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The WASH approach: fighting waterborne diseases in emergency situations.

Nicole W - Environ. Health Perspect. (2015)

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To report this story, Wendee Nicole visited two refugee settlements in Northern Uganda, Arua District’s Rhino Camp and the settlements of Adjumani District... She celebrated Global Handwashing Day 2014 with dozens of young children at Rhino Camp. “No water!” a young mother with short cornrowed hair says in her limited English, a worried look etched in her brow... It’s a sweltering October day just 3 degrees north of the Equator in Northern Uganda’s Adjumani District, where a dozen children and a handful of women have gathered at the public tap stand with their 20-liter jerrycans... More than 66,000 men, women, and children have settled here, in camps in Adjumani District, with over 15,000 more in Arua District’s Rhino Camp... Worldwide, only 19% of people on average are estimated to wash their hands with soap after defecating (see table)... Yet studies consistently show that handwashing with soap is effective at reducing diarrheal diseases; one systematic review of the literature estimated it reduces risk by 23–40%, while another estimated a 48% reduction... We bring a sense of shock or shame, while respecting the culture. ” The goal is to ignite awareness and a genuine desire for change in the community, and it works, Maung says—typically within a week people will begin building latrines or start using ones that are already there... But the effectiveness of CLTS largely depends on the skill of the facilitator, he adds... Refugees have a different situation, however, so the process is adapted slightly. “Traditionally we don’t provide materials to construct the latrines, but in refugee situations, we create demand first, then provide materials,” Maung says; this encourages the refugees to use the facilities... But does the mere presence of latrines and improved infrastructure really improve health outcomes? A team of researchers studied 100 villages in Odisha, India, some of which received latrines and some of which did not... They found no significant differences in diarrheal incidence or associated deaths, fecal contamination of water stored in households, contamination of the hands of mothers and children, malnutrition, or helminth worm infection between villages with and without additional latrines. “The lesson to draw is not that latrines don’t produce a benefit but the latrine programs weren’t properly implemented,” says Sandy Cairncross, a professor of environmental health at the London School of Hygiene & Tropical Medicine, who was not directly involved in the Odisha study... At Arua’s Rhino Camp, dozens of children and their parents gathered to celebrate Global Handwashing Day 2014... The Ugandan government and UNHCR have a policy of devoting 70% of aid to refugees and 30% to nationals, according to Maung... This arrangement helps reduce resentment and also improves infrastructure that remains once refugees return home. “We are in the process of transition from acute emergency to stabilized emergency,” says Maung, “but [there’s] quite a lot of work to be done in terms of operation and maintenance of WASH facilities to ensure sustainability. ” “There is not much data on long-term behavior change for handwashing with soap,” says Jelena Vujcic, an epidemiology researcher at the University of Buffalo.

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The pathways of fecal–oral transmission all start with “F,” hence the name “F diagram.” Water, sanitation, and hygiene act as barriers to prevent contact with feces.Joseph Tart/EHP
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d35e320: The pathways of fecal–oral transmission all start with “F,” hence the name “F diagram.” Water, sanitation, and hygiene act as barriers to prevent contact with feces.Joseph Tart/EHP


The WASH approach: fighting waterborne diseases in emergency situations.

Nicole W - Environ. Health Perspect. (2015)

The pathways of fecal–oral transmission all start with “F,” hence the name “F diagram.” Water, sanitation, and hygiene act as barriers to prevent contact with feces.Joseph Tart/EHP
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4286267&req=5

d35e320: The pathways of fecal–oral transmission all start with “F,” hence the name “F diagram.” Water, sanitation, and hygiene act as barriers to prevent contact with feces.Joseph Tart/EHP

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

To report this story, Wendee Nicole visited two refugee settlements in Northern Uganda, Arua District’s Rhino Camp and the settlements of Adjumani District... She celebrated Global Handwashing Day 2014 with dozens of young children at Rhino Camp. “No water!” a young mother with short cornrowed hair says in her limited English, a worried look etched in her brow... It’s a sweltering October day just 3 degrees north of the Equator in Northern Uganda’s Adjumani District, where a dozen children and a handful of women have gathered at the public tap stand with their 20-liter jerrycans... More than 66,000 men, women, and children have settled here, in camps in Adjumani District, with over 15,000 more in Arua District’s Rhino Camp... Worldwide, only 19% of people on average are estimated to wash their hands with soap after defecating (see table)... Yet studies consistently show that handwashing with soap is effective at reducing diarrheal diseases; one systematic review of the literature estimated it reduces risk by 23–40%, while another estimated a 48% reduction... We bring a sense of shock or shame, while respecting the culture. ” The goal is to ignite awareness and a genuine desire for change in the community, and it works, Maung says—typically within a week people will begin building latrines or start using ones that are already there... But the effectiveness of CLTS largely depends on the skill of the facilitator, he adds... Refugees have a different situation, however, so the process is adapted slightly. “Traditionally we don’t provide materials to construct the latrines, but in refugee situations, we create demand first, then provide materials,” Maung says; this encourages the refugees to use the facilities... But does the mere presence of latrines and improved infrastructure really improve health outcomes? A team of researchers studied 100 villages in Odisha, India, some of which received latrines and some of which did not... They found no significant differences in diarrheal incidence or associated deaths, fecal contamination of water stored in households, contamination of the hands of mothers and children, malnutrition, or helminth worm infection between villages with and without additional latrines. “The lesson to draw is not that latrines don’t produce a benefit but the latrine programs weren’t properly implemented,” says Sandy Cairncross, a professor of environmental health at the London School of Hygiene & Tropical Medicine, who was not directly involved in the Odisha study... At Arua’s Rhino Camp, dozens of children and their parents gathered to celebrate Global Handwashing Day 2014... The Ugandan government and UNHCR have a policy of devoting 70% of aid to refugees and 30% to nationals, according to Maung... This arrangement helps reduce resentment and also improves infrastructure that remains once refugees return home. “We are in the process of transition from acute emergency to stabilized emergency,” says Maung, “but [there’s] quite a lot of work to be done in terms of operation and maintenance of WASH facilities to ensure sustainability. ” “There is not much data on long-term behavior change for handwashing with soap,” says Jelena Vujcic, an epidemiology researcher at the University of Buffalo.

Show MeSH
Related in: MedlinePlus