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Water, Sanitation, and Hygiene in Humanitarian Contexts

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A special issue of Water (ISSN 2073-4441). This special issue belongs to the section "Wastewater Treatment and Reuse".

Deadline for manuscript submissions: closed (30 April 2019) | Viewed by 113622

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Special Issue Editors

Dr. Caetano C. Dorea

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Guest Editor

Department of Civil Engineering, University of Victoria, Victoria, BC, Canada
Interests: water and sanitation for developing countries and humanitarian emergencies; drinking water quality and treatment; wastewater treatment and resource recovery; faecal sludge management

Dr. Travis Yates

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Guest Editor

Yates International Limited
Interests: water sanitation and hygiene (WASH) programming; evidence in humanitarian aid; impact evaluation; decision making; policy research

Dr. Claire Furlong

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Guest Editor

IHE Delft Institute for Water Education, Delft, The Netherlands
Interests: sanitation; fecal sludge management; gender in sanitation; laboratories
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Special Issue Information

Dear Colleagues,

Humanitarian emergencies can result from the effects of unpredictable natural forces or from the cruelty of conflicts. The total number of natural disasters and violent manmade conflicts has been on the rise, affecting a growing number of poor and marginalised populations that often face displacement and unsanitary living conditions. Provision of adequate water supply together with sanitation, and hygiene promotion (WASH) form a vital three-pronged public health intervention approach aimed at preventing infectious water- and excreta-related (diarrhoeal) diseases. Such illnesses are one of the major contributors to the overall morbidity and mortality rates during a humanitarian crisis. Humanitarian WASH has cross-cutting implications to other areas also impacting maternal, child and newborn health (MNCH) and nutrition. In recent years, the increase in number of humanitarian emergencies has been compounded with changing contexts (e.g., urban disasters) and new challenges (e.g., Ebola outbreak). This has prompted a push for emergency WASH innovations. However, there is an overall lack of evidence to support many established and novel humanitarian WASH interventions.

This Special Issue is dedicated to the theme of humanitarian emergency WASH and seeks to capture the most up-to-date research and field experience curated to benefit practitioners, decision-makers, scientists, and engineers. Given the complexities of operating and researching in humanitarian contexts, relevant WASH research applied to development contexts will also be considered for this issue.

We would therefore like to call for original papers to disseminate and share research findings the theme of WASH in Humanitarian Contexts. Papers will be selected by a rigorous peer review procedure with the aim of rapid and wide dissemination of research results, development and application.

We would like to dedicate this Special Issue to Prof. Huw Taylor, who recently passed away. Huw has made significant contributions to WASH-related research with applications in humanitarian and development contexts. A formidable researcher, a great mentor and a friend to many, he will be sorely missed.

Prof. Caetano C. Dorea
Dr. Travis Yates
Dr. Claire Furlong
Guest Editors

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Keywords

Water treatment & supply
Sanitation & Faecal Sludge Management
Hygiene promotion
Handwashing
WASH innovations
Evidence of intervention impact/effectiveness
Use with other interventions (e.g. oral cholera vaccine, nutrition, etc.)
Capacity-building
Challenging & changing contexts
Recurrent & emerging diseases
WASH for vulnerable populations
Inclusive WASH
Behaviour change
Protracted crises
Approaches to provision of WASH

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Published Papers (14 papers)

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14 pages, 1566 KiB

Open AccessArticle

Residual Maintenance Using Sodium Hypochlorite, Sodium Dichloroisocyanurate, and Chlorine Dioxide in Laboratory Waters of Varying Turbidity

