NATIONAL DISASTER MANAGEMENT GUIDELINES Minimum Standards for Sanitation & Hygiene Promotion
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NATIONAL DISASTER MANAGEMENT GUIDELINES
Minimum Standards for Sanitation & Hygiene Promotion - extracted text
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NATIONAL DISASTER MANAGEMENT GUIDELINES
Minimum Standards for Sanitation & Hygiene Promotion
NATIONAL DISASTER MANAGEMENT AUTHORITY
CM-SER^ER
1
Introduction
1.1 Background:
Disasters whether natural or man-made, often lead to increase in mortality rates. This could be due to: 1)
die direct impact of the occurrence of hazard event which leaves many dead and a large number of
people in immediate need of medical relief or 2) due to post disaster consequences where in a large
number of displaced people take shelter in temporary setdements or relief camps and dieir access to basic
facilities like water, food, shelter, sanitation etc gets highly compromised. The limited access to any one or
more of these basic necessities adversely affects die health of people and if appropriate hygiene and
sanitation response is not planned, it may lead to epidemic situations. At risk groups like women,
pregnant women, lactating modiers, children, old aged, disabled and people living with HIV/AIDS are
most vulnerable in such situations.
In such situations die State has a primary responsibility to ensure sufficient sanitation and hygiene
promotion measures are in place at die relief camps. The directive principles of the Indian
constitution include Article 47, which specifies the duty of the state in this regard, ^I'he State shall regard
raising the levels of nutrition and the standard of living of its people and the improvement ofpublic health as among its
primary duties’. The right to life is recognised as a fundamental right in die constitution (Article 21) and
this right has been quoted in various judgements as a basis for preventing avoidable disease producing
conditions and to protect health and life. The right to health promotion facilities is also recognised
internationally as a human right and India is a signatory’ to the International Covenant on Economic,
Social and Cultural Rights which states in its Article 12 -“The States Parties to the present Covenant recognise the
right of everyone to the enjoyment of the highest attainable standard of physical and mental health... The steps to be
taken. ..shall include those necessaryfor,,. The creation of conditions which would assure to all medical service and medical
attention in the event ofsickness. ”
So die States and non-state actors shall coordinate and collaborate to meet the specific needs of the
people affected with disaster. The provisions under section 12 of the National Disaster Management Act,
2005, mandate National Disaster Management Authority to define the minimum standards for Hygiene
and Sanitation to be provided to people affected by disaster.
1.2 Aim
The aim of this document is to provide guideline about Hygiene and Sanitation requirements of people
affected with disasters as minimum standards applicable to whole country and on the basis of this the
State Governments shall lay down detailed guidelines for providing minimum standards of relief to
persons affected by disaster in die state, which in no way should be lesser than the minimum standards
prescribed in this document. (Section 12 and Section 19 of the National Disaster Management Act, 2005
refers)
1.3 The Importance and Purpose of Hygiene Promotion and Sanitation in
Emergencies:
People displaced by disasters and living in temporary camp like situations, are more prone to illness and
death from disease. These are related to inadequate excreta disposal, solid waste management, inadequate
vector control measures, and improper hygiene — domestic, environmental and personal hygiene. Added
risk is pollution of environment by medical waste. There is need to ensure minimum standards for
hygiene promotion and sanitation while responding to disasters. This is especially important during the
first 10 days to initiate the systems and in the next 40 days to continuously upgrade and monitor the
conditions.
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Hygiene and sanitation are critical determinants for control of communicable diseases during disaster
situations, especially diseases related to inadequate sanitation, inadequate water supplies and poor hygiene.
The most significant of these diseases are diarrhoeal diseases and infectious diseases transmitted by die
faeco-oral route . Other water- and sanitation-related diseases include those carried by vectors associated
with solid waste and water. The main objective in disasters is to reduce the transmission of faeco-oral
diseases and exposure to disease-bearing vectors dirough the promotion of good hygiene practices, die
provision of safe drinking water and die reduction of environmental healdi risks and by establishing die
conditions that allow people to live with good health, dignity, comfort and security. The term ‘sanitation’,
throughout this guideline refers to excreta disposal, vector control, solid waste management, health care
waste management and waste water management.
Simply providing sanitation facilities will not, on its own, ensure their optimal use or impact on public
health. In order to achieve the maximum benefit from a response, it is imperative to ensure that disasteraffected people have the necessary information, knowledge and understanding to prevent water- and
sanitation-related disease, and to mobilise their involvement in die design and maintenance of those
facilities. Promotion of hygiene will be a specific component of the response.
1.4 Important Considerations for Sanitation and Hygiene Promotion during
Emergencies:
1.4.1
Planning and Preparedness: In spite of recent developments and
advances in Sanitation facilities created through “Total Sanitation Campaign” in the country,
there are wide gaps in outreach and behavioural acceptance of such measures by people in
certain regions. If any disaster strikes in these parts of the country the situation becomes
worst. Therefore, preventive measures must be integrated in disaster management plans at
the district, state and national levels to ensure emergency sanitation facilities and hygiene
promotion measures.
1.4.2
Assessment: Hie Sanitation and Hygiene promotion response in relief
camps should be based on the sound Public and Environmental Health assessments as part
of multi-sectoral assessments (in coordination with assessments for Food and Nutrition
security; Water,; Shelter and settlement planning and other sectoral assessments) as explained
in the relevant chapters and annexure attached.
1.4.3
Coordination: During disasters die government and non government
organizations need to work together along with the affected population. The planning and
coordination at camp levels, NGO-NGO coordination and GO-NGO coordination shall be
part of the incident response system and support designated authorities at all levels.
1.4.4
Identifying vulnerable groups and addressing their special needs:
The groups most frequently at risk in disasters are women, children, older people, disabled
people and people living with HIV/AIDS (PLWH/A). In certain contexts, people may also
become vulnerable by reason of ethnic origin, religious or political affiliation, or
displacement. The specific concerns and measures for tire vulnerable groups along with some
other important issues pertaining to gender, protection, social inclusion and environment are
cross cutting issues that should be considered at all stages of the medical response in relief
camps.
1.4.5
Monitoring: The post disaster situation changes very rapidly. With the
progression of the sanitation and hygiene promotion response, there is generally an
improvement in the living conditions, however, the situation shall be monitored
continuously for having a better focus in the program interventions and addressing mid
course corrections if any.
1.4.6
Participation of Communities:
The participation of disaster-affS&fe??^^
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people in assessment, planning, decision-making and implementation, helps to ensure that
programmes are equitable, effective and reinforce people’s sense of dignity. Special effort
should be made to ensure the participation of women and other vulnerable groups.
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Assessment
Safe disposal of human excreta creates the first barrier to excreta related disease, helping to reduce
transmission of diseases. Safe excreta disposal is therefore a major priority, and in most disaster situations
should be addressed with as much speed and effort as the provision of safe water supply. The provision
of appropriate facilities for defecation is an important response essential for ensuring people’s dignity,
safety, health and well-being.
fherefore, die respective SDMA/DDMA in collaboration and coordination widi other non government
actors should plan the rapid need assessment and the detailed need assessment as per the minimum
standards and guidance given below. The assessment should be based on the risk-vulnerability assessment
information as part of existing disaster management plan at state and district level respectively.
2.2 Minimum Standards and Guidance for Sanitation and Hygiene
Assessment:
1.
2.
Key information should be collected from as many different people and sources as possible to
corroborate findings. Additional data may be collected after decisions have been made for
confirmation
It is essential to understand local content and social structures and to be aware of conflicting
interests and biases within communities when collecting information. It is also important to
discuss the purpose of the assessment with communities to avoid raising expectations
unrealistically.
3.
The assessment should investigate the community coping mechanisms in
the post disaster situation. The sanitation aid response should preferably be designed and build
on these practices or shall strengthen them to ensure long term sustainability, fhe information
may be collected through participatory methods in the field or by doing some focus group
discussion (FGD).
4.
Acceptable facilities: successful excreta disposal programmes are based on an understanding of
peoples’ varied needs and on the participation of the users in the use of facilities as people may
not be accustomed to or may not find it easy or attractive to use. Design, construction and
location of toilets must consider die preferences of the intended users.
