Sanitation saves lives after a disaster

If you’ve read any of our blogs, you’ll notice we constantly reiterate how important and essential clean water is. But today, for a change, we’re focusing on sanitation. 

We’re talking about this dirty topic because significance of sanitation has been exponentially heightening due to the relentless and compounding force of increased natural disasters.

For 95 million people across the globe, natural disasters cause significant fear and loss each year through the sheer destruction and disruption of lives and their communities.

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Research has shown that climate change is a catalyst in increasing the number of natural disaster events, and according to EM-DAT, the number recorded has increased by almost three-fold; from 1,300 natural disaster events between 1975-1984 to 3,900 events between 2005-2014. 

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The rapid rise in recorded natural disasters highlights its scale of destruction as infrastructures, the environment and ultimately the population’s health are repeatedly affected.  Communities with effective sanitation become jeopardized as sanitation systems are threatened by floods, drought and rising sea levels. In addition, natural disasters play a role in aggravating the already ongoing and long-term issue of improper sanitation for populations that are located in underserved regions.

In efforts to maintain good hygiene and to reduce the spread of communicable diseases, affected populations have to rely on rapid and high quality humanitarian responses for the provision of safe water and basic sanitation facilities, especially in low-income countries. The fight for survival is far more challenging in low-income countries as they face greater negative repercussions and require a longer period of time to recover.

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Food, water, shelter, and non-food items such as clothing, blankets, and bedding are generally the more publicised requests for public humanitarian aid.

​Undeniably, the urgency for sanitation facilities is not a widely discussed topic.

In commemoration of World Toilet Day and our effort to de-stigmatise the topic of sanitation, we’re highlighting important factors that should be considered during a humanitarian response in order to appropriately and safely tackle the prevalent sanitation crisis in disaster settings. 

Impact on sanitation

Natural disasters often leave affected populations with damaged water supplies and destroyed sanitation facilities. 

​This can expose individuals to excreta-related disease due to the absence of important barriers needed to protect them from direct and indirect faecal-oral routes of disease transmission. The lack of proper sanitation facilities and safely managed water supplies encourages contamination and the vast spread of water-related infectious diseases, known as an outbreak. To learn more about routes of faecal disease transmission and protective barriers, read our blog here. 

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Purpose of Sphere Standards 

In emergency situations, it is important to reduce public health risks by building barriers along the different pathways that can transmit faecal-oral diseases (faeces, fluids, fingers, flies and food), as disaster-affected populations are more vulnerable to life-threatening illnesses such as diarrhoea and dehydration during this time.

​To ensure elevated quality, effectiveness and accountability for humanitarian assistance, there are a few minimum standards that must be achieved by affected populations and humanitarian aid groups.  Continue reading as we highlight and emphasise the most  important pointers from the Sphere Standards handbook to ensure the health of vulnerable populations after a disaster.

Sphere Standards: Excreta management

Within the Sphere handbook, the essential concepts and minimum standards for WASH promotion are: Excreta management; Water supply; Hygiene promotion; Vector control; Solid waste management and WASH in disease outbreak and healthcare settings. Today, we will be directing our focus on excreta management, however, it is important to note that the multiple standards should not be practiced in isolation, as progress in one aspect influences progress in other areas as well.  

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In efforts to prevent the contamination of natural, living, learning, working and communal environments, excreta needs to be safely contained on-site. After a disaster or an emergency crisis, there is a clear urgency to control indiscriminate open defecation. If sanitation facilities are not immediately provided, individuals have no choice but to practice open defecation through no fault of their own. Therefore urgency is an important consideration when determining what sanitation facilities can be used. 

The optimal sanitation system for disaster response is non-existent.

The most suitable system is dependent on the specific conditions in a disaster setting. Typically, simple pit latrines are deployed during disaster response as they may be the easiest to set up and resources can be sourced locally. 

Pit latrines

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However, environmental challenges such as difficult ground composition (rocky, sandy surfaces etc.); elevated water table or flooding; insufficient water; or the shortage of space may make the use of a pit latrine ineffective. 

Other viable options for sanitation following a disaster are:

• urine diverting toilets
• elevated latrines,
• shallow/trench latrines
• peepoo bags​

These options may come with their own challenges however; while a urine diverting toilet doesn’t require water usage, it may be difficult to source after a large scale disaster. An elevated latrine is ideal if the groundwater table is too high for a standard pit latrine to be dug, but the composition of the ground may not allow for stable construction. A trench latrine can be created on a larger scale with fewer required resources, however it may be susceptible to overflowing or flooding that could cause dangerous contamination to its nearby users. Peepoo bags are an innovative single-use bag that self-sanitises to prevent contamination once enclosed. They are biodegradable and can be used in the privacy of one’s own shelter or a simple toilet tent, however, there is possibility of contamination if the Peepoo bag is used improperly and they must be stored or buried after use, which space may not allow for. 

Peepoo Bag

Image from Sswm.info

​Now that we have a clearer perspective on the different sanitation systems available, next, we will explore the critical factors within the excreta management standard.  

Establishment of proper defecation areas: 
This standard emphasises that humanitarian organisations must immediately assess and consider the location for defecation carefully, as these areas must be established away from water sources, water storage and water facilities. 

Undeniably, establishing defecation facilities along public roads, near communal facilities or near food storage and preparation areas should be avoided. The separation of human excreta from living, learning and working environments helps to prevent the spread of pathogens in the environment.

The distance of containment facilities from water sources:
In order to preserve the natural environment, faecal material from containment facilities such as trench latrines, pits, vaults, septic tanks, and soakaway pits should be distanced away from water sources to prevent faecal contamination. 