by Karin Gallandat, David Stack, Gabrielle String and Daniele Lantagne

Water 2019, 11(6), 1309; https://doi.org/10.3390/w11061309 - 25 Jun 2019

Cited by 11 | Viewed by 8042

Abstract

Sodium hypochlorite (NaOCl) and sodium dichloroisocyanurate (NaDCC) are commonly used for household water treatment (HWT); chlorine dioxide (ClO₂) is a potential new HWT option. We compared the residual maintenance of NaOCl, NaDCC, and ClO₂ over 24 hours using recommended dosages (2 and 4 mg/L) in waters of varying turbidity (0–300 NTU, from kaolin clay or creek-bottom sediments) and total organic carbon (TOC) concentrations (0–100 mg/L), for a total of 324 reactors. NaOCl and NaDCC had similar free chlorine decay rates, and ClO₂ decayed more rapidly across all of the tested conditions. Little variability was observed across clay-based turbidity levels and TOC concentrations. With a dosage of 2 mg/L, a residual ≥0.2 mg/L was maintained at 30 NTU for NaOCl and 100 NTU for NaDCC; for ClO₂, 4 mg/L were required to maintain ≥0.2 mg/L under all conditions except at zero turbidity. Comparisons with data from the literature suggest that the three compounds would inactivate E. coli, rotavirus, and Giardia cysts within 1 hour under all conditions, except 300 NTU for NaOCl and NaDCC. All three disinfectants are similarly efficacious for this usage; however, differences are seen in decay rates that may influence disinfectant selection depending on water storage time. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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26 pages, 8183 KiB

Open AccessArticle

Community Engagement in WASH Emergencies: Understanding Barriers and Enablers Based on Action Research from Bangladesh and the Democratic Republic of Congo (DRC)

by Eva Niederberger and Tanya Glanville-Wallis

Water 2019, 11(4), 862; https://doi.org/10.3390/w11040862 - 25 Apr 2019

Cited by 9 | Viewed by 9303

Abstract

Engaging communities in humanitarian programming is key to ensuring their participation in decision-making that affects them as outlined by commitment 4 of the Core Humanitarian Standards. Based on learning from the West-African Ebola response (2014–2016), Oxfam’s WASH (water, sanitation, and hygiene) team is undertaking a paradigm shift toward greater community engagement (hereafter referred to as CE) in WASH, with a strong focus on measuring community participation—a crucial step toward understanding how we can better involve communities in reducing the risks of WASH-related diseases. This article presents key findings from Oxfam’s recent responses in Bangladesh and the Democratic Republic of Congo (DRC), describing the process of building trust and identifying barriers and enablers to meaningful CE in emergencies. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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11 pages, 487 KiB

Open AccessArticle

Informally Vended Sachet Water: Handling Practices and Microbial Water Quality

by David Manjaya, Elizabeth Tilley and Sara J. Marks

Water 2019, 11(4), 800; https://doi.org/10.3390/w11040800 - 17 Apr 2019

Cited by 15 | Viewed by 7834

Abstract

Informally vended water is an important source of water for marginalized people who do not have access to formal or public sources. In Malawi, hand-tied sachets of water are common but not regulated, and the quality of the water and hygienic practices during packaging are unclear. We analyzed microbial concentrations in the source water (origin), internal water (packaged) and on the external surface (plastic bag) of sachets from 76 vendors operating in the busy Mwanza crossing into Malawi from Mozambique. The results indicated that the majority (75%) of the water sources met the WHO guidelines (<1 CFU/100 mL) for potable water, while only 38% of the water inside packages met this guideline, indicating a sharp increase in contamination due to packaging and handling practices. The external surface was highly contaminated and is the point of contact between the consumer’s mouth and the liquid within; furthermore, external contamination was a strong and significant predictor of internal contamination. We advise against strict enforcement that would limit access to this important drinking water source, but recommend hygiene education for vendors that focuses on filling and storage, refrigeration and especially ensuring sanitary coolers from which the bags are sold in order to limit re-contamination during handling. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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16 pages, 1364 KiB

Open AccessArticle

Insecure Security: Emergency Water Supply and Minimum Standards in Countries with a High Supply Reliability

by Lisa Bross, Steffen Krause, Mia Wannewitz, Eva Stock, Simone Sandholz and Ina Wienand

Water 2019, 11(4), 732; https://doi.org/10.3390/w11040732 - 9 Apr 2019

Cited by 32 | Viewed by 9926

Abstract

Drinking water supply is at the core of both, humanitarian action in times of crisis, as well as national policies for regular and emergency supply. In countries with a continuous water supply, the population mostly relies ingenuously on the permanent availability of tap water due to high supply standards. In case of a disruption in the drinking water infrastructure, minimum supply standards become important for emergency management during disasters. However, wider recognition of this issue is still lacking, particularly in countries facing comparably fewer disruptions. Several international agencies provide guideline values for minimum water provision standards in case of a disaster. Acknowledging that these minimum standards were developed for humanitarian assistance, it remains to be analyzed whether these standards apply to disaster management in countries with high supply standards. Based on a comprehensive literature review of scientific publications and humanitarian guidelines, as well as policies from selected countries, current processes, contents, and shortcomings of emergency water supply planning are assessed. To close the identified gaps, this paper flags potential improvements for emergency water supply planning and identifies future fields of research. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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12 pages, 7629 KiB

