Session 3 2 WASH Cholera AWD EPR training

Session 3. 2 WASH Cholera / AWD EP&R training Key responses – Water treatment and Priorities in Different Settings WASH cholera / AWD EP&R training

Learning Objectives By the end of the session the participants • specify water treatment during a cholera / AWD outbreak • describe basic principles of chlorination, its limitations and advantages • suggest solutions to provision of water for different settings at different stages of cholera / AWD response WASH cholera / AWD EP&R training

IMPORTANT During a cholera outbreak it is advisable to use chlorinated water only for drinking and cooking!!! WASH cholera / AWD EP&R training

Bulk vs. household water treatment • . WASH cholera / AWD EP&R training

Work in pairs Discuss advantages and disadvantages of household and bulk water treatment 10 min WASH cholera / AWD EP&R training

Bulk vs. household treatment + Bulk water treatment • Can supply to large numbers of people • Not useful for dispersed populations • Can control water quality • Water can be contaminated post treatment (at source, during transport and storage) • High Operation & Maintenance • Can provide drinking water quickly inputs • Can monitor changing water needs Household water treatment - • More control by users • Training needed for effective use • More sustainable (if appropriate to • More difficult to supply for large situation) numbers of people • Less risk of contamination post treatment • Good for dispersed populations • Limited control on effective use • Might be difficult to introduce quickly to communities if no prior knowledge WASH cholera / AWD EP&R training

Water Treatment Chlorination Most common water treatment is chlorination because…. . 1. It is easy to use and monitor 2. it is readily available 3. It has a residual effect 4. It is effective against most pathogens WASH cholera / AWD EP&R training

Chlorination Limitation • Chlorination works most effectively with low turbidity <5 NTU (max 20 NTU) • Chlorination will require 30 minutes contact time under the conditions that: – p. H<8 – turbidity <5 NTU – temperature approx 20 o. C • If p. H higher, temp lower, turbidity higher then processes need to be adjusted WASH cholera / AWD EP&R training

Chlorine Source High Test Hypochlorite (HTH ) Granules Sodium Dichloroisocyanurate (Na. DCC) Available Chlorine % 70 Remarks Preferable for high chlorine content & stability. Let the deposit settle & use only supernatant. Strict air transport regulations. 60% powder Preferable for high chlorine content & stability. 1 g tablets Completely soluble. Usually more expensive than HTH. Chlorinated Lime (Bleaching Powder) 30 Let the deposit settle & use only supernatant. Sodium Hypochlorite Concentrate 15 Only use if manufactured very recently (<3 months) and if stored away from heat & light. Sodium Hypochlorite (Bleach) 5 Only use if manufactured very recently (<3 months) and if stored away from heat & light. Antiseptic Solution – e. g. Milton, Javel 1 Keeps for a very short time after being opened WASH cholera / AWD EP&R training

Handling & Storage of Chlorine • Metal consumes chlorine - do not store chlorine solutions in metallic containers • When in contact with air and especially humidity, HTH, chlorinated lime and Na. DCC produce corrosive and toxic chlorine gas heavier than air. Stores should be ventilated at the bottom of the walls. • Both powdered and liquid forms of chlorine reduce in strength over time. Store dry chlorine in sealed containers, away from heat & out of sunlight and keep liquid solutions in dark coloured bottles. • Chlorine in corrosive – handle with care, avoid skin contact and when mixing chlorine solution, wear protective clothes and gloves, protect eyes and do not inhale fumes. In case of contact, rinse thoroughly with water. WASH cholera / AWD EP&R training

Chlorination – important points 1. Training & on-going monitoring – check correct use regularly 2. Care when agencies using different makes - different instructions, package size and strengths 3. Check instructions – they can vary even for same product 4. Turbidity & type of water affects use – test samples & residuals before distribution 5. Work closely with hygiene promotion staff - ensure effective communication (e. g. why used, how used, taste) with users, training and support WASH cholera / AWD EP&R training

Bucket Chlorination Picture MSF WASH cholera / AWD EP&R training

Bucket Chlorination Water is treated with chlorine generating product at water source at each individual water container There are some issues you need to consider……. • Different sizes of water containers need different dose • Requires recruitment, training and close support supervision of “chlorinators” • Could be expensive if there are many water points to cover • Short term solution only • Effective and fast method if properly implemented WASH cholera / AWD EP&R training

Exercise Calculate how much HTH (70%) active chlorine you will need to make 1 litre of 1% solution. WASH cholera / AWD EP&R training

Answer Exercise PREPARATION OF A 1% SOLUTION • 1% chlorine solution contains 10 g of active chlorine per litre • HTH is not 100% active chlorine but 70% Calculation: calcium hypochlorite (HTH) at 70% active chlorine : 10 x (100/70) = 14. 2 g (which is about 14 g / l of solution) WASH cholera / AWD EP&R training

Instructions for group work In your groups discuss what would be your water priorities in this setting during the First two weeks of a cholera / AWD outbreak response After first two weeks up to 2 months Beyond 2 months Time 25 min Make notes on your handouts. Choose who will to present your priorities in plenary WASH cholera / AWD EP&R training 16

Nomadic communities WASH cholera / AWD EP&R training 17

Rural area - spring WASH cholera / AWD EP&R training 18

Peri Urban area WASH cholera / AWD EP&R training 19

Urban formal setting with broken infrastructure WASH cholera / AWD EP&R training 20

Established IDP Camp WASH cholera / AWD EP&R training 21

New IDP camp WASH cholera / AWD EP&R training 22

Rural setting - open wells WASH cholera / AWD EP&R training 23

Urban informal settings WASH cholera / AWD EP&R training 24

Learning Objectives By the end of the session the participants • specify water treatment during a cholera / AWD outbreak • describe basic principles of chlorination, its limitations and advantages • suggest solutions to provision of water for different settings at different stages of cholera / AWD response WASH cholera / AWD EP&R training