Water-related Emergencies & Outbreaks

Sanitation Solutions in Emergency Response Settings

Overview

Lack of adequate and appropriate sanitation and hygiene access can be chronic public health challenges contributing to disease transmission in low- and medium-income countries. This situation can be further exacerbated during environmental disasters and environmental and public health emergencies.
In response to disasters and emergencies, prevention of indiscriminate open defecation and containing waste is critical to reduce disease transmission.
While planning for long-term waste management, immediate sanitation solutions are often needed to minimize public health impact during emergencies, and should include sanitation facilities, hand washing facilities with soap and water, operation and maintenance regimes, operator training, and community education. Sanitation options are discussed below.

Sanitation Solutions (Immediate Term)

Packet Latrines

Individual, single-use biodegradable bags for point-of-use sanitation that are buried or properly disposed.

Bags typically inside reusable buckets
Brand names: Peepoople, Wagbag

Advantages

No infrastructure required
Lightweight and easy to transport
May be used where space is severely limited or in flooded areas

Constraints

Active supply chain needed to provide </=1 bag/person/day
High costs of some types of bags
Need for disposal site and possibly collection services
Potential for bags to be discarded in open areas or areas posing risks to others
Social acceptance varies and would need to be determined for target population
Requires intense hygiene campaign to educate the community on handling and disposal of bags

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Bucket Latrines or Elevated Toilets

Elevated temporary structure over large container or tank that can be lined with large, replaceable plastic bag.

Advantages

Large containers typically easily procured
Suitable for sites where digging of latrines is not feasible or suitable.
Well suited to areas with high water table or where flooding occurs
Larger tank requires less frequent emptying

Constraints

Requires tanks and superstructure
Requires desludging trucks and personnel
Need for sewage disposal site
Vehicle access required to empty containers
Social acceptance varies and would need to be determined for target population
Requires intense hygiene campaign to ensure bags are buried/disposed and containers sanitized
May be difficult to access for handicapped, elderly and small children

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Chemical Toilets

Portable prefabricated sanitation units with water-tight excreta-holding tank, containing a chemical solution to aid digestion and reduce odour.

Advantages

Portable
Hygienic
Minimize odor
Can be mobilized rapidly
Demonstrated success in the Dominican Republic 2003 flooding
Well suited to areas with high water table or where flooding occurs

Constraints

High cost
Difficult to transport
Requires desludging trucks and personnel and disposal sites
Vehicle access required to service toilets
Require frequent emptying due to small size of tank
Need for sewage disposal site
Uncommon outside Europe, North America, and parts of Latin America

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Trench Latrines

Narrow trenches with temporary privacy structure; waste covered daily with soil.

Advantages

Rapid to implement (one worker can dig 50m of trench per day)
Feces can be covered easily with soil

Constraints

Short life span
Flooding of trenches during rainy season
Drainage to divert surface water from trench required
Constant management required to ensure covering of wastes daily
Limited privacy
Unsuitable where water table is high
Odor problems

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Communal or family pit latrines with short-term structure

Shallow pit of approximately 0.3m x 0.5m x 0.5m depth with simple privacy structure; waste covered with soil when latrine is near-full.

Advantages

Increased privacy
Rapid to implement
Reduced labor input
Higher-level of user involvement / ownership

Constraints

Require adequate space for digging of pits
Rainy season may pose issues with flooding of pits
Unsuitable where water table is high
Pit latrines fill-up and need to be capped long-term
Large quantity of tools and equipment required
Community must be able and willing to construct latrines

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Recommendations for Sanitation in Improvised Settlements and Cholera Prone Areas

Chemical toilets should be used in the immediate term where available and where the means to service them adequately exists.
If chemical toilets are not feasible, trench latrines or temporary pit latrines should be constructed immediately where no toilet facilities exist.
Elevated latrines should be considered for areas where digging of latrines is not possible or acceptable or areas with high water table or prone to flooding. They have larger reservoir and need to be desludged less frequently than chemical toilets.
The Sphere standard of 50 people per latrine for emergency situations should be used for the immediate term, with the aim of decreasing to the Sphere minimum standard for excreta disposal of 20 people per latrine.
Residents of IDP settlements should be engaged in choosing among appropriate alternatives.
Existing practices should be further investigated to identify other feasible alternatives (e.g., are people in improvised settlements using toilets in minimally damaged buildings in the vicinity?).
Further investigation of the local feasibility and local acceptability of packet and bucket latrines should be undertaken.
Health communication materials should contain information about latrine use and care (in local languages), and provisions made to communicate with non-literate populations.
Longer term sanitation solutions should be investigated further to help prevent recurrence of cholera and other infectious diseases.
Regardless of the type of sanitation facility installed, handwashing stations should be installed at every sanitation facility.

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