Questions and answers: South Asia earthquake and tsunami
What are the options of getting safe water to people in affected areas?
If water is deemed by local authorities to be unsafe, bottled water may need to be distributed or clean water transported by tanker truck to distribution points to meet immediate needs. Alternative temporary water sources and treatment plants may sometimes be available from dairies, soft-drink bottling plants, or breweries.
How can water be most effectively treated at household level and on a large scale?
If safe water cannot be supplied, it is critical to communicate to families that they need to treat water themselves, at home. Household water treatment is effective, simple, and inexpensive. It is especially applicable to populations recovering from a disaster situation who often lack facilities and resources. Following emergencies, chlorine or iodine tablets, or sachets of combined flocculant/disinfection powder may have been distributed. If this is the case, water should be treated using the directions that come with the tablets. If household bleach or other sources of chlorine are available, water may be disinfected with a dilute chlorine solution. Solar disinfection is an effective water treatment method that is applicable to emergencies, especially when no chemical disinfectants are available. Ultra-violet rays from the sun are used to inactivate pathogens present in water. This technique involves exposing water in clear plastic bottles to sunlight for a day, for example on the roof of a house. In emergencies, empty bottles can be used that are left over from an initial shipment of drinking water. Another option to treat water at home is to use of simple ceramic pot filters.
How can personal hygiene be maintained in difficult circumstances?
Despite water shortage and restricted sanitation facilities in emergency situations, it's critical to ensure that some of the available water supply is used for personal hygiene to minimize health risks. Messages about the importance of handwashing with soap at critical times-i.e. after defecation, after handling babies faeces, and before preparing food-are particularly important. As soap may be in short supply during emergencies, the use of ash, sand, or other culturally acceptable substitutes should be promoted.
What should people who have no access to sanitation facilities do and how can you minimize risk?
Where normal sanitation structures have been damaged or destroyed it is essential to provide toilet facilities immediately. Emergency facilities are usually provisional and need to be progressively improved or replaced as the situation develops.
Designated defecation fields or areas can be used where enough space is available. These work best in hot, dry climates and should be clearly marked, fenced (if possible), and protected against flooding. They should be located downwind and away from living areas, avoid water courses, and at a reasonable distance (minimum 50m) from water points. Shovels should be provided to families so that they can dig small holes to defecate into and cover their faeces with dirt. Collective trench latrines may also be an option. In longer term situations or after the initial emergency period has subsided, it may be more practical to build simple pit latrines, VIP latrines, or poor-flush latrines. In situations where the soil is rocky or the ground water is very close to the surface elevated platforms may be constructed.
As a general rule, individual family latrines are preferred, are more socially acceptable and can be maintained by the family. If necessary, centralized toilet facilities can be built at the edge of a living quarter or camp section where each family has access to their own latrine. The area allowed for latrines should be big enough to dig new pits when the first ones are full. Latrines of all types need to be properly cleaned and maintained. Responsibilities for cleaning and maintaining latrines should be clearly spelled out. For collective latrines it may be necessary to hire someone to take care of them.
In all cases, good hygiene practices are very important for preventing disease transmission. Clean water should be provided in sufficient quantities to enable proper hygiene. Hands should be washed immediately after defecation, after handling babies' faeces, before preparing food and before eating.
Is waste management a priority in such precarious situations?
The accumulation of waste, especially in urban and peri-urban like situations because of their high population density, creates public health risks through the presence of insect or rodent vectors of diseases. Breeding of flies plays a major role in the transmission of faeco-oral diseases as flies are vectors that carry pathogens. Rodents are directly or indirectly responsible for the transmission of diseases such as plague, leptospirosis and salmonella. Water in empty tins, tyres, etc., may be a breeding site for Aedes mosquitoes responsible for the transmission of dengue and yellow fevers and other arboviruses. Inadequate waste management may cause the pollution of surface and groundwater and increase the risk of fire. Medical wastes represent a particular risk as they are infectious, and therefore need special attention. As much as possible waste should be disposed of by on-site burying, brought to a defined landfill, or incineration if no better options are available.