Centers for Disease Control and Prevention - CDC
Background: Refugees are at high risk for communicable diseases due to overcrowding and poor water, sanitation,
and hygiene conditions. Handwashing with soap removes pathogens from hands and reduces disease risk. A
hepatitis E outbreak in the refugee camps of Maban County, South Sudan in 2012 prompted increased hygiene
promotion and improved provision of soap, handwashing stations, and latrines. We conducted a study 1 year after
After the flood: an evaluation of in-home drinking water treatment with combined flocculent-disinfectant following Tropical Storm Jeanne — Gonaives, Haiti, 2004
Tropical Storm Jeanne struck Haiti in September 2004, causing widespread flooding which contaminated water sources, displaced thousands of families and killed approximately 2,800 people. Local leaders distributed PuR, a flocculent-disinfectant product for household water treatment, to affected populations. We evaluated knowledge, attitudes, practices, and drinking water quality among a sample of PuRw recipients. We interviewed representatives of 100 households in three rural communities who received PuR and PuR-related education.
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).
Sanitation practices and perceptions in Kakuma refugee camp, Kenya: Comparing the status quo with a novel service-based approach
Globally, an estimated 2.5 billion people lack access to improved sanitation. Unimproved sanitation increases the risk of morbidity and mortality, especially in protracted refugee situ- ations where sanitation is based on pit latrine use. Once the pit is full, waste remains in the pit, necessitating the construction of a new latrine, straining available land and funding resources. A viable, sustainable solution is needed.
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.
Inadequate drinking water quality from tanker trucks following a tsunami disaster, Aceh, Indonesia, June 2005
A number of organizations engaged in tanker trucks to deliver water to populations affected by the 2005 tsunami in Indonesia. Many relief organizations assumed that the trucks provided safe water, even promoting tanker truck water as safe water; however, no surveillance systems were in place to monitor tank truck water quality. We surveyed 40 tanker trucks operated by 12 organizations. A total of 75 water samples were tested for residual free chlorine, and of these, 54 were also tested for E.coli.
Perceptions of health Communication, Water Treatment and Sanitation in Artibonite Department, Haiti, March-April 2012
The international response to Haiti’s ongoing cholera outbreak has been multifaceted, including health education efforts by community health workers and the distribution of free water treatment products. Artibonite Department was the first region affected by the outbreak. Numerous organizations have been involved in cholera response efforts in Haiti with many focusing on efforts to improve water, sanitation, and hygiene (WASH). Multiple types of water treatment products have been distributed, creating the potential for confusion over correct dosage and water treatment methods.
Household water treatment uptake during a public health response to a large typhoid fever outbreak in Harare, Zimbabwe
Locally manufactured sodium hypochlorite (chlorine) solution has been sold in Zimbabwe since 2010. During October 1, 2011–April 30, 2012, 4,181 suspected and 52 confirmed cases of typhoid fever were identified in Harare. In response to this outbreak, chlorine tablets were distributed. To evaluate household water treatment uptake, we conducted a survey and water quality testing in 458 randomly selected households in two suburbs most affected by the outbreak.