Environmental Health in Emergencies: Technical Notes On Water and Sanitation

Environmental Health
in Emergencies
Technical Notes on
Water and Sanitation
EHA Publication No. 20

Kathmandu
March 2007
ENVIRONMENTAL HEALTH IN EMERGENCIES
Technical Notes on Water & Sanitation
Health and Environment

Emergency and Humanitarian Action
World Health Organization
Kathmandu
Nepal, March 2007
Kjaergaard, Erik; Heijnen, Han; Adhikari, Damodar; Adhikary, Sharad .-ed
Environmental health in emergencies: technical notes on water and sanitation,
Kathmandu: WHO, 2007.
55p.; illus (EHA Publication No. 20)

500 copies printed
Keywords: emergency water supply; water quality testing; water purification; disinfection;
environmental health; hygiene; solid waste management; dead body
management
Printed by the WHO Emergency and Humanitarian Action (EHA) Programme with financial
contribution from Swedish International Development Agency (SIDA)
For feedback and further information, please contact:
WHO Environmental Health Unit

Han Heijnen, Environmental Health Advisor [email protected]
Sharad Adhikary, National Professional Officer [email protected]
© World Health Organization, March 2007
This document is not a formal publication of the World Health Organization (WHO), and all rights
are reserved by the Organization. The document may, however, be freely reviewed, abstracted,
reproduced or translated, in part or in whole, but not for sale or for use in conjunction with
commercial purposes.
The views expressed in documents by named authors are solely the responsibility of those
authors.
Preface
The World Heath Organization is pleased to present this publication on effective water and
sanitation measures during emergencies. Given the high risk of natural calamities and prolonged
complex emergencies in Nepal, it is important to have sound public health guidelines and trained
staff in place to ensure provision of clean water, basic sanitation and good hygiene practices.
Past experience has shown that simple methods to improve environmental health reduce excess
mortality and morbidity in emergencies.
Nepal is exposed to multiple hazards. The country is located in an active seismic zone which
could anytime transform into an emergency situation as witnessed in Gujarat in 2001 and in
Pakistan in 2005. Steep hillsides are vulnerable to earth slips and landslides especially during
the rainy season, where trails and roads often get cut off. During the monsoon season, several
parts of the Terai get flooded, for a few days and sometimes for weeks. These hazards have an
impact on water and sanitation and compel us to consider preparedness, mitigation and relief
measures to minimize the health consequences of a natural calamity and restore services as
soon as possible.
In view of the increasing vulnerability of the population in the region, the World Health
Organization in 2003 initiated a project to develop a capacity building strategy for water,
sanitation and hygiene in emergencies. This strategy of the WHO South East Asia Regional
Office aims to support national counterparts and other organizations involved in emergency
preparedness and disaster response with authoritative advice and information on water supply
and sanitation, in order to protect the health and wellbeing of vulnerable populations.
The rationale for the WHO strategy is:

• There is better global understanding of how disasters impact on people’s livelihoods, health
and wellbeing. Disasters cannot be ignored as an ‘isolated issue’ but must be treated as an
integral component of (national/local) development
• The poor are often most vulnerable to disasters and their health impact. Disasters are
obstructing progress towards achieving poverty alleviation and the Millennium Development
Goals
• Disasters often disrupt water supplies, sanitation facilities and people’s hygiene practices,
exposing the affected population to significant health risks. Safe water supplies and
sanitation are often priority public health concerns in an emergency, and are certainly
perceived to be so by the affected population
The fourteen illustrated technical notes presented in this publication is one of the initiatives to
enhance the capacity of emergency and relief staff in dealing with water and sanitation. The
notes were prepared jointly by the WHO South East Asia Regional Office and the Water,
Engineering and Development Centre at Loughborough University, United Kingdom. The papers
cover various aspects of environmental health in emergencies such as the minimum water
quantity needed; measuring of residual chlorine in water; cleaning and disinfection of wells,
boreholes, water storage tanks and tankers; emergency sanitation and essential hygiene
messages.
The objective of these technical notes is to assist those working immediately or shortly after an
emergency to plan and execute appropriate responses to the urgent and medium-term water
and sanitation needs of the affected population. The notes are relevant to a wide range of
geological and topographic settings, and to various types of natural disasters and complex
emergencies. During the Tsunami disaster response in 2004-2005, the fact sheets proved their
worth. They are suitable for field technicians, engineers, hygiene promoters, as well as
programme staff.
WHO Nepal is currently working on the fact sheets to make them more applicable in the Nepal
context. We intend to add more sheets to address particular concerns that may be important in
the case of an earthquake. We welcome comments from the users of the sheets in order to
make them relevant and useful.
I hope this publication will be a useful guide to the staff and volunteers who will be called upon to
respond during crisis.
Dr Kan Tun
WHO Representative to Nepal
Table of Contents
1. Cleaning and disinfecting wells in emergencies 1
2. Cleaning and disinfecting boreholes in emergencies 5
3. Cleaning and disinfecting water storage tanks and tankers 9
4. Rehabilitating small-scale piped water distribution systems 13
5. Emergency treatment of drinking water at point-of-use 17
6. Rehabilitating water treatment works after an emergency 21
7. Solid waste management in emergencies 25
8. Disposal of dead bodies in emergency conditions 29
9. Minimum water quantity needed for domestic use in emergencies 33
10. Essential hygiene messages in post-disaster emergencies 37
11. How to measure chlorine residual in water 40
12. Delivering safe water by tanker 44
13. Emergency sanitation – planning 48
14. Emergency sanitation – technical options 52

Cleaning and disinfecting wells
in emergencies
Steps of cleaning and

Step 1:
disinfection Inventory of existing wells
Figure1 outlines a five stage approach to cleaning and
disinfecting wells after natural disasters. It is an
emergency approach designed to rehabilitate wells so
that they produce water of a similar quality to that Step 2:
supplied before the disaster. Cleaning and rehabilitation
of wells
Step 1: Inventory of existing wells

The disaster may have contaminated or damaged a
large number of wells. The first step must be to select Further well QUESTION
No
which wells should be repaired first. The following cleaning including Test turbidity levels.
actions should help you to make your selection. dewatering Are they 5NTU?
Meet with community leaders and ask them to Yes

briefly outline which wells serve which sections of
Step 3:
the community. Disinfection of wells
Select the wells that are most commonly used for
drinking water.
Assess the type and extent of damage to the top of
the well. Step 4:
Dewatering of wells
Estimate the amount of silt and debris in the well.
Test the pump to see if it is still working or
determine what repairs are necessary.
Step 5:
Estimate resources needed for repairs (personnel, Monitor chlorine levels
equipment, time and materials).
Select the wells that are used most and are easiest Figure 1. Steps for cleaning and
to repair first. disinfecting a well
Step 2: Rehabilitation and cleaning

of wells
Disinfecting a well without first removing the source of
contamination provides only temporary health
protection. Rehabilitation may include:
1. Repair/replacement of the pumping mechanism.
2. Removal of polluted water and debris from well

using either buckets or pumps.
3. Sealing the top of the well using a clay sanitary

Damaged well head and surround seal built around top of well (Figure 2).
Page 1
Check turbidity and pH

2.5m - 3.5m diameter apron
Following cleaning and repair, allow the water level in
the well to return to its normal position. Measure the
150mm thick
(cast in situ) turbidity and pH levels to check if chlorination will be
1m
Concrete effective. This can be done using simple hand held
Seal slab equipments similar to that shown in Figure 3. Never
chlorinate turbid water because the suspended
particles can protect the micro-organisms. Table 1
outlines why pH and turbidity are important and what
can be done to ensure guideline levels are met.
If the turbidity of the well water is greater than 5NTU

Compacted Hardcore after the cleaning and rehabilitation stage, remove all
clay foundation
water in the well once again and scrub the well lining
with a strong concentration of bleach in water. Allow the
well to refill with water and test turbidity levels again to
ensure compliance.
Figure 2. Sealing the top of a well
4. Construction of a drainage apron and head wall

around the well to prevent surface water, insects
and rodents entering the well.
5. Relining the well to reduce subsurface

contamination.
Examining the turbidity of water
Bleach gives off chlorine gas

which is very dangerous.
Try to clean the well lining from
outside the well using a long
handled brush.
If you must enter the well either

wear full protective clothing and
breathing apparatus and provide
a strong air flow inside the well
to carry away the chlorine gas.
Taking a water sample from a well
Page 2
The level of residual chlorine in mg of chlorine per litre of

water (mg/l) is determined by dissolving a chlorine testing
tablet in the water supply under test, in chamber (A).
Compare the colour produced with the standard colours on
the wall of chamber (B).
A B C
1Dml Chlorine
DPD colour
1.0 8.0
0.8 5.0
0.6 3.0
0.4 2.0
0.2 mg/l 1.5
Note: A third chamber (C) would be used if a higher chlorine

residual is to be measured.
A separate fact sheet is available on chlorine testing.
Testing chlorine levels using a comparator

Figure 3. A comparator
Step 3: Disinfection of the well

WHO endorses the disinfection of drinking water in
emergency situations. There are various ways of doing
this but the most common is chlorination as it leaves a
residual disinfectant in the water after chlorination.
Chlorine has the advantage of being widely available,

simple to measure and use and dissolves easily in
water. Its disadvantages are that it is a hazardous
substance (handled with care) and is not effective
against all pathogens (e.g. cysts and viruses, which
require higher chlorine concentrations).
The chlorine compound most commonly used is

calcium hypochlorite as high test hypochlorite (HTH) in
powder or granule form. Also used is sodium
hypochlorite in liquid bleach or bleaching powder form.
Each chlorine compound has a different amount of
usable chlorine depending on the quantity of time the
product has been stored or exposed to the atmosphere
Testing pH level of water and the way it is made.
Table 1. Physico-chemical parameters
Parameter WHO GDWQ Why? Corrective action
pH 6–8 pH of 6.8-7.2 is required to If pH is less than 6 add hydrated

reduce level of chlorine required. lime (calcium hydroxide)
Turbidity < 5NTU High turbidity (>5NTU) requires Dewater well and rebleach well
(20NTU emergency more chlorine to oxidise organic lining using chlorine solution
limit) matter
Page 3
The best type of chlorine in an emergency is HTH as

this normally contains 50 to 70% chlorine. Box 1. Calculating the chlorine dosage for
disinfecting a well using Calcium Hypochlorie
Box 1 outline methods for calculating appropriate (HTH)
chlorine doses for HTH granule chlorine.
Equipment
The amount of chlorine needed will depend on the
• 20 litre bucket
volume of water in the well. Add 1 litre of 0.2% chlorine
• HTH chlorine granuals or powder
solutions for every 100 litres of water in the well. Stir the
water in the well thoroughly with a long pole and then
Method
allow the water to stand for at least 30 minutes.
• Calculate the volume of water in the well using
the formula:
Step 4: Dewater the well
Following the contact period, remove all water in the V = πD2 x h
well using a pump or bucket. When the well has refilled, 4
wait a further 30 minutes and measure the chlorine Where
concentration using a comparator. If the residual V = volume of water in the well (m3)
chlorine concentration is less than 0.5mg/l the well is D = diameter of the well (m)
safe to use. If the concentration is greater than 0.5mg/l, h = depth of water (m)
remove all the water from the well again and repeat the π = 3.142
process.
• Fill the bucket with clear water from the well.
• Add 50g of HTH and stir unitl disolved.
For every cubic metre (m3) of water in the well add

10 litres (half bucket) of the chlorine solution.
Do not allow anyone to use the well during the

cleaning process. The water will have a strong
concentration of chlorine that will give it a bad
taste and smell and could be dangerous.
Further information
Godfrey, S. (2003), ‘Appropriate chlorination techniques
for wells in Angola’, Waterlines, Vol. 21, No. 5
pp 6-8, ITDG Publishing, UK.
Wisner, B. and Adams, J. (2002), Environmental Health
in Emergencies and Disasters: A practical guide,
A reconditioned well with windlass and bucket WHO, Geneva.
Page 4
Cleaning and disinfecting
boreholes in emergencies
Steps of rehabilitation Step 1: Assessment of damage

Figure1 outlines a five stage approach to cleaning and The disaster may have damaged the above ground or
disinfecting boreholes after natural disasters. It is an below ground parts of the borehole. This may have led
emergency approach designed to rehabilitate to contamination of the borehole. The first step must be
boreholes so they produce water of a similar quality to to assess the extent of the damage to the borehole and
that supplied before the disaster. pump. The following actions should help you to make
your assessment.
Meet with community leaders and ask them to

briefly outline which boreholes serve which
sections of the community.
Step 1:
Assessment of damage Assess the type and extent of damage to the top of
the well.
Remove the handpump or mechanised pump from
the borehole.
Step 2:
Rehabilitation of borehole Estimate the amount of silt and debris in the
borehole using a steel pipe the length of whole
depth of the well.
Check if borehole casing is damaged or out of line.
Step 3: Do this by inserting the steel pipe. If it is out of line
Pump test borehole the pipe will catch against the side of the borehole.
If this happens, select other sites.
Test the pump (and motor) to see if they are still
working or what repairs are necessary.
No QUESTION
Flush borehole
Does quantity equal demand? Estimate resources needed for repairs (personnel,
equipment, time and materials).
Yes
Select the boreholes that are used most and are
easiest to repair first.
Step 4:
Disinfection of borehole
Step 5:
Dewater borehole
Figure 1. Steps for cleaning and

disinfecting a borehole
A damaged handpump and surround
Page 5
Cleaning and disinfecting boreholes
Step 2: Rehabilitation of boreholes 3. To remove the silt from the borehole filter insert the
Before the borehole can be cleaned, all silt and debris end of the compressed air hose at the head of the
should be removed. The following steps may be filter. Open the valve until water starts coming out
followed: of the top of the borehole. Close valve 1 and open
valve 2 until no more air is heard coming out.
1. If not already removed, take out the pump and Repeat until the water coming out of the borehole is
motor from the borehole and clean and repair them. clear.
2. Flush the sediment from the borehole using

Valve (2) closed Compressed air lifts column of
compressed air or water. Place the compressor water - go to step 3 as soon as
hose in the borehole and blow out the sediment. Vent to atmosphere water is seen to erupt at surface
(or for a set time 1-3 seconds)
Valve (1) open

Compressed air supply
Removing components of a pump

Figure 3. Removing silt with
5000 litre water tanker
a compressed air hose
Water hose
High pressure water hose 2.5m - 3.5m diameter apron
Compressed air hose

