Red Cross Blogs

Posts tagged ‘latrines’

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Cathy Ayer is part of a British Red Cross team in Haiti helping improve sanitation for earthquake survivors. She sent back this story on some of the more unusual ways they’ve found to make toilets fun.

Clowns. Funny guys that fall over a lot. Baggy pants. Little tricycles. Honking. More likely to be found in a circus than a camp for earthquake affected people. That was my experience of clowns until this morning when I attended a Red Cross hygiene promotion session in Automeca camp in Port Au Prince.

Automeca camp is currently home to approximately 10,000 people, densely populated in the centre of town with ramshshackle shelters squeezed tightly together. The British Red Cross sanitation team has been working in this camp for over 4 weeks for people made homeless by the earthquake. We have erected latrines and hand washing facilities so that people now have a safe and secure place to go to the loo. We have also undertaken a large hygiene promotion campaign with the residents of the camp. Hygiene promotion is all about delivering essential messages on how to maintain good hygiene to keep you and your family healthy, such as correct use of latrines, hand washing and storage of water. These things are absolutely vital…but is talking about going to the toilet sexy?

This is why hygiene promoters have to be extremely creative. They have to get the key messages out in such a way that it is interesting, engaging, clear, easily understood and makes people want to tell their friends and practice good hygiene. Today I saw Red Cross volunteers conducting a hygiene promotion session using glitter on people’s hands to demonstrate how harmful bacteria can be spread from person to person if they don’t wash their hands. They taught the people songs about why hygiene is good and everyone joined in singing and clapping their hands!

I then wandered over in to the centre of Automeca camp for the main attraction…the clowns! Liz, our hygiene promoter had found a group of local, professional performers, living in another camp in Port Au Prince, who have a clown act and she asked if they would join us to speak to the people in Automeca to promote hygiene. I was not sure what to expect…red noses? make up? Twirling bow ties? Instead I found something much more hilarious. A young guy dressed as an old man complete with white beard, an old man dressed as a baby (man size nappy included) and a scruffy clown with comedy breeches.

Hundreds of people gathered to see what was going to happen with these odd individuals. They had a loud speaker, and the girls in the group explained to the audience that they were here with the Red Cross to give them important information on health and hygiene, then the guys launched in to their fast paced comedy Creole routine. The “baby clown” spoke in a high pitched baby voice and had the crowd in hysterical laughter! The old man scolded the baby for not knowing how to use a latrine properly and instead invited the audience to contribute ideas on how it should be done properly. Members of the audience were pulled in to the act and everyone participated in agreeing what was good hygiene and what wasn’t.

Empowering people with the knowledge to keep themselves healthy in very difficult circumstances in these camps is very rewarding but what really touched me was the reaction of the kids to the clowns. Thousands of kids live in these camps across Haiti. Many will have lost parents and guardians, all are vulnerable and the trauma they experienced during the earthquake and since is hard to imagine. A group of hygiene promoting clowns is not going to take away all that trauma but if they can make them smile and laugh and perhaps forget their situation for a short time, it is a wonderful thing.

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Alastair Burnett, our recovery manger, just sent this candid account of what he’s been seeing in Haiti:

So it is 0530 and I am in my tent in the Red Cross base camp close to the airport in Port au Prince. I wouldn’t ideally be up at this time, but the noises of the aircraft taking off, the noises from others within the tent and the heat means that once you are awake at this time, there is no going back to sleep.

I arrived here from Santo Domingo in the Dominican Republic. Flying over Port-au-Prince was fascinating. In must have been a very striking looking city even before the earthquake, with hills to the back and the sea to the front, but flying in what strikes you is the clearly massive destruction many parts of this city has experienced. This was further compounded over the course of my first day as I visited camp after camp of internally displaced people (IDP). Discussing with colleagues, and many of us have seen a lot of areas of destruction whether that be in Africa, Asia or Europe, we all agreed that none of us have seen anything like this. The only way to really describe it is to think back to old black and white footage of cities like Berlin and Dresden at the end of the Second World War. This city looks as though it has had a war fought through it.

The Red Cross has a camp, in the grounds of what was destined to be the Hilton Hotel, close to the airport. The shell of the Hilton building is now our offices. Don’t get me wrong, there is no breakfast in bed here – it is a concrete shell with no windows or proper floors, functioning sanitation, water or power. However, people have done a great job getting this area operational and it is now home to over 250 Red Cross staff from across the world, ranging from doctors and nurses to logisticians and water engineers. There are two canteens, toilet and shower blocks and wireless internet access.  Scores of tents are neatly arranged around the concrete structure. It is far from 5 star but it provides safe and secure location for people to work from, which of course is so important in these situations. The camp empties out during the day but begins to fill up again from 1800 as it begins to get dark and the curfew that we apply to staff comes into force.

I spent yesterday with one of the sanitation engineers the British Red Cross has provided to the relief operation. He was carrying out a survey of some of the camps in which people have gathered, there are about 800 of them now ranging in size from a few hundred people to tens of thousands.  The situation in these camps is terrible. People lack adequate materials for shelter and for some people their shelter consists of little more than a bed sheet strung over a piece of string. Some of the lucky few have received some tarpaulin, which provides greater protection from the sun and the rain, as well as a better degree of privacy, and an even smaller minority a tent, although these are relatively few and far between, for a range of reasons.