Open AccessArticle

Characterization of Disinfection By-Products Levels at an Emergency Surface Water Treatment Plant in a Refugee Settlement in Northern Uganda

by Syed Imran Ali, Matt Arnold, Frederick Liesner and Jean-Francois Fesselet

Water 2019, 11(4), 647; https://doi.org/10.3390/w11040647 - 28 Mar 2019

Cited by 12 | Viewed by 6007

Abstract

The reliance on chlorination in humanitarian operations has raised concerns among practitioners about possible health risks associated with disinfection by-products; however, to date, there has not been an evaluation of disinfection by-product (DBP) levels in an emergency water supply intervention. This study aimed to investigate DBP levels at a surface-water treatment plant serving a refugee settlement in northern Uganda using the colorimetric Hach THM Plus Method. The plant had two treatment processes: (1) Simultaneous clarification–chlorination (“rapid treatment”); and (2) pre-clarification and chlorination in separate tanks (“standard treatment”). For both standard (n = 17) and rapid (n = 3) treatment processes, DBP levels in unique parcels of water were tested at 30 min post-chlorination and after 24 h of storage (to simulate what refugees actually consume). DBP levels after 24 h did not exceed the World Health Organization (WHO) guideline limit of 300 ppb equivalent chloroform, either for standard treatment (mean: 85.1 ppb; 95% confidence interval (C.I.): 71.0–99.1 ppb; maximum: 133.7 ppb) or for rapid treatment (mean: 218.0 ppb; 95% C.I.: 151.2–284.8; maximum: 249.0 ppb). Observed DBPs levels do not appear to be problematic with respect to the general population, but may pose sub-chronic exposure risks to specifically vulnerable populations that warrant further investigation. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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33 pages, 1142 KiB

Open AccessArticle

Legitimization of the Inclusion of Cultural Practices in the Planning of Water and Sanitation Services for Displaced Persons

by Julie C. Faure, Kasey M. Faust and Jessica Kaminsky

Water 2019, 11(2), 359; https://doi.org/10.3390/w11020359 - 20 Feb 2019

Cited by 6 | Viewed by 3729

Abstract

During large and rapid influxes of displaced persons, hosting communities may face challenges in accommodating incoming populations. This study seeks to assess the institutional response to international displacement in developed urban contexts through exploring how stakeholders (de)legitimized (i.e., either withheld or attributed legitimacy to) the inclusion of cultural practices in the planning of water and sanitation for displaced persons. This study is enabled by 28 semi-structured interviews of individuals involved in the accommodation of displaced persons in Germany conducted in 2016. The interview content was qualitatively analyzed to identify the types of decisions made, legitimacy types used to (de)legitimize those decisions, and information used to assess cultural practices. Results indicate that the institutional response to international displacement was most commonly reactive rather than proactive. However, the interviewees demonstrated a willingness to adapt, primarily using their experiences (comprehensibility legitimacy) and moral considerations (procedural legitimacy). Recommendations to stakeholders arising from this study include: (1) improve access to information about displaced persons’ practices and needs in water and sanitation, (2) collect more information by communicating with displaced persons, (3) promote collaborations between involved organizations, (4) monitor organizational changes during the response, and (5) enhance discussions about integration through the built environment. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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7 pages, 3350 KiB