150mm thick (cast in situ)
Water overflowing Concrete
to waste slab
Water pump
and compressor
Casing
3m 3m
Water table Hardcore

foundation
Screen Borehole casing

Compacted clay
Figure 2. Flushing out a borehole Figure 4. Sanitary seal
Page 6
4. Reseal the top of the borehole using a clay sanitary

seal built around the top. Box 1. Estimate flow rate from a borehole
5. Construct or repair the drainage apron and head Put a bucket under the outlet from the pump and
wall around the borehole to prevent surface water, measure how long it takes to fill.
insects and rodents entering the borehole.
Amount of water pumped in 1 hour is:
6. Replace the pump in the hole and check that it is
working and the water it is producing is clear of silt.
⎛ AxC ⎞
If the water is silty, remove the pump and flush out ⎜ ⎟ −B
the borehole. If, after two flushes, the bore is ⎝ B ⎠
producing silty water, the underground filter is
Where:
probably broken and no further attempt at repair
A = The volume of the bucket in litres
should be made.
B = Number of seconds taken to fill the
bucket
Step 3: Pump test C = 3600 seconds
Q = flow (litres/hour)
Handpumps
Once the pump is replaced in the borehole, operate it in
the normal way. Ask the local community to assess
whether the amount produced is similar to what was
produced before the disaster and to compare how easy Compare the flow rate with what was produced before
the pump is to use. If pumping is difficult and a small the disaster. If it is significantly less check the pump
amount of water is produced it could be a blockage or and motor for damage and/or flush the borehole again.
the pump could be broken. Re-check the pump If this does not change the flow rate either accept the
mechanism and reflush the borehole. lower flow or abandon the hole.
Motorised pump
Measure how much water the pump produces using the Step 4: Disinfecting the borehole
procedure shown in Box 1 and the Figure 5 below.
Following the rehabilitation of the borehole, test the
levels of turbidity and pH to ensure that chlorination will
Oil drum to collect Stand to support pipe be effective. This can be done using simple hand-held
and measure water
flow Measuring tape with float on equipment. Never chlorinate turbid water because the
the end to measure depth to
water level suspended particles can protect the microorganisms.
Borehole casing Table 1 outlines why pH and turbidity are important and
what can be done to ensure guideline levels are met.
Water table If the turbidity of the water is greater than 5NTU after
the cleaning and rehabilitation stage, pump out the
water, allow the well to refill and then re-test turbidity
levels.
Submersible pump
WHO endorses the disinfection of drinking water in
emergency situations. There are various ways of
disinfecting wells but the most common is chlorination
Figure 5. A pump test as it leaves a residual disinfectant in the water
afterwards.
Table 1. Physico-chemical parameters
Parameter WHO GDWQ Why? Corrective action
pH 6–8 pH of 6.8-7.2 is required to If pH is less than 6 add hydrated

reduce level of chlorine required. lime (calcium hydroxide)
Turbidity < 5NTU High turbidity (>5NTU) requires Dewater well and rebleach well
(20NTU emergency more chlorine to oxidise organic lining using chlorine solution
limit) matter
Page 7
The chlorine compound most commonly used is

calcium hypochlorite as high test hypochlorite (HTH) in Box 2. Disinfecting a borehole using
powder or granule form. Also used is sodium Calcium Hypochlorie (HTH)
hypochlorite in liquid bleach form. Each chlorine
compound has a different amount of usable chlorine Equipment
depending on the quantity of time the product has been • 20 litre bucket
stored or exposed to the atmosphere. The best type of • HTH chlorine granuals or powder
chlorine in an emergency is HTH as this normally
contains 50 to 70% chlorine. Box 2 outline methods for Method
calculating appropriate chlorine doses for HTH granule • Fill the bucket with clear water from the
chlorine. borehole
• Add 50g of HTH powder and stir until disolved

Bleach gives off chlorine gas which is very
dangerous. Try to clean the well lining using a • Calculate the volume of water in the borehole
brush on the end of a series of connected 25mm using the formula:
diameter metal pipes.
V = πD2 x h
4
The amount of chlorine needed will depend on the Where
volume of water in the borehole. Add 1 litre of 0.2% V = volume of water in the well (m3)
chlorine solutions for every 100 litres of water in the D = diameter of the well (m)
borehole. Leave the water undisturbed for at least 30 h = depth of water (m)
minutes. π = 3.142
• Fill the bucket with clear water from the well.

Do not allow anyone to use the well during the • Add 50g of HTH and stir unitl disolved.
cleaning process. The water will have a strong
concentration of chlorine that will give it a bad For every cubic metre (m3) of water in the borehole
taste and smell and could be dangerous. add 10 litres (half bucket) of the chlorine solution.
Step 5: Dewater borehole Further information

Following the contact period, dewater the borehole Godfrey, S. and Ball, P. (2003) ‘Making Boreholes Work
once again using compressed air. When the borehole – Rehabilitation strategies from Angola’,
has refilled, wait a further 30 minutes and measure the 29th WEDC Conference Proceedings, WEDC,
chlorine concentration using a comparator. If the Loughborough, UK.
residual chlorine concentration is less than 0.5mg/l the
borehole is safe to use. If the concentration is greater Ball, P. (1999) Drilled Wells, SKAT Publications,
than 0.5mg/l, remove all the water from the well again Geneva, Switzerland.
and repeat the process.
This information has been prepared by WEDC

Author: Sam Godfrey Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Water, Engineering and Development Centre, Loughborough University, Leicestershire, UK.
Phone: +44 1509 222885 Fax: +44 1509 211079 E-mail: [email protected] Website: www.lboro.ac.uk/wedc
Page 8
Cleaning and disinfecting water
storage tanks and tankers
Introduction
Large quantities of clean water will be required
It is often necessary to quickly provide a basic water
to clean and treat storage tanks and tankers
supply during and shortly after an emergency. This
before they can be used to store water.
may be because the normal supply has been
damaged or destroyed, or because people collect in a
place where no water supply exists (a new refugee
camp, for example). Step 1: Cleaning the tank
The tank must be cleaned to ensure that water stored in
Often the quickest way of providing a water supply is to the tank does not become contaminated by dirt or
transport water in tankers from a nearby source and traces of the substance the tank previously held. This
store the water in tanks and reservoirs. However it is can be achieved by following the three steps below:
rare for water tankers and reservoirs to be readily
available in such situations. The most common solution
1. Drain/empty the tank. Open the outlet valve/tap
is to hire vehicles and tanks that have been used for
and drain out any remaining liquid. Collect the
other purposes but they must be cleaned and
liquids so that they can be safely disposed of. Most
disinfected before they can be used.
tankers have their outlet valve at the back, so park
it on a slope so that all the liquids can be
discharged (Figure 2).
Step 1: Permanent storage tanks are usually fitted with a

Clean the tank
washout valve that draws water from the base. Use
this for emptying rather than the normal outlet
valve. The process of emptying the remaining
liquids from portable tanks will depend on the
Step 2: shape and design of the tank. Some can be tipped
Chlorinate the tank on their side and others dismantled.
2. Clean/scrub all internal surfaces. Use a mixture

of detergent and water (household laundry soap
Step 3:
Check chlorine residual
powder will do) to clean all internal surfaces of the
tank. This can be done with a stiff brush or a high
pressure jet. If the tank has contained volatile
substances such as oil or organic liquids such as
milk, try not to enter the tank as the gases given off
Figure 1. Steps for cleaning and by the liquids could be dangerous. (See page 4 for
disinfecting a water tanker health and safety advice.) Attaching the brush to
a long pole may make it possible to clean the tank
without entering it. Take special care to clean
corners and joints so that no small amounts of the
Steps of rehabilitation original liquid remain. Even minute amounts of
Figure 1 outlines a three step approach to cleaning and some liquids can give the water a bad taste and
disinfecting water tanks and tankers. It is an emergency people will refuse to drink it.
response to disinfect polluted or disused tankers so
they can store and transport water of satisfactory Leave the outlet valve open whilst cleaning and
quality. collect the waste liquid for safe disposal.
Page 9
Water storage tanks and tankers
3. Wash all internal surfaces to remove all traces of

detergent. This is most easily done with a high
pressure hose pipe or water jet but if they are not
available the tank can be filled with water and left
to stand for a few hours. Drain all the water from
the tank and collect for safe disposal as before.
Continue flushing the tank until there are no longer
traces of detergent in the water.
Tank cleaning should be done in an open area

away from houses to avoid possible health
problems.
Cleaning the inside of the tank with a broom
Prepare a concentrated chlorine solution to

disinfect the tank. The best source of chlorine to
use is High Test Hypochlorite (HTH) granules or
powder as this normally contains 50 to 70%
chlorine. Box 1 outline methods for calculating the
appropriate chlorine dose to disinfect a tank using
HTH granules.
Pour the solution slowly into the tank, mixing as you

pour and then fill the tank up to full capacity with
clean water.
Let the chlorine stand in the tank for 24 hours to

ensure that the tank is fully disinfected. If the tank
has a cover (which is recommended) it should be
Figure 2. Draining tanks
closed.
If the tank is required for use urgently double the

Step 2: Disinfecting the tank quantity of chlorine added to the tank. This will
To effectively disinfect the tank, fill it with clean reduce the standing time from 24 to 8 hours.
water up to ¼ level only. It is important to not fill the
tank too much as this will reduce the concentration Completely empty the tank and carefully dispose of
of the chlorine solution and limit the effectiveness of the disinfecting water as it will contain a high
cleaning. To estimate ¼ of the tank, use a stick with concentration of chlorine.
graded markers to indicate the water level. The
markers should be marked on to the stick at 10cm Remember to also clean and disinfect any pipes or
intervals beginning at 0cm at the base of the tank hoses connected to the tank. Use the same
and then upwards to 10, 20cm etc (Figure 4). procedure as described above.
Page 10
Disposal of waste liquids

Box 1. Chlorine disinfection of a tank Care must be taken when disposing of liquids from
containers. Sudden discharge of water will cause
localised erosion or flooding. Make sure the water is
• Calculate the total volume of the tank. channelled into a natural water course such as a river,
gully or lake.
• Fill a 20 litre bucket with clean water.
If the tanker has been used for carrying other liquids,
• Add 50g of HTH to the water and stir until special arrangements must be made to prevent
dissolved. environmental pollution.
• Add 10 litres (half a bucket) of the chlorine One disposal option is to collect the waste liquid in a
solution to the water in the tank for every cubic temporary pond and then mix the liquid with sand. The
meter (m3) of tank volume. mix can then be transported to a suitable site (such as
a land fill site) for disposal.
• Remember 1m3 = 1000lt
If there are large quantities of waste liquid, absorbing
Example them into sand is not possible. In that case a vacuum
The tank on a water truck needs to be disinfected. tanker (such as one used for emptying septic tanks)
The tank is 4 meters long 1.8m wide and 1.4m high will be needed to remove the liquid for safe disposal.
(the tank is oval shaped).
The total volume of the tank is:
2
⎡ (1.4 + 1.8) ⎤ Π
⎥⎦ x 4 x 4.0 = 8.04m
3
⎢⎣ 2
Therefore add slightly more than four, 20 litre

buckets of chlorine solution as you fill the tank with
clean water.
A vacuum tanker
Stage 3: Chlorine testing The level of residual chlorine in mg of chlorine per litre of
water (mg/l) is determined by dissolving a chlorine testing
Refill the tank with clean water and allow to stand tablet in the water supply under test, in chamber (A).
for 30 minutes. Test the residual chlorine left in the Compare the colour produced with the standard colours on
tank using a comparator. the wall of chamber (B).
A B C
If the residual chlorine concentration is 0.5mg/l or
less the tank is safe to use for water storage. If the
concentration is greater than 0.5mg/l, empty the
1Dml Chlorine
tank again and refill with clean water. Re-test to DPD colour
check that the chlorine concentration is 0.5mg/l or 1.0 8.0
less. 0.8 5.0

0.6 3.0
0.4 2.0
0.2 mg/l 1.5
Note: A third chamber (C) would be used if a higher chlorine

residual is to be measured.
A separate fact sheet is available on chlorine testing.
Figure 3. A chlorine comparator

Hand-held comparator
Page 11
Health and safety issues

Gaining access and working inside a water tanker can
be difficult and dangerous. Frequently there is only a
small access hatch on the top of the tanker through
which to get in and out. Cleaners should be aware that
some liquid carried in tankers can give off dangerous
gases which may remain even when the liquid has
been removed. The liquids may also cause physical
dangers such as falling on slippery surfaces or burning
from corrosive liquids.
Always blow fresh air into the tank for a period before
allowing a person to enter the tanker. The cleaner
should wear protective clothing, including gloves,
boots, a hat and glasses.
Make sure someone remains outside, next to the

access hatch all the time someone is working inside in
case there is an accident. The availability of gas masks
and portable ventilators would be an advantage.
Further information
Davis, J. and Lambert, R. (2002) Engineering and
Emergencies – A practical guide to fieldworkers,
2nd Edition, ITDG Publishing, UK.

WHO Headquarters Telephone: (+ 41 22) 791 21 11
Avenue Appia 20 Facsimile: (+ 41 22) 791 3111
1211 Geneva 27 Telex: 415 416
Switzerland Telegraph: UNISANTE GENEVA

Author: Sam Godfrey Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 12
Rehabilitating small-scale piped
water distribution systems
This technical brief covers a process of rehabilitating Step 1: Assessment and isolation
small-scale piped water distribution systems (with pipe Find out who manages the water distribution network,
diameters up to 150mm) after natural disasters such as and identify local staff who understand the distribution
earthquakes, flooding, hurricanes, tornadoes, severe system. These staff should participate in the
weather and fires. It does not cover disasters rehabilitation.
concerned with industrial pollution. This intervention
aims at restoring supply to survival levels. Inspect the distribution network as soon as possible.
Assessment will be easier if there are updated
drawings of the distribution network. Indentify:
Step 1 Number and location of visible breakage points

Assess damage, isolate affected area and
inform consumers. Are the breakage points leaks, bursts, pipe
fractures, pipe dislocations or complete pipeline
section displacements?
Proximity of the damage to the water source?
Step 2 Type of pipelines affected i.e. transmission mains,
Provide alternative supply to affected consumers.
primary distribution mains, secondary distribution
mains or tertiary distribution mains?
Sizes and material of pipes affected?
Step 3 Extent of the affected area? Does it affect multiple

Isolate pipeline in sections and repair obvious leaks. supply zones?
Pressure-test the section. If leakage is higher than
optimal value, repeat repair procedures. Is it possible to isolate the supply zones affected?
Monitor the basic water quality parameters and

feedback from consumers.
Step 4 The affected area(s) should be isolated from the rest of
Clean and disinfect the repaired section.
the distribution network. If flow control valves are not
available, or cannot be traced, new valves should be
installed. The affected consumers should be informed.
Step 5
Pressurise the section and test WQ. If WQ is bad,
Step 2: Provide an alternative supply to
repeat cleaning and disinfenction procedures in Step 4. affected consumers
Otherwise commission section.
Establish what capacity of the system has remained
intact and is able to provide emergency requirements.
Assess emergency water requirements based on basic
Step 6 lifeline supply. Establish procedures for emergency
Carry out Steps 3 - 5 to all affected sections, starting treatment, pumping and distribution for service of
with the section nearest the water source, emergency supply. For example, this could be
and moving outwards.
achieved through:
provision of tankered water to various locations in
Figure 1. Steps for cleaning and disinfecting the residential areas;
a piped water distribution main in a
post-disaster situation using simple materials to construct emergency
stand taps.
Page 13
Water distribution systems
Step 3: Repair breakages

