Using Water, Sanitation and Hygiene Services to fight COVID-19: Experiences from African countries

Using Water Sanitation and Hygiene Services to Fight Covid-19: Experiences from African Countries

Supporting Member States to respond to Covid-19 crisis

The African Ministers' Council on Water (AMCOW) used the Covid-19 pandemic as an opportunity to highlight the importance of access to Water, Sanitation and Hygiene in Africa.

In working with partners such as the United States Agency for International Development (USAID, the World Bank and the African Development Bank, AMCOW supported specific response and resilience aspects of Covid-19 interventions across Member States.

AMCOW organized a series of webinars and virtual coordination meetings in order to communicate with member states and other stakeholders, share information on various approaches used by the WASH sector to contribute to quick recovery from Covid-19 pandemic, learn from one another and coordinate our efforts as a continent. The first webinar: Improving Hygiene Services, the Foundation for Strengthening Public Health highlighted the critical role of hygiene in eliminating diseases such as the novel Coronavirus. The webinar also provided the platform for participants to learn the various interventions that African countries are implementing to curb the spread of the virus. The webinar featured four presenters with a wealth of experience from the WASH sector and around 300 participants from 57 countries.

AMCOW also developed its inaugural newsletter called: The Calabash. Coming off the press during the advent of the Coronavirus pandemic, the first issue focused on sharing experiences from African countries in fighting Covid-19 using Water, Sanitation and Hygiene services. The newsletter reached over 5,700 people globally.

 
Africa WASH sector in the context of COVID-19 pandemic and other public health emergencies

According to the African Union’s Africa CDC, at the end of October 2020 and about 8 months after the first cases of Covid-19 was reported in Africa, the continent had over 1.8 million cases. Of these, over 1.2 million had recovered and over 40,000 had died. The implication of this is huge and far-reaching.

COVID-19 implications on the continent

The pandemic has deepened poverty and widened inequalities across the region. One of the immediate impacts of the pandemic was on the African economy. Analysts say that compared to pre-Covid-19 forecasts, the continent’s economy will be between US$ 349 billion – US$ 643 billion smaller by 2030. Other forecasts show that the GDP per capita will only return to the 2019 level in 2024 or at worse 2030. In addition, and compared to the pre-Covid-19 forecasts, additional 14 million Africans will be extremely poor in 2020. By 2030 at the end of the SDGs period, an additional 38–70 million more people will be classified as extremely poor. This will raise the poverty rate of the continent’s population from 35 to 37 %.

It is also expected that, due to the significant reduction in government revenue and health expenditure, more people will have died from the impact of this reduction than from Covid-19 by 2030. Ultimately, Africa will be further constrained in its efforts to attain the 2030 SDGs. It is therefore, very important to focus more attention on WASH which in itself is key to prevention and management of the pandemic.

The International Monetary Fund (IMF) has projected that Africa will need about US$ 114 billion in the year 2020 to manage the virus.

The role of WASH in prevention

It is important to underscore the importance of WASH in the prevention of Covid-19 and post Covid-19 recovery. We are all aware of the importance of hand hygiene in the prevention of the pandemic: washing of hands with soap and water or using alcohol-based hand sanitizers are also very important in limiting the spread of the virus and in protecting ourselves and our neighbors from contamination. As a result, there is an increased water demand at household and a higher pressure on water utilities across our countries. We have compiled case studies from countries on how their WASH sector strived to ensure access to water services even to disadvantaged neighborhoods and communities.

 Highlights of innovations in WASH to respond to Covid-19

Countries have made several policy decisions to manage coordination, information flow and to strengthen the capacity for WASH service delivery. Notable among these is the establishment of the National Command Centre (comprising the ministry in charge of WASH, water service institutions, and local governments) which coordinates interventions, identifies water services “hotspots” and procurement, delivery and installation in the identified areas, with support from the states, provinces and regions.