The work of the Red Cross is largely evident in the water it is providing to these camps, a huge amount has clearly been done in this area. We are currently trucking in large amounts of water on a daily basis and, through the emergency water facilities we have brought into the country, providing about a million litres of water a day to these camps. We have also provided some basic household items for people (cooking sets, soap etc) as well as some sanitation facilities.

The sanitation situation is very poor.  In many places people simply have no where to go to the toilet. Some camps have a small hole in the ground that needs to be shared by hundreds of people.  Other camps, some in the grounds of schools or colleges, may have one toilet but these rapidly become blocked and unusable. Piles of rubbish can be seen around these camps, as well as growing amounts of standing water.

The rainy season will start in a couple of months, and we have to see how we can do more to address some of these immediate issues. I came here with shelter in mind as a priority. In fact I was wrong, it is the sanitation needs that are the greatest, although everything here at the moment is urgent.

Without improved sanitation there is a high risk of the outbreak of disease in the densely packed camps people are living in. Cholera in particular could spread very quickly. One camp I went to today had eight toilets for 2,000 people. But of course for many people those facilities are inaccessible as they are located on just one side of the camp. There are many issues to consider in regard to location of toilets – not just health and hygiene, but also protection for women and children if such facilities are not easily available. People have a good understanding of basic hygiene issues – you can see that around you when you walk around – but lack the hardware to be able to put that into practice, and again, you can see that when you walk around. So – toilets, and lots more of them, as soon as possible.

Waste management also needs to be addressed – piles of waste attract rats. Rats spread disease.  We have to look at how peoples waste can be better managed and work with the communities to help them on that. Again, many people understand that and have asked us for the tools to enable them to improve their current squalid living environments.

Vector control is also an issue – ensuring there are no pools of standing water is pretty much the number one thing in this to stop mosquitoes breeding. In a country where malaria and dengue fever is endemic we have to work with the communities to minimise the risk of major outbreaks.

Shelter here will be a nightmare. People are displaced in a number of different ways. I went to one location where many houses are still standing but there are just thousands of people camped in the road outside their homes as they do not want to return inside. Others are camped by the ruins of their homes in small groups. Others, gathering in their hundreds, in the grounds of churches or schools. The big camps, containing up to 10,000 people are located in former parks or other public spaces. Some people who fled the city in search of work are now returning and new camps of people are springing up all the time. People’s shelters are very basic and back to back – there is no security, there is no privacy and there is no dignity for the occupants. The risk of fire is huge and the space so cramped it is hard to think of ways to improve the conditions. For people who have endured years of political and social unrest, as well as in many cases chronic poverty I personally feel they deserve better. Despite the challenges this country has faced, and its poor image to the outside world, many of these people still maintain a level of pride in themselves that they should not be allowed to lose. It may be one of the most important things to help them through the years to come, and rebuilding their lives will take years.

Well, it is getting light and I have things to do. I will write more when I get a chance later.

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On Friday, my colleague Sarah wrote about the importance of toilets after a disaster like the Haiti earthquake. David Peppiatt, our international director, is in Haiti now and has sent back a vivid description of why they’re so needed.

Some early reflections at the end of my first day, which was spent mostly at base camp meeting with Red Cross and Red Crescent delegates and then a visit to La Piste camp, where our  mass sanitation emergency response unit is working.

I cannot emphasise enough the enormous scale of this operation. There are 500 Red Cross delegates on the ground with more on their way.  There’s a constant flow of people through base camp coming from Red Cross and Red Crescent National Societies around the world..  Base camp infrastructure and coordination are huge tasks alone – can you imagine having to provide tents, food, water and toilets for a few hundred aid workers on the edge of a city of rubble?

Conditions in the camps earthquake survivors are living in are shocking.  Overcrowded.  Filthy.  People sleeping under scraps of plastic, old sheets draped over some precarious frame of wood,  pieces of timber or whatever they have recovered from the rubble.  What struck me most was the human waste scattered throughout the camp.  The stench in places was repulsive.

Our mass sanitation team is working around the clock to dig latrines in the camp. It’s encouraging to see some already up and in use. They’re working to get 100 up by the end of next week.  The public health team went in today to deliver hygiene promotion messages – translated into Creole and posters put up on toilets about washing hands.  They’ve sent out thousands of SMS messages with public health advice and also launched a public health campaign on the radio.

Shelter is proving very problematic. People are extremely vulnerable in these makeshift shelters for long – little protection, unsafe and no dignity. The looming rainy season followed by hurricanes make this a matter of urgency and huge responsibility for the Red Cross as we lead the shelter response in Haiti.

As for the earthquake damage and destruction, words fail to describe what you see. It is like those desperate images of a bombed city where huge swathes have been decimated, destroyed and turned into mountains of rubble and debris.  It will surely take many months, if not years in some places, to clear the damage and debris before the rebuilding can begin.

