1 Basic principles - European...

Integral quality system for the operation of water and sanitation programs in camps

Tom de Veer

DRAFT(second edition)

Leiden, January 1st, 1999

De Veer Consultancy

ACF, IFRC, CARE-I, MSF-H

Table of contents

Table of contents i

Foreword v

1. Introduction 1

1.1 Background. 1

1.2 Structure of the document. 3

1.3 How the manual can be used 4

1.4 Current situation 4

1.5 Terminology. 5

2. Program planning 8

2.1 Introduction. 8

2.2 Initial assessment(s). 9

2.3 Problem tree. 9

2.4 Objective tree. 10

2.5 Program objectives 11

2.6 Strategy 12

2.7 Program design and activities 12

2.8 Program success factors 12

2.9 The place of this manual in the planning process 17

2.10 Recommended literature 17

3. General tasks 17

3.1 Introduction. 17

3.2 Obtaining and interpreting health statistics. 173.2.1 Using health statistics to assess the impact of a watsan program 173.2.2 How health statistics are obtained 183.2.3 Analysis of health statistics from curative health facilities 19

3.3 Information gathering: description of some general techniques 243.3.1 Informal information gathering. 243.3.2 Structured observations. 263.3.3 Interviewing. 283.3.4 Meetings. 28

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3.3.4.1 Informal group discussion 283.3.4.2 Focus group discussion 293.3.4.3 Open group discussion 343.3.4.4 Mass meetings 343.3.4.5 Workshop 36

3.4 Population census. 373.4.1 Counting inhabited huts and determining the average number of inhabitants per hut.

373.4.2 Obtaining figures from other programs. 373.4.3 Mapping. 373.4.4 Counting from the air. 373.4.5 Interpretation of aerial or satellite photographs. 37

3.5 Tasks of general support staff. 383.5.1 Field Administrator 393.5.2 Office administrator 413.5.3 Office logistician 413.5.4 Program manager 41

4. Drinking water 45

4.1 Introduction 45

4.2 Piped water supply program 484.2.1 Tapstand caretakers 504.2.2 System controllers 524.2.3 Plumbers 584.2.4 Team leader of the plumbers 604.2.5 Supervisor Distribution 624.2.6 Guards at pump stations and storage tanks 664.2.7 Mechanics 674.2.8 Source caretaker 704.2.9 Tank operators 714.2.10 Pump operators 734.2.11 Supervisor Water Pumping and Storage 794.2.12 Guards of the water treatment site 844.2.13 Water treatment staff 854.2.14 Supervisor Water Treatment 97

Name water treatment site:__________________ Name Supervisor:____________________ 99

4.2.15 Overall Supervisor Piped Water Program 1004.2.16 Program Manager 1004.2.17 Office Administrator 1074.2.18 Office Logistician 1074.2.19 Evaluating piped water supply programs 107

5. Family pit latrines 108

5.1.1 Sanitation workers 113

6. Vector control 115


6.2 Residual spraying programs. 1216.2.1 Sprayers 1246.2.2 Spraying solution carriers 128

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6.2.3 Team leader of a spraying team 1296.2.4 Insecticide mixers 1406.2.5 Supervisor 1426.2.6 Program manager 1466.2.7 Field administrator 1586.2.8 Office administrator 1586.2.9 Logistician in charge of purchasing the insecticide 1596.2.10 Recommended literature 159

6.3 Rodent control programs 1596.3.1 Introduction 1596.3.2 Preventive measures 1616.3.3 Trapping and hunting 1626.3.4 Chemical control measures 162

6.3.4.1 Chemical control of the parasites carried by rodents 1626.3.4.2 Chemical rodent control with acute poisons 1636.3.4.3 Chemical rodent control with anticoagulents (chronic or slow-acting poisons) 1636.3.4.4 Bait 1646.3.4.5 Recommendations for safety in chemical rodent control programs 165

6.3.5 Rodent control in food stores 1666.3.6 Sequence of activities 1676.3.7 monitoring aspects of rodent control programs 167

6.3.7.1 Monitoring of trapping programs 1686.3.7.2 Monitoring of chemical rodent control programs 168

6.3.8 Recommended literature 169

7. Hygiene promotion 151


7.2 Hygiene promoters 153

7.3 Team leader 172

8. Reporting formats 175

8.1 Introduction 175

8.2 Weekly report 175

8.3 Monthly report 176

8.4 Periodic report (usually every 3 or 6 months) 176

8.5 External evaluation report (executed in ongoing programmes when needed or at standard intervals) 178

8.6 Handover and/or end of mission report for programmes which are not yet finished 179

8.7 Final external evaluation report at the end of a programme or cluster of programmes 1818.7.1.1.1.1 Examples of a water points map, water point sheet and water point table 1828.7.1.1.1.2 Environmental hygiene survey 1878.7.1.1.1.3 household survey 191

Annex 1 Mosquito surveys 193A 1.1 Initial mosquito survey 193A 1.2 Methods to identify mosquitoes and/or determine their numbers 195

Annex 2 An example of a monthly report 200Annex 3 Diseases that may be found in camps and which are or may be related to water supply and/or environmental hygiene 204

A 3.1 Diarrheal diseases 204A 3.2 Fevers 205

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A 3.3 Pneumonial diseases 207A 3.4 Skin infections 207A 3.5 Hepatitis A and E 207A 3.6 Meningitis 208A 3.7 Measles 208

Annex 4 Recommended minimum standards 209Annex 5 Bibliography 213

Table of Contentsp. iv

Foreword

This manual has been produced with financial support from the organizations Action Contre la Faim (ACF), the International Federation of Red Cross and Red Crescent Societies (IFRC), Care International (CARE-I) and Artsen Zonder Grenzen (MSF-H).

The manual is still a draft. The final aim is to produce an integral quality system for the operation of water and sanitation programs in camps. This draft is a first attempt in this direction. Only a few programs have been worked out. The idea is that implementing organizations can, with this draft, assess whether the concept of the document fulfils their requirements for integral quality systems. It is also hoped that both implementing and donor agencies will further look into the contents and field test the described systems and finally use their experiences to continue work on this manual so that the final aim can be realized.

Forwardp. v

1. IntroductionThe aspects dealt with in this chapter are: background to the development of this manual and target groups, the structure of the document, how the manual can be used, and some basic terminology used in this manual

1.1Background.In 1995 just after returning from 5 months work as a manager of water and sanitation programs in large camps for displaced persons in Rwanda, the author conducted a study to assess how monitoring and evaluation of water and sanitation programs in camps can be improved. The most important conclusion of the study was that a comprehensive manual was needed on the subject in order to improve program management and accountability functions. This conclusion was supported by 12, most implementing, agencies who had participated in the study. As a result work started in 1997 to produce such a manual.

The following conclusions from early results of the work led to a change of the project though: Monitoring concerns each and every person working within a watsan program. A distinction is necessary between the construction of facilities (during which certain

monitoring tasks need to be executed) and the regular operation of programs (during which often completely different monitoring tasks are needed).

It is very difficult and artificial to distinguish between operational tasks and monitoring tasks. For instance, in task descriptions often the term ‘control’ is used which in fact constitutes both a monitoring and an operational task. This led to the general feeling that it is no good to describe only one part of people’s tasks (the monitoring tasks). People in the field need a complete and comprehensive description of their tasks, not only part of it. This was very much related to the question who the manual was meant for and how it should be used.

The result of these conclusions was that we decided to:1. Concentrate on the operational tasks of a program (because descriptions of

monitoring in construction are already extensively described in other manuals).2. Produce a manual for use in the field directly by program staff as well as by

managers.3. Change the emphasis from a generic approach to a practical program oriented

approach comprising the description of specific programs which are often found in camps.

4. Describe all tasks that different staff active in watsan programs in camps should execute and include directive texts for the further explanation of certain topics that are also suitable for training of those staff.

These decisions have finally led to the production of the current manual, comprising an integral quality system for the operation of a number of watsan programs typical for camps. In this first draft only a number of topics have been worked on and even several of these topics need much further attention. The reason to present these initial results in

Chapter 1 : Introductionp. 1

this document is simply because funds to continue the work are lacking and because it is believed that it the work is sufficiently far advanced that together with others it can be assessed to what extent the approach followed in the document is useful.


1.2Structure of the document.

Chapter 1 An introductory chapter explaining the background and use of the manual as well as some important terminology used.

Chapter 2 Explanation of how programs should be planned and why and how this is important for their success, structure, management and evaluation afterwards plus an explanation of the part of the planning process covered by the manual.

Chapter 3 A description of general subjects important for all water and sanitation programs: Obtaining and interpreting health statistics Information gathering; description of some general techniques Population census The general tasks of general support staff (administrator, logistician,

program manager)

Chapter 4-7 Chapters describing different water and sanitation programs often executed in camps1. The chapter on drinking water for instance describes 5 different types of water programs2: piped water supply, deep boreholes, handpumps, water tankering, and springs. Each chapter contains an introduction in which the ‘minimum recommended objective’ for the program(s) described in that chapter is given together with a set of specifications. For each program the following aspects are included: An organogram showing how the program is built up and who are

working in it. For each of the different staff working in the program the following is

described:1. materials/tools needed,2. number of those staff needed,3. operational tasks (a distinction is made, where applicable, between

tasks in emergencies and tasks in non-emergencies),4. examples of reporting and logbook forms where applicable.

Boxes in which specific subjects important for the implementation and operation of the program are worked out, giving additional background information which can for instance be used as a basis for the training of staff.

Notes of use for the evaluation of the program.

The descriptions of the operational tasks include: a short statement of the task a more detailed task description including elements as how the task

should be executed, how to react in case problems arise, who to report to, referrals to the boxes in which subjects important for that task are further worked out etc.

indications of the timing (when/how often should the task be executed) specifications important for the execution of that task.

1 The chapters currently included are: drinking water, family pit latrines, vector control and hygiene promotion. In the final document chapters on other subjects will be included as well, e.g. solid waste, drainage, etc.

2 In the current draft document only the piped water program has been included.


1.3How the manual can be used

The manual can be used in a couple of ways: Field managers can build up a new program according to the structures described in

the manual. Doing so they can be pretty sure that all essential elements are included. They can hand out copies of the task descriptions to each of the involved staff and provide additional training on issues where they lack experience3.

In an existing program a field manager can use the manual to assess whether all aspects are sufficiently covered and whether the structure of the program and/or the task descriptions of the staff can be optimized.

As a general background information source for water and sanitation programs. As a basis for training courses. As a resource document for donor and implementing agencies to develop their own

guidelines.

The manual is most suitable for camps of say 15.000 people or more. For smaller camps or for camps with very specific circumstances the structures will have to be adapted. It is the task of the field manager to work out, together with his staff what the most optimal structures, but also the most optimal task descriptions are for the specific situation in which the program has to operate. The manual can hereby be used as a checklist, example and toolkit for building up the most suitable structures, not as a definite form prescribing how things should be.

To start using the tool in the field one can hand out copies of the task descriptions to each staff member so that they can work with it (the tasks described may have to be divided differently in order to fit to the specific staffing structure of the concerned program). When developing programs from scratch, for instance in new camps, the manual will help to set up clear structures in which everybody knows what to do in a very short time. Later workshops can be organized enabling people to feed back on their experiences and work together to further optimize and fit the program to the specific circumstances in their camp.

1.4Current situation

The current document contains about 170 pages of text and is ready for use in the field. Much work is still needed though to: describe other types of programs that are not yet included now, further work out a number of appendixes, and test the tool in practice.

Field-testing is absolutely necessary! The document is largely designed for work in the field. It can only function as such if it fits completely to the circumstances in the field and the practice of the people working there. Therefore it would be good if field staff of organizations test the tool and give feed back about their experiences. This can then be used for the finalization of a more comprehensive and complete tool: an integral quality system for water and sanitation programs in camps.

3 In the boxes included in each of the chapters handholds are provided for all kinds of operational aspects many of which can immediately be used as training material.


1.5Terminology.The terminology used in this manual is as simple and basic as possible. This is to avoid confusion among the readers who will often be people who are not experts in the subjects dealt with. On top of this we have left out many terms which are often used in handbooks but of which we believe that they are difficult to interpret and use. For instance terms as ‘monitoring’, ‘indicators’ and ‘standards’ are left out because they are confusing, in many documents used in different meanings and in their definitions also often overlapping. Instead we use expressions that need no further explanation, such as ‘information needed’, ‘who should obtain the information’, ‘when and how to obtain the information’, ‘the analysis and use of information’ and ‘specifications’. The next pages contain an overview of the terms that we do use and of which we believed that they need (some simple) explanation.

Objective: the result(s) to be achieved.Depending on the use of an objective it can be described in more or less detail. In its most detailed form the description of an objective usually includes specifications such as the timing (when do you want it to be achieved), the target groups (who are the results meant for), and specifications with regard to quantity and quality of the results to be achieved (e.g. the amount of water that should be available per person per day, water quality specifications etc.). When planning programs a distinction is often made between objectives at different levels (see also chapter 2). Objectives at the higher levels are usually described in general terms (e.g. ‘to release the suffering of those affected by the disaster’, or ‘to safeguard the health of the beneficiaries’) while objectives at lower levels are much more specifically directed to certain programs or activities and described in much more detail (e.g. the objectives used in the chapters on the different programs in this manual with their sets of specifications). Other documents often use terms as ‘goal’, ‘aim’, ‘main’ or ‘overall objective’ etc. to refer to different levels of objectives. To avoid confusion these terms have been left out in this manual.

Recommended minimum objective: the results that we recommend should minimally be achieved in a given situation.

A distinction is made between emergencies and non-emergencies. Each recommended minimum objective goes together with a list of specifications many of which are in accordance with the minimum standards and rules of good practice as defined by the Sphere project and well-known documents such as 'Engineering in Emergencies'. With regard to timing: in general, objectives for emergencies should be achieved within a couple of days to a couple of weeks (say 1 to 4 weeks), while objectives for non-emergencies should usually be achieved within a couple of months (say 2 to 6 months).

Assessment: an investigation during a limited period of time to obtain specific information for the (possible) planning of new activities.

Evaluation: an in-depth investigation, of the performance of an ongoing or completed programme, executed, as systematically and objectively as possible, during a limited period of time.

During an evaluation one may be interested in only certain aspects or in a wide range of aspects (see the aspects mentioned under ‘programs’). However, the more aspects you want to investigate, the more information you will need to obtain and analyse and therewith the more time and resources (money, human resources) you will need to complete the exercise. Therefore it is very important to prepare an evaluation carefully and decide on the aspects on which one really wants to have information (see also paragraph .....). Evaluations are usually done to get recommendations on how to further improve the aspects looked at of on-going programs or on how to improve those aspects


in similar programs in the future. Evaluations make use of the information available through program documents (reports, administrations, logbooks etc.), the people working in the programs (interviews, workshops) and additional investigations (especially if the first two do not provide sufficient information). An important basis of each evaluation therewith is the information that comes available through the normal day to day practises of the program on which the evaluation focusses.

Disaster: an event or combination of events which causes physical loss or damage, social and/or economic disruption.

Disasters can consist of any combination of the following categories: natural, sudden-onset disasters, caused by cyclones, floods, earthquakes; natural, slow-onset disasters, caused by draught or famine; human-induced sudden-onset disasters, such as those caused by war; human-induced slow-onset disasters, such as for instance those caused by chronic

political problems developing over a longer period of time.

Emergency: a situation of hardship and human suffering arising from a disaster, which may develop if the organizational structures in place can not or do not cope with this situation or if no such structures are available.

In case an emergency is caused by a combination of the disaster categories as described above one often talks about a complex emergency. With regard to camps an emergency may develop when displaced people rapidly settle down in an area where no or insufficient organisational structures are or have been put in place to provide these people with the basic services they need. Such a situation often exists during the initial phase of the development of a new camp but it can also arise in an existing camp where for instance suddenly large influxes of new arrivals settle down (overloading the existing organizational structures to such an extent that one can talk about an emergency).

Non-emergency: all situations that do not fit in the definition for ‘emergency’, usually marked by at least some kind of stability and limited problems.

Displaced persons: people who have fled their home area to other areas within their country of origin.

Refugees: people who have fled their home area to other areas outside their country of origin. In this manual the term refugees will further be used to mean both ‘refugees’ and ‘displaced persons’ unless the distinction is explicitly stipulated.

Camp: a temporary basis for refugees or displaced persons.

Donors: every organization and person donating funds.

Donor agencies: funding organizations.

Implementing agencies: organizations responsible for program implementation.


Support agencies: organizations specialized in and responsible for a number of supporting tasks to implementing and sometimes donor agencies, e.g. training of expat staff, finding and supplying expatriate staff when needed, production of manuals and advice to other organizations.

Program: used in this report to mean both 'program' and 'project'.In a program the following aspects are often of importance: effectivity, efficiency, utilization, impact, safety, contingency, relevance, sustainability and replicability. When staff gather, interpret, use and report information as part of their tasks it is often information with regard to one or a combination of these aspects. Also evaluations are often based on obtaining information on one or a combination of these aspects. See further chapter 2.

Operation: all activities executed to continue an existing program (thus including what others call ‘maintenance activities’)

Implementation: all activities to start a new program or new activities within a program after the planning phase.

Project cycle:An interpretation of what we mean with a project cycle is presented below.


2. Program planning

2.1 Introduction.This chapter describes the process of program planning. It enables the reader to develop an understanding of the importance of proper planning as a basis for successful programs while it also shows what part of the planning process is covered by this manual.

The process to be followed when planning a program is as follows:

Figure 2.1 The program planning process

Chapter 2 : Program planningp. 8

2.2Initial assessment(s).An initial assessment provides the basic information needed to obtain a first idea about the circumstances and the need for further investigations. In emergencies the time is often too limited for further investigations and the program then has to be planned on basis of the initial assessment alone. The information obtained during an initial assessment is also used often to form an information baseline against which later the program can be evaluated. Usually however, the initial assessment does not provide sufficient information for evaluation purposes and additional information should then be gathered as soon as possible after the initial assessment.

An initial assessment usually includes: A review of existing documents with relevant information (existing reports about the area,

documents about the subjects you expect to become involved in, topographical maps). Discussions with experts who worked in the area before. A visit to the area to obtain information through informal observations, discussions and

meetings with program staff, leaders, beneficiaries and other key informants. To prepare for this, one should set objectives for the initial assessment, define activities, develop checklists for information gathering, and select information gathering methods. Some of the checklists of chapter 7 and Appendix ... can be used as an example, also Appendix 8 in Davis and Lambert 1995 and Appendix 1 of The Sphere Project, Chapter 2 contain useful checklists.

Much of what is described in chapter 3 of this document about information gathering techniques through structured walks, meetings etc. is also applicable for initial assessments.

2.3Problem tree.When as much information as possible has been gathered it is necessary to process and analyze the information. Based on the analyzed information and knowledge of the persons involved in the planning process, the problems can be structured in a problem tree:

Figure 2.2 Example of a problem tree (certain parts worked out in more detail)


To make a problem tree: sit together with key informants and members of the assessment team and ask them to write down problems on charts (based both on their personal knowledge and experience and the information obtained through the assessment4), one problem per chart Then gather the charts and put them on a wall or board (group the ones which express the same problem). Distinguish between the level or order of problems: problems of a higher order are usually underlain by causes which in themselves are problems concerning more detailed subjects. They are therefore problems of a so-called lower order. When distinguishing between the levels of the problems the problem tree develops. Important principle: a problem at one level is caused by the combination of problems one level lower.

2.4Objective tree.Now each problem can be converted to an objective. That is, a problem is a negative statement (e.g. not enough food) which should be converted to a positive statement (ensure that people have enough food). When doing so the problem tree is converted to an objective tree. For the example problem tree of figure 2.2 the following objective tree can be developed:

Figure 2.3 Example of an objective tree (certain parts worked out more than others)

Rule: Achieving all the objectives at one level should mean the achievement of the connected objective at one level higher!

4 Practice has learned that involving illiterate or poorly educated people in such an exercise is difficult. You may therefore best work with respected literate representatives of the beneficiaries, motivated to take actively and objectively part in the exercise, and who are aware that they should especially provide information about the needs and problems of the most vulnerable people such as women, children and elderly people. Additionally one should always try to obtain sufficient information through assessments about what and how problems are perceived by different groups of beneficiaries and what their needs and priorities are (for instance by including methods such as group discussions with beneficiaries and interviews with individual beneficiaries in the assessment).


2.5Program objectivesUsually it is not possible (e.g. if resources and/or time are limited, or permission can not be obtained for certain activities) or not necessary (e.g. others already work on some of the objectives) to work on the achievement of all the objectives. Choices for one or a limited number of objectives thus often need to be made. The choices will depend on factors such as: situational factors (see Box 2.1) the quality and completeness of the assessment (in other words: how well information

about the situation has been made available by the assessment) the proper analyses of the information obtained, the knowledge of the persons involved in the planning process, the personal preferences of the persons involved in the planning process, the methodologies used to prioritize the objectives (e.g. ranking methods can be used

which will contribute to more objective and more complete weighing of factors/variables identified while other methods might leave more room for more subjective forms of prioritizing),

activities by other organizations, the extent to which achieving the considered objectives is believed to contribute to

achievement of the objective one level higher (the perceived relevance of objectives), resources and experience available within the involved organizations/people, required speed of action, assumptions about issues that can not easily be predicted or on which no information is

available.

Box 2.1 : Situational factors(resources / threats / restrictions / potentials)

Situational factors are decisive for the possibilities to achieve certain objectives or to carry out a certain strategy. They may limit or enhance the possibilities. They can be divided in:

1. Humans (the refugees, your team, yourself)

2. Environment (trees, topography, water sources, climate, soil, stone)

3. Infrastructures (transport routes, communication systems)

4. Institutions (national/local government, agencies/NGO’s, local commercial sector, local markets,

the military, rebels, warlords, religious leaders)

5. Finances

6. Information (the media, universities, internet, existing reports, persons)


2.6StrategyOnce the program objectives have been determined a strategy will need to be developed for achieving the objectives as optimal and quick as possible. Often a more detailed description of the program objectives will be needed (with more detailed specifications, for instance with regard to timing, quality and quantity of the services needed). This again depends on choices made by the planning team but often also on specifications and/or rules of good practice prescribed by the organizations involved (e.g. the ones determined by the Sphere project).

The choice for a certain strategy will depend largely on the same factors as the factors involved in the selection of the program objectives. Important is to describe or have clearly in mind what the assumptions are. Describe so-called killer assumptions: assumptions that, if not true will make your strategy impossible to carry out. Define alternative strategies and motivate why the assumptions are reasonable and the strategy chosen the most optimal one for the situation. If at this point too many problems are encountered it may be necessary to choose other program objectives or reformulate them or change to one of the alternative strategies.

Box 2.2 : Example of two alternative strategies for achieving the same objective

Suppose you have a camp where you need water rapidly. There is a possibility of getting water from a river at 1 km away or you could use an existing borehole plus reservoir located inside the camp, which, however, needs a new submersible pump and generator.

Strategies can be to install a new pump in the borehole, to supply water from the river by water tankering or to quickly implement pipelines plus a pump. As time is an important factor the choice for one of these strategies will mainly depend on which can be realized most rapidly. This again will depend on questions like what materials are available directly, and what knowledge and skills do people available for the works have. Sometimes it is easy to motivate the choice for a certain strategy, sometimes also different alternative strategies are possible and it may not be so easy to choose. This manual concentrates on the phase after such a choice has already been made.

2.7Program design and activitiesOnce a strategy is defined the program will need to be designed. Activities may include: additional assessments design of facilities and decisions of the numbers needed of them design of non-material facilities (e.g. hygiene promotion services) design of the organizational structures needed (both for program implementation and

operation); this should include issues like task descriptions for the involved staff, development of monitoring systems and reporting formats

description of activities needed for the implementation of the facilities

Designs of facilities. Technical designs (e.g. designs for toilets or water systems). Other designs (e.g. a description of hygiene promotion methodologies and messages).

Organizational designs. Set-ups and task divisions both for program implementation and program operation.2.8Program success factors


The aim of each program is to be successful. Usually we mean with this that the program objectives will be achieved as well and efficient as possible. However, whether or not a program is successful also depends on what is 'considered' successful. This depends on things like the context in which the program is analyzed (for instance from an efficiency point of view a program may be very unsuccessful while at the same time the program may be an enormous success in terms of effectiveness and impact), personal preferences and so on. Success can thus be defined in different ways. It depends on the angles from which we look at it. These ‘angles’ are reflected by the 'success factors' that give each part of success its own domain.

Program objectives usually specify success factors to some extent through their wording and the specifications (indicators) attached to them. If the program is well planned and executed people working in those programs will obtain information with regard to these specifications on a regular basis (monitoring). This will enable them to adapt, improve and redirect things on a continuous basis, all in order to achieve the objectives in the best possible way and have a successful program. Which success factors are included depends very much on the type of program or even program part. With insect spraying programs for instance the success factor 'safety' is a very important one while in other programs this factor is not an issue simply because these programs can hardly cause any danger.

Success factors are determined and used during planning: to determine what information is needed as baseline information in order to be able later

to determine whether the program has been successful, to develop the strategy, activities and objectives of the program, and, with regard to this,

to develop specifications and tasks for staff in such a way that the program will be successful.

During program operation it is then important that people execute their tasks correctly. Part of this is that they obtain, analyze, interpret, react to and partly report information regarding the success factors on a regular basis to optimize the program, i.e. to make it as successful as possible in terms of what was regarded to be 'successful' during the planning phase.

During program evaluations usually a number of success factors are investigated in order to get an idea about what is considered by that evaluation 'the success of the program'. Depending on the objectives of the evaluation the same or other success factors than used for program planning and program operation are applied to ‘weigh’ the success of the program.

As success factors constitute such an important basis for programs it is good to have an overview of the main success factors used in emergency programs and/or in their evaluations. The most commonly distinguished success factors are:

Impact The actual results of the program. In emergency programs usually 'impact' is used in the mea-ning of 'the contribution to the objective at the highest level', in other words, 'the contribution to the health and well-being of the target population'. Information sources are usually health statistics (usually available through curative health programs executed in the camp), informa-tion about the watsan situation, social circumstances, etc. With regard to watsan: if positive trends in the incidences of water and sanitation related diseases go together with proof of well functioning watsan programs (effectiveness) this is accepted as a strong indication that these programs have a positive impact on health (the actual contribution of the programs to health can not be quantified or completely proven as simultaneously also other factors such as other programs, climate changes etc. do or may have an impact on those same diseases).


Other important types of impact may be: Environmental impact (which is often negative) Impact on others than the target population (which can be positive or negative) Unforeseen or unexpected effects (can be positive or negative) The contribution of the program to the protection of victims of conflict, the

stabilization of conflict, or the recovery of autonomy of the disaster victims. Often aid agencies have these kind of things as general objectives and see this as an important reason for being in an area. Protection from murder and harassment for instance may be the first need of a population under threat and the presence of expatriates and the program may help to prevent that the beneficiary population is harrassed or murdered to a certain extent. This can therefore be a reason to run a program which then has as one of its objectives (although often not spoken out or written down officially) 'protection of the beneficiary population'. Conversely, the impact of a program may also enhance the escalation of a conflict or bring beneficiaries in even more danger (which is then an unexpected effect)5.

Efficiency As it is difficult to assess the efficiency of a program in absolute terms it is better to ask whether the program can be executed more efficiently (i.e. at lower cost) than asking how efficient the program is. It may difficult to assess financial efficiency (e.g. a cost-effectiveness analysis) or the interest may be in other forms of efficiency. In these cases one can assess: Efficiency of the organisation: important aspects may be material and financial book-

keeping, phasing/timing of activities (though this may be part of 'effectiveness' as well), ability to react quickly/easily at changing circumstances, numbers of staff, kilometrage of vehicles used in the program, etc.

Efficiency of the approach and method used for implementation of the program. One could assess for example whether an approach putting more emphasis on participation of the beneficiaries or a better training of the local staff would result in a more efficient program?

Efficiency of timing and phasing the program. Resources will be used most efficiently usually if timing of activities is optimized and if programs continue to a next phase as soon as this is possible (it is for instance very cost-effective to shift as early as possible from emergency type of program to a participative program in which beneficiaries execute management largely themselves).

