Clean Water Case Studies

Case Study 1: Hygiene access for people with disabilities during COVID-19 

 

Challenge Statement: How might we provide people with disabilities adequate and dignified hygiene services, whilst adhering to requirements to prevent and manage COVID-19? 

 

The UN recognises that the Human Rights to Water and Sanitation are essential to achieving all other human rights. This includes the UN Convention on the Rights of Persons with Disabilities, which has been signed by 163 countries, and stipulates that humanitarian responses must be disability inclusive (Article 11).  

 

As of 23 June 2020: 6 countries (Commonwealth of the Northern Marianas, Papua New Guinea, Fiji, French Polynesia, Guam and New Caledonia) in the PICTs have reported 363 cases and 7 deaths, Cases were also reported in Australia, New Zealand and Hawaii. Between 16 and 23 June 2020, 41 new cases (1 in PNG and 40 in Guam) were confirmed in the PICTs. Fiji, French Polynesia have not reported any new cases for at least three incubation periods (42 days).

 

 

Papua New Guinea, Guam, Commonwealth of the Northern Marianas and New Caledonia have reported new cases in the past 14 days. 

 

Recently, the UN’s Secretary General urged governments “to place people with disabilities at the center of COVID-19 response and recovery efforts and to consult and engage people with disabilities”. However, water, sanitation and hygiene access is considered to be one of the biggest challenges of daily life for many people with disabilities. The International Centre for Evidence in Disability’s research in Vanuatu showed that people with disabilities were two times more likely to experience incontinence than people without disabilities. Incontinence is a complex social and medical issue, and people who experience it and their carers need to use more water and soap for washing hands, bathing and doing the laundry, as well as easy access to a toilet. Without it, the health and dignity of people who experience incontinence and their carers is compromised, as well as their health and risk of contraction of COVID-19. 

 

During a crisis, marginalised groups face increased vulnerabilities, from heightened risk of infection, through to neglect and violence. This is due to existing discrimination and inequality, which is very often heightened during a crisis, as well as lower access to public health information and services. For persons with disabilities COVID-19 brings particular risks. People with disabilities may be more likely to become infected with COVID-19, and if infected may be more likely to experience serious symptoms or death. For example, they face barriers in accessing critical public health information which is not in accessible formats or doesn’t use clear and simple language. The Pacific Disability Forum has also highlighted that public health recommendations such as social distancing or home isolation may not be options for people who rely on assistance to eat, bathe and dress. Furthermore, persons with disabilities are very often unemployed, poor and living in poor living conditions, which increases their exposure to the outbreak and reduces options for implementing recommended protective measures and hygiene controls. 

 

Applying the principles of human rights (equality and non-discrimination, participation, transparency, accountability and sustainability) within COVID-19 responses can reduce inequalities. 

 

Frequent and proper hand hygiene is one of the most important measures that can be used to prevent infection with the COVID-19 virus. The specific hygiene needs of people with disabilities needs to be considered in WASH response planning and implementation. All hygiene communication needs to be inclusive. Further,  hygiene services should enable more frequent and regular hand hygiene by improving facilities and using proven  behaviour  change techniques and disability inclusive infrastructure. 

Materials for hand washing and hygiene may include provision of fixed and portable hand washing facilities, purchase of soap and alcohol-based hand rubs, provision of water supplies for hand washing, and point of use water treatment. Schools, workplaces, markets, transport stations, and other areas where people gather all require easy access to hand washing facilities and water and soap for hand washing for people with disabilities. 

 

References 

https://www.unicef.org/disabilities/index_65839.html 

https://resources.hygienehub.info/en/articles/4097594-summary-report-on-considering-disability-in-covid-19-hygiene-programmes 

https://www.waterforwomenfund.org/en/learning-and-resources/resources/KL/WfW-CBM-Guidance-Note_COVID-19-WASH-Disability-Inclusion_FINAL.pdf 

https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/15376/Handwashing%20Compendium_edition%202_FINAL.pdf?sequence=1&isAllowed=y 

https://www.cbm.org.au/wp-content/uploads/2020/06/WfW-CBM-Guidance-Note_COVID-19-WASH-Disability-Inclusion_FINAL.pdf 

https://news.vanderbilt.edu/2020/05/20/ask-an-expert-how-can-a-disabled-person-safely-navigate-the-covid19-crisis/ 

http://www.pacificdisability.org/News/Disability-and-COVID-19.aspx 

Case Study 2: Giving remote, dispersed and isolated populations a voice on water supply

 

Challenge Statement:How might we give a voice to remote, dispersed and isolated populations in Timor Leste and allow their opinions and ideas regarding water and sanitation to be heard at the Government level? 

 

Under SGD6 the Government is required to deliver water services to its people. In rural Timor Leste, this is partially the case.  While the National  Directoriate for Water and Sanitation (DNSAS) and the National Directorate for Water Resource Management (DNGRA) hold the responsibility for water supply delivery and management respectively, the prime responsibility for managing rural supplies gets passed on to villages, who often own the land, including water sources (rivers, lakes springs.) These villages are then expected to elect community water management groups, or Water Committees) to operate and maintain their supply with limited technical support.  

 

This approach is marred by a lack of communication. Confusion around asset ownership and clarity over operation and maintenance responsibility means that water systems often breakdown and go unrepaired, leaving communities without a safe and reliable source of water for a prolonged periods of time. Many decisions and initiatives affecting the WASH sector are developed in the Nation’s capital of Dili and do not always make it to aldeia (communities) in a timely manner, due to poor telecommunication infrastructure in isolated communities and rare visits from government staff.  

