Emergency sanitation

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Emergency toilet in Haiti, suitable for areas where digging pit latrines is not possible Raised toilet in Haiti (7281252188).jpg
Emergency toilet in Haiti, suitable for areas where digging pit latrines is not possible

Emergency sanitation is the management and technical processes required to provide sanitation in emergency situations. Emergency sanitation is required during humanitarian relief operations for refugees, people affected by natural disasters and internally displaced persons. [1] There are three phases of emergency response: Immediate, short term and long term. [1] In the immediate phase, the focus is on managing open defecation, and toilet technologies might include very basic latrines, pit latrines, bucket toilets, container-based toilets, chemical toilets. The short term phase might also involve technologies such as urine-diverting dry toilets, septic tanks, decentralized wastewater systems. Providing handwashing facilities and management of fecal sludge are also part of emergency sanitation.

Contents

The immediate sanitation phase focuses on the provision of proper waste management resources. The main course of action during this stage is reducing open defecation. It is implemented as a course of initial action in emergency situations and it lasts from one to three months. Toilets provided might include very basic Latrines, pit latrines, Bucket toilets, container-based toilets or Chemical toilets.

The Sphere Project handbook provides protection principles and core standards for sanitation to put in place after a disaster or conflict. [2] The short term sanitation phase provides technology to contain fecal matter for as long as six months. 75% of the affected population have access to such resources and 75% of the collected waste is disposed of properly. One waste bin that is around 100 liters is provided for the use of 100 people. [3] Bins are placed at a maximum walking distance of 50 metres from where people are housed or camped.

Waste management bins installed during the long-term phase are sustainable to use for three years. During this phase, 95% of the population have access to the bins and 95% of the waste is properly disposed of. Bins are placed at a maximum distance of 15 metres from living areas. [3] Fecal sludge management becomes a priority during the long-term emergency management phase. Providing showers and handwashing facilities is part of emergency sanitation during all phases.

Background

Open defecation along the river bank in Burundi Open defecation along the river bank (6908382463).jpg
Open defecation along the river bank in Burundi

The term "Emergency" is perceived differently by different people and organizations. In a general sense, an emergency may be considered to be a phenomenon originating from a man-made and/or natural disaster which results in a serious, usually sudden threat to the health or well-being of the affected community which relies on external assistance to easily cope up with the situation. [1] There are different categories of emergency depending on its time frame, whether it lasts for few weeks, several months or years. [1] The number of people who are and will be affected by catastrophes (human crisis and natural disasters), which are increasing in magnitude and frequency, is rapidly increasing. The affected people are subjected to such dangers as temporary homelessness and risks to life and health. [4]

Emergency sanitation is put into place to create suitable living conditions for populations who lack proper water resources and to decrease the spread of waterborne illnesses. In June 2012, a conference was held with various relief agencies and government officials in order to address proper management of human fecal matter along with the public health of people struck with disaster. [5] They concluded that the current sanitation solutions were not up to date nor the best of quality. The decision to utilize technology to track human feces collection along with the creation of emergency sanitation coordination centers and the use of smart toilets were among a few of the implemented policies. [5]

Methods

Emergency pit latrines with bathing shelters built in the Bidi Bidi Refugee Settlement in northern Uganda Emergencysan unhcr.jpg
Emergency pit latrines with bathing shelters built in the Bidi Bidi Refugee Settlement in northern Uganda

To address the problem of public health and the spread of dangerous diseases that come as a result of lack of sanitation and open defecation, humanitarian actors focus on the construction of, for example, pit latrines and the implementation of hygiene promotion programs. [6]

The supply of drinking water during an emergency in an urban-setting has been improved by the introduction of standardised, rapid deployment kits. Alternatively, germ-infected water can be sanitized by adding disinfectants, boiling and/or filtering. If the water supply contains toxic chemicals it cannot be made safe to drink. [7]

In the immediate emergency phase, the focus is on managing open defecation, and toilet technologies might include very basic trench latrines, pit latrines, bucket toilets, container-based toilets, chemical toilets. For short-term emergencies there should be an approximate of 1 latrine or toilet for every 50 people, and work should be done with the goal of eventually reducing this amount to 20 people per latrine/toilet if possible. [8] The short term phase might also involve technologies such as urine-diverting dry toilets, septic tanks, decentralized wastewater systems.

In urban emergencies, the main focus is usually on a quick rehabilitation and extension of existing services such as sewer-lines and waste-water treatment plants. This can also include the installation of sewerage pumping stations to improve or extend services.

