Fecal-oral diseases can proliferate rapidly, sometimes to epidemic proportions, when people in crowded conditions lack clean water for hygiene and sanitation. Among the agents involved are at least 20 viral, bacterial, and protozoan pathogens that cause diseases such as cholera, bacillary dysentery, and the relatively recently discovered hepatitis E. Aid groups are combating these pathogens with WASH, an integrated approach to disease prevention that ensures not only that people in emergency situations have water and sanitation infrastructure, but have water and sanitation infrastructure, but also that they practice behaviors that prevent disease. Teaching people to use latrines, wash with soap, or engage in other new behaviors takes time, especially if they have grown up with their own cultural beliefs. One technique used UNHCR in refugee situations is Community-Led Total Sanitation (CLTS) where the goal is to ignite awareness and a genuine desire for change in the community.
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