Walers
From the assessment of the damage carried out in
Step 1, determine and acquire the resources OPEN SHEATHING
(manpower, equipment and materials) required for the
repair work. Start at, or near, a source of supply and
work outwards into the distribution system. Repair the Open sheathing
pipeline in a stepped manner, one section after another.
For example, referring to Figure 2, start with the section
between SV1 and SV5, and move to the section
Tight sheathing
between SV5 and SV6. Select a pipeline section that
can easily be isolated by existing stop valves, of say
500m apart. The maximum length that can repaired,
flushed and pressure-tested effectively is 1000m.
Before starting any repair work:
Locate other underground utilities in the work Struts
area, and liase with their Maintenance
Department, if necessary.
As a safety precaution, find out what type of
industries are nearby or which have ever used the Walers
site. If the soil is thought to contain
hazardous wastes, the local responsible
authority should be contacted for advice on
further precautionary measures. TIGHT SHEATHING
Isolate the section by shutting valves (such as SV1,

SV2, SV3, WO1 and SV5 as shown in Figure 2) and Struts
close off all service connections. Arrange to install Figure 3. Types of shoring
washout valves (such as WO1), and fire hydrants
(such as FH1) if none can be traced in the selected
section.
Excavate and expose the leaking/broken pipelines,
Route traffic away from the work area. ensuring that the excavated soil is piled by the side of
the trench with enough clearance for traffic, but far
enough from the trench such that the repair crew can
Service reservoir safely walk between the trench and the excavated
(if needed) Source or
reservoir tank material.
Main pipeline Protect the repair crew from trenches collapsing in the
Branch
(transmission main course of repairs. This is achieved through trench
pipeline
Branch pipeline shoring, as shown in Figure 3. The need for shoring
Main depends on the following factors:
pipeline
SV2
SV1
Service pipe Depth and width of trench.
SV4
FH1
SV3 Type of soil (clay, loam or sand).
B1 B2
SC2 Soil conditions (compaction, moisture).
SV5
WO1 Nearby activities that could cause
Branch SC1
pipeline vibration.
SV6
Length of time excavation is expected to be
KEY open.
SV Stop valve SC Boundary stop cock
B Breakage FH Fire hydrant Use simple but effective methods of repair that will take
WO Wash-out valve the shortest time to restore services. Examples of
simple methods:
The damaged section may be replaced by
use of repair pipe clamps, as shown in
Figure 2. Pipework making up a Figure 4.
distribution system Repair of cracks and breaks in steel pipes
by welding.
Page 14
Replace pipe support structures such as concrete

anchorage and thrust blocks , if necessary. Table 2. Velocity and flow required for flushing
Pipe Velocity required Flow required

Backfill the excavation with select material, and diameter(mm) (m/s) (litres/sec)
compact as necessary, initially leaving the pipe joints
exposed for water pressure testing. Fill the repaired 50 1.3 2.7
pipeline section with water, and let it sit idle for at least 7.2
75 1.6
24 hours before the pressure test starts. Increase the
pressure up to a level of at least 50% higher than the 100 1.8 15
normal operating pressure, and maintain this for at least 150 2.2 41
4 hours. The leakage is determined by measuring the
200 2.6 83
amount of water needed to refill the pipeline. However
some leakage is expected. Table 1 shows a guideline Source: Institution of Water Engineers and Scientists, 1984
of values of allowable leakage for pipes.
Examine the trench, and repair any joints if they show
leakage.
If the repaired pipeline has passed the pressure test,

backfill the pipe joints, and proceed to clean and
disinfect the pipeline section.
Step 4: Cleaning and disinfection

Pipe flushing
Isolate the section to be flushed from the rest of the
system.
Backfilling
Confirm if quantity to flush the repaired pipeline has
sufficient pressure and water in the system. Table 2
shows guidelines for adequate velocities and flow. If
there is insufficient water additional pumps and storage
tanks will be needed.
Flush the section by opening the stop valve (SV1 on

Figure 2) on the supply side slowly, and open the
washout valve on the remote end (WO1).
Inject the water through the pipe section continuously

for a period long enough to stir up deposits inside the
water main and wash out all silt (about 15 minutes).
Direct flushing water away from traffic, pedestrians and

private plots. Avoid erosion damage to streets, lawns
Figure 4. A pipe clamp and yards by use of tarpaulins and lead-off discharge
devices. Avoid flooding which can cause traffic
congestion.
Table 1. Allowable leakage from pipes
Collect two water samples from each flowing hydrant,
Pipe diameter(mm) Allowable leakage one at the beginning (about 2 to 3 minutes after the
(litres per day per km) hydrant was opened) and the second sample when the
dirty water is assumed to be clean (just before closing
50 166
the hydrant). Test the water quality to ascertain return
75 249 to normality. If the water quality is not yet satisfactory,
100 332 repeat the procedure.
150 498
When the water quality has been restored to normal,
Source: California State University, 1994 slowly close the washout valve.
Page 15
Pipe commissioning
Calculate the volume of water in the pipeline section to
be disinfected, as shown in Box 1. Box 1. Calculating the volume of water
in a pipeline
Acquire tanker(s) of volume equal to or higher than the
calculated volume of the pipe. Example:
Diameter of the pipeline is 100mm, and the
section is 500 m long. The volume (V) of water
in the pipe will be:
V= π d2L/4 = 3.14*0.1*0.1*500/4 = 3.925 m3
Box 2. Preparing a chlorine solution
Example:
A water tanker If we need 4000 litres of chlorine solution to fill
the pipeline, we shall need (25 mg x 4000) =
100 grams of chlorine.
Prepare a chlorine solution of 25 mg/litre of free chlorine
and mix it with clean water in the tanker (Box 2).
If the source of chlorine is High Test Hypo
chlorite (HTH) powder, with say a chlorine
Keeping the pipeline isolated, set up the feed tanker at
concentration of 50%, then we need:
the injection site (labelled as FH1 in Figure 2).
(100 g)/0.5 = 200 grams of HTH powder.
Fill up the pipeline section with the chlorine solution.
Keep the water in the pipeline for a minimum of 24
Mix the water and the powder thoroughly,
hours, during which time all valves and hydrants along
before use
the main should be operated to ensure their proper
disinfection. Check the chlorine residual in the pipeline.
If it has dropped significantly, repeat the disinfection
procedure.
Flush the pipeline section with clean water until a Further information
chlorine residual of 0.2-0.8 mg/litre is achieved. California State University, Sacramento School of
Engineering (1994), Water Distribution System
Reconnect the pipeline to the network and move onto Operation and Maintenance, 3rd ed., California
the next section. State University, Sacramento Foundation, USA.

Avenue Appia 20 Facsimile: (+ 41 22) 791 31 11
1211 Geneva 27 Telex: 415 416

Author: Sam Kayaga Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 16
Emergency treatment of
drinking water at point-of-use
This note is about simple treatment of drinking water at Such cloths remove organisms known as copepods,
point-of-use for people in, or just after an emergency. which act as intermediate hosts for the guinea-worm
The options suggested are quick short-term measures larvae. The cloth must always be used with the same
to provide a safe survival level supply of drinking water surface uppermost. The cloth may be cleaned using
from unsafe polluted water sources. The options should soap and clean water.
be sustainable until a longer-term safe and cost-
effective supply is available to the population.
Aeration
The methods described are suitable for water taken Aeration is a treatment process in which water is
from any source but, in general, will only remove brought into close contact with air for the primary
physical and microbiological pollution. Pollution by purpose of increasing the oxygen content of the water.
chemicals such as after a spillage of industrial waste With increased oxygen content:
will not normally be removed by these processes and
specialist advice should be taken. volatile substances such as hydrogen sulphide
and methane which affect taste and odour are
In general terms, treatment of water at household level removed;
follows the processes shown in Figure1. However,
carbon dioxide content of water is reduced; and
depending on the quality of raw water, some processes
may not be necessary. dissolved minerals such as iron and manganese
are oxidised so that they form precipitates, which
can be removed by sedimentation and filtration.
The close contact between water and air required for

Straining aeration can be achieved in a number of ways. At a
household level, rapidly shake a container part-full of
Storage/Settlement
Raw water
Filtration Aerator tray
Disinfection
Figure 1. General steps in the water treatment

processes undertaken at household level
Aerated
water
Straining
Pouring water through a clean piece of cotton cloth will
remove a certain amount of the suspended silt and
solids. It is important that the cloth used is clean, as
dirty cloth may introduce additional pollutants.
Specifically made monofilament filter cloths may be Figure 2. Aerator trays
used in areas where guinea-worm disease is prevalent.
Page 17
Emergency treatment of drinking water
2 4 2
2
3
3 3
1
(a) (b) 1 (c) 1
Drinking water: Always take from pot 3. This water has been stored for at least two days, and the quality has improved.
Periodically this pot will be washed out and may be sterilized by scalding with boiling water.
Each day when new water is brought to the house:
(a) Slowly pour water stored in Pot 2 into Pot 3, wash out Pot 2.
(b) Slowly pour water stored in Pot 1 into Pot 2, wash out Pot 1.
(c) Pour water collected from the source (Bucket 4) into Pot 1. You may wish to strain it through a clean cloth.
Using a flexible pipe to siphon water from one pot to another disturbs the sediment less than pouring.
Figure 3. The three pot treatment system
water, for about five minutes and then stand the water Simple up-flow sand filter
for a further 30 minutes to allow any suspended Simple household filters may be put together inside
particles to settle to the bottom. clay, metal or plastic containers. The vessels are filled
with layers of sand and gravel and pipework arranged
On a larger scale, aeration may be achieved by to force the water to flow either upwards or downwards
allowing water to trickle through one or more well- through the filter. Figure 4 shows a modified simple
ventilated, perforated trays containing small stones, as upward rapid flow filter.
shown in Figure 2. Again, the water must be collected
in a container and allowed to stand for about 30 A filter such as this could be built from a 200 litre drum.
minutes to settle suspended particles. It has a filter bed made up coarse sand (of about 0.3m
depth) of grain size between 3 and 4mm diameter, and
supported by gravel covered by a perforated metal
Storage and settlement tray. The effective filtration rate of such a filter could be
When water is stored for a day in safe conditions, more as high as 230 litres per hour.
than 50% of most bacteria die. Furthermore, during
storage, the suspended solids and some of the Such filters must be dismantled regularly to clean the
pathogens will settle to the bottom of the container. The sand and gravel and remove any settled silt. The
container used for storage and settlement should have frequency of cleaning is dependant on the level of
a lid to avoid recontamination, but should have a neck turbidity of the raw water. Furthermore, such filters are
wide enough to facilitate periodic cleaning. For not effective at removing the pathogens. Therefore the
example a bucket with a lid could be used for this water must be disinfected or stored for 48 hours in
purpose. order to make it safe.
Water should be drawn from the top of the container

where it will be cleanest and contain less pathogens. Charcoal filters
Storage and settlement for at least 48 hours also Charcoal can be quite effective at removing some
eliminates organisms called the cercariae, which act as tastes, odours, and colour. Ordinary charcoal available
intermediate host in the life cycle of bilharziasis locally could be used, but activated carbon is more
(schistosomoasis), a water-based disease prevalent in effective, though rather expensive. An example of such
some countries. Longer periods of storage will leader a filter is the UNICEF upflow sand filter, illustrated in
to better water quality. Figure 5. However, if the charcoal is not regularly
renewed or if the filter is left unused for some time,
A household can maximize the benefit of storage and
there is evidence that it can become the breeding
settlement by using the three-pot system illustrated in
ground for harmful bacteria.
Figure 3.
Filtration Ceramic filters

Filtration is the passage of polluted water through a Water may be purified by allowing it to pass through a
porous medium (such as sand). The process uses the ceramic filter element. These are sometimes called
principle of natural cleansing of the soil. candles. In this process, suspended particles are
Page 18
mechanically filtered from the water. The filtered water

Inlet must be boiled or otherwise disinfected. Some filters are
Cover impregnated with silver which acts as a disinfectant and
kills bacteria, removing the need for boiling the water
Outlet
after filtration. Ceramic filters can be manufactured
locally, but are also mass-produced. They can be costly
but have a long storage life and so can be purchased
and stored in preparation for future emergencies. The
Water impurities held back by the candle surface need to be
brushed off under running water, at regular intervals. In
order to reduce frequent clogging, the inlet water
should have a low turbidity. Figure 6 shows a variety of
300mm
Coarse
Sand ceramic candles.
Drain Perforated
Rocks
stopper metal plate
Figure 4. A simple upflow rapid sand filter
Candle filters
Disinfection
It is essential that drinking water be free of harmful
organisms. Storage, sedimentation and filtration of
water reduce the contents of harmful bacteria but none
of them can guarantee the complete removal of germs.
Disinfection is a treatment process that ensures drinking
water is free from harmful organisms or pathogens. It is
recommended that this be the final treatment stage, as
many of the disinfection processes will be hampered by
suspended solids and organic matter in the water.
Figure 5. The Unicef upflow charcoal filter There are various methods of achieving disinfection at
household level:
(a) Manufactured unit (b) Candle with jars (c) Using candle with siphon (d) Porous jar
Figure 6. Ceramic filters
Page 19
Disinfection by boiling solution, at the point of dispensing.