Children’s faeces: particular attention should be given to children’s faeces, which are commonly
more dangerous than those of adults. Parents need to be involved, and facilities should be
designed and installed with children in mind.
Anal cleansing: water should be provided for people who use it. For other people it may be
necessary to provide some sort of paper or other material for anal cleansing.
Hand washing: users should have the means to wash their hands after defecation, and should
be encouraged to do so if necessary. This provides an important barrier to the spread of disease.
Menstruation: women and girls of reproductive age should have access to suitable materials for
die absorption and disposal of menstrual blood. If these materials are to be provided by the
agency, women should be consulted on what is appropriate. Where cloths are washed, dried and
re-used, women should have access to a private place to do diis in a hygienic way.
Hygienic toilets: if toilets are not kept clean diey may be a focus for disease transmission and
people will prefer not to use them. Cleaning and maintenance of all types of toilet should be
addressed. Toilets are more likely to be kept clean if users have a sense of ownership. This is
encouraged by having them close to where people sleep, avoiding large blocks, and involving
users, where possible, in decisions about their design and construction.
5.
6.
7.
8.
9.
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10.
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The checklist, methodologies and reporting formats for rapid and detailed
assessment are attached as annexures.
Minimum standards for Hygiene and Sanitation
The term "sanitation’, refers to excreta disposal, vector control, solid waste management, health care waste
management and waste water management.
3.1 Excreta Disposal: Safe disposal of human excreta creates the first barrier to excreta related disease,
helping to reduce transmission through direct and indirect routes. Safe excreta disposal is therefore a
major priority, and in most disaster situations should be addressed with speed to ensure that peoples
have adequate numbers of toilets, sufficiently close to their dwellings, to allow them rapid, safe and
acceptable access at all times of the day and night..
3.1.1
3.1.2
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•
3.1.3
•
•
•
•
•
•
•
•
•
•
Defecation areas and shadow trench latrines:
In the initial phase of a disaster, before any toilets can be constructed, it may be
necessary to
mark off an area to be used for defecation purposes. To discourage open defecation
the
appropriate number of shallow trench latrines should be constructed as
soon as possible for
first 72 hours of the disaster response.
Number of toilets:
If there are no existing toilets for the displaced population, Plans and efforts should be made to
provide it one toilet per 20 people. A figure of one toilet for fifty people may be used initially but
it should be reduced to 20 within 7 days of the, notification of die camp, especially if die people
arc going to live in camps for a longer time.
Disaggregated population data should be used to plan the ratio of women’s cubicles to men’s (of
approximately 3:1). Where possible urinals should be provided for men.
Design and Construction of toilets:
Users (especially women) should be consulted for siting and design of toilet. Appropriate design
should be planned for ease of use by all sections of population including children, aged and
people widi disability.
The toilets should be sited in such a way to minimise the threat to users especially women and
girls throughout the day and night. Where ever possible the community toilets should be
provided with lighting for nights or families should be provided with torches. The inputs of the
community' should be sought with regard to ways of enhancing the safety of users
The toilets should be easy to clean and do not pose any health hazard. They should provide the
degree of privacy in line with norms of the users.
The facilities for women’s sanitary disposal or providing women with the necessary privacy for
washing and drying sanitary protection clothes should be planned.
The toilet design should minimise fly and mosquito breeding.
The constructed toilets that use water for flushing and/or hygiene should have an adequate
storage and supply of water.
Pit latrines and soakaways should be atleast 30 m from any surface water source and die bottom
of any latrine should be at least 1.5 m above the water table.
Drainage and spillage from defecation systems must not run towards surface water source or
shallow ground water source.
The hand washing facilities should be planned with the toilets
The tools and materials required for construction, maintenance and and cleaning of toilets should
be planned and provided to communities.
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3.1.4
3.1.5
3.1.6
Acesss, use and manitainence of toilets:
Systems for the proper regular cleaning and maintenance of the Toilet facilities should be
established.
In situations where the population has not traditionally used toilets, it may be necessary to
conduct a concerted education/promotion campaign to encourage their use and to create a
demand for more toilets to be constructed.
The families should be consulted about the siting, design, the responsibility and the means to
clean and maintain the Toilets. It is generally observed where one toilet is shared by four or five
families, it is better kept, cleaner and regularly used.
Children^ faeces:
Particular attention should be given to the disposal of children’s faeces, which are commonly
more dangerous than those of adults, as the level of excreta-related infection
among
children is frequently higher and children lack antibodies. Parents or care givers
need to be
involved, and facilities should be designed with children in mind. It may be necessary to provide
parents or care givers with information about safe disposal of infant
faeces and nappy
(diaper) laundering practices.
In Urban settings:
Disasters in urban areas where the sewerage system is damaged may require solutions
such as isolating parts of the system that still work (and re-routing pipes), installing portable
toilets and using septic tanks and containment tanks that can be regularly desludged.
3.2 Vector Control: A vector is a disease-carrying agent and vector-borne diseases are a major cause of
sickness and death in many disaster situations. Mosquitoes are the vector responsible for malaria
transmission, which is one of the leading causes of morbidity and mortality. Mosquitoes also transmit
other diseases, such as yellow fever and dengue haemorrhagic fever. Non-biting or synanthropic flies,
such as the house fly, the blow fly and the flesh fly,play an important role in the transmission of
diarrhoeal disease. Biting flies, bed bugs and fleas are a painful nuisance and in some cases transmit
significant diseases such as murine typhus and plague. Ticks transmit relapsing fever and human body lice
transmit typhus and relapsing fever. Rats and mice can transmit diseases such as leptospirosis and
salmonellosis and can be hosts for other vectors e.g. fleas, which may transmit Lassa fever, plague and
other infections.
Vcctor-borne diseases can be controlled tlirough a variety of initiatives, including appropriate site
selection and shelter provision, appropriate water supply^ excreta disposal, solid waste management and
drainage, the provision of health services (including community mobilisation and health promotion), tire
use of chemical controls, family and individual protection and the effective protection of food stores.
Although the nature of vector-borne disease is often complex and addressing vectorrelated problems may
demand specialist attention, there is much that can be done to help prevent the spread of such diseases
with simple and effective measures, once the disease, its vector and their interaction with the population
have been identified.
Family and Individual Protection: All disaster-affected people should have (or have access to) the
knowledge and the means to protect themselves from disease and nuisance vectors that are likely to
represent a significant risk to health or well-being.
3.2.1 Defining vector-borne disease risk: "Decisions about vector control interventions should be based
on an assessment of potential disease risk, as well as on clinical evidence of a vector-borne disease
problem. Factors influencing this risk may include:
• Immunity status of the population, including previous exposure,
• Nutritional stress and other stresses. Movement of people (e.g. IDPs) from a non-endemic to an
endemic area is a common cause of epidemics;
• Pathogen type and prevalence, in both vectors and humans;
• Vector species, behaviours and ecology;
• Vector numbers (season, breeding sites, etc.);
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•
Increased exposure to vectors: proximity, settlement pattern, shelter type, existing individual
protection and avoidance measures.
3.2.2 Awareness: All populations at risk from vector-bome disease should understand the modes of
transmission and possible methods of prevention. People should be informed of health risks and
should avoid entering water bodies where there is a known risk of contracting diseases such as
schistosomiasis, Guinea worm or leptospirosis (transmitted by exposure to mammalian urine,
especially that of rats. Agencies may need to work with the community to find alternative sources
of water or ensure that water for all uses is appropriately treated.
3.2.3 Appropriate Shelter: All populations at risk should have access to shelters that do not harbour or
encourage the growth of vector populations and are protected by appropriate vector control
measures.
3.2.4 Individual Malaria Protection: People avoid exposure to mosquitoes during peak biting times by
using all non-harmful means available to them. Special attention is paid to protection of high-risk
groups such as pregnant and feeding mothers, babies, infants, older people and the sick people
with treated mosquito nets use them effectively.
3.2.5 Individual protection measures for other vectors: Control of human body lice should be
carried out where louse-borne typhus or relapsing fever is a threat. Good personal hygiene and
regular washing and airing of clothes and bedding is die most effective protection against body lice.
Infestations can be controlled by personal treatment (powdering), mass laundering or delousing
campaigns and by treatment protocols as newly displaced people arrive in a setdement.
