Category Archives: Emergency Sanitation

An Emergency WASH update – new Sphere and UNHCR handbooks, recent research

Emergency WASH Google Group – October 31, 2018 Update


Draft 2 of the Sphere Handbook 2018 – Highlights of Draft 2 include: A new Delivering Through Markets annex covering Supply Chain Management and Cash-Based Assistance; New WASH standards on linkages to health for disease outbreaks and nutrition interventions.

The Sphere Handbook 2018 – The Sphere Handbook 2018 will be launched on 6 November 2018. New standards have also been developed, informed by recent practice and learning, such as WASH and healthcare settings in disease outbreaks, security of tenure in shelter and settlement, and palliative care in health. Different ways to deliver or enable assistance, including cash-based assistance, are also integrated into the Handbook.

UNHCR WASH Manual for Refugee Settings. UNHCR, September 2018. The manual outlines WASH guidelines that should be met in all refugee settings to provide an adequate level of basic WASH services for refugees. The manual discusses overarching principles that should be considered in all refugee WASH programs and provides an simple overview of WASH technical options that are suitable for refugee settings.

Too tough to scale? Challenges to scaling innovation in the humanitarian sector. Elrha, October 2018. Drawing from Elrha’s own experience in funding over 150 humanitarian organizations to develop, test and scale many highly impactful innovations, and research and experience from the social and development sectors, this report identifies 13 key barriers across five different challenge areas.

Female-friendly public and community toilets: a guide for planners and decision makers. WaterAid; WSUP; UNICEF, October 2018. The guide explains why toilets must be female-friendly, before detailing the essential and desirable features needed to make them so. The guide draws the recommendations and practical steps from existing literature, expert opinion and analysis of pioneering experiences from around the world.

Guidelines on sanitation and health. WHO, October 2018. The guidelines summarize the evidence on the links between sanitation and health, provide evidence-informed recommendations, and offer guidance for international, national and local sanitation policies and program actions.

Using innovation to break down barriers to handwashing in emergency settings. Elrha, October 2018.  Two years on, these innovations have refined their creations and have been testing them in humanitarian and emergency settings to gain vital insight into their use. Here’s a glimpse at these handwashing innovations and how they are helping.

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Handwashing in Emergencies – Emergency WASH Biweekly Update

Dear Colleagues:

October 15 is Global Handwashing Day, a global advocacy day dedicated to increasing awareness and understanding about the importance of handwashing with soap as an effective and affordable way to prevent diseases and save lives.


Innovative ‘Surprise Soap’ gets children washing hands in emergencies, with lifesaving implications. LSHTM, October 2018.
Researchers gave families in a displaced persons camp in Iraq a soap with a visible toy embedded in the center. The more children used the soap, the quicker they reached the toy. Children in the camp were involved in choosing the toys that were used, before they were manufactured locally using 3D printers. The findings show that play may be the key to increasing handwashing and saving lives in emergencies. It is the first time a motive-based handwashing approach has been tested with children in an emergency.

Child’s play: Harnessing play and curiosity motives to improve child handwashing in a humanitarian setting. International Journal of Hygiene and Environmental Health, September 2018.
We show that distributing soaps with toys embedded inside, in a rapidly deployable intervention, can improve child handwashing behaviour in a humanitarian emergency context. Further studies are needed to determine the longer-term behavioural and health impact of such an intervention when delivered at a greater scale in a humanitarian context.

What doesn’t kill you: let’s talk about failure. UNHCR Innovation Service, September 2018.
This blog post by Cecilie Hestbæk, HIF Innovation Management Adviser, Elrha, discusses lessons learned from the Handwashing Innovation Challenge.

Promoting Good Hygiene in Burj El Burajneh Refugee Camp. Anera, September 2018.
In the southern suburbs of Beirut, Lebanon lies Burj El Barajneh; the most densely populated Palestinian refugee camp in the city and home to more than 17,000 registered refugees; all living within a mere 1 square kilometer area. In response to these challenges, Anera partnered with UNICEF to do outreach in Burj El Barajneh as part of the Community Based Sanitation and Hygiene Promotion Project.


Water insecurity and gendered risk for depression in rural Uganda: a hotspot analysis. BMC Public Health, September 2018.
Residing in a water insecurity hotspot is associated with greater risk for probable depression among women, but not among men, pointing to the need for focused depression screening among women residing in water insecure households.

