Medair News UK November 2017 by Medair UK

MEDAIR | news No. 3

Could WASH save your life? The crucial need for safe water, sanitation, and hygiene in emergencies

2017

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WELCOME

Could WASH save your life?

Neil Casey Director, Medair UK

I wonder how many of you are sitting down to read this edition of Medair News with a cup of tea or coffee? And when you went to fill your kettle, it was simply a matter of turning on the tap. Getting access to clean water is something we take for granted, but is a trial of human endeavour in an emergency. In an emergency drinking from an unclean water-source can be the only choice, but it is a choice that comes with the risk of serious illness or even loss of life is very real. Tens of thousands of people are exposed to cholera in South Sudan. It’s a similar scenario in the Democratic Republic of Congo. The solution can be as simple as disinfection using chlorine or a cost efficient oral vaccine for protection against disease. When storms hit, flooding can destroy water sources and pollute others. Storing water becomes a problem. The prepositioning of items such as buckets, or jerry cans before disaster hits means supplies of clean water can get to those who need them most. Forward planning saves lives and buys time until wells and other water sources can be rehabilitated. And when that isn’t possible a simple water fi lter or water purification tablets will provide life-saving access to clean water. These are simple and effective solutions; solutions that Medair uses time and again to help those in crisis who do not have clean water to drink. And many of these solutions cost less than a cup of tea or coffee!

MADAGASCAR

Cyclone Enawo

W H AT ' S N E W ?

Somalia & DR Congo

CRISIS BRIEFING

Could WASH save your life? SOUTH SUDAN

Lucky to be alive

CRISIS BRIEFING

Emergency WASH at work

BEHIND THE SCENES

Meet our team

Programme Funders DR Congo: Swiss Agency for Development and Cooperation, EU Civil Protection and Humanitarian Aid, US Agency for International Development, Medicor Foundation (LI), UN Children’s Fund, Common Humanitarian Fund, Fondation Gertrude Hirzel (CH), Migros (CH), Däster-Schild Foundation (CH), Agence de l'eau Rhône Méditerranée Corse (FR) Iraq: US Agency for International Development, Swiss Solidarity, EU Civil Protection and Humanitarian Fund, German Federal Enterprise for International Cooperation, UN Office for the Coordination of Humanitarian Affairs, Medicor (LI), Transform Aid International (AU), Fondation Famille Sandoz (CH), Fondation Resurgens (CH) Lebanon: Global Affairs Canada (through World Relief Canada), EU Civil Protection and Humanitarian Aid, UN High Commissioner for Refugees, Lebanon Humanitarian Fund (UN-OCHA), Swiss Solidarity, ERIKS Development Partner (SE) Madagascar: EU International Cooperation and Development, Swiss Agency for Development and Cooperation, Swiss Solidarity, Zoo Zurich (CH), Agence de l’eau Rhône Méditerranée Corse (FR), Canton of Aargau (CH), Centre de crise et de soutien du ministère des Affaires étrangères et du Développement international (FR), US Agency for International Development Somalia: TEAR (AU), US Agency for International Development, Dutch Ministry of Foreign Affairs, through the Dutch Relief Alliance Joint Response, in partnership with Dorcas Aid International (NL), EO Metterdaad (NL), Swiss Solidarity, All We Can (UK), Ferster Foundation (CH) South Sudan: EU Civil Protection and Humanitarian Aid, US Agency for International Development, UK Government, South Sudan Humanitarian Fund, Swiss Agency for Development and Cooperation, US Department of State, Dutch Ministry of Foreign Affairs, in partnership with Tear NL, and through the Dutch Relief Alliance Joint Response for South Sudan Cover Photo: Children wait for safe drinking water during a cholera outbreak in DR Congo. © Medair / Odile Meylan

IRAQ

"You have given us dignity"

BANGLADESH

The Rohingya Crisis — Medair responds M EDA I R U K

345 Canterbury Court 1–3 Brixton Road London, SW9 6DE Tel: 020 8772 0100 united.kingdom@medair.org medair.org

In March 2017, tropical cyclone Enawo hit Madagascar. Massive floodwaters reached up to four metres high (13 feet) in the District of Maroantsetra, swamping latrines and sweeping through dumps and stables. Filthy water contaminated hundreds of wells and displaced thousands of people.