In other cases, there is the strengthening of the partnership with critical non-state actors, especially the private sector. This is necessary to strengthen resource mobilization towards plugging the financing gaps that are widespread in the response strategy. Other cases involve the establishment of a WASH/IPC (Infection Prevention Control). WASH is a core component of quality improvement in health care and patient safety programs. The IPC is the prevention of health care associated infections. IPC is key to health and patient safety programs. The principles of WASH/IPC include hand hygiene, personal protective equipment, cleaning and disinfection of waste management and environmental hygiene. Adopting the WASH/IPC principles is very important in managing Covid-19.

Recommendations on the way forward

Based on what the African Ministers' Council on Water (AMCOW) is doing with member states and according to AMCOW’s strategy, we hereby recommend a two-step approach towards managing Covid-19 that we believe will improve the response to Covid-19 pandemic and contribute to creating resilience to other public health emergencies.

In the first phase, ensure effective management of the present pandemic through the establishment of a coordination platform for the emergency response related to WASH. There will improve communication and strengthen knowledge sharing on emergency responses related to WASH. Finally, the documentation and sharing of lessons learnt in the present and past pandemics will go a long way in sparing countries to reinvent the wheel and enable them to save time and hence save lives.

In the second phase, build preparedness, resilience, and mitigation to public health emergencies through developing appropriate policies, strategies and plans. The enabling environment is a prerequisite key to unlock the necessary institutional arrangement, institutional capacity including required funding. The African Sanitation Policy Guidelines (ASPG), whose development is spearheaded by AMCOW is recommended to help countries update their sanitation and hygiene policies and position the WASH sector as a crucial player in building countries’ resilience to public health emergencies and their socio-economic effects.

 

Angola: A strong alliance against COVID-19

As at 6th November 2020, Angola had recorded a total of 11,813 Covid-19 cases with 296 deaths according to the Ministry of Energy and Water and World Health organization.

The country confirmed its first two COVID-19 cases on the 21st of March 2020. Since then, authorities have taken prompt actions to tackle the challenges arising from the pandemic. With a contingency plan installed, the country has introduced a range of preventive measures across all governance levels.

The water sector alliance for change

The water sector in Angola is considered a significant alliance in the fight against the pandemic. With several actions which started in March to control and possibly curb the situation, Angolans have leveraged on a National Plan, in partnership with the provincial governments and municipal administrations of the provincial water companies. They have demonstrated a series of actions for change, raised awareness, mobilized means including water tanks, trucks, cisterns, aided by contractors.

State Secretary visits water supply infrastructure

 

Municipal administrations receive motorcycles tankers

 

Some of the initiatives put in place to contain the pandemic include the government guaranteed fueling for trucks and cisterns provided by water companies to freely distribute water, mobile truck drivers distributing water who are paid more than 50% of the usual value traded by the water companies, repairs and improvement of water distribution channels to expand customer services through piped water.

At the national level an average of 167 tank trucks and 218 motorized tank trucks have been deployed. Where there are no trucks or cisterns, fountains with free water have been set up. In addition, contractors have been asked to quickly adhere to a call to have projects that are at an advanced state of execution to provide water to people with minimum conditions of access.

For more information, please visit: https://www.minea.gv.ao/

 

Egypt’s response and interventions in combating Covid-19 Pandemic and its effects: The case of Holding Company for Water and Wastewater

As at 6th November 2020, the Covid-19 status in Egypt had confirmed cases totaling 108,530 and 6,329 deaths according to the World Health Organization.

Best practices adopted

Egypt has taken serious and proactive steps in dealing with Covid-19 pandemic with efforts being integrated from all over the government agencies and civil society organizations. The Egyptian holding company for water and wastewater has taken several steps to improve the water and sanitation situation in the wake of the pandemic. As a new regulatory measure, all water used within communities should have a residual concentration of free chlorine of ≥ 0.5 mg/l after at least 30 min contact time, while storage containers must be regularly cleaned. The rural communities which do not have sewered sanitation services must have any broken or cracked water pipes repaired immediately, and further, disinfecting the pipeline before pumping water to customers must be done.

Further, any new tanks, water valve chambers and all drinking water components inside or outside any water treatment plant must be at a safe distance from any potential sewage contamination and must be disinfected before being commissioned.