Functionality or effectivenessThe extent to which facilities (e.g. toilets, water taps, but also hygiene promotion methods and messages) function properly. This comprises aspects such as the quality of the facilities and services (which also includes proper timing of services), the numbers of facilities implemented, their distribution over the camp, etc.

5 An example of activities of aid agencies that brought the targeted beneficiaries in more danger. In November 1996 rebels attacked refugee camps in Zaire. Many refugees as a result returned to Rwanda but in several parts the refugees fled into the Zairean mountains. Aid agencies were allowed to operate in the area. They set up facilities along roads to provide direct services to the refugees as soon as they would come out of the forests on the roads and to transport them back to Rwanda as quick as possible. Special missions of the aid agencies went into the forests to find refugees. Whenever they found them they communicated this over their radios to their basis in Bukavu. However, in several of these occasions large groups of refugees disappeared suddenly after they were discovered. Many people believe that the rebels, Interahamwe or other fighters got the news about where to find the refugees by listening to the same radio channels and used this information to go and kill them.


UtilizationThe extent to which facilities are used properly. For instance how people use toilets, how people use health messages promoted to them.

ContingencyOne needs to have extra capacity for emergency purposes. An emergency can develop for instance if in an existing camp suddenly large numbers of new arrivals settle down. In a water program using pumps one should always have one or a few spare pumps, extra pipelines etc. not only for possible new arrivals, but also for unexpected large breakdowns.

SafetyIn some programs dangerous situations may develop. For instance during well construction poisonous fumes may build up during digging of the well when water is pumped out by a pump plus running generator lowered into the well. In spraying programs against insects there is always a danger that staff and/or beneficiaries get poisoned by the chemicals used.

SustainabilityUsually this is an important factor in development programs. In programs in camps it may also be of importance though. In hygiene promotion programs for instance the objective may be that people continue to practice improved hygiene behaviors not only during their camp period but also after they returned home. Sustainability definitely also is an issue in longer-term camps. In such camps usually the emphasis comes more and more on management by the beneficiaries themselves mainly for cost-effectiveness reasons.

Relevance/appropriatenessThis is about issues such as the extent to which a program works on problems that really do exist and are perceived as such. The question is usually posed to assess whether the resources could not better be used for solving other problems. Also the program should: Be in line with needs, priorities and policies of involved actors such as the beneficiaries,

other people living in the area, local and national authorities, the donors, the aid agency itself (taking into account that these may change over time and that the program should evolve with that).

Be tailored to local circumstances (cultural, socio-economic, institutional, financial) and enhance the use of locally available resources.

Address one or more major problems and with that effectively contribute to the overall objective (usually 'improve health and well-being of the target population')

Identify and work on other to the program related problems that were not known initially or that have developed later.

ReplicabilityThis is about the question whether a program can be executed in more or less the same way in other areas/camps as well.

CoordinationLooks into the effectiveness of coordination mechanisms.

Timeliness Looks into the timing and phasing of programs and activities (see also under 'efficiency').

Phasing out/handing overLooks into the way the program fits to longer term approaches.


Participation of beneficiariesParticipation has to do with the feeling of ownership and pride and as such is important for the well-being of the beneficiaries (the feeling of having your destiny in your own hands again; see also under 'Connectedness'). The degree of participation by the beneficiaries usually is also a good indication for the cost-effectiveness of the program although this definitely then needs to go together with other relevant information.

ConnectednessThe extent to which the emergency program fits in/connects to the longer-term context. Important aspects may be: Institutional aspects. Were adequate measures taken to prepare a withdrawal of the agency

and the handing-over to other organizations? Was the local institutional structure sufficiently taken into account to permit an easier integration and handing over of the project activities ?

Environmental aspects. Will the environmental effects of the project endanger long-term environmental protection and management?

Socio-political aspects - gender issues. What are the effects of the program on existing political and power relations, and gender relations, and how do these again affect the actual program results.

Self reliance - autonomy. Does the program contribute to a dependency syndrome among the beneficiaries? Is an effort made to facilitate a recovery of self-reliant and autonomous communities?

CoherenceAll actors involved in the camps, including political, diplomatic, military, humanitarian, should work towards the same overall objectives and their activities should be coordinated and streamlined and be carried out with an effective division of labor. The program should fit in this and actively contribute/take initiative to enhance a coherent overall approach.

AdvocacyBearing witness to the fate of the victims in the program area. Important questions: Are the policy of the program and the agency in this matter coherent with the policies of

other organizations? Is there an effective cooperation with other humanitarian agencies, UN agencies, local

government and other relevant organisations? Does the program have staff who specifically have this aspect being described as one of

their tasks? How dangerous may advocating the fate of victims be to expatriate and local staff

working in the area?

CoverageThe program should as much as possible cover the whole target population equally. It should also be assessed regularly whether the program should also cover other people, for instance local people living near the camps.


2.9The place of this manual in the planning processIn this document examples of organizational designs have been worked out for the operation of a number of standard water and sanitation programs commonly found in camps. It is believed that these examples are needed because: making organizational designs for program operation is a very time consuming activity,

time which field managers and their staff usually do not sufficiently have, it will help to make field managers and their staff more aware of the importance of proper

designs for the operation of their programs working out the design of a program operation is very complex requiring a high level of

knowledge and experience, and there is hardly any other good documentation available on this subject.

Much emphasis has been put on the gathering, analysis, use and reporting of information in the example designs. This is believed to be the backbone of each and every program. Proper information systems enable people to react properly and timely on all kinds of changes and to further optimize the program for the achievement of its objectives. In determining the kind of information needed we have based ourselves on the recommended minimum objectives we defined for each of the programs and their specifications. On top of that we have looked at which success factors we believed were important for the different activities and tasks in the programs and included aspects of these in the information systems if they were not yet included yet. The aim of all this is that programs operated according to the standard organizational designs provided in this manual will be successful and are regarded as such even if they would be evaluated on the basis of analysis of different success factors.

2.10 Recommended literature Davis and Lambert (1995). Engineering in emergencies. House and Reed (1997). Emergency water sources. Guidelines for selection and treatment. NORAD. The logical framework approach (LFA); handbook for objective oriented project

planning. ZOPP manual


3. General tasks

3.1 Introduction.This chapter describes a number of general operational tasks that are important for all water and sanitation programs executed in camps. They are:

Obtaining and interpreting health statisticsInformation gathering; description of some general techniques

Population censusTasks of general support staff

3.2Obtaining and interpreting health statistics.

3.2.1 Using health statistics to assess the impact of a watsan programGood health of the camp population is usually the highest level objective aimed at by all programs in a camp. It is therefore necessary to obtain information on the extent to which good health is realized. Information about the health of people is provided by health statistics: data on diseases (morbidity data) and deaths (mortality data).

Always keep in mind though that information about the health situation in a camp is not enough to know whether a water or sanitation program functions well. There are always other factors that also influence the health of the people at the same time. Other programs in the camp for instance and the season do have an impact on health (the rainy season for instance often causes a large increase in malaria).

Because of all these involved factors it is impossible to draw conclusions about the functioning of a water or sanitation program on basis of the health statistics alone. If for instance the health situation in a camp is very poor this does not automatically mean that the water or sanitation program is functioning badly and vice versa. To get a good idea about the impact of a water or sanitation program one should therefore combine information obtained from health statistics with information about the program success factors (see paragraph 2.8). Usually if positive trends in the incidences of water and sanitation related diseases go together with proof of well functioning programs (effectiveness) this is accepted as a strong indication that the programs do have a positive impact on health.

In this paragraph we pay attention to health statistics. We thereby concentrate on diseases which are or can be related to water and sanitation and are often common in camps. Such diseases are: diarrhea, malaria, respiratory tract infections, eye infections, skin infections, measles, meningitis and tuberculosis. Each of these diseases is shortly described in Appendix 11.

Chapter 3 : General tasksp. 17

3.2.2 How health statistics are obtainedData on morbidity and mortality can be obtained in the following ways:

Health statistics from curative health facilities: this is in camps often the most important source of information about health. The data are obtained from IPD’s and OPD’s1 . With the health statistics from IPD’s and OPD’s one can determine the incidence levels of the diseases. The incidence level of a disease is the number of patients diagnosed with that disease per week per 10.000 of the target population. To be able to determine incidence levels it is thus also needed to know the total number of camp inhabitants; often also incidence levels in the different camp parts are determined for which population figures for the different parts should be known. Health statistics from curative health facilities, if of good quality, often give a good indication of the health situation in a camp. One should keep in mind though that often not all cases of the diseases included in the statistics pass through the health system. Some sick people do not attend the health facilities, especially in case of diseases as watery diarrhea, which are by many people regarded not worthwhile to go to a health clinic for. Important is to control: whether the different health centers use the same diagnosis and registration procedures (if

health facilities are run by different organizations these may differ), whether the figures of both in and out-patients are included and to what extent the patients

were camp inhabitants (often also local people living near the camp visit the health facilities which may wrongly push up incidence levels if not accounted for),

to what extent the target population has access to the health facilities and actually uses them,

the quality of diagnosing and other quality issues (see also Appendix 12). Often it is better to look at trends in the health statistics over time instead of interpreting the absolute values of the statistics. Looking at trends is also useful if the quality of the data is not very good (as long as the statistics are obtained over time in the same way the trends may then still give quite a good indication of the developments). However some idea about absolute values is needed (e.g. a watsan manager should be able to recognize high malaria incidence even if the figure has been more or less the same for a long period).

Medical surveillance: surveys carried out to determine the prevalence of certain diseases. The prevalence of a disease is the percentage of the target group that at the moment of the surveillance actually has the disease. Medical surveillance is often carried out if an epidemic of a certain disease is suspected. They may also be carried out on a regular basis in case of endemic diseases that could become epidemic.

Death registrations: many health programs have staff who register the deaths (and the death causes as far as possible) in the camp during house visits (often the same staff who also carry out the medical surveillances and follow-ups on specific cases). The deaths are also sometimes registered at the graveyards (although these statistics are often incomplete as many people bury their deaths without registering them). To stimulate death registration health programs often offer goods (e.g. a sheet to cover the body of the dead person) in return for registering a dead person (controlled by health staff who also then determine and register the cause of death as far as possible).

In this paragraph we pay attention mainly to the health statistics from curative health facilities as this is usually the most important source of health data available in camps while the other sources of information are often not or only infrequently available and much less reliable.

1 Two kinds of curative health facilities are distinguished: In-patient Departments (IPD’s), facilities where patients stay to be treated, and Outpatient Departments (OPD’s), facilities where people come only to get a medical treatment and/or consultation and leave directly afterwards.


3.2.3 Analysis of health statistics from curative health facilitiesThe graphs on the following pages give an overview of thresholds that can be distinguished for general mortality as well as morbidity incidences of diseases related to water and sanitation. They are based on an analysis of health statistics from curative health facilities (including the interpretations by the producers of the documents containing those statistics) from a large number of curative health programs executed in camps in Africa and Asia during recent years (1990 to 1996). Only the thresholds determined for general mortality are based on other data as well, such as statistics from death registrations and the thresholds proposed in WHO guidelines.

Two threshold levels are distinguished in the graphs for each disease: a ‘high level’ above which it was generally concluded in the documents studied that there really was a large problem with regard to the considered disease, and an ‘acceptable level’ below which the general conclusion was, both in emergencies and non-emergencies, that there was no problem with regard to the considered disease.

Two types of incidences are distinguished: incidence of under fives which is the incidence among children up to an age of 5 years, and crude incidence which is the incidence among all people (under fives + over fives together).

Morbidity and mortality figures are also expressed as a proportion: the percentage of the total number of consultations in which again a distinction is made between 'under fives' and 'crude'.

The graphs only cover part of the watsan related diseases found in camps because of the other diseases insufficient data were found in the reports studied. For an extensive description of watsan related diseases in camps see Appendix 11.

Before using the graphs please be aware that they are indicative and first read paragraph 3.2.2 and the explanation of how to work with the graphs further in this paragraph carefully!


Morbidity MortalityIncidence (number of cases/10.000/week)

Proportion (% of total no. of consultations)

Incidence (no. of cases/10.000/week)

Proportion (% of total no. of deaths)

Disease Threshold < 5 crude <5 crude < 5 crude <5 crude

Mortality general highacceptable

- -

- -

- -

- -

14 7

73.5

- -

- -

Diarrheal diseases

Diarrhea (general indication for all diarrheas together)

highacceptable

200 90 60

25%10%

25%10%

4.0 2.0

acute watery diarrhea highacceptable

150 75

100 50

22%10%

22%10%

3.51.8

1.81.0

25%10%

25%10%

Bloody diarrhea (= dysentery)

highacceptable

100 30

65 20

Cholera action needed for each individual suspected or confirmed case

Fevers FUO (includes all suspected malaria cases)1

highacceptable

200100

30%15%

20.5

20%10%

Malaria (lab confirmed) highacceptable

100 20

Typhoid fever highacceptable

Filariasis highacceptable

Yellow fever highacceptable

Dengue highacceptable

1 FUO = Fever of Unknown Origin. All malaria cases should be included in this disease group with exception of the malaria cases confirmed by proper blood tests (which in camps is almost never the case; therefore, if in the statistics malaria figures are given, verify whether these are suspected or lab confirmed cases of malaria). For camps where malaria transmission usually is low: If the weekly incidence of FUO increases to two times or more, a cross sectional survey has to be carried out to determine the proportion of malaria cases among cases with FUO. If the proportion of positive bloodslides (obtain through microscopic survey) for P. falciparum in this sample is 50% or more (excluding new arrivals), this means that there is a malaria outbreak and practical measures have to be taken immediately (make sure that the blood smear testing is well done: often badly done and giving far too high percentages) (in the camps with low transmission investigated in Rwanda, Tanzania and Zaire this proportion was usually less than 20%).


Morbidity Mortality

Incidence (number of cases/10.000/week)

Proportion (% of total no. of consultations)

Incidence (no. of cases/10.000/week)

Proportion (% of total no. of deaths)

Disease Threshold < 5 crude <5 crude < 5 crude <5 crude

Skin diseases Scabies + other skin diseases

highacceptable

8040

12% (??) 5%

Pneumonial diseases

RTI general highacceptable

170 1.61.0

LRTI highacceptable

150 20%10%

URTI highacceptable

20%10%

Tuberculosis highacceptable

Eye infections highacceptable 65 35 3%

Measles not sure whether these figures are for vaccinated or not vaccinated populations

highacceptable

2010

Meningitis high 1.5/10,000/week during two consecutive weeks or doubling of cases each week during a three week periodacceptable 7.0 (??)


How to work with the graphsThe figures in the first row of each disease indicate the thresholds regarded as ‘high’. Even in emergencies the incidence levels found should not get above these figures. The figures in the second row of each disease indicate the thresholds that are regarded as ‘acceptable’. The aim should be to achieve these or lower incidence levels as fast as possible, especially in non-emergencies.

An appropriate way of using the graphs is as follows:

1. Always keep in mind that the graphs are indicative. Large differences may and do exist between different camps due to factors as discussed in Appendix 12 of this document. Therefore please read this appendix carefully in conjunction with the below advises on how the graphs can be used.

2. The field manager should obtain health statistics from the curative health programs as often as possible. Usually they are made available with weekly intervals. Look at the additional remarks for FUO’s and malaria at the bottom of the first graph. Appendix 11 contains descriptions of the diseases.

3. There should be at least some idea about the extent to which the health statistics effectively cover the whole target population and similarly the extent to which they also cover non-target populations. The figures should be adjusted for these sources of error as much as possible (if this is not possible the statistics should be used with even more care, i.e. don't rush into drawing conclusions but first investigate further; hurry up though if the indications are worrying). Further there should be an idea about whether there are differences between the statistics in the different camp parts. If there are large differences each camp part should be looked at separately. Finally there should be a good idea about the quality of the statistics (the less sure you are about the quality of the data the less you can draw conclusions from them). See further Appendix 12.

4. In general the ‘incidence levels’ in the graphs should be given more weight than ‘the proportion levels’.

If all this is taken into account, assessed and possibly adjusted for, continue:

5. For the diseases of which the incidence levels are at or below the ‘acceptable’ levels given in the graphs no specific action is usually needed unless a clearly rising trend can be distinguished making it likely that within due time the acceptable level will be surpassed.

6. For the diseases of which the incidence levels are between the ‘acceptable’ and ‘high’ thresholds one should distinguish between emergencies and non-emergencies.

Emergencies: get an idea about whether the levels can be brought down by improvements in the watsan programs or by taking up new watsan related activities. Investigation methods can be quick informal observations in the camp by yourself and/or program staff and discussions with: managers and staff of other programs in the camp, program staff, key resource persons and beneficiaries. However, if resources and time are too limited for additional investigations or measures one can for the time being accept the levels. The closer the figures are to the ‘high’ thresholds or the clearer there are upward trends in the statistics, the more caution is needed though.

Non-emergencies: basically being above the ‘acceptable’ thresholds can not be allowed, especially if there is an upward trend in the health statistics or if figures are close to the ‘high’ thresholds. Therefore, discuss together with managers and staff of all programs in the camp, key resource persons and beneficiaries about the possible causes and how the levels can be


brought down. A detailed assessment may be needed, especially if the causes are not well known and/or if after a few weeks of implementing additional measures no considerable improvements have been realized. Depending on the expected causes the assessment may cover all or only certain programs and it may thus also be needed to focus the assessment on the watsan programs. In case it is difficult to find any clear causes you may have to investigate the reliability of the statistics again. The discussions and investigations will need to give an answer to the question whether and how the watsan and/or other programs will need to be improved. Possibly a complete new program will be needed to tackle certain specific problems not dealt with yet by any of the other programs. In some cases experts may have to be brought in (especially in case figures go towards the high levels and in case of new activities).

7. In case incidence levels surpass the ‘high’ thresholds in the graphs immediate action is needed both in emergencies and non-emergencies. This means that directly a thorough investigation is needed (if the causes and remedial actions needed are not very clear) followed by immediate action. Depending on the outcome of the investigations (in which the watsan managers and staff should actively take part together with managers and staff of other programs in the camp, key resource persons and beneficiaries) immediate action will probably also be needed in the watsan programs. It will probably be needed to quickly bring in experts and extra resources for the investigations and immediate implementation of remedial actions.

8. In the weekly and monthly reports of the field watsan managers health statistics need to be presented together with a textual interpretation and comparison to the thresholds distinguished in the graphs.

Some examples of how statistics were interpreted in a few camps

///to be included///


3.3Information gathering: description of some general techniques

In this paragraph we pay attention to a number of information gathering techniques which are important for and used by many of the actors working in drinking water and sanitation programs in camps. The information gathering techniques described in this paragraph are: informal information gathering structured observations interviewing meetings

3.3.1 Informal information gathering.

Who can/should use the technique:All staff

When to use the technique:Continuously in all situations. However, informal information gathering is especially important in emergencies as in these circumstances very often there is insufficient infrastructure (people, equipment), time or security available to execute the structured ways of information gathering that would normally be required.

Explanation of the technique:Informal information gathering is information coming to people unplanned and without the use of any methodology for it. It is the information gathered, without having planned to gather it, through informal and unstructured every day observations/talks/meetings/discussions with/by program staff, managers and staff of other programs, yourself, camp inhabitants and so on.

Importance of the technique; what it can be used for:Watsan staff (including the manager) can use informally obtained information for:

Signaling: obtaining knowledge about problems for which no program activities exist yet.

Cross-checking: beside all the information obtained through structured ways informally obtained information can provide us additional information about our or other programs in the camp which can be used to cross-check whether programs do function as good as the structured information tells us and whether the structured information gathering of those programs in itself functions well.

Provision of information about subjects for which there are no structured information gathering methods in place in the program (e.g. because it is extremely difficult to obtain information about certain topics with structured methods, because structured methods would require too much time, because the equipment needed for structured information gathering is not available or because there is insufficient experience among people to work with certain structured information gathering methods).

(Remark: there are several structured and semi-structured information gathering methods that can have the same functions, e.g. during meetings, often much information can be obtained, if questions are posed in the right way and there is a respect and trust relation, important as a cross-check, to signal new problems or to provide information that can not easily be obtained in another way; often informal, semi-structured and/or structured information gathering methods can/should be used simultaneously to obtain better proof about things).


Example of use of technique:1. You are working somewhere and you happen to see or hear something of which, after you

think about it, you feel it could be of importance in one way or another for one of the programs in the camp (cross-check function), or more general for the health of the people in the camp while no activities exist yet with relation to that information (signaling).

2. A hygiene promotion program pays attention to handwashing after toilet use. In such programs it is hardly ever measured though whether the efforts have effect or whether people already know about the need for it and practice the behavior (explaining the need for that behavior in that case is not necessary any more). Unless information is obtained about the effects or relevance of the efforts it remains unknown whether the efforts are useful and how they should/could be improved. It may be difficult to obtain structured information though. Observing for instance how many people wash their hands after coming out of a toilet requires much time and effort. Most hygienists may be able to give quite reliable information though. They obtain the information every day through informal talks with people, their own unstructured observations when they happen to pass a latrine and see that people don’t wash their hands. Thy also know because they are themselves part of the people, and thus have a good understanding of the habits, culture, etc.

Remarks:Disadvantages of informal information gathering: difficult to find out whether or to what extent the information obtained through informal ways

of information gathering is correct, often not or hardly possible to assess the obtained information against the objectives of your

programs.

Example of the disadvantages:If you walk through the camp and you happen to see a few rats, which you have never seen before in the camp you may get the feeling that, may be rats have infested the camp and could become a plague. But you are not sure whether these rats are few and possibly have always been there. And even if there is a rat control program in the camp in which specifications have been formulated for the maximum allowable number of rats per area you will not be able to assess your informal observations against these. The only thing you can do is to take your feeling serious and further investigate with more formal and structured information gathering methods that should enable you to be surer and assess the information against the specifications set. And this exactly often is the importance of informal information gathering: it gives a first signal which should, if listened to and taken serious, trigger further investigations if the signs are clear enough that there might be a problem.

Despite the shortcomings (subjective, incomplete) informally obtained information often contains at least some valid indication and it may be the only possible way of getting information about certain subjects. So make program staff aware that they should be receptive to it, stimulate it, take it serious, use it and report it! Especially when time or access (e.g. due to insecurity) to the area is limited informal ways of information gathering may be one of the few options left to get information. Whenever they are in the camp, both manager and all program staff should regularly stop and talk to the camp inhabitants, not only to the men but also to women and children. Ask: ‘what problems do you have?’ Don’t ask: ‘what vector problems do you have?’ (because then suddenly everybody has vector problems), or ‘Do you have a problem with drinking water?’ (because the answer will then always be yes).

Most important with regard to informal information gathering is that everybody should be aware of its importance and what can and should be done with it. Program staff should be made aware that their ‘antenna’s’ for informal in many circumstances may be the only or best way of getting information and that they should share that information with others, even if it’s only a feeling or intuition.


Sharing informal information with others is a good method to verify/cross-check the validity of the information: if others have similar experiences independent of each other the chance increases that the informally obtained information is at least valid to some extent. In case of doubt, don’t ask others ‘did you also hear/see that?’ or ‘do you also think this happened?’, but ask ‘what do you think about this subject?’ or ‘what did you see when you were there yesterday?’ (with regard to the example of the rats you could for instance ask staff who work in the area were you saw the rats: ‘have you seen anything unusual or worrying in that area?’ then if they say ‘yes’ you ask them to explain what). So, if many people tell you about the same feelings or ideas they have about something or have heard or seen the same things (telling this to you independently of each other without the possibility that they have agreed on a certain message on beforehand with each other), then the chance that the information is right is increasing. This can even be structured by counting numbers of people who feel or have heard or seen something and compare them against the number of people (who were in the same position in which they could also have developed that feeling or have seen something) who don’t feel it that way or have not heard or seen anything.///other methods for analyzing/using informally gathered information are needed///

3.3.2 Structured observations.Structured observations are observations which are well planned and organized on beforehand and which are meant to yield quantitative data. The data have an absolute value in the sense that they can be used to assess them against the specifications for the objectives of the involved programs. The data may also have a relative importance though: if similar observations have been done before they may be used to determine trends which again may be used to assess whether the developments may lead in time to achieving objectives of the involved programs. The main sorts of structured observations are:

1. Continuous observations: observations that are carried out over an extended period of time, e.g. a few hours but sometimes longer. Examples: number of people washing their hands after leaving the toilet in comparison to the total number of people who visit the toilet, observed during a couple of hours; no. of times that people in a household scoop out water from a container while touching the water with their hands against no. of times that people scoop water without touching the water with their hands. Observation method: the observer should sit somewhere inconspicuously (if possible) for about 2 to 3 hours, but where he can see well what is going on, and register the observations done. Analysis: with regard to hygiene behaviors observed: calculate the percentage of the people observed to practice a proper behavior = 100 x no. of people who practiced the proper behavior/total no. of people observed with regard to that behavior. If the percentages found in different parts of the camp do not differ much, calculate the average percentage for the whole camp, otherwise calculate also the percentages for each of the camp parts. Beside this usually the observer also gives textual comments.

2. Spot-check observations: observations and registration made during a limited period of time directly after arrival at a certain site Examples: shelter has drain way or not, shelter has solid waste pit or not, water reservoir in household is covered or not. Analysis: count the total number observed in each part of the camp and the number fulfilling the criterion and calculate the percentage, e.g. 100 x number of no. of shelters with drainage in a certain camp part/total no. of shelters observed in that part (report the results of the analysis of the camp as a whole and also per part of the camp if differences between the parts are large).

3. Rating check observations: observations which require a judgement by the observer (can be spot checks or continuous). Examples: numbers of ‘clean’ toilets against number of ‘dirty’ toilets. It should thus be discussed on beforehand how the criteria are interpreted, in this


example, what is considered ‘clean’ and what is ‘dirty’. Analysis: same as with spot check observations.


3.3.3 Interviewing.This paragraph gives an overview of what is generally considered as interviewing techniques. There is some overlap with the paragraphs on informal information gathering and meetings that basically make use or are almost similar to several of the interviewing techniques described here.

Open or unstructured interviews: Informal conversational interviews: spontaneous talks with individuals/groups (see par.

3.3.1). Key informant interviews: informal interviews with people who have a certain specific

knowledge on the subject of interest. Focus group discussions: an open discussion amongst a small group of people on a

specific subject in which the interviewer acts as a facilitator, stimulating the participants to keep discussing the subject until no new points emerge (see further par. 3.3.4).

Topic focused interviews: the interviewer has a list with a number of topics that should be discussed during the interview and formulates the questions him/herself during the interview.

Semi-structured or standardised open-ended interviews:Interviews guided by a list of open-ended questions. The questions are posed in exact wording and order as written down. But they allow the respondent to give his or her own words, thoughts and insights in answering the questions. The questions are formulated after a qualitative investigation. This interviewing technique is often used in household surveys where the results should be comparable to the results of other household surveys (see further chapter 7).

Structured interviews:Interviews with closed instead questions which limit the answers to a predetermined set of choices.

3.3.4 Meetings.Meetings are events in which more than one person come together at a certain location and communicate with each other and sometimes work at the location on certain issues to accomplish a task (mainly formulating/documenting things together). Exchange of information between the participants and the possible facilitators is a central purpose of meetings. Another purpose is often decision making. The following types of meetings are discussed here: informal group discussions focus group discussions open group discussions mass meetings workshops

3.3.4.1 Informal group discussionWho can/should use the technique:All staff.

When to use the technique:Staff use this technique often when gathering spontaneously after or during work, exchanging information. It is of special importance also for hygienists who meet with small groups of camp inhabitants as part of their work.

Explanation of the technique:Informal group discussions are gatherings of groups of people discussing things without any planning or formal preparations made for it and usually without a specific subject set. Such


discussions are one of the ways for informal gathering of information, described in par. 3.3.1 and also shortly in par. 3.3.3.

3.3.4.2 Focus group discussionWho can/should use the technique:Mainly: manager, higher level staff, and hygiene promoters.

When to use the technique:Whenever there is a need to discuss with people a subject in detail.

