Proceedings ofan

International Workshop,

held in Oxford, December 1995

Edited byJohn Adams

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An Oxfam Working Paper

Published by Oxfam (UKand Ireland)

First published 1996

Oxihm (UK and Ireland) 1996

ISBN 0 85598 350 7

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Conteuts

Introduction 5

Executive summary 71.1 Summaryof working group

discussions 71.2 Summaryofrecommendations and

action points 10

2 Working paper summaries 112.1 Principles for better sanitanon

programmes 11Dennts Warner, WHO, Geneva

2.2 Excreta clisposal kits 12Jim Howard

2.3 First-phase excreta disposal 13Martin Oudman, MSFHolland, Amsterdam

2.4 Latrine construction 14Woldu Mahaiy, Oxfam, Oxford

2.5 Excreta disposal on difficult sites 14Yves Chartier, MSF France, Fans

2.6 Emergency solid waste managementand disposal 15

Bob Reed, WEDG, Loughborough University,Loughhorough

2.7 Vector control in emergencysituations 17

Lynette Lowndes, IFRC, Geneva/Tanzania

2.8 Personal hygiene, water collectionand storage facilities 18

Eddie PotLs, Liverpool School ofTropwalMediczne, Liverpool

2.9 Drainage, and washing and bathingareas and facilities 19

RichardLuff Oxfam, Oxford

2.10 Sanitation inenciosed centres 21Riccardo Conti, ICRC, Geneva

2.11 Environmental impact ofsanitationprogrammes 22

Paul Skerlock, Oxfam, Oxford

2.12 Preparation and nning of staff 24Bobby Lambert, RedR, London

2.13 Conununity participation in emer-gency sanitationprogrammes 26

John Adams, Oxfam, Oxford

2.14 Assessment, monitoring andevaluation 29

Claude Rakotomalala, UNHCR, Geneva

3 Working group discu.ssions andpresentations 32

3.1 Principles for sanitationpromotion inemergencies 32

3.2 Objectives, techniques, tools andequipment for first-phase excretadisposal 33

3.3 Objectives, techniques, tools, andequipment for second-phase andlonger-term excreta disposal 34

3.4 Off-site and on-site excretadisposal 34

3.5 Strategy flow-chart for emergencyexcreta disposal fora range ofsiteconditions 35

Reflise disposal 36

Hygiene education in first-phaseemergencies 37

3.8 Personal hygiene kits 37

3.9 Vector control in emergencies 38

3.10 Hygiene facilities 39

3.11 Environmental impact ofemergencysanitation programmes 40

3.12 Sanitation in enclosed centres 41

3.13 Preparation and training of reliefworkers 41

Recommendadons and aclion points 42

Annexes 461 Programme and presentations 462 List ofpardcipants 47

3.6

3.7

3

Introduction

It is generally acceptedthat in most emergencies,water supply and sanitation are among the mostimportant mtervenrions for improving publichealth and controlling disease. However, whilstwater supply programmes are easily understoodand have obvious, measurable objectives andresults, this is largely not the case for sanitation.There is a widespread lack of understanding,evenwithin reliefagencies, about what sanitationis, how important it is and how to do it well.Emergency sanitation is weak m many areas,including programme funding, agreement ontechnical approaches and standards, and recog-nition ofits importance by donors, reliefagenciesand people affected by emergencies.

While it is important that water supply andsanitation programines are dosely coordinatedso that they make a full impact on health, theydiffer in time-scale, technology, skills required,and ways of working with affected communines.It is timeto give more attention to sanitation as anessential emergency intervention in its own right,needing a distinct technical and organisationalapproach, its own research and development,particular professionai competence, and tar-geted funding.

Sanitation is taken here to mean interventionsto reduce peoples exposure to diseaseby prowd-ing a clean environment in which to live. Thisinciudes dispesing of human excreta, reflise andwastewater; control of disease vectors; andproviding washing fcilities. These activities areclosely linked and often overlap; for instance,disposing of wastewater and refuse helps tocontrol vectors, and washing facilities producewastewater, which needs to be dealt with. Com-munity participation and hygiene education areessential paris of a sanitation programme,because so much of sanitation is concerned withhuman behaviour. There are other interventionswhich are also closely allied, such as the provisionof sufilcient water for washing, which could,arguably be included, but emergency watersupply is dealt with verywell elsewhere.

The workshop

The idea for holding an inter-agency workshopto share experiences of sanitation interventionswas conceived at a summer party and bom justsix months later at Manchester College inOxford. Forty-five delegates from 25 orgamsa-tions, includmg NGOs, UN organisations, andthe Red Cross, and independent sanitationworkers, met for four days to discuss technicaland organisational problems and to try to agreeon basic operating principles, recommendauons,and action points. Working papers were pres-ented on a range ofsubjects relating tosanitationin emergencies, and issues arising from thepapers were citscussed by working groups andthen presented to plenary sessions for comment.The workshop was organisedby a steering grouprepresentmg Oxfam, UNHCR, MSF, ICRC andIFRC.

Thanks are due to: PatDiskett and PaulSrnithLomas ofOxfam, andjim Howard, for their ideafor holding the workshop. Yves Chartier ofMSF-France, Riccardo Conti of ICRC, Ulijaspers andHaken Sandbladh of IFRC, and ClaudeRakotomalala and Gloria de Sagarra ofTJNHCR,members of the steenng committee who coliab-orated on the preparation, running, and Postmortem of the workshop. Prisdilla Frost ofOxford Conference Management for the work-shop administradon, and for transcribing hoursof discussion about sanitation. Anita Owen andthe staff of Manchester College, Oxford, forlooking after the workshop participants. All theparticipants for their time and effort, and fortheir contribution to the successof the workshop.

Contents of this Working Paper

Section 1 of the paper takes the form of asummary of plenary discussions, illustrated withquotes from participants, foliowed by a list oftherecommendations and action points agreed

5

Sanitation inemergency situadons

during the finai sessions of the workshop, insummary form.

The working papers presented during theworkshop are given in Section 2 They havebeenedited and appear in a shortened form. Theyprovide many ideas and insights, but were notintended to present a comprehensive review ofthe issues, but rather topromote discussion in theworking groups.

Presentations from the workmg groups are inSection 3. These represent the experience and

thought of many of the people most involved inthe field of emergency sanitation and indicatesubstanual agreement between agencies on mostissues. They should provide a good basis fordeveloping ideas on a range ofsubjects, either byindividual agencies or through inter-agencycollahoration.

Finally, Secdon 4 gives a complete version ofthe list of recommendations and acdon pointsdrawn up in the plenary session at the end of theworkshop.

6

Section 1 Executive summary

1.1 Summary of workshopdiscussions

The fundamental problem which prompted thisworkshop is this: in most emergency situations,sanitation intervendons are often inadequate,and certainly not as effecdve as those to providewater, health care or other vital necessides.There was a remarkable consensus among theparticipants on a number of related and over-lapping reasons for this.The following summary,illustrated by quotes from the workshop dis-cussions, presents some of the areas where workis needed. The participants agreed on recom-mendations for addressing some of these needsand these are presented in full in Section 4.

Promotion of sanitation i