 

The information that gets missed due to this lack of communication flows both ways.  While rural water scheme functionality is tracked through a monitoring system, reporting practices are non-standardised and more granular data such as customer behaviour is left out. Gaps in knowledge around rural household management practices and how they vary across communities, seasons and available water sources, poses a significant challenge to resource planning.    

 

By leaving Water Committees are therefore often left out of national and international debates regarding water supply, meaning their voices, ideas and concerns are left unheard.  

 

References: 

Rapid Review of Water Knowledge for Pacific Small Islands and Developing States. http://documents1.worldbank.org/curated/en/532991532957755291/pdf/129020-WP-P165164-PUBLIC-W18018-Pacific-Water-Knowledge-Review-v2.pdf 

Equitable Management of Water and Santiation in Pacific Island Countries. http://nauruenv.appspot.com/file/library/regional/Equitable%20management%20of%20water%20and%20sanitation%20in%20Pacific%20island%20countries.pdf 

 

Case study 3: The operation and maintenance of Rural Water Infrastructure in Vanuatu

 

Challenge Statement: How might we efficiently (time, cost) and effectively (quality) undertake asset maintenance and operation of water infrastructure for remote, dispersed and isolated populations?

 

Vanuatu has a population of around 281,000 – seventy percent of who live in rural areas across 65 of the country’s 80+ islands.  Many of these island communities are small and dispersed, meaning the same sized population that can be serviced by a single water system in an urban context can require up to 10 – 15 systems. This high per-capita cost, combined with distance from supply chains, makes rural water supplies expensive to build, operate and maintain. 

 

The construction of rural water supply infrastructure in Vanuatu is the responsibility of Rural Water Supply (RWS) section of the Department of Geology, Mines and Water Resources (DGMWR.) Due to limited resources; however, these projects are normally financed through bilateral donors, and /or NGOs. Once infrastructure is built, it is maintained by the communities, and – in theory – financed through user fees collected by the village water committees. The success of these arrangements vary between villages based and often depend on the user’s ability to pay. In, 2009,  the Pacific Islands Applied Geoscience Commission (SOPAC) conducted a water balance assessment on the Lunganville supply system and found that 33% of the system input resulted in non-revenue water — a significant part of which was lost due to leakages within the system. 

 

While the Vanuatu National Water Strategy acknowledges community water management as a crucial component in recognizing its vision of sustainable and equitable access to safe water and sanitation for the people of Vanuatu, many community water committees lack the resources and training needed to effectively manage their supply. Maintenance is often restricted by an absence of spare parts and materials in isolated parts of the country and the lack of skilled operators and technicians means expertise must brought in from outside, which can drive up costs as well as the time between repairs, stranding communities without a safe supply for weeks or even months at a time. 

 

These issues are only exacerbated by the harsh tropical environment, which shortens the lifespan of assets. Many of these systems are also extremely vulnerable to natural disasters, such as landslide and flood, which are only projected to grow worse with climate change.  

 

An audit of the Rural Water Supply Data Base found that of 1200 small water supply systems spread across the islands of Vanuatu 663 supply systems were functioning well, 269 were in need to repair and 189 were not operating at all. 

Case study 4: Culturally appropriate menstrual hygiene management for people who menstruate 

 

Challenge Statement: How might we provide menstrual hygiene management options in a way that is empowering for people who menstruate and considerate of local culture(s)? 

 

  • Around 500 million people worldwide lack access to adequate facilities to manage their periods 
  • Limited knowledge is available about the extent of the problem across the pacific, but a 2017 study, The Last Taboo, which focussed on Papua New Guinea, Solomon Islands and Fiji found problems were prevalent in all three countries: 
  • “If the woman does not follow the … custom during her menstruation and makes food and gives to her husband or young boys in the family then she makes her husband and the young boys grow old quickly or make them sick.” (Women, informal workplace; urban PNG) 
  • “One of the difficulties the teachers face- they have the knowledge to teach in class, but they need training in how to teach it” (Teacher; rural Solomon Islands) 
  • “After changing [sanitary pads], we have to take our dirty hands to the tap outside in order to wash them… It’s degrading treatment towards us women” (Women, urban, informal employment Fiji). 
  • In many areas of the Pacific such as Solomon Islands and Papua New Guinea, it is taboo for men to see evidence of menstruation such as blood or cloths. Under these conditions it is particularly important for women and girls to have access to menstrual hygiene products and sufficient water for personal use. 15 per cent of women in Fiji reported never or rarely having sufficient water for personal use, compared to 10 per cent of men. 
  • Lack of education, access to supplies and suitable places for changing, washing and disposing of them, coupled with cultural stigma, leads to a lack of confidence, missed school and work and missed opportunities. This can trap people who menstruate into a cycle of poverty. 
  • This is a problem right across the pacific and has led the New Zealand government to start providing free sanitary products in all state schools from next year. 
  • The Pacific Menstrual Health Network was formed in May this year to provide a community of practice across the pacific around menstrual health management. 
  • Things to consider 
  • The pacific is a large and diverse region with a wide range of cultural norms and levels of development. Some cultural norms, including diverse genders, could add additional complexity to this problem. 
  • There are multiple aspects to this problem, including: 
  • Access to, and affordability, of sanitary products 
  • Acess to adequate facilities for changing and washing 
  • Adequate disposal facilities, both as an individual and as a country. This has led to Days for Girls developing reusable sanitary pads 
  • Eduacation and knowledge, particularly for young people when they first start their periods 

 

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