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Conflict And Catastrophe Medicine > WASH > Flashcards

WASH Flashcards

1
Q

Learning Objectives

A
  • Understand the importance of good hygiene practices in Conflict & Catastrophe situations.
  • Understand the importance of the provision of safe drinking water and how this may be delivered.
  • Understand how environmental risks might be reduced.
  • Consider the conditions necessary to allow people to live with good health, dignity, comfort, and security.
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2
Q

What are the different levels of safety measures when it comes to someone taking a dump? VD

A
  • When a person takes a dump
  • Having a toilet barrier will prevent Fluid, Fields/floors/Flies from becoming contaminated
  • But contamination can still occur by hand
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3
Q

How does having a safe water Barrier from fluids prevent contamination?

A
  • A safe water barrier from fluids prevents:
  • Contamination to a new host
  • Contaminated Foods
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4
Q

How does having a Hygiene barrier from fluids prevent contamination?

A
  • Prevents contamination from Fluids, Fields/floors, Flies and hands
  • Prevents these from going into foods and entering a new host
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5
Q

Why is WASH important?

A
  • Diarrhoeal disease is second-leading cause of death in children under 5.
  • Diarrhoea kills ~525,000 children under-5 each year
  • That means: ~1 child dies from a diarrhoeal infection each minute.
  • Majority of diarrhoeal disease can be prevented through safe drinking water and adequate sanitation & hygiene
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6
Q

By how much, would water, sanitation and hygiene interventions reduce diarrhoea in less developed countries?

A
  • Hand washing: 43%
  • Sanitation: 32%
  • Water quality household: 35%
  • Water quality source: 11%
  • Water supply (quality & quantity): 25%
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7
Q

Why is WASH important?
What is the SDG 6 goal?

A
  • WASH is a part of the SDG goals
  • SDG 6: Ensure access to water and sanitation for all
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8
Q

What are the results of clean water and sanitation as of 2022?

A
  • As of 2022:
  • 2.2 billion people lacked safely-managed drinking water: 703 million of those had no basic water source at all
  • 3.5 billion people lacked safely managed sanitation: 1.5 billion of those has no basic sanitation services
  • 2 billion people lacked a basic hand washing facility: 653 million of those had no hand washing facility at all
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9
Q

What are the principles of WASH response?

A

VD

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10
Q

What are the standards of a WASH response?

A
  • Sphere Handbook sets out minimum standards across 6 domains
  • Access to water: 15 L/person/day within 500m of household
  • Sanitation facilities: Basic toilet per household, Appropriate privacy, hygiene, and security
  • Hygiene promotion: Promote handwashing, safe food handling, safe waste
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11
Q

What are the priorities of emergency water supply?

A
  • Identify and set-up water supply and distribution for affected population and households
  • Install institutional water supply (HCF, schools, feeding centres)
  • Monitor needs, accessibility, equity, and gaps
  • Plan for contingencies: Weather events, Population movements, Disease outbreaks
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12
Q

What are the water requirements?

A
  • Max 250 people per tap
  • 500 people per hand pump
  • 400 people per open hand well
  • 100 people per laundry facility
  • 50 people per bathing facility
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13
Q

What is the immediate response for water supply?

A
  • Storage bladders/tanks
  • Treatment units
  • Distribution network
  • Water trucking
  • Household water treatment and storage
  • Jerry can distribution
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14
Q

What is the medium to long term response to water supply?

A
  • Rehabilitation of existing water points: Equipping, cleaning, repairing
  • Development of new water points: Drilling, Jetting, Spring protection, Gravity system, Pumping station
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15
Q

What are the key considerations for water supply?

A
  • Identify most appropriate sources: Environmental impacts, Seasonal variations in water supply (drought/floods)
  • Determine quantity required and systems needed to deliver: Safe and equitable for all community members, Maintenance systems, Sustainability
  • Appropriate drainage: Reuse water (vegetable gardens, brick-making, irrigation), Risk of stagnant water?
  • Phased approach: Limit water trucking
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16
Q

How do you choose a water source?

A
  • Availability, safety, proximity, and sustainability of a sufficient quantity of water
  • Need for, and feasibility of, water treatment: bulk or household level
  • Social, political, or legal factors affecting source control: Controversy, especially during conflicts, Ensure equitable access for women, children, disabled, and elderly people
  • Quantity over quality
17
Q

How is bulk treatment for water carried out?

A
  • Sedimentation: Setting out physical impurities
  • Coagulation & Flocculation: Removal of suspension solids, Not disinfection
  • Chlorination: Quick, comprehensive destruction of pathogens, Residual chlorine 0.2 – 0.5 mg/L
18
Q

What is Household Water Treatment and Storage? (HWTS)

A
  • Aim: “reduce diarrhoea and improve microbiological quality of stored household water” – The Sphere Handbook, 2018
  • Boiling
  • Chlorination
  • Solar disinfection (SODIS)
  • Straining (through cloth)  Sedimentation  Filtration
19
Q

Sanitation

A
20
Q

What are the priorities of Emergency Sanitation?

