Purpose. The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest in history. Starting in September 2014, International Medical Corps (IMC) operated five Ebola treatment units (ETUs) in Sierra Leone and Liberia. This paper explores how future infectious disease outbreak facilities in resource-limited settings can be planned, organized, and managed by analyzing data collected on water, sanitation, and hygiene (WASH) and infection prevention control (IPC) protocols. Design/Methodology/Approach.
The Sawyer PointOne household hollow fiber membrane filter (PointOne) efficaciously removes microbiological indicators in the laboratory, and is increasingly considered for emergency response. To our knowledge, PointOne effectiveness in emergencies had not been evaluated. In South Sudan, 773 PointOnes were distributed.
Assessment of water sanitation and hygiene interventions in response to an outbreak of typhoid fever in Neno District Malawi
On May 2, 2009 an outbreak of typhoid fever began in rural villages along the Malawi-Mozambique border resulting in 748 illnesses and 44 deaths by September 2010. Despite numerous interventions, including distribution of WaterGuard (WG) for in-home water treatment and education on its use, cases of typhoid fever continued. To inform response activities during the ongoing Typhoid outbreak information on knowledge, attitudes, and practices surrounding typhoid fever, safe water, and hygiene were necessary to plan future outbreak interventions.
Bucket chlorination (where workers stationed at water sources manually add chlorine solution to recipients’ water containers during collection) is a common emergency response intervention with little evidence to support its effectiveness in preventing waterborne disease. We evaluated a bucket chlorination intervention implemented during a cholera outbreak by visiting 234 recipients’ homes across five intervention villages to conduct an unannounced survey and test stored household drinking water for free chlorine residual (FCR).
Evaluation of an Emergency Bulk Chlorination Project Targeting Drinking Water Vendors in Cholera-Affected Wards of Dar es Salaam and Morogoro, Tanzania
In August 2015, an outbreak of cholera was reported in Tanzania. In cholera-affected areas of urban Dar es Salaam and Morogoro, many households obtained drinking water from vendors, who sold water from tanks ranging in volume from 1,000 to 20,000 L. Water supplied by vendors was not adequately chlorinated. The Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children and the U.N.
The Case-Area Targeted Rapid Response Strategy to Control Cholera in Haiti: a Four-year Implementation Study
Background In October 2010, Haiti was struck by a large-scale cholera epidemic. The Haitian government, UNICEF and other international partners launched an unprecedented nationwide alert-response strategy in July 2013. Coordinated NGOs recruited local rapid response mobile teams to conduct case-area targeted interventions (CATIs), including education sessions, household decontamination by chlorine spraying, and distribution of chlorine tablets.
Assessing emotional motivators for handwashing with soap in emergencies: results from three Asian countries
This paper examines how emotional motivators can be used to promote handwashing with soap (HWWS) among mothers affected by an emergency. The impact of using emotional motivators along with other behaviour determinants for behaviour change in development settings has been well documented; however there is limited evidence for the use of motives for HWWS in emergency contexts.
Water, sanitation, and hygiene access in southern Syria: analysis of survey data and recommendations for response
Background. Water, sanitation, and hygiene (WASH) are immediate priorities for human survival and dignity in emergencies. In 2010, > 90% of Syrians had access to improved drinking water. In 2011, armed conflict began and currently 12 million people need WASH services. We analyzed data collected in southern Syria to identify effective WASH response activities for this context.
Effectiveness of Multilevel Risk Management Emergency Response Activities To Ensure Free Chlorine Residual in Household Drinking Water in Southern Syria
To provide safe drinking water and reduce the risk of disease, emergency responders in southern Syria are implementing a multilevel risk reduction strategy with the aim of ensuring free chlorine residual (FCR) in household drinking water. Responders implemented activities across the water chain (from chlorination station and well operators to water vendors to household members), including distribution of supplies for chlorination and training on chlorine use; activities varied by responder.
Household water treatment with chlorine can improve the microbiological quality of household water and reduce diarrheal disease. We conducted laboratory and field studies to inform chlorine dosage recommendations. In the laboratory, reactors of varying turbidity (10–300 NTU) and total organic carbon (0–25 mg/L addition) were created, spiked with Escherichia coli, and dosed with 3.75 mg/Ls odium hypochlorite. All reactors had>4 log reduction of E. coli 24 hours after chlorine addition