The creation of provisional hand washing stations or the distribution of hand sanitizer (that contains 60% of alcohol or more) are put into practice so that people keep their hands clean and thus eliminate the propagation of germs. [9]

Information on health care can be provided to the affected population in their respective languages, including instructions on how to use latrines efficiently. Further efforts can be made to help educate individuals who are not able to read the health communication materials. [8]

Standards

The handbook by Sphere on "Humanitarian Charter and Minimum Standards in Humanitarian Response" describes minimum standards in four "key response sectors" in humanitarian response situations. This places "Water Supply, Sanitation and Hygiene Promotion" (WASH) alongside the other response sectors which are: Food security and nutrition, shelter and settlement and health. [2] :5 Within the "Water supply, sanitation, and hygiene promotion standards" the handbook describes standards in the following areas: Hygiene promotion, water supply, excreta management, vector control, solid waste management and WASH in disease outbreaks and healthcare settings. [2] :91

With regards to excreta management, standards relate to: "(1) Environment free from human excreta, (2) Access to and use of toilets, (3) Management and maintenance of excreta collection, transport, disposal and treatment" (fecal sludge management). [2] :90

Some key indicators include:

Manhole toilet

Historical Museum of Waterworks and Sewerage. Chikusa-ku, Nagoya city, Aichi Prefecture, Japan. Temporary Manhole toilet for Disaster.jpg
Historical Museum of Waterworks and Sewerage. Chikusa-ku, Nagoya city, Aichi Prefecture, Japan.

Manhole toilet is simple toilet setup on sewer manhole used for disaster time.

Bathrooms are one of the biggest issues of evacuation facilities after a disaster like a big earthquake. The water supply comes relatively quick but bathroom issue will be handled not so well. There are many municipal governments encourage Twin Bucket Toilet for residential house and evacuation sites. We need pretty big facilities for long-term evacuation. It is also called "disaster toilet", "toilet for disaster" and "disaster preventative toilet".

Japanese Ministry of Land, Infrastructure, Transport and Tourism started using manhole toilets by putting a simple toilet over a public sewage manhole. There were many problems because manholes are located on public roads.

There are several types of manhole toilets that are directly connected to the sewerage system, and it is necessary to consider their adoption depending on the environment. The main types are 1. Flow type (sewer main connection), 2. Storage type (sewer main connection) and 3. Toilet tank type.

Japan Trying to Spread Use of "Manhole Toilets" in Disasters. [10]

Locations

Mass shelter

Mass shelter settings where the displaced population is housed in existing but often re-purposed building-complexes such as schools, community centres, places of worship, malls, warehouses and sport stadiums. Jurisdictional governments are primarily responsible for ensuring that people are directed to clear evacuation routes and zones. In some disaster prone countries, dedicated large emergency shelters are built for this purpose. [11]

Existing sanitation facilities are usually inadequate for full-time stay of a high number of people, and the non-emergency management structures are typically unable or unwilling to continue their services. Legal issues over the re-purposing are also fairly common, especially if occupation continues for a longer time.

Due to usually cramped living conditions there is a high risk of conflict and often also cases of sexual violence, both of which often are in some relation to the sanitation facilities. Mortality rates are high among large groups of internally displaced people. [12]

Emergency settlements

Emergency settlements (formal or informal) where previously sparsely populated areas are newly occupied by the displaced population in large numbers. Refugee camps fall into this category. Typically these are set up by governments, the UN and humanitarian aid organizations. [13]

Due to the typically short time frame of arrivals and the non-existing infrastructure, these kind of encampments pose maybe the greatest challenge in regards to providing adequate emergency sanitation facilities. The immediate demand for basic supplies and health services, having to account for the injured, dead, and survivors of man-made and/or natural disasters also aggravates these issues. [14]

Emergency healthcare

Infection prevention and control (IPC) is an important activity in disease prevention in any emergency situation. It is critical for the patients and the healthcare worker to ensure Minimum Standards are met in healthcare settings during emergency situations, but doing so often requires structured collaboration and support from emergency response teams, including WASH actors. [2]

All healthcare settings should maintain minimum WASH infection prevention and Control standards.

