The WASH Approach: Fighting Waterborne Diseases in Emergency Situations

To report this story, Wendee Nicole visited two refugee settlements in Northern Uganda, Arua District’s Rhino Camp and the settlements of Adjumani District. She celebrated Global Handwashing Day 2014 with dozens of young children at Rhino Camp.“No water!” a young mother with short cornrowed hair says in her limited English, a worried look etched in her brow. She points to the spigots, dripping with the scant water remaining in the pipes.Refugees collect water from a public tap stand in an Adjumani settlement.It’s a sweltering October day just 3 degrees north of the Equator in Northern Uganda’s Adjumani District, where a dozen children and a handful of women have gathered at the public tap stand with their 20-liter jerrycans. They are among nearly 600,000 refugees who have walked hundreds of miles from South Sudan to neighboring countries, fleeing violence that began in December 2013.1 More than 66,000 men, women, and children have settled here, in camps in Adjumani District, with over 15,000 more in Arua District’s Rhino Camp.2The tap stand has six spigots that, until a few days ago, supplied an ample supply of fresh water. “It was producing 140,000 liters of clean water, but two weeks ago the pump malfunctioned,” explains Tim Sutton, Oxfam’s WASH (Water, Sanitation, and Hygiene Promotion) interim team leader for the Adjumani and Arua settlements. Working under the aegis of the United Nations High Commission on Refugees (UNHCR) and Uganda’s Office of the Prime Minister Department of Refugees, Oxfam installed an electric generator in June 2014 that provides water for two of six refugee settlements in Adjumani District.Rhino Camp, Arua District. Refugees in Uganda live on land donated by Ugandan nationals. Refugee families are given plots on which they can build temporary shelters and grow crops.Although the refugees can still get water from hand-operated pumps on other boreholes, accessing them requires walking further distances and physical labor to prime the pump. Sutton reassures the young mother, his own brow furrowed with concern, “We are working on it.”Sutton, who has engineered solutions for humanitarian crises around the world, knows well the importance of ready access to clean water. Most pressing, of course, is the need for drinking water. But the lack of water for washing also puts people’s lives at risk from waterborne illnesses spread by the fecal–oral route.Fecal–oral diseases can proliferate rapidly, sometimes to epidemic proportions, when people in crowded conditions lack clean water for hygiene and sanitation.3 Among the agents involved are at least 20 viral, bacterial, and protozoan pathogens that cause diseases such as cholera, bacillary dysentery, and the relatively recently discovered hepatitis E.4,5Aid groups are combating these pathogens with WASH, an integrated approach to disease prevention that ensures notonly that people in emergency situations have water and sanitation infrastructure, but also that they practice behaviors that prevent disease.