Boiling is a very effective though energy consuming See Note 1 Cleaning and Clear side of
disinfecting wells for details of bottle facing Half
method to destroy various pathogens such as viruses, sun blackened
preparing chlorine solutions. bottle
spores, cysts and worm eggs. The water should be
brought to a rolling boil for at least five minutes and
preferably up to a period of twenty minutes. Apart from Solar disinfection
the high energy costs involved in boiling, the other Ultra-violent rays from the
disadvantage is the change in taste of water due to the sun are used to inactivate and
release of air from the water. The taste can be destroy pathogens present in Ultra violet
radiation
improved by vigorously stirring the water, or shaking the water. Fill transparent plastic
water in a sealed container after it has cooled. A better containers with water and
water quality can be obtained by storing the boiled expose them to full sunlight for
water, as described earlier. about five hours (or two consecutive
days under 100% cloudy sky).
Disinfection using chlorine Disinfection occurs by a combination of
Chlorine is a chemical most widely used for the radiation and thermal treatment. If a water
disinfection of drinking water because of its ease of temperature of least 50oC is achieved, an exposure
use, ability to measure its effectiveness, availability and period of one hour is sufficient. Solar disinfection
relatively lower cost. When used correctly, chlorine will requires clear water to be effective.
kill all viruses and bacteria, but some species of
protozoa and helmithes are resistant. There are several An enhanced example is the SODIS system, whereby
different sources of chlorine for home use; in liquid, half-blackened bottles are used to increase the heat
powder and tablet form. Chlorine is commonly available gain, with the clear side of the bottle facing the sun, as
to households as liquid bleach (sodium hypo chlorite), shown above.
usually with a chlorine concentration of 1%. Liquid
bleach is sold in bottles or sachets, available on a Other water treatment chemicals
commercial basis. A number of commercially produced chemicals have
been developed to holistically treat water at household
Chlorine must be added in sufficient quantities to level in emergency situations. Studies have shown that
destroy all the germs but not so much as to affect the some of these powders significantly remove pathogenic
taste adversely. The chemicals should also have bacteria, viruses and parasites from water. They also
sufficient contact time with the pathogens (at least 30 enable the particles to flocculate together, so they then
minutes for chlorine). Deciding on the right quantity can to sink to the bottom of the container. Commercially
be difficult, as substances in the water will react with available sachets typically treat 10 litres of water. The
the disinfectant at different rates. Furthermore, the water should be allowed to stand for at least 5 minutes
strength of the disinfectant may decline with time before it is strained. It should be allowed to stand for a
depending on how it is stored. It is therefore further 30 minutes before it is used for human
recommended that in emergency situations, chlorine consumption.
solutions be centrally dispensed to the users by
qualified personnel. Displaced people should receive
standard containers for collecting/storing water, as well Further information
as simple dropper tubes or syringes. Technical staff Shaw, Rod (ed.) (1999) Running Water: More technical
should provide the instructions for mixing the chlorine briefs on health, water and sanitation, ITDG, UK.

Author: Sam Kayaga Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 20
Rehabilitating water treatment
works after an emergency
In urban areas, the population may be entirely reliant on

the public water supply system for their drinking water. Service reservoir Source or
(if needed) Reservoir tank
Modern water treatment works (WTWs) rely on inputs of
chemicals, electricity and skilled operators as well as Main pipeline
Branch
the constructed plant and machinery. Clean water then (transmission main)
pipeline
needs to be delivered but piped systems can be prone Main Branch pipeline
to leaks, intermittent operation and contamination. pipeline
Branch Service
pipe
Managing a water supply system is a complicated task pipeline House
Service connection
and it is strongly recommended that a suitably qualified pipe
engineer is responsible for the rehabilitation of any Standpost
system.
Yard tap
Collecting basic information
Find out who runs the water system – operators Service pipe
and managers.
How does the system work?
What is not working?
Figure 2. A distribution network
Identifying local WTW operators who understand the
system is a priority; this will provide knowledge (of the
works and sources of supplies) and a skilled work In order to repair a water supply it is important to
force. Efforts should be made at an early stage to find, understand how the system works. Individual WTWs will
recruit and pay the operators and managers. vary in design, but most are based on a variety of basic
components that fit together. These improve the quality
Water source of water in stages
The condition of each component needs to be

assessed. Repair and renovation are faster than
replacement because any existing staff will know how
to use existing plant and finding replacement parts is
Power generally quicker than building a new unit.
Distribution systems are based on a series of large

Drinking (trunk) water mains that feed into smaller pipes.
water Concentrate on trunk mains before moving onto local
distribution networks. Reservoirs are needed at various
points in the system to ensure continuous supplies of
water. Both pipes and reservoirs need to be physically
undamaged and clean.
Water treatment Setting priorities

works
Staff Chemicals Provide a basic supply
Identify risks of contamination
Figure 1. WTW requirements
Improve quality in stages
Page 21
Rehabilitating water treatment works
Distribution first Risk assessment

The first requirement is to get water into the There are many chances for water to become re-
distribution system, with only enough treatment to contaminated once it leaves the WTW (such as
ensure that the water is free of gross contaminants improper handling or pollution through leaking pipes)
that may block or damage the pipes and pumps so investments in water quality improvements need to
used. The order of rehabilitation should be: be assessed by looking at the whole system and
seeing the impact at the point of use. If water in the
1. Intake
distribution system cannot be guaranteed to stay clean,
2. Pumps and trunk water mains
it may be better to supply some users (such as
3. Local distribution pipes
hospitals) with water in a tanker, that can be disinfected
4. Storage reservoirs
and the quality maintained. Simple treatment can be
5. Water treatment
provided at a more local level, such as chlorinating
This may involve by-passing all or part of the WTW. local water storage tanks.
Initially water may be pumped directly from the source
into the distribution system, without any treatment apart Pumps may be used at various stages, such as
from the intake screens or simple sedimentation without pumping water from the intake to the WTW or from the
chemicals. Storage in service reservoirs is important as WTW to the distribution system. In some cases the
it can ensure a continuous supply – intermittent supply water can flow for all or part of its way through the WTW
can lead to contamination of water in the pipes and under gravity. Replacement parts may take time to be
deprive people at the end of the pipes of water. delivered, so ask an engineer to make an early
assessment of the state of the pumps.
Checking for leaks Power for pumps should be given priority over every
Reducing leakage can improve both the quantity and other use – even over hospitals.
quality of water available to the public, but the
distribution system is difficult to assess because it will
be buried and spread out over the whole urban area. Delivery
Power unit
Repair obvious leaks first as they are likely to be the
Flexible flange
largest. Ask the public to report problems and sightings coupling
of leaks and puddles. Offer a small reward for
information – this will be cost effective as it will quickly
identify problem areas in the distribution network.
Pump
Meters and pressure tests may also identify leaks and
broken pipes.
WLIC1111
Suction
Figure 3. Centrifugal pump driven by

a shaft connection
Providing treatment in stages

The order of water treatment is important – for example
coarse filtration needs to take place before finer
filtration and chlorination needs to take place only once
the water is physically clean and there is little chance of
re-contamination during delivery or use. The order of
WTW rehabilitation activities
should be:
1. Source protection (preventing pollution in the first
place)
2. Physical treatment (screening, aeration, settlement,
filtration)
3. Chemical treatment (coagulation, pH correction)
Water distribution is the first priority 4. Disinfection (chlorination)
Page 22
River source Excreta,solid waste

and stormwater
Intake Delivery pipe network
Screen Water storage
Agricultural
pollution and Chemical
soil erosion pollution
Sedimentation Filtration
Figure 5. Preventing pollution upstream

reduces the need for treatment
Coagulation Chlorination
Power can be supplied by mobile generators if

mains supplies are not available or unreliable.
Figure 4. Treatment in stages
Maintenance: This includes manual tasks, such as
cleaning screens, removing settled sludge and
lubricating pumps The filters will begin to get
Repairs, restoration and operation clogged with solids. Pipes need to be checked for
The damage to a water supply system will vary leaks.
according to the cause of the emergency. Floods may
inundate and pollute the whole system, necessitating Other actions
cleaning of the whole WTW and piped system and Pollution prevention: A more effective way of
repairing or replacing electrical equipment. Damage to increasing the quality of water may be to reduce
the electric motors for water pumps are a main cause of the need for treatment in the first place. Preventing
failure of the whole system. Earthquakes or landslides pollution from occurring in the first place by
may leave machinery unharmed but break pipes or providing environmental sanitation (management
tanks. War or civil unrest may lead to looting or wanton and disposal of excreta, solid waste and
damage, especially to mechanical and electrical plant. rainwater), controlling erosion and restricting public
Any precarious situation may disrupt inputs of access to the catchment of the water source can
chemicals, electricity and technical expertise. reduce the amount of contaminants that have to be
removed from the water. Restoring sewage
Once part of the WTW has been re-commissioned, it collection and treatment may be more important
will need to be operated. Other tasks include than a complete WTW.
measuring the quality of the water to ensure that the
WTW is being operated efficiently. Spare parts, water Public information: The public should be kept
quality testing kits and other consumables will all be informed of developments in the availability and
required. quality of water. They can help in reducing wastage
and identifying leaks in the distribution system.
Chemicals: Modern WTW rely on the addition of
chemicals to aid the treatment process. These
include alum to help settlement, lime for adjusting Further information
the pH of the water and chlorine for disinfection. Twort, A.C. et al. (2000) Water Supply, 5th ed. Arnold
There may be a long time delay in gaining new with IWA Publishing: London
supplies so the need for chemicals should be
identified and suppliers contacted. A reduced level
of treatment can be provided if chemicals are in
short supply, using what materials are available
where they are most needed (e.g. for disinfecting
water supplies to hospitals).
Page 23
Source: Water may be from surface water (river or lake) or groundwater.

Prevent pollution to reduce the amount of treatment needed later.
Intake: Some simple treatment may take place at the intake, such as a
coarse screen or aeration. Storage at this stage allows some solids to
settle out before treatment and provides a limited reservoir of water if the
Pump
source fails (e.g. an oil spill in a river). to next Intake with screen
stage?
Settlement/clarification: If the water is stored for a while, solids will fall
to the botton of the tank and scum will float to the surface. This process
can be enhanced by mixing a coagulant into the water (such as alum), Sludge
to make small solids stick together (flocculate) and settle faster. Water bleed Effluent
can either slowly flow horizontally through a tank or vertically, with the Pump
sediment forming a horizontal suspended layer. to next
stage? Sludge
blanket
Filtration: Various types of filters may be used:
Sedimentation
Roughing filters have a coarse media, and actually promote settlement
as well as filtration within the media. They are used for treatment early in
the WTW.
Sludge
Rapid gravity filters are a standard method of treating water. Settled
water is passed through a layer of coarse sand to remove silt. Filtration
Direct filtration is rapid filtration without any settlement stage before it. Feed
These filters require backwashing frequently.
Pressure filters operate in an enclosed vessel under pressure. This Drain

reduces the need for pumping in some circumstances, but requires
careful operation.
Slow sand filters have a fine sand media and can also reduce pathogens. Filtrate
They are simple to use. Sand Gravel
Membranes are complex to operate but can provide a high quality level Pump
of treatment. to next
stage? Control guage Chemical
Disinfection: Adding chlorine to the water not only kills many pathogens,
but also provides a level of protection from recontamination in the
distribution system. Complex chlorine dosing systems use chlorine gas,
but liquid or solid chlorine compounds are also available and can be used Pump
manually. The treated water needs to be stored for a while to allow the
chemical to work. The effectiveness of chlorination is reduced for water
that is dirty or will be re-contaminated, so priority should be given to Disinfection
cleaning the water and ensuring it stays clean before disinfecting it.
Treated water storage: The supply and demand for water varies
throughout the day; to cater for this variation, a tank is used. This also
provides water for use in emergencies - such as for fire fighting or for Water level
rises and falls
short breakdowns in the WTW. during day
Distribution: Once the WTW is producing water, this can then be Storage
distributed to the population. Tankers may be used if the piped system
is out of use.
Figure 6. A water supply system at a glance

Author: Brian Reed Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 24
Solid waste management
in emergencies
This technical note outlines some of the key activities in What opportunities or restrictions does the
dealing with solid waste in the immediate aftermath of a environment present? Is it possible to dig pits?
disaster. Solid waste refers here to all non-liquid wastes Where are surface water sources located? At what
(e.g. rubbish or garbage). Sometimes solid waste may level does the water table like? Where is land
contain faeces. Solid waste can create significant health available?
problems and a very unpleasant living environment if not
disposed of safely and appropriately. It can provide The waste
breeding sites for insects and vermin (e.g. rats) which What waste is being generated
increase the likelihood of disease transmission, and can (e.g. organic, hazardous, dry etc.)?
attract snakes and other pests. Unmanaged waste can Where is waste being generated? How accessible
also pollute water sources and the environment. are waste generators?
The process of planning solid waste management in an How much waste is being generated?
emergency is illustrated in Figure 1. Please note: Medical and hazardous wastes are not
discussed in this technical note.
Initial assessment
The first stage in dealing with solid waste is to
understand the emergency context and the nature of Initial assessment
waste being generated. The following sections outline
key questions for consideration. Understanding the context
and waste generation.
The context
What solid waste management systems/ equipment
is already in place? How has it been affected? Is it
possible to work with and learn from the existing
systems?
How many people are affected? Where are they? Immediate response (1 month)
What are they doing with waste at present?
Are there any pertinent cultural factors? Clearing scattered waste and
introducing onsite and community pits.
Waste generation, density and sources

Waste is produced by households, shops, markets,
businesses, medical centres and distribution
points. Intermediate response (6 months)
Generation rates vary considerably according to Developing collection and disposal
seasons, diets (e.g. changes from fresh vegetable system and building landfill pits
to packaged aid goods) and even the day of the away from settlements.
week. An average of around 0.5kg/ capita/ day is Consulting and educating users.
common in low-income cities.
Waste densities also vary considerably.
Densities for low-income cities are usually around Long term solutions
200-400 kg/m3. (Not covered in this technical note).
Where lots of packaging is used in emergency Figure 1. The process of planning

situations, densities are likely to decrease. solid waste management in an emergency
Page 25
Immediate response Intermediate solutions

Activities should be prioritised according to present
and future health hazards of different waste types and Community issues
sources. Activities are likely to focus on clearing of Consultation. It is useful and important to consult
existing scattered waste and managing waste from potential users of a waste management system before
households and markets. and during design and implementation.
On-site household disposal Education. It is important for participating communities

Suitable where space is not too limited and where to understand how good solid waste management can
waste has a high organic content (as it will decompose be achieved and can benefit their health.
and reduce in volume). Also useful in areas where
access is difficult.
Pits should be 1m deep and be frequently covered with

ash/soil to prevent access to waste by insects and rats,
and to reduce odours.
Note that on-site disposal is labour-intensive and

requires advanced household cooperation.
Collection and storage

In some situations on-site, community pits may be a
suitable medium-term solution, whilst in others it will be
necessary to devise ways of removing and disposing of
waste. This will usually involve the following:
storage in the house;

deposition at intermediate storage point; and
Community pits
Must be located within 100m walking distance of any collection and transport to final disposal.
household (SPHERE Guidelines).
In the home, plastic bags or a small container with a lid
As a rough guide guide, 50 people will fill 1m3 of a pit make suitable storage containers.
each month, depending on generation rates and density.
These are rapid to implement and requires little operation

and maintenance. Note that some people may object to
walking 100m to deposit waste.
For intermediate storage points in communal areas bins

of maximum 100 litre capacity are required (when full
this will weigh around 40kg). Oil drums cut in half can be
suitable. Ideally the bin will be arranged so that it can be
emptied easily (e.g. hinged so it can tip into a handcart).
A 100 litre bin is required for each 50 people or for a few
market stalls. Bins require daily emptying, and this is
labour-intensive.
Page 26
Transport
When selecting suitable vehicles, waste generation
rates and densities need to be considered along with:
areas they need to access (e.g. narrow alleys or
uneven paths); and
distance between collection and disposal points.
For example, a wheelbarrow could collect waste from

approximately 50 individuals before requiring emptying.
Page 27
Disposal Recycling and composting

