Category Archives: Emergency Sanitation

WASHplus Weekly: Focus on Management of Health Care Waste

Issue 118 September 27, 2013 | Focus on Management of Health Care Waste

To reduce the burden of disease, health care waste needs sound management. The unsafe disposal of health care waste (for example, contaminated syringes and needles) poses public health risks. If not managed, direct reuse of contaminated injection equipment results in occupational hazards to health workers, waste handlers, and scavengers. Resources in this issue include the just published World Health Organization (WHO) manual “Safe Management of Wastes from Health-Care Activities,” USAID’s 2013 health care waste guidelines, a United Nationals Environment Program (UNEP) policy brief, and country studies from Cameroon, Ethiopia, Nigeria, Malaysia, and Morocco.

GENERAL/OVERVIEW

Healthcare Waste Management: The Current Issues in Developing Countries.Waste Management Research, 30(6) 2012. E Titto. (Link, pdf)
Special attention should be paid to the fate of health care waste after it leaves a facility where it can expose an entire community to risk, particularly those who come in close contact with it, such as waste transporters, landfill workers, waste pickers, scavengers, recyclers, and children. WASHPlus_HTMLbanner_weekly_600x159

Safe Management of Wastes from Health-Care Activities, 2013. A Prüss-Ustun, WHO. (Link, pdf)
This is the second edition of the WHO handbook on the safe, sustainable, and affordable management of health care waste—commonly known as the Blue Book. The original Blue Book was a comprehensive publication used widely in health care centers and government agencies to assist in the adoption of national guidance. In many countries, knowledge about the potential for harm from health care waste has expanded among governments, medical practitioners, and civil society. Increasingly, managers and medical staff are expected to take more responsibility for the waste they produce from their medical care and related activities.

UNEP Policy Brief on Healthcare Waste: What, Why and How, 2013. International Environmental Technology Centre. (Link, pdf)
Management of health care waste is becoming an issue of growing concern in urban areas. In many developing countries it is still indiscriminately disposed of and often mixed with municipal waste, thus causing serious health and environmental hazards, particularly to the scavengers operating at dump sites. Because of the extreme health hazards, health care waste cannot be disposed of along with other municipal waste. The technologies for the treatment of health care waste are not well understood or widely available in developing countries. As a result, choices made on the basis of technology may not be well informed, resulting in poor or uneconomic performance.

USAID Health Sectoral Guidelines: Healthcare Waste, 2013. G Gulis. (Link, pdf)
Currently, little or no management of health care waste occurs in small-scale facilities in developing countries. Training and infrastructure are minimal. Common practice in urban areas is to dispose of health care waste along with the general solid waste or, in peri-urban and rural areas, to bury waste without treatment. Since money for health care waste management is scarce, the first priority is to adopt actions and procedures that maximize risk reduction and cost the least.

Water, Sanitation and Hygiene (WASH) in Health-Care Facilities in Emergencies, 2013. WHO. (Link, pdf)
Health care facilities play a vital role within the community by providing essential medical care at all times including during emergencies. Any incident that causes loss of infrastructure, energy supply, loss of equipment, loss of staff or staff attrition, interruption to supply chains, or patient surge—such as sudden communicable disease epidemics, natural disasters (e.g., floods, earthquakes), or conflict—requires a holistic health response and recovery effort that includes actions to assess and restore basic WASH services.

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From WEDC – 2013 updates of WHO technical notes for emergencies

WHO Technical Notes for Emergencies, 2013 

Please click the links below to view pdfs of the World Health Organization Technical Notes for EmergenciesWEDC

  1. Cleaning and disinfecting wells
  2. Cleaning and disinfecting boreholes
  3. Cleaning and disinfecting water storage tanks and tankers
  4. Rehabilitating small-scale piped water distribution systems
  5. Emergency treatment of drinking water at the point of use
  6. Rehabilitating water treatment works after an emergency
  7. Solid waste management in emergencies
  8. Disposal of dead bodies
  9. How much water is needed
  10. Hygiene promotion in emergencies
  11. Measuring chlorine levels in water supplies
  12. Delivering safe water by tanker
  13. Planning for excreta disposal in emergencies
  14. Technical options for excreta disposal
  15. Cleaning wells after seawater flooding
  16. Complete: all 15 notes in one file

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Will a “cottage industry” approach make emergency WASH more sustainable?

Al Madad hygiene and sanitation project in Aqbiyeh

Al Madad hygiene and sanitation project in Aqbiyeh, Bekaa Valley in Lebanon. Photo: Al Madad Foundation & AUB Association

An NGO is employing a self-help “cottage industry model” to introduce water, sanitation and hygiene (WASH)  services in refugee camps. Instead of relying on handouts, refugees are offered a steady wage to participate in the improvement of their own living conditions.

The NGO promoting this approach, is the Al Madad Foundation, a UK registered charity since 2001, based in London. The Foundation is active in two main areas:

  • education and literacy programmes for refugee and disadvantaged children
  • sustainable relief in emergencies

The Foundation’s Director is Aya Haidar, a Lebanese multimedia artist/activist with an MSc in NGOs and Development.