Explanation of the technique:A focus group discussion is a discussion among a small group of people on a specific subject. The group consists usually of not more than 6 to 15 persons in order to make it possible for each participant to take actively part in the discussion. There is a facilitator, who has prepared the discussion and stimulates each participant (and especially those who are shy or less active in the discussion for whatever reason) to keep discussing the subject until no new points emerge. The facilitator mainly asks open questions (questions that can not be answered with yes or no) and sometimes explains some things if the participants really lack knowledge. The subject of discussion can be decided on by the facilitator, or, which is preferable, by the participants themselves or by a few representatives of them (which should then be done some time before the meeting allowing the facilitator to prepare the discussion about that subject).

Importance of the technique; what it can be used for:1. To enable people to build up knowledge and become aware themselves about the subject2. To obtain information about the people’s knowledge, awareness, ideas, beliefs, possibilities or

restrictions with respect to the subject.

People learn best and also become aware about things (i.e. built up motivation to really practice the things) by discovering those things themselves. Therefore to transmit knowledge and stimulate people to become aware in first instance the best thing to do is to ask questions about the subject only and let people discover the answers and form their own opinions through discussion among themselves. This motivates people much more to be open to the subjects discussed and to accept and do something with the outcome of the discussion while it also increases people’s self-esteem (we knew all this ourselves!).

Example of use of technique:Focus group discussions are often held with groups of camp inhabitants to discuss one or a few hygiene behaviors (the hygiene promoter then being the facilitator; see chapter 7). It can also be held with staff to discuss certain things with regard to the work (higher level staff or the manager then usually being the facilitator).

Methods used: open questions following up upon each other pocket charts (optional) explanation of things registration of the discussion either through writing or with a recorder (optional)

Preparing a focus group discussion:For asking the questions the facilitator can make a list of the aspects he would like to pose questions about. The list should be such that if people have discussed all the questions they should all have a good understanding and awareness of all aspects involved with the subject (including different opinions etc. so that people can form their own opinion based on a complete overview of all aspects involved and all opinions).


Some hints for the facilitator on how to act during the meeting:

Keep in mind what your role is

1. To stimulate the participants to focus the discussion on the subject and ensure that all participants are enabled to look at the subject from all possible angles and standpoints so that each of them will have a complete overview and understanding of all aspects and be able to form a well-balanced opinion about it (which not necessarily has to be the same opinion as the facilitator or other participants; the strong convincement behind it is that people are capable and should be respected to form their own ideas and opinions which are best for and/or most suitable to them, as long as they have been enabled to build up an understanding of all aspects involved with the subject).

2. To observe and listen carefully and learn about what people already know, what knowledge is lacking, to what extent people are aware and why or why not they do practice or use the knowledge with regard to the subject. Focus group discussions may for instance be held to find out what hygiene subjects need attention and in what form. The obtained information should be fed-back to the involved programs and be used to improve those programs. To be able to execute this role well it may be necessary to record the discussion. This can be done by someone writing down the things said/discussed, or by a tape recorder.

Prepare the meetingDevelop a number of questions with regard to the subject. The questions should follow-up on each other. For instance when promoting latrines and the need to keep them clean you can start with questions like ‘Where do we go to the toilet?’ , then ‘What kind of toilet do we prefer?’, then ‘Why do we prefer such toilets’, then ‘What is better for our health, going to the preferred toilet, or doing it the way we do it now?’, then ‘Why?’ etc. (see also the example lists of questions for group discussions with regard to hygiene subjects in Box ..., chapter 7).

Invite suitable participantsInvite relatively homogenous groups that have something in common in relation to the topic (directly or indirectly), for instance groups of women, leaders, or persons from a particular area where certain problems exist. Let the participants decide on the place and time. Six to twelve participants is often cited as ideal but do not turn people away. Try to sit somewhere where there is privacy. This may not always be possible though (ask the participants on beforehand whether they know a suitable place). The discussion can also be held under a tree or outside someone’s shelter. If more people attend the meeting, explain why initially you wanted a small group (the reason for a small group is that you want each participant to have enough possibility to come forward with his or her answers, ideas, opinions) but that everybody is welcome.

Introduce yourself to the groupExplain the subject of the meeting clearly. Express the hope that everybody, including yourself, will learn from the meeting. Explain that there are no right or wrong answers to the questions (especially in cases where opinions with regard to the questions are important). Then you can ask the participants to first decide on how they will discuss. Usually people decide then together that they should only speak one at a time (otherwise ask them to do so), that everybody should be able to give their opinion, sometimes they decide to appoint someone among themselves to record the things said, etc.

Ask open questions as much as possibleThese are questions that give room to the respondent to formulate her or his own answer without any limits to it and that can not be answered with yes or no. During the discussions use the opinions and things said before as a basis for the coming questions, if necessary adapting the questions that were planned to be posed.


Clarify things and obtain information by asking questions and sometimes by explainingIf it appears that people do not know or understand certain things it is necessary to first clarify these. This should preferably be done by asking additional questions that may help them, when discussing those questions, to find the answers themselves and obtain a better understanding. If necessary explain certain things shortly, but take care not to interfere too much in the discussions and restrict yourself to providing knowledge only and not pushing a certain (your) opinion forward. So don’t say ‘you must wash your hands’ because this is a conclusion that people will hopefully draw themselves once they understand why that is important. Instead you may decide to explain how diseases can be transmitted (use drawings etc.) and ask people what they think they can do to prevent such disease transmissions if you have the feeling that the knowledge about this is lacking and that this is the main reason for not practicing the desired behavior (in this case handwashing).

If it appears that people do have the required knowledge but still don’t wash their hands don’t ask ‘why don’t you wash your hands?’ as this may be interpreted by people as a conviction. Instead ask things in the third person: ‘What do you think could be the reason for people not to wash their hands?’ or 'what could be a reason for people to wash their hands?'. Also if the discussed subject is or could be in the taboo sphere it may be better to refer to things in the third person. For instance don’t ask ‘what do you use for protection during menstruation?’ but ask ‘what do women use to protect themselves during menstruation?’.

It may for instance be that things like cultural habits, beliefs or preferences, religion etc. have a relation to the subject and cause people to practice an undesirable behavior even if they have knowledge about it. You may then better emphasize these aspects and ask questions about them (to see whether within these cultural issues acceptable solutions can be found) instead of approaching the subject from a scientific point of view. If people ask your opinion of something answer for instance that you will participate more once you have heard their views.

Inform people about existing programs and initiatives related to the subjectGive the participants information about existing programs and other initiatives related to the discussed subject. Explain how they function, who they can contact about it, how they can get assistance with regard to the subject etc.

In case you are recording the discussion with a tape recorderWhen recording the discussion with a tape recorder make sure that the recorder can register everybody’s remarks (women often speak very softly and there may be background noises). Therefore it may be necessary to sit in a place where background noises are limited. Also ask people to speak loudly and don’t talk through each other. Remember that people may be more shy if their remarks are recorded in one way or another which may rehold certain people to speak openly thus causing the discussion to not be fully representative and not providing all the information and opinions one would otherwise have obtained (so if you are afraid for this effect, don’t use a recorder). If not recording the difficulty is that you will have to remember all the relevant things said write them down or memorize them by head in order to feed-back the important issues to the involved program.

Ending the meetingBring the meeting to a close when you feel that the subject has been exhausted. If problems have been identified try also to get people to consider any possible solutions, especially what they can do themselves to solve the problems. Ask them how they intend to implement them.

Thank the participants for their contribution to the discussion and their time. Ask them whether they think that everybody has fully participated and that all things were sufficiently discussed. If not ask them to speak out further and continue the discussion trying to further motivate especially shy people to speak out.


If you think it is useful/important you can ask the participants whether they would like to be involved in further discussion groups, if you could meet up with them again to discuss any further conclusions you or they have come to or discuss things that were/are not clear, or to prepare for follow-up actions resulting from the meeting. Also explain them that you will feedback the results to your program and that you will keep them informed about anything done with that feedback. Be careful though not to promise things of which you are not 100% sure that they can/will be realized!

Learning facilitators learn:People who are involved in training facilitators about the techniques and skills needed for focus group discussions should keep in mind that they should use the same approach as used in focus group discussions to stimulate/enable the trainees to build up knowledge and become aware. Only if facilitators have a full understanding and awareness of the usefulness of the approach (i.e. enabling people to learn through asking questions) will they use it themselves. So, have focus group discussions with the facilitators and ask them questions, only explaining things with regard to pure knowledge (for instance giving a talk about the principles behind behaviors of people and the relation with Knowledge, Attitude and Practice; see chapter 7), not pushing forward the opinion that they should use this approach. Such trainings thus need careful preparations.

3.3.4.3 Open group discussionWho can/should use the technique:

When to use the technique:

Explanation of the technique:

Importance of the technique; what it can be used for:

Example of use of technique:

Remarks:

3.3.4.4 Mass meetings

Importance of the technique; what it can be used for:The purpose of a mass meeting is to have contact during a short time with a very large group of people (up to 4000 people or even more is possible) in order to transmit certain important messages effectively during that very short time and in that same time learn about what the major problems and priority needs are as perceived by the people attending the meeting.

Who can/should use the technique:Manager(s) of water and sanitation program(s).

When to use the technique:Mass meetings may be held when things change rapidly suddenly either in an emergency or when there is a threat that the situation may develop into an emergency.

Explanation of the technique:The effect of a mass meeting is usually caused by the fact that a by the beneficiaries regarded important official person calls for and heads the meeting (which also ensures that people will turn up in large numbers). This person can be the manager of a program, a tribal, political or military


leader etc. In water and sanitation programs it is often the manager of one of the programs who calls for and heads the meeting, assisted by senior program staff.

Also the subject of the meeting is important. We think that spreading the news that you want to talk about a certain subject but that people can also express their problems, needs and priorities will assure a high turn up.

The person heading the meeting uses his influence through his status and by the things he says to convince people of the messages he wants to promote. Instead of concentrating on the message only it is better to start with asking the people to tell you about what they feel are their main problems and needs. This will give you an idea of the major problems people are facing and perceiving as a priority to them. The fact that you are willing to listen to them and take them serious will ‘open up’ people (invite especially women to talk in the meeting and discuss their problems). They will understand that you are also ready to listen to them, which creates trust and respect.

This however also has consequences: the fact that you ask people to come forward and express their problems and priorities raises expectations! It means that using this approach will oblige you to do something with the information they provide to you! We recommend acting as follows:

With regard to the problems brought forward which are not concerning your program you can tell them that you can’t do much about it, only that you will pass on the information to the relevant programs in the camp and feed-back to some of the representatives of the beneficiaries about what has come out of that (which you will then also have to do!). Then concentrate on the things brought forward by the people which are concerning your program (discuss and agree with them on what they will do about it themselves and what the program can/will do) and only after that, if still necessary, you can continue discussing the messages you want to promote to the people.

To prepare the meeting:1. Discuss with others involved about the need of the meeting and the subject(s) to be dealt with.2. Visit community leaders to inform them about the meeting, the time and location, and the

purpose (and ask their opinion about it; discuss with them; be ready to adapt if necessary).3. Ask the community leaders to ensure that many people will turn up.4. If necessary, send staff around to invite people to come to the meeting and explain them

shortly what it is about.A mass meeting can be planned, prepared and executed within a few hours if necessary!

During the meeting:1. Have staff to explain arriving people where they can sit or stand.2. Have staff to assist with translation if necessary (make sure to have the megaphone available

although it should preferably be used as little as possible as it creates ‘a distinction’ between you and the people)

3. Discuss with the people as explained above. Explain the reason for the meeting first (you want to pass on a message but, more important you want to learn from them what their problems are). Speak with a friendly but loud enough voice (preferably not with the megaphone). Invite the people to stand up and speak out loudly if they want to say something, not to wait but react directly on the things said, not to be shy, and invite especially the women and elderly to speak up.

4. Ask one or two of the staff to make notes about the things said (or, better, make notes yourself: it further convinces people that you take them serious and that you will do something with the things they say).

People usually start with telling you about all the material things they are lacking. Be prepared for that and think on beforehand what you will answer to such questions/remarks.

After the meeting:Follow up on the things discussed.


Example of use of technique:In a camp in Rwanda there was suddenly a large influx in February 95 of new arrivals within 4 weeks (30.000 new arrivals on a total camp population of 50.000) due to unrest in certain parts of the country. Mass meetings with 3000 people (heads of families) per meeting were held to convince people that they had to dig latrines as the situation was rapidly deteriorating (new arrivals were using latrines of people who already had built one which caused frictions, open defecation was increasing, etc.). Some staff started to argue that the participatory approach of the program should be abandoned and that the program should dig latrines for the people. Instead it was chosen to hold mass meetings with both the new arrivals and the people who lived already longer in the camp. The result was that many people who already had a latrine started to allow new arrivals to make use of their latrine for the time being while new arrivals started to dig latrines in large numbers. Within a few days (!) the problems were almost solved. In the same meetings it was learned that one of the biggest problems of the people was the lack of plastic sheeting for their huts. This information was passed on to other programs in the camp. Unfortunately not much could be done, as the military forces did not allow distributions of plastic sheeting. Things were further investigated though and for the worst cases some sheeting was distributed secretly.

3.3.4.5 WorkshopWho can/should use the technique:

When to use the technique:

Explanation of the technique:

Importance of the technique; what it can be used for:

Example of use of technique:

Remarks:


3.4 Population census. Counting inhabited huts and determining the average number of inhabitants per hut. Obtaining figures from other programs. Mapping. Counting from the air. Interpretation from aerial or satellite photographs.

3.4.1 Counting inhabited huts and determining the average number of inhabitants per hut.Let staff who are good in counting (often hygiene promoters, sometimes together with sanitation workers) count the huts in all parts of the camp and let one senior staff person cross-check the countings in a few places. They should not count abandoned huts! Multiplication of the numbers counted with the average number of household members per hut (see below) gives a very good approximation of the total population in the camp usually. Asking households with how many they are can be done by asking ad randomly to household members at their huts (ask at least at 0.5% of all huts and never less than 50 households), or, though less accurate, by asking people at for instance a market in the camp with how many they live in their huts (ask to 0.1% of the estimated population with a minimum of 50 people). Be careful: often numbers of household members change very fast, e.g. when the mobility of people is very high (people often work in other areas where they stay some time, or whole families migrate up and down between different camps, for instance to get food rations from more than one camp). Timing: at least once a month and even once every two weeks or more when the camp population changes fast. Execution: by programme staff who are accurate and good in counting. Reporting: include figures obtained in all reports.

3.4.2 Obtaining figures from other programs.But be careful: the figures may be inaccurate. An example: food programs often work through local chiefs who are asked for the numbers of their people in the camp. The chiefs often try to push up the figures as much as possible in order to get more food supplied to their people. Try to get an idea about accuracy by asking how the information is obtained and, especially if you don’t have other population figures, try to get population figures determined with different methods. Also curative health programs often do population censuses (usually reasonable quality). Best is to do your own census as described in par. 3.4.1 and compare the figures obtained with the figures from other programs (include all figures in the reports and explain textually, especially if differences are large).

3.4.3 Mapping. Make a rough map of the camp and divide it in 100m x 100m grids. Define for each grid whether it is low, medium or highly populated, and count for each category the numbers of people in a few of the grids. With these figures an average number of people per category can be determined. After this a rough estimation of the camp population can be made. Especially suitable in emergency phase (for instance when many people have not yet built a good hut).

3.4.4 Counting from the air. Especially in situations were large numbers of people enter in an area without any services established nor huts built etc. one should try to organize a small plain or helicopter to observe things from the air (initial counting of numbers of people is one of the things, others are observation of possible water sources, identification of proper camp sites, soil conditions etc.). If influxes continue to be large counting from the air may have to be continued on a regular basis for some time.

3.4.5 Interpretation of aerial or satellite photographs. ///still to be worked on///


3.5Tasks of general support staff.General support staff are all staff in a program with a supportive function, executing tasks which are meant to better enable others to do their tasks. Support staff often fulfill supportive tasks for more than one program although this is not always so.

The general support staff described here are: field administrator office administrator office logistician program manager

The below organogramme highlights the positions of general support staff in water and sanitation programs in camps:

Figure 3.1 Organogram of general support staff described in this paragraph

Other general support staff not described here are: drivers and other staff working at the office level team coordinator support staff at the country and head office levels


Field administrator

programs under the program manager'sreponsibility

Program Manager Office administratorOffice logisticien

3.5.1 Field Administrator

Tools/materials needed:3 pens, 3 notebooks, administration item cards, ruler, scissors, hole puncher, stapler, staples, ...

Number of Field Administrators needed: one head field administrator, possibly assisted by one or two storekeepers, in case many water and sanitation programs are included, working in the main store and going out to control things at the other sites and smaller stores.

Tasks (both for emergencies and non-emergencies):

Task Description Timing Specifications important for execution of the task

Manage the field store

When materials, tools or equipment arrive count them carefully, control their quality and only when everything is OK accept them and sign for acceptance. After that store them correctly and register them on their respective store cards

When people come to take things make sure that each item they take is registered at the right store card, including: 1) the amounts/numbers of the items they take, 2) the name of the person, 3) the purpose of use, 4) signature of the person taking the items, and 5) if the items are borrowed, the agreed date on which they will be returned to the store. Also control whether new items should be ordered (if the balance is going toward the minimum required amount indicated on the store card new items should be ordered; to ensure ordering supplies in time take for each item into account the delivery time and the rate at which the item is leaving the store)

When people bring back borrowed items make sure they sign on the store card for it and add the number of the items that were brought back to the balance

If doubting about authorized use of tools, materials or equipment by any person obtaining things from the store try to find out to what extent unauthorized and undetected use may be the case. Crosscheck with your and other administrations to find proof for any unauthorized use. This can be done for instance by asking people who were supposed to receive materials whether they have really received them, looking at other uses of material which are connected to the things under research in one way or another (see example of soap distributions), etc. See also the examples given.

Check whether uses of materials, tools, equipment which are expensive or in short supply can not be replaced by alternative items which are in better supply or less expensive. Discuss regularly about this with other involved staff, supervisors and manager.

Make sure that chemicals, fuel and lubricants, food items and other items are stored separately according to the prescriptions

continuously

see example of store card

Check all materials, tools and equipment in the store

Count all materials, tools and equipment in the store and compare with the store cards whether numbers/amounts are correct. If not, report immediately to the manager and find out the reason.

Control for all tools, materials and equipment whether their numbers/amounts available are still sufficient for operation and contingency purposes (required numbers should be written on the cards). If things are in short supply they should be ordered immediately again.

Check for each store card whether there are borrowed items, which have not been returned to the store in time. Make a list of these cases and follow these up during the days after-wards (let someone go and find the involved persons and let those explain things). Report to the manager in case people do not have the borrowed items any more.

Count all the materials, tools and equipment in other stores (e.g. the plumbers’ store) and control with the administration of the field store.

once a month

Look for alternatives for rare or expensive items

In case certain items needed are difficult to find look at local markets for alternative items that can also fulfil the function for which the item is needed.

Whenever needed

Control lists of all sites and cross-check a few

Once a month control all lists with materials, tools and equipment and the lists of spare parts use of the different sites (pumping stations, tank stations, treatment site etc.) and compare with the administration of the field storeEach month crosscheck a few of the lists by actually visiting the involved sites and count yourself the numbers of tools, materials and equipment.

once a month


Form 3.1 Example of store card for field stores

Store cardName of item: Code of item: Minimum quantity that should be in store:

Date Amount Amount Balance If borrowed If received, reason for Details of receiver, borrower or supplier Signature forissued received agreed date of

returnReason for borrowing receiving Name Signature for

agreementagreement by administrator


Card number:______________

3.5.2 Office administrator//For materials, tools and equipment largely the same as for field administrator, although this may be done by a separate storekeeper falling under the responsibility of the office administrator (or of the office logistician). The office administrator is also responsible for financial administration ... still to be worked out///

3.5.3 Office logistician

3.5.4 Program managerThe program manager is responsible for one or a number of water and sanitation programs in one or a number of camps. In this paragraph the general tasks of a program manager are described while in the chapters on the programs additional tasks of the program manager specific for those programs are described.

Tools/materials needed:pen, notebook, report forms, rubber boots, small rucksack,... + access to computer (e.g. notebook), printer, copy machine, communication means (e.g. telephone, e-mail, radio, satellite connections), handbooks (see recommended literature in each of the chapters), and other means to run the programs effectively (e.g. cars, repair facilities, etc.)

Number of field managers needed: Emergencies: ///clear guidelines needed/////Non-emergencies: //??one per large program in one or two large camps (up to 150.000 inhabitants altogether)?? more guidelines needed!///




Coordinate direct action

Whenever action is needed, be on site to instruct people and discuss with them about the most appropriate actions. In case of doubt contact the other managers or the coordinator to get feed-back

every day

Control field administration

In the main and other stores count the numbers of several of the items and check with the store cards. Cross-check several of the items which are ‘connected’ with each other (e.g. if for each latrine slab distributed also a bar of soap is distributed, after finishing the latrine, the numbers of these items distributed should be more or less equal).

once a month

see task description of field administrator

Camp walk Informal walk through the camp during which spot check observations are done and short informal discussions held with people about water and sanitation related topics. The walk is usually planned to pass certain areas or structures of interest and often focuses on certain subjects. The information is noted down, as much as possible in quantifiable terms, e.g. the no. of the huts observed to be unclean against the total no. of huts visited. Other staff usually accompanies the manager. Follow-up on the results.

once a week to once a month

For spot check observations see par. 3.3.2For an example of a camp walk see Appendix ...

Follow-up on problems

Follow-up on problems reported to you or detected by yourself, even if you think they are not very important (enables you to check the magnitude of a problem and to show the involved staff that you take them serious). In case no time available to check yourself ask other staff to further investigate. Also take personal problems serious; even stimulate people to come to you with their personal problems. It creates trust and respect. In case of suspected or proven theft it may be necessary to dismiss the involved person(s) (try to proof; be careful with national regulations with regard to dismissing persons)

continuously

Meet with supervisors

Meet regularly to discuss certain problems or to discuss the work in general. These meetings can be called for by the manager or by any of the supervisors. One can also decide to hold such a meeting at fixed intervals (e.g. once a week). Discuss problems, ideas etc. Make sure to follow-up on the outcome.

preferably once a week + when believed necessary

informal or focus group discussions (see par. ..)

Meetings with staff

These can be informal meetings during field visits, formal, well prepared meetings, workshops or training sessions. You or any of the staff can initiate them.

when belie-ved necessary, or when proposed

see par. ...

Meetings with others

Meetings with beneficiaries, leaders and key informants, etc. These can be informal meetings during field visits, formal, well prepared meetings, mass meetings (with beneficiaries), and workshops.

whenever believed necessary

see par. ...

Visit staff during their work

Go into the field with different teams or individuals of staff and observe how they exe-cute their tasks and at the same time discuss with them about the work, what they think of it, their problems, ideas, etc. Try to give every group attention at regular intervals but concentrate on the staff who have problems with their tasks (get info about this through discussions with everybody, info from the supervisors and your own observations). Often such visits are done together with the supervisors of the staff. Control some of the logbooks and weekly reportings of that staff and crosscheck with the reporting done by the supervisor. Also crosscheck by doing observations yourself (e.g. counting the fuel drums at a pump station etc.; see also the specific tasks described in the chapters on the programs). In case of doubt about correctness take logbooks and/or reports with you for further study. Make sure to follow-up on the outcome. During the visits also talk to camp inhabitants, caretakers, leaders etc. who you meet during these visits (mainly to discuss subjects related to the staff visited at that moment).

as often as possible

Look at the task descriptions of the staff visited

Meetings with other managers

Attend meetings with other organizations and also meetings with the other managers of your own organization. Be open and provide all information you have available. If such meetings are not regularly held try to initiate them. Obtain all information needed (especially health statistics, and other information relevant for the programs under your responsibility) and coordinate actions to be taken

Meet at least daily with managers of your org. and weekly with mana-gers of other org.

Obtain and analyze health statistics

If not obtained through the above-described meetings, make sure to obtain them in any other way (ask the responsible managers for them). Find out which parts of the camp they cover. Analyze the statistics as much as possible together with the managers of the curative health programs and develop appropriate action according to the outcome. In-clude results and explanations/interpretations in weekly and monthly reports.

every week For health statistics see par.....

Reporting weekly report monthly report

every week

every month

See Forms ... and ... + the Forms in the chapters about the programs


Form 3.... Example of weekly report by the Program Manager

Country:________________ Camp:__________________ Date:_______________

Name program manager:___________________________________General part

Programs under the manager’s responsibility

Total numbers of staff and beneficiaries (per program)

Staff

Beneficiaries

Are new arrivals expected soon? If so, describe

Security problems encountered or expected to become a problem soon? Describe

Remarks, ideas, activities undertaken, problems encountered, which are not covered by any other part of this report? Describe

Any large changes with regard to the other organizations active in the camp and the programs they execute? Describe

Population

1 2 3 4 5 6 7 8 9 10 11 12 13

Last day of week 1 =____________ (fill in date) x-----x----x = total population O---O---O = population of camp part ....., etc.

What to do:1. Copy population graph from last week and fill in the population figures for this week2. Fill in the graph for total population and, if possible, for the populations of the different camp parts, especially if

there are large differences in the health statistics and/or other developments between those parts. Give textual explanations on a separate page or on the back of this form.

Fill in the below table, also for the subjects for which no program activities exist (yet) (use back of form if necessary)

Activities realized last week Problem(s) detected / suspected? (Y/N). If yes, give short

Actions planned/proposed


100 90 80 70 60 50 40 30 20 10 0

Weeks

Population (in thousands)

Subject description of problem(s)water

toilet facilities

drainage

erosion

solid waste

vectors

corpses

shelter

livestock

hygiene behavior

Other subjects (describe)


Health statisticsWhat to do:1. Copy health statistic graphs from last week.1. Register on the copies the incidences for total mortality and the most important watsan related diseases for this

week (for the whole camp, and, if needed, for different camp parts). Give interpretations on the back of this form.

Last day week 1 = ____________ (fill in date) x-----x----x = incidence ‘under fives’ O---O---O = incidence ‘crude’

Total mortality

1 2 3 4 5 6 7 8 9 10 11 12 13

Disease:

1 2 3 4 5 6 7 8 9 10 11 12 13

Disease:

1 2 3 4 5 6 7 8 9 10 11 12 13

Disease:


200180160140120100 80 60 40 20 0

200180160140120100 80 60 40 20 0

200180160140120100 80 60 40 20 0200180160140120100 80 60 40 20 0

Weeks

Weeks

Weeks

Incidence(cases/10.000/week)



1 2 3 4 5 6 7 8 9 10 11 12 13

Disease:

1 2 3 4 5 6 7 8 9 10 11 12 13

Disease:

1 2 3 4 5 6 7 8 9 10 11 12 13


200180160140120100 80 60 40 20 0

200180160140120100 80 60 40 20 0

Weeks

Weeks

Weeks




Form 3.... Example of monthly report by the Program Manager


Name program manager:___________________________________

////Still to be worked on. Include:

general part of weekly report+monthly report parts of programs included+map of the camp with facilities of the programs, boundaries, main roads, public health centers, markets etc.+ Executive summary. Short description of the history of the program(s) reported on, including a broad outline of

the original strategies and planning, the changes made in the planning so far (and the reasons for them), and the current main objectives and time frame of the program(s).

General description of the environmental health situation in the program area(s). Discuss progress, results, and problems of and coordination with other

organizations/programs as far as they are relevant/important for the program(s) reported on.

Describe other (potential) problems or issues important for the program(s) reported on (e.g. security, (potential) problems with water and/or sanitation related subjects for which no program activities exist, (potential) influx of new arrivals).

Describe important (unforeseen) activities carried out that are not standard for the program (unofficial activities).


4. Drinking water4.1 Introduction

The recommended minimum objective of a water supply program is:To ensure that, in accordance with the below specifications, water is available in sufficient quantity and of sufficient quality to the targeted beneficiaries6.

Specifications for the recommended minimum objective of a water supply programWater quantity

Situation

Subject

Emergency Non-emergency

general Water quantity is more important than water qualityWater availability must be: (water needed for

people, including personal needs, health centers, feeding centers etc. + water needed for livestock + if possible water needed for other water uses) x 110%. Give account to increases in population and livestock numbers in the near future (coming weeks to months). Assure sufficient clean water for people, esp. for drinking

For livestock, irrigation, laundry, personal cleanliness, washing dishes, household cleaning, water of less quality can be used

Be aware that people often have access to different alternative water sources that may reduce the quantity of water that needs to be produced by the drinking water program.