Challenges

Emergency pit lining kits, suitable for areas with high water table Emergency pit lining kits by Evenproducts (6619616743).jpg
Emergency pit lining kits, suitable for areas with high water table

The provision of sanitation programmes is usually more challenging than water supply as it provides a limited choice of technologies. [6] [15] This is exacerbated by the overwhelming and diverse needs of WASH. [15]

The World Health Organization recognises that the emergency setting is a challenging situation with respect to access to sanitation, and therefore recognises shared or public toilets that safely contain excreta under this setting as safe sanitation. [16]

Challenges with excreta disposal in emergencies building Latrines in areas where pits cannot be dug, desludging latrines, no-toilet options and the final treatment or disposal of the fecal sludge. [17]

See also

Related Research Articles

<span class="mw-page-title-main">Sanitation</span> Public health conditions related to clean water and proper excreta and sewage disposal

Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems aim to protect human health by providing a clean environment that will stop the transmission of disease, especially through the fecal–oral route. For example, diarrhea, a main cause of malnutrition and stunted growth in children, can be reduced through adequate sanitation. There are many other diseases which are easily transmitted in communities that have low levels of sanitation, such as ascariasis, cholera, hepatitis, polio, schistosomiasis, and trachoma, to name just a few.

Human waste refers to the waste products of the human digestive system, menses, and human metabolism including urine and feces. As part of a sanitation system that is in place, human waste is collected, transported, treated and disposed of or reused by one method or another, depending on the type of toilet being used, ability by the users to pay for services and other factors. Fecal sludge management is used to deal with fecal matter collected in on-site sanitation systems such as pit latrines and septic tanks.

<span class="mw-page-title-main">Pit latrine</span> Toilet that collects human waste in a hole in the ground

A pit latrine, also known as pit toilet, is a type of toilet that collects human waste in a hole in the ground. Urine and feces enter the pit through a drop hole in the floor, which might be connected to a toilet seat or squatting pan for user comfort. Pit latrines can be built to function without water or they can have a water seal. When properly built and maintained, pit latrines can decrease the spread of disease by reducing the amount of human feces in the environment from open defecation. This decreases the transfer of pathogens between feces and food by flies. These pathogens are major causes of infectious diarrhea and intestinal worm infections. Infectious diarrhea resulted in about 700,000 deaths in children under five years old in 2011 and 250 million lost school days. Pit latrines are a low-cost method of separating feces from people.

<span class="mw-page-title-main">Bucket toilet</span> Basic form of a dry toilet with a bucket

A bucket toilet is a basic form of a dry toilet whereby a bucket (pail) is used to collect excreta. Usually, feces and urine are collected together in the same bucket, leading to odor issues. The bucket may be situated inside a dwelling, or in a nearby small structure.

<span class="mw-page-title-main">Ecological sanitation</span> Approach to sanitation provision which aims to safely reuse excreta in agriculture

Ecological sanitation, commonly abbreviated as ecosan, is an approach to sanitation provision which aims to safely reuse excreta in agriculture. It is an approach, rather than a technology or a device which is characterized by a desire to "close the loop", mainly for the nutrients and organic matter between sanitation and agriculture in a safe manner. One of the aims is to minimise the use of non-renewable resources. When properly designed and operated, ecosan systems provide a hygienically safe system to convert human excreta into nutrients to be returned to the soil, and water to be returned to the land. Ecosan is also called resource-oriented sanitation.

<span class="mw-page-title-main">Community-led total sanitation</span> Approach to improve sanitation and hygiene practices, mainly in developing countries

Community-led total sanitation (CLTS) is an approach used mainly in developing countries to improve sanitation and hygiene practices in a community. The approach tries to achieve behavior change in mainly rural people by a process of "triggering", leading to spontaneous and long-term abandonment of open defecation practices. It focuses on spontaneous and long-lasting behavior change of an entire community. The term "triggering" is central to the CLTS process: It refers to ways of igniting community interest in ending open defecation, usually by building simple toilets, such as pit latrines. CLTS involves actions leading to increased self-respect and pride in one's community. It also involves shame and disgust about one's own open defecation behaviors. CLTS takes an approach to rural sanitation that works without hardware subsidies and that facilitates communities to recognize the problem of open defecation and take collective action to clean up and become "open defecation free".

Manual scavenging is a term used mainly in India for "manually cleaning, carrying, disposing of, or otherwise handling, human excreta in an insanitary latrine or in an open drain or sewer or in a septic tank or a pit". Manual scavengers usually use hand tools such as buckets, brooms and shovels. The workers have to move the excreta, using brooms and tin plates, into baskets, which they carry to disposal locations sometimes several kilometers away. The practice of employing human labour for cleaning of sewers and septic tanks is also prevalent in Bangladesh and Pakistan. These sanitation workers, called "manual scavengers", rarely have any personal protective equipment. The work is regarded as a dehumanizing practice.