For communities supplied by trucks or with ground tanks, the water must achieve the proper residual chlorine at the end user. Also, customer awareness about the importance of keeping tanks clean. Microbiology laboratories must undertake safety precautions, while chemists and technicians must wear personal protective equipment. A disinfection campaign for streets and public service sites has been done by trucks.

Following the instruction to early detect any infections by employees across public and private sector, measures such as body temperature measurement, monitoring of dry cough occurrence and breathing difficulties have been heightened. As a precaution, new disinfection cabins have been designed and distributed at the entrances of the Holding Company for Water and Wastewater (HCWW) and affiliated company sites. 

The country is also manufacturing ethyl alcohol at 70% at its central laboratory and has made this available to the general public. To further enhance safety for employees, the companies and government agencies have cancelled all fingerprint recording for employee attendance. An employee reduction plan has been applied in many of the duty stations that are highly populated with high populations while a provision of gloves, masks and disinfectants for the employees is being undertaken.

For female employees with children less than 12 years, a special vacation has been granted till the crisis ends or recedes, and employees with chronic diseases, the elderly, and pregnant women have also been granted a special vacation. Awareness posters and conferences have been held to increase people’s consciousness and awareness on Covid-19 virus and how to deal with the pandemic while workers in plants must now wear appropriate personal protective equipment (PPE) which include protective outer wear, gloves, boots, goggles, and masks.

 

Lessons learnt

Equitable access to water and sanitation related activities can support governments to be prepared and respond to pandemics such as Covid-19 by further considering those left behind in access to water and sanitation. In the same breath, a radical increase in water and sanitation investment is required to meet development targets.

Increase in reported cases in informal settlements and slums has exposed the importance of adequately managed water and sanitation systems for addressing the Covid-19 pandemic or a similar situation. In this case, expanding the private sector and stakeholders’ role in water and sanitation investments is a crucial issue for system reinforcement and optimization.

Updating and monitoring the progress of the national water and sanitation management policies, regulatory frameworks and programs, in addition to preparing national strategies and action plans for achieving SDG6; adopting innovative mechanisms to manage demand and improve efficiency in the production, supply and utilization of water in all sectors are needed.

Promoting national and regional cooperation, especially in Africa by sharing the available knowledge about the novel coronavirus and proposed solutions which can confine its spreading and control the situation is an urgent need. For instance, untreated wastewater presents an environmental problem which must be overcome.

Implementing appropriate communications systems, hardware and software, as well as providing support and training services, is essential. Digital transformation is a key element in fighting the current pandemic; reliable and secure enough to facilitate smooth communication between decision makers and operational/administrative staff, through information management systems. In this regard, identifying high-risk spatial clusters based on overcrowding and high habitat density, water and sanitation deficits, lack of health facilities or health data, vulnerable groups (homeless, migrants, people with disabilities) and collective sites (nursing homes, transit places, schools) must also be addressed.

The preparation of work environment that facilitates all decision-making processes, information exchange, and indicator monitoring and remote assistance to project teams during any unexpected crisis needs to be beefed. It will be necessary to allocate greater financial resources to the renewal of infrastructure and the optimization of the services provided, strengthening both the use of water resources – which are increasingly scarce – and the use of treated water for environmental and other human-related purposes.

Challenges

Challenges abound in addressing the issues affecting WASH intervention in a Covid-19 pandemic reality. These challenges include making access to drinking water services to about 1.3 million people in rural areas and slums and constructing a managed sanitation system for about 40.6 million people.

Implementation of digital transformation system for the entire water and sanitation sector and provision of the required training remain a challenge, and so is the elimination of water resources pollution which increases water treatment costs.

Lastly, governments, regional institutions, the private sector, scientific community, and civil society, contributing to the development of knowledge and proactively promoting the uptake of innovation by bridging the gap between academic science and practice, policy and implementation needs to be appreciated It is important to also note that adequate and equitable access to water and sanitation makes a critical contribution to Africa’s progress towards sustainable development.