Water quantity is more important than water qualityWater availability must be: (water needed for people,

including personal needs, health centers, feeding centers etc. + water needed for livestock + water needed for other water uses). Give account to possible increases in population and livestock numbers in the future (coming months to years). Assure sufficient clean water for people, esp. for drinking


Be aware that people often have access to different alternative water sources that may reduce the quantity of water that needs to be produced by the drinking water program.

person 3-5 l/person/day. 3 is the minimum for cold weather, 5 the minimum for hot weather

10-20 l/person/day, depending on water availability, water use culture, climate etc.

health center/hospital out-patients

5 l/patient/day same

health center/hospital in-patients

40-60 l/patient/day same

cholera center in-patients


Feeding center therapeutic feeding

? 30 l/patient/day

Feeding center supplementary feeding

? 15 l/patient/day

Surgery/maternity 100 l/patient/day sameKitchen in health facility


Family latrines none 2-8 l/cubicle/day for cleaning latrine?1-2 l/user/day for handwashing

Defecation field none 1-2 l/user/day for handwashingAnal cleaning 1-2 l/person/day sameCommunal trench latrines

none 2-8 l/cubicle/day for cleaning?2-8 l/m of trench/day for cleaning latrine?1-2 l/user/day for handwashing

6 Activities regarding water use in households are not included in this chapter; they are described in chapter 7.Chapter 4 : Drinking water

p. 45

Specifications for the recommended minimum objective of a water supply program (continued)Water quantity (continued)

SituationSubject


pour-flush latrine (1-4 l/flush)

don’t apply in emergencies, especially not when water is scarce and/or difficult to obtain

2-8 l/user/day

conventional flush (10-20 l/flush)

don’t apply in emergencies, especially not when water is scarce and/or difficult to obtain

20-50 l/user/day

Schools none 10-15 l/cubicle/day for cleaning the latrine1-2 l/user/day for handwashing

Mosques none 5 l/person/day?Other communal units

none 5 l/person/day?

Offices none 5 l/person/day?Aid staff 30 l/person/day 80 l/person/daycattle 20-40 l/head/day?? samedonkeys, mules, horses

10-40 l/head/day?? same

Pigs ? sameChicken 20 l/100 chicken/day? samesheep, goats 1-5 l/head/day ?? samecamels 40-90 l/head/day ?? sameirrigation In an emergency usually not a priority, especially if water

is scarce. Therefore only apply if drinking water requirements are covered and sufficient water is available for irrigation. If irrigation possible: 3-9 mm/day, depending on climate, crop type and soil type.

3-9 mm/day (only allow irrigation if sufficient water is available and if the supply is cost-effective; irrigation water has other water quality requirements than water used for domestic purposes; bacteriological contamination may be acceptable)

Water quality Situation

Subjectemergency non-emergency

General The specifications given in this table are valid for drinking water. Water used for other purposes such as laundry, personal cleanliness and irrigation can have other, usually less stringent requirements.

Disinfect all waters if possible, especially if possibly contaminated or no proof available of water quality.

same

Fecal coliformexpressed in FC (= thermotolerant coliform = E.coli)

Chlorinated water: no need to measure fecal coliforms if a sufficient residual free chlorine level is available

Not chlorinated (or otherwise disinfected water) or chlorinated water with a too low residual free chlorine level: < 1000 FC/100 ml both in households and at water collection points (for drinking water for people). No restrictions for water used by livestock, water for laundry, personal cleanliness, washing dishes, and household cleaning

Chlorinated water: no need to measure fecal coliforms if a sufficient residual free chlorine level is available

Not chlorinated (or otherwise disinfected water) or chlorinated water with a too low residual free chlorine level: < 10 FC/100 ml (for drinking water for people). No restrictions for water used by livestock, and much less restrictions for water for washing/bathing etc.

Conductivity < 3000 uS/cm < 2000 uS/cmOdor no restrictions must be acceptable to the usersColor no restrictions must be acceptable to the userspH 6<pH<9.5 (if disinfection is needed pH should preferably be

lower than 8.5)6<pH<8 if coagulation with aluminum sulfate is needed.< 8 if disinfection is needed

Turbidity < 20 NTUIf turbidity > 20 NTU pre-treatment is required, i.e. eliminating suspended matter before chlorination

< 10 NTU (acceptable for the first couple of months but the aim should be to get a turbidity of at least <5 NTU)< 1 NTU if disinfection is done/needed

Residual free chlorine Beginning of chain (just after chlorination): high enough (measure after contact time of 30 min.) to assure a residual free chlorine level at the water points of 0,3-5,0 mg/l

At the water collection points: 0,3-5,0 mg/l (the high level only for short periods, if supplying for more than a few days aim for a maximum of 1,0 mg/l)

In the households: 0,2-1,0 mg/l just after collection from water point (be aware that the resiudal may disappear quickly due to the nature of the water and that it may therefore be difficult to draw any conclusions from residual measurements done in this stage)

Beginning of chain (just after chlorination): high enough (measure after contact time of 30 min.) to assure a residual free chlorine level at the water points of 0,3-1,0 mg/l (if a high residual is needed to accomplish this check for contamination entering in the system’s chain after chlorination).

At the water collection points: 0,3-1,0 mg/l.

In the households: 0,2-1,0 mg/l just after collection from water point (be aware that the resiudal may disappear quickly due to the nature of the water and that it may therefore be difficult to draw any conclusions from residual measurements done in this stage)

Other parameters Only monitor other parameters which have been found to be a (potential) problem and use the maximum values as indicated in House and Reed 1997, p. 172-173

same

Chapter 4 : Drinking waterp. 46

Specifications for the recommended minimum objective of a water supply program (continued)

Water accessibility Situation

Subject

emergency non-emergency

walking distance /time to/from water point

maximum distance: 1 kmmaximum time to walk from shelter to nearest water collection point: 30 minutesminimum distance water points to shelters: 30 m

maximum distance: 700 mmaximum time to walk from shelter to nearest water collection point: 20 minutesminimum distance water points to shelters: 30 m

Maximum number of people per handpump

750 500

Maximum number of people per water collection point

Tapstand with 8 taps with enough flow: 1500 Tapstand with 6 taps with enough flow: 1200Tapstand with 4 taps with enough flow: 900Handpump: 500 - 1000 (depending on its yield)Well: ? Capped spring: ... persons if flow is ... - ..., ... persons if flow is higher

(e.g. tapstand with 8 taps, 5 l/min./tap, yields 2.400 l/hour, use of tapstand during 12 hours a day will give a total of 28.800 l which is with 1500 people 19,2 l/person, which is much more than the minimum required amount of 5 l/person per day and this is necessary because of course it will be difficult to occupy all taps simultaneously full time)

Tapstand with 8 taps with enough flow: 1300 Tapstand with 6 taps with enough flow: 1000Tapstand with 4 taps with enough flow: 800Handpump: 350Well: ? Capped spring: ... persons if flow is ... - ..., ... persons if flow is higher

Maximum number of users per tap

250 same

number of taps per tapstand

1 to 8 same

Maximum waiting time at water collection point

2 hours 20 minutes

Minimum and maximum flow from tap

minimum: 5 l/minutemaximum: 25 (normal tap), 15 (Talflo water saving tap)

same

Water collection and storage Situation

Subject

emergency non-emergency

household water collection vessel capacity

1 water collection vessel of 10-20 l per family. The vessel has a narrow neck and/or a cover.

2 water collection vessels of 10-20 l each per family. The vessels have narrow necks and/or covers.

storage capacity of water tanks in piped water supply system

Population size x 5 l (= 1 day drinking water for each person)

37% of the daily volume of water needed. This is based on the need to cover the peak demands: based on 40% abstraction of daily water demand between 5 and 9 in the morning, 10% between 9 and 14 hours, 40% between 14 and 18 hours and 10% between 18 and 20 hours //this is a usual rule in development programs, but possibly 37% is a bit much for a camp situation//

The choice for a certain drinking water system depends on factors such as availability of water sources and the quantities and quality of the water that can be obtained from them, the time needed to develop the water sources, the availability of funds and other resources, etc. (see also chapter 2). In this chapter 5 types of drinking water systems often found in camps are described:

Piped water supply system River or lake water pumped; treatment which may include sedimentation, roughing filtration, coagulation + flocculation, slow sand filtration and/or chlorination; pipeline supply which includes storage tanks and intermediate pump stations; tapstands

Deep boreholeswith submersible pumps, no water treatment, further as piped supply system

Hand pumpsProtected springsWater tankering


4.2Piped water supply program

This paragraph gives an example of the tasks that should be executed by the involved actors in a piped supply system as schematized below.

////put here figure from p. 290 Eng. in emergencies ///

Figure 4.1 Elements of the piped water supply system described in this paragraphFrom Davis and Lambert, 1995

Figure 4.2 Organogram of the piped water supply system described in this paragraph


Other programs

Field administratorof the water program

water treatment staffguards of treatment site

Supervisor water treatment

pump and tank operatorssource caretakers

mechanicsguards of pump and storage sites

Supervisor water pumping and storage

plumbers

team leader plumbers

tapstand caretakers

system controlers

Supervisor distribution

Overall supervisor piped water program

Manager of water and sanitation program Office administratorOffice logisticien

The program can be divided in 3 work units:

The distribution unitComprises everything that has to do with the pipeline and the tapstands (described in paragraphs 4.2.1 to 4.2.5)

The pumping and storage unitComprises all works regarding pumping and storage of water (described in paragraphs 4.2.6 to 4.2.11)

The water treatment unitComprises all water treatment works (described in paragraphs 4.2.12 to 4.2.14)

Each of the units is manned by staff, who together are responsible to fulfil the tasks of their work unit. Other staff are to support each of the work units, for instance overall supervisor, field administrator, program manager, office administrator and office logistician. The tasks are divided over the different staff for the first two units while for the third, the water treatment unit, a list of tasks is described which should be divided among the staff working in this unit by these staff themselves.


4.2.1 Tapstand caretakersTapstand caretakers can be unpaid refugees who have committed themselves to keep an eye on one or more tapstand(s). They can be further motivated through training, meetings and regular contact with the system controllers. It is recommended to let the community choose their own tapstand caretaker (see paragraph ... for a methodology on how to let people choose their own project staff) and discuss with the people how important the function is. The caretakers should be provided with the tools they need for carrying out their tasks plus some kind of work outfit, and it may be good to give them some incentives (e.g. soap). Their tasks are largely the same for emergencies and non-emergencies (only some of the specifications to be applied are different).

Tools/materials needed per tapstand caretaker:One shovel, one pick, one ho. The tools can also be borrowed by the people in the area for works such as improvement of drainage around their huts and latrines, burial of people, etc. The tapstand caretaker remains responsible for them though. People should also be allowed to borrow tools from the program (see ...).

Number of tapstand caretakers needed:One tapstand caretaker for each tapstand. Sometimes one tapstand caretaker can take care of more than one tapstand (e.g. if tapstands are near to each other, or temporarily in emergencies).

Tasks during emergencies:

Task Description Timing SpecificationsOrganize orderly and proper water collection at the tapstands

If the situation at the tapstands tend to become chaotic start first to organize people telling them to stand in rows and allow each family to take more or less the same limited/rationed amount of water. If this doesn’t help warn the system controller or supervisor.

control several times a day; be at the tapstand whenever needed

Control waiting times

Control whether waiting times are not too long. If they are too long warn the system controller.

Measure once a day

waiting time should be less than 2 hours

Control the taps and ensure their proper use

Control whether:* the flow from the taps is in order,* taps are still functioning properly and are undamaged (especially

leaking taps causes a lot of unnecessary waste of water), and* people use the taps correctly.

Ask the system controller to get spare parts, new taps etc. from the field store if needed.

Execute small repairs yourself or ensure that plumber or system controller will pass by soon to do the repair.

Ensure proper use of the taps by people. Don’t allow them to fix ropes or do other things to the taps (people may do such things to keep taps open continuously which will lead to a lot of water spillage).

Don’t allow the water to be tapped for any other purposes (e.g. irrigation) than drinking water if water from the system is scarce.

control twice a day

water should be flowing easily from the taps whenever opened.

Control whether water quality is measured

Control whether the system controller comes by at least once a day to carry out water quality measurements. If he doesn’t show up one day to carry out this task find him and discuss it with him (keep in mind that it may be that it is decided that they only need to pass by once every few days, for instance if the water quality is not likely to become bad easily).

Control every day

residual chlorine control should be done once a day

Report serious problems

Contact and report (orally) to the system controller, or the Supervisor, as quick as possible in case of serious problems.

every day


Tasks during non-emergencies:

Task Description Timing SpecificationsOrganize orderly and proper water collection at the tapstands

If the situation at the tapstands tend to become chaotic start first to organize people telling them to stand in rows and allow each family to take more or less the same limited/rationed amount of water. If this doesn’t help warn the system controller or supervisor.

control once to twice a day; be at the tapstand continuously whenever needed

Control waiting times

Control whether waiting times are not too long. If they are too long warn the system controller.

Measure once a day

waiting time should be less than 20 minutes

Control the taps and ensure their proper use

Control whether:* the flow from the taps is in order,* taps are still functioning properly and are undamaged

(especially leaking of taps can cause a lot of unnecessary waste of water), and

* people use the taps correctly.

Ask the system controller to get spare parts, new taps etc. from the field store if needed and execute the repairs yourself and/or together with the system controller or plumber (ask them to pass by if you think this is necessary)

Ensure proper use of the taps by people. Don’t allow them to fix ropes or do other things to the taps (they may do this in order to keep them open continuously).

Don’t allow taps to be opened for irrigation purposes if water is scarce.

control once to twice a day

water should be flowing easily from the taps.

Ensure a proper platform

Check every day for cracks or other damage to the platform. Contact the system controller or plumbers and ask them to do the repairs if required. Also try to find out the causes for the damage. If people damage the platform discuss this with them and if necessary their leaders, parents etc. in order to convince them to stop damaging the structures.

every day

Ensure a clean tapstand environment

Control whether spilt water drains away properly and surroundings are kept clean. If not, organize the community to improve the situation.

every day

Control whether water quality is measured

Control whether the system controller comes by every week to carry out water quality measurements. If he doesn’t show up in time find him and discuss it with him.

Control every day

residual chlorine control should be done once a week

Ensure proper functioning and use of showers, laundry and other washing facilities

In case other water use facilities such as public showers, laundry and other washing facilities are constructed at or near the tapstand these should also be checked for proper drainage, sufficient water flow and capacity. Repair and improve where needed and possible and discuss with people about proper use. If materials are needed contact the system controller who will then take care of that (execute the repair together with him if possible).

waiting times for showers should be less than ...


Contact and report (orally) to the system controller, or directly to the Supervisor Distribution or Manager, as quick as possible in case serious problems are encountered.

every day


4.2.2 System controllersA system controller is a paid staff member of the piped water supply program responsible for the control of a part of the pipelines and tapstands. In emergencies the most important tasks are to control the water flow, waiting times and free residual chlorine levels at the tapstands. In situations regarded as ‘non-emergency’ the system controller keeps a logbook for each tapstand under his responsibility.

Tools/materials needed per system controller:One adjustable spanner, one role of white tape, copies of reporting forms, one pen, one small notebook, one color comparator, 20 to 50 free residual chlorine testing tablets (DPD1).

Number of system controllers needed:In emergencies one system controller is needed per ... tapstands or per ... km of pipeline. In non-emergencies this should be one system controller per ... tapstands or per ... km of pipeline.

Box 4.1 Testing the pH and free residual chlorine level

Both pH and free residual chlorine levels can be determined using a color comparator (see Figure 4.1). The comparator contains two compartments, one for the pH and one for the residual chlorine test. Depending on the parameter to be measured one of the compartments is filled with the water to be tested. Add the reagents specific for the test (for pH: Phenol Red; for free residual chlorine testing: DPD1) to this water. As a result the water develops a color which can be compared with color scales on the comparator. The corresponding values for the parameter measured can be read at the side of the color indications on the comparator. Also the combined residual chlorine level can be measured (with DPD3 tablets) but this is only done in certain specific circumstances and usually not in camps.

Figure 4.1 Color comparatorFrom Davis and Lambert, 1995



Task Description Timing SpecificationsControl public tapstands

At each public tapstand:

* Contact the tapstand caretaker (if already installed) and discuss any problems encountered by him. Take appropriate actions for problems encountered that are not yet solved.

* Check the water flow from all taps. Clean or change the taps with poor flows (change taps yourself or ask the plumbers to do this). Tighten leaking taps and, if this doesn’t stop the leaking, replace with new taps and bring the removed ones to the plumbers’ workshop. Check, if suspected, whether too low flows are caused by under pressure in the system (assess by removing a tap while keeping all other taps closed, and allowing water to flow out free from the pipe; if this gives a low flow, then there is too little pressure). Discuss with supervisor and plumbers about the measures to be taken.

* Observe whether people are using the taps correctly (not fixing anything to keep taps opened, not spoiling too much water etc.). Instruct the caretaker to keep an eye on this and instruct people about proper use if necessary.

* Look whether there are long rows of people waiting (or many containers standing in a row in front of the tapstand). If so, ask the tapstand caretaker about waiting times. If suspected that waiting times are too long, measure the waiting times. If waiting times are too long, find out what the causes are, contact the supervisor and other important actors, e.g. the plumbers, and determine together the appropriate actions to be taken.

* Observe whether water is used only for drinking, especially if water is scarce. Look for signs of irrigation (should be absolutely forbidden) or other not allowed uses. Discuss with the tapstand caretaker that he should contact people involved in those uses and explain them that this can not be allowed (and that if they refuse to listen he will contact supervisor, manager, village leaders, etc.). Also visit the involved people together and discuss with them.

* Report all serious problems to the supervisor and if believed necessary, also to the manager and ensure that if problems are not yet solved, appropriate action is taken by (together with) them.

Further: go to tapstands whenever asked for by caretakers or other people who have observed or suspect problems with those tapstands. Try to solve the problems, otherwise ensure remedial action by staff who can solve the problems.

Control each tapstand once a day and whenever asked for by caretaker or other people

* Water should flow freely and easily from the taps when opened.

* Waiting times should be less than 2 hours

Execute free residual chlorine tests

The test is described in Box 4.1. If the levels found are too high or too low contact the Supervisor Distribution as well as the Supervisor Water Treatment to discuss what measures should be taken.

Every day * execute in 20% of the tap-stands (2 tests per tapstand)

* residual chlo-rine level should be between 0,3 and 0,6 mg/l.

Check for large leaks in the pipeline

Ask tapstand caretakers and people living near the pipeline to inform you whenever they observe or suspect large leaks. Control yourself by walking along the pipeline and looking for wet places. If detected contact the plumbers to repair the leak.

once every 2-7 days, depending on vulnerability of system.

every large leak should be repaired as soon as possible.

Control tapstands in public centers

For connections in health centers, feeding centers etc: keep contact with staff of those facilities and fulfil basically the same functions as for the public tapstands, though giving the tapstands in these centers a higher priority than the public tapstands.

every day see the specifications described for public tapstands


Tasks during non-emergencies:Task Description Timing SpecificationsControl public tapstands

At each public tapstand:

* Contact the tapstand caretaker and discuss any problems encountered by him. Take appropriate actions for problems encountered that are not yet solved.

* Check the water flow from all taps (open the taps and check the flow; determine in more detail for one tap: fully open the tap, let the water flow into a reservoir of known volume and measure the time to fill it, then calculate the flow). Change the taps with poor flow (do this yourself or ask the plumbers to do this). Tighten leaking taps. If this doesn’t stop the leaking, replace with new taps. Bring removed taps to the plumbers’ workshop. Check, if suspected, whether too low flows are caused by under pressure in the system: assess by removing a tap while keeping all other taps closed, and allowing water to flow out free from the pipe; if this gives a low flow, then there is too little pressure. Discuss with supervisor and plumbers about the measures to be taken.

* Check for cracks in platform, proper wastewater drainage, cleanliness of tapstand and immediate surroundings etc. Execute remedial action and contact other staff to execute repairs if needed.

* Observe whether people are using the taps correctly (the users should not: fix anything to keep taps opened, spoil too much water, leave taps open after use, etc.). Instruct the caretaker to keep an eye on these things and instruct people yourself shortly about proper use if necessary.

* Measure the time people are waiting to get water. Look at your watch when someone just arrives and look at your watch again at the moment this person actually starts to take water. Note down the time in the logbook. If the measured time is too long, find out what the causes are (discuss also with caretaker), and contact the supervisor and other important actors, e.g. the plumbers, and determine together the appropriate actions to be taken.

* Observe whether water is used for other purposes than drinking. In most camps irrigation should best be forbidden, especially if water is scarce. Discuss with the caretaker that he should contact people involved in water uses that are not allowed and explain to them that they should stop with those uses (and that if they refuse he will contact supervisor, manager, community leaders, etc.). Also visit involved people together and discuss with them.

* Check other water facilities. If there are other water use facilities (public showers, laundry facilities etc.) at or near the tapstand these should also be checked for sufficient capacity, cleanliness etc. as well. Take appropriate action in case of problems.

* Control whether the materials and tools of the caretaker are still with him. If not ask what the problem is. Replace items if the explanation is satisfactory (e.g. if a tool is broken the caretaker should be given a new one). Discuss with supervisor in case theft is suspected and take appropriate measures if necessary (only after finding proof!).

* Try to get an idea about the causes of the problems encountered and contact supervisor, community leaders, other staff, manager or the beneficiaries themselves in order to develop and take measures to prevent these problems to emerge again, especially if you feel the causes of the problems may be difficult to take away (especially if vandalism is observed or suspected).

* Report all serious problems to the supervisor and if believed necessary, also to the manager and ensure that if problems are

control each tapstand once a week and whenever asked for by caretaker or other people

* flow from a tap should be 5 - 25 l/min.; for a Talflo water saving tap: 5 - 15 l/min.

* waiting times for tapstands should be less than 20 minutes

* waiting times for public showers and other washing facilities should be ...


not yet solved, appropriate action is taken by (together with) them to solve the problems.

* Fill in the tapstand logbook (Form 4.1). There should be a tapstand logbook for each tapstand.

Further: go to tapstands whenever asked for by caretakers or other people who have observed or suspect problems with those tapstands. Try to solve the problems, otherwise ensure remedial action by staff who can solve the problems.

Execute free residual chlorine tests

The test is described in Box 4.1. If the levels found are too high or too low contact the Supervisor Distribution as well as the Supervisor Water Treatment to discuss what measures should be taken.

once a week * Execute in 20% of tapstands (2 tests per tapstand)

* Residual chlo-rine level should be between 0,3 and 0,6 mg/l.

Check for leaks in pipeline

Ask tapstand caretakers and people living near the pipeline to inform you whenever they observe or suspect leaks. Control yourself by walking along the pipeline and looking for wet places. If detected contact the plumbers to repair the leak.

once a week every leak should be repaired as soon as possible.

Control tapstands in public centers

Tapstands in health centers, feeding centers etc. Keep contact with staff of those facilities and fulfil basically the same functions as for the public tapstands, though usually giving the connections in these centers a higher priority.

once a week see the speci-fications for public tapstands

Report Make a report at the end of each week and provide to the supervisor. every week see Form 4.2

/// put figure here of tapstand with arrows indicating the spots to be checked///


Form 4.1 Example of tapstand logbook to be filled in during each control of that tapstand by the system controller.

Camp:________________ Name of tapstand:______________ Camp part:______________ Name of system controller:_____________

Date Outflow measured (describe in last column what the problem is if the outflow is insufficient

Waiting time(describe in last column what the problem is if waiting time is too long)

Residual chlorine levels (in mg/l) (if values are too low or too high explain in last column)

Are all materials and tools still with the caretaker?

Materials/spare parts used (by caretaker, system controller and plumbers)

Problems and recommendationsDescribe the problems found, recommendations, remarks etc. (also ask caretaker and people) and whether the problems have been solved

sample 1 sample 2


Form 4.2 Example of report form to be filled in each week by system controllers.

Country:__________________ Date:______________ Camp:___________________

Name of system controller:____________________

System part under controller’s responsibility: _______________

Number of tapstands under system controller’s responsibility:__________

Total length of pipeline under system controller’s responsibility:________________

Number of tapstands checked

Number of tapstands where the outflow at one or more of the taps was not enough

Were all problems with outflow from taps solved? If not, explain on the back of this form

Number of tapstands where free residual chlorine tests were executed

Number of tapstands where too high or too low free residual chlorine levels were found

Were the problems with too low or too high free residual chlorine levels solved? If not, explain on the back of this form and give recommendations for solving the problems.

Number of tapstands with other problems than problems with outflow or free residual chlorine.

Were the problems solved? If not describe on the back of this form and give recommendations for solving the problems.

Do you or the caretakers of the tapstands have important remarks, questions or recommendations? If so, describe per tapstand on the back of this form (in case of remarks, questions or recommendations by caretakers also give your own opinion).

Did all caretakers still have all materials and tools that were given to them for their tasks? If not describe, mention the caretakers where problems were found and give your opinion and recommendations.

Materials used for the tapstands by caretakers, system controller and plumbers

Number of leaks or other water loss problems found in the pipeline

Were the problems with the leaks or other water losses in the pipeline solved? If not, explain on the back of this form and give recommendations for solving the problems.


4.2.3 Plumbers

Tools/materials needed:Each plumber should have: working gloves, rubber boots, an overall, ..

Plumbers usually have a small working place that contains a number of tools and equipment plus some spare materials while the larger stocks of spare materials are in the field store and/or in the project or regional store usually at some distance from the camp. The team leader of the plumbers is responsible for the working place (unless there are more than one plumbing team in which case there should be a separate administrator for the working place). A plumbers’ working place for a piped system as described in this paragraph which mainly consists of PVC pipes, but with several parts in GI (e.g. for gullies, stream and road crossings, tapstands, parts with high pressure, parts where pipes can not be buried etc.) typically contains the tools, materials and equipment described in Box 4.....

Number of plumbers needed:Usually ////??... plumbers are needed per ... km of pipeline???////. The plumbers operate in a team. We recommended having teams of max.. plumbers. If there are more than one team, all teams can make use of the same working place, although it may be necessary then to have one additional person to be fully and only responsible for the management of the working place.

Tasks (both for emergencies and non-emergencies):Task Description Timing Specifications

important for execution of the task

Work on extension of system

Work in team to further build up the pipeline system. Often casual labor is hired for this who should be supervised by the plumbers. The works will include laying of pipes and connecting them, erecting of water tanks, construction of tapstands.

whenever needed

technical specifications; see technical guidelines, e.g. Davis and Lambert 1995.

Execute repairs

Execute repairs to the pipeline (e.g. fixing leaks), tapstands (leaks, fixing new taps, repairing platform), tanks and other structures which are part of the pipeline system. When stressed in time due to much work it will be necessary to make a careful planning and prioritize the actions (largest problems first).

when asked for by system controller, tapstand caretaker, supervisors or manager

technical specifications; see technical guidelines, e.g. Davis and Lambert 1995.