3.2.6 Protection of Food: Food should be protected at all times from contamination by vectors such as
flies, insects and rodents.
3.2.7 Monitoring Vector borne diseases: Vector-borne disease incidence rates (from epidemiological
data, community-based data and proxy indicators, depending on the response) and parasite counts
(using rapid diagnostic kits or microscopy) should be monitored.
Vector Control: Physical, environmental and chemical protection measures: The numbers of
disease vectors that pose a risk to people’s health and nuisance vectors that pose a risk to people’s wellbeing are kept to an acceptable level.
3.2.8 Site selection: Camps should be located l-2km upwind from large breeding sites, such as swamps
or lakes, whenever an additional clean water source can be provided.
3.2.9 Environmental and chemical vector control: Basic environmental engineering measures should
be taken to reduce the opportunities for vector breeding. These include tire proper disposal of
human and animal excreta, proper disposal of refuse to control flies and rodents and drainage of
standing water to control mosquitoes Such priority environmental health measures will have some
impact bn the population density of some vectors. However, it may not be possible to have
sufficient impact on all the breeding, feeding and resting sites within a settlement or near it, even in
the longer term, so die localised chemical control measures or individual protection measures
should be used. For example, space spraying may reduce die numbers of adult flies and prevent a
diarrhoea epidemic, or may help to minimise the disease burden if employed during an epidemic.
3.2.10 Intensive Vector control in high-density vector conditions with potential epidemic risks:
In such situations, the vector control programmes should aim 1) to reduce the vector population
density; 2) to reduce the human-vector contact; and 3) to reduce die vector breeding sites. Control
programmes may have no impact on disease if diey target die wrong vector, use ineffective
methods, or target the right vector in the wrong place or at die wrong time.
3.2.11 Environmental mosquito control: Environmental control aims primarily at eliminating
mosquito breeding sites. The three main species of mosquitoes responsible for transmitting disease
are Culex (filariasis). Anopheles (malaria and filariasis) and Aedes (yellow fever and dengue). Culex
mosquitoes breed in stagnant water loaded with organic matter such as latrines. Anopheles in
relatively unpolluted surface water such as puddles, slow-flowing streams and wells, and Aedes in
water receptacles such as botdes, buckets, tyres, etc. Examples of environmental mosquito control
include good drainage, properly functioning latrines, keeping lids on die squatting hole
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latrines and on water containers, and keeping wells covered and/or treating them with a larvicide
(e.g. for areas where dengue fever is endemic).
3.2.12 Malaria treatment: Malaria control strategies should aim to reduce the mosquito population
density by eliminating breeding sites, reducing the mosquito daily survival rate and restricting the
human biting habit. These should be carried out simultaneously with early diagnosis and treatment
with effective anti-malarials in a sustainable manner.
Chemical control safety measures: Chemical vector control measures should be carried out in a
manner that ensures that staff, the people affected by the disaster and the local environment are
adequately protected, and avoids creating resistance to the substances used.
3.2.13
3.2.14
3.2.15
Protection of Personnel: Personnel are protected by the provision of training, protective
clothing, use of bathing facilities, supervision and a restriction on the number of hours spent on
handling chemicals.
National and International Protocols: I'hc choice, quality, transport and storage of chemicals
used for vector control, the application equipment and the disposal of the substances should
follow die National and/or International norms (published by WHO), and should be accounted
for at all times.
Community Awareness: Communities should be informed about the potential risks of the
substances used in chemical vector control and about the schedule for application. They are
protected during and after the application of poisons or pesticides, according to national and/or
internationally agreed procedures (specified by WHO).
3.3 Solid waste Management: If organic solid waste is not disposed of, major risks are incurred of
fly and rat breeding and surface water pollution. Uncollected and accumulating solid waste and the debris
left after a natural disaster or conflict may also create a depressing and ugly environment, discouraging
efforts to improve other aspects of environmental health. Solid waste often blocks drainage channels and
leads to environmental healtli problems associated with stagnant and polluted surface water.
'lhe people should have the means to dispose of their domestic waste conveniently and effectively and an
environment acceptably uncontaminated by solid waste should be sustained in the relief camps.
3.3.1 Refuse type and quantity:
• The refuse in settlements should be assessed for its composition and quantity, according to the
amount and type of economic activity’, the staple foods consumed and local practices of recycling
and/or waste disposal. The extent to which solid waste has an impact on people’s health should
be assessed and appropriate actions should be planned.
• Recycling of solid waste within the community should be encouraged, provided it presents no
significant health risk. Distribution of commodities that produce a large amount of solid waste
from packaging or processing on-site should be avoided.
3.3.2 Disposal of waste:
• Household waste should be put in containers daily for regular collection, burnt or buried in a
specified refuse pit.
• All households should have access to a refuse container and/or are no more than 100 metres
from a communal refuse pit.
• At least one 100-litre refuse container should be available per 10 families, where domestic refuse
is not buried on-site.
• Refuse should be removed from the settlement before it becomes a nuisance or a health risk.
• If waste is to be buried on-site in either household or communal pits, it should be covered at
least weekly with a thin layer of soil to prevent it attracting vectors such as flies and rodents and
becoming their breeding ground.
• If children’s faeces/nappies are being disposed of they should be covered with earth directk
afterwards.
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•
•
•
•
•
Disposal sites should be fenced off to prevent accidents and access by children and animals; care
should be taken to prevent any leachate contaminating the ground water.
The public places, such as markets and slaughtering areas should have clearly marked and
appropriately fenced refuse pits, bins or specified areas widi a regular collection system in place.
Appropriate measures should be ensured for disposal of waste from any slaughterhouse, to
butchery. Slaughterhouse waste may need special treatment and special facilities to deal with die
liquid wastes produced, and to ensure diat slaughtering is carried out in hygienic conditions and
in compliance with local laws. Slaughter waste can be disposed of in a large pit with a hole cover
next to the abattoir. Blood, etc. can be run from die abattoir into the pit through a slab-covered
channel (reducing fly access to the pit).
Water should be made available for cleaning purposes.
Final disposal of solid waste is carried out in such a place and in such a way as to avoid creating
health and environmental problems for the local and affected populations.
3.3.3 Participation ofcommunities and staff welfare:
•
•
People from the affected population should be involved in die design and implementation of the
solid waste programme. They should be made aware of the importance of solid waste disposal
dirough a proper household and community hygiene promotion programme.
All solid waste management staff who collect, transport or dispose of waste should be provided
widi protective clothing, at minimum gloves and ideally overalls, boots and protective masks.
Water and soap should be available for their hand and face washing. Staff who comes into
contact with medical waste should-be informed of die correct mediods of storage, transport and
disposal and die risks associated with improper management of die waste.
3.4 Drainage: Surface water in or near emergency settlements may come from household and waterpoint wastewater, leaking toilets and sewers, rainwater or rising floodwater. The main health risks
associated with surface water are contamination of water supplies and the living environment, damage to
toilets and dwellings, vector breeding and drowning* Rainwater and rising floodwaters can worsen the
drainage situation in a settlement and further increase the risk of contamination. A proper drainage plan,
addressing storm water drainage through site planning and wastewater disposal using small-scale, on-site
drainage, should be implemented to reduce potential health risks to the population.
The risks posed by water erosion and standing water, including stormwater, floodwater, domestic
wastewater and wastewater from medical facilities, should be minimised and a healthy and risk free
environment should be preserved.
3.4.1 Site selection and Planning: Camp sites should be selected and planned in a manner to minimise
the drainage problems:
• Shelters, paths and water and sanitation facilities should not get flooded or eroded by water.
• Drainage waters do not pollute existing surface or groundwater sources or cause erosion
3.4.2 Assessment and classification of waste water: The assessment exercise should analyse the waste
water origins, threats and risks and classify the domestic waste water, storm water and sullage/sewage
waste points. The waste water mixed with human excreta is classified as sewage. As sewage is difficult and
more expensive to treat and dispose off, it should not be allowed to mix with domestic or storm waste
water.
3.4.3 Domestic Wastewater Drainage:
• The areas around dwellings and water points should be kept free of standing wastewater, and
stormwater drains should be clear.
• The domestic waste water from water points, washing and bathing areas should be utilised by
creation of small gardens or kitchen gardens if any.