Open AccessCommunication

Experimental Determination of Moisture Sorption Isotherm of Fecal Sludge

by Catherine Bourgault, Paul Lessard, Claire Remington and Caetano C. Dorea

Water 2019, 11(2), 303; https://doi.org/10.3390/w11020303 - 11 Feb 2019

Cited by 8 | Viewed by 5626

Abstract

Dewatering and drying of fecal sludge (FS) is a key treatment objective in fecal sludge management as it reduces volume (thereby reducing emptying frequency and associated transportation costs), inactivates pathogens, and is beneficial and/or necessary to resource recovery activities such as composting and combustion as fuel. However, studies on dewatering performances of FS are limited. The physical water distribution of such matrices is not fully understood, limiting the progress in the development and optimization of FS dewatering technologies. The objective of this study is to present a gravimetric method intended to assess the dewatering characteristics and associated modelling of FS through moisture sorption isotherms. Samples were placed in airtight jars containing different saturated salt (NaOH, CaCl₂, NaCl, KCl, K₂SO₄) solutions to reproduce a range of relative humidity values (6 to 97%). Results confirmed the achievement of characteristic sigma-shaped moisture sorption isotherms with increasing moisture adsorption at higher values of relative humidity. Furthermore, experimental data best fit the three-parameter Guggenheim–Anderson–de Boer (GAB) model. This method can be replicated to contribute critical data about the characterization of fecal sludge, a seriously under-researched matrix. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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12 pages, 1175 KiB

Open AccessArticle

A Traditional Closed-Loop Sanitation System in a Chronic Emergency: A Qualitative Study from Afghanistan

by Sayed Mohammad Nazim Uddin, Jean Lapegue, Jutta Gutberlet, Jan Franklin Adamowski, Caetano C. Dorea and Federico Sorezo

Water 2019, 11(2), 298; https://doi.org/10.3390/w11020298 - 9 Feb 2019

Cited by 4 | Viewed by 4681

Abstract

The use of closed-loop sanitation systems (CLSS), or reuse-oriented sanitation systems, has increased in recent years, and such systems have been successfully implemented in many parts of the world. However, no research has explored Traditional CLSS (T-CLSS) for a long-term humanitarian situation. This study explores the strengths, weaknesses, opportunities and threats (SWOT) of T-CLSS in peri-urban and rural contexts in three different provinces in Afghanistan (the first study of its kind in Afghanistan). Participatory research tools, such as transect walks, focus group discussions, smart community gatherings and interactive workshops, were applied to assess the SWOT associated with T-CLSS. The results indicate that T-CLSS has been practiced historically in both peri-urban and rural areas using local and traditional knowledge, skills and technologies. The socio-cultural acceptance of the system in both rural and peri-urban areas is an important strength of this established system. However, due to chronic development challenges in the study regions, T-CLSS may possibly lead to exposure to microbial contaminants. It is recommended that the feasibility of an improved CLSS be assessed and implemented in light of the issues that are inherent in the use of T-CLSS in Afghanistan. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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16 pages, 2715 KiB

Open AccessArticle

Assessment of Recommendation for the Containment and Disinfection of Human Excreta in Cholera Treatment Centers

by Diogo Trajano Gomes da Silva, Kevin Ives, Jean-Francois Fesselet, James Ebdon and Huw Taylor

Water 2019, 11(2), 188; https://doi.org/10.3390/w11020188 - 22 Jan 2019

Cited by 5 | Viewed by 6797

Abstract

Containment, safe handling and disinfection of human excreta in cholera treatment centers (CTC) are key to preventing the onward spread of the disease. This study compared the efficacy of three chlorine-based approaches at concentrations of 0.5%, 1%, and 2% and one hydrated lime-based (Ca(OH)₂ at 30% w:v) approach. Experiments followed existing Médecins Sans Frontières (MSF) cholera guidelines. Three simulated human excreta matrices consisting of either raw municipal wastewater (4.5 liters), or raw municipal wastewater plus 1%, or 20% faecal sludge (w:v), were treated in 14 liter Oxfam^® buckets containing 125 mL of chlorine solution or hydrated lime suspension. Bacterial indicators (faecal coliforms (FC) and intestinal enterococci (IE)) and viral indicator (somatic coliphages (SOMPH)) were used to determine treatment efficacy following contact times of 10, 30 and 60min. Results showed that efficacy improved as chlorine concentrations increased. No statistical differences were observed with respect to the various contact times. Overall median log removal for 0.5% chlorine were: FC (1.66), IE (1.41); SOMPH (1.28); for 1% chlorine: FC (1.98), IE (1.82); SOMPH (1.79); and for 2% chlorine: FC (2.88), IE (2.60), SOMPH (2.38). Hydrated lime (30%) provided the greatest overall log removal for bacterial indicators (FC (3.93) and IE (3.50), but not for the viral indicator, SOMPH (1.67)). These findings suggest that the use of 30% hydrated lime suspensions or 2% chlorine solutions may offer a simple public health protection measure for the containment, safe handling, and disinfection of human excreta during humanitarian emergencies. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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13 pages, 2085 KiB