<span class="mw-page-title-main">Sustainable sanitation</span> Sanitation system designed to meet certain criteria and to work well over the long-term

Sustainable sanitation is a sanitation system designed to meet certain criteria and to work well over the long-term. Sustainable sanitation systems consider the entire "sanitation value chain", from the experience of the user, excreta and wastewater collection methods, transportation or conveyance of waste, treatment, and reuse or disposal. The Sustainable Sanitation Alliance (SuSanA) includes five features in its definition of "sustainable sanitation": Systems need to be economically and socially acceptable, technically and institutionally appropriate and protect the environment and natural resources.

<span class="mw-page-title-main">Improved sanitation</span> Term used to categorize types or levels of sanitation for monitoring purposes

Improved sanitation is a term used to categorize types of sanitation for monitoring purposes. It refers to the management of human feces at the household level. The term was coined by the Joint Monitoring Program (JMP) for Water Supply and Sanitation of UNICEF and WHO in 2002 to help monitor the progress towards Goal Number 7 of the Millennium Development Goals (MDGs). The opposite of "improved sanitation" has been termed "unimproved sanitation" in the JMP definitions. The same terms are used to monitor progress towards Sustainable Development Goal 6 from 2015 onwards. Here, they are a component of the definition for "safely managed sanitation service".

<span class="mw-page-title-main">Sanitation worker</span> Person who is responsible for the cleaning and maintaining of a sanitation technology

A sanitation worker is a person responsible for cleaning, maintaining, operating, or emptying the equipment or technology at any step of the sanitation chain. This is the definition used in the narrower sense within the WASH sector. More broadly speaking, sanitation workers may also be involved in cleaning streets, parks, public spaces, sewers, stormwater drains, and public toilets. Another definition is: "The moment an individual’s waste is outsourced to another, it becomes sanitation work." Some organizations use the term specifically for municipal solid waste collectors, whereas others exclude the workers involved in management of solid waste sector from its definition.

<span class="mw-page-title-main">Dry toilet</span> Toilet that operates without flush water

A dry toilet is a toilet which, unlike a flush toilet, does not use flush water. Dry toilets do not use water to move excreta along or block odors. They do not produce sewage, and are not connected to a sewer system or septic tank. Instead, excreta falls through a drop hole.

<span class="mw-page-title-main">WASH</span> Acronym that stands for "water, sanitation and hygiene"

WASH is an acronym that stands for "water, sanitation and hygiene". It is used widely by non-governmental organizations and aid agencies in developing countries. The purposes of providing access to WASH services include achieving public health gains, improving human dignity in the case of sanitation, implementing the human right to water and sanitation, reducing the burden of collecting drinking water for women, reducing risks of violence against women, improving education and health outcomes at schools and health facilities, and reducing water pollution. Access to WASH services is also an important component of water security. Universal, affordable and sustainable access to WASH is a key issue within international development and is the focus of the first two targets of Sustainable Development Goal 6. Targets 6.1 and 6.2 aim at equitable and accessible water and sanitation for all. In 2017, it was estimated that 2.3 billion people live without basic sanitation facilities and 844 million people live without access to safe and clean drinking water.

<span class="mw-page-title-main">Open defecation</span> Humans defecating outside (in the open environment) rather than into a toilet

Open defecation is the human practice of defecating outside rather than into a toilet. People may choose fields, bushes, forests, ditches, streets, canals, or other open spaces for defecation. They do so either because they do not have a toilet readily accessible or due to traditional cultural practices. The practice is common where sanitation infrastructure and services are not available. Even if toilets are available, behavior change efforts may still be needed to promote the use of toilets. 'Open defecation free' (ODF) is a term used to describe communities that have shifted to using toilets instead of open defecation. This can happen, for example, after community-led total sanitation programs have been implemented.

Solidarités International is a non-profit organization working in areas of conflict and natural disasters. Its main aim is to provide quick and effective support for people in life-threatening situations by meeting their vital needs: water, food and shelter. The organization also has a particular focus on unsafe drinking water and food insecurity among the most vulnerable populations. Solidarités International, an organization founded in 1980 by Alain Boinet under France's 1901 charity law, comprises 2 350 national and international employees. Each year it carries out over 120 humanitarian programs in 20 countries.