\/\/ER
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•
•
•
The water should be safely drained and special attention should be paid to prevent washing and
badring areas waste water from contaminating water sources.
If favourable soil conditions exist, drainage should be on-site radier than via open channels,
which are difficult to maintain and often clog. Simple and cheap techniques such as soak pits can
be used for on-site disposal of wastewater.
Where off-site disposal is die only possibility, channels are preferable to pipes. Channels should
be designed both to provide flow velocity to carry stormwater and other wastes. Where the slope
is more dian 5%, engineering techniques must be applied to prevent excessive erosion.
3.4.4 Sewage Drainage:
• Special care is needed to protect toilets and sewers from flooding in order to avoid structural
damage and leakage.
• If there is an existing sewage system near the camp/setdement, attempt should be made to
connect die toilets and sewage drainage with the system.
• Otherwise the sewage pits with design appropriate to the soil conditions should be planned.
3.4.5 Participation ofcommunities and Promotion:
• The communities should essentially be involved in design, planning, construction and
maintenance of die drainage systems. If they understand the potential health and physical risks
involved and have participated in construction of drainage system, they are more likely to
maintain it.
• The technical tools and support should be extended to communities for construction and
maintenance purposes.
3.5 Hygiene Promotion: In die post disaster situation, the hygiene promotion is defined as the mix
between the population’s knowledge, practice and resources and the response program management or
camp management’s knowledge and resources, which together enable risky hygiene behaviours to be
avoided. The three key factors important in achieving a good community’ hygiene in a post disaster
situation are: 1) a mutual sharing of information and knowledge, 2) the mobilisation of communities and
3) the provision of essential materials and facilities.
Effective hygiene promotion relies on an exchange of information between the camp management and
the affected community in order to identify key hygiene problems and to design, implement and monitor
a programme to promote hygiene practices that will ensure the optimal use of facilities and the greatest
impact on public health. Community mobilisation is especially pertinent during disasters as die emphasis
must be on encouraging people to take action to protect their health and make good use of facilities and
services provided, rather than on die dissemination of messages. It must be stressed that hygiene
promotion should never be a substitute for good sanitation and water supplies, which are fundamental to
good hygiene. Hygiene promotion is integral to all odier essential services.
So, the Hygiene promotion should be based on the vulnerabilities, needs and preferences of the affected
communities and die users should be involved in the management and maintenance of hygiene facilities
wherever possible and appropriate.
3.5.1 Assessment.
• An initial assessment should be carried out to identify the key hygiene risks of public healdi
importance and the hygiene behaviours to be addressed.
• Generally the key risks centres on excreta disposal, the use and maintenance of toilets, die lack of
hand washing widi soap or an alternative, the unhygienic collection and storage of water, and
unhygienic food storage and preparation.
• The assessment should look at resources available to die population as well as local behaviours,
knowledge and practices so diat relevant and practical could be developed.
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It should pay special attention to the needs of vulnerable groups. If consultation with any group is
not possible, this should be clearly stated in the assessment report and addressed as quickly as
possible.
3.5.2 Sharing Responsibility:
•
The responsibility for hygiene practice lies primarily with all members of the affected population.
The camp management should ensure that all actors responding to die disaster should share
responsibilities and work to ensure diat bodi knowledge and facilities for hygiene promotion are
accessible to all sections of the affected communities.
• Hygiene Promotion programme should aim at the users taking responsibility for the management
and maintenance of facilities as appropriate, and different groups contribute equitably.
3.5.3 Reaching al! sections of the population:
• All groups within the population should have equitable access to the resources or facilities needed to
continue or achieve the hygiene practices that are promoted.
• Hygiene promotion messages and activities address key behaviours and misconceptions and are
targeted for all user groups. Representatives from these groups participate in planning, training,
implementation, monitoring and evaluation.
• Materials should be designed so that messages reach members of the population who are illiterate.
• As a rough guide, in a camp scenario there should be two hygiene promoters/community mobilisers
per 1,000 members of the target population.
• For information on hygiene items, see Non-food items standard 2 on page 232.
3.5.4. Targeting priority hygiene risks and behaviours:
•
The objectives of hygiene promotion and communication strategies should be clearly defined and
prioritised.
• The understanding gained through assessing hygiene risks, tasks and responsibilities of different
groups should be used to plan and prioritise assistance, so that misconceptions (for example, how
HIV/AIDS is transmitted) are addressed and information flow between camp management and the
affected population is appropriate and targeted:
3.5.5. Management ofFacilities:
• Where possible, the committees made up of representatives from the various user groups (half of
whose members are women) should be formed in a participatory way. The functions of these
committees are to manage the communal facilities such as water points, public toilets and washing
areas, be involved in hygiene promotion activities and also act as a mechanism for ensuring
representation and promoting sustainability.
cfcA-se^ER
10
Annexure -1
Assessment Checklist
Assessment
Checklist
Assessment Methodology Checklist
1. Should include the clear description of
— The Goal and objectives
— Background and number of assessors
— Selection of key informants /sample population
— Composition of focus or other discussion groups
— Criteria for selection of informants / sample population
— Methodologies Tools and techniques: including PRA.
— Framework for analysis and
-Timeframe of the assessment
Reporting
assessment report
r The
findings should cover:
2. Be based on a qualitative approach, including review of
secondary sources of quantitative information;
3. Involve local NGOs and community institutions as partners in
the assessment process, unless inappropriate.
4. Employ an appropriate range of PRA tools and techniques
which are applied in sequence to analyse and triangulate findings;
6. Involve a representative range of affected population groups;
7. Describe the limitations or practical constraints of the
assessment;
8. Describe the coverage of the assessment, including its
geographic spread, the range of water sources, supply
mechanisms included and other relevant stratification of the
population (e.g. gender, ethnicity, tribal group, etc.);
9.
Include interviews with representatives of relevant
government ministries and public services, traditional leaders,
representatives of key civil society organisations (religious groups,
local NGOs, advocacy or pressure groups, women’s groups) and
representatives of each of the groups under consideration.
1. The recent history of
Hygiene and Sanitation and
the relevant policies prior to
the disaster situation;
2. A description of the
different vulnerable groups
and their situation prior to the
disaster;
3. The impact of the disaster
on
the
Hygiene
and
Sanitation system and access
to different groups;
4. Suggested interventions.
5.
Advocacy,
awareness
building
and
additional
measures required;
precise
nature,
7.
The
purpose and duration of
and
Sanitation
Hygiene
Response if a response is
considered appropriate.
Suggested questions for Hygiene and Sanitation Initial Assessment
1. Excreta disposal
• What is the current defecation practice? If it is open defecation, is there a designated area? Is the
area secure?
• What are current beliefs and practices, including gender-specific practices, concerning excreta
disposal?
11
•
•
•
•
•
•
•
•
•
•
•
•
•
Are there any existing facilities? If so, are they used, are they sufficient and are they operating
successfully? Can they be extended or adapted?
Is the current defecation practice a threat to water supplies (surface or ground water) or living
areas?
Do people wash their hands after defecation and before food preparation and eating? Are soap
or odier cleansing materials available?
Are people familiar with the construction and use of toilets?
What local materials are available for constructing toilets?
Are people prepared to use pit latrines, defecation fields, trenches, etc.?
Is diere sufficient space for defecation fields, pit latrines, toilets, etc.?
What is the slope of the terrain?
What is the level of the groundwater table?
Are soil conditions suitable for on-site excreta disposal?
Do current excreta disposal arrangements encourage vectors?
Are there materials or water available for anal cleansing?How do people normally dispose of
these materials?
How do women manage issues related to menstruation? Are there appropriate materials or
facilities available for this?
i L:
4. Vector-borne disease
• What are the vector-borne disease risks and how serious are these risks?
•
What traditional beliefs and practices relate to vectors and vectorborne disease? Are any of these
either useful or harmful?
•
If vector-bome disease risks are high, do people at risk have access to individual protection?
•
Is it possible to make changes to die local environment (by drainage, scrub clearance, excreta
disposal, refuse disposal, etc.) to discourage vector breeding?
• Is it necessary to control vectors by chemical means? What programmes, regulations and
resources exist for vector control and die use of chemicals?
•
What information and safety precautions need to be provided to households?
5 Solid waste disposal
•
Is solid waste a problem?