As a medium-term solution, larger-scale landfill pits can In time it may be possible to work with local recycling
be constructed. Without leachate (liquid runoff) industries to encourage entrepreneurs or waste
treatment these are not suitable for long-term use. They collectors to gather recyclable items. This can provide
should be situated at least1km downwind of a source of income as well as reducing the amount of
settlements, at a location selected in consultation with waste requiring disposal. Home composting can also
the population. They should also be situated downhill of be an effective means by which to reduce the volume of
water sources and at least 50m from surface water waste requiring collection and disposal.
sources. Carefully consider drainage where the pit is on
sloping ground and erect fences to keep animals and Management and implementation
scavengers out. It is important to consider management structures and
implementation methods. At times in emergency
Staff situations, particularly early on, activities may have to
Approximately 2.5 workers are required for 1000 be strongly enforced until more participating systems
community members (WHO/ UNEP 1991). Protective can be introduced.
clothing and equipment need to be considered (e.g.
gloves, boots, visibility jackets). Continuously review, monitor and response to the
nature of waste, pervading conditions and levels of
community participation.
Other important factors
Long-term waste management
Incineration In the long-term, capacity of landfill sites need to be
Incineration is not usually a favourable option for solid increased, leachate needs to be contained and treated
waste management as it requires a large capital input and the overall sustainability of waste management
and care for operation and management to ensure non- practices must be considered. Long-term solutions are
polluting bone. Where burning is deemed necessary beyond the scope of this technical note.
(e.g. to reduce waste volume), it must be done at least
1km downwind of settlements, and ashes should be
covered with soil daily. On-site burning of household Further information
waste can be highly-polluting and can be a fire hazard.
Harvey, P., Baghri, S and Reed, R. A. (2002)
Care of equipment Emergency Sanitation: Assessment and
Waste can often be corrosive, so it is important to paint Programme Design. WEDC, Loughborough, UK
all metal waste management equipment and to wash it
frequently. Such activity can significantly increased the SPHERE Guidelines, The Sphere Project (2004)
life of equipment. Humanitarian Charter and Minimum
Standards in Disaster Response,
Emergency response waste The Sphere Project: Geneva,
Packaging of emergency response provisions (e.g. Switzerland (Distributed
food, water, medicine, shelter) can produce serious worldwide by Oxfam GB)
waste problems. Consider this in procurement and
where possible manage packaging waste at point of http://www.sphereproject.org/
distribution to prevent its widespread scattering. handbook/index.htm

Author: Jonathan Rouse Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 28
Disposal of dead bodies
in emergency conditions
This technical note provides guidance on the disposal Mental health risks
of dead bodies in emergency situations. Where there
The psychological trauma of losing loved ones and
are many fatalities, the collection and disposal of
witnessing death on a large scale is the greatest cause
bodies becomes an urgent need. This is not usually
for concern. It is therefore, important to collect corpses
due to any health-related risks, which are likely to be
as quickly as possible to minimise this distress. It is,
negligible, but is important because of the possible
however, not necessary to rush their burial or
social and political impact and trauma. So emergency
cremation. This does not allow for the correct
relief teams should primarily be concerned with the
identification and record taking of the details of the
mental health of the community and its need to carry
dead. Nor does it give the time for the bereaved to
out the cultural obligations and traditions to take care of
carry out the ceremonial and cultural practices, which
the dead, rather than potential disease transmission.
would normally occur after a death.
Physical health risks

The widespread belief that corpses pose a risk of
communicable disease is wrong. Especially if death Cultural and religious practice
resulted from trauma, bodies are quite unlikely to cause Relief workers should respect the wishes of the
outbreaks of diseases such as typhoid fever, cholera, families and communities of the dead to observe
or plague, though they may transmit gastroenteritis or whatever cultural and religious events are usually
food poisoning syndrome to survivors if they practised on death. This is important in helping
contaminate streams, wells, or other water sources. people deal with the psychological impact of such
disasters. Encouraging stricken communities to
carry out traditional ceremonies and grieving
processes sets in motion the process of disaster
recovery.
Recovery of bodies
To minimise the distress caused by the sight of dead
bodies and the odours produced by their
decomposition, it is important to collect and remove
corpses to a collection point as quickly as possible.
Anyone in charge of a body recovery team should be
aware of the stress and trauma that team members
might feel, and provide support for this where possible.
Mortuary services
It is important to provide secure morgue facilities where
there are casualties following an emergency, where
there is an epidemic, or if burial or cremation are likely
to be delayed. A temporary mortuary site should
consist of a reception, a viewing room, a storage
chamber for bodies not suitable for viewing and a room
to store personal possessions and records. The
recommended capacity for a field morgue is 10 bodies
A mass grave per 10,000 population. Bodies should be stored at 4ºC,
Page 29
although this is rarely possible. Mortuary staff should Displaying bodies for identification needs space; 1000
wear gloves and protective clothing and should wash bodies require over 2000m2. Identification can be a
with disinfectant soap. A complete list of mortuary lengthy process, especially where no personal
requirements is given below. Where this is not possible, documentation is carried. When relatives and friends of
the minimum facilities are stretchers, leather gloves, the dead are involved, it must be remembered that
rubber gloves, overalls, boots, caps, soap, visual identification is not scientific. In emergency
disinfectants and cotton cloth. Following an emergency, situations, this process is even more difficult as it may
when the decision is made to close a temporary be necessary for relatives to view numerous bodies in
mortuary, appropriate cleansing of the site should take the hope that they will make an identification. This
place. would normally be avoided. Where possible, it is
important to differentiate viewing a body for
identification from viewing a body for grieving purposes
and separate locations should be provided.
Equipment for mortuary services
in major disasters Once identified, a death certificate should be issued,
an official record of death prepared and the body
• Stainless steel postmortem tables or heavy duty tagged. With violent deaths, it is also important to
trestle tables covered with plastic sheeting. record the cause of death for possible future
investigation.
• Wheeled trolleys for transporting bodies within
the mortuary.
Body disposal
• Tarpaulin or plastic sheeting for the floor, if it is
not made of concrete.
Burials in common graves and mass cremations
• Heavy-duty black plastic sheeting for are rarely warranted and should be avoided.
temporary screens.
• Refuse bins and bags.
• Cleaning materials – mops, buckets, cloths, Burial

soap, towels. Burial is the preferred method of body disposal in
emergency situations unless there are cultural and
• Disinfectant and deodorizer. religious observances which prohibit it. The location of
graveyards should be agreed with the community and
• Protective clothing and heavy-duty rubber attention should be given to ground conditions,
gloves. proximity to groundwater drinking sources (which
should be a least 50m) and to the nearest habitat
• Translucent plastic body bags 0.1 mm thick (500m). An area of at least 1500m2 per 10,000
and labels (if epidemic circumstances). population is required. The burial site can be divided to
accommodate different religious groups if necessary.
• Wall charts to record progress or large poster Burial depth should be at least 1.5m above the
boards if there are no walls. groundwater table, with at least a 1m covering of soil.
Burial in individual graves is preferred and can be dug
Revised list taken from Clark, Nicholls and Gillespie manually. If coffins are not available, corpses should be
(1992), cited in Wisner and Adams (2002). wrapped in plastic sheeting to keep the remains
speparate from the soil. Burial procedures should be
consistent with the usual practices of the community
concerned.
Identification of bodies
One of the major challenges of effective management Cremation
of dead bodies is their early identification and tagging. There are no health advantages of cremation over burial
Records of deaths and funerals need to be kept to but some communities may prefer it for religious or
monitor mortality rates and the incidence of disease cultural reasons. Factors against it are the amount of
and to be able to provide timely, understandable and fuel required by a single cremation (approx 300kg.
accurate information to relatives of the dead. wood) and the smoke pollution caused. For this reason,
Page 30
cremation sites should be located at least 500m Cholera

downwind of dwellings. The resultant ashes should be Contact with the body leads to exposure to cholera
disposed of according to the cultural and religious vibrios and requires careful washing using soap and
practice of the community. water.
Action in medical epidemics Ebola

Where possible, in the case of a medical epidemic, Ebola is spread through bodily secretions such as
body handling should be left to specialist medical staff. blood, saliva, vomit, urine and stools, but can easily be
Rather than using lime for disinfection purposes, which killed with soap and water. Those dealing with the
has a limited effect on infectious pathogens, it is better disposal of bodies require high levels of protection.
to use chlorine solution or other medical disinfectants.
Any vehicles used to transport bodies to burial or Typhus and plague
cremation sites during epidemics should also be
To avoid infestation with the fleas and lice that spread
disinfected after use. It is important to make
these diseases, protective clothing should be worn.
communities aware of the risks of contagion from
Body bags should be used to store the bodies prior to
practices such as traditional washing of the dead. Also,
burial or cremation.
any large gathering, including a funeral, can be a way
of spreading an epidemic. Consequently, burial or
cremation should take place soon after death at a site
near the place of death with limits placed on the size of
any gathering.
WP Road
KEY:
V12 V16
BG Burial ground
Scrub woodland/
CC Cholero centre
CC V11 V15 small-scale farming
WP BG HP Health post
SCH School
V10
V14
SCH WP Water points
Dispensary
Swampy V1 Village 1
Buffer zone
HP V9 V13 ground
2.6km
BG
V20
BG
V4 V8
WP
V19 V23 V31
Buffer zone
WP
V3 V7
Buffer zone
V18 V22 V30 V33

V2 V6 WP SCH
Compound SCH
entrance
V1 V5 V17 V21 V29
WP WP WP
IFRC HP WP WP WP
compound Market 1 V27 V28
V24 V25 V26
Food Market 2
distribution centre 1.3km 1.2km 1.2km
Figure 1. Location of burial ground
Page 31
Important principles
• Give priority to the living over the dead.
• Dispel myths about health risks posed by

corpses.
• Identify and tag corpses.
• Provide appropriate mortuary services.
• Reject unceremonious and mass disposal of

unidentified corpses.
Volunteers remove bodies with extreme caution
• Respond to the wishes of the family.
• Respect cultural and religious observances.
• Protect communities from the transmission of

medical epidemics.
Further information
Harvey, P., Baghri, S. and Reed, R.A. (2002)
Emergency Sanitation, Assessment and
Programme Design. WEDC, Loughborough, UK.
Davis, J. and Lambert, R. (2002) Engineering in

Emergencies: a Practical Guide for Relief Workers,
(2nd. Edn.) ITDG Publishing, London.
Wisner, B. and Adams, J. (eds.) (2002) Environmental

Health in Emergencies and Disasters. WHO,
Geneva.
Pan American Health Organization (PAHO) (2003)

‘Unseating the Myths Surrounding the Management
of Cadavers’, Disaster newsletter, No. 93, October
2003. PAHO, USA.

Author: Julie Fisher Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 32
Minimum water quantity needed
for domestic use in emergencies
How much water is needed? How much does

A water supply is an essential requirement for all
people. Determining how much is needed is one of the
each individual use?
first steps in providing that supply. Providing enough People use water for a wide
water to meet everybody’s needs may be difficult in the variety of activities. Some of these
short-term so water can be made available in stages. are more important than others, for example, having a
Continuous checking – including talking to the various few litres of water to drink a day is more vital than
users of the supply (especially women) will enable washing clothes - but people will need to wash if skin
limited resources to be focused effectively. Providing diseases are to be prevented and physiological needs
water is never free; the water needs to be collected, met. Each additional use has health and other benefits,
stored, treated and distributed. Providing too much but with decreasing urgency (see Figure 1). This is
water is a waste of money. Taking too much water from often measured in litres per person (capita) per day
a limited source may deprive people elsewhere of water (Lpcd).
and have adverse environmental and health impacts.
Collect basic information

How many people are there? A hierarchy of water requirements
How much does each individual use? People’s needs are not always predictable. For
example, the need to wash sanitary towels or to wash
hands and feet before prayer may be felt to be more
important than other uses. Talk to people to confirm
their priorities. Different populations may also have
How many people are there? specific needs such as using water for anal cleansing.
Establishing the population to be supplied may not be Different genders will also have different priorities, with
easy after an emergency, but consulting administrators, women being concerned about basic household needs
feeding centres, community leaders and making direct at the top of the hierarchy, men perhaps having a
observations (such as the average number of people concern for livestock, girls needing water to wash
per shelter and then counting shelters) can give various during menstruation and boys wanting to go for a swim!
estimates of the population. Don’t just rely on one figure Waste, spillage and leaks also need to be taken into
but compare independent assessments. Displaced consideration. Hot or windy weather may increase
people will also be moving about, so estimate changes people’s individual needs.
in population. Include local populations as well as
displaced people. To establish how much an individual
needs, standard quantities have
been established as guidelines
(see Table 1). These have been
broken down into categories to
increase the accuracy of the
estimate. For example, not all
water will be needed at the
house. It may be preferable to
provide separate water supplies
for bathing, washing or animals, as
well as for hospitals, feeding centres and
schools. Water for hand washing will be
needed near latrines.
Page 33
– lasting solution
Medium term
- maintaining
Short term
-survival
Long term
10L drinking
20L cooking
30L personal washing
40L washing clothes
50L cleaning home

Generally:
60L growing food (domestic use) Increasing
quantity
70L waste disposal (sanitation)
Decreasing
business (crops production livestock) quality
gardens recreation
Figure 1. Hierarchy of water requirements

(after Abraham Maslow’s (1908-1970) hierarchy of needs)
Water does not all have to come Managing demands

from the same source. People It may be that some water demands can be reduced by
may be provided with bottled providing alternatives. Flush toilets (water borne
drinking water, but use a stream sanitation) require a large volume of water (up to 70L
to wash their clothes in. As per person per day). Pit latrines or simple pour-flush
demand for water increases, toilets should be the first choice. Some water
generally the quality needed for requirements may be met by using lower quality
each use can be reduced. Water (untreated) water or by recycling water. Encouraging
for cleaning a floor does not have drought resistant crops or keeping livestock that can
to be of drinking water standard survive on less water can reduce demands, as can
and water for growing providing alternative livelihoods that require less water.
subsistence crops can be of a
lower quality still. Before the
quantity of water can be
Ensuring supply has an impact
established, decisions need to Supplying water does not mean it is all having the
be made. desired impact. Look at the whole water supply system
and identify weak points. Providing more water to a tap
stand will not necessarily increase consumption if it is
Decide: too far away or people do not have enough water
containers. Providing more water may cause drainage
what needs are going to be catered for;
problems if there are no facilities for disposing of
(e.g. only drinking or drinking, cooking and
sullage.
washing)
what is the programme for implementation; Evaluate

(e.g. provide limited water initially and a full supply See how much water people
later) are actually using.
what sources are available; When and where