Support is needed

There is a need to share countries’ experience in tackling the novel coronavirus, in addition to allowing knowledge exchange between the countries, organizations, scientists and specialized platforms in responding to administering the current pandemic. Financing is also needed to develop safe and clean drinking water projects to the tune of about USD 7.15 billion. Finally, technical support is needed to enable the construction of sanitation service projects worth USD300 billion.

Looking into the future

As a solution to the identified bottlenecks, there is need to fund and establish projects on water supply as well as wastewater treatment systems within rural areas.

Stakeholders involved must work together to close the gap in infrastructure deficit and at the same time ensure coordination and surveillance by identifying and targeting hotspots for rapid and effective response. Emergency services like water supply by trucks and sewerage conveyance need to be provided and extended to reach rural communities, slums and informal settlements.

There is a need to improve the governance and policy framework needed to develop an inclusive and effective response to possible future epidemics by ensuring complete water sanitation services access and developing action plans to address inequities.

Water and wastewater company in Matrouh Governorate and disinfection for streets.

 

For more information, please visit:  https://covid19.who.int/region/emro/country/eg

 

Ethiopia: Water, Sanitation, and Hygiene (WASH) and Infection Prevention and Control (IPC): COVID-19 response

As of 6th November 2020, the total number confirmed Covid-19 cases in Ethiopia was 97,881 with 1,503 deaths according to the World Health Organization and the Federal Ministry of Health (FMoH). After the announcement of the first Covid-19 case in Wuhan, China, the FMoH and Ethiopian Public Health Institute (EPHI) activated the Emergency Operating Center (EOC) in January 2020. 

Challenges

The centre started intensified multidimensional response by establishing an incident management system with an incident manager, deputy incident manager and 12 different sections leading the preventive, case management and administrative interventions.

The WASH- IPC section is one of the major sections with a chief head and eight members with activities done under the WASH-IPC responses including gap identification, stakeholder mapping and resource mobilization. The section has developed standardized WASH-IPC assessment tools and shared with regional counterparts. An assessment and gap identification have been made in Covid-19 centers (quarantine, isolation and treatment centers) nationally with the identified gaps being shortage of water supply and non-functional toilets, shower and hand washing facilities.

Others include a shortage of cleaning materials such as soap and detergents, shortage of sanitary materials such as soap and sanitizers, lack or shortage of waste bins, inadequate cleaners and poor waste disposal systems.

Intervention

In mapping stakeholders, plan alignment has been done with the Ministry of Water and WASH development partners with resources being mobilized and distributed based on the identified gaps.

On WASH interventions in Covid-19 centers such as quarantine, isolation and treatment, interventions have been made and mobilized resources distributed, based on the identified gaps.

 Other measures are installation of water tankers and pumps, water tracking with 29 water trucks being deployed in different sites to address areas with water shortage, designing and installation of handwashing facilities which don’t need human contact at entrances and critical points of the Covid-19 centres.

Maintenance of toilets, hand washing facilities and bathrooms has been undertaken with different sanitary materials; buckets, laundry soap, body soap, drum chlorine powder, and sanitizers being mobilized and distributed. Additionally, colour-coded bins with biohazard

bags have been availed at critical points in the centres with pits for waste disposal being dug and incinerators being constructed.

Regular water quality assessment in quarantine and treatment centres and based on finding remedial actions are being taken with WASH-IPC orientations and training being provided to cleaners, food handlers and other support staffs. Daily monitoring of the WASH-IPC status and practice is being conducted with a standard checklist.

The intervention is also preparing and distributing relevant documents such as WASH-IPC guides, and SOPs, with protocols for Covid-19 having been developed and distributed nationally. There has been several of those documents including IPC interim guide for COVID-19, rational use of PPE: 1st and 2nd versions, cleaning and disinfection: 1st and 2nd version, WASH guidelines, mask and glove use SOP, IPC in quarantines, Triage protocol, design, engineering and environmental control, health care workers protection, dead body management for HFs, protocol for death management during Covid-19 epidemic, home care and IPC, ambulance transport and patient transferring, and re-use and re-processing PPE. These documents have been translated into local languages and distributed to all regions.