Household Water Treatment and Cholera Control. Journal of Infectious Diseases, September 2018.
We conducted a systematic review of published and gray literature to determine the outcomes and impacts of HWT in preventing cholera specifically. Overall, a moderate quality of evidence suggests that HWT interventions reduce the burden of disease in cholera outbreaks and the risk of disease transmission. Appropriate training for users and community health worker follow-up are necessary for use.

Impact of social capital, harassment of women and girls, and water and sanitation access on premature birth and low infant birth weight in India. PLoS One, October 2018.
Globally, preterm birth (PTB) and low infant birth weight (LBW) are leading causes of maternal and child morbidity and mortality. Inadequate water and sanitation access (WASH) are risk factors for PTB and LBW in low-income countries. The objective of this study is to assess the relationships between WASH access and social conditions (including harassment and social capital) on PTB and LBW outcomes among Indian women, and to test whether social conditions modified the association between WASH and birth outcomes.

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Emergency WASH papers from the 2018 WEDC Conference

Please check out the Emergency WASH page on, and let us know of any suggestions or comments.

WEDC conference papers are an important source for learning about WASH innovations and lessons learned in the field and more than 150 papers were accepted for the 2018 WEDC conference. Here is the link to all of the papers and selected papers on Emergency WASH are listed below:

Designing evidence-based and context-specific hygiene programs in emergencies: could there be an app for that? – This research explored the factors that determine hygiene behaviour in emergencies and the barriers that prevent humanitarian actors from improving hygiene program design. Humanitarian actors felt that hygiene behaviour change was the remit of experts and that current guides are overly generic and hard to adapt and apply. The findings from this research are being used to develop a software-based tool to aid practitioners in designing rapid, evidence-based and context-specific programs in emergencies.

Shedding light on humanitarian sanitation – A three-country research project looking at the impact of lighting on WASH use and GenderBased Violence (GBV) required a multi-disciplinary approach, combining OXFAM’s practical implementing expertise with WEDC’s research-orientated approach. The research showed how much more is needed for safe sanitation than just building latrines.

Surface water management in humanitarian crises – This paper reports on the scoping stage of a practical toolkit being developed to support the application of surface water management practices in humanitarian contexts. The toolkit is predominately aimed at refugee and IDP camps for displaced people and aims to address the lack of suitable guidance in this area.

Using pre-crisis market analysis to strengthen emergency preparedness and resilience of WASH systems – This paper describes Oxfam’s experiences using pre-crisis market analysis in Bangladesh, Indonesia, South Sudan and Zimbabwe in order to support market-based programming to strengthen the resilience of market systems and prepare for reoccurring emergencies.

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WASH in Emergencies – Water Currents, September 19, 2018

Emergency water, sanitation, and hygiene (WASH) is a critical component of USAID’s humanitarian assistance for vulnerable populations, who are much more susceptible to diseases related to inadequate sanitation and water supplies.

USAID responds to emergency WASH needs through the Bureau for Democracy, Conflict, and Humanitarian Assistance, including the Office of U.S. Foreign Disaster Assistance (OFDA), responsible for leading and coordinating the U.S. Government’s response to disasters overseas, and the Office of Food for Peace, responsible for leading the U.S. Government’s international food assistance efforts.


USAID/OFDA and its partners provide water supply services to a large camp of displaced people in northern Syria. Photo credit: USAID/OFDA

Combined, these two offices ensure that emergency and life-saving WASH needs of vulnerable populations are met in disaster, conflict, and early recovery operations. Where appropriate, emergency WASH connects to, supports, or aligns with the work that USAID will carry out under its Water and Development Plan to increase water and sanitation access, and is an important complementary result.

This issue contains several reviews and evaluations of WASH in emergency interventions as well as recent manuals and guidelines on appropriate technologies, disease outbreaks, menstrual hygiene management, and other topics. In addition to producing Water Currents, the USAID Water Team also publishes a biweekly bulletin of the latest studies and events related to WASH in emergencies, so contact us if you would like to subscribe to the bulletin. Stay tuned for a new Emergency WASH page on the website in the near future.

Link to the complete issue.

Ebola Species Found in Bats ahead of Any Potential Outbreak

Ebola Species Found in Bats ahead of Any Potential Outbreak. USAID Global Health, August 28, 2018.