A
  • Identify and set-up sanitation facilities for affected populations and households
  • Install institutional sanitation facility (HCF, schools, feeding centres)
  • Monitor needs, accessibility, equity, and gaps
  • Plan for contingencies: Weather events, Population movements, Disease outbreak
21
Q

What are sanitation requirements?

A
  • Communal toilets: minimum 1 per 50 people (should improve ASAP to…)
  • Minimum 1 shared toilet per 20 people: 3:1 for female to male toilets
  • Maximum 50 metres between dwelling and shared toilet
  • Sphere Handbook sets out further standards for minimum numbers of toilets in community, public places and institutions (long-term response)
22
Q

What is the immediate response for sanitation?

A
  • Controlled defecation field
  • Shallow trench latrine
  • Deep trench latrine
  • Shallow family latrine
  • Bucket latrine
  • Bio-degradable bag latrine
  • Chemical toilets
23
Q

What is the medium to long term response for sanitation?

A
  • Simple pit latrines
  • Ventilated improved pit (VIP) latrines
  • Pour flush latrines
  • Septic tanks
  • Portable
  • Elevated latrines
24
Q

What is the Ventilated Improved Pit (VIP) Latrine?

A

VD

25
Q

What are some key considerations involving Sanitation?

A
  • Cleaning and maintenance: Voluntary or paid attendants
  • Fill-rate, life span, and de-sludging
  • Accessibility: Minimum ratio of 1 single-access, gender-neutral toilet with ramp or level entries + enhanced accessibility per 250 people
  • Safety & security: Internal locks and adequate lighting, Safe locations – vulnerability to attack?
  • Water & anal cleansing material
  • Opening hours
  • Menstrual hygiene management
26
Q

List the outcomes of Hygiene Promotion?

A
  • Ensures proper and optimal use of facilities
  • Supports participation and accountability
  • Monitor acceptability and impact on health
  • Community engagement is critical
27
Q

List a few Hygiene requirements

A
  • 2x water containers per household, 10-20L each: One for collection, one for storage
  • 250g pp of soap for bathing per month
  • 200g pp of soap for laundry per month
  • Soap & water at handwashing station: One station per shared toilet or one per household
  • Means of collecting/disposing of children’s faeces: Potty, scoop, or nappies
28
Q

What are the key considerations for Hygiene promotion?

A
  • Identify essential hygiene items required: Differing needs among population (men, women, children, elderly, disabilities), Environmental hygiene (cleaning equipment)
  • Provide timely access to essential items: Assess availability
  • Work with stakeholders for acquisition: Timing, location, content, intended recipients
  • Seek feedback from affected population: Appropriateness, Satisfaction
29
Q

What is menstrual hygiene & incontinence?

A
  • Dedicated lidded container for pad/cloth storage & soaking
  • Rope & pegs for drying
30
Q

How is Menstrual hygiene carried out?

A
  • Absorbant cotton material (4m2/yr) OR
  • Disposable pads (15/mth) OR
  • Reusable sanitary pads (6/yr) as preferred
  • Underwear (6/yr)
  • Extra soap (250g/mth)
31
Q

How is incontinence (urinary & faecal) carried out?

A
  • Absorbent cotton material (8m2/yr) OR disposable pads (150/mth) OR reusable incontinence underwear (12/yr)
    •Underwear (12/yr)
    •Extra soap (500g bathing + 500g laundry /mth)
    •2x washable, leak-proof mattress protectors
    •Additional water containers
    •Bleach/disinfectant (3L/yr, non-diluted)
    •Bed pan & urinal bottles (M+F), commode
32
Q

WASH in healthcare facilities

A
33
Q

What is the importance of WASH in healthcare facilities?

A
  • Weaker health condition
  • Increased risk of infection, disease and potentially new pathogens
  • Enables curative interventions
  • Prevents patients from being infected secondary disease during treatment
34
Q

What are the key considerations for healthcare facilities?

A
  • Infection prevention & control (IPC)
  • Water quantity & quality: Varying requirements for disease burden (e.g., cholera)
  • Excreta management
  • Healthcare waste: Environmental impact
  • PPE: Risk mitigation (IPC protocols)
  • Management of the dead
35
Q

What is waste segregation?

A

VD

36
Q

What do we do once a disease outbreak occurs?

A
  • Always follow up-to-date technical guidance
  • Ensure chlorine is available to make varying conc solutions for disinfection
  • 1 toilet per 20 patients (high-risk: 1 per 5 pts)
  • Dead body mgmt.: 0.5% or 2% Cl soln + double body bags
  • Increase water supply
  • Assess PPE requirement based on anticipated exposure
37
Q

What are the different methods for delivering WASH?

A

VD

38
Q

Summary

A
  • Access to WASH is a human right: Critical in meeting health needs of affected population
  • Facets of WASH response: Water supply, Sanitation, Excreta management, Solid waste management, Vector control, Hygiene promotion, Disease outbreaks & healthcare facilities
  • Sphere Handbook sets out standards: Requirements are recommended minimum, but should be improved upon where appropriate
  • Vital to engage with stakeholders every step of the way

Conflict And Catastrophe Medicine (34 decks)

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