• How do people dispose of their waste? Wliat type and quantity of solid waste is produced?
•
Can solid waste be disposed of on-site, or does it need to be collected and disposed of off-site?
•
What is die normal practice of solid waste disposal for the affected population? (compost/refuse
pits? collection system? bins?)
• Are there medical facilities and activities producing waste? I low is this being disposed of? Who is
responsible?
6 Drainage
• Is there a drainage problem (e.g. flooding of dwellings or toilets, vector breeding sites, polluted
water contaminating living areas or water supplies)?
• Is die soil prone to waterlogging?
• Do people have the means to protect their dwellings and toilets from local flooding?
cm-sek\N£r
12
Annexure - II
Planning Guidelines for Minimum Numbers of Toilets at Public Places and
Institutions in Disaster Situations
Institution
Shen term
Long term
Market areas
1 toilet to 50 stalls
1 toilet to 20 stalls
Hospi ta te/medical
centres
1 toilet to 20 beds
or 50 out-patients
:1 toilet to 10 beds or
20 out-patients
Feeding centres
1 toilet to 50 adults
1 toilet to 20
children
1 toilet to 20 adults
1 toiler to 10 children
Reception/transit
centres
1 toilet per 50
people
3:1 female to male
Schools
1 toilet to 30 girls
1 toilet to 6'0 boys
Offices
1 toiler to 30 girls
1 toilet to 60 boys
1 toilet to 20 staff
Smitce: adapted from Harwy, Bagbri and Reed (2i)i)2)
cm-seb^eR
Scenario of a relief camp on embankments
Approximately 12,000 poor and backward families took shelter on a road cum embankment, cramped in
less than 13km stretch with over 4000 livestock animals. They are from surrounding villages that were
inundated by floodwater and from the villages washed away by erosion & embankment breach. People
are living in makeshift huts made out of sticks and plastic sheeting on both sides of the road leaving a
meter width of narrow alley in the middle. Local govt declared this as a relief camp. According to
meteorological department, another spell of rain is imminent within next two weeks, which will only
prolong peoples suffering. During the daytime men return to their village to secure assets and property
and also to collect fodder for cows, while the women and children stay at the displaced camp, spending
most of the time in queues for relief and water distribution. A number of local groups and civil societies
are providing dry foods and district authority provided a health camp and 3 days food ration. More than
50 people died by drowning and snake bites. Diarrhoea incidents are increasing among children. Local
government prioritizes relief needs around food, shelter, medical and water.
Water
Panchayet/PHED installed 4 nos of very shallow (<20’) temporary tube-wells along the road a km apart,
people complains of water from these TW’s are smelly and its quality is questioned as it draws water very
close to the surface. Families those who have small boat/canoe travel far to get water from a raised tube
well or the one accentuated from flood water in village. It was clear that people are aware of risks
associated with poor drinking water and try to collect from a safe source but unhygienic conditions and
some risky health behaviour means there are concerns about water quality at household level. People
are using floodwater for other than drinking water purposes. PHED/Panchayet also distributed halogen
tablets (chlorine base), it has been observed that people are not using it.
Sanitation & solid waste
Sanitation situation is worsening as cow-dung and human faces are strewn all over the place. The
standing floodwater adjacent to the road embankment is covered by a blanket of floating excreta and
rubbish, making the camp environment extremely unhygienic. Women defecate by dipping in to water or
use behind hut in dark, as there is no privacy in the overcrowded space. Some minorities arranged
privacy screen by using cloths and bed-sheets behind or beside their huts and used as open latrine.
From a FGD, women expressed their severe mental and physical discomfort and dignity problem around
privacy related to defecation and other private acts. It was also revealed that some women and elderly
persons defecate inside the hut to dispose later in to water. Children defecate indiscriminately. Digging
hole on the road/embankment is not permitted, therefore pre-cast ring slabs brought by a local NGOs are
not being used.
Personal Hygiene
The struggle forgetting drinking water and finding appropriate places to defecate took preference over
personal hygiene. Many had fled without any personal belongings and household items including water
container and utensils. Some had fled with only the clothes they wore and hence refrained from bathing
for several days for lack of a change of clothes. Women in menstruation experienced great difficulty.
Food was kept uncovered due to non-availability of required utensils. Food once cooked was eaten over
extended periods by members of the family from the same utensil throughout the day until the food
lasted. Flood water used to prepare food and cleaning purpose. Open defecation is commonly seen, as
agricultural land and orchards (normal place for adult defecation) are still flooded. Minor skin diseases
have also been observed in children, however children seem to be well animated, alert and no signs of
acute malnutrition has been noted. Many of the children look to be on the small side for their age, hinting
stunting resulting from chronic malnutrition.
CM-SEFf'A/ER
Flood scenario West Bengal;
Access to potable Water
In response to the floods a task force has been set up at sub national level led by
Government, with representatives of Public health engineering department, the
department of health, NGOs, and the national Red Cross Society. The urgency of
the situation this year and the scale of the situation which is much worse than in
many years in living memory is calling for a collective approach to deal with the
situation. As a group of engineers, health specialists and hygiene experts you are
asked to develop an action plan and report back to the overall Government
coordination mechanisms.
This task force has been asked to focus on 12,000 or so people displaced into
shelters /relief camps (out of 400,000 in shelters). Specifically you are tasked
with dealing with the populations displaced to the relief camps/centres/areas and
by 15.30 you must present a plan to a coordination meeting which chooses just
one method, that all agencies will adopt, of enabling potable water to be made
available to the affected families, i.e. HWTS (as opposed to bulk water supply
and delivery by truck).
The options that are available to you in this situation are;
• Candlle/ceramic filters
• Locally purchased chlorine bleach products and alum
• Pre packed imported sachets of combined coagulant and disinfiectant,
e.g. PUR
• Fuelwood supply for boiling options
• Bottled/pouched water
Your task is to rank the major common Household water treatment options
according to the following critera
Criteria
• Cost of treatment technology purchase
• Treatment effectiveness (reduction pathogens)
• Ease of use
• Transportation costs and feasibility
• Community familiarity/acceptance
• Availability in local market place
• Sustainability over 1 year
•
Provide approximate costs for this solution per person per day for the
12,000 people affected.
cm-seR^eR
Flood scenario West Bengal;
Excreta disposal
In response to the floods a task force has been set up at sub national level led by
Government, with representatives of Public health engineering department, the
department of health, NGOs, and the national Red Cross Society. The urgency of
the situation this year and the scale of the situation which is much worse than in
many years in living memory is calling for a collective approach to deal with the
situation. As a group of engineers, health specialists and hygiene experts you are
asked to develop an action plan and report back to the overall Government
coordination mechanisms.
This task force has been asked to focus on 12,000 or so people displaced into
shelters /relief camps (out of 400,000 in shelters). Specifically you are tasked
with dealing with the populations displaced to the relief camps/centres/areas and
by 16.45 you must present a plan to a coordination meeting which;
• Provide an overview analysis of the excreta disposal situation
• Build an understanding of the community profile
• Choice of intervention/ design of excreta disposal facilities
• Design with sketches showing choice of materials, prepare budget.
• Establish plan for purchase and transportation of materials
In your solutions you must demonstrate how you can address needs of all 12,000
people.
Flood scenario West Bengal;
Excreta disposal group work
Each participant to rank each of the group work options presented - do this on
your own, i.e. not as groups. Scores for each option will be added up and a total
calculated to determine which option is considered to be the best all round
choice.