For the first time, a discovery by the PREDICT project uncovered a new Ebola virus in animals before it spread to humans.  


Photo credit: Jaber Belkhiria/UC Davis

The discovery of the Bombali virus in bats in Sierra Leone and the sequencing of the complete genome was published yesterday in the journal Nature Microbiology. The government of Sierra Leone announced preliminary findings in late July.

The discovery was made by scientists at the University of California Davis’ One Health Institute and Columbia University’s Center for Infection and Immunity, working with the government of Sierra Leone and the University of Makeni and Metabiota. The work is part of the PREDICT Ebola Host project, funded by USAID.

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Emergency WASH Biweekly Update, August 15, 2018


The Global WASH Cluster has a new website. How to Provide Feedback on the Website. Go to the bottom of the home back and you can find the link to the feedback form right below the ‘Contract us’ heading. You can also just send us an email to if that is easier for you.

Emergency & reconstruction situations – Working Group 8 of the Sustainable Sanitation Alliance – Register as a SuSanA member to join this working group and its mailing list. The objective of this working group is to combine the knowledge from experts in the fields of sanitation with the knowledge from experts in the field of emergency response and reconstruction. Some of the resources include a Factsheet and Reading List.


Water Supply in a War Zone: A Preliminary Analysis of Two Urban Water Tanker Supply Systems in the Republic of Yemen. World Bank. World Bank, July 2018.
This discussion paper presents assessments of basic features of urban water supply systems in Sana’a and Aden, a detailed profile of the tanker truck service structure, including supply chain mapping, value chain analysis, and an assessment of changes to the sector since the war began. It also covers institutional support structure for the water sector, well-to-consumer supply chain, water quality, well operations, tanker trucks water delivery services, and household water demand.

A humanitarian response to the West African Ebola virus disease outbreak. Journal of International Humanitarian Action, August 2018.
The 2014–2016 Ebola virus disease (EVD) outbreak in West Africa was of unprecedented magnitude with a total of 28,616 suspected, probable, and confirmed cases reported in Guinea, Liberia, and Sierra Leone. Unique multisectoral partnerships forged between traditional public health actors and humanitarian actors facilitated mutual learning and opened the door to ongoing working relationships that will hasten efficient and effective response to future global public health emergencies.

Are there health hazards from disinfection byproducts in humanitarian water? Findings from a MSF water treatment plant, Palorinya, Uganda. A presentation by Matt Arnold, et al, Médecins Sans Frontières, May 2018.
Water was compliant with WHO standards for total THMs (TTHMs). Emergency treatment methods such as direct chlorination of surface water may present more risk of DBP formation.  The complicated nature and sheer number of identified DBPs make analysis, measurement and standard setting complex.

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Emergency WASH Biweekly Update – July 30, 2018

Dear Colleagues:

The Emergency WASH Google Group will be sharing information with the Sustainable Sanitation Alliance’s Working Group on Emergency & Reconstruction Situations so please check out the Working Group:


Sustainable Sanitation Alliance (SuSanA) Working Group 8 – Emergency & reconstruction situations – The objective of this working group is to combine the knowledge from experts in the fields of sanitation with the knowledge from experts in the field of emergency response and reconstruction.


Exploring menstrual practices and potential acceptability of reusable menstrual underwear among a Middle Eastern population living in a refugee setting. International Journal of Women’s Health, July 2018.
Menstrual hygiene beliefs, behaviors, and practices are mostly consistent with existing literature. An acceptance of the concept of reusable menstrual underwear was expressed, although the perceived benefits of this product did not outweigh customary practices. The use of menstrual underwear as a complimentary product to traditional absorbents was expressed as helpful for promoting dignity.


UNHCR Public Health 2017 Annual Global Overview. UNHCR, July 2018.
The average litres per person per day globally was at 21 litres. Where possible, high yield boreholes coupled with solar energy have been used to provide water to refugees through chlorinated gravity fed distribution systems. An average latrine ratio of 22 persons per latrine was achieved globally, which is just below standard and represents an improvement from 2016.

Management of radioactivity in drinking-water. WHO, 2018.
Management of radioactivity in drinking-water responds to Member States requests for additional guidance to support radionuclide management in drinking-water in emergency and non-emergency situations.

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