(e.g. are resources limited, what is the water are they using it?
quality) and
who is managing each supply (e.g. which

organisation is responsible for domestic supplies,
hospital supplies, needs of schools).
Page 34
Table 1. Some standard water requirements
Standard: All people have safe access to a sufficient

quantity of water for drinking, cooking and personal and
domestic hygiene. Public water points are sufficiently
close to shelters to allow use of the minimum water
requirement.
Key indicators
At least 15 Lpcd is collected.
• Flow at each water collection point is at least
0.125 litres per second.
• There is at least 1 water point per 250 people.
• The maximum distance from any shelter to the
nearest water point is 500 metres. Figure 3. Typical relationship between water
collection journey time and domestic consumption
Guidelines
(after Cairncross & Feachem 1993)
Individuals
Minimum ‘survival’ allocation: 7 Lpcd
(sustainable for only a few days)
• Drinking: 3-4 Lpcd
• Food preparation, cleanup: 2-3 Lpcd Table 2. Water collection standards
Medium term allocation: 15-20 Lpcd
(sustainable for a few months) Two vessels 10-20L for collecting water plus one 20L
• Drinking: 3-4 Lpcd vessel for water storage, (narrow necks and covers) per
• Food preparation, cleanup: 2-3 Lpcd 5 person household.
• Personal hygiene: 6-7 Lpcd
• Laundry: 4-6 Lpcd
Other needs
• Health Centres: 5 litres per out-patient;
What happens to waste water?
40-60 litres per In-patient Simply supplying as much water as possible is not the
• Hospital (with laundry facilities): 220-300 litres per best solution. Once more than the basic quantity is
bed available, any additional water will eventually need to
• Schools: 2 litres per student; (10-15 litres per be disposed of (spillages, sullage or wastewater). The
student if water-flushed toilets). costs of supplying water will therefore need to take the
• Feeding Centres: 20-30 litres per patient costs of disposing of this used water safely.
• Camp Administration: (Staff accommodation not
included) 5 Lpcd
• Staff accommodation: 30 Lpcd Some water can be re-cycled, reducing the need for
• Mosques: 5 litres per visitor both supplying and disposing of water - for example
• Sanitation (hand-washing, cleaning latrines etc.): using sullage and spilled water from washing facilities
depends on technology. can be used to grow crops.
Livestock and agriculture
• Cattle, horses, mules: 20-30 litres per head
• Goats, sheep, pigs: 10-20 litres per head Further information
• Chickens: 10-20 litres per 100
The Sphere Project (2004)
• Vegetable gardens: 3-6 litres per square metre
Humanitarian charter and minimum standards in
Actual values depend on many variables (such as disaster response. The Sphere Project: Geneva,
cultural practices and climate) that should be assessed Switzerland. http://www.sphereproject.org
by specialists
U.S. Agency for International Development, Bureau for
Humanitarian Response, Office of Foreign Disaster
From the water point to the home Assistance (OFDA) (1998) Field operations guide
Even if plenty of water is provided, there may be other for disaster assessment and response. http://
limits to its use, such as the time taken for people to www.usaid.gov/our_work/humanitarian_assistance/
travel and queue to get it. If people take more than 30 disaster_assistance/resources/index.html#fog
minutes to collect water, the amount they will collect will
reduce (see Figure 3). The amount of storage facilities House, Sarah and Reed, Bob (2000) Emergency water
available is also important (see Table 2). Washing sources: Guidelines for selection and treatment
facilities near the water points reduce the need to WEDC, Loughborough University, UK.
transport water. http://wedc.lboro.ac.uk/publications/
Page 35
A sample calculation
How much water is needed for a refugee camp for 5,000 displaced people (including 2000 school age
children), 25 relief agency staff, and 75 cows?
Decisions
• Water for crops will not be provided
• Water for livestock will rely on a river
• Water for the hospital is the responsibility of another agency and will be a separate supply system.
A feeding centre, however, will be supplied with water.
• Staff will be resident during the initial stages but will be able to travel into the camp at a later date and are
not included in that calculation
• Assume 10% wastage (from spills, leaks, waste)
• School will not be operational until after phase 1 and will not have flush toilets
• Assume some further population movement
Phase 1 - an emergency supply

Domestic use: 5000 x 7 litres = 35,000L (7 Lpcd)
Feeding centre: 5000 x 20 litres = 100,000 L (20 Lpcd)
Staff centre: 25 x (5 + 30) litres = 875 L (5 Lcpd for office plus 30 Lcpd for accommodation)
Total = 135,875 L plus 10% leakage
≈ 150,000 litres per day
Phase 2 - a long-term solution

Domestic use: 4500 x 20 litres = 90,000 L (planned decrease in population, but increase allowance
to 20 Lpcd)
Feeding centre: 1000 x 30 litres = 30,000 L (feeding vulnerable groups only but providing 30 Lpcd)
Staff centre: 25 x 5 litres = 125 L (staff no-longer resident)
School: 2000 x 2 litres = 4,000 L (2L per pupil)
Total = 124,125 L plus 10% leakage
≈ 137,000 litres per day
Evaluate
Long term treatment facilities limited due to difficulties in importing chemicals,
so reduce domestic demand by providing washing facilities using partially treated water.

Author: Brian Reed Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 36
Essential hygiene messages
in post-disaster emergencies
This fact sheet outlines some of the key activities in In carrying out hygiene promotion, you will need to
dealing with hygiene promotion in post-disaster carry out the following activities:
emergencies.
Evaluate current hygiene practices.
Plan what you need to promote.
What is hygiene promotion? Implement your plan.
The goal of hygiene promotion is to help people
Monitor and evaluate your plan.
understand and develop good hygiene practices to
prevent disease and promote positive attitudes towards
good health practices. Evaluate whether current hygiene
practices are good and safe
Focus of hygiene promotion in You will need to identify the key hygiene behaviour risks
and judge the probable success of any promotional
emergencies activity. The main risks are likely to be:
Your aim in carrying out hygiene promotion in
emergencies is to: Excreta disposal.
Use and maintenance of toilets.
rower high-risk hygiene behaviour; and Lack of hand washing with soap or alternative.
sensitize your target population to the appropriate Unhygienic collection and storage of water.
use and maintenance of facilities. Unhygienic preparation and storage of food.
This latter point is important. Your efforts should be Prioritize these by

directed at encouraging people to take action to protect choosing those
their health and make best use of the facilities and which pose the
services provided. greatest health risk.
You should look at
the resources
Hygiene promotion is not simply a matter of available to your
providing information. It is more a dialogue with target population
communities about hygiene and related taking into account local behaviours, knowledge and
health problems, to encourage improved cultural norms. The needs of vulnerable groups should
hygiene practices. be given particular attention.
Plan which good hygiene practices

to promote
The understanding you gain from the above evaluation
should be used to plan and prioritize assistance. Give
priority to targeting those behaviours which pose the
greatest health risks. Target a small number of
practices for each user group: sustained and repeated
messages covering a small number of practices are
likely to have greater impact than a large amount of
promotional messages centred on several practices.
The key is to identify the most harmful practices in each
user group and focus on these.
Implement a health promotion programme that meets

Community meeting community needs and is understandable by everyone.
Page 37
Implement your plan

Certain behaviours may be seen to confer status
Target specific audiences. It is important that you within the community and be adopted for this
know who your audience are and that you direct reason.
messages at groups responsible for carrying out the
activity being referred to. For example: Fatima built a utensils drying rack for
after noticing her neighbour Zainabu, who is a
teacher, had one.
Messages about diarrhoea in children should be
A woman may adopt the correct disposal of
directed at those involved in childcare.
childrens’ faeces upon seeing a health worker
doing so.
Hygiene messages need to be positive. Hygiene

messages should be presented in a positive light
making use of humour wherever possible. Nobody likes
being lectured to: people will be much more receptive
to positive messages.
Identify appropriate communication channels. You

need to know how your different target audiences
prefer to receive information and any cultural aspects to
this. Do they listen to the radio, pick up information
through informal discussions, use health facilities, rely
on religious functions, theatre and dance and so on?
It is usually more effective to use the channel that your

audience identifies with and regards as trustworthy.
It is desirable that all gender groups (women, men,

children and those with disabilities), should receive
equal attention. There are reasons why this does not
always happen. Women, for example, will shoulder
domestic responsibilities in most households. As a
consequence, most promotion activities are directed at
women, on the premise that if they understand, accept
and act upon the messages, the benefits will be
immediate. Men, on the other hand, might understand
and accept the messages but not act upon them if they
are not involved in domestic duties.
Identify motives for behavioural change. People may

change their behaviour for reasons not necessarily
related to potential health benefits, but for totally
unrelated reasons.
It is important to identify and understand cultural norms

and use this knowledge as a basis for articulating
motives for change.
Page 38
Staff may be recruited from among elders with a lot of

life experience, teachers, community leaders, health
workers, religious leaders, traditional birth attendants
and so on. Although there are no hard and fast rules, a
ratio of one facilitator to every five hundred people or
one hundred families is recommended.
Mix your communication channels. A message

received through a variety of channels is more likely to
be remembered. However, there are costs to take into
account. Broadcast media is less expensive per capita
than is say, face-to-face communication, but information
provided one-to-one has greater impact than an
impersonal message received through the media. You
need, therefore, to balance the costs of using a channel
against its effectiveness.
Materials. These should be designed in a way that

messages will reach illiterate members of your
population. Participatory methods and materials that
are culturally appropriate offer opportunities for groups
to plan and monitor their own hygiene improvements.
Facilitators. Facilitators are the people you will use to

implement your plan, working with the community, face-
to-face. It is important to select the right people as
facilitators as they are the single most important factor
for the success of a hygiene promotion campaign.
Generally speaking, facilitators should be selected from
among the target population. They should be able to
communicate in the local language and, where
possible, be people who are respected within the Monitor and evaluate the programme
community.
to see whether it is meeting targets
A reasonable standard of education and an enthusiasm You will need to review your hygiene promotion
for community work are desirable. They should be programme regularly.
aware of the constraints that may cause people not to
adopt good practices. Ideally, members of the community should be involved
to ensure that issues important to them are covered.
The review should evaluate members’ feelings about

the hygiene message and whether they need more
information.
Reviews should also mean you gain feedback about

how to improve your programme.
It is a good idea to have members decide the

frequency of reviews. All information gathered during
monitoring and evaluation should be shared with the
wider community and interested stakeholders.
Page 39
How to measure
chlorine residual in water
The importance of chlorine

force people to live in poor conditions such as
in water tents or temporary buildings which make it
Many of the most common diseases found in difficult to retain good hygiene practices; and they
traumatized communities after a disaster or
emergency are related to drinking contaminated water. affect their diet, often lowering their nutritional
The contamination can be from micro-organisms (Table level and making them more vulnerable to
1) or natural and man made chemicals (Table 2). This disease.
fact sheet concentrates on the problems caused by
drinking water contaminated by micro-organisms as It is important, therefore, that all people affected by an
these are by far the most common and can be emergency are provided with water of a high quality.
reduced by chlorination. Chemical contamination is
difficult to remove and requires specialist knowledge There are a number of ways of improving the quality of
and equipment. drinking water. The most common are sedimentation
and filtration followed by disinfection. (These are
discussed in other notes in this series). Disinfection
Table 1. Diseases related to drinking water (the killing of harmful organisms) can be achieved in a
contaminated with micro-organisms number of ways but the most common is through the
addition of chlorine. Chlorine will only work correctly,
Diarrhoea* however, if the water is clear (Box 1).
Typhoid*
Hepatitis*
Box 1.
Cholera* How chlorine kills
*Contaminated water is not the only cause of these diseases; water quantity, poor
sanitation and poor hygiene practices also play a role
When chlorine is added, it purifies the water by
destroying the cell structure of organisms,
thereby killing them. The process only works,
however, if the chlorine comes into direct contact
Table 2. Some chemical contaminants of with the organisms. If the water contains silt, the
drinking water that may be a danger to health bacteria can hide inside it and not be reached by
Arsenic Fluoride
the chlorine.
Cadmium Lead
Chlorine takes time to kill all the organisms. In
Chromium Mercury water above about 18oC the chlorine should be in
Cyanide contact with the water for at least 30 minutes. If the
water is colder then the contact time must be
increased.
People who live in the same place all their lives and It is normal, therefore, to add chlorine to water as
regularly drink contaminated water may develop some it enters a storage tank or a long delivery pipeline
resistance to the contaminants and suffer little or no to give the chemical time to react with the water
health problems. Communities affected by an before it reaches the consumer.
emergency, however, are very different. Emergencies
have three relevant effects on people, they: The effectiveness of chlorine is also affected by
the pH (acidity) of the water. Chlorination is not
force people to move to new places where the effective if the pH is above 7.2 or below 6.8.
water quality is different from what they usually
drink and for which they have no immunity;
Page 40
How to measure chlorine residual
Chlorine residual
Chlorine is a relatively cheap and readily available Caution: All forms of chlorine are harmful to
chemical that, when dissolved in clear water in sufficient health. Avoid skin contact and do not inhale the
quantities, will destroy most disease causing organisms fumes. Chlorine should always be stored in
without being a danger to people. The chlorine, cool, dark, dry and sealed containers and out of
however, is used up as organisms are destroyed. If reach of children.
enough chlorine is added, there will be some left in the
water after all the organisms have been destroyed,
this is called free chlorine. (Figure 1) Free chlorine will Just after the chlorine has been added to the
remain in the water until it is either lost to the outside water to check that the chlorination process is
world or used up destroying new contamination. working.
Therefore, if we test water and find that there is still At the outlet of the consumer nearest to the
some free chlorine left, it proves that most dangerous chlorination point to check that residual chlorine
organisms in the water have been removed and it is levels are within acceptable levels (between 0.5
safe to drink. We call this measuring the chlorine and 0.2 mg/l).
residual.
At the furthest points in the network where residual
Measuring the chlorine residual in a water supply is a chlorine levels are likely to be at there lowest. If
simple but important method of checking that the water chlorine levels are found to be below 0.2 mg/l it
that is being delivered is safe to drink might be necessary to add more chlorine at an
intermediate point in the network.
When and where to test water
The most common place to use chlorine as a The amount of chlorine residual changes during the day
disinfectant is in a piped water supply. Regular and night. Assuming the pipe network is under pressure
chlorination of other water supplies is difficult and all the time (see Box 2, overleaf) there will tend to be
usually reserved for disinfection after repair and more residual chlorine in the system during the day
maintenance. The chlorine residual is usually tested at than at night. This is because the water stays in the
the following points: system for longer at night (when demand is lower) and
so there is more opportunity for the water to be
contaminated which will use up the residual chlorine.
Chlorine residual should be checked regularly. If the

Water requires 2.0mg/l
Chlorine added of chlorine to destroy
system is new or has been rehabilitated then check
all organisms daily until you are sure that the chlorination process is
working properly. After that, check at least once a
week.
1.5 mg/l Water not
disinfected
Testing for chlorine residual