In Lebanon, the Al Madad Foundation is partnering with the AUB Association’s Community Project Development Unit to improve water, sanitation and hygiene within the country’s Syrian refugee communities. Under the supervision of qualified architects and civil engineers from the AUB Association, refugees will be employed to help dig holes, build toilets, pipe laying, and installing septic tanks and drainage systems.

The Foundation thinks this “cottage industry model” could eventually be extended to other fields such as education, by employing refugee women, many of whom are qualified teachers.

The Foundation chose to focus on WASH services in the camps, not only to “minimise avoidable morbidity and mortality” but also to “minimise the resulting impact upon the local Lebanese environment, including fresh water, ecosystems and the impact upon agriculture”. Hygiene promotion and awareness raising will go hand-in-hand with the provisions of water and sanitation infrastructure.

The UK government is considering implementing cash-for-work (CFW) programmes for both Syrian refugees and vulnerable Lebanese as part of their new £50 million (US$ 77 million) humanitarian aid initiative [1].

Oxfam implements a CFW initiative, that includes latrine construction, in Kenya’s Dadaab refugee camp, the world’s largest refugee complex housing more than 400,000 people. Men and women are paid between 250 and 500 Kenyan Shillings (about US$ 3 – 6) $ per day depending on their skill levels [2].

The most well-known CFW aid programme was implemented by Mercy Corps in post-tsunami Aceh, Indonesia.  At its peak the seven-month programme employed nearly 18,000 participants and disbursed over US$ 4.5 million in direct payments [3]. Based of their experience in Indonesia and other countries like Afghanistan, Pakistan, Somalia, Sri Lanka and Sudan, Mercy Corps published a CfW manual in 2007 [4].

[1] DFID, £50m UK support to Lebanon as refugee numbers soar, Gov.UK, 18 Jul 2013

[2]  Cash-for-work in Kenya: Building latrines at Dadaab camp, Oxfam, 15 Aug 2011

[3] Doocy, S. et al., 2005. The Mercy Corps Cash for Work Program in post-tsunami Aceh. Available at: http://preventionweb.net/go/2171

[4]  Mercy Corps, 2007. Guide to cash-for-work programming. [online] Portland, OR, USA: Mercy Corps. Available at: <http://www.mercycorps.org/files/file1179375619.pdf>

Source: Al Madad Foundation – Lebanon Emergency Aid Report 2013

Design Contest on Public Urinal Systems for Emergency Situations

The Emergency Sanitation Project, a collaboration between IFRC, WASTE and Oxfam GB, has launched a design contest for public urinals.

The urinals should be attractive and safe to use, lightweight to transport by air to emergency situations and easy to install. The urinals need to be equipped with a urine management facility: a storage container that can be emptied or, in the worst case a soak pit for disposal.  The urinal should be suitable for children, adult men, adult women or the less abled

The Award

  • Twelve project will be selected for final review: 3 for children, 3 for adult men, 3 for adult women and 3 for less abled.
  • The finalist will present their design concept to the judging panel on world toilet day 2013, 19th November 2013.
  • The emergency sanitation project will approach producers to produce the designs of the overall top finalist.
  • The overall top finalist will receive a field visit of a week including travel and lodging to the country where the produced design will be field-tested or € 1000 cash.

Download the flyer

Download the Application Form

Application deadline: 12:00 pm GMT Friday, 18 October 2013

Web sitewww.emergencysanitationproject.org

100 issues of the WASHplus Weekly – March 2011 to May 4, 2013

Below are links to the past 100 issues of the WASHplus Weekly on various sanitation and other topics. We welcome suggestions on how to make the Weekly more useful.

2013

2012

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Raised latrines survive floods in Bangladesh

Low cost latrines constructed by the Chars Livelihoods Programme (CLP) in Bangladesh performed well in their first real flood test.

After the July 2012 floods, which also hit the CLP programme area in the districts of Jamalpur and Kurigram on the northern Jamuna, only 14% of the low cost latrines were destroyed or unusable. During the flooding, recipients continued to have access to sanitation.

Low cost latrines raised above flood levels

Low cost latrines raised above flood levels. Photo: CLP

Households in CLP districts are raised on earthen plinths 60 cm above the highest known flood level. The Programme ensures access to clean water and sanitation by also raising water points and installing latrines on plinths.

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Fifth Emergency Environmental Health Forum, London, UK, 17-19 December 2012

The focus of forum is the Public Health Promotion (PHP) aspect of water and sanitation programmes. Presentations on this theme address topics such as new technologies and hygiene promotion, menstrual hygiene management, metrics for assessing the impact of hygiene promotion activities and Community Led Total Sanitation in the emergency environment.

The forum is convened by the SHARE Research Consortium and sponsored by Oxfam, IFRC, ICRC, International Rescue Committee, ACF, MSF and UNICEF.

The forum, which is being held on 17-18 December will be followed by a separate one day event on 19 December organised by the Hygiene Promotion Forum on hand washing. Participants will share examples of hardware solutions used in the field for hand washing and best practices on promotion and social marketing.

To register for both events go to: 5eehforum.eventbrite.com/