The capacity of 12 regional states has been strengthened to establish similar WASH-IPC section under their EOC. Additionally, WASH-IPC standard training material for COVID-19 has been developed while WASH-IPC ToT has been provided in all regions.

Regions have been supported to cascade the basic WASH-IPC training to all levels with different health professionals being deployed on a contract basis to manage the response for COVID-19 at the national and regional level. To further beef up the intervention, environmental health professionals have been recruited and deployed to COVID-19 centres to daily monitor the status and implementation.

In the area of WASH- IPC in non-Covid-19 Health Care Facilities, standardized assessment checklist has been developed and shared with regions while regular monitoring of the WASH-IPC implementation status has been conducted starting from the gates to the triage sites.

Under WASH-IPC in institutions with vulnerable groups, WASH standards for detention centres and confined settings have been developed and distributed for regional EOC’s for implementation. Additionally, WASH assessment has been done and the response is given for nursing home centres, prisons, detention centres, orphanage centres and GBV survivor shelters based on assessment findings. WASH-IPC materials and supplies have been mobilized and distributed for federal prisons and police departments and offices from partners and CSOs while ToT training and orientation on WASH-IPC has been given for police officers and health care professionals in confined settings including detention centres.

In Community WASH-IPC intervention, community assessment has been made to identify major gaps and challenges with community volunteers trained in community WASH and IPC measures and deployed with mobile vans. Further, religious leaders have been oriented to take part in messaging with handwashing facilities having been installed in public places, markets and slum areas. Locally made masks and sanitizers have been produced at national and regional levels according to national standards and distributed with target audience-oriented risk communication messages being developed and transmitted through mass and social media.

Through a partnership with Ethiopian telecom, important messages on Covid-19 have been delivered as a ring tone with community awareness on hygiene promotion being regularly delivered through celebrities. Lastly, training has been given to health extension workers and they have been providing house to house awareness creation on hand hygiene and other preventive measures.

To support and monitor WASH-IPC in other sectors, sector-specific WASH-IPC SOPs have been developed and distributed to those sectors such as businesses, transport, prisons, food handling, hotels and restaurants, workplace, schools, sports institutions, detention centres, homeless and confinements while the development of criteria for schools as part of the school reopening program.

 

Under monitoring, evaluation and learning, Key Performance Indicators (KPIs) have been identified and reports have been collected from regions based on the KPIs. Regular virtual meetings have been conducted with regional WASH-IPC counterparts and relevant partners with reports being documented and filled with pictures, graphs, and tables. An inter-action review of the response was made in July with external facilitators to identify best practices and gaps throughout the response, identify the enablers and disablers and design strategy for better performance.

Support is needed

To support an acceleration of the current effort or progress currently being made by the government, additional WASH materials to address the gaps around borders, slum areas and vulnerable groups is needed. Additional financial and technical support to build the capacity of the health professionals at all levels on WASH-IPC is required while additional financial support to avail sanitary materials to all health facilities, vulnerable groups and pro-poor societies is of utmost need.

Looking into the future

Plans are underway to link the results to potential implications for WASH policy review or development and practice, including future opportunities. The WASH-IPC response for the Covid-19 could be an eye-opener for government officials and managers at all levels to practically see the importance of investing in WASH to prevent and control communicable diseases. It is also a good opportunity to mainstream the concept of WASH services in all sectors to improve WASH services to the set standards. Additionally, it is a good opportunity to flag hand hygiene as a priority area to focus on and to work on ensuring sustainable behaviour change of the community on hand hygiene.

 An assessment has been done at the household and institution level to assess available handwashing facilities and handwashing practices to see if they are up to the required standards in infection prevention and proper wastewater management. Based on the findings, a national protocol on handwashing facility and practice is underway.

A plan has been prepared to develop a national strategy on ensuring sustainable hand hygiene practice. It has opened the way to focus on improving WASH services for vulnerable groups including police officers, nursing homes, orphanages and GBV survivor shelters.