Open AccessArticle

Laboratory Efficacy and Disinfection by-Product Formation of a Coagulant/Disinfectant Tablet for Point-of-Use Water Treatment

by Félix Légaré-Julien, Olivier Lemay, Ulysse Vallée-Godbout, Christian Bouchard and Caetano C. Dorea

Water 2018, 10(11), 1567; https://doi.org/10.3390/w10111567 - 2 Nov 2018

Cited by 6 | Viewed by 4465

Abstract

Coagulant/disinfection products (CDPs) are a point-of-use (POU) water treatment technique that can improve microbial quality, reduce turbidity, and produce a free chlorine residual (FCR), serving as a potentially effective option for decentralized water treatment in a variety of contexts, including humanitarian emergencies. A novel CDP with a sodium dichloroisocyanurate-based disinfectant was evaluated with regard to its laboratory water treatment efficacy and generation of disinfection byproducts (DBPs). The CDP water treatment performance was assessed relative to bacteriological (E. coli) humanitarian water quality objectives, World Health Organization recommendations for evaluating POU water treatment options, and available DBP regulations and guidelines. At least 4 log₁₀ E. coli reductions, for a “highly protective” status with regard to bacterial reductions, were attained in the tested conditions. Treated waters were consistently below 10 MPN/100 mL with regard to E. coli concentrations, with the majority of samples showing no detectable E. coli. For most conditions, target FCR values were not attained. Treated water turbidity levels were mostly between 5 NTU and 10 NTU. DBP levels were below the regulatory and health-based targets for both families of DBPs studied. This study has served to identify the performance envelopes of the CDP tested under challenging conditions. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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8 pages, 198 KiB

Open AccessArticle

Determining the Efficacy, Safety and Suitability of Disinfectants to Prevent Emerging Infectious Disease Transmission

by Daniele Lantagne, Marlene Wolfe, Karin Gallandat and Melissa Opryszko

Water 2018, 10(10), 1397; https://doi.org/10.3390/w10101397 - 9 Oct 2018

Cited by 3 | Viewed by 7569

Abstract

The scale of the 2014–2017 West African Ebola Virus Disease outbreak overwhelmed the international response capacity. This has led to inconsistencies in international guidance documents, particularly around chlorine disinfection of surfaces and hands to prevent transmission. To provide evidence for the disinfection recommendations, three research strands were conducted: (1) impacts of chlorine chemistry; (2) efficacy of surface cleaning recommendations; and (3) safety and efficacy of handwashing recommendations. Strand 1 research found that the compound chemistry of the chlorine source has an impact on the chlorine solution shelf-life (<1 day–30 days), with testing of chlorine solutions recommended to ensure accuracy. Strand 2 research found that surface cleaning with 0.5% chlorine solutions with a 15-min exposure time is efficacious in reducing transmission risk. Strand 3 research found that community handwashing with chlorine solutions is as safe and efficacious as handwashing with soap and water or sanitizer, which offers a benefit of reducing pathogens in the rinsing water. Using calcium hypochlorite as the chlorine source compound provided a particularly good performance in chemistry and handwashing studies. The research was successful at providing information to align with the inconsistent international guidelines. Further research is needed to proactively establish the efficacy, safety and suitability of disinfection for the seven viral pathogens that are considered likely to cause severe outbreaks with few/no medical countermeasures. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

17 pages, 870 KiB

Open AccessArticle

Evaluation of Key Antimicrobial Properties of Moringa oleifera in Relation to Its Use as a Hand-Washing Product

by Yasaman Naemi-Baghshomali Clark, Monica Jimenez, Enrique Raso, Loretta Antwi, Lawrence H. Ofosu-Appiah, David Opare and Belen Torondel