Group 1
Disposal system chosen:
Selection criteria_______________________________________
cost to construct and operate the excreta system_____________
feasibility to construct in a timely manner and operate the system
whether excreta is safely disposed of/contained______________
whether permission will be granted to build it_________________
whether it provides privacy and dignity, especially for women
Total score
Group 2
Disposal system chosen:
Selection criteria_______________________________________
cost to construct and operate the excreta system_____________
feasibility to construct in a timely manner and operate the system
whether excreta is safely disposed of/contained______________
whether permission will be granted to build it_________________
whether it provides privacy and dignity, especially for women
Total score
Group 3
Disposal system chosen:
Selection criteria_______________________________________
cost to construct and operate the excreta system_____________
feasibility to construct in a timely manner and operate the system
whether excreta is safely disposed of/contained_______________
whether permission will be granted to build it_________________
whether it provides privacy and dignity, especially for women
Total score
Group 4
Disposal system chosen:
Selection criteria_______________________________________
cost to construct and operate the excreta system_____________
feasibility to construct in a timely manner and operate the system
whether excreta is safely disposed of/contained______________
whether permission will be granted to build it_________________
whether it provides privacy and dignity, especially for women
Total score
1=poor
2=acceptable
3=good
1=poor
2=acceptable
3=good
1=poor
2=acceptable
3=good
1=poor
2=acceptable
3=good
cM-seR^eR
Group 5
Disposal system chosen:
Selection criteria____________________________________
cost to construct and operate the excreta system____________
feasibility to construct in a timely manner and operate the system
whether excreta is safely disposed of/contained_____________
whether permission will be granted to build it________________
whether it provides privacy and dignity, especially for women
1=poor
2=acceptable
3=good
cm-seR^
BUJUMBURA CASE STUDY
Oxfam GB implemented an emergency public health project for displaced people in
Bujumbura Rural Province in northwestern Burundi. The project sought a reduction in
diarrhoeal and vector-borne diseases through two integrated components: technical
improvement such as water point rehabilitation, production of portable latrines slabs
(“san-plats”), and residual spraying; and health promotion activities organised and carried
out through volunteer committees.
Establishing The Committees
The process of setting up committees followed several steps:
•
meetings with commune administrators to present the project;
•
meetings with the administrator's representatives and community elders in each site to
present the idea of the committees;
•
meetings with prospective committee members to discuss the kind of work they
would be doing, the voluntary nature of the work, and the issues we would be
addressing.
In recruiting committee members, we aimed to have each site represented by at least one
man and one woman; we also hoped to find people who were dynamic, respected by the
community, and interested in public health issues. A capacity inventory was carried out
to learn about skills and preferences among committee members regarding different
aspects of health promotion.
Additionally one man and one woman for every 100 households was identified and
trained to be community animator. These were energetic men and women who could
organise action to address public health issues and who would support the committee
volunteers in implementing health promotion and community mobilisation activities.
Originally, the animators were conceived of as a group separate from the more
management-orientated committee members. As time went by however, the distinction
between committee members and animators became irrelevant: everyone participated in
decision making as well as promotion activities.
The idea behind Oxfam’s work with committee members and animators was that:
•
working with natural helpers, i.e., community members whom others consult for
advice and who are already involved in helping their community develop as apart of
their everyday life, would be more effective than working on our own;
•
focusing on action that the community could take to improve public health would be
more effective than increasing knowledge about public health risks.
CM-SERWER
This led to a standard way of operating: first to discuss and analyse a public health
problem, such as diarrhoea, where all participants, including the Oxfam Public Health
promotion staff, could share knowledge and correct misconceptions. Then to plan what
action(s) could address the problem, such as digging latrine pits and installing sanplats, as
well as planning the promotion of these activities that would have to take place in the
community. Finally to review the activities carried out by the committee and the
community, resolving problems, and celebrating successes. Thus learning took place
through doing, and discussions always had a practical objective in mind.
This approach seemed to work well: the committee members and the animators felt
respected and included in the process. One valuable aspect of the approach was
respecting the voluntary nature of their time and work: I felt that we did not overburden
them with demands, and they responded by working hard in the small amount of time
they did have. The group dynamics within the committees was frequently monitored and
adjustments when needed. The Oxfam office staff found ways to recognise their
accomplishments by giving committee members gifts such as t-shirts (with the phrase
"Working Together for Hygiene" on them), cooking pots, hoes, and seeds. The voluntary
nature of the committees proved to be sustainable over the ten months of the project.
However, the gifts given by Oxfam were crucial to maintaining their commitment, so it
could be seen that we were paying the committees in some way.
The Ministry of Health (MOH) has a theoretical structure of health promoters and
community health workers in each commune, and the committees should have been
linked to that structure. However, we discovered that the structure did not exist to any
great extent, and it was more important to establish the committees and begin addressing
urgent public health issues in the camps.
Activities:
Diarrhoeal diseases were the most prevalent health problem in the camps, and there were
a fairly wide range of conditions that could foster their transmission; thus, action to
prevent and treat diarrhoea made up most of our promotion efforts. Over the course of the
project the committee members and animators:
•
Developed and presented a marionette show, sketches, songs, and dances related to
general hygiene issues. Everyone involved quickly embraced the use of creative
promotion techniques, which made the whole project much more interesting and fun.
However, we did not do a very good job of documenting the use of these techniques.
•
Created lists of all the households in the camp to organise distributions. Doing this
and carrying out the distributions proved to be a relatively easy and empowering task
that helped establish trust and credibility. However there was a danger that it would
create a parallel bureaucracy in the committees.
•
Introduced and distributed 2,000 sanplats, and promoted their correct installation and
use. In most sites, the sanplats were properly installed and maintained, and all were
CM-SERVVER
carried back and reinstalled when people went home. The weakest point was the use
of lids, which appeared spotty at best.
•
Organized varied health promotion activities at primary schools. Used a set of
drawings showing different hygiene conditions and asked students to sort them into
safe or dangerous categories and then discussed the results. Songs and sketches were
created and performed by the students.
Female committee members volunteered for an oral rehydration project, where they
received training at their closest health centre and distributed ORS donated by NGOs
on an emergency basis. The ORS activity was an exciting initiative as it created direct
links between the committees and the existing health care structure, but it will require
a lot of attention to make sure that the health centres continue giving the donated
ORS to the women.
Distributed Hygiene-related non-food items including water containers, soap and
chamber pots. Overall, the water containers were appropriate, but the extent to which
they were properly used is not clear. The soap was a very welcome item, although we had
to specifically ask people to reserve one piece per household for hand washing as most
was used for washing clothes. The chamber pots were not appropriate at all: most seemed
to have been sold or were not being used
•
cm-seb^k
Situation Report No. 1
Flood Update -West Bengal; 09:00 hrs; 23rd June 2008
Highlights
District Number of Block affected
Municipalities affected:
Total villages affected:
Gram Panchayats affected
Severely affected blocks:
Total Affected Population
Deaths:
Relief camps:
Rescue operation:
Funds allocation:
Crop damage:
House damage:
Government supplies:
Other support:
West & East Medinipur
- 17 out of total 29 blocks of West Medinipur and 15 out of
total 25 blocks of East Medinipur
Eight
7810
- 243 GPs (80% of the 304 GPs) of the affected 32 blocks
Pingla, Sabang, Narayangarh (WM) and Mugberia,
Bhagawanpur-I and II, Patashpur I-& II, Egra (EM)
- 2.70 million (approx)
27 persons
1136, approximately 400,000 persons are in relief camps
shelters
47 boats in operation to rescue and provide relief material
Rs. 17 crores ($3.97 million) by GoWB
93,400 hectares of agriculture land under water, 60-70%
crops damaged
16,000 houses fully collapsed, over 22,000 partly collapsed
Safe water pouch 155,000, Halogen tablets 1 million, ORS
packets 40,000 and 123 bags of bleaching powder. 225
medical teams are deployed, 5 MT food packets. Supplies
in pipeline are 500 MT of rice, 55 thousand Tarpaulin and
100,000 safe water pouch everyday
Through RKM network, 50,000 halogen tablets, 12,000
ORS packets, 5 MT bleaching powder, 2000 Jeri canes for
water storage, 1500 family hygiene kits and 30,000 water
purifiers were provided. Around 300 volunteers from 14
cluster organizations are working in relief operations.
Multi sectoral team to undertake rapid assessment from 2325 June 08 to facilitate future response
Current situation and assessment
Overall
Due to incessant rains wherein the total precipitation was 750-1000 mm in three days that was
more than half the annual rainfall (i.e. 1500 mm) of the region followed by heavy release of water
from dams resulted in severe flooding in large parts of West and East Medinipur. There has been
severe flooding in both districts affecting more than 2.7 million people (by 21.06.08; numbers may
increase) and severely limiting transport (rail and road). Even NH 7 considered to be all weather
roads was over flowing. The rivers having water above danger level are Chandika, Suwarnrekha
and Keleghai. Last 24 hours rains has stopped and water has started receding. The summary of
the response from the government is as under:
sekvvhR
1
•
•
•
Rescue operation was very well organized in time by state Government where local community
also actively contributed. Army and air force were deployed that actively supported civil
administration in relief and rescue operation including dropping of food. This has saved many
lives in affected areas.
