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How can WASH programmes be adapted to reduce person-to-person transmission in camps or camp-like settings?
How can WASH programmes be adapted to reduce person-to-person transmission in camps or camp-like settings?
Lauren D'Mello-Guyett avatar
Written by Lauren D'Mello-Guyett
Updated over a week ago

Access to and coverage of WASH services in camps and informal settlements should be increased to reduce the transmission of COVID-19. Frequent handwashing and respiratory hygiene (including respiratory etiquette and mask use) are some of the most important measures that prevent infection with COVID-19. WASH infrastructure and activities should enable greater frequency of hand washing by increasing access to soap, expanding access to handwashing facilities and using evidence-based strategies for hygiene behaviour change.

Expanded and adapted WASH services for camp and camp-like settings should include:

  • Increase water points: Fix any damaged water points and increase the number of taps per population and the number of water points. Where possible construct water points that minimize hand contact with water infrastructure (e.g. pedal action taps or taps with sensors) and which allow physical distancing to be maintained.

Image: Newly constructed water points in Syria with taps that are spaced apart to enable physical distancing. ©ATAA

  • Increase water quantity: Increased water quantity facilitates improved domestic hygiene practices. Ensure populations have sufficient water to meet their needs. This may mean increasing the number of litres per capita per day (LPCD) for the population and ensuring that these are in excess of minimum standards.

  • Maintain water quality: In centralised systems, maintain Free Residual Chlorine (FRC) of 0.5 mg/l in drinking water after at least 30 minutes contact time, and regularly clean water storage containers. If centralised systems are unavailable, provide or encourage the use of household water treatment technologies such as boiling or using high performing ultrafiltration or nanomembrane filters, solar irradiation and, in non-turbid waters, UV irradiation and appropriately dosed free chlorine. For more on water treatment in relation to COVID-19 see this resource or the WHO guidelines.

  • Maintain sanitation services: Maintain access to improved sanitation and regularly clean communal toilets with detergents and ensure workers use appropriate personal-protective equipment (PPE). Safe fecal-sludge management (FSM) services should also be expanded to service the local population. For further advice on FSM in camps and camp like settings see the Octopus resources.

  • Increase handwashing stations: Increase the number of and access to handwashing stations at homes, within blocks or clusters of households (e.g. at shared sanitation or entrance and exit points to camp regions), schools and public places (e.g. markets, health centres, child friendly spaces, places of worship, and transport centres) and ensure water and soap are available at all handwashing points. See our resources on handwashing infrastructure for further guidance.

  • Increase distribution of soap and WASH materials: People will require increased quantities of cleaning products at this time in order to adhere to preventative actions. Non-Food Items (NFIs) such as soap, sanitizer, cleaning products and masks could be included in hygiene kits. Distributing NFI kits should be done in line with existing guidance, (e.g. from Sphere) and be done in such a way that minimises contact and the likelihood of transmission. At minimum, this includes setting up handwashing facilities at distribution sites. Expanding distributions and adjusting the timing of distributions should also be considered.

  • Promote hygiene behaviour change: Standard programme design processes should be followed for designing hygiene promotion activities in camps or camp like settings. This involves talking to and engaging with and learning from the population in order to develop hygiene promotion activities that align with their circumstances, cultural norms and motives during this crisis. The Wash’Em process has been used to rapidly design handwashing promotion activities in camps and camp-like settings.

  • Adapt dead body handling and burial ceremonies: The risk of viral transmission while preparing the body of a person infected with COVID-19 is low and mainly occurs through contact with contaminated surfaces. Personnel who are interacting with the body, such as health care staff or the burial team, should use appropriate personal protective equipment (PPE), follow standard precautions and practice hand hygiene before and after interaction with the body, and the environment. People at high risk of severe illness, such as older people and those with pre-existing conditions, should be discouraged from participating in preparing the body, however, they do not necessarily need to be excluded from the mourning process. One of the key lessons from the recent Ebola outbreaks in Africa was that in addition to burials being safe and preventing disease transmission, they must also be culturally appropriate and dignified. The CDC has developed guidance on mourning and burial ceremonies and this includes specific recommendations for humanitarian settings and camps. Most governments have also developed guidance on how many people can attend funerals. However it is important to work with populations to get funeral procedures right. In camps in Cox’s Bazar they conducted a qualitative learning process to decide how to manage burial processes.

Considerations for the delivery of WASH services and products include:

Community engagement and learning: Work through existing structures to engage with the population to learn about perceptions related to COVID-19 and the community’s concerns. Note that for many crisis-affected populations, COVID-19 may not be their primary concern. Populations living in camps and camp-like settings may perceive themselves to be at a different level of risk of getting COVID-19 in comparison to the rest of the population. To counter this, it may be useful to normalise and share experiences of people who have had COVID-19 within the camp.

Use of a range of delivery channels: In camps and camp-like settings, the most common way of reaching people for hygiene promotion activities has historically been through face-to-face interactions. It is likely that this will need to be adjusted for COVID-19 response. During the pandemic, many countries have focused on using digital media to reach populations but displaced and crisis-affected populations may not always have high levels of access to mobile phones, the internet and mass media. To understand the best ways of reaching people, include an assessment of delivery channels as part of routine assessments and community engagement. If you are developing communication materials for camps see this guide.

Ensure hygiene promotion staff stay safe: All staff who are conducting work in camps or camp-like settings should follow physical distancing recommendations, have access to sanitizer or handwashing facilities and wear masks. These measures are key for keeping themselves and the population safe. For more guidance on the measures to be taken by frontline staff see this resource.

Align WASH actions with the national response, global standards and actions within other sectors: Activities within camps and camp-like settings should be aligned with the national coordinated response and continue to consider general guidance on environmental health in emergencies. There are also useful WASH checklists which have been developed by SPHERE and UNHCR. These include preparedness activities and how WASH intersects with other emergency response sectors such as food distribution and community engagement.

Want to learn more about COVID-19 programming in camps and camp-like settings?

Editor's note

Author: Lauren D’Mello Guyett

Review: Miriam Harter, Nada Abdelmagid, Tara Vernon, Bruce Spires

Last update: 11.8.2020

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