The most common test is the dpd (diethyl
paraphenylene diamine) indicator test, using a
2.0 mg/l
All organisms comparator. This test is the quickest and simplest
destroyed but no
chlorine left for method for testing chlorine residual.
future contamination
With this test, a tablet reagent is added to a sample of

water, colouring it red. The strength of colour is
2.5 mg/l All organisms
measured against standard colours on a chart to
destroyed and 0.5 determine the chlorine concentration. The stronger the
mg/l residual
chlorine remaining colour, the higher the concentration of chlorine in the
water.
Several kits for analysing the chlorine residual in

water, such as the one illustrated in Figure 2, are
Figure 1. Effect of chlorine residual
available commercially. The kits are small and
portable.
Page 41
Step 1. Place one tablet in the test chamber (a) Step 2. Crush the tablet, then fill chamber (a)
and add a few drops of the chlorinated water with the chlorinated water supply under test.
supply under test.
Step 3. Place more of the same water supply Step 4. The level of residual chlorine (R) in mg of
under test (without a tablet) in the second chlorine per litre of water (mg/l) is determined by
chamber (b). This is the blank control for colour comparing the colour of the water supply under
comparison. test in chamber (a) with the tablet added with the
standard colours on the vessel (chamber (b)).
Note: Chamber (c) would be used if a higher

chlorine residual is to be measured.
Figure 2. Steps in determining the chlorine residual in water using a comparator
Page 42
Box 2.
Chlorination and intermittent supplies
There is no point in chlorinating pipe networks if the

water supply is intermittent. All pipe systems leak
and when the water supply in switched off, the
pressure will drop and contaminated water will enter
the pipes through the breaks in the pipe wall. No
level of residual chlorine acceptable to consumers
will be able to deal with such high levels of
contamination. All intermittent water supplies should
be assumed to be contaminated and measures
taken to disinfect it at the point of use.
A chlorination checklist
• Chlorine needs at least half an hour contact time with water to disinfect it. The best time to apply it is
after any other treatment process, and before storage and use.
• Never apply chlorine before slow sand filtration or any other biological process, as the chlorine will kill
off the bacteria which assist treatment, making the treatment ineffective.
• Never add any solid form of chlorine directly to a water supply, as it will not mix and dissolve. Always
make up as a paste first, mixing the chlorine compound with a little water.
• Disinfection is only one defence against disease. Every effort should be made to protect water sources
from contamination, and to prevent subsequent contamination during collection and storage.
• The correct procedure for applying a disinfectant to water should be strictly adhered to, and water
supplies should be monitored regularly to ensure that they are free from bacteria. Otherwise, people
may be misled to believe that the water is safe to drink when, in fact, it is hazardous to do so.
• The optimum chlorine residual in a small, communal water supply is in the range of 0.3 to 0.5mg/l.
• The chlorine dose required to disinfect a supply will increase if the water is very turbid. In such
circumstances, it is best to treat the water to reduce turbidity before chlorination.

Avenue Appia 20 Facsimile: (+ 41 22) 791 31 11
1211 Geneva 27 Telex: 415 416

Author and Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 43
Delivering safe water
by tanker
When to use tankers made from flat bed trucks with portable storage tanks
attached can be very dangerous if the tank is not
Moving water by tankers should be avoided if possible.
securely fastened. The delivery of bottled water may
It is expensive and difficult to organize. It should be
be a short term option but it is expensive and
seen as a temporary measure to allow for the
inefficient. It also produces a major solid waste
development of a more sustainable solution. Tankering,
problem from all the discarded empty water bottles.
however, is a common method for delivering water
immediately after an emergency has happened while
more long term measures are being put in place; Tanker management
where the emergency is thought to be temporary and Consider the following points when organizing a
the situation will return to normal soon; and where tankering programme:
security and political problems make it difficult to
change to a more sustainable approach. In the last Good management is the key to successful
case, tankering may continue for long periods tankering. Identify reliable and capable supervisors.
– sometimes for years. Closely monitor tanker performance, fuel
consumption and spare parts use.
Tankering is a major logistical operation. It requires a
fleet of vehicles that require frequent maintenance and Get clearance from local authorities and owners
proper management. Tankers full of water are heavy before using a water source. Check the water’s
vehicles and the operation may require regular attention quality and reliability before committing to its use.
to the access routes if they are to remain open.
Tankers may have been used for carrying other
The key to a successful tankering operation is good liquids before the emergency. Always insist on all
management, and proper financing. tankers being properly cleaned and disinfected
before being used to carry water (see Note 3).
Types of tanker
Establish detailed contracts with private tankering
Water can be carried in a variety of different containers,
contractors. Payment should be based on the
some specifically designed for the task and others
quantity and quality of water delivered not the
fabricated to meet an urgent need. Figure 1 shows a
working time. Establish a monitoring system at the
selection of different vehicles for carrying water.
delivery point to check the quantities delivered.
If possible, try to use specially designed water tankers.
Make sure the routes to be taken by the tankers are
They will be safer and more reliable. Temporary tankers
capable of carrying the wheel loads. You may have
to reinforce bridges and resurface sections of road.
Choose the right tanker for the job. Some sites may
be inaccessible and unsuitable for large tankers.
Others may require water to be transported over
long distances that would be unsuitable for small
tractor drawn bowsers.
Arrange an adequate supply of fuel. If the area has

been hit by an emergency, supplies of fuel may be
disrupted and there will be a high demand from
other emergency services. It may be necessary to
set up a temporary fuel storage depot to ensure a
reliable supply.
Page 44
Delivering safe water by tanker
The provision of storage tanks increases the efficiency

of the tankering system and extends the time over
which users can collect water. It also improves the
quality of the water as it provides additional storage
time before use.
There are many different designs for storage tank,

some specifically developed for emergency situations
and others adapting existing equipment and ideas.
Always raise tanks off the ground so that users can
A temporary tanker get their containers under the outlet tap. Tankering
(Temporaty tankers made from flat bed trucks with portable storage tanks efficiency can be further increased by fitting the tanker
attached can be very dangerous if the tank is not securely fastened.) with a water pump so that the water can be pumped
into the storage tanks rather than allowing it to flow by
gravity.
A well managed tankering programme is heavily
dependent on staff relations. Drivers are particularly Access is improved if the storage tank is connected to
important. Make sure they are properly paid, have a tap stand. This moves the users away from the
adequate rest periods and have the proper storage tank that reduces the problems associated
equipment. Make clear the divisions of with wasted water and vandalism and allows more
responsibility for the different tasks such as people to collect water at the same time.
loading, chlorination and pump operation. Don’t
forget to consider the security of the vehicle and its
driver and make appropriate arrangements.
If the driver is to look after other machinery (such

as water pumps), make sure they are properly
trained in their use and day to day maintenance.
Tankers are machines and need regular

maintenance. Build a regular maintenance schedule
into the programme to keep the delivery reliable
and ensure a good supply of spare parts and
mechanics to fit them.
Providing water in an emergency is only successful if
the users also have suitable containers to collect and
Water distribution and collection store it. Domestic containers come in a wide variety of
The simplest method of distributing water from tankers designs. One of the most popular
is to allow the public to collect it directly from the is the jerry can. Provided it is
vehicle. This method is slow and reduces the number of fitted with a lid, the jerry can is
trips the vehicle can do each day. Efficiency can be easily carried in the hand or on
improved slightly by fitting a tap bar on the back of the the head. The problem with jerry
tanker but the best method is to transfer the water from cans is that they are difficult to fill,
the tanker to a storage tank. causing a high proportion of water
to be wasted, and they are almost
impossible to clean on the inside.
If used for extended periods they
can become a serious health
hazard.
The other common design of container is the bucket.

These are cheap to buy, easy to fill but hard to carry
when full. Water is easily spilt during carriage and the
large open water surface can easily lead to
contamination. These problems can be reduced by
fitting the bucket with a tight fitting lid that can be
removed for filling and cleaning.
Page 45
Emergency water tanks
Page 46
Calculating tankering requirements
A community affected by an earthquake requires 200,000 litres of water a day to be tankered in. The water is
to be collected from a borehole 10km from the community. Estimate the number of tankers that will be
required to deliver the quantity of water required.
The following activities are assessed to take these times:
Filling the tanker 20 min

Travel time from borehole to community 30 min
Offloading time for tanker 10 min
Return travel time 30 min
Net turnaround time 90 min
Add 30% for unforeseen activities 30 min
Gross turnaround time 120 min
Assume each tanker can work 14 hours per day using two drivers then the number of trips each tanker can
make a day is: 14 x 60/120 = 7
If each tanker can carry 5,000 litres per trip then one tanker can transport 5,000 x 7
= 35,000 litres per day
Therefore the number of tankers required to deliver sufficient water is 200,000/35,000

= 5.7 say 6 tankers
Further information
Davis, J. and Lambert, R. (2002)
Engineering in Emergencies – A practical guide
for relief workers”, 2nd edition,
ITDG Publishing, UK.
Page 47
Emergency sanitation
– planning
Why is it important
to plan?
The pressure to help people
immediately after a disaster
often leads to actions being
started before they have been
properly planned. Wide
experience has shown that this
leads to a waste of resources,
poor service delivery and low
long term benefits for the
affected community. It is
always important to plan
sanitation interventions before
starting work and there is no
reason why this should not
apply in emergencies or after
disasters.
What is meant by
sanitation?
The term sanitation means
different things to different
people. In this note it is taken
to mean the collection and
disposal of human excreta
(urine and faeces). Other
wastes from human activities
such as solid waste and
medical waste are not covered
but the principles involved are
the same.
Figure 1. Stages in emergency sanitation programme design
Stages in planning Rapid assessment and priority setting

Figure 1 shows the main stages in planning It is only necessary to intervene in a situation if there
emergency sanitation. The main complaint about the is a need to do so. This stage aims to rapidly collect
planning process is that it takes too long in an and analyse key information to identify if an
emergency. This is not true: Figure 1 also shows the intervention is necessary and whether it is of high,
approximate time required for each stage for an medium or low priority.
affected population of about 10,000.
Page 48
Emergency sanitation – planning
Table 2. Key data to be collected ...continued
General description Are any excreta disposal facilities breeding sites for
Write a general description of the emergency, affected vectors or pests?
area and population. Include socio-political, institutional, Are appropriate anal cleansing and handwashing
demographic, health and geographical information. materials available?
Is there evidence of any indiscriminate defecation or
General information potential for direct human contact with excreta?
Organisation carrying out the assessment For how long are current facilities and practices
Name of assessor(s) sustainable?
Position of assessor(s)
Dates of assessment Quantity
Maximum level of intervention (short-term or long-term) What is the ratio of domestic facilities (cubicle or space) to
General location or site affected population?
Logistics and resources available If required, what is the ratio of population to facilities for
Human resources available children, disabled or elderly?
Nature and history of emergency If there is a need for facilities in public places or
Government involvement institutions, what is the ratio of facilities to unit of measure?
Conflicts and likely resolutions What is the maximum one-way walking distance for users?
Origin of affected population
Seasonal/climatic implications Usage
Existing/potential donors What proportion of the affected population has access to
Other organisations working in the area including current appropriate facilities? What groups do not have access
and planned activities and why?
What proportion of the affected population is using the
Demographic data appropriate facilities correctly on a regular basis?
Approximate number of affected people Are facilities maintained hygienically?
Breakdown of the population by sex
Breakdown of the population by age
Proportion of vulnerable groups (e.g. female-headed
households, children, sick, disabled, etc.)
Average family size
Likely increase in population over next month Box 1. Data collection principles
Geographical information The main things to remember when collecting
A sketch map should be produced and the following features information are:
identified and located:
Location and types of existing sanitary facilities with • Collect it from as many sources as
estimates of key distances from dwelling areas possible to reduce bias and inaccuracies
Location of indiscriminate dumping of solid or medical
waste • Be aware of local political and social
Areas of indiscriminate excreta disposal structures so as not to raise unrealistic
Location of key public services/institutions
Water sources
expectations
Water storage and distribution points • Consider the effects of the data you
Pooling of wastewater
Burial / cremation sites
collect on your decisions
Groundwater levels • Keep good records of what you have
Ground conditions
Geological features
learned and from whom
Slope directions and drainage • Remember that situations
General description
change rapidly in
Write a full description of the current facilities and an emergency and
practices (including anal cleansing). Include how facilities things may not be
were constructed, operated and maintained with general the same tomorrow
comments on quantities, qualities and cultural factors. as they are today
Quality • Get a good
Are existing facilities technically appropriate? interpreter if you
Are existing facilities socio-culturally acceptable to all
users?
are working with
What are the potential hazards for disease transmission? people who speak
Is there any potential contamination of food and water a different language
sources? from you
Page 49
Table 3. Recommended minimum objectives for safe excreta disposal
Criteria Immediate Short-term Long-term
Quality • Technically basic • Technically appropriate • Technically very appropriate
• Barely socially and culturally • Socially and culturally • Very socially and culturally
acceptable acceptable acceptable
• Basic health protection • Minimal health hazard • No health hazard

measures in place
• Technology sustainable for six • Technology sustainable for
• Technology sustainable for one months three years
month
Quantity • Ratio of one space/cubicle to • Ratio of one space/cubicle to • Ratio of one space/cubicle to
100 persons accessible to all 50 persons accessible to all 20 persons accessible to all
population or immediate population population
responses only
• Maximum walking distance
• Maximum walking distance
• Maximum walking distance 50m (one way)
25m (one way)
70m (one way) • Availability of sufficient
numbers of facilities at: • Availability of facilities at:
• Availability of sufficient numbers
of facilities at:
1. Medical centres (one latrine 1. Medical centres (one latrine 1. Medical centres (one latrine
space to 50 beds or 100 space to 20 beds or 50 space to 10 beds or 20
outpatients) outpatients) outpatients)
2. Schools (one to 50 girls and one 2. Schools (one to 30 girls and 2. Schools (one to 15 girls and one
to 100 boys) one to 60 boys) to 30 boys)
3. Market areas (one to 100 adults 3. Market areas (one to 50 stalls) 3. Feeding centres (one to 20
and one to 50 children) adults and one to 10 children)
4. Feeding centres (one to 50
4. Feeding centres (one to 100 adults and one to 20 children) 4. Market areas (one to 20 stalls)
adults and one to 50 children)
5. Offices (one to 20 staff)
Usage • 50% of affected population • 75% of affected population has • 95% of affected population
has access to domestic access to domestic facilities has access to domestic
facilities (100% in medical (100% in medical and feeding facilities (100% in medical and
and feeding centres) centres feeding centres)
• 50% using facilities correctly on • 75% using facilities correctly • 95% using facilities correctly
a regular basis on a regular basis on a regular basis
Should you get involved? quickly but in sufficient detail that the information
External organisations should only get involved if the collected is of use for analysis (Box 1). Table 2
affected institutions and population are unable to deal suggests the key information you should collect.
with the situation and if the health of the population is
getting (or is likely to get) worse. Table 1 suggests
health data that will assist in deciding whether to Minimum objectives
intervene. In emergencies the normal routes for making decisions
on what technologies to use do not work. Instead, a set
Data collection of internationally recognised standards are used to
Data must be collected to assess the problems and ensure that the services provided to people in distress
needs of the affected population. This must be done are broadly the same all round the world. Table 3 sets
Page 50
out accepted standards for emergency excreta communities in the planning and design process is
disposal. These standards are used decide what beneficial to their recovery as it gives them self respect
should be provided and whether they are a success. and promotes continued independence.
What to do? The affected community should be involved as soon as