MADAGASCAR

Before the cyclone season, Medair had prepositioned thousands of emergency WASH kits (buckets, soap, water treatment). The team started delivering them to families in the first 48 hours.

“Our first priority was to save lives,” recalls Ketsia, Medair relief worker. “The next 48 hours were a blur of constant activity. Our teams assessed the damage by foot, boat, and air. The powerful winds and heavy rains had left Maroantsetra unrecognisable.”

Thanks to your support, our emergency WASH team disinfected more than 800 contaminated wells and restored safe drinking water to nearly 30,000 people.

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CRISIS BRIEFING

Could WASH save your life? When emergencies strike and families are suffering, there is an urgent need to provide water, sanitation, and hygiene (WASH) to prevent further illness and death.

WHY ARE WATERBORNE DISEASES A MAJOR THREAT DURING EMERGENCIES?

Faecal matter transmits disease Multiple pathways to disease transmission:

Fluids Fingers Flies Fields/floors Food

I’ve done a lot of camping and backpacking in my life, and honestly that’s often what it’s like after a catastrophe hits. You need the basics like shelter, water, safe sanitation, and food. Imagine yourself camping: if you don’t have a proper water source, you’re 100 percent going to get sick. You could even die without proper medical attention. If you’re not safely disposing of your human waste, it can contaminate water sources and make you or others sick. That’s why we need WASH in emergencies.

– James McDowell, Head of Medair Global Emergency Response Team

Our WASH approach

Medair promotes handwashing and good hygiene practices, provides safe water, and ensures hygienic sanitation options to prevent the spread of water-related diseases. Our work takes us to dry regions with little water, and to wet regions with dirty water. We help families in forgotten rural villages and in large urban areas.

When Medair responds to an emergency, we think about the whole picture. You can’t improve water without also focusing on sanitation and hygiene. At the same time, you can’t just improve WASH without looking at other urgent needs like health, nutrition, and shelter. Communities get so much more benefit out of a WASH intervention if you integrate your response with health and other urgent needs.

– James Ray III, Medair WASH Advisor 4

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November 2017

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Water sources contaminated or damaged Loss of sanitation facilities Families displaced to areas with no existing water or sanitation services Limited awareness of health risks or poor hygiene practices

HOW DO WATERBORNE DISEASES SPREAD?

CRISIS BRIEFING

Emergency WASH at work E M E R G E N C Y WAT E R Water purification tablets Critical in outbreaks and sudden emergencies. Not sustainable over time. Water trucking Needed in some emergency contexts with limited water supply options; water gets trucked in from a nearby safe water source. Costly and unsustainable.

Repairing wells Where wells exist, the ideal emergency solution is to repair and/or decontaminate them, along with any hand pumps.

SWAT system in DR Congo © Medair /Bethany Williams

Water filters (Sawyer PointONE) Ideal for displaced families on the move. Lightweight, fairly inexpensive, and provide safe treatment for drinking water. Less ideal during outbreaks because fi ltered water does not provide secondary disinfection for household items like dishes.

Digging new wells Rarely done in an acute emergency context. Requires too much time (can take several days or weeks). Surface Water Treatment Systems (SWATs) Medair’s SWAT system uses a two-stage treatment process that clarifies (or cleans) the water and then chlorinates it prior to distribution. An effective short-term solution. Water storage Jerry cans and storage tanks provide for safe transport and storage of water.

Latrines in Lebanon

E M E R G E N C Y S A N I TAT I O N Latrines Ideal solution unless people are continually on the move. Takes time and materials to build. Usually supported by promotion of good hygiene behaviours. Handwashing stations Washing hands with soap or ash is crucial to protect against disease. Disposal of waste at medical facilities Needed to maintain hygienic conditions at health clinics.