It is an opportunity to prove WASH and IPC are interdependent and inseparable. A discussion to merge WASH-IPC under one department is underway. It also provided an opportunity to see the importance of WASH services in health facilities including the waste management system. In the planning of schools re-opening, the first intervention planned was ensuring adequate and functional WASH facilities are available. Lastly, it created an opportunity for different stakeholders to conduct assessment and research on WASH-IPC in different areas.

For more information, please visit: http://www.moh.gov.et/ejcc/ and https://covid19.who.int/region/afro/country/et

 

Malawi WASH Cluster COVID-19 interventions: Pooling together resources, and maximizing utilization

As at 6th November 2020, the Covid-19 situation in Malawi had 5,940 confirmed cases and 184 deaths according to the country’s ministry of health.

In responding to the pandemic, the Government established a Water, Sanitation and Hygiene (WASH) intervention for combating COVID-19 spearhead by the WASH Cluster with the Department of Water Development leading while and UNICEF co-leading. The response initiatives are being implemented by the Malawi Government, development partners such as the World Bank, UNICEF, the United States Agency for International Development (USAID) and Japanese International Development Agency (JICA) including NGOs like United Purpose, WaterAid, World Vision, Habitat for Humanity,Heart to Heart Foundation, Water Missions International, World Relief, Catholic Relief Services (CRS) and Malawi Red Cross Society among others.

The WASH cluster is set up to pool resources together, maximize their utilization and develop a response plan that focuses on the installation of water systems and provision of sanitation facilities at Emergency Treatment Units, border crossings, and screening centres. The plan ensures the rehabilitation and minor repair of boreholes and water supply schemes in the hot-spot areas while also intensifying water quality monitoring and surveillance and supporting rural water users’ associations.

It supports water boards in service continuity and mobilization of funds and supports WASH assessments in schools and health care facilities in collaboration with the health and education clusters. The cluster ensures that procurement and provision of WASH supplies, hand washing facilities and materials across the country is done while facilitating the training of health care workers, volunteers, and local leaders on Covid-19 preventive measures as well as providing personal protection equipment and disseminating messages on Covid-19 and hygiene practices.

In addition, the Government of Malawi through the Ministry of Health released the guidelines which are to be followed in combating Covid-19. In this effort, the WASH cluster has supported adherence to guidelines by the population and implementing partners. The national WASH cluster plan of US$21 million has so far mobilized some US$7.6 million while districts, partners, the government and donors are working to increase the effort.

Challenges

The WASH cluster has managed to achieve a lot in its emergency response and preparedness despite a myriad of challenges. For example, resource mobilization for the hardware component of WASH to allow for “building back better” is an outstanding bottleneck while only a few partners have the capacity to install permanent water and sanitation schemes. Currently only a third of the total WASH cluster budget is funded.

Hiking of prices by suppliers taking advantage of Covid-19 has reduced the level of interventions by partners with limited stocks in the market causing delays in the implementation of activities. It has been difficult for rural and urban service providers to maintain a high quality of water and sanitation services as a result of the drastic decrease in revenues.

Results

So far, the WASH cluster has mobilized financial resources including for 5 water boards to ensure service continuity to the tune of USD 2.5million and supporting the prioritization of activities. The cluster has supported over 5,000 returnees with WASH services and supplies with hygiene promotion efforts reaching over 7million people through the radios, door to door messaging, mobile vans and posters and IEC materials on the importance of proper handwashing and general hygiene practices. Assessments and installation of solar water schemes and sanitation facilities in 12 ETUs have been undertaken with identification of cluster partners to support decentralized coordination in 26 of the 28 districts having been done.

Lessons learnt

The importance of partners’ flexibility and realignment of priorities/reprogramming, collaboration with other partners and general coordination cannot be underestimated. It is important to have data available for quick action, mobilization of partners and resources, and overall advocacy for the WASH sector. There is a need to intensify the use of the mass media to reach more people with Covid-19 messages and to adapt to new ways of hygiene promotion. In the same vein, it is difficult to enforce social distancing for hot-spot communities as they have other pressing economic matters, hence the need for the WASH cluster to engage local leaders, volunteers, and the community at large. Covid-19 should be looked at as an opportunity to intensify handwashing behaviour at all levels.

