1. Introduction

Water and sanitation are basic human needs and rights. During and after emergencies, people are at great risk of contracting infectious diseases. Inadequate sanitation, poor hygiene practice and lack of access to safe water can lead to outbreak of disease. Even when there is no emergency, lack of access to safe water and sanitation is the world’s single largest cause of illness (UNICEF web, 2006, http://www.unicef.org/wash/index_31600.html). During protracted conflict, simple diarrhoeal diseases can kill more people than the fighting itself (WASH Cluster Hygiene Promotion Briefing Paper, 2007).

Provision of WASH is also fundamental to maintaining the dignity of displaced people, particularly women, through providing secure bathing spaces, hygiene supplies and private sanitation facilities.

This makes WASH is a critical intervention in any emergency. CARE’s Emergency Strategy aims for CARE to be a recognised leader in water, sanitation and hygiene response. CARE is an active participant in the Global WASH cluster led by UNICEF, and adopts approaches and standards set by the cluster (see section 3.1). CARE—like other WASH cluster agencies—is guided by the Sphere standards in all WASH programmes and makes every effort to achieve them (see Annex 8.1.1, Sphere handbook, 2011).

WASH in emergencies normally includes a range of interventions, from providing safe water through water trucking, on-site water treatment and distribution, or household water treatment and storage; to construction of latrines and bathing spaces, as well as hygiene promotion through trained volunteers and distribution of essential hygiene supplies. Provision of water and sanitation facilities, or hygiene kits, alone is not enough—if people lack knowledge or understanding of how to prevent water- and sanitation-related disease, then disease outbreak is likely to occur. Wherever possible, emergency interventions should aim to build longer-term sustainable solutions together with the community.

According to Sphere (2011) the main objective of WASH programmes in disasters is to reduce the transmis­sion of faeco-oral diseases and exposure to disease-bearing vectors through the promotion of:


  • good hygiene practices
  • provision of safe drinking water
  • reduction of environmental health risks
  • conditions that allow people to live with good health, dignity, comfort and security.


The type of WASH intervention needed will depend on the scale of emergency, level and nature of displacement, existing conditions, and resources available to be assessed through a rapid assessment and subsequent detailed WASH assessment (see section 3 for factors to consider in assessment).


Many factors need to be considered in combination in a WASH response.


For example, for water supply, general consumption should be planned alongside water for personal hygiene, cooking and other domestic uses. This requires adequate source, distribution and storage facilities. Often, treatment will be required to achieve acceptable water quality, and disinfection can be necessary to maintain stored water in a safe condition. All components of the water supply—from source to consumer—need to be protected from contamination. Water supply systems should be monitored routinely to ensure that the quality of the water supply is fit for use.


Sanitation measures that need urgent attention include the safe disposal of excreta, provision of adequate drainage (including drainage of waste water from cooking and washing), the safe disposal of solid waste, provision of bathing spaces, and the control of insects and rodents. Adequate disposal of human faeces is critical in any emergency situation, and lack of sanitation can lead to the transmission of faeco-oral diseases, as well as contaminate water sites and provide breeding grounds for vectors that may carry infection.


To protect the health of people, effective water and sanitation programmes must be combined with the promotion of good personal and environmental hygiene. Studies show that hygiene practices—such as hand washing with soap, and safe water storage in the home—are just as important as water supply and sanitation when reducing overall disease risk.

Contribution of WASH interventions to reduction of diarrhoeal disease

Hygiene promotion should utilise people’s existing knowledge, practices and resources, supported by sound health promotion techniques and material assistance such as soap and hygiene kits. Effective hygiene promotion is based on dialogue and partnership with affected communities. As women and girls are frequently responsible for WASH at the household level, an understanding of gender dynamics and traditional roles is necessary for a successful program. Hygiene promotion also involves ensuring that optimal use is made of water, sanitation and hygiene facilities that are provided. Experience has shown that facilities are not used in the most effective and sustainable manner unless hygiene promotion is carried out.


See also Annex 24.1.2 CARE WASH in Emergencies Cheat Sheet: What you need to know about WASH in Emergencies.