Sawyer water filters in Ecuador

EMERGENCY HYGIENE Hygiene promotion The heart of emergency WASH interventions. Educating and motivating people about life-threatening risks and life-saving hygiene practices. Often delivered through community volunteers like Care Groups. Hygiene kits Buckets containing hygiene items such as soap and water purification tablets or fi lters. Hygiene promotion in Haiti

IRAQ

“You have given us dignity.” Amal and her family fled the conflict in Mosul and felt they had lost everything. When Amal counts the things she’s lost since the crisis began in 2014, she thinks of her village, of her loved ones killed in the conflict, of her extended family who had always lived nearby. She talks about losing her dignity, living without proper sanitation, relying on the kindness of neighbours for access to water. She and her family fled from Mosul’s conflict to a sprawling suburb and settled on a spot of vacant land. More than 10,000 people poured into this area, newly retaken from armed groups. Even though she lives in an open space, with little protection from the wind or relief from the harsh sun, Amal says she feels fortunate.

With thousands of people arriving, Medair installed water storage tanks, handwashing stations, and latrines at 164 locations in the suburb. We also provided hygiene training and many families were given essential household items, shower facilities, and shelter materials, while a mobile health team provided free medical care.

When a Medair emergency team first met Amal, she and her family were using a tiny tarped-off toilet area which offered some privacy but had no pit or drainage for waste. Every few days, they brought jugs and barrels to their neighbour to get water, but their containers were not protected from contamination. Amal’s family was at risk of waterborne diseases like cholera.

“This is a big thing for us,” says Amal. “You have given us dignity. When we arrived here we had nothing, but step by step we are fixing everything. Only Medair has been here to help us, and we thank you.”

Amal and her family still need many things, but for now, they have their dignity, better protection from disease, and healthier living conditions.

When our engineers came to inspect the new water tank and latrine, Amal’s children turned on the tap to show them how well it worked. Their young faces lit up as they splashed water over themselves in the 48 C (118 F) heat, just as children anywhere in the world might play on a hot day.

Amal (second from left) and her extended family in their shelter. 6

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November 2017

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A woman uses her Sawyer filter in Somalia.

WHAT’S NEW?

Health staff learn to make chlorine in DR Congo.

Treating water with Sawyer filters in Somalia

Making chlorine in DR Congo

Naimo, 26, lives in one of the biggest displacement camps in Somalia. She fetches her water from a nearby shallow well. “Sometimes we stand for over an hour in long queues,” she says. “By the time it’s your turn to fetch water, sometimes the well has already dried up and you end up going home with no water.”

When a cholera outbreak struck the remote village of Mateka, five people died within three days, and 21 became gravely ill. To contain the outbreak, the health clinic and the entire village needed to be disinfected with chlorine. Yet chlorine is hard to come by in the rainforests of DR Congo.

Naimo and her children used to drink the well water without boiling it, but her children often became ill. She began using aqua tabs from Medair to treat the water, although her family didn’t like the strong chlorine smell.

Just months earlier, Medair had begun field testing a process which uses a solar-powered kit that converts kitchen salt and water into chlorine through electrolysis. “We can now produce our own chlorine at very low cost,” said Dr Jude, Biakato-Mines clinic. “The supply is reliable and the quality is good. Thanks to Medair, we can provide a safe place for our patients.”

In the past year, Medair began distributing Sawyer water fi lters and large storage containers to nearly 7,000 Somalian households. It’s made a huge difference for Naimo and her family. They much prefer the taste and smell of the fi ltered water, and her children have not been ill for quite some time, not since she started treating the water regularly. Naimo also received hygiene training from Medair’s network of community health volunteers on how to properly use the fi lters. “Thanks for giving us water fi lters and jerry cans,” says Naimo. “They have improved our lives!”

Sawyer filters show great promise for providing safe drinking water in emergency contexts. We are now conducting research on their effectiveness, in partnership with Tufts University and USAID.

