WASH and Ebola

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Safe drinking water, sanitation, and hygiene (WASH) are essential for Ebola patient treatment and preventing the transmission of Ebola (and other infectious diseases) in health care facilities, treatment centers, households, and communities. Long-term, sustainable public health and WASH infrastructure and education are key to prepare communities, particularly in West Africa, and prevent future outbreaks of Ebola and other diseases.

WASH for Ebola Prevention and Treatment

  • Diligent hygiene practices including handwashing are essential at households, health care centers, and Ebola Care Centers (ECCs) to prevent the spread of Ebola.[1]
  • WASH infrastructure at ECCs is crucial to ensure the disease is not spread between patients and to protect health care workers.[2] This includes:
    • Water treatment, storage, and distribution
    • Adequate water supply for washing and drinking
    • Handwashing facilities
    • Latrines and showers with gender separation
    • Fecal waste management and disinfection
    • Disinfection of clinical equipment, human waste, dead bodies, bedding, and health personnel
    • Protected pits for liquid waste (vomit, urine, and diarrhea)
    • Public education campaigns effectively dispel myths and educate the general population on safe hygiene practices and Ebola prevention. Increases in this knowledge can mitigate Ebola transmission. According to a recent study in Sierra Leone, the most trusted sources of information are health professionals and the government and the preferred means to receive messages is via the radio.[3] Therefore, accurate and persuasive hygiene messages via these channels are important to stop the spread of Ebola.
    • Diarrhea is common among Ebola patients, which enforces the need to focus on human waste management, disposal, and treatment.
    • According to Bryan Lewis, a computational epidemiologist from Virginia Tech, in cities without adequate sanitation “a person is more likely to come in contact with infected effluents than in rural areas where houses are further apart. More concrete surfaces might actually make things worse – causing sewage to run down the street and pool between buildings – making ‘effective contact’ more likely”.[4] Therefore, addressing WASH infrastructure and improving hygiene facilities and behavior is imperative.

 Why Increase Funding for WASH?

  • In low resource settings where the health systems are poor, WASH facilities and infrastructure do not exist or are insufficient to deal with disease outbreaks such as Ebola or Cholera.
  • Specific funding for WASH ensures developing countries have the capacity for the hygiene education; handwashing facilities and supplies; and sanitation/waste disposal and treatment needed in outbreaks such as these.
  • Investing in WASH is a means to prevent future disease outbreaks. In urban areas, there is often low water quality, unreliable supply, and distorted pricing, which disproportionately affect the poor living in slums or informal settlements. The dense population and inadequate sanitation can lead to unhygienic conditions and rapidly increase the spread of diseases such as Ebola.[5]

 Unanswered Questions

  • How long does Ebola remain infectious in fecal matter and urine found in the environment if left untreated?
  • Can Ebola patients who are not buried properly contaminate ground water or the environment more broadly?
  • How long can the virus survive in water?

 Resources and Further Reading:

WASH Advocates closed in December 2015. The information on this page was last updated at that time and may not be the most up-to-date. 


Endnotes

[1] Centers for Disease Control and Prevention (CDC). October 2014. Ebola (Ebola Virus Disease) Prevention. http://www.cdc.gov/vhf/ebola/prevention/index.html

[2] WASH Cluster. October 2014. Simple Guidance on WASH in Ebola Response. http://washcluster.net/wash-ebola-dropbox/

[3] Catholic Relief Services (CRS), Focus 1000, and UNICEF. September 2014. Study on public knowledge, attitudes, and practices related to EVD prevention and medical care in Sierra Leone. http://reliefweb.int/report/sierra-leone/study-public-knowledge-attitudes-and-practices-relating-ebola-virus-disease-evd

[4] The Atlantic. October 3, 2014. Does Ebola Spread Faster in Cities? http://www.citylab.com/work/2014/10/does-ebola-spread-faster-in-cities/381115/

[5] The Water and Sanitation Program of the World Bank. 2014. Targeting the Urban Poor and Improving Services in Small Towns. http://wsp.org/content/targeting-urban-poor-and-improving-services-small-towns-0

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