A comparison of existing facilities with those suggested a decision has been made to intervene, this usually
to meet minimum objectives will tell you if any further means at the detailed design stage.
work needs to be done and if it is urgent.
Outline design
Box 2. Stages in an emergency
Assuming the assessment has shown a need to
intervene, this stage develops an outline plan for what Emergencies last from a few days to many years.
should be done and how. The plan contains sufficient The type of intervention required will not be the
information for senior officials to decide whether action same for all. In general emergencies can be
should be taken and to allocate resources. divided as follows:
The outline design should include brief information on Immediate After the impact of the disaster.
the current situation and problems, an analysis of the Typified by great instability and high mortality.
causes of the problem, an outline of possible solutions Typically lasts one to two months.
and general estimates labour, materials and costs.
Short term The period of stabilisation where the
Immediate action aim is to reduce morbidity and mortality. Typically
Sometimes the threat to health is so high that something up to six months
must be done immediately to prevent widespread
disease and death. Immediate actions are targeted at Long term Recovery and resettlement of the
providing a quick response to an urgent situation while affected community. Lasts several years.
a more sustainable solution can be developed and
implemented.
Detailed design Further information

Once approval for a proper response to the problem has Harvey, P., Baghri, S. and Reed (2002) Emergency
been granted, a detailed plan and design must be Sanitation – Assessment and programme design,
drawn up prior to beginning implementation. The design WEDC, Loughborough University, UK.
process is the same as for any other sanitation project
except that it must remain flexible in case the situation
changes rapidly.
Community participation
Affected people have views and opinions, just like any
others. There is no reason to treat them any differently
than other communities except to make allowances for
the trauma they have experienced. Involving

Author and Series Editor: Bob Reed Design: Glenda McMahon Illustrations: Rod Shaw Graphics: Ken Chatterton
Page 51
Emergency sanitation
– technical options
The immediate provision of clean

water supplies and sanitation
facilities in refugee camps is
essential to the health, well-being
and, in some cases, even the
survival of the refugees.
Sanitation is usually allocated a

much lower priority than clean
water, but it is just as important in
the control of many of the most
common diseases found in refugee
camps.
Sanitation is the efficient disposal

of excreta, urine, refuse, and
sullage. As indiscriminate
defecation is normally the initial
health hazard in refugee camps,
this note outlines ways in which it
can be controlled temporarily while Figure 1. Plan of a defecation field
long-term solutions are devised.
Immediate measures Preventing defecation in certain areas

The technical options for emergency excreta disposal When a large group of people are excreting
are limited and simple. If they are to work, however, indiscriminately, it is necessary, first of all, to protect
they must be managed well and be understood and the food-chain and water supplies from contamination.
supported by the community. This means preventing people defecating on:
The immediate tasks at a new camp include: the banks of rivers, streams, or ponds which may
be used as a water source. If water is to be
obtaining the services of a good translator and abstracted from shallow wells, then it is important
consulting with all interested parties including to ensure that these wells are situated upstream
representatives of the refugees, aid agencies, and of the defecation areas; or
government officials;
agricultural land planted with crops, particularly if
surveying the site to gather information on the crops are soon to be handled or harvested for
existing sanitation facilities (if any), the site human consumption.
layout, population clusters, topography, ground
conditions, and available construction materials; Keeping people away from such areas may not be easy,
particularly where traditional habits make such practices
preventing defecation in areas likely to common. It may be necessary to construct a physical
contaminate the food chain or water supplies; and barrier, such as a fence, which may need patrolling.
Immediate measures to control indiscriminate defecation
selecting areas where defecation may safely be should not be solely negative, though; it is much better
allowed. to designate areas where defecation is allowed than to
fence off those that are not.
Page 52
Emergency sanitation – technical options
Defecation fields
Areas with fixed boundaries within
which defecation is permitted are
known as 'excretion' or 'defecation'
fields. The use of these fields
localizes pollution, and makes the
management and the cleaning of
the site easier. They should be
located carefully so that they are
easily reached by the community
but do not pollute water supplies or
sources of food. It is better if there
are a number of fields at roughly
equal intervals over the site area,
as this will reduce the walking
distance for most users and allow
for flexibility of operation and the
separation of the sexes.
The defecation field should be as

large as possible, but it should not
be open for use all at once. It is
better to divide the field into strips
so that a different strip can be
used each day. The area of the
field farthest from the community
should be used first, so that people Figure 2. A shallow family latrine
do not have to walk across
contaminated ground to reach the
designated area (Figure 1).
Intermediate
measures
The life-span of the excretion fields
is not long because the areas
polluted by excreta cannot be used
again unless a system is
established to cover the excreta
with soil. Their purpose is to allow
time for latrines to be built.
The ideal solution is to provide

each family with their own latrine,
but unless this is the simplest of
structures (Figure 2), it is neither
feasible nor advisable immediately.
In the early days it will not be
known how long it will be before
the situation which has caused the
disruption to the refugee
community will return to normal.
Furthermore, refugees will naturally
be unsettled at this stage, and may
be unable or unwilling to commit Figure 3. Trench defecation fields
themselves to the maintenance of
permanent or semi-permanent
Page 53
structures that may suggest that

their displacement will last a long
time.
An intermediate solution is required.

It is usual for this to be some form
of communal latrine, as communal
latrines are quick and cheap to
construct. Some are commercially
available, but these are expensive
and take time to transport to the
site. In most cases, 'trench' latrines
provide the simplest solution
(Figures 3 and 4).
Trench latrines
A trench latrine is a rectangular hole
in the ground. The hole should be
dug as deep as possible — about
2m and may be lined with timber
where there is danger of collapse. It
may be of any convenient length,
usually between 5 and 10m, and
between 1 and 1.5m wide. The
trench is spanned by pairs of
wooden boards on which the users
squat (see Figure 4). There is a gap
between the boards through which
the users excrete. An alternative
(and better) solution is to use Figure 4. Deep trench latrines
plastic squatting slabs overlaying
the boards if these are available.
Preferably, each pair of boards is separated by a Mobile package latrines
simple screen to provide privacy. In wet weather a roof
In the North, mobile package latrines are common.
is needed to prevent the trench from filling up with
There is no reason why they cannot be used in other
rainwater. A drainage ditch should be built to divert
places provided provision is made for the ultimate
surface water.
disposal of the excreta.
Each week the contents of the trench are covered by a
100 to 150mm-deep layer of soil. This will reduce the Borehole latrines
smell and prevent flies from breeding in the trench. In areas with deep soil, many borehole latrines can be
When the bottom of the trench has risen to within built in a short time using hand augers. The holes are
300mm of the surface, the trench is filled in and the usually 30 to 50cm in diameter and 2 to 5m deep. The
latrine is closed. A trench latrine system is very top of each hole is lined with a pipe, and two pieces of
labour-intensive and requires constant supervision. wood comprise the footrests. Borehole latrines should
Not only must the contents of each latrine be covered be closed when the contents are only 500mm from the
each day, but new latrines must be prepared, old surface.
ones filled in, and regularly used latrines cleaned.
Close supervision is essential. A poorly maintained Long-term solutions
latrine will quickly become offensive to the community Trench or borehole latrines are only an intermediate
and will not be used. solution because their operation is so labour-intensive
and requires constant supervision. As soon as it
Making use of existing facilities becomes obvious that the community is likely to
If refugees settle in or near urban areas, it may be remain disrupted for any length of time, longer-term
possible to make use of existing facilities such as solutions should be sought. In most cases, some form
sewers, public toilets, bucket latrines, or drains. of on-site sanitation will be most appropriate.
Page 54
Community mobilization contact is more appropriate. Improving hygiene

The safe disposal of excreta in refugee camps is awareness, particularly among mothers, is usually
primarily the result of good supervision and better achieved on a one-to-one basis or within very
management, and this can only be achieved with the small groups. Such education is long term and slow,
full co-operation of the community. It is essential, but it should be started as soon as possible since it is
therefore, that the community is fully consulted at all often easier to establish new behaviour patterns in a
times and that their views are considered and their community before it becomes established.
suggestions implemented. Problems may arise as
immediate sanitation measures usually conflict with Labour
personal habits and social customs, but strict control The day-to-day operation of latrines and programmes
measures at the outset, when people are still of education require substantial labour. While key
disorientated, will usually help them to become management posts are likely to be provided from
accustomed to new ideas and methods. Later, the outside the area, much of the initial routine work can
supervision of the excretion fields and the policing of be done by the community. In most cases the
protected areas can easily be done by the community community is only too willing to help since it gives
itself. people something to do, prestige, and possibly a
source of income. Latrine supervision is not a popular
The co-operation of the community will only be gained job and will almost certainly have to be paid for.
and retained if it is kept fully informed of what is being Motivation may be improved by providing a uniform
done and why. Information is communicated best and protective clothing or installing special bathing
through group meetings and personal contact. facilities for supervisors. People working on latrine
operation require little or no training; those involved in
Group meetings health education and information dissemination will
Group meetings can be used to advise the community require more.
about what is proposed, how the systems will operate,
and why they are important. Such meetings should
give the community an opportunity to question and
Further information
advise on what is being proposed. It is important that Harvey, P., Baghri, S. and Reed, R.A. (2002)
every effort is made to include as many of their views Emergency Sanitation – Assessment and programme
as possible. In the early stages, the community is design, WEDC, Loughborough University, UK.
usually too tired and confused to contribute to the
proposals, but this stage quickly passes and soon the
community will start to take a lively interest in its
surroundings.
Individual contact
Group meetings are effective at passing on general
information, but there is a possibility that some
sections of the community will not be reached and
these meetings are not appropriate for dealing with
individual problems. For these situations, personal
Page 55
WHO EHA Publications
Publication Published
Publication Title
No. in
1 Draft Emergency Preparedness & Disaster Response Plan for the Heatlh Sector in Nepal May 2001
2 Emergency Preparedness & Disaster Management for Hospitals Feb 2002
3 Emergency Preparedness & Disaster Management for Hospitals (Nepali) Feb 2002
4 Establishing A Mass Casualty Management System Jun 2002
5 Structural Vulnerability Assessment of Hospitals in Kathmandu Valley Aug 2002
6 Health Sector Emergency Preparedness & Disaster Response Plan Nepal Sep 2003
7 Computer-based Mass Casualty Management Simulation Exercises: MUSTER Guidelines Dec 2003
8 Non-Structural Vulnerability Assessment of Hospitals in Nepal Dec 2003
9 Best Public Health Practices in Emergencies for Disaster Health Workers Mar 2004
10 Non-structural Safety in Health Facilities Mar 2004
11 Seismic Vulnerability Assessment of Hospitals Apr 2004
12 Establishing A Mass Casualty Management System (Nepali) Jun 2004
National Seminar on Biological, Chemical, Radiological Emergency Preparedness &

13 Jun 2004
Response (Radioactive)
14 Best Public Health Practices in Emergencies for Disaster Health Workers (Nepali) Sep 2005
15 Public Health District Profiles: Baseline Data through Secondary Sources Dec 2005
16 Mass Casualty Management Trainer's Manuals Jan 2006
17 Non-structural Safety in Health Facilities (Nepali) Mar 2006
18 Health Interventions in Crisis-affected Communities of Nepal Oct 2006
19 Health Action in Crisis in Nepal: WHO CAP Programme Outline Dec 2006
20 Environmental Health in Emergencies: Technical Notes on Water and Sanitation Mar 2007

UN House, P. O. Box 108
Pulchowk, Kathmandu, Nepal

Environmental Health in Emergencies: Technical Notes On Water and Sanitation

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Environmental Health

EHA Publication No. 20

Health and Environment

World Health Organization

55p.; illus (EHA Publication No. 20)

For feedback and further information, please contact:

WHO Environmental Health Unit

© World Health Organization, March 2007

The rationale for the WHO strategy is:

1. Cleaning and disinfecting wells in emergencies 1

2. Cleaning and disinfecting boreholes in emergencies 5

3. Cleaning and disinfecting water storage tanks and tankers 9

4. Rehabilitating small-scale piped water distribution systems 13

5. Emergency treatment of drinking water at point-of-use 17

6. Rehabilitating water treatment works after an emergency 21

7. Solid waste management in emergencies 25

8. Disposal of dead bodies in emergency conditions 29

9. Minimum water quantity needed for domestic use in emergencies 33

10. Essential hygiene messages in post-disaster emergencies 37

11. How to measure chlorine residual in water 40

12. Delivering safe water by tanker 44

13. Emergency sanitation – planning 48

14. Emergency sanitation – technical options 52

World Health Organization

Steps of cleaning and

Step 1: Inventory of existing wells

 Meet with community leaders and ask them to Yes

Step 2: Rehabilitation and cleaning

1. Repair/replacement of the pumping mechanism.

2. Removal of polluted water and debris from well

3. Sealing the top of the well using a clay sanitary

Check turbidity and pH

If the turbidity of the well water is greater than 5NTU

4. Construction of a drainage apron and head wall

5. Relining the well to reduce subsurface

Examining the turbidity of water

Bleach gives off chlorine gas

If you must enter the well either

The level of residual chlorine in mg of chlorine per litre of

Note: A third chamber (C) would be used if a higher chlorine

Testing chlorine levels using a comparator

Step 3: Disinfection of the well

Chlorine has the advantage of being widely available,

The chlorine compound most commonly used is

Table 1. Physico-chemical parameters

Parameter WHO GDWQ Why? Corrective action

pH 6–8 pH of 6.8-7.2 is required to If pH is less than 6 add hydrated

The best type of chlorine in an emergency is HTH as

For every cubic metre (m3) of water in the well add

Do not allow anyone to use the well during the

World Health Organization

Steps of rehabilitation Step 1: Assessment of damage

 Meet with community leaders and ask them to

Figure 1. Steps for cleaning and

A damaged handpump and surround

2. Flush the sediment from the borehole using

Valve (1) open

Removing components of a pump

High pressure water hose 2.5m - 3.5m diameter apron

Compressed air hose

Water table Hardcore

Screen Borehole casing

Meet with community leaders and ask them to Yes

Meet with community leaders and ask them to

Prepare a concentrated chlorine solution to

Pour the solution slowly into the tank, mixing as you

Let the chlorine stand in the tank for 24 hours to

If the tank is required for use urgently double the

Step 1 Number and location of visible breakage points

Step 3 Extent of the affected area? Does it affect multiple

V= π d2L/4 = 3.140.10.1*500/4 = 3.925 m3

Power can be supplied by mobile generators if