The minimum distance required between containment facilities and water sources can be determined by executing the soil permeability test. The objective of this test is to find out the speed at which waste moves through the soil (infiltration rate). If these factors are not strongly considered, a severe outbreak can occur as a result of faecal matter seeping into a primary water source. A leaking or inadequate waste treatment facility can result in unexpected water contamination, similarly to what sparked Haiti’s decade-long cholera outbreak which still affects the nation today. 

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Next, the purpose of excreta management is to also provide the communities with safe and secure access to adequate, appropriate and acceptable toilets at all times. Toilets are considered adequate, appropriate and acceptable if they fulfill the following criteria:

• Safe to use for the entire population (including children, elderly, pregnant women and persons with disabilities);
• Established in a safe location, minimising security threats to people with protection concerns;
• No more than 50 metres from dwellings;
• Provide privacy in line with users’ expectations;
• Are easy to use and keep clean;
• Not a hazard to the environment;
• Provide adequate space for different users;
• Have inside locks;
• Provide easy access to water for handwashing, anal cleansing and flushing;
• Allow for the dignified cleaning, drying and disposal of women’s menstrual hygiene materials, and child and adult incontinence materials;
• Minimise fly and mosquito breeding; and
• Minimise smell

In the following sections, we will be providing a comprehensive explanation on the different factors that require additional emphasis and attention when providing humanitarian aid, as the significance of these factors have a strong possibility of being overshadowed or overlooked.   

Safe and secure facilities:

• Established in a safe location, minimising security threats to people with protection concerns.
• Provide privacy in line with users’ expectations.
• Have inside locks.

In low-income countries, the safety of women and girls are threatened, especially at night.

This emphasises the need to establish toilets for vulnerable groups (including women and girls, boys, older individuals and others with specific protection concerns) that can offer protection from external threats while allowing them to maintain good personal hygiene during the day and night. 

Undeniably, everyone deserves the right to feel safe and secure while using the toilet.

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Did you know?

In India, when women have no choice but to defecate in open fields, they are vulnerable to harassment, rape, kidnapping and wild animal attacks. In an effort to protect them from such threats, the 'No Toilet, No Bride' campaign was launched in 2005 to motivate women to demand a private latrine from their male suitors before agreeing to the marriage. Ultimately the aim is for women to abandon open defecation and protect themselves.

Easy access to clean water:

• ​Provide easy access to water for handwashing, anal cleansing and flushing.

​Having easy access to safe and clean water is of paramount importance, especially in disaster settings where the procurement of safe water is extremely difficult. 

With proper sanitation products such as soap (or an alternative such as ash), toilet paper or other anal cleansing equipment, individuals are able to practice good personal hygiene. Handwashing after using sanitation facilities, before and after changing a diaper, and again before coming in contact with food creates protective barriers, prevents food contamination and ultimately, protects individuals and those around them from excreta-related diseases. 

If vulnerable communities lack easy access to safe water, they are forced to either use unsafe water or travel a greater distance to collect it.

Image from Who.int

If the total amount of time required to obtain clean water exceeds 30 minutes, the amount of water they collect will gradually reduce. ​

​These communities would then have to rely on a lesser amount of clean water, segregating and prioritising it for different purposes such as survival, basic hygiene practices and basic cooking needs.

Thus, there will be insufficient clean water available for vulnerable communities to serve their different objectives, especially maintaining hand hygiene and staying hydrated and healthy. 

Image from Opecfund.org

Solid waste management and vector control:

• Allow for the dignified cleaning, drying and disposal of women’s menstrual hygiene materials, and child and adult incontinence materials. 
• Minimise fly and mosquito breeding.

As part of managing solid waste, appropriate containers should be included in toilets to allow proper disposal of women’s menstrual hygiene materials alongside child and adult incontinence materials. This is to prevent the blockage of drainage systems which have the ability to pollute surface water, and consequently, encourage the breeding of vectors such as mosquitos and flies. 

Image from News18.com

​Vector-related issues can be controlled by implementing simple environmental engineering measures (such as placing appropriate containers in toilets for the disposal of sanitation materials and ensuring excreta is properly contained and covered). Hence, this would better protect the vulnerable population from vector-borne diseases which play one of the major roles in causing sickness and deaths in emergency settings.  

Hygiene promotion is crucial for proper excreta management

​While hygiene promotion is considered separate to excreta management, it is a factor that needs to be strongly considered when responding to emergency or disaster situations. 

WASH related diseases are easily preventable through the use of proper hygiene practices. Following a standardised approach to educate on hygiene can be ineffective and different approaches largely depend on the social context of each unique community. Additionally, education is not enough if the resources, such as soap and clean water, are not available. 

Excreta management, clean water provision and hygiene promotion are an important trifecta that require each other to be effective on the whole. 

We hope that this blog provides a clearer understanding of the minimum standards that should be adhered to by humanitarian groups and the affected populations in disaster settings.

​Vulnerable communities will be better protected from life-threatening diseases when following and adopting these guidelines, ultimately aiding them in the process of recovery.

Image from Wateraid.org

If you’ve enjoyed reading this blog, be sure to read our blog on the prevalent sanitation crisis that is impacting millions of people across the globe. Click here to learn more!

During this time of the year, ASEAN nations are extremely vulnerable towards natural disasters, jeopardising lives and their surrounding environments. Visit our Disaster Relief page to discover how our products are capable of responding to natural disasters efficiently, bringing safe drinking water to communities in need.

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Blog Author: Nur Khairiyah Bte Mohd Samion
Chief Editor: Michelle Falcone 

Sources:
https://www.un.org/en/observances/toilet-day  
https://washmatters.wateraid.org/disasters 
https://handbook.spherestandards.org/en/sphere/#ch002_002 
https://www.humanosphere.org/global-health/2017/05/women-northern-india-said-no-toilet-no-bride-worked/