Box 4.2 Fixing and entrenching pipes

Include Box about fixing and entrenching different kinds of pipes


Box 4.3 Tools, materials and equipment needed in a plumbers’ working place

//////////needed: a complete list of all tools, materials and equipment needed in a plumbers’ workshop.Toolkit for erecting and dismantling OXFAM tanks:(MSF module KWATMTOOOT-). Needed: 1 set per ... tanks.Description Quantity3/8” square drive cranked handle speed brace 117 mm 3/8” square drive 12 point spanner socket 217 mm combination ring / open-end spanner 224 mm combination ring / open-end spanner 2200 mm Blade flared tip screwdriver 28” half round bastard file and handle 116 cm knife cut 2 needle file 18” adjustable spanner 112” adjustable hacksaw frame 112” 24 TPI HSS hacksaw blades 3Retractable trimming knife c/w 5 blades 1200 mm capacity strap wrench-gedore 36-2-00 212” aluminum spirit level 1Line level 1Pair of line pins with 18 m of line 1Pair of 0.5 mm scissors 117 mm open-ended podger / spanner, 279 mm long 2

Toolkit for work on pipeline and taps:(MSF module KWATMTOOWAT). Needed: 1 toolkit per ... km of pipelineDescription QuantityBucket of 20 l with lid 1Band clip 12 mm, 2” 5High pressure band clip diameter 80 to 85, simple tightening 10(Symm. half coupling 2” ND50) Gasket 5(Symm. half coupling 3” ND80) Gasket 5(coupling) Hook spanner for Guillemin 2”3”4” DN20 to DN115 5Thread seal tape, Teflon role 10Monkey wrench 80 mm max. opening 1Club hammer 1250 g 1Pipe wrenches chain, max. opening 4”/115 mm 1Constant-profile flat chisel 200 x 24 mm 1Long-leverage end nippers 1OGV angled open-socket wrench 6x6 point 13 mm 2OGV angled open-socket wrench 6x6 point 7 mm 2Electrician knife 3Round-shank screwdriver 5.5 x 200 mm 1Shackle, diameter 8mm, straight 3Wire, tie, galvanized, small diameter 1.1, 25 m, roll 1Paint, red, fluorescent, spr/tin 1Gun, for silicone compound 1(gun, silicone) Silicone compound, cartridge 310 ml 2Tube, extension, for pincer tool 1Oil, penetrating, 500 ml, spr/tin 1

Other:spanner, strip spanners, PVC glue, PVC pipe rubber rings (if re-openable fittings), shovels, picks, large adjustable spanners, tool for threading GI pipes, Work table with clamps to hold GI and PVC pipes, ... PVC pipes of the classes and diameters used in the system per ... of m of that pipe class/diameter used, ... GI pipes of the classes and diameters used in the system per ... of m of that pipe class/diameter used, ... sockets, etc.//////////


4.2.4 Team leader of the plumbers

Tools/materials needed per team leader:Additional to the normal working outfit of the plumbers the team leader of the plumbers should have ....

Number of team leaders of plumbers needed:One per team of plumbers.

Tasks (emergencies and non-emergencies):

Task Description Timing SpecificationsWork as a plumber

Work together with the plumbers executing the same tasks as they have, but in the same time coordinating the work and taking time as well for the other below described tasks.

Reporting in logbook

Record the repairs made and the materials/spare parts used in the logbook (see Form 4.3)

Reporting problems orally

Make sure that specific problems encountered that are not yet solved are reported to the supervisor and/or the manager and are followed up.

Manage the plumbers’ workshop

Keep administration forms (see par. ..) of all spare parts used. For tools and equipment the team leader should know by head who has them and where they are and control regularly whether they are still there. If things have disappeared it is the team leader who will be held responsible for the losses. Control the administration and remaining spare parts, tools and equipment on a regular basis together with the field administrator and assess whether anything is missing and whether any new things are needed in the field stock. This can be done by counting all items and verify with the administration forms and the plumbers’ logbook. Ensure together with the field administrator that all items needed will be delivered to the workshop on short notice.

management is a continuous task; control of the stock is once a week for emergencies to once a month for non-emergencies, depending on available time and circumstances


Form 4.3 Example of logbook of the team leader of the plumbers

Country:_________________________ Camp:________________________

Name of plumbing team:____________________ Name of team leader:_______________

Date Repair done(indicate type of repair and exact location)

Materials/spare parts used

Specific problems encountered (make sure that such problems are followed up if they are not yet solved)


4.2.5 Supervisor Distribution

Tools/materials needed:

Number of Supervisors Distribution needed:One

Tasks during emergencies:Task Description Timing SpecificationsCoordinate extension works

Coordinate works needed to extend the pipeline system together with the plumbing team(s), and if needed also with other supervisors and the manager.

when needed

technical specifications; see technical guidelines, e.g. Davis and Lambert 1995


Ensure that problems reported to you or observed by yourself are followed up, i.e. coordinate solving the problems with your unit (distribution) and if necessary contact others to assist. Report all large problems immediately to the overall supervisor and manager.

whenever needed

Hold short informal meetings with staff

Discuss problems encountered, ideas, remarks etc. and make plans together on how to solve problems, improve the work etc. Coordinate the follow up on these meetings.

Meetings can be held in the field (e.g. during the field visits; see below) or at any suitable place.

Inform and discuss the results with the manager (he may also be at or initiate these meetings) and ask his reaction on/permission for any new plans or ideas developed.

The meetings can also be held to give short trainings to staff (often together with the manager).

every day

keep meetings short and to the point to avoid losing time.

execute as infor-mal group discus-sions (see ch. 3, par. 3.3.1 and 3.3.4.1

Field visits Go into the field with each system controller and each team of plumbers to observe and discuss their work. Control whether they execute all the tasks they are supposed to execute and whether they execute them correctly (look at their task descriptions and to the explanations of subjects in the specific boxes).

Check whether the staff visited still have their materials, tools and equipment. Ask why if things are lacking. Organize to renew things if needed. If things are stolen or if this is suspected investigate and report immediately to the manager.

Also discuss with the people and the caretakers during such visits.

every day

Meet with other supervisors and the manager

Meet with and discuss about problems, ideas and plans with the manager, other supervisors of the piped water program and supervisors of other programs as well (e.g. supervisors of the hygiene education and toilet programs). Such meetings are often called for by the manager but they can also be initiated by any of the supervisors and do not necessarily always have to be held together with the manager; the meetings can be formally organized meetings, but also informal unplanned and unorganized meetings. Make sure always to discuss the outcome of the meetings with the manager and ask his opinion about it and permission for plans, ideas etc.

regularly, e.g. once every 2 to 6 days


Tasks during non-emergencies:Task Description Timing SpecificationsCoordinate extension works

Coordinate works needed to extend or adapt the pipeline system together with the plumbing team(s), and if needed also with other supervisors and the manager.

when needed

technical guide-lines, e.g. Davis and Lambert 95


Ensure that problems reported to you or observed by yourself are followed up, i.e. coordinate solving the problems with your unit staff and if necessary contact others to assist. Report all large problems immediately to overall supervisor and manager.

whenever needed

Discuss weekly reports of plumbers and system controllers + produce the weekly Distribution Unit report

Discuss weekly reportsIn a meeting with system controllers + team leaders of the plumbing teams receive their weekly reports, discuss these and other things brought forward (e.g. progress of the works, problems, ideas, remarks). Every week take one of the weekly reports to study in more detail: crosscheck it against the related logbooks, your own observations made during the week and other information obtained by you or any of the staff.

Pro duce the weekly report of the Distribution Unit Use all information to produce the weekly report of the Distribution Unit. You can do this together with some of the staff. Give the report to the Manager and keep a copy of it yourself.

Keep all reports in fileKeep the copy of weekly report of the Distribution Unit and all other weekly reports in file.

once a week (meeting should not be longer than half a working day)

For an example of a weekly Distribution Unit report see Form 4....

Hold formal meetings with and give trainings to the staff of the Unit.

Meet with the plumbers, team leaders of the plumbers, tapstand caretakers and/or the system controllers (in separate groups, or in any combination found useful). These meetings may be initiated by the manager, but also by the supervisor or by the staff. Discuss any problems they have with the work, things that can/should be improved, ideas or practical and organizational issues.

Let staff bring the tools, materials and equipment they work with to the meeting (with exception of the items belonging to the plumbers’ working place) and control whether these are still complete (you can also ask the field administrator to attend the meeting and count and control). Follow up on the outcome of the meetings.

Also use these meetings to train staff on specific subjects if necessary or to develop/plan new activities with them, etc.

whenever believed necessary; try to meet with each group of staff at least once a month for 1-2 hours.

execute as focus group discussions, open group discussions or workshops (see chapter 3) or as a training

Hold short informal meetings with staff

Discuss problems encountered, ideas, remarks etc. and make plans together on how to solve problems, improve the work etc. Coordinate follow-up on these meetings.

Meetings can be held in the field (e.g. during field visits; see below) or at any suitable place.

Inform and discuss the results with the manager (he may also be at or initiate these meetings) and ask his reaction on/permission for any plans or ideas developed.

The meetings can also be used to give short trainings to staff (often together with the manager).

every day; keep meetings short + to the point to avoid losing time.

execute as informal group dis-cussions (see ch. 3, par. 3.3.1 and 3.3.4.1


Tasks during non-emergencies (continued):

Field visits Go into the field with each system controller and each plumbing team to observe and discuss their work. Control whether they execute all their tasks and whether they execute them correctly (look at task descriptions and the explanations of subjects in the specific boxes).

Check whether the staff visited still have their materials, tools and equipment. Ask for an explanation if things are lacking. Organize to renew things if needed. If things are stolen or if this is suspected investigate and report immediately to the manager.

Also discuss with the people and the caretakers during such visits.

at least once a month for a couple of hours with each plumbing team and each controller

Control the plumbers’ working place and the field stock

Control with the field administrator and the team leader of the plumbers or other responsible person the materials, equipment and tools in the plumbers’ working place.

Use the store cars to make a list of materials used that month and cross-check this with the logbooks of the tapstands and the plumbers logbooks. (Later, during the field visits) visit a few sites to control whether really the materials as indicated in the logbooks were used there.

Control together with field administrator and other supervisors whether sufficient spare parts, tools and equipment for the Distribution Unit are in the field stock (see the required quantities indicated at the top of the store cards). Ensure together with the field administrator that any items needed are ordered immediately in sufficient quantity.

once a month.

Stored materials tools, equipment should cover for normal operational needs + contingency. See also par. ... and ch. 3 par. ...

Meet with other supervisors and/or the manager

Meet with and discuss about the findings and problems with the other supervisors of the piped water program and supervisors of other programs as well, for instance the hygiene education program, toilet program, etc. (these can be formally organized meetings, but also informal unplanned, unorganized meetings). The meetings can be initiated by any of the supervisors or by the manager.



Form 4.4 Example of weekly report form Distribution Unit1

Country:______________________ Date:___________________________

Camp:_________________ Name of Supervisor Distribution:____________________

Total number of tapstandsTotal length of pipelineTotal number of caretakersTotal number of system controllersTotal number of plumbers plus their team leader(s)Did you receive all weekly reports from the system controllers and the team leaders of the plumbers? If not explain.Total number of tapstands with insufficient outflow at one or more of the taps. Describe in which parts of the camp the problems occurred, whether the problems have been solved, and if not, what the believed causes and solutions are. Indicate what you plan to do about the problems that are not yet solved.With regard to free residual chlorine tests done at the tapstands describe:* the total number of free residual chlorine tests executed,* the maximum free residual chlorine level found (in mg/l), * the minimum free residual chlorine level found (in mg/l),* the average of the free residual chlorine levels of all tests (in mg/l),* the number of tests that had too high values, and * the number of tests which resulted in too low values. Comment in case values found differ much from former weeks or if large differences occurred during the week. Describe in which parts of the camp the problems occurred, whether the problems have been solved, and if not, what the believed causes and solutions are. Indicate what you plan to do about the problems that are not yet solved.Other problems with tapstands. Describe in which parts of the camp the problems occurred, whether the problems have been solved, and if not, what the believed causes and solutions are. Indicate what you plan to do about the problems that are not yet solved.Problems encountered with materials and tools of plumbers, system controllers or caretakers? Are there sufficient supplies in stock? Give short explanations. Indicate what you plan to do about problems encountered that are not yet solved.Number of leaks or other water loss problems found in the pipeline systems. Describe in which parts of the camp the problems occur(red), whether the problems have been solved, and if not, what the believed causes and solutions are. Indicate what you plan to do about the problems that are not yet solved.Number of repairs by plumbers. Describe the large repairs and causes of the problems shortly. If any structural action needs to be undertaken, describe. Indicate what you plan to do about the problems that are not yet solved.Number of taps replacedNumber of taps repairedAdditional remarks, ideas, recommendations, questions

1To be filled in by the Supervisor of the Distribution Unit. Use the back of the form or add other papers for the explanations if there is not enough space. Try to answer brief and to the point.


4.2.6 Guards at pump stations and storage tanks

Tools/materials needed per guard:Some kind of official costume plus badge, identity card of the organization, some kind of shelter against the rain, possibly a raincoat.Additional for night guards: torch, blanket.

Numbers of guards needed:1 day guard, 2 night guards per pump station1 day guard, 2 night guards per storage tank site

Tasks during (both for emergencies and non-emergencies):

Task Description Timing SpecificationsGuard the site

Go around at least once an hour and observe whether any unauthorized people are within the pump station or storage tank area. If observed, control whether they may have stolen or damaged anything. If so, bring them to the supervisor (make sure not to endanger yourself), otherwise warn them and send them away immediately.

Additional for night guards: * Do not sleep* If people are found who have entered the site to damage or steal

things, they should be kept at the site till the morning and be handed over then to the supervisor or any other authority. Any other irregularities observed or heard should be reported to him as well.

continuously; go around at least every hour

Help with cleaning and repairs

Observe regularly whether the site is clean and whether there are any repairs needed. Assist with cleaning and repairing when asked to do so by the pump or tank operator. Report to the pump or tank operator when you think any action is needed.

observe continuously, act whenever needed

Know who is on site

Make sure to know who of the staff is on site. continuously

Assist with communication between tank and pump stations

Assist with communication between tank and pump stations whenever necessary (but only if guarding task is not endangered by it).

whenever needed


4.2.7 MechanicsMechanics keep engines functioning well. They execute preventive maintenance (services) and repairs or replacements. Mechanics should have a separate logbook for each engine, pump and water meter under their responsibility7.

Tools/materials needed://make list of tools needed/////

Number of mechanics needed: one per ///?????////

Tasks during (both for emergencies and non-emergencies):Task Description Timing SpecificationsExecute and facilitate repairs

Execute any repairs on engines or pumps when asked to do so by any of the staff. If the repair is too difficult to execute on site assist with contacting the appropriate persons to ensure the repair and possibly the transport of the item to a site where it can be repaired (e.g. a professional workshop). Coordinate with supervisor. Fill in logbooks.

whenever needed

See technical handbooks

Example of logbook form: see Form ..

Control whether pump operators function well and check for need of and execute services and calibrations at the pump stations

When at a pump station:Control whether pump operator properly fulfils his tasks. Instruct on how to improve if necessary. Also control his logbook. Discuss the work with him. Check together with the pump operators whether any services, repairs, calibration/cleaning of water meter or other activities are needed (check from your and his logbooks and check the engine, pump, and, if applicable, the water meter).

With regard to services:Make sure to execute the services needed in time. Check regularly from your own your logbooks plus the operator’s logbook whether next service time is near, and estimate with that when next service will be necessary. Discuss and make an appointment for each service well in time with the involved pump operator. For the service activities you can’t execute yourself coordinate it to be done elsewhere or by someone else, including temporary replacement by a spare engine, pump or water meter if needed.

With regard to water meters:Compare the water meter indication after 1 hour pumping with the amount of water it is supposed to pump per hour (see also Box ...). Usually water meters are placed directly after a pump. The load of abrasive particles in the water should be as low as possible otherwise the meter will become unreliable very quickly (indicated by strange values for amounts of water pumped per liter of fuel; see also Box ...). To avoid stopping the pump during maintenance of the meter, the meter must be fitted with strainers and installed on a bypass. The strainers should be cleaned at least once a month ///by who??//. Note down when the last calibration took place in the logbook (see Form ...) //how often does a water meter need to be calibrated?//

pass by at each pump station at least once a week.

check your own logbooks regularly to find out whether and at which pump stations services will soon be needed

control water meters at least once a month

For specifications with regard to services needed and their timing see Box ...

For control of the pump operator see descriptions of his tasks (par. ..)

Fill in logbooks

Describe each service, water meter check + cleaning, repair or other activity done in the appropriate logbooks

fill in after each activity

see Form 4.5

7 If they would not have separate logbooks and in the future they would be split and put together with other systems confusion could easily arise about which service was actually meant for which part of equipment etc.


Box 4.4 Services needed at a diesel engine///what about services needed for the pump??? no info on that yet: which service activities needed when and to be executed by who???///Services need to be carried out by a skilled mechanic. Actual servicing periods will vary between engines. Consult the relevant handbooks if possible. The following guidelines can be used in the absence of specific information.

Every 125 hoursAll tasks described for the pump operator and the following:Check the condition of the battery if fittedCheck for coolant leaks (water cooled)When moderately dusty, empty dust cap/bowl and clean or replace the air cleaner elementIn high ambient temperatures (above 35o C) change the engine oil and oil filter

Every 250 hoursChange the engine oil and oil filter element. Inspect drained waste oil for the presence of metallic debris (indicates possible internal damage or excessive wear), water (will appear as separate globules or as a creamy oil/water mix; this can indicate leakage from the cooling system), fuel (check by smell; this indicates internal leakage from the fuel system)Check the valve clearancesClean or replace the injectors if the exhaust smoke is blackRenew fuel filter element if using dirty fuelCheck condition and tension of drive belts (alternator, fan, etc.), if applicable

Every 500 hoursReplace air cleaner elementRenew fuel filter elementCheck exhaust and air intake for leaks, damage or restrictionsCheck the battery charging system, if applicableReplace the fan belt, if applicable

Every 1000 hoursDecarbonize only if engine performance is poor (engine will be out of action for some time; therefore temporary replacement with a spare engine may be needed)Clean wire gauze in engine breather, where applicable

Every 2000 hoursDecarbonize (engine will be out of action for some time; therefore temporary replacement with a spare engine may be needed)Check fuel injection timingCheck lubricating oil pressure

Every 6000 hoursCarry out a major overhaul

Every yearFor water cooled engines: drain, flush and refill the cooling system

Source: Davis and Lambert 1995. For more detail plus information about problem detection/solving see par. 13.2.3 of this manual.


Form 4.5 Example of mechanic’s logbook form for pump, engine or water meter

Country:______________ Camp:____________ Engine, pump or water meter’s serial number8:_____________ Name mechanic:_____________

Date Service done (indicate what service)

Repairs executed (describe)

Other activities executed (describe)

Are all activities indica-ted in the logbooks of the pump operator? (Y/N)

Spare parts used Remarks (use the back of the form to explain in more detail if needed)

8 Have a separate logbook for each pump, engine and water meter!Chapter 4 : Drinking water

p. 69

4.2.8 Source caretaker

Tools/materials needed:Rubber boots, gloves, shovel, knife, panga. In some cases an adjustable spanner, screwdriver or imbus key may be useful. Other tools/materials, if needed, can be borrowed or obtained from the pump operator, the plumbers or the mechanics.

Number of source caretakers needed:One per source. The tasks of a source caretaker are often executed by the pump operator and/or (together with) the guard working in the pump station at the source.

Tasks during (both for emergencies and non-emergencies):Task Description Timing SpecificationsControl and maintain the inlet

Control whether the inlet of the suction pipe is at the right position. If the water level drops towards the intake of the pump change the inlet level in the water. The pump should be stopped whenever there is a danger that the water level drops beyond the inlet. Never allow a pump to run dry! If the inlet is too close to the bottom of the source it should be lifted up and tightened to prevent it to sink towards the bottom again. Coordinate the actions with the pump operator (it may be necessary to stop pumping for a while during the activities).

Maintain/repair the pump inlet and keep the screen clean. Ensure that the inlet is placed in such a way that pumping silt is avoided while keeping suction lifts and lengths to a minimum.

control twice a day and more in case of much fluctuation + whenever levels are expected to drop or rise fast.Maintain and repair whenever needed

inlet of suction pipe should be at least 0.3 m beneath the water level (to prevent ingress of air in the system) and at least 0.3 m above the bottom of the source (to prevent silt from the bottom to enter in the inlet)

Keep surroundings in order

Keep the surroundings of the inlet clean and maintain the fence.

every day

Check for contamination

Observe whether the source is being threatened by contamination. Look for:

agricultural chemicals used upstream or at the level of the intake (visit places where such contamination could occur; contact the involved actors and discuss the problem with them)

open defecation, washing, bathing etc. upstream or at the level of the intake, in or near the source.

latrines near the intake

You can undertake appropriate action by determining where and what contamination takes place and who are the people involved in the contaminating activities, then contact those people and discuss the problems with them (can also be done together with supervisors or manager). If this does not yield results discuss with the supervisor, overall supervisor and supervisors of other concerned programs as well as the manager and ask them to undertake further action (by contacting those people, their leaders etc., developing awareness campaigns etc.).

every day if problems are expected/suspected

once a week if no problems are expected or suspected

Communicate to other staff involved

In case any problems arise which require the pump connected to the intake to stop or slow down, immediately warn the involved pump operator.Report immediately to the Supervisor Water Pumping and Storage in case of serious problems.

continuously


4.2.9 Tank operators

Tools/materials needed:Rubber boots, watch, pen, tank operators’ logbook forms (see Form ...). Other tools and materials, if needed, can be borrowed/obtained from pump operators, plumbers or mechanics.There should be some kind of shelter to protect the operator against sun and rain.

Number of tank operators needed:One per tank. In many occasions other staff will take up the tasks of a tank operator. For instance in a pumping station that also contains a tank, the pump operator or other staff working at the site may execute the tasks of the tank operator. In the water treatment site the tasks of the tank operator of the tank connected to the pumping station at the source may be executed by the water treatment staff. Also the tasks of the day guard of a tank station and the tank operator may be combined, depending on the situation.

Tasks during (both for emergencies and non-emergencies):


Coordinate filling of tank with pump operator

Whenever filling a tank which is supplied with water directly by a pump station, make sure to warn the pump operator of that station in time (that is well before the tank starts overflowing) when pumping needs to stop. Avoid closing the supply line to the tank if the pump is still running!

just before and during filling the tank

Close the water supply in time when filling the tank

When filling a tank make sure to close the supply in time to avoid the water to flow over.

when filling the tank

Ensure continuous supply of water to tapstands

Make sure that tapstands fed directly or indirectly by the tank will never be without water as a result of an intermittent water supply by the tank. Have clear arrangements with tapstand caretakers, system controllers, pump operators and other tank operators on how to communicate with each other to avoid such a situation as much as possible.

continuously

Protect the site Watch out for (potential) erosion, flooding and other hazards which may affect the tank and take appropriate action when needed (e.g. digging interception drains, planting grass, making small dikes of earth, wood and/or other materials, etc.).

Ask other staff to help if needed (e.g. plumbers, guard, casual labor). Coordinate with supervisor and/or manager).

continuously


Report immediately to the Supervisor Water Pumping and Storage, or to higher levels, if serious (potential) problems are observed or suspected that can not easily be solved.

whenever needed

Keep the site clean and avoid contami-nation of the water

Keep the site clean. Observe whether there is anything that may contaminate the water. If so, take appropriate action to avoid this and report to the supervisor in case of serious problems.

continuously

Fill the logbook in Report all actions in the logbook. This may be more important for non-emergencies but it should be tried to also fill in a logbook during emergencies. There should be a separate logbook for each tank!

whenever needed

see Form ...


Form 4.6 Example of tank operator’s logbook

Country:_______________ Camp:______________ Tank station:_______________ Tank number:______ Tank operator:________________

Date Time at start of filling tank

Water level at start of filling tank

Water meter indication at start of filling tank (fill in only if water meter is available)

Water level at end of filling tank

Problems encountered / repairs done

Remarks


4.2.10 Pump operatorsMuch information about the operation of pumps and engines, relevant for the work of pump operators can also be found in Davis and Lambert 1995. When describing a pump station here it is assumed that only one pumping unit (an engine plus pump) is operative. If there are more they should be regarded administration wise as separate pump stations (thus with separate logbooks) even if they are situated at the same site. It is possible of course that one pump operator is responsible for two or more pumping units at the same time.

Tools/materials needed:Measuring can for fuel, overall, rubber boots, workman’s gloves, .. adjustable spanners (sizes ..), screwdriver, ......

Number of pump operators needed:One per location if pumping not more than 12 hours a day and if not to much work in case of more pumping units, otherwise two per location. It is recommended to have one or more extra pump operators who can take over work at any of the pump stations to allow for days off for pump operators or to fill up gaps in case pump operators fall ill, resign from their job etc.

Tasks with regard to the centrifugal pump (both for emergencies and non-emergencies):Task Description Timing Specifications


Check bearings and lubricate or replace when necessary

Check whether bearings are sufficiently lubricated during pumping. This can be done by putting a hand on the bearing house and feeling whether it’s too hot: a bearing is too hot if a hand can not be comfortably placed on the bearing house. Lubricate if necessary. Bearings may need to be replaced as often as once a month if pumping is intensive. If lubricants or new bearings are needed get them from the stock (replace bearings together with the mechanic if necessary).

//a few times a day??//

Check the shaft seals

The seals prevent the escape of pressurized water from inside the pump along the rotating drive shaft. If they leak too much ..//what to do???///

a few times a day

seals should not leak more than 10 drips/min.

Check priming

Control whether the pump is filled with water (unless it is a submersible or self-priming pump), even if it has a valve to prevent water to flow out of the pump (these often leak and then the pump still looses water). Remove the priming plug and fill the pump chamber and suction pipe with water whenever necessary ///can the pump continue to pump when this is done or should it be stopped shortly???///.

Just before starting to pump + several times/day

Close the valve in the delivery pipe before pumping starts and open it just after pumping has started.

Control whether the valve in the delivery pipe is closed before pumping starts (it is good for the pump to run for //about a minute// against a closed valve just after starting). Make sure the valve is opened shortly afterwards (///about one minute//) once the pump is running (otherwise the pump will overheat and get damaged).

Before starting to pump

Ensure timely servicing

Check in logbook for need of next service. Contact mechanic in time and agree together when he will do the service. Help him, if possible, during servicing. Indicate in the logbook when a service is done and when the next service will be executed (as well as the kind of service). The mechanic should have a schedule himself and control once in a while whether a next service is soon to be due, but the operator should help to remember and warn the mechanic about the need for a next service well in time.

for timing of services see Box .. and handbooks of equipment used

For overview of services see Box ...


Tasks with regard to the diesel engine and use of fuel (for emergencies and non-emergencies):Task Description Timing Specifications impor-

tant for execution of the task

Start and stop the engine Communicate with tank operators and others involved when pumping is needed. Whenever starting or stopping the engine record this in the logbook. This is very important!

whenever necessa-ry, stop engine at least once a day

Refill fuel tank before it is empty

Refill well in time. Record in logbook every time when refueling. If fuel use is too high or too low (compare with the engine’s normal fuel use) try to find out why and take measures if possible.

check several times a day

Check engine oil level; fill up when necessary

Make sure to refill well in time check once a day

Check cooling water; fill up when necessary

If the system works with water coolant make sure to refill well in time

check once a day

Check battery water level; fill up if necessary

If a battery is used: the water level should be just above the battery plates. Fill up whenever necessary. Use distilled water of good quality (well distilled, not standing in store too long).

check once a day

Check for loose nuts and bolts All nuts and bolts should be tightly fixed check several times a day

Check for oil and fuel leaks ///Look for dripping of oil or fuel from the engine. If detected/suspected, start with a control of nuts and bolts, and ....... Warn the mechanic in case you can’t solve the problem. .... is this description correct?//

check several times a day

Warn the mechanic in case of problems

If mechanical problems are detected or suspected close the engine and warn the mechanic. If direct repair is not possible it may be necessary to replace the engine temporarily with a spare one. This should then be organized together with the mechanic, supervisor and others involved.


Check fan belt tension, if applicable

//Tighten if needed,, how??// once a day //?//

Check and drain the sedimen-tor //same as: ‘drain water from fuel filter/agglomerator’?//

Check and drain the sedimentor (intercepts water and dirt from the fuel)

///???several times a day???///

Check air filter and clean if needed //same as ‘in very dusty conditions, empty dust cap/ bowl of dry air cleaners’?/

?? daily

Bleed air from the fuel system? ??? dailyControl fuel drums and handle them correctly

Ensure fuel drums are clean on the outside (especially around the opening at the top). When new drums are delivered:check whether each fuel drum is full.control each drum on presence of water or other

fluids (take a sample with a ‘drum thief’ as indicated in Figure 4.....; look at the sample and note the fluid layers; then discharge each fluid layer into a container and try to identify it by smell.

only sign for delivery if everything is OK (check whether the number written on the list you sign is the actual number of drums delivered)

note down in the logbook the number of drums delivered.let fuel stand still at least 12 hours to allow

sediment and water to settle before use

daily

Ensure timely servicing Check in logbook for need of next service. Contact mechanic in time and agree together when he will come to do the service. Help him, if possible, during servicing. Indicate in the logbook when a service is done and when the next service will have to be executed (as well as the kind of service). The mechanic should have a schedule himself and control once in a while whether a next service is soon to be due, but the

for timing of services see Box .. and the handbooks of the equipment used

For overview of services see Box ...


operator should help to remember and warn the mechanic about the need for a next service well in time.