<span class="mw-page-title-main">Urine-diverting dry toilet</span> Dry toilet with separate collection of feces and urine without any flush water

A urine-diverting dry toilet (UDDT) is a type of dry toilet with urine diversion that can be used to provide safe, affordable sanitation in a variety of contexts worldwide. The separate collection of feces and urine without any flush water has many advantages, such as odor-free operation and pathogen reduction by drying. While dried feces and urine harvested from UDDTs can be and routinely are used in agriculture, many UDDT installations do not apply any sort of recovery scheme. The UDDT is an example of a technology that can be used to achieve a sustainable sanitation system. This dry excreta management system is an alternative to pit latrines and flush toilets, especially where water is scarce, a connection to a sewer system and centralized wastewater treatment plant is not feasible or desired, fertilizer and soil conditioner are needed for agriculture, or groundwater pollution should be minimized.

<span class="mw-page-title-main">Reuse of human excreta</span> Safe, beneficial use of human excreta mainly in agriculture (after treatment)

Reuse of human excreta is the safe, beneficial use of treated human excreta after applying suitable treatment steps and risk management approaches that are customized for the intended reuse application. Beneficial uses of the treated excreta may focus on using the plant-available nutrients that are contained in the treated excreta. They may also make use of the organic matter and energy contained in the excreta. To a lesser extent, reuse of the excreta's water content might also take place, although this is better known as water reclamation from municipal wastewater. The intended reuse applications for the nutrient content may include: soil conditioner or fertilizer in agriculture or horticultural activities. Other reuse applications, which focus more on the organic matter content of the excreta, include use as a fuel source or as an energy source in the form of biogas.

<span class="mw-page-title-main">Omni Processor</span> Group of physical, biological or chemical treatments to process fecal sludge

Omni Processor is a term coined in 2012 by staff of the Water, Sanitation, Hygiene Program of the Bill & Melinda Gates Foundation to describe a range of physical, biological or chemical treatments to remove pathogens from human-generated fecal sludge, while simultaneously creating commercially valuable byproducts. An Omni Processor mitigates unsafe methods in developing countries of capturing and treating human waste, which annually result in the spread of disease and the deaths of more than 1.5 million children.

<span class="mw-page-title-main">Fecal sludge management</span> Collection, transport, and treatment of fecal sludge from onsite sanitation systems

Fecal sludge management (FSM) is the storage, collection, transport, treatment and safe end use or disposal of fecal sludge. Together, the collection, transport, treatment and end use of fecal sludge constitute the "value chain" or "service chain" of fecal sludge management. Fecal sludge is defined very broadly as what accumulates in onsite sanitation systems and specifically is not transported through a sewer. It is composed of human excreta, but also anything else that may go into an onsite containment technology, such as flushwater, cleansing materials, menstrual hygiene products, grey water, and solid waste. Fecal sludge that is removed from septic tanks is called septage.

<span class="mw-page-title-main">Container-based sanitation</span> Sanitation system which uses removable containers

Container-based sanitation refers to a sanitation system where toilets collect human excreta in sealable, removable containers that are transported to treatment facilities. This type of sanitation involves a commercial service which provides certain types of portable toilets, and delivers empty containers when picking up full ones. The service transports and safely disposes of or reuses collected excreta. The cost of collection of excreta is usually borne by the users. With suitable development, support and functioning partnerships, CBS can be used to provide low-income urban populations with safe collection, transport and treatment of excrement at a lower cost than installing and maintaining sewers. In most cases, CBS is based on the use of urine-diverting dry toilets.

References

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  2. 1 2 3 4 5 6 7 8 Sphere Association (2018) The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response, fourth edition, Geneva, Switzerland, 2018.
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  10. Japan Trying to Spread Use of "Manhole Toilets" in Disasters, nippon.com (2020).
  11. United States Federal Emergency Management Agency (2019) Planning Considerations: Evacuation and Shelter-in-Place
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  13. "Shelter and settlements - IFRC". www.ifrc.org. Retrieved 2020-04-23.
  14. "Responding to shelter needs in post-earthquake Pakistan: a self-help approach". Humanitarian Practice Network. Retrieved 2020-05-04.
  15. 1 2 "Urban Humanitarian Response Portal". urban-response.org. Retrieved 2017-04-19.
  16. World Health Organization (WHO) (2018). Guidelines on Sanitation and Health. Geneva, Switzerland: WHO.
  17. Bastable, A., Russell, L. (2013). Gap Analysis in Emergency Water, Sanitation and Hygiene Promotion. Humanitarian Innovation Fund (HIF), London, UK
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