In Mateka, health staff used the kit and doubled the usual chlorine production, disinfecting the treatment unit and every water source and house in the village. We educated people on prevention, set up handwashing stations, and within two weeks, the outbreak was contained. “The kit enabled the health facility team to respond quickly and appropriately,” said Yannick, Medair relief worker.

Solar-powered chlorine production is an innovative use of technology to benefit humanitarian needs. Our WASH team and our local partners in DR Congo are now using it regularly.

In South Sudan…1

59%

Lucky to be alive

Drink unsafe water every day

When you hear about Adiew’s life, it might be hard to think of her as lucky.

74% Resort to open defecation

When she was 22, Adiew fled from violent conflicts near her home with her husband and four children. She hasn’t seen her husband since; he left in search of work and hasn’t returned. A year later, she lost a daughter to malaria; her voice breaks as she speaks about her loss. Three years have now passed. She lives in Mingkaman displacement settlement on the shores of the Nile River. Adiew works hard to fi nd enough food for her children, but they rarely eat more than one meal a day: “I collect water lilies, which we eat.”

Adiew with two of her children.

Yet she counts herself lucky. Adiew survived cholera, one of the deadliest diseases in South Sudan. She reached the hospital in time and was successfully treated. “It’s a very, very dangerous disease. It kills a lot of people,” she says. “People are really suffering in Mingkaman. The number of cases is too high.” South Sudan is facing the longest and most widespread cholera outbreak in its history. The highly contagious waterborne disease can kill within hours. “With very few health services available in the area, many lives are at immediate risk of being lost,” says Dr Liz Lewis, Medair relief worker. In Ayod, Medair has set up a cholera treatment unit, and works to ensure access to safe water, along with sanitation and hygiene promotion. We are also conducting mass Oral Cholera Vaccine campaigns, a short-term but life-saving solution that can help protect someone for up to five years.

In Mingkaman, Medair is vaccinating 68,000 people, an enormous logistical feat. “We need to transport in tens of thousands of vials and keep them cold,” says Diana, Medair relief worker. “It’s a major, exhausting undertaking, but knowing that 68,000 people will be protected is worth all the effort!” Although there’s little we can do on this day to relieve all the struggles that Adiew faces, we have at least been able to support her and her children with a potentially life-saving vaccine. “I’m happy with the vaccines and I appreciate you,” she says. Her sincere gratitude is a reminder that actions like this can make a big difference. Adiew wakes every day with an empty stomach, far from her husband, yet keeps holding onto her faith that one day things will be better. If we were in her shoes, could we do the same?

Children in Mingkaman, now protected from cholera.

See our cholera vaccination team in action: www.medair.org/cholera

Adiew's daughter receives her vaccine. 1

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November 2017

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2017 South Sudan Humanitarian Response Plan

SOUTH SUDAN

MEET OUR TEAM

Joining Medair changed my perception of life…

Charbel Haddad, WASH Senior Officer, Lebanon

James Ray III, Medair WASH Advisor

I’ve been working with Medair for over three years now. I’m from Zahle in Lebanon, and have my license in electro-mechanics from the International Technical Institute in Beirut. When I fi rst started, we were assessing the informal settlements in the Bekaa Valley so we could provide water tanks, water trucking, and latrines for families who urgently needed them.

I’m from Birmingham, Alabama in the USA. After a 10-year career as an engineer in the private sector I joined Medair. I was looking for a way to exercise my faith while using my engineering background. For the past decade, I have implemented water supply projects in conflict and post-conflict zones in East Africa and the Middle East, and I’m now a WASH technical advisor at Medair HQ.

Before working with Medair I wasn’t aware of the immense poverty experienced by refugees in Bekaa. They were completely deprived even of their basic needs. Working on a humanitarian level made me grow as a person and made me more aware of the importance of helping others in need. I see how much every person can contribute and make a change in someone else’s life. Joining Medair changed my perception of life.