Oth

er t

asks

Keep the site clean Control every day whether the pump, engine and the direct surroundings are clean. Clean if necessary (ask the guard or other staff to help or completely do this).

continuously

Report pumping times, services, re-pairs, fuel use, water meter readings and other findings in the logbook

fill in for each action undertaken

see Form 4...

////here figure 15.6, p. 490 of Davis and Lambert 1995/////

Figure 4... Sampling using a ‘drum thief’From Davis and Lambert, 1995


Box 4.... How to determine an engine’s fuel use and the pumping rate of the pump connected to it

To determine an engine’s fuel consumption per unit of time:Run the engine up to normal working temperature under its normal working load.While the engine is running fill up the fuel tank completely.Let the engine run for a considerable time period, say 1 or 2 hours.Refill fuel tank. Measure how many liters of fuel are needed to fill the tank completely.Divide the total amount needed by the total number of hours the engine worked on this amount of fuel to

calculate the fuel consumption in liters per hour.Execute this exercise two or three times. If the results do not differ much take the average of the figures

found and use this as a figure for the engine’s fuel use in liters per hour.

If the engine drives a pump which pumps water to a reservoir, the engine’s fuel consumption can be determined in terms of fuel use per volume of water pumped as well. This can be done as follows:Run the engine up to normal working temperature under its normal working load.While the engine is running fill up the fuel tank completely and let at that same moment someone measure

the water level in the water reservoir.Continue to pump water into the reservoir until the reservoir is full, then turn of the engineMeasure how much fuel was needed (fill up the fuel reservoir again and measure the amount needed). Determine how much water was pumped into the reservoir: calculate the height of the water column

pumped into the reservoir in meters (= end level of water in reservoir - start level) and multiply with the volume per meter of the reservoir. Volume per meter of reservoir = 1 x length x width (for square formed reservoir, all measurements expressed in m), or 3,1416 x r2 (circular formed reservoir, with r being half the diameter, expressed in m).

Divide amount of fuel used by the amount of water pumped to determine the fuel consumption in liters per m3 of water pumped.

Execute this exercise two or three times. If the results do not differ much take the average of the figures found and use this as a figure for the engine’s normal fuel use per m3 of water pumped.

If also the time is measured one can determine the average volume of water pumped per hour as well (can also be determined by measuring at the tank directly though).


Form 4.7 Example of pump operator’s logbook form

Country:___________ Camp:_____________ Pump station:______________ Pump operator:_________________

Date Time Engine started? (Y/N)

Engine stopped? (Y/N)

Refueled? (Y/N) (if yes, how much, write in l)

Water meter indication (if available)

Repairs, services, replace-ments etc. executed? (Y/N) (if yes, describe)

Lubricants or spare parts used? (Y/N) (if yes, describe what, how much/many etc.)

Number of fuel drums. (fill in at the start of each week, at the end of each week and each time when new fuel drums are delivered)Number of drums delivered

Total number of drums at the site


next water meter service:

next engine service:

next pump service:

fig 12.4 p. 388////

Figure 4.2 End suction, single-stage centrifugal pumpFrom Davis and Lambert, 1995

///fig 12.7, p. 391//

Figure 4.3 Typical arrangement of centrifugal pump fittingsFrom Davis and Lambert, 1995


4.2.11 Supervisor Water Pumping and Storage

Tools/materials needed: pen, notebook, report forms, rubber boots

Number of Supervisors Water Pumping and Storage needed: one




Ensure that problems reported to you or observed by yourself are followed up, i.e. coordinate solving the problems with your unit (water pumping and storage) and if necessary contact others to assist.

whenever needed

Hold short meetings with staff

Hold regular meetings with groups of staff, e.g. all pump operators, all mechanics, all guards etc. Discuss problems encountered, ideas, remarks and make plans together on how to solve problems, improve the work etc. Coordinate the follow up on these meetings.

Meetings can be held at pump and tank stations or at any suitable place. Inform and discuss with the manager (he may also be at or initiate these meetings) and ask his reaction on/permission for any new plans or ideas developed.

The meetings can also be held to give short trainings to staff (often together with the manager)

whenever believed necessary; keep meetings short and to the point to avoid losing time.

execute as infor-mal or focus group discus-sions (see ch. 3) or as training sessions

Visit pump stations

Control the work of staff and discuss things with them. Pay special attention to:

Cleanliness of the pump station.

Control whether pumps and engines are functioning well.

Control logbook of the pump operator (if not yet used introduce the use of a logbook as fast as possible).

Count numbers of full fuel drums and crosscheck with logbook of the pump operator (if no logbook used yet, instruct the pump operator to inform you every week how many drums he has used).

Determine fuel use per hour together with pump operator: fill the tank with fuel, let the engine run one hour under its normal work load, then fill the tank again and measure how much fuel was consumed. Check whether the amount used is normal (compare with earlier figures measured for fuel use). If there are large differences try to identify the reasons. Reasons for differences could be: 1) change of pumping height or length (if so, the engine’s fuel consumption measured can be regarded as the new standard, i.e. if further the engine functions well and pumping has been done as it will be done in the coming future), 2) engine less efficient because it is getting old, it needs servicing or a repair (discuss with mechanic if this is suspected), 3) the fuel use is wrongly measured (if this is a possibility, measure again).

Compare whether the measured fuel use is consistent with the number of fuel drums emptied (e.g. calculate from the pump operator’s logbook the number of engine hours for a certain period and multiply with its normal fuel use per hour; the total can be compared with the number of drums emptied during that time). If not the same try to identify the reasons (could be: theft, poor measurements, poor registration, etc.)

Check whether the staff visited still have their materials, tools and equipment. Ask about the reason if things are lacking. Organize to renew these things if needed only if they have good reasons, otherwise investigate.

visit at least one pump station every day

Control fuel use and compare with fuel drums emptied at each pump station at least once a week

Check materials etc. at each pump station at least once a month

for control of quality of work look at the task descriptions of the different staff

See Box ... for further details on how to determine an engine’s fuel use


Tasks (both for emergencies and non-emergencies) (continued):

Visit tank stations

Control the work of staff and discuss things with them. Pay special attention to:

Cleanliness of the tank stations.

Signs of erosion. If so discuss what action is needed to prevent erosion especially if it could undermine the tank. Coordinate action.

Discuss with caretakers and the responsible system controllers of the tapstands connected to the tank whether they have problems with water availability at those tapstands.

Control the logbook of the tank operator (if used; otherwise introduce it as fast as possible).

Check whether the guards and tank operator at the site still have their materials, tools and equipment. Ask about the reason if things are lacking. Organize to renew these things if needed only if they have good reasons, otherwise investigate.

visit at least one tank station every day

for control of quality of work look at the task descriptions of the different staff

Visit source intakes

Check cleanliness of the site. Check whether the intake is rightly positioned in the source. Discuss problems and threats to the source (pollution etc.). Check whether the source caretaker still has the materials and tools for the work. Follow-up on the outcome of the visit if necessary.

once a week look at task description source caretaker

Control the work of the mechanics

Go with them and observe their work. Check their logbooks and control whether services have been done in time (crosscheck if necessary with logbooks of pump operators). Discuss with the mechanics about problems encountered, how things can be improved etc. Check whether they still have the materials and tools for the work. Follow-up on the outcome.

once a week for each mechanic during a couple of hours.


Meet with and discuss about problems, ideas and plans with the manager, other supervisors of the piped water program and supervisors of other programs as well, for instance the hygiene education program, toilet program, etc. (such meetings are often called for by the manager but they can also be initiated by any of the supervisors and do not necessarily always have to be held together with the manager). Make sure always to discuss the outcome of the meetings with the manager and ask his opinion about and permission for plans, ideas etc.

regularly, e.g. once every 2 to 6 days

can be informal meetings or focus group discussions; see chapter 3.

Fill in weekly report

At the end of each week get the logbooks of that week from the tank operators, the pump operators and the mechanics. With the information from the logbooks and the information obtained during the week through observing and control of all activities fill in the weekly report (during observations certain details can be filled in directly in the weekly report, so always take it with you). Provide a copy to the program manager and give further oral explanations if believed necessary.

once a week see Form ...

Control of spare parts used and tools, equipment and spare parts at the site

Control the tools, equipment, and spare parts at each site, based on your observations during the month, and the logbooks of pump and tank operators and the mechanics. Make an overview of all spare parts used during that month. Then crosscheck the results with the bookkeeping of the field administrator. Also adapt lists with tools, equipment and spare parts available at each site. Give comments in the last weekly report of the month.

once a month

Report large problems immediately

Report all large problems immediately to the overall supervisor and the manager, especially if they can not be solved immediately. If theft is suspected or detected this should always be reported to the manager.

continuously


Form 4.8 Example of report forms to be filled in each week by the Supervisor Water Pumping and Storage1

Country:______________________ Date:_____________________________

Camp:_________________ Name of Supervisor:___________________________

PUMPSPump station 1

Pump station 2

Pump station 3

Pump station 42

Serial numbers of pump and engineName of responsible pump operatorTotal actual fuel consumption (in liters) Sum up the fuel consumption for the whole week from the pump operator’s logbookTotal number of fuel drums used (= sum of drums delivered during the week + no. of drums at site at start of the week - no. of drums at site at the end of the week; figures to be obtained from pump operator’s logbook). Compare whether this is consistent with the ‘total actual fuel consumption ’ and with the ‘total theoretic fuel consumption’ (1 drum = 200 l).Total time of engine operation (in hours) Sum up from the pump operator’s logbook all periods the engine was operating during that weekEngine’s normal fuel consumption (in l/hour)Total theoretic fuel consumption (in liters)(= ‘total time of engine operation’ x the ‘engine’s normal fuel consumption’; write down the answer in l of fuel). Give comments if this figure differs substantially from the ‘total actual fuel consumption’Total theoretic water production (in m3)(= ‘total time of engine operation’ x the pump’s normal water production; determine for each pump station, write down in m3 of water). Compare this figure with the total actual water production (sum of water fillings in the tank to which the pump pumps, indicated in the tank operators’ logbook; this is the same as what you fill in for that tank in this same weekly report under ‘total volume of water that passed through the tank’) Problems with pumps and enginesOnly describe pump or engine replacements and problems with pumps and engines which are not yet solved or which need further follow-up; give recommendations for solving the problems.Services done. Check both the logbooks of the pump operators and of the mechanics. Were they on schedule? Was the service well done? If not explainSpare parts usedProblems with fuel Describe problems with fuel (e.g. fuel drums not full when delivered, fuel mixed with other liquids etc.)Comments about functioning of guards, pump operators and mechanicsConsumption of lubricants

1 Mainly for non-emergencies, but to be introduced as fast as possible. Use the back of the form or add other papers for the explanations if there is not enough space. Try to answer brief and to the point.

2 If there are more pumps and engines use a second form. Also try, if applicable, to get figures from pump stations operated by other organizations to get a good overall picture (then indicate which pump stations are from your and which are from other organizations).


compare

Water tanksWater tank 1 Water tank 2 Water tank 3 Water tank

41 Problems encountered with tanks. Only describe the problems which are not yet solved, explain and give recommendationsVolume per meter height (in m3)Total volume (in m3)Total water volume of water that passed through the tank (in m3)Get info from logbook: sum up all the meters of tank height that passed through and multiply with the volume per meter height of the considered tank.

Other issuesTotal number of pump stations visited during the weekHow much water goes to:1. domestic use by the target population;2. domestic use by others than the target population;3. irrigation4. small industrial activities5. other activities (describe)(answer together with the supervisor of the distribution unit)Total number of tank stations visited during the weekNumber of mechanics controlled during the weekDid you visit the source?Turbidity of the water in the source (comment if much difference with figure of week before)

Problems encountered with the source.

At the stations visited: were all tools, materials and equipment still available. Comment if not

Remarks with regard to safety issues

Any problems, remarks, questions not covered yet? Give recommendations, ideas etc.

1 If there are more tank stations add another form.


4.2.12 Guards of the water treatment site

Tools/materials needed per guard:Some kind of official costume plus badge, identity card of the organization, some kind of shelter against the rain, possibly a raincoat.Additional for night guards: torch, blanket.

Numbers of guards needed:At least one day guard and two night guards



Guard the site Go around at least once an hour and observe whether any unauthorized people are within the water treatment area. If observed, control whether they may have stolen or damaged anything. If so, bring them to the supervisor (make sure not to endanger yourself), otherwise warn them and send them away immediately.

Additional for night guards:

Do not sleep

If people are found at the site who have damaged or stolen things, they should be kept there till the morning and be handed over then to the supervisor or any other authority. Any other irregularities observed or heard should be reported to him as well.

continuously; go around at least every hour

Help with cleaning and repairs

For day guards: Observe regularly whether the site is clean and whether there are any repairs needed. Assist with cleaning and repairing when asked to do so by the staff at the treatment site. Report to the staff and/or supervisor when you think any cleaning or repair is needed.

observe continuously, act whenever needed

Know who is on site

Make sure to know who of the staff is on site. continuously

Assist with communication between treatment site and pump stations if possible

Assist with communication between the treatment site and pump stations connected to the site whenever necessary (but only if guarding task is not endangered by it).

whenever needed


4.2.13 Water treatment staffDepending on the water treatment methods used in the treatment plant the operational tasks can be divided by and between the staff available. The operational tasks are here described mainly per treatment step (with exception of a few general tasks that should be carried out by all staff).

Tools/materials needed:For each staff: rubber boots, plastic gloves, workman’s gloves, overall, eye mask, mouth protection mask, General: 5 shovels, 3 picks, 3 hoes, one color comparator, 300 free residual chlorine testing tablets (DPD1), logbook forms for the different treatment steps, 3 long sticks, 3 brooms, 3 buckets normal size, 2 large size buckets (100 l), three measuring cans of different sizes, measuring spoons or cups, ......

Number of water treatment staff needed:Usually two to three operators who divide tasks among them and help each other when necessary. One of these people acts as the supervisor but in the same time also executes part of the tasks described here.

General tasks (both for emergencies and non-emergencies; to be executed by all staff ):


Keep the site clean

Keep the site clean and free from vegetation, every day

Check for leaks

Check regularly for leaks in pipes, valves, tanks and other parts (danger for erosion by leaking water and for contamination entering in the system!!!) and repair when necessary (or get the plumbers to do it).

every day

Check for adequate drainage

Check for adequate drainage to prevent erosion of tank foundations. Improve drainage if necessary

every day

Coordinate water flows

Regulate (coordinate with all involved) the inflow and outflow of the tanks.

whenever needed

Coordinate actions with pump stations

Communicate and coordinate with the station pumping water to the treatment site and the station(s) receiving water directly from the treatment site to ensure that pumps do not run dry and tanks do not fall empty.

every day

Report problems

Report all serious problems immediately to the manager. whenever needed


Tasks with regard to sedimentation and storage of raw water (for emergencies and non-emergencies):Task Description Timing Specifications


Check the overflow and drainage system

Control whether it is not obstructed. Keep the drainage system clean to prevent possible erosion and overflowing of the site.

every day

Clean and desludge the tank

Determine the need for desludging:Sludge should be removed well before it starts to mix with the water streaming into the outlet pipe of the tank. One can determine the need for desludging in the following ways

Check the turbidities of the in- and outflowing water (see below). If the turbidity of the outflowing water is increasing while the turbidity of the inflowing water does not change much then desludging is needed.

Observe the sludge layer when the tank has no water.

The desludging interval is variable because turbidities of the water entering the tank may vary (e.g. in the rainy season often turbidities are higher) and therewith the speed of sludge building up in the tank.

Desludge as follows:When the tank is almost empty, disconnect the outlet from the pipe system and open it so that all remaining water flows out into the drainage system. Then enter the tank on bare feet. With plastic buckets and other not too hard materials which could damage the lining and by letting some water flow in the tank and mix with the sludge (by stirring) scoop the sludge + water towards the outlet. Continue until most sludge is drained out of the tank.

Clean as follows:When desludging also clean the walls of the tank on the inside //(only with water??)//. This should also be done when much algae growth is apparent on the inner walls after emptying a tank.

Dispose of sludge and cleaning water as follows:Although the sludge will probably not constitute any major health threat it is best when desludging to ensure that the sludge and/or the water used to flush out and clean the tank is safely drained, well away from any water sources, agricultural land or inhibited area.

Desludging is usually needed only once in a few months but the actually required interval should be determined through measurements and observations (measure turbidities every day and observe the sludge layer once a week or so when the tank is empty) as the actually required desludging interval depends very much on the circumstances

Clean the sides of the tank whenever desludging plus whenever algae growth or other contaminations become a problem

sludge level should be at least 10 cm below the lowest part of the outlet.

for turbidity measurements see ...

Determine the amount of water passing through the tank

Measure the water height in tank each time just before emptying starts and again when emptying stops. Note down the results in the logbook. The easiest way of working is to empty the tank completely and then fill it completely, so that measuring of the water height is not needed (you can then indicate in the logbook the numbers of full tanks emptied).

measure each time when emptying the tank

for an example of the logbook see Form 4...

Determine the turbidity of the water

Measure the turbidity of both the inflowing and outflowing water. Note down the results in the logbook.

measure at least once a day

for an example of the logbook see Form 4...



Form 4.9 Example of logbook form for tank receiving water from the pump station at the source

Country:_____________________ Camp:__________________ Name of treatment site:____________________ Tank number:_________

Date Name operator Time at start of

filling tank

Water level at start of

filling tank

Water meter indica-tion at start of filling

tank (fill in only

Water level at end of filling

tank

Turbidity (measure at least once a day)

Cleaning and/ or desludging activities undertaken? (Y/N)

if water meter is available) inflowing water

outflowing water

(describe)


Tasks with regard to horizontal-flow roughing filters (HRF) (emergencies and non-emergencies):Task Description Timing Specifications

important for exe-cution of the task

Keep HRF outflow constant and below its maximum allowed rate1

If the outflow is too high cut down the inflow by partly closing the inlet valve. Try to keep a constant outflow. Note down the outflow rate in the logbook. It can be determined by catching the water flowing out of the filter in a bucket of known volume measuring the time to fill it, then calculate the outflow in l/s (if water flows out through a V-notch or other weir, the rate can be determined by measuring the height of the outflowing water above the bottom of the weir and using this figure in the equation specific for that weir). One can also place a mark at the side in the outflow channel to indicate the maximum height of water column corresponding with the maximum outflow. This makes it easy to observe when the outflow is too high.

Measure the outflow from the roughing filter //daily?/

For further information about weirs see Appendix 9 in Davis and Lambert, 1995 and other technical handbooks

Measure turbidity of inflowing and outflowing water

Note down the figure(s) measured in the logbook. If the turbidity of the inflowing water is higher than normal check whether anything is wrong with the treatment steps before HRF. If so discuss with the involved staff and try to determine and solve the problems. If due to higher turbidity of raw water assess whether the turbidity of the outflowing water is still sufficient (and if not assess how this can be improved, e.g. by introducing additional treatments to reduce turbidity). If the turbidity of the outflowing water is higher than normal while there are no large differences in the turbidity of the inflowing water then cleaning of the filter is necessary.

Measure at least once a day

For how turbidities can be measured see ...

If the treatment step after the roughing fil-tration is slow sand filtration or chlorina-tion the turbidity should not be higher than 20 NTU (emer-gencies) or 5 NTU (non-emergencies, preferably even < 1NTU).

Keep the water level high enough

It should be prevented that the water level goes down too much (as this would enhance the growth of algae). Therefore the water level should be regularly checked and its height adapted if necessary. Adapting the inlet and/or outlet valve openings can do this.

Check the water level in the roughing filter //at least once a day??//

The water level should be kept at 10 cm below the top of the filter media.

Clean the HRF

Cleaning should be done by drainage of the filter (open the outlet drain valve) which will cause sediment to be washed to the filter bottom and flushed out with the accumulated sludge. Complete removal of the filter media for cleaning is only necessary after several years. Note down in the logbook the expected date of the next cleaning/flushing.

Clean 1-2 times a month (wet season), 2-3 times/month (dry season) but may have to be more often if filter is small or particle load of raw water large. Also clean whenever the turbidity of the outflowing water rises while turbidity of the inflowing water does not change much (see above).

1 The figure for the maximum allowed outflow rate should be provided by the constructors of the facility; it can be calculated when knowing the surface of the roughing filter and the allowed filtration rate or surface loading of the filter which is the allowed inflow in the filter in m3/h per m2 of the filter surface. The filtration rate depends on factors such as the particle load of the raw water, size of the filter, sorts and particle sizes of filter material used etc.; see also Davis and Lambert, 1995, p. 324-329.


//here Figure 11.21, p. 325 of Davis and Lambert 1995////

Figure 4.3 The main features of a rectangular horizontal-flow roughing filterFrom Davis and Lambert, 1995. Original source: Wegelin, 1986.


Form 4.10 Example of logbook form for roughing filter

Country:_________________________ Camp:________________________ Name of treatment plant:______________________

Date Name operator Outflow from filter (note down in l/s or in seconds needed

to fill the bucket; measure at least once a day)

Turbidity (in NTU)(measure at least once a day)

Cleaning activities undertaken (describe)

inflowing water outflowing water


next cleaning:

Tasks with regard to coagulation and flocculation with aluminum sulfate (emergencies and non-emergencies):


Check the overflow + drainage system


every day

Coagulate and flocculate the water

Prepare the coagulant solution //// how??./////

Fill a tank completely with water and make sure that the required amount of aluminum sulfate is mixed as rapid as possible in the water just before entering the tank (this is called coagulation; it can be done by adding the coagulant solution into the stream at the point where the water is entering the tank).

Stir the water gently for at least 30 minutes to encourage the formation and settlement of flocs (flocculation) following the rapid mixing. The incoming water should preferably be directed around the periphery of a circular tank to provide the gentle motion needed to effect an optimal flocculation process; otherwise stirring with a long wooden pole may do.

Always empty a tank completely to fill it up afterwards again with a new load of water (coordinate with the people responsible for the tanks delivering water to and the tanks receiving water from the flocculation tanks). Note down each tank emptied in the logbook

Prepare the solution just before filling a tank with water

Let flocculation continue for at least 30 minutes

note down in the logbook each time when emptying a tank.

for an example of the logbook see Form 4.11

Measure the pH of the water

If the pH gets out of the 6<pH<8 range a new jar test (see p. ... of Davis and Lambert 1995) will be needed to determine the aluminum dosage required and possibly coagulation may not be a suitable treatment any more. Therefore if the pH is out of this range contact the manager immediately and discuss together the measures to be taken.

measure once a day if the pH is known to fluctu-ate, otherwise once a week to once a month

pH should be between 6 and 8

Clean and desludge the tank

Determine the need for desludging:Sludge should be removed well before it starts to mix with the water streaming into the outlet of the tank. One can determine the need for desludging as follows:

Check the turbidities of the in- and outflowing water (see below). If the turbidity of the outflowing water is increasing while the turbidity of the inflowing water does not change much then desludging is needed.

Observe the sludge layer when the tank has no water.

The desludging interval is variable because turbidities of the water entering the tank may vary (e.g. in the rainy season often turbidities are higher) and therewith the speed of sludge building up in the tank.

Desludge as follows:When the tank is almost empty, disconnect the outlet from the pipe system and open it so that all remaining water flows out into the drainage system. Then enter the tank wearing overall, ///eye protection mask (??)//, plastic gloves and rubber boots (to prevent contact with the sludge as much as possible as it contains harmful chemicals), but be careful not to damage the lining of the tank. With plastic buckets and other not too hard materials which could damage the lining and by letting some water flow in the tank and mix with the sludge (by stirring) scoop the sludge + water towards the outlet. Continue until most sludge is drained out of the tank. Also clean the walls of the tank on the inside //(only with water??)//.

Dispose of sludge and cleaning water as follows:The sludge contains chemicals that can be harmful. It is therefore best when desludging to ensure that the sludge and the water used to flush out and clean the tank is safely drained, well away from any water sources, agricultural land or inhabited area.

Desludging is probably needed once every one to two months but the actually required interval should be determined through measurements and observations (measure turbidi-ties every day and observe the sludge layer once a week or so when the tank is empty) as the actually re-quired desludging interval depends very much on the circumstances

sludge level should be at least 10 cm below the lowest part of the outlet.





logbook: Form 4.11

turbidity mea-surements: ...


Form 4.11 Example of logbook form for coagulation and flocculation

Country:_____________________ Camp:__________________ Name of treatment site:____________________ Tank number:_________

Date Name operator Time at start of emptying

tank

Was it a full tank and was it emptied

completely? (if not, explain)

Water meter indica-tion at start of filling tank (fill in only if water

meter is available)

pH Turbidity (in NTU)(measure at least once a day)

Desludging activities undertaken? (Y/N)

(describe)

inflowing water outflowing water


Next date of desludging:

Tasks with regard to slow sand filtration (both for emergencies and non-emergencies):Task Description Timing Specifications




every day

Keep the inflow at a constant rate and ensure a layer of water on top of the filter bed

The inflow should be as constant as possible and should not be too high (would affect the filtration quality) nor too low (would increase the danger for falling dry of the filter bed). If the flow is too high decrease it by further closing the inlet valve. If the flow is too low further open it. Prevention of a too high water layer can be automatically arranged with a ball float valve (which however does not take away the need to control regularly whether the water layer is not too thin). When the filter bed is dry for more than one day it has to be drained completely (just adding water again would then give anaerobic conditions in the filter which can cause a lasting bad taste to the water): close all valves except the inlet valve, wait until there is a water layer on top of the filter bed again, then open the drain valve and let water pass through for about ...??... hours; then close the drain valve and continue the filtration process as normal.

The flow of water can be determined with a water meter (make sure it is calibrated properly; see Box ...) or by catching the inflowing water in a container of known volume and measuring the time to fill it, then calculate the outflow (if a V-notch or other weir is placed, the outflow can be determined by measuring the water level above the weir and entering the measurement in the equation specific for that weir; e.g. see Appendix 9 in Davis and Lambert, 1995).

Measure the inflow in the tank once a day

Observe regularly whether there is still a sufficient layer of water on top of the filter bed

The inflow should not exceed 0.3 x the surface area in m2 of the filter (gives the maximum inflow rate in m3/h; divide by 3.6 to get an answer in l/s; but better is to have an inflow rate of 0.2 x the surface area or even lower).

Optimally there should be a layer of .... cm of water on top of the filter bed

Scrape the filter

The filter should be cleaned by scraping off the ‘schmutzdecke’, a thin top layer of about 2 cm thick, of sand and impurities, when this layer starts to obstruct the flow of water through the filter too much. This can easily be determined: when the inflow clearly needs to be decreased in comparison to its normal rate scraping will be needed. During scraping leave water in the filter at 20 cm below the surface of the sand. Scrape with a long stick to which a horizontal piece of wood is fixed at the end that will allow for equal, horizontal scraping of thin layers. Put the scraped sand in buckets to transport it out of the filter and leave it on site (it will be washed and re-used later when fully replacing the filter bed). Note down scrapings in the logbook including the expected date of the next scraping.

Scrape 2 to 20 weeks after the last scra-ping (interval depends on turbidity of the water, tank design etc. and should be determined in practice)

for logbook see example in Form ...



If turbidity if inflowing water is too high another treatment process should be added before the slow sand filter (e.g. coagulation and flocculation or roughing filtration).

