The WASH Approach: Fighting Waterborne Disease

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The WASH Approach: Fighting Waterborne Disease

Stabilizing the Crisis

With several months of hard work since the refugees began arriving here, the Adjumani and Arua settlements resemble traditional African villages. Latrines, boreholes, and roads have been built, and families have been assigned plots of land they can temporarily call their own. Before long, technicians repair the broken pump, and water soon returns to tap stands throughout the settlement.

Unlike a traditional refugee setting, where refugees live in tents in a fenced-off camp, those in Uganda live on land donated by Ugandan nationals through arrangement of the government, and refugee families are given plots on which they can build shelters and grow crops. 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. Outstanding questions include how to make handwashing with soap a social norm in a way that's culturally conscious and acceptable to a society, and which handwashing technologies support good handwashing practice and are acceptable to the communities that use them.

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"Overall, there is a dearth of data on handwashing in emergencies," Vujcic says. "There is no evidence on what works in emergencies to improve handwashing behavior." But with no shortage of emergencies for UNHCR to attend to around the world, both humanitarians and epidemiologists will have their hands full for the foreseeable future—and hopefully those hands will be cleaned with soap.

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