Follow updates from the mass sanitation team on the British Red Cross international blog.

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Okay so toilets may not be the first thing you think of when it comes to life-saving equipment, but think again. Without decent sanitation facilities, diseases like cholera can spread like wild fire and as was seen in the Zimbabwe crisis last year – thousands of people can die as a result.

In an article on Reuters AlertNet, the UN reports that 7,000 latrines are urgently needed in Haiti to help prevent the spread of disease.

My colleague, Sharon Reader, is currently in Port-au-Prince with our sanitation emergency response unit. Listen in as I speak to her and find out how it’s all going.

Image © Joe Lowry/IFRC

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The smell of the jet fuel, the roar of the engine, the sting of the icy rain. That was last Friday as I stood on the tarmac at East Midlands airport with one thing on my to-do list – send the Mass Sanitation Module (MSM) Emergency Response Unit (ERU) to Haiti following the earthquake.

After a disaster there is always the fear that disease will spread amongst the survivors, pushing up the already mounting death toll. One of the biggest concerns is that the presence of dead bodies will increase this. There is panic and a rush to inter the deceased into mass graves. This can lead to problems later down the line either emotionally where loved ones have not been properly identified which makes the grieving process harder or practically where a death cannot be proved. Without a death certificate sorting out the inheritance of land or money can be a legal nightmare. In Indonesia after the Tsunami the mass burials occurred and then later the bodies were exhumed to allow for the identification process to take place.

And sadly this fear is based on myth. The people in Haiti have died due to injuries not infection and so there is no disease to pass on. Instead common diarrhoeal illnesses caused by contaminated water sources and a lack of good hygiene practises are going to put the people most at risk. Particularly the very old and the very young.

That is why the MSM is such a brilliant kit and so very much needed. Reports are saying that ninety percent of buildings have been destroyed in towns close to the epicentre. That’s houses, schools, shops, and toilets. Were you concerned about the loss of toilets? They aren’t necessarily the first thing that comes to mind in the aftermath of a disaster but without them there is a real risk that sewage will get into the drinking water and make people very sick.

That is why the MSM kit contains a mini-digger and latrines so that temporary toilet blocks can be constructed, giving people a dignified place to spend a penny whilst also protecting the local water source from contamination. The rapid latrines are quick to put up and are also a simple design which can be copied and made in country. This will allow far more to be built than I was able to load on the flight last Friday.

Another way disease is spread is through pests such as flies and mosquitoes. The kit contains disinfectant and sprayers to kill these insects. Getting rid of rubbish which can attract rats will also be something that the MSM team will look at. Methods include burning, burying, recycling and composting and what ever worked best for Port au Prince will be put into action.

As well as the equipment that comes with the MSM, a large part of the success of the team comes through showing families simple and practical actions that can stop the spread of disease. When your way of life has quite literally crumbled around you, it is much harder to maintain your usual standard of cleanliness or you may have to adopt new ways. So knowing to cover buckets of water to that they can’t be used as a breeding ground for mosquitoes, or boiling water before drinking can save your life.

Through posters, focus group discussions or radio broadcasts the messages can get out to a wide number of people quickly. Debunking such myths as children’s poo is less harmful than adults – it’s actually far more dangerous because kids have less well developed immune systems and it’s literally crawling with nasties. Or demonstrating the best technique for hand washing.

It might sounds simple and perhaps even a little condescending but just consider for a moment that 6.6 million people in Britain do not wash their hands after going to the toilet and a massive 69% do not washing hands before eating. Under regular circumstances they may be fine but after a mega disaster those same people will be traumatised, possibly injured, maybe malnourished or dehydrated and they are much more vulnerable and likely to pick up an infection.

It was therefore very important to get the MSM kit loaded last week and on its way to Haiti.  I had calculated all the weights and volumes and had ordered a suitably sized plane but when you look at all the boxes sitting on the tarmac you get a real heart in the mouth moment and you think, it’s never all going to fit. I was feeling pretty confident when we’d loaded the two land cruisers then the digger and the plane was only half full but then it started to rapidly fill up and I felt a jolt of alarm.

After five hours of loading we still had fifteen boxes of latrines to go and the back doors on the Ilyushin 76 had only just managed to close. Not quitters, the loading team discovered a small pocket of available space at the front of the plane and they started hauling the final boxes through the passenger door. Like a torturous new years-esque countdown I silently mouthed five, four, three, two, suddenly the load master appeared at the door and shock his head, no more room. You’ve got to be kidding I thought, and it turns out he was, as he broke into a big beaming smile and gave me the thumbs up.

The icy rain that had our teeth chattering finally stopped just as the last latrine was hoisted up the ladder and inside. Happiness is the thunk of a fully laden aircraft door closing. I knew by the time I woke up the next day the aircraft would have arrived in Santo Domingo and the kit would be unloaded onto a truck to go across the border to Haiti. With soggy feet but a happy heart I scrawled a large tick on the to-do list and headed home.

Follow updates from Sharon Reader who is currently in Haiti with the MSM on the British Red Cross international delegate blog.

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