Support is needed

The main hindrance in WASH intervention in a Covid-19 reality is lack of adequate financial resources for “building back better” and providing resilient WASH schemes. In addition, to provide such systems, there is a need for support with data, quick assessments, and advocacy processes.

Looking into the future

To help the fight against Covid-19 the WASH cluster is strengthening its coordination mechanisms at national and district level, at inter-cluster coordination platforms, as well as increasing its advocacy and communication. There is an ongoing collaboration with health, protection, and education on schools WASH and health care facilities through technical support, assessments, and planning. The WASH sector is facing structural challenges which should be addressed in the medium to long term period.

For more information, please visit: https://covid19.health.gov.mw/

 

Senegal: Access to safe water as a strategic priority

The policy on access to drinking water and sanitation in Senegal has become a de facto strategic priority with quality and sustainable services in support of an effective response. This is confirmed by the SDG vision which attests to the fact that the achievement of the SDG 6 will imply a range of positive impacts on other SDGs.

The first case of Covid-19 in Senegal was confirmed on March 2, 2020 in Dakar and as at 6th November 2020, some 15,640 cases had been reported with 326 deaths according to the Ministry of Health and Social Action.

Challenges

With a population of 15,400,000 inhabitants, access to water in the country is estimated at 98.8% and 91.8% in urban and rural areas respectively. However, the state of sanitation accounts for 67.4% and 42.3% for urban and rural areas, respectively. In addition, it is worth mentioning that most of the Senegalese population (<80%) use on-site sanitation (latrines, cesspools, etc.). It is even more significant that these latest sanitation infrastructure systems are currently used in hospitals and health care centers across the country.

Intervention

Health authorities insist on proper mask wear, hand hygiene and respect of social distancing. In addition to these precautions, the Government has taken several measures including implementation of free consumption measures of water for two months in urban areas, payment of water bills for households in rural areas, additional credits for clearing debts contracted within companies implementation of the Community Led Total Sanitation, an emergency plan to mobilize additional water production of 47,000M3 per day internally in urban areas, and a collaboration protocol for the implementation proposed by a team of professional experts and researchers in sanitation is under operation by a laboratory which is specialized in water analysis.

Identification of SARS-COVID-19 in wastewater and faecal sludge in Dakar: challenges and perspectives in the context of managing the spread of Covid-19 in Senegal.

Senegal like other African countries is affected by the Covid-19 pandemic. The spread of the virus is very quick due to non-compliance with safety measures. To reduce this spread, the Senegalese authorities have organized several coordination meetings with stakeholders in the water and sanitation sector.

Recommendations have been reviewed in accordance with the technical aspects and acceptable sanitary standards. Further, other activities have been conducted including awareness-raising activities in rural areas on safety measures such as hand washing, good practice of using the toilet, mobilization of WASH sector agents in national and regional epidemic management committees, the launch of Pre-Winter Operations and the emergency response program which includes mobile contactless hand washing devices, support for the installation, rehabilitation and maintenance of toilets in markets and schools, and increased investments in hydraulic and sanitation facilities.

For more information, please visit: http://www.sante.gouv.sn/

 

South Africa: Helping poor and low-income urban communities to contain Covid-19

Despite South Africa's efforts to achieve the Sustainable Development Goals relating to water and sanitation, the recent drought and Covid-19 outbreak highlighted a need to improve the water and sanitation sectors' services to poor and low-income communities. This understanding has given birth to emergency interventions activated to enable and accelerate adherence to hygienic protocols in those areas.

A Presidential action

South Africa's first case of Covid-19 was confirmed on March 5 by the National Institute for Communicable Diseases, as announced by the Minister of Health, Dr. Zweli Mkhize. By 6th November 2020, confirmed cases was up to 730,548 with 19,585 according to the Ministry of Health.