The quantity of food, water and tarpaulin is reaching to people however it is inadequate. This
may result in resentment among people.
After the recent elections PRIs are in transition phase, the response from PRI is not to its full
potential. RKMLP is actively engaged in the relief operation through their strong cluster
organization and field volunteers. While over 42 boats are in operation, communication and
movement is restricted and require additional boats for timely relief and medical team to reach
the inaccessible pockets. These boats would also be helpful for inaccessible communities to
access markets.
Food and Nutrition
Acute demand of food visible and people are very vocal about it. Immediate requirement is of dry
food but many families had facilities to cook food. Block and Panchayat official stated requirement
of cooked food, RKM is providing cooked food and also from some local clubs. People have been
found engaged in fishing and most of the households are cooking fish. Food or especially
livelihood (poor, vulnerable families) would be a need in near future, as people could not carry
adequate food stocks with them. Some families do not have fuel for cooking. For them ready to
eat food will be very helpful.
Water Supply
Government is providing water pouch however availability of safe water is inadequate. People are
using flood water in some places for cooking, with time this situation may become worse. Few TW
were raised earlier and these are being used now for drinking. People are carrying water using
temporary boats. Presently people are traveling 2-3 km on temporary raft or foot to carry water
limiting the per capita quantity to 5-10 liter. In terms of water the following interventions
required:
•
•
•
•
TW disinfection needs to be initiated , the best part is that panchayat is aware of it and knows
the technical aspect, however bleaching powder supply is limited. RKM network has initiated
disinfection with UNICEF support in their operational areas.
People lack water storage containers; closed lid water storage containers would be helpful. In
the present context where people have to carry water long distances, improper water handling
can contaminate the water.
Household water treatment is a need in immediate effect, the good part is panchayat and
many people are aware of Halogen use, some people were even given Halogen tablets but
numbers inadequate.
Some households are also using floodwater for cooking in such instance they should also be
provided with ferric Alum and Halogen. Ferric alum will help to coagulate before disinfection by
Halogen tablet; disinfection doesn't work well in turbid water. Some message dissemination
also needs to be done. UNICEF supplied PUR is working well in RKM supported areas and the
block authorities have demanded for more sachets.
Sanitation & Hygiene
j.
The affected areas have some latrine coverage, thereby those women and girls have practice of
latrine usage and finding open defecation very difficult. The number of latrine available in school
2
is grossly inadequate 2 toilets for 400 people (it will take 20 hrs if each member defecates once a
day for 3 min). Some people have constructed temporary hanging toilets in camps. While
temporary toilets are highly required with adequate water supply for hygiene, the safe excreta
disposal requires attention. Other aspects of sanitation are:
•
•
•
•
More toilets would be required especially in camps with adequate water supply and sanitary
protection to avoid contamination of water sources.
People have practice of hand washing after defecation; soap supply would be helpful. Some
message dissemination of hand washing before eating and cooking would be beneficial.
Once the water recedes, reviving or reconstruction of the broken toilets in their household
would be a uphill task and would need immediate attention of planning and simultaneous
resource mobilization. This is critical at this juncture when district has claimed for
Nirmal District award under TSC. Who pays for the BPL families that has already
contributed their share for the household toilet and the TSC programme has also
paid the subsidy.
Due to change in environmental situation there is an increased instance of mosquito bites,
impregnated bed nets would be helpful.
Shelter
There has been widespread damage in terms of houses especially the katcha houses. Most houses
have CGI sheet, straw, clay tiles as roof and mud walls and mud floor; the roof is still intact for
some houses with the walls and floors damaged. Government is providing tarpaulin for shelter
however in view of the requirement, the following intervention would be required:
•
•
•
•
•
Tarpaulin sheet would be helpful in situation of future flooding. It would also be useful for
households who have to prolong their stay in camps, as return to houses would be difficult
especially in cases of crumpled houses.
The biggest challenge is house reconstruction especially the wet floor (muddy floor) that
would take considerable time to dry. This is a major health risk for children. Muddy floor also
raises various issues related to hygiene.
Impregnated bed net with some bedding material (bed sheet, blanket and mattress) would be
helpful for household who have lost their bedding material
For families who have an extended stay in camps proper camp orientation needs to be
organized, like facilitation of toilets, solid waste, access to health care and drainage.
Households are in fear of being evicted from camps and nowhere to go, as their houses are
broken; this needs advocacy with local government institutions.
Some community malaria control intervention would be helpful, especially keeping in note,
prolonged water logging in low lands.
Summary: Where water is receding that will improve access to the difficult areas. The ongoing
multi sector assessment will facilitate assessment of situation and developing response plan. More
resources may need to be mobilized to respond the emergency. District administration is willing
and open for external support however, state has reservation in formally requesting for supplies.
An organisation has prepared the ready to print artwork in Bangla to facilitate developing IEC
material for community awareness on floods. After replication, it will be used through RKMLP
network.
3
Situation Report No. 2
Flood Update -West Bengal
Highlights
District Number of Block affected
15 out of
Municipalities affected:
Total villages affected:
Severely affected blocks:
West & East Medinipur
- 17 out of total 29 blocks of West Medinipur and
total 25 blocks of East Medinipur
ten
1132
Pingla, Sabang, Narayangarh (WM) and Mugberia,
Bhagawanpur-I and II , Patashpur I-& II,
Egra (EM)
Total Affected Population
Deaths:
Relief camps:
shelters
-2.90 million (approx)
36 persons
1070, approximately 375,000 persons are in
Current situation and assessment
Relief camps have been in existence for some time now and interventions to improve
conditions have been limited and ad hoc. Many areas remain inaccessible due to flood
water. The met department has reported further heavy rain in the next two weeks and
water levels of rivers upstream are now above critical level. The state government has
called for analysis of the situation over the coming few weeks based upon the available
information. There is agreement that the situation will remain critical for several more
weeks and that most of the population currently in relief camps will remain in shelters
for perhaps another 4-6 weeks, if not more.
CM-SER^ER
Situation Report No. 3
Flood Update-West Bengal
Highlights
District Number of Block affected
15 out of
Municipalities affected:
Total villages affected:
Severely affected blocks:
West & East Medinipur
- 17 out of total 29 blocks of West Medinipur and
total 25 blocks of East Medinipur
ten
1132
Pingla, Sabang, Narayangarh (WM) and Mugberia,
Bhagawanpur-I and II , Patashpur I-& II,
Egra (EM)
Total Affected Population
Deaths:
Relief camps:
shelters
- 2.90 million (approx)
36 persons
1070, approximately 375,000 persons are in
Current situation and assessment
The health department are now reporting break out of watery diarrhoea in many
locations in the relief camps. Data collected from health outposts/centres across the
area reveal a pattern of diarrhoea. There are reports of bloody diarrhoea in a few
locations, though this has not yet been confirmed. Public heath inspectors have been
reporting that relief camps are in very poor condition this year, in their analysis due to
the high floods levels and extent of displacement. This has yet many more people than
normal to be displaced into relief camps and has led to overcrowding. Of course the
absence of anything other than make shift shelters for latrines is not encouraging a
sanitary environment. Large numbers of animals living adjacent and within the camps
has also contributed to the in sanitary situations. The chief medical officer is demanding
urgent action to address the problem, forecasting that "deaths from diarrhoea will start
to occur unless urgent action is taken"
cm-se^veR
Team task
Session materials to be
prepared
1) Read sitrep/scenario brief_____
2) Read specific scenario briefing
Sitrep 1 scenario brief______
Scenarios for displaced to
embankments and to schools
paper. Gain an overview analysis
of the sanitary situation_______
3) Get shared understanding of the
task________________________
4) Gain an understanding of the
profile of the community (to
establish what preferences and
needs they may have)
5) Location survey (to inspect
physical area to see what solutions
maybe feasible)_______________
6) Choice of intervention/ design of
sanitary facilities (to make outline
choice about excreta
disposal/containment system to be
adopted)____________________
7) Design with sketches showing
choice of materials, prepare
budget. Explain how facilities would
be provided, e.g. by distribution
materials to communities,
contractors to build, NGOs etc
8) Establish plan for purchase and
transportation of materials
9) Develop plan for maintenance
and closure (if appropriate of
facilities)__________________
10) Respond to changed
circumstance
Point at which
information will
be provided (in
mins from start
sessions)_____
0 (at start)
0
Task brief
0
A paper briefing of the
community and its profile will
be provided. A member of the
training team will play the part
of a community representative
Either this will be a walk
around a marked area or
diagrams will be provided
Sitrep 2. Provide an update on
the sitrep which shows
flooding situation worsened
and some people likely to
remain displaced for longer
Provide either samples of
materials, pictures and sheet
with typical material costs.