If the turbidity of the outflowing water is too high while the turbidity of the inflowing water is acceptable one should probably scrape the filter (see above). If this does not yield sufficient effect it will probably mean that the design of the filter is not correct: discuss with manager and others what measures should be taken in this case.


logbook: Form 4.12

turbidity measure-ments: ...

max. turbidity of inflowing water: 20 NTU (up to 200 NTU can be tolerated for a few days).

max. allowable turbidity of outflowing water: ... NTU


Tasks with regard to slow sand filtration (both for emergencies and non-emergencies) (continued):


Replace filter bed

The filter bed should be replaced when the thickness of the sand layer is 0.6 m or less. Check this by sticking a long thin stick (e.g. an iron concrete weapening bar) into the layer till reaching the bottom of the sand layer, indicate the level of the surface on the stick, remove and then measure the thickness. To replace the filter bed:

stop the inflow,

when the filter is dry, take out all the filter sand,

wash all the sand taken out + the sand removed during earlier scrapings (see p. 334 of Davis and Lambert 1995 for how to wash),

fill the filter with cleaned sand (add new additional sand if needed) to its original level,

open the inlet valve to allow water to flow in.

After replacing the filter bed it may take up to two days before the quality of the water has reached normal operational standards. It is therefore best to let this water drain away. If water is scarce however, it may have be used anyway. This may be acceptable as the filter will directly start to reduce at least some of the bacteria (and when chlorine is added after filtration this will sufficiently safeguard the quality of the water!). When filling the filter for the first time or when new sand is needed due to losses of sand, try to use locally available sand that is suitable for the filter. This will save time and expenses (in comparison to transporting especially suitable sand over long distances to the site) and usually gives very acceptable results. For determining the suitability of sand for a slow sand filtration see Davis and Lambert, 1995, p. 333.

Usually needed once only in a few years but this may be much shorter if scrapings are need more often. This may also change over time etc.

Therefore it is recommended to check the thickness of the sand layer every time when scraping the filter

Put here figure 11.25 p. 334 of Davis and Lambert 1995

Figure .. Washing the filter sandFrom Davis and Lambert, 1995.


Form 4.12 Example of logbook form for a slow sand filter

Country:___________________ Camp:__________________ Name of treatment site:__________________ Water filter number:_______

Date Name operator Water level above filter bed

(in cm)

Inflow rate (in l/s or seconds needed to fill a bucket)

Turbidity (in NTU)(measure at least once a day)

Scraping done or filter bed changed? (Y/N)

(describe)inflowing water outflowing water


Next expected date of scraping:

Next expected date of filter bed change:

Tasks with regard to chlorination (both for emergencies and non-emergencies):




every day

Add chlorine to the water

Measure: 1) the amount of chlorine powder needed with a measuring cup and put in a reservoir, or 2) the amount of chlorine solution needed

Empty the reservoir with the chlorine powder in a full tank of water and stir gently with a long stick to dissolve it, or 2) add the chlorine solution to the inflow of the water in the tank, for instance with a dripping device (see e.g. p. 344 of Davis and Lambert 1995; dripping devices should be controlled and recalibrated regularly!).

After 30 minutes measure the free residual chlorine level with the color comparator (see Box ... and Figure ...).

If the free residual chlorine level measured is too low, add chlorine, wait another 30 min and measure again. If the residual free chlorine level is too high then either drain away part of the water and refill with unchlorinated water or pump part of the water to another tank and then add unchlorinated water until an acceptable low level is established. Assess together with the manager why levels found were too high or too low and develop appropriate action (e.g. adapt the amount of chlorine added to the water) if necessary.

Then release the tank load into the pipeline system

Fill up the tank after it is emptied with new, unchlorinated water and start chlorinating again..

Register tank loads released into the system and their residual free chlorine levels in the logbook (see Form 4.13).

Assess with different system controllers what the free residual chlorine levels are at the tapstands. If these are too low or too high the amount of chlorine added to the water should be adjusted accordingly. Contact the manager in case of very big differences with what is normal in the system.

free residual chlorine level should be measured after 30 minutes of contact time

discuss with system controllers to assess free residual chlorine levels at the tapstands every day

Wear gloves, eye protection and a mouth cap whenever handling chlorine powder.

The required free residual chlorine level should have been determined. It is a level that is high enough to assure a residual free chlorine level at the tapstands of 0,3 - 0,6 mg/l. If this turns out to be more than 1,0 mg/l check for contamination entering in the system’s chain after chlorination.

Handle chlorine correctly and safely and control its availability

There should always be a chlorine supply on site sufficient for about 6 to 10 days, not more and not less

Chlorine should be stored in a dry place, away from heat and sunlight, and in corrosion resistant containers that are closed each time directly after taking out the chlorine needed.

When new chlorine is arriving, check the expiry date.

Chlorine is a powerful oxidizing agent, handle it with care and store in a safe place where no unauthorized persons can have access to it.

When handling chlorine wear rubber boots, an overall, plastic gloves, eye protection and mouth protection.

continuously

Check pH and turbidity

Check pH (see Box ... and Figure ...) and the turbidity (see Box ...). Chlorination is considerably less effective when the pH is greater than 8 or when the turbidity >5 NTU. In an emergency turbidities up to 20 NTU can be accepted (this will however mean that high chlorine dosages will be needed). Such high dosages should be minimized as much as possible though and not be continued longer than .... days in a row . In case of too high turbidities one should implement treatment methods to diminish the turbidity. Register the results of the measurements in the logbook

check pH and turbidity once a day

pH should be < 8

Turbidity should preferably be < 1 NTU (5 NTU is still acceptable and 20 NTU is acceptable temporarily in emergencies)


Form 4.13 Example of chlorinator’s logbook

Country:___________________ Camp:_________________ Name of treatment plant:________________ Chlorine tank number:________

Date Name operator

Time Tank filled? (Y/N)

Turbidity (in NTU) (measure just before

adding chlorine to the water, once a day)

pH(measure just before adding

chlorine to the water, once a day)

Amount of chlorine added (in grams or number

of standard cups of which volume is known)

Residual free chlorine level (in mg/l)(measure for each tank load after a contact time of the chlorine with the water of 30

minutes)


4.2.14 Supervisor Water Treatment

Tools/materials needed:pen, notebook, report forms, rubber boots

Number of Supervisors Water Treatment needed: one



Execute part of the tasks described for water treatment staff

The supervisor water treatment often fulfils part of the tasks of the water treatment staff himself (together with all staff a division of tasks is made) depending on the amount of work of the below tasks.

continuously see task descriptions of water treatment staff


Ensure that problems reported to you or observed by yourself are followed up, i.e. coordinate solving the problems with your unit (water treatment) and if necessary contact others to assist.

whenever needed

Hold short meetings with staff

Hold regular meetings with all staff of your unit together. Discuss problems encountered, ideas, remarks and make plans together on how to solve problems, improve the work etc. Coordinate the follow up on these meetings. Such meetings are usually held at the water treatment site but can also be held at any other suitable place. Inform and discuss with the manager (he may also be at or initiate these meetings sometimes) and ask his reaction on/permission for any new plans or ideas developed. The meetings can also be held to give short trainings to the staff (often together with the manager)

whenever believed necessary; keep meetings short and to the point to avoid losing time.

execute as infor-mal or focus group discus-sions (see ch. 3) or as training sessions

Visit the treatment steps

Control the work of staff and discuss things with them (instruct how to improve, discuss what can be done to improve/solve problems). Pay special attention to:

Cleanliness of the site in general.

Capacity of and any possible obstructions in the drainage systems

Signs of erosion undermining or threatening the tanks

Control whether the treatment steps visited are functioning well.

Dosing and proper application of chemicals used

Safety of working (especially when applying or in contact with chemicals or sludge containing chemicals)

Measuring of water flows, turbidities, pH and free residual chlorine levels.

Control the logbooks of the treatment steps visited (if not yet used introduce the use of logbooks as fast as possible). Also make crosschecks: e.g. outflow from one tank should be the same as the inflow of the tank connected to it, same for turbidities etc.

Check whether the staff visited still have their materials, tools and equipment. Ask about the reason if things are lacking. Organize to renew these things if needed only if they have good reasons, otherwise investigate.

visit each treatment step at least once a day and whenever believed necessary

for control of quality of work look at the task descriptions for the different water treatment steps

Tasks (both for emergencies and non-emergencies) (continued): Task Description Timing Specifications



Meet and discuss problems, ideas and plans with manager, other supervisors of the program and supervisors of other programs as well, for instance the hygiene education program, toilet program, etc. (such meetings are often called for by the manager but they can also be initiated by any of the supervisors and do not necessarily always have to be held together with the manager). Make sure always to discuss the outcome of the meetings with the manager and ask his opinion about and permission for plans, ideas etc.

regularly, e.g. once every few days to once a month

can be informal meetings or focus group discussions; see chapter 3.

Meet with pump and tank operators and system controllers

Visit pump and tank operators who receive or deliver water to/from the treatment site in order to get comments from them about coordination matters and whether they face any problems related to the treatment site. Also contact some of the system controllers responsible for some parts near the treatment site to discuss things. Follow up on the outcome of the discussions.

contact once a week to once a month to discuss things shortly

see informal meetings in chapter 3

Fill in weekly report

At the end of each week get the logbooks of that week from the different treatment steps. With the information from the logbooks and the information obtained during the week through observing and control of all activities fill in the weekly report (during observations certain details can be filled in directly in the weekly report, so always take it with you). Filling in the report can also be done together with other staff. Provide a copy to the program manager and give further oral explanations if believed necessary.

once a week see Form 4.14

Control of spare parts used and tools, equipment and spare parts at the site

Count all tools, equipment, and spare parts at the site. Make an overview of all spare parts used during that month based on your observations during the month, and all logbooks. Crosscheck the results with the bookkeeping of the field administrator and lists of former months. Give comments, especially if anything is missing.

once a month

Report large problems immediately

Report all large problems immediately to the overall supervisor and the manager, especially if they can not be solved immediately. If theft is suspected or detected this should always be reported to the manager.

continuously

Form 4.14 Example of weekly report by the Supervisor of the Water Treatment Site


Name water treatment site:__________________ Name Supervisor:____________________

Total number of water treatment staff (including supervisor)

Total number of other staff (guards, ..)

Total amount of water pumped into the water tank receiving water from the pump station at the source (in liters, m3, or number of tank loads if tank volumes are the same and known). Comment in case the amount differs much from former weeks.Maximum, minimum and average turbidity determined in the water flowing into the sedimentation tank water (in NTU). Comment in case values found differ much from former weeks or if large differences occurred during the week.Maximum, minimum and average turbidity determined in the water flowing out of the last turbidity reducing treatment step (in NTU). Comment in case values found differ much from former weeks or if large differences occurred during the week)Describe any other problems encountered with turbidity levels

Was any cleaning, desludging or scraping activities undertaken? (Y/N). (If yes, describe shortly)Total outflow during the whole week from last treatment step (in liters, m3, or number of tank loads if tank volumes are the same and known) (get figures from the logbook(s) of this treatment step; comment in case the total outflow determined in this way differs much from the total amount of water received by the tank connected to the pumping station at the source as determined in the third row of this form)Any problems encountered with water flow in or out any of the treatment steps? (Y/N) (If yes, explain)

For the water coming out of the chlorination tank(s) describe:* the total number of free residual chlorine tests executed,* the maximum free residual chlorine level found (in mg/l), * the minimum free residual chlorine level found (in mg/l),* the average free residual chlorine level of all tests (in mg/l),* the number of tests that had too high values, and * the number of tests which resulted in too low values. Comment in case values found differ much from former weeks or if large differences occurred during the week.Did any tools, equipment or materials get lost? (Y/N). (If yes, explain)

Are there sufficient materials, chemicals (chlorine, aluminum sulfate, DPD1 tablets), tools and equipment at the site? (Y/N). (if no, explain)

Did staff work safely? (control especially whether safety rules were respected during work with chemicals and desludging and cleaning activities) (Y/N). (If no, explain) Remarks with respect to quality of work by staff, ideas for improvement, and any other things found important

4.2.15 Overall Supervisor Piped Water Program//still to be worked on; it should be assessed whether this function is needed at all///

4.2.16 Program ManagerTools/materials needed:In addition to the general tools and materials needed (described in chapter 3) for the piped drinking water system the manager will need: color comparator together pH and DPD1 tablets, in some cases an EC meter, in some cases a Del Agua kit, turbidity meter, watch with stopwatch function, ...........

Number of Program Managers needed: Emergencies: ///to be worked on////Non-emergencies: ///one, up to a maximum of 150.000 beneficiaries??///



Execute general tasks

Execute all manager’s general tasks see par. 3.5.4 see par. 3.5.4

Cross-checks during visits or camp walk

Cross-check fuel use of a few pump stations (info through report of supervisor pumping and storage) with the administration of those responsible for delivery of the fuel drums

Check some of the equipment, tools and materials of staff against what they should have

test free residual chlorine at a few points and check against what the responsible staff have registered in their logbooks

Check at a few tapstands: cleanliness, rows of people (or containers) and flow from taps

Observe cleanliness at the treatment site and a few other sites

Check out some of the repairs done by plumbers (look in logbook of team leader)

Crosscheck numbers of staff provided by supervisors with numbers of staff on payrolls (once a month??).

/////work out further/////

during visits to staff

look at task descriptions of the staff visited

other checks can of course also e done (the list given is only a sample of checks)

Fuel check

Execute a full check on fuel use at the pump stations. Check fuel use by a few engines. Count fuel drums at pump stations, check logbooks pump operators and crosscheck with administration of people delivering the fuel. Check quality of the fuel.

once a month

see Box ..., task description of pump operators, logbooks of pump operators and administra-tion of those delivering fuel

Measure EC

Measure EC value of the raw water once a month

should be < 3000 uS/cm (emergencies) and < 1400 uS/cm (non-emergencies)

///other tasks still to be worked on////

Form 4.14 Example of piped water program part of the Program Manager’s weekly report (in addition to general part of Program Manager’s weekly report; see par3.5.4)

Total number of staff of the Water Treatment UnitTotal number of staff of the Distribution unitTotal number of staff of the Water Pumping and Storage UnitTotal number of beneficiariesTotal water production by system (in m3)

Total number of free residual chlorine tests done by system controllers at the tapstands.Number of tests with too high values.Number of tests with too low values.Comment in case too high or too low values are found

Total number of free residual chlorine tests done by water treatment staffNumber of tests with too high values.Number of tests with too low values.Comment in case too high or too low values are found

Average turbidity of water at tapstands (in NTU)Maximum turbidity of water at tapstands (in NTU)Give comments in case of high values found

Average and maximum turbidities (in NTU) of:* Raw water* The water just before slow sand filtration* The water just before chlorination Comment in case of high values foundTotal number of tapstands

Total number of pumps + engines in operation

Total number of storage tanks in system and their total storage capacity (in m3)

Any problems with people waiting for water? Describe

Any problems with flow from tapstands or number of working taps at tapstands? Describe

Number of collection vessels distributed and their capacity (in l)Did staff work safely? (control especially whether safety rules were respected during work with engines, chemicals and desludging and cleaning activities) (Y/N). (If no, explain) Remarks with regard to use of lubricants and fuel

Remarks with respect to quality of work by staff, ideas for improvement, new activities believed necessary, and any other things found importantActivities planned for next week

Form 4.15 Example of piped water program part of Program Manager’s monthly report (in addition to general part of Program Manager’s monthly report; see par. 3.5.4)

This month Last month

Total number of staff of the Water Treatment Unit

Total number of staff of the Distribution unit

Total number of staff of the Water Pumping and Storage Unit

Total no. of beneficiaries per camp part (refer to the map)

Camp part …

Camp part …

Camp part …

Total water production by system (in m3) + estimation of part which goes to beneficiaries and parts that go to other uses (e.g. animals, public health facilities, irrigation, etc.). Is the water enough for the beneficiaries? Is the water delivered to other uses enough? Describe if large differences between different parts of the camp. Refer to the map

Total number of free residual chlorine tests done by system controllers at the tapstands.

Number of tests with too high values.

Number of tests with too low values.

Comment in case too high or too low values are found

Total number of free residual chlorine tests done by water treatment staff.

Number of tests with too high values.

Number of tests with too low values.

Comment in case too high or too low values are found

Average turbidity of water at tapstands (in NTU)

Maximum turbidity of water at tapstands (in NTU)

Give comments in case of high values found

Average and maximum turbidities (in NTU) of:

* Raw water

* The water just before slow sand filtration

* The water just before chlorination

Comment in case of high values found

Total number of tapstands

Ec of raw water (in uS/cm)

Are odor and color of the water at the tapstands OK? If no, describe

Total number of pumps + engines in operation

Total number of storage tanks in system and their total storage capacity (in m3)

Form 4.15 (continued)This month Last month

Any problems with access of beneficiaries to water points (distances, obstacles, locations)? Comment, distinguish between camp parts and refer to map.

Any problems with people waiting for water? Describe (waiting times, locations). Refer to the map

Any problems with flow from tapstands or number of working taps at tapstands? Describe (severity, locations, relation with longer waiting times). Refer to map.

Number of collection vessels distributed and their capacity (in l).

Did staff work safely? (control especially whether safety rules were respected during work with engines, chemicals and desludging and cleaning activities) (Y/N). (If no, explain)

StatisticsWhat to do:1. Register the first time the date the first report was made (= the last day of week 1)

2. Copy graphs from last week.

3. Register on the copied graphs the values of the variables of this week (for the whole camp, and, if necessary, making separate graphs distinguishing between the different camp parts). Give explanations/interpretations on a separate paper or on the back of this form.

Last day week 1 = ____________ (fill in date)

Graph 1 Facilities and water production against numbers of beneficiaries X----X----X = average daily water production during the week; O---O---O = no. of beneficiaries; T----T----T = no. of functioning tapstands; S---S---S = storage capacity of the tanks; V---V---V = no. of vessels distributed

1 2 3 4 5 6 7 8 9 10

Graph 2 Free residual chlorine at tapstands X-----X----X = total number of free residual chlorine tests done during the week at tapstands; H---H---H = percentage of the free residual chlorine tests done at the tapstands which had too high values; L---L---L = percentage of the free residual chlorine tests done at the tapstands which had too low values

1 2 3 4 5 6 7 8 9 10

100 90 80 70 60 50 40 30 20 10 0

200180160140120100 80 60 40 20 0

Numbers of beneficiaries (in thousands), tapstands, and vessels distributed (in hundreds)

Number of tests executed

Weeks

Weeks

1.000 900 800 700 600 500 400 300 200 100 0

100 90 80 70 60 50 40 30 20 10 0

Amount ofwater (in m3)

Percentage

Graph 3 Free residual chlorine at treatment site X----X----X = total number of free residual chlorine tests executed just after chlorination; H---H---H = percentage of the free residual chlorine tests done just after chlorination which had too high values;L---L---L = percentage of the free residual chlorine tests done just after chlorination which had too low values.

1 2 3 4 5 6 7 8 9 10

Graph 4 Turbidities G---G---G = average turbidity raw water; M--M--M = maximum raw water turbidity;V---V---V = average turbidity of water at tapstands; T---T---T = maximum turbidity of water at tapstands

1 2 3 4 5 6 7 8 9 10

Graph 5 Water production against fuel use W---W---W = total monthly water production; F--F--F = monthly fuel use

200180160140120100 80 60 40 20 0

Number of tests executed

Raw water Turbidity(in NTU)

Weeks

Weeks

100 90 80 70 60 50 40 30 20 10 0

Percentage

1.000 900 800 700 600 500 400 300 200 100 0

100 90 80 70 60 50 40 30 20 10 0

Treated water turbidity (in NTU)

100.000 90.000 80.000 70.000 60.000 50.000 40.000 30.000 20.000 10.000 0

20.000 18.000 16.000 14.000 12.000 10.000 8.000 6.000 4.000 2.000 0

1 2 3 4 5 6 7 8 9 10

Monthly water production(in m3)

Weeks

Fuel use (in l)

Piped water program part of the monthly report by the Program Manager (continued)Remarks with regard to use of lubricants and fuel

Remarks with regard to administration of materials, tools and equipment (operation, contingency, theft, loss, damage, etc.). Describe

Describe training activities executed (who were trained, subjects)

Are objectives being achieved well enough and in time? Comment

Remarks with respect to quality of work by staff, ideas for improvement, and any other things found important

Potential problems, threats. Describe

Main activities planned for next month

/////For each program discuss progress and problems/constraints of the activities in relation to the program planning. Include an overview of all the indicators measured during that month, preferably in graphs against time also containing the results of former months, so that a comparison with those months is easy. Assess whether the program results are according to the objectives and time frame planned. If activities have not been carried out or indicators have not been measured according to the program planning, explain why./////

///Box ...: For the manager: Control of fuel consumption by engines driving pumps

For each pump operator’s logbook:1. sum up the amounts of fuel used during the week,

2. calculate the amount of water produced by multiplying the number of liters of fuel used with the normal water production per liter of fuel as determined for the engine used (see Box ...).

3. If also water meter data are present the above calculated water production should be cross-checked with the water meter readings.

4. Get the logbook(s) from the tank(s) to which the considered pump station is pumping, and sum up the total volume of water that has passed through that/those tank(s) during that week.

If there is any discrepancy, report as such and try to find out what the causes are.

//////

4.2.17 Office Administrator///still to be worked on: possibly not needed any more, as already sufficiently covered in chapter 3?///

4.2.18 Office Logistician////still to be worked on; possibly sufficiently covered by chapter 3??Cross-check fuel use of each pump station with the administration of those responsible for delivery of the fuel drums////

4.2.19 Evaluating piped water supply programs///still to be worked on//////

5. Family pit latrines

The recommended minimum objective of a family pit latrine program is:To ensure that all camp inhabitants have access to family pit latrines according to the below specifications.

Specifications for the recommended minimum objective of a pit latrine program:Situation

Subject


Number of family pit latrines

1 latrine in use per 10 families or 50 persons

1 latrine in use per 4 families or 20 persons

Pit dimensions and distance to water table

surface area: 0.8 x 1.2 m (square hole in relatively stable soil without lining), 0,8 m diameter (round hole in relatively stable soil without lining), up to 1,2 m diameter or sides of rectangular hole in case lining is available.

depth: at least 3 m (the bottom should be at least 1.5 m above the water table; may have to be more in case of fissured rocks or other unfavorable conditions).

surface area: 0.8 x 1.2 m (square hole in relatively stable soil without lining), 0,8 m diameter (round hole in relatively stable soil without lining), up to 1,2 m diameter or sides of rectangular hole in case lining is available.

depth: preferably 4 m or more (the bottom should be at least 1.5 m above the water table; may have to be more in case of fissured rocks or other unfavorable conditions).

Distance of the latrines

latrines should be between 15 (not less because of smell) and 100 m (not more because of walking distance) from the dwellings and not be less than 15 m from any water source (a minimum of 30 m is preferable though; may have to be more in case of fissured rocks or other unfavorable conditions)

latrines should be between 15 (not less because of smell) and 50 m (not more because of walking distance) from the dwellings and not be less than 15 m from any water source (a minimum of 30 m is preferable though; may have to be more in case of fissured rocks or other unfavorable conditions)

Quality of construction

see Box 5.1 same

Tools/materials needed

described per group of staff in the paragraph

described per group of staff in the paragraph

Staff described per group of staff in the paragraphs of this chapter

described per group of staff in the paragraphs of this chapter

Width of corridors

10 to 20 m same

Chapter 5 : Family pit latrinesp. 108

Box 5.1 : technical specifications for a simple family pit latrine

A family pit latrine in the most common form as found in many camps consists of: A hole in the ground (the pit) dug by the household members themselves (the hole should be just wide

enough to enable an adult to stand in it and dig the pit deeper, and small enough to allow for a reasonable size and not too heavy slab with sufficient strength).

If the ground is unstable: a lining of bricks, mud stones, corrugated iron, old oil drums, concrete rings, etc. partly or completely down the pit (materials are usually provided by the program after the pit has been completed according to the prescribed dimensions which is controlled by sanitation workers). A lining should preferably be avoided as this makes the latrine much more expensive (therefore if you can choose between a smaller hole without lining and a larger hole with lining it is preferable to choose for the first option).

A strong platform covering the hole (the slab), e.g. of concrete (easy to clean and not soaking up liquids that may feed pathogens), preferably with a key formed drop hole and raised foot rests. If the soil is unstable and no financial means are available for a lining the platform should have a large overlap (at least 50 cm) with the ground. In this case reinforced concrete is a better option than the dome-shaped unreinforced concrete platforms. The dome-shaped platforms have a limited diameter and therefore have little overlap with the ground. They will thus need a lining in the pit for most soils (for design see Davis and Lamberts 1995 p. 167 - 169). In case of using reinforced slabs it is best to make them in different parts, otherwise they will be too heavy to carry. In many camps wood is used (light in weight, thus less danger for collapse of the underground and easier to transport, cheap, and easy to make, but less hygienic and less durable than concrete). Wooden slabs should preferably be treated with some kind of preservative (even old motor oil can be used). Covering the wooden slab with plastic or a layer of mortar may help to make the slab more hygienic. In camps households are usually given the slab after they have finished the hole according to the prescriptions. A slab should always be raised 15 cm or more above ground level (put earth from the hole on the ground around the hole and compact it). This is to prevent runoff rainwater flowing into the pit.

The superstructure. In its simplest form it may consist of branches and leaves or mud walls, without a roof. A roof is often not preferred as it makes the structure more expensive and allows the inside to remain more humid and with that more suitable for insects and pathogens (while the rain falling directly onto the platform is negligible; it will by no means fill up the pit). Without a roof the platform usually dries up quickly, killing (some of the) insects and pathogens. Important is to encourage people to cover the hole in the slab with a lid to avoid insect breeding in the pit as much as possible. Proper cleaning and covering the pit contents with 100 mm of soil every 2-3 days will also help to reduce fly breeding and smells. VIP latrines are often not suitable: they are expensive and need to be really well constructed to ensure the required dark inside of the structure (which is in most cases not well done). The entrance into the superstructure should be at the downstream side of the latrine if there is any slope.

An earth bund around the superstructure. The bund should be 20 to 30 cm high and at least 50 cm wide to prevent runoff water to enter directly or through the underground into the pit. Additionally a runoff diversion channel can be dug at some distance from the latrine (especially on sloping grounds).

Construction of latrines in wide corridors. If the camp is situated on sloping grounds the latrines should be constructed in wide corridors (20 m or more) running downhill between the huts. The reason is that if, despite all the precautions, latrines should overflow due to excessive runoff entering the pits, this will not affect the people in their homes as the effluents will run down the corridors, and not into the huts. The corridors also function as firebreaks and are often used as pathways (and are thus also useful on non-sloping grounds).


Entrance Simple superstructure of twigs and leaves or other local material

Reinforced concrete slab

Earth from pit

0.80 m 3 - 4 m

groundlevel Drop hole (key shape)

PitReinforced concreteslab

1,5 m

Entrance Downhill

Earth from pit

0,8 m

Drain

8 mm 0,5 m

Reinforced concrete slab6 mm

1,70 m


Figure 5.1 An example of a simple family pit latrine

Advantages of a simple family pit latrine: Cheaper than a VIP latrine so more people can be facilitated in making their own

latrine with the same budget. People can maintain the latrine themselves as most materials can be locally found

(with exception of the slab that will however be provided to them and will be so strong that it will last at least 20 to 30 years)

Easily reconstructed when the pit is full and the concrete slab can then be re-used.

Disadvantages of a simple family pit latrine: More danger for fly infestation as no VIP principle is used. To prevent this as

much as possible a strong concrete lid should be provided with the slab and attached firmly to it with an iron chain in order to make it possible to close the hole and therewith reduce fly problems. It should be remarked that the VIP concept only really functions if a proper screen is attached on top of the vent-pipe. This is usually done during construction, but it is believed that such screens disintegrate over the years and are in most cases not replaced when they break. Another question with regard to the VIP concept is whether the inside of the superstructure is dark enough to prevent that flies come out of the squatting hole instead of flying into the vent-pipe (often this is not the case, especially if the beneficiaries make their own superstructures).

The hole must be dug exactly accordingly to the prescribed dimensions: often people tend to dig it wider which increases the danger of collapse. This requires careful supervision.

Organisation needed for the production of the reinforced concrete slab:Set up a temporary workshop in the community with one skilled person paid by the program to instruct the community members. The community members who want to make a latrine should start making the slab before digging the pit, so that the slab is ready and its concrete cured sufficiently by the time the pit is ready. Before they are allowed to take the slab home it should be controlled that indeed they have finalized digging the pit and that it has the right dimension. The instructor (a professional mason employed by the district authorities and receiving a small allowance from PRDO) explains to the people how to make the slabs and he controls that the community members do it right. It is proposed to have a professional because otherwise community members who are not very experienced and trained will most probably tend to put too much water in the concrete mix, don’t vibrate the fresh concrete enough, use too little cement, and/or let the concrete cure without keeping it wet.