Responding to the shock, in March 2020, South African President Cyril Ramaphosa, declared a National State of Disaster as mandated by the National Disaster Management Act, 2002 to implement measures to curb the spread of the pandemic. These included awareness on social distancing, frequent handwashing, use of sanitizers, mandatory wearing of face masks and other measures. These were however challenging to the low-income urban communities and the far-flung rural areas who are without reliable water and sanitation services and therefore, required emergency support.

The short-term and long-term interventions

As short-term measures, the Department of Water and Sanitation's Covid-19 response commenced with the establishment of the national command centre. The centre coordinated interventions, identified water services "hotspots" and procured about 20,000 water storage tanks for delivery and installation in the identified areas, supported by the various provinces.

The on-going Covid-19 water services emergency intervention provided water storage tanks through the support of the water tanker-service to fill the tanks. The country has now embarked on the implementation of phase 2 of the Covid-19 interventions aimed at ensuring the costly initial emergency interventions' sustainability by linking the installed water tanks to the nearest local (ground) water source or water supply system.

As a long-term intervention, the department compiled the National Water and Sanitation Master Plan, which includes developing water service infrastructure up to 2030 and beyond in alignment with the Sustainable Development Goal 6. The department further made a provision in its annual budgets to establish water service infrastructure to support local government's water and sanitation service delivery programs.

For more information, please visit: https://sacoronavirus.co.za/

 

Uganda: WASH household clustering to tackle COVID-19

As at 6th November 2020, the Ugandan Ministry of health reported a cumulative 13 568 confirmed Covid-19 cases with 117 deaths.

The Ministry of Health in March 2020 established a Covid-19 Incident Management Team (IMT) comprising several committees, including the WASH sub-committee, and which was tasked with providing technical guidance and supervision on the Covid-19 pandemic under the leadership of the Commissioner for Environmental Health.

This coordination mechanism has helped in the fight against the virus. A good example is the households clustering approach on sanitation and hygiene, designed to mitigate the widespread of the virus, and which has proven to be very effective as it aligns with the government’s guidelines on social distancing and stay-at-home measures.

At the community level, households were clustered into ten units with each community leader assigned to each cluster to demonstrate hand washing best practices and transform them into a clean homestead and appropriate standard construction as well as use of sanitation facilities locally. Each cluster in a village is headed by a member from the local sanitation committee, which comprises of community leaders and Village Health Teams. As a next effect, sanitation and hygiene behaviour at the community level across 48 districts, especially in rural and semi-urban settings.

Lessons learnt and Way Forward

The cluster approach structure has proved to be very useful in responding to the Covid-19 pandemic, with activities such as community-based surveillance, contact tracing and sensitization. Further, with the high birth rates and increased unplanned settlement systems, the cluster approach will be useful in managing the distribution of supplies and services in Covid-19 national and community support. Local materials have been judiciously utilized in rural communities thereby reducing the costs of acquiring hygiene and sanitation facilities. A household-level approach involving the cluster system now serves as one of the best practice interventions against the virus. These best practices in hand washing and standard construction and use of sanitation facilities are promoting self-enforcement of Covid-19 response among village members, while the utilization of Village Health Teams ensures maintenance of standard scientific application of measures among the illiterate for sustainability in Ugandan societies.

As many communities across the country experienced flooding for almost half of the year, there was an increase in water tables while the soils got weak, resulting in a collapse of sanitation facilities. Availability of WASH services is important in responding to the spread of Covid-19. However, with the different status of healthcare services in the country, some facilities lack appropriate WASH infrastructure that is necessary to strengthen the effectiveness of healthcare workers in prevention and control.

The establishment of the WASH sub-committee has directed and strengthened the quality of the WASH Covid-19 response. We are therefore optimistic that a sustained public dialogue on “what’’, “where’’, “when”, “why” and “how” particular measures should be implemented will reduce the spread of the infection, in addition to the measures being deployed by the government. This will however require that human resource capacity in districts and villages is strengthened, and those key sanitation performance indicators form part of the national priorities to ensure the sustainability of these interventions. Ultimately, more funding in the WASH sector will go a long way in preventing hygiene and sanitation-related diseases.

For more information: https://covid19.gou.go.ug/statistics.html https://covid19.gou.go.ug/statistics.html