15
Provide message from
Gov/UNICEF/NRCS
procurement deps about lead
time and transport costs
materials_______________
Environment memo; Provide
lessons learnt from previous
floods about toilets________
Sit rep 3 with information
about diarrhoea outbreak
15
30
30
45
60
75
CM-SER>'veR
The community leader says (prior to floods), "We are a large growing population.
About 41% pf the population is Muslim while Hindus are 55% & others 4%. We face
widespread poverty, political instability, poor governance, and frequent natural
disasters like floods. These very often affect the livelihoods of the millions
of poor and marginal people. Many people are landless and forced to live on and
cultivate flood-prone land. Associated problems include water-borne diseases,
water pollution (especially of fishing areas resulting from use of commercial
pesticides), ground water contaminated by naturally occurring arsenic,
intermittent water shortages due to falling water tables, soil degradation and
erosion, deforestation, and severe overpopulation.
We normally access water through open wells, only about 15% of which are fitted
with hand pumps. Latrine usage in normal times is low with only about 25% of
people owning a latrine in rural areas. The remaining 75% simply resort to open
defecation. In most communities, people tend to use leaves for anal cleansing.
Young children do not usually use latrines as they find them too dark and
usually defecate in the open even if the family has a latrine."
(After the floods) the community leader says:
■ There are around 30% adult males, 25% females and remaining are children in
the groups of displaced people who are presently in this relief camp.
■ The wells are now flooded and contaminated. Reports of bodies and livestock
being found in wells are increasing.
■ Now there are very few dry areas for either defecation or construction of
latrines, so people are simply defecating in the floodwaters.
■ We have nothing. We fled with some food initially, but we have eaten
everything we had.
■ There is no security here, Two of our women were attacked when they went to
the toilet at night.
■ Worst-off group are the women without men or older children. They have to do
everything for themselves.
■ We cannot get help at the hospital as we cannot pay the charges.
CM-SER^ER
1.6 Implementation; Coordinating our response, the cluster approach- Case study
Parti
The Asian country of DIANICH has significant numbers of people that live in flood prone
river basin areas. Each year hundreds of thousands, sometimes millions of people are
affected by floods.
The country has a fairly strong government at central level, though the sheer size of the
country means the reach of government services to the sub national level (district) is
limited. Civil society is active in the country with many NGOs, CBOs and other
organisations working at sub national level. All civil society agencies are registered with
the Government either centrally or at the next government administration level down.
However while the broad activities of these organisations are sometimes known to Gov
officials working at the sub national level, all too often the details of what these
organisations do where and when is simply not available. On the other hand the working
of the government, the relationship between key Government ministries, the extent of
their resources and activities is unknown to the civil society organisations. There is a
national disaster management plan at the national level, which gives power to central
government to take over leadership during major crisis. Within this, the military is
understood to be given a role in coordination during major crisis or events which are
deemed to threaten national stability or security. There are a good number of major
international organisations present in the country and operating right across the country
in different districts. At times of major crisis in the recent past (major floods 5 years ago
and major earthquake 8 years ago) these agencies have been active in bringing in
significant assistance, both material and human resources and welcomed both by
central Government and by affected populations at the district level.
This year flooding is significant as it has been raining steadily since the start of the
monsoon season, 2 months ago. However in the last 9 days torrential rain has meant
that rivers that had been running very full, have now burst their banks and rapid surges
of water and inundation is now occurring. The metrological organisation predicts that rain
will continue heavily for some more weeks, so is predicting continued flooding and
standing water over large areas of land. Some cities are flooding around the edges, as
well as large areas of rural land. The Government has called a national emergency and
asked the army to play a role in rescue operations. It is reported that the army is also
supplying water to some locations where people are displaced and setting up facilities
for those people who may be displaced for some time. The health ministry is reporting
diarrhoea outbreaks in some locations and as part of its response is mobilising its health
outreach workers to deliver chorine tablets and ORS so affected people can treat their
own water. For those towns affected the water supply companies and municipality are
reportedly trucking water supplies to those that have had their wells flooded and have no
access to water supply. The water resources ministry, which is responsible for provision
of water and sanitation to rural areas, is now working with ministry of roads and transport
to provide assistance to the tens of thousands of people now displaced to road
embankments and higher areas of ground. National NGOs, with support from their
international NGO funding partners are now mounting assessments in the affected
areas. Proposals have been submitted with a range of different solutions for different
groups. Some are proposing distribution of candle/ceramic water filters. One
international organisation has an ongoing partnership with a company that provides
sachets of combined coagulant and disinfectant and is now embarking upon a major
distribution, along with water containers.
cM-seR^er
Part 2
The military has now set up a coordination cell in the most seriously affected area. It is
now taking control of many. Government inputs to assist the affected flood populations.
Its focus is on food, shelter material, water supplies and search and rescue operations.
Those people on high areas of ground and embankments are now being provided
facilities in camps. Army helicopter flights, with journalists on board over the affected
reveal that there are many small groups of population that are receiving no assistance
what so ever, while groups on embankments are getting assistance from Gov, the UN
and NGOs. The journalist is reporting an absence of any overall picture/pattem of
assessments, but rather a series of disconnected interventions based upon isolated
assessment. Some NGOs are working to coordinate their activities with Gov public
health and engineering departments in rural areas. However in towns and areas of major
concentrations of people it seems as if the military or the town authority and/or the water
supply authority are the ones in charge. One NGO is reported as saying that the ministry
of health is in change of sanitation programmes for the affected population, but this is
unclear and unconfirmed. What is clear is that there is little activity on sanitation for
those displaced with the only latrines being provided by people’s own initiatives.
Part 3
Some three weeks after the major surge of water, movements of people appear to have
stopped and many thousands of people are facing the prospect of some more weeks
remaining in schools, on road embankments and on other high areas of ground. Some
WASH coordination meetings have occurred and there appears to be a chair for these
meetings. In one location the chair is from the army, in a major town location it is the
deputy engineer, a third location someone from UNICEF is leading efforts, while in
another location with a strong ministry of health, a local doctor with a strong interest in
public health is overseeing/coordinating distributions of chlorine tablets and organising
the construction of latrines. Journalists in the affected areas have been reporting that
organisations have been active in putting up signs indicating they are undertaking
activities but have not done very much. Interviews with affected people report numerous
visits from organisations, without knowing who they are, all of which say they will do
something but most don’t. The coordinators in the affected areas are reporting similar
things, promises being made but being unfulfilled. Some areas are still reportedly not
receiving any assistance and in the last days Department of health officials have limited
data to suggest that diarrhoea is 5-7 times higher than others areas The UNICEF
coordinator in one area is being asked to provide information to report back on activities
of all organisations involved in any WASH activities. However she is facing enormous
problems in doing so and has explained to her superior the reason for this; assessment
and activity reports are not shared unless there is a funding obligation to do so, agencies
have not set up monitoring and reporting mechanisms, agencies who do not work as
partners of UNICEF will not share information with anyone else. Information from Gov is
simply not made available. Her superior asked if she is aware of whether there is
sufficient capacity and particularly funding resources to cover all the needs but she is
unable to answer that question. It appears as if major funding has come from
international sources to the Gov of DIANICH and major international organisations have
brought in many new resources which are being made available to national NGOs. The
IFRC has an active national Red Cross/Crescent Society working in country and with
major appeals successfully raising money they are undertaking many activities but these
are unknown to the UNICEF WASH lead. Her conclusion is that while there are many
unmet needs, most organisation work fairly independently, it is very hard to get an
overall funding picture and many promises are made but without the follow up.
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