Other programs

Field administratorof the pit latrine program

Sanitation teams:team leaders

sanitation workers

Supervisor sanitation workers

Slab and lid producerslining producers

Supervisor production

Manager of family pit latrine program Office administratorOffice logisticien

Figure 5.2 Organogram of the family pit latrine program described in this paragraph

Sanitation teams are responsible for the proper construction by the people of latrines in their area, lending out tools for drainage, and other tasks (see task description of the sanitation workers and their team leaders). The teams usually each have their own area. The sanitation workers usually work alone in their part of that area while sometimes they assist each other. They often discuss things between the members of the team to exchange information and get feedback on the specific problems they have met. The team leaders of the teams work together. In smaller programs they can also fulfil the tasks of the supervisor together.

The rest of this paragraph gives an example of the tasks that should be executed by the involved actors in the family pit latrine program presented in the organogram.


5.1.1 Sanitation workersSanitation workers ensure that the camp inhabitants build latrines in the right way and in the right place, old latrines are closed in the right way, etc. They often also fulfil a broader function, being involved in marking off and indicating to new arrivals the areas for construction of huts, indicating where corridors should be, and giving feed-back to the program about new arrivals and specific camp planning problems. Those who are good in counting may be involved in population censuses.

Tools/materials needed per sanitation worker:Sanitation workers can obtain from the field store the materials they need, such as shovels, picks, hoes, large hammers, wood saws, etc (see below). The small poles and possibly rope or other materials needed for marking off areas, fencing etc. are provided by the production unit of the program.

Tools needed for the programone shovel per ... camp inhabitantsone pick per .... camp inhabitantsone ho per .... camp inhabitantsone large hammer per ... camp inhabitantsone saw per .... camp inhabitants(these tools should be available to both beneficiaries and sanitation workers from the field store, on top of the tools already available with tapstand caretakers, chefs de corridors etc. In case tools are not enough during certain busy periods, sanitation workers have a higher priority than the beneficiaries)

Number of sanitation workers needed:Emergencies: one per ..... Non-emergencies: one per 1000 to 2000 persons.

Box 5.2 : Administrative system for incentives in family pit latrine programs

Many family pit latrine programs give some kind of incentive to people who construct their own latrine after they have finished it. This is to encourage people in a positive way. Often the incentive has a relation to the latrines, e.g. some soap which also stimulates and enables people to improve their hygiene behavior. To ensure a proper system and prevent corruption with it (e.g. staff selling the incentives) the following system can be used:

Let each sanitation worker be responsible for the latrines in a certain area: a sanitation worker can only provide the incentive notes for the finished latrines in his own area. On the note the name of the sanitation worker and the area should be printed. If in the administration it is seen that more incentive notes are received than the number of latrines produced in the area of a sanitation worker, it is clear that the responsible sanitation worker is selling or giving away the notes. The comparison between numbers of latrines and incentive notes should be done every month. Appropriate action should be taken against the sanitation workers performing corruptive behavior.

The same system can be used with the notes for the slabs as also slabs have a value.


Tasks (emergencies and non-emergencies):Task Description Timing Specifications


Siting of huts and latrines

Place pickets at the places where new arrivals can build their latrines and their huts and lead the new arrivals to these places (discuss with them whether they prefer to stay in a certain part of the camp, e.g. where the people from their own area have settled and try to make this possible). Once the people have build the structures gather the pickets to use them at other sites (explain to the people on beforehand that they have to give back the pickets afterwards).

Every time when new latrine or hut constructions are needed

Ensure right dimensions of the pits

Control and direct people to ensure that the holes they dig have the right dimensions (especially width and length are important: the slab must have enough overlap with the ground; therefore it is important to be on-site whenever people start digging and come back a few times afterwards to control whether they have not enlarged the hole). If people have made a too large hole it should be rejected and they should not be given a slab.

Explain to people before they start dig-ging and visit them regularly when they are digging

See Box 5.1 and the specifica-tions of the recommended minimum objective

Inform people about digging tools

Inform people who need tools for digging latrine holes or improving drainage around their huts where and how they can obtain these. Usually tools can be borrowed from tapstand caretakers, chef de corridors etc. but if they do not have sufficient tools people should be informed that they can also go to the field store and borrow tools from there.

Give a note for the slab

If people are ready with digging the hole it should be controlled once again whether it has the right dimensions. If everything is OK give them a note with which they can go to the production or storage site to obtain a slab.

Control the quality of the structure

Continue to advise people when they are finalizing the latrine, e.g. about the necessity of raising the slab, the earth bank and interception drain etc. Control whether people do a good job. If not, they should be strongly advised to do it better (if the program gives an incentive to the people after finalizing the latrine, e.g. a piece of soap, a properly finished latrine should be put as a condition for receiving the incentive).

See Box 5.1 and the specifica-tions of the recommended minimum objective

Provide incen-tives to those who have properly finished their latrine

Give people who have properly finished their latrine a note with which they can obtain the incentive from the field store.

Visit the latrines shortly after they have been finalized

See Box 5.2

Give instructions about proper operation and maintenance

Explain people who have completed their latrine about proper operation and maintenance:

Keep the latrine clean. Cover the pit contents with 100 mm of soil every 2 to 3 days to reduce fly breeding and smells.

When the pit is full to within 150 mm of the surface,

Explain just after people have finalized their latrine and whenever believed necessary (control latrines when passing

See paragraph 3.3.4.1 (informal group discussions)


dig another pit and fill the old pit with soil. The old slab and possibly parts of the superstructure can be used for the new latrine. Digging tools can be borrowed (ask the sanitation worker or any representative of the beneficiaries who is entitled to lending out tools)

If the latrine is owned by several families together they should agree on beforehand on a rotation scheme for the above operation and maintenance tasks.

by and talk informally to people about it as often as possible)


6. Vector control

6.1Introduction.

Definition of a Vector

A vector is an insect or other animal that can transmit infection directly or indirectly from one person to another, or from an infected animal to a person.

The most effective method of controlling vectors in the longer term is prevention by improved general hygiene. This includes improved toilet facilities, garbage disposal, drainage, burial of the dead, food storage and handling practices, improved personal hygiene through provision of soap, hygiene education, and sufficient supply of clean water. However, sometimes these methods may need to be supplemented by specific vector control programs to prevent disease outbreaks. In these specific programs the chemical control measures should only be considered as a supplement to preventive measures or as an emergency solution as long as preventive measures are not yet executed or effective. They should be executed for as limited a period as possible. To determine which program is most suited to control the vector problem a large number of factors should be taken into account which all vary according to the circumstances. This can therefore best be done by an expert. Some general rules are:control, both through improved hygiene and other measures, should aim to make the focus area

unfavorable to the development and survival of vectors;control of vectors is generally more effective if it focuses on vector forms that have not yet

attained sexual maturity (eggs, larvae, etc.);eradication of vectors is frequently unattainable: the goal should be to maintain a vector popula-

tion beneath a fixed threshold beyond which the risk of epidemic would be too great.

This chapter describes the operational activities for 5 types of vector control programs:residual spraying programs

larviciding programsspace spraying programs

bednet programsrodent control programs

TerminologyResidual spraying: spraying with insecticides which retain their killing power for some time

after application on a surface upon which the vector is known to rest long enough to pick up a lethal dose.

Larviciding: treatment of known breeding sites that are not sources of drinking water with insecticide or light oil.

Space spraying: outdoor spraying with insecticides in the air; this can be done from the ground or from the air (by plane).

Bed-nets: mosquito nets, often impregnated with an insecticide.Rodents: rats and mice.

Chapter 6 : Vector controlp. 115

Table 6.1 : Vectors of public health importance in camps

Vector Potential disease transmission

Methods to control the vector Methods to control the diseases caused by the vector

Mosqui-toes

malaria

elephantiasis

dengue

yellow fever

Japanese ence-phalitis

improve environmental hygiene in general

hygiene education

reduce/destruct breeding sites/eliminate stagnant water (especially the smallest ones)

put lids at latrine holes

cover water containers

cover stagnant water pools

put polystyrene pellets to float on the surface of the water in water-filled latrine pits and other small water bodies (suffocates existing larvae and prevents egg laying by adult mosquitoes)

put screening at doors, windows etc.

remove vegetation from standing surface water edges (or let the vegetation be very thick, e.g. in case of a densely overgrown swamp; choice for removal or leaving vegetation depends on type of mosquito and circumstances)

Make edges of ponds deeper than 1 m steep and straight

bednets or other netting measures

larviciding

indoor residual spraying

space spraying

repellents

medical curative treatments

preventive malaria drugs

vaccination against yellow fever and encephalitis

Body lice

louse-borne typhus

louse-borne relapsing fever

trench fever

other arboviral infections

skin irritations

reduce overcrowding

hygiene education

bednets

treating contaminated clothes by steaming, boiling or dry heating

distribution of clean clothes (esp. underwear)

insecticide treatment of clothes and bedding (treat again after 1 week)

insecticidal dusting of individuals, especially new arrivals, school children (treat periodically), feverish persons, and corpses


Head lice

considerable discomfort and malaise

allergic reactions

hygiene education

use of ‘nit’ combs

smearing the head with certain oils

shaving

Tsetse-flies

sleeping sickness (in humans)

insecticide spraying on vegetation

selective destruction of vegetation

medical curative treatment (can


trypanosomiasis (in animals)

application of natural baits, e.g. cows impregnated with insecticide

application of artificial baits such as traps and screens impregnated with insecticide

be risky though)


Table 6.1 : Vectors of public health importance in camps (continued)



Flies(non-biting)

diarheal diseases (shigella, salmonella, dysentery)

eye diseases (trachoma)

provide hygiene education and improve hygiene in general

implement good sanitary facilities (esp. toilets and garbage disposal) at households, markets and public buildings

clean dwellings, latrines and surroundings

put lids on latrine holes

clean/dispose spilled food and other garbage safely

dispose waste water safely

fly traps with poisoned baits (take care that people can not touch or eat the bait!)

fly screening

larviciding in latrine pits and garbage pits (only during short periods to avoid building up of resistance and affect the decomposition process of faces, and only in combination with sanitation measures)

weekly space spraying (esp. large garbage areas near populated places; e.g. at markets, spray after closing time)

residual spraying (usually not recommended because of danger for fast building up of resistance, but is often used mainly for malaria control and then usually also reduces flies)

biological larviciding (with Bacillus thuringiensis, strain H-1; larvae which eat this bacillus are killed by the toxin it releases with a long residual effect). In camps where fecal matter rapidly accumulates in latrine pits it is only partly effective though


oral rehydration (for diarrhoeal diseases)

hygiene education

water for regular face washing (control of eye diseases)

water and soap for hand washing (control of diarrhoeal diseases)

Bedbugs and Reduviid bugs

nuisance because of biting by night

hepatitis B

chagas disease

improvement in housing (well-maintained brick walls and corrugated iron roofs)

bednets (esp. effective against reduviid bugs)

residual spraying


Black-flies

river blindness Insecticidal control of the blackfly larvae in the ‘white water’ sections of fast flowing rivers

repellents

medical curative treatment

Sandflies

leishmaniasis

sandfly fever

destruction of rodent colonies, thereby eliminating the flies’ breeding and resting sites

siting of camp at least 1 km from Acacia-Balanites woodland (if in Kala-azar endemic areas in Sudan and Ethiopia)

information campaign (don’t go in Acacia-Balanites woodlands at dusk or night)


Ticks relapsing fever

spotted fever

dipping animal in appropriate insecticide

repellents



residual spraying in houses (e.g. when spraying against malaria)


Table 6.1 : Vectors of public health importance in camps (continued)



Mites scabies

scrub typhus

treatment of body with special emulsion, solution or cream to kill the mites that cause scabies

change clothes and blankets

hygiene education

good and regular washing of body, clothes, blankets etc. with sufficient water and soap

insecticide spraying of soil and vegetation in areas with scrub typhus followed by destroying the rodent population that hosts the mites.

medical curative treatment

Fleas plague (from infected rats)

flea-borne typhus

hygiene education

clean shelters and surroundings

Use of insecticidal dusts in rat runs, burrows and around dwellings followed by rodent control

Airing bedding

insecticidal dusting/powdering of bedding, clothes and furniture

wearing shoes (against jigger fleas that settle on feet)

removing jigger fleas with a sterilized needle


Rats rat bite fever

lassa fever

leptospirosis

salmonellosis

toxoplasmosis

the diseases caused by fleas, mites and ticks, hosted by rats

Rodent control (if diseases occur caused by insects hosted by rats first control measures must be executed against these insects: the vector must be controlled before controlling the rodent) through:

proper garbage disposal and other sanitary measures

rodent trapping (if not well done, can work counter-effective)

rodent proofing of food stores, stores for medical supplies and buildings in general

applying rodenticides (oral poisons for rats and mice); can be dangerous in camps; if done it must be accompanied by a thorough and effective information campaign

protection of buildings by cats and dogs (only effective when no rodent population present yet in the buildings)

clean-up campaign after a trapping or poisoning campaign



6.2Residual spraying programs.

As spraying programs are usually not executed in emergencies, this paragraph focuses on residual spraying programs in non-emergency situations.

The recommended minimum objective of a residual spraying program is:To ensure that, in accordance with the below specifications, the concerned vector populations are in a safe way reduced to and/or maintained at low enough thresholds to keep the diseases transmitted by them within acceptable levels.

Specifications for the recommended minimum objective of a residual spraying program:Situation

Subject

Non-emergency

Suitable insecticides: Dose: in g of active ingredient per m2

Frequency of treatment

Deltamethrin 0.05 at least once a year, but every 2 to 3 months is the normal standard (persistence = 4-6 months)

Permethrin 0.5 at least once a year, but every 2 to 3 months is the normal standard (persistence = 4-6 months)

Lambda-cyhalothrin 0.025-0.03 at least once a year, but every 2 to 3 months is the normal standard (persistence = 4-6 months)

Pirimiphos-methyl 1-2 every 1 to 2 months? (persistence = 2-3 months)Malathion 2 every 1 to 2 months? (persistence = 2-3 months)Fenitrothion 1-2 every 2 to 3 months? (persistence = 3-4 months)DDT and HCH (BHC) ? ?Bendiocarb and propoxur ? ?Timing In case of seasonal transmission: spray before start of transmission period.

In case of continuous transmission: spray periodically, based on the required frequency of treatment..

Application and coverage Obtain uniform surface coverage, at a rate of 40 ml of solution per m2

Safety See BoxAcceptable incidence levels of diseases transmitted by vectors

See Chapter 3

Acceptable thresholds for vector populations

See Chapter ... and Appendix ...

Numbers of staff See the respective paragraphs in this chapter.Equipment Most suitable for internal residual spraying are hand-operated,

continuously pumped or pre-pressurized knapsack sprayers. They should be cleaned daily and regularly serviced, with particular attention given to preventing and repairing leaks. Outdoor treatments can also be done with power-operated sprayers.


Box 6.1 : Safety rules for residual spraying programsRead insect labels. They should give: the identity of the product, its effectiveness against pests, safe handling procedures, and treatment in case of poisoning

Wash and destroy all empty insecticide containers before burial

Insecticides in the ‘Extremely’ and ‘Highly Hazardous’ WHO classification should not be used

Secure insecticide containers properly when transporting in vehicles and ensure that the vehicle is well ventilated

Inspect containers for damage after transport and check the vehicle is not contaminated

Never transport or store insecticides and food together

Never transfer insecticides to unmarked containers

Provide separate working clothes for those who handle pesticides and splashproof clothing for those handling concentrate.

Provide soap, detergents and water for washing after concentrates are mixed and for washing before eating and at the end of the work (body and work clothes)

Soak up liquids with absorbent material (e.g. sand); place material and swept solid formulations in plastic bags and bury

Keep records of: insecticides received, used, and in store; places treated; and containers buried

Empty and clean spraying equipment after use and ensure unused insecticide is returned to store.

Ensure wastewater from washing associated with insecticide is not disposed of near water supplies. Use an isolated soakaway.

Keep children away from insecticides, application equipment and stores

Avoid contaminating food and drinking water. Do not spray eating or cooking areas, animals, or the surfaces they might lick

Workers should work only 4 to 5 hours a day

Sprayers must wear full protective clothing covering their entire body: pair of rubber gloves (+ 1 spare pair), rubber boots, comfortable long-sleeved cotton overall (must have 1 spare one), broad rimmed hat (+ 1 spare one), pair of plastic safety glasses, felt mask (+ 1 spare)

Sprayers must be properly trained, be aware of the dangers, and supervised

Equipment must be kept in good condition

Sprayers must use the minimum pressure necessary to deliver a good spray

Insecticide mixers must have a plastic apron, rubber gloves and rubber boots

All staff supervising sprayers and other staff handling pesticides must be able to quickly diagnose a case of poisoning and take proper action. A stock of injectable atropine must be kept on hand for organophosphate poisoning cases (see further Box 6.3).


A common organizational set-up for a residual spraying program, taken in this paragraph as an example, is presented in the organogram below:

Figure 6.1 Organogram of the residual spraying program described in this paragraph

The rest of this paragraph gives an example of the tasks of the involved actors in the residual spraying program presented in the above organogram.


Other programmes

Field administrator

Sprayers Spraying solution carriers

Team leader spraying team Other spraying teams Insecticide mixers

Supervisor vector control programme Supervisors of other programmes

Manager of water and sanitation programme Office administratorOffice logisticien

6.2.1 Sprayers

Tools/materials needed per sprayer:1 hand compression sprayer, soap, 2 pairs of rubber gloves, 1 pair of rubber boots, 2 comfor-table long-sleeved cotton overalls, 2 broad rimmed hats, 1 pair of plastic safety glasses, 2 /felt?/ masks. The sprayers are responsible for their spraying equipment and in principle have to carry out all checks, repairs and calibrations themselves. Number of sprayers needed:A very general and theoretical rule of thumb is one sprayer per 100.000 m2 surface to be sprayed. This equals 2000 dwellings of 50 m2 (probably a reasonable average for a dwelling in a camp, although per camp this will need to be checked). This is probably too much though for most circumstances. The number of sprayers needed depends on:* The actual surface one sprayer can effectively spray per day. This depends on factors as the

types and sizes of the facilities to be sprayed, logistical organization and so on.* The frequency of spraying needed (depends on the chemicals used and the type of material

sprayed on).Therefore large differences may exist between different camps in the numbers of sprayers needed. See further Box 6.6.

//// here: figure of sprayer with full equipment/////


Tasks:

Task Description Timing Specifications important for exe-cution of the task

Spray the facilities

Spray according to the requirements:

1. Compare the time used for spraying a facility regularly with the required spraying time for that facility. If the difference is large adjust the spraying speed, unless there is another reason for the difference (e.g. if the facility is much larger or smaller than the one for which the spraying time was determined).

2. If not sure whether the surfaces of the facility should be completely or only partly sprayed (e.g. in toilets spraying is often only needed to about 30 cm above the platform) check with the team leader first.

3. Make sure to keep a distance of 45 cm from the surface (measure regularly, for instance with a stick cut at 45 cm length) and bend through the knees to assure keeping the spraying nozzle horizontal.

Every day See Box 6.4

Clean clothes

Clean the overall and other working clothes by washing with water and soap

At least once a week

Check discharge rate

Check the discharge rate of the pump. In case of problems clean the equipment thoroughly, check for leaks and assess whether calibration is needed. If so, repair/calibrate (get tools from the store, ask others to help you if needed).

At least once a week and each time when obstruction is suspected

See Boxes 6.2 and 6.4

Clean equipment

Clean the equipment. In case of problems repair (get tools from the store; ask team leader, other sprayers, mechanic etc. for help if needed).

At the end of each day

See Box 6.2

Control spraying pressure

Control whether the spraying pressure is correct. Decreasing pressure causes a decrease in flow, a wider angle of spray and an increase in the size of the droplets.

If the pressure is too low, increase it by pumping.

If a leak or calibration problem is suspected discuss with the team leader and change for another sprayer for the time being and repair/calibrate the first one at the end of the day.

Control regularly during the day.

Repair at the end of the day if needed


Ensure safety of goods, people and animals during spraying

Check whether items which might be harmed (food, cooking utensils, animals etc.) have been removed or well covered with plastic each time before spraying starts.

To avoid loosing time it is good to tell the people the day before where spraying will be done the next day (the team leader can also ask the hygiene promoters to inform the people).

Don’t start spraying until things are safe. In case of problems warn the team leader and continue with the next facility (and return back only when the problems are solved).

Every time before starting to spray somewhere

See Box 6.1


Tasks (continued):


Ensure safety for the beneficiaries after spraying

Control that people do not enter just sprayed facilities for at least half an hour after spraying (keep an eye on the facilities just sprayed when already busy with the next facility).

Warn people on beforehand and again when you see that they want to enter a just sprayed facility too early (can also be done by the insecticide carriers if part of the team or by the team leader or hygiene promoters).

If it is observed that people do not respect this it should be discussed with the team leader and the supervisor of the program to find a way to prevent people from endangering themselves with this behavior (e.g. by developing better information campaigns about the subject or putting pressure on people through local leaders).

Warn people on beforehand

Control each time after spraying somewhere

See Box 6.1

Count facilities sprayed and tanks emptied

Each sprayer should count the numbers of facilities he has sprayed and the number of spraying tanks emptied per type of facility sprayed.

Every day

Report problems

Report all problems encountered to the team leader. Whenever problems occur


6.2.2 Spraying solution carriers

Tools/materials needed per carrier:///??2 pairs of rubber gloves, 1 pair of rubber boots, 2 comfortable long-sleeved cotton overalls??// Number of carriers needed:One to .... per team of four sprayers and one team leader. Depends on use of spraying solution and distances to be covered.

Tasks:Task Description Timing Specifications


Carry spraying solution

Carry spraying solution from the site where mixing is done to the site where the sprayers are spraying

Every time when spraying solution is needed somewhere.

Clean clothes Clean the overall and other working clothes by washing with water and soap

At least once a week.

Help to ensure safety of goods, people and animals during spraying

Help the sprayers to check whether items which might be harmed (food, cooking utensils, animals etc.) have been removed or well covered with plastic each time before spraying starts and tell the people in advance where spraying will be done so that they can start on this in time. Only help if you don’t need to carry out other tasks.

Before sprayers start to spray.

Help to ensure safety for the beneficiaries after spraying

Help the sprayers to control that people do not enter just sprayed facilities for at least half an hour after spraying (keep an eye on the facilities which are just sprayed). Warn people on beforehand and again when you see that they want to enter a just sprayed facility too early. If it is observed that people do not respect this inform the team leader. Only help if you don’t need to carry out other tasks.

Warn people on beforehand. Control each time after spraying has been completed somewhere.

Report problems

Report all problems encountered to the team leader. Whenever problems occur.


6.2.3 Team leader of a spraying teamTools/materials needed per sprayer:Report forms, pen, notebook, soap, 2 pairs of rubber gloves, 1 pair of rubber boots, 2 comfortable long-sleeved cotton overalls, 2 broad rimmed hats, 1 pair plastic safety glasses, 2 /felt/ masks. Number of team leaders needed: one per 4 sprayers.



Ensure that sprayers clean their working clothes

Control that the sprayers clean their overalls at least once a week1.

Control every week

Control whether sprayers wear protective clothing

Control whether the sprayers wear fully protective clothing during spraying. Don’t allow them to work without!

Every day

Control the quality of spraying

Make sure the sprayers spray according to the requirements. Check their:

* spraying technique: nozzle 45 cm from surface, bending through knees to keep nozzle horizontal;

* spraying speed: should be such that the spraying time needed for the facility worked on is not much lower or higher than the required spraying time for that facility (unless there is a good reason for it, e.g. when the facility is much bigger or smaller than the facility for which the required spraying time was determined).

Correct if necessary.

Control several times a day

See the task description of the sprayers and Box 6.4

Make sure sprayers clean their equipment and check its functioning

Ensure that sprayers clean their equipment and control its proper functioning (they are responsible for their own equipment, for the repairs and the calibration!). Check, with a few of the sprayers whether and how they:

control the discharge rate at the beginning of the day;

control spraying pressure during the day;

clean their equipment and control it for leaks at the end of the day.

At the end of each day


Check mixing of chemicals

//??Observe in the spraying tanks (open them to have a look) whether the insecticide is well mixed in the water??//. If not, warn the insecticide mixer that he should improve his mixing.

Every day check at least two tanks

1 Another option is to organize people to wash the clothes of spraying staff.Chapter 6 : Vector control

p. 129

Tasks (continued):


Let sprayers change equipment when needed

If a sprayer has observed or suspects a problem with his equipment allow him to change for another one (send him with a note for the field administrator to the store) and assess together at the end of the day what the problem is. Repair or calibrate the equipment. Hand the equipment over to the program manager if it can not be repaired/calibrated on site.

Whenever needed

For how to repair or calibrate the handpumps see Box 6.2

Control washing of hands

Control that sprayers and solution carriers wash their hands with water and soap each time after mixing chemicals, after finishing the work and before eating anything.


Control whether sprayers ensure safety during spraying

Control when a sprayer is spraying a facility whether all items that might be harmed have been covered or removed. If not, explain to the sprayer that he must check this and not start spraying until this is in order. Check a next time whether he has understood.


Control whether sprayers ensure safety for the beneficiaries after spraying

Observe whether people stay out of their huts for at least half an hour after spraying and whether the sprayers are explaining the need for this to the people. If not make the sprayers aware that it is important to explain this to the people and check whether people respect it. If the problem is with the people, discuss with them. If it seems to be a structural problem discuss with the supervisor and program manager and develop a strategy to prevent this behavior (e.g. ask local leaders to discuss it with the people, organize better information campaigns).


Register numbers of facilities sprayed

Count the numbers of facilities sprayed and compare at the end of the day with the countings of the sprayers. Control whether the number of facilities sprayed was sufficient1 . Also ask the sprayers for the numbers of spraying tanks emptied (in case of doubt double check with the insecticide mixer).

During the day.

Compare at the end of the day

Ensure limited spraying hours

Make sure that the sprayers are not spraying for more than 4 to 5 hours per day. Let them take a rest, well away from the just sprayed facilities for more than one hour half way the day.

Every day

Recognize and treat poison symptoms in time

Observe the sprayers for symptoms of poisoning. If organophosphate poisoning is suspected take the affected person immediately to the health post where injectable atropine is available and ask the health staff to take over (stand on it that the person is helped immediately).

Continu-ously

see Box 6.3 for a description of the symptoms of poisoning

Control whether spraying kills the vector targeted

Observe whether spraying kills the vectors targeted: observe in facilities just sprayed as well as in facilities sprayed a few days earlier, ask people how long it takes until the vectors come back.

Every day

See Appendix 8

Make daily Register all findings in the daily report. Every See Form 6.1

1 There should be a figure for how many facilities a sprayer must spray per day. If this has not been done discuss with the supervisor and program manager and make a plan together on how to determine this figure and advise them on this matter (see also Boxes 6.4 and 6.6).


reports day

Report problems Report immediately to the supervisor and/or manager in case of serious problems.

Whenever serious problems arise


Box 6.2 : Maintenance of spraying equipment

How to control for leaks//?pump a little bit with finger closing off the nozzle and listen for sizzing sound ?//

How to clean a hand operated sprayerMake sure that during cleaning the equipment the wastewater is drained well away from any water source

How to check for need of calibration

How to calibrate a hand operated sprayer


Box 6.3 : Pesticide poisoning and first aid

All persons in charge of supervising workers handling pesticides must be able to diagnose a case of poisoning and take appropriate action

OrganophosphatesPirimiphos-methyl, Malathion and Fenitrothion are organophosphates.Poisoning or overexposure produces symptoms quickly - typically 1/2 hour to 1 hour later. The symptoms can appear somewhat later (2 to 3 hours) if the chemical entered the body through the skin.

The first symptoms of poisoning are nausea, headache, fatigue, and weakness, accompanied by mental