CPH Finals

• Public Health in Emergencies and Disaster


  Water, Sanitation and Hygiene (WASH)
• Learning Objectives


  • Show awareness of the public health significance of WASH in emergencies
  • Identify the causes and route of transmission and spread of WASH related diseases
  • Identify prevention strategies in the spread of diseases
  • Identify strategies to promote a safe environment during disaster/calamities and emergencies
• During emergency situations, prompt and efficient environmental sanitation measures must be undertaken to prevent or minimize health hazards.
• Health protection cannot be effective without the creation of a healthful environment.
• A primary concern in disaster management is the provision of


  • emergency sanitation facilities
  • services to prevent and control occurrence of sanitation related diseases
• Common Sanitation-Related Problems During Emergencies


  • disruption and crowding together of people accustomed to living in different less crowded conditions makes adequate sanitation of critical importance
  • facilities to which the evacuees were accustomed are no longer available
  • basic services are often lacking
  • habits may have to be changed
• Common Sanitation-Related Problems During Emergencies


  • indiscriminate disposal of human waste and other waste pose serious threats to the health of individuals, family groups and the community
  • general sanitation activities for the protection of the people are interrupted and alternative measures may differ from those of normal periods
• Common Sanitation-Related Problems During Emergencies


  • provision of safe water
  • proper disposal of human excreta
  • disposal of wastewater and solid waste
  • proliferation of insect and rodents
  • personal hygiene and safe food handling practices
• Flow of Presentation


  • Introduction
  • Principles of environmental health related to emergencies
  • Effects of disasters on environmental health facilities
  • Importance of hygiene promotion, water supply and sanitation
  • Standards and indicators on excreta disposal
  • Solid waste management, wastewater, drainage
  • Summary
• Emergencies and disasters


  • can occur anywhere in the world
  • may be predictable to a certain extent, or unpredictable in many incidents
  • can specifically affect individual human health
  • can impact people's lives, the communities and the infrastructure built to support them
• Principles of Environmental Health Related to Emergencies


  • Emergencies and disasters
  • Environmental health problems (physical, biological, social environment)
  • human health, well-being and survival: shelter, water, sanitation, disease vectors, pollution, etc.
• Effects of Disasters on Environmental Health Facilities


  • Water supply
  • Solid waste handling
  • Food handling
  • Vector control
  • Home sanitation
• Water Supply


  • Damage to civil engineering structure
  • Lack of drinking water
  • Contamination: microbiological, physical or chemical
• Waterborne diseases


  • caused by the ingestion of water contaminated by human or animal feces or urine containing pathogenic bacteria or viruses
  • include cholera, typhoid, amoebic and bacillary dysentery and other diarrheal diseases
• Water-Related Diseases


  • Water-vector borne diseases
  • Water-washed diseases
  • Water-based diseases
• Water-vector borne diseases


  • are diseases transmitted by insects harboring and propagating in water
  • Include dengue, filariasis, malaria, yellow fever, chikungunya, zika virus
• Water-washed diseases


  • Due to lack of water and poor personal hygiene
  • include scabies, trachoma and flea, lice and tick-borne diseases
• Water-based diseases


  • infectious diseases transmitted through an aquatic invertebrate organism
  • include Schistosomiasis, Leptospirosis
• Solid Waste Handling


  • Damage to civil engineering structure
  • Collection and transportation failures
  • Equipment shortages
  • Personnel shortages
  • Water and soil pollution
• Food Handling


  • Shortage of food
  • Spoilage of stored/refrigerated foods
  • Damage to food preparation facilities
  • Transportation failures
  • Power outages
  • Flooding of facilities
  • Contamination
• Vector and Pest Control


  • Proliferation of vector breeding sites
  • Increase in human/vector contacts
  • Disruption of vector-borne disease control program
• Examples of common vectors and the corresponding diseases


  • Anopheles mosquitoes - malaria
  • Aedes mosquitoes - dengue fever
  • Lice - epidemic typhus
• Insects and other arthropods can constitute a major nuisance in disasters
• Vectors and diseases likely to be present in emergency settlements


  • Mosquitoes - Malaria, yellow fever, dengue, viral encephalitis, filariasis
  • Houseflies - Diarrhoea, dysentery, conjunctivitis, typhoid fever, trachoma
  • Cockroaches - Diarrhoea, dysentery, salmonellosis, cholera
  • Lice - Endemic typhus, pediculosis, relapsing fever, trench fever, skin irritation
  • Bedbugs - Severe skin inflammation
  • Triatomid bugs - Chagas' disease
  • Ticks - Rickettsial fever, tularaemia, relapsing fever, viral encephalitis, borreliosis
  • Rodent (mites) - Rickettsial pox, scrub typhus
  • Rodent (fleas) - Bubonic plague, endemic typhus
  • Rodents - Rat bite fever, leptospirosis, salmonellosis, melioidosis
• Home Sanitation


  • Destruction of structures
  • Contamination of water and food
  • Disruption of power, heating fuel, water supply and waste disposal services
  • Overcrowding
• WASH in Emergencies


  It consist of strategies, intervention and concerns related to water supply, sanitation, vector control, waste management and hygiene promotion to minimize morbidities, mortalities, and disabilities in times of emergencies and disasters
• The goal of WASH

  To promote good personal hygiene in order to protect health, improve health conditions, promote dignity of living or enhance the quality of life, and protect the environment
• Hygiene Promotion


  The planned, systematic attempt to enable people to take action to prevent or mitigate water, sanitation and hygiene related diseases
• Aspects to Consider in Hygiene Promotion


  • Shared responsibility
  • Needs assessment
  • Targeting priority hygiene risks and behaviors
  • Reaching out all to sectors of the population
  • Managing facilities
• Public Health Promoters (PHP)


  Focus on helping communities to prevent diseases related to WASH
• Public Health Promotion


  • Distribution of hygiene kits and water kits
  • Communication and information dissemination on things like: Importance of hand washing, how to keep water clean, how to dispose of human waste
  • Training on use and maintenance of latrines
  • Vector control and malaria prevention activities: Fly and mosquito control chemical sprays, Campaign to clean up after animal waste, Destruction of mosquito breeding grounds and ponds, Mosquito net distribution, Education program on vector and mosquito control
• Innovative approach to public health promotion


  • Communicating in different ways to influence behaviour change: Radio and songs, Street theatre, Puppet shows, Interactive text messaging
  • Development of interactive e-learning module on information, education and communication (IEC) in WASH emergencies
• Public Health Significance of Water Supply and Sanitation


  • In most emergencies, provision of a safe and adequate water supply is the most urgent need of the community
  • Occurrence of waterborne and foodborne diseases is usually associated with the absence of lack of potable and safe water
  • In emergencies water is often not available in adequate quantity and quality, thus creating a major health hazard
• Mobilize resources to ensure access to adequate and safe water


  • water quality surveillance
  • disinfection/treatment
  • provision of storage facility
  • development and protection of water supply sources
• Ensure operation and maintenance of water supply facilities including provision of spare parts
• Minimum amount of water needed to survive

  1. 5 liters/person/day
• Reduction in the quantity of water available to individuals


  Directly affects their health
• Average water used for drinking, cooking and personal hygiene in any household

  • at least 15 liters per person per day
• Maximum distance from any household to the nearest water point

  500 meters
• Queuing time at a water source

  no more than 15 minutes