Diarrhoeal diseases cause seventeen percent of all deaths of children under five. These are largely due to unsafe disposal of faeces and poor hygiene. During emergency situations, the risk of disease increases, yet excreta disposal is considered a lower priority than other humanitarian interventions such as healthcare, food and water supply.

A manual by the Water, Engineering and Development Centre, at Loughborough University, in the UK, considers hygiene and sanitation in emergencies. It provides a practical guide to selecting, designing, constructing and maintaining a range of appropriate waste disposal systems to reduce the risk of faecal-oral diseases during emergency situations. The manual was compiled in collaboration with the International Federation of Red Cross Red Crescent Societies (IFRC), Oxfam, the United Nations Children Fund (UNICEF) and the United Nations Refugee Agency (UNHCR).

The importance of excreta disposal in emergencies cannot be overestimated. Among Rwandan refugees in the Democratic Republic of Congo (formerly Zaire) in 1994, more than 85 percent of all deaths in the initial emergency phase were associated with diarrhoeal diseases. Although improvements in water quality and quantity can reduce childhood diarrhoea by 15 to 20 percent, safer excreta disposal can reduce it by 36 percent and hand washing by 35 to 42 percent.

Poor excreta disposal can result in the contamination of water sources and can provide breeding sites for flies and mosquitoes, which may carry infection. Unsafe disposal of human faeces can lead to diseases such as cholera, typhoid, dysentery, diarrhoea, hookworm, schistosomiasis, filariasis, roundworms, poliomyelitis and hepatitis.

Malnutrition, resulting from food insecurity and chronic emergencies, increases the risk of diarrhoeal disease. Children and elderly people are particularly vulnerable, especially if exhausted after travelling long distances.

The objective of an excreta disposal programme is to minimise high-risk practices and reduce faecal disease transmission rates. During emergencies, agencies should adopt technical solutions that are both acceptable to affected communities and appropriate to the situation:

• In the initial stages of an emergency (phase one), the priority is to provide basic facilities to contain and separate excreta and ensure survival.
• Options in phase one can include designating open areas where people can defecate (to reduce indiscriminate defecation); shallow and deep trench latrines; shallow family latrines; bucket latrines; packet latrines; and chemical toilets.
• In phase two, agencies should consider more sustainable structures designed for longer-term use.
• Options in this phase include simple pit latrines; ventilated-improved pit latrines; eco-san; borehole latrines; pour-flush latrines; septic tanks; communal aqua-privies; and wastewater treatment systems
• In considering options, the particular setting also needs to be considered, such as whether the area has high water tables or rocky areas, is prone to flooding, is an urban environment, or where toilets are not wanted.

Any decisions must be made in consultation with intended users. In addition, the following steps must be taken to ensure that suitable excreta disposal systems are set up:

• make a rapid first assessment to differentiate those tasks that require immediate attention from those that are important in the longer term
• outline a programme design that identifies immediate key actions needed to protect public health and stabilise the situation
• follow up with more detailed data collection, analysis and consultation, and invite all affected groups to join the decision-making process
• develop a detailed plan of action for longer-term invtervention and implement the second stage excreta disposal programme
• monitor and evaluate programme activities to identify future priorities and to assess performance

Source(s):
‘Excreta Disposal in Emergencies, a Field Manual,’ WEDC: Loughborough, by Peter Harvey, 2007 (PDF) Full document.

Funded by: International Federation of Red Cross and Red Crescent Societies, Oxfam, UNICEF, United Nations High Commission for Refugees, Water, Engineering and Development Centre

id21 Research Highlight: 27 April 2008

Further Information:
Peter Harvey
Water, Engineering and Development Centre (WEDC)
Loughborough University
Leicestershire
LE11 3TU
UK

Tel: + 44 (0)1509 222397
Contact the contributor: p.a.harvey@lboro.ac.uk

Water, Engineering and Development Centre (WEDC), Loughborough University, UK

Other related links:
'Restoring appropriate sanitation services in Bam'

'Stopping crises from becoming catastrophes'

'Preparing for the worst: responding to refugee flows in southern Africa'

'Climate change and cities' id21 insights 71, January 2008