Water 2018, 10(9), 1154; https://doi.org/10.3390/w10091154 - 29 Aug 2018

Cited by 2 | Viewed by 10055

Abstract

Moringa oleifera (M. oleifera) is a fast-growing, drought-resistant plant found throughout tropical and subtropical regions. A previous study found dry M. oleifera leaf powder to be similarly efficacious to non-medicated soap when used as a hand-wash, even without the use of water. These characteristics suggest that M. oleifera could serve as a potential hand-washing product in water and resource-limited contexts, such as humanitarian and emergency settings. The purpose of this study was to assess the efficacy of minimally processed M. oleifera sourced locally in Ghana as a hand-washing and antimicrobial product by assessing whether: (1) different preparations of M. oleifera have antibacterial properties against potential diarrheal pathogens through set-up of die-off studies; (2) M. oleifera is an effective hand-washing product by conducting an in-vivo trial with healthy volunteers; and (3) M. oleifera has antimicrobial properties in potentially reusable aqueous solutions, such as rinse water used for hand-washing. M. oleifera was found to be significantly less effective than non-medicated soap when tested as a hand-washing product and promoted the growth of bacteria in aqueous solution. Moreover, the Moringa used in the study was found to be host to pathogenic bacteria, reinforcing the idea that it is unsuitable to use as a hand-washing product. Accordingly, in its minimally processed form, M. oleifera appears to be an ineffective antimicrobial agent and its use as a hand-washing product in water-scarce and resource-limited settings is not recommended. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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17 pages, 1091 KiB

Open AccessArticle

Development of a Field Laboratory for Monitoring of Fecal-Sludge Treatment Plants

by Johannes Bousek, Marco Skodak, Magdalena Bäuerl, Georg Ecker, Jan Spit, Adam Hayes and Werner Fuchs

Water 2018, 10(9), 1153; https://doi.org/10.3390/w10091153 - 28 Aug 2018

Cited by 2 | Viewed by 5397

Abstract

In urban humanitarian-aid operations, safe treatment of fecal sludge is highly important. While currently field-deployable fecal-sludge treatment plants are being developed, field-ready analytical equipment for process-control and public health monitoring is missing. Within the Microbial Sludge Quality project, a field laboratory was developed. A minimum set of parameters for the considered processes was developed through literature research. The analytical methods were tested on their field applicability and, if necessary, modified. The following methods were modified for field use: bacteriological analysis (sample homogenization and counting), chemical oxygen demand (sample digestion), volatile fatty acid–alkalinity titration (redesigned test setup), total solids (redesigned test setup), and ammonia determination (redesigned test setup). For bacteriological analysis, chemical oxygen demand, and total solids the modifications lead to highly comparable analytical results. The results obtained by the field methodology for volatile fatty acid–alkalinity titration and ammonia determination were sufficient for field-process monitoring; however, they did not correlate as well. To enable rapid startup of the laboratory during humanitarian-aid missions, it was developed to include analytical and support equipment. The usage of the developed laboratory should allow close-in-time process monitoring and public-health assessments of fecal-sludge treatment plants. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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9 pages, 674 KiB

Open AccessFeature PaperEditor’s ChoiceCommentary

Making the Case for a Female-Friendly Toilet

by Margaret L. Schmitt, David Clatworthy, Tom Ogello and Marni Sommer

Water 2018, 10(9), 1193; https://doi.org/10.3390/w10091193 - 5 Sep 2018

Cited by 39 | Viewed by 21261

Abstract

Inadequate access to a private, comfortable, and well-located toilet remains a critical challenge for many girls and women around the world. This issue is especially acute for girls and women living in densely populated urban slums, displacement camps, and informal settlements, often resulting in anxiety, embarrassment, discomfort, and gender-based violence. The unique sanitation needs of girls and women are rarely accounted for during the design and construction of toilet facilities, including needs related to their physiology, reproductive health processes, prevalent social norms, and their heightened vulnerability to violence. It is critical that a new norm be developed regarding the design of female-friendly toilets which better enables girls and women to feel confident, safe, and dignified while managing their daily sanitation needs. This includes adopting specific design measures which account for their menstrual hygiene, personal safety, and dignity-related needs. Ultimately, an enhanced dialogue must take place among designers, policy makers, water, sanitation, and hygiene (WASH) practitioners, and other relevant actors, in addition to the target female users themselves, about how to adapt toilets in a range of development and emergency contexts and operations to better address these critical needs of girls and women. Full article

(This article belongs to the Special Issue Water, Sanitation, and Hygiene in Humanitarian Contexts)

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