I came into the job thinking, from a civil engineering background, that as long as I put up a latrine or put in a well, I’ve done my job. Clean water’s available and a latrine is available. The biggest change I’ve seen in myself, and in Medair’s programming, has been a much-increased focus on hygiene promotion and on teaching people why they should use this infrastructure. We spend a lot more time now on promoting positive behaviour change, and understanding what the barriers are to using a latrine.

Join our WASH team! www.medair.org/wash-jobs medair.org

November 2017

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every second counts when lives are on the line We move fast to save the lives of families during emergencies. Wherever they live, whatever it takes. Send life-saving help today at medair.org

Your gift this Christmas brings life

£25

can provide two families with hygiene kits

EMERGENCY HEALTH © Medair / James Cousins

£47

can provide emergency shelter plus a hygiene kit for one family

Give today at medair.org/donate 10

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EMERGENCY WASH

£88

can provide a mobile medical team for one day

UK NEWS

Qlik visits Medair in Jordan Marcus Gordon, (Vice President and regional head for the Qlik legal EMEA and APAC regions) was recently in Jordan as part of a Qlik delegation. The Qlik team had the opportunity to work with the Medair Jordanian and regional teams in the area observing their work in assisting with the Syrian conflict and more specifically the refugees in Jordan. Qlik supports, as part of its Corporate Social Responsibility programme, global fundraising initiatives for Medair and also donates software to Medair to assist their operatives on the ground and their HQ staff.

Qlik and Medair staff visiting one family in Jordan with many children living under the same roof.

Reflecting on the experience, Marcus observed: “It's not very often I get the chance to talk about life-changing moments. But having the opportunity to work with the Medair team in Jordan is one such experience. It was a privilege to see such passionate, dedicated and talented individuals at work and providing support in a way that truly makes a difference to people’s lives. It was also moving to see how the provision of Qlik Software was being used to deliver aid and resources to those who needed it most. I learnt how QlikSense was used in Lebanon to unify geo-mapping technology and beneficiary identification software in order to pinpoint healthcare for people who previously could not be easily identified or physically located. Medair was truly saving lives. We took with us some footballs, as a small token, to offer to some of the families. However, visiting the first family with some 17 children, living in confined quarters, brought home the reality of day-to-day life for a refugee in Jordan, as well as the dawning realisation that I should have brought with me more footballs.”

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BANGLADESH

The Rohingya Crisis — Medair responds by Nath Fauveau, Medair Global Emergency Response Team Three weeks before I snapped this photo, Lal Bana was pregnant and fleeing for her life. Her attackers rampaged and set Rohingya villages ablaze in Myanmar. Nearly 600,000 Rohingya people fled en masse to Bangladesh, seeing the country as their only hope of survival from the attacks. They came with nothing and had nowhere to live. On the day Medair’s emergency response team arrives in Kutapalo camp extension site, steady rain is pouring down, churning the ground to mud. Families walk barefoot through the mud, gather water from contaminated ponds, and huddle under makeshift shelters that do little to keep out the rain. Lal Bana, 20, (pictured above) shares her story with me, her newborn daughter sleeping by her side: “Three weeks ago, they set fire to our house. We ran to the hills and hid there for three days, and that’s when I gave birth. Nobody was there to help me; I did not see a doctor. After a few days, I was still bleeding, and I started to cough. We arrived in this camp one week ago. I was able to see a doctor for the first time two days ago. I had a fever, and so did my two-year-old daughter and my baby. They are still coughing today.” She doesn’t say it, but I can hear that she is ill too. The shelter that she lives in is a basic tarpaulin pulled over a couple of sticks with no protection whatsoever from the elements. As I stand in front of the shelter, my feet coated in mud under the cold rain, I can’t help but wonder how this baby will survive the winter. Giving Rohingya refugees shelter is more than urgent, it’s a question of life and death. Medair is in Bangladesh to distribute thousands of emergency shelter kits and essential hygiene supplies to help Rohingya families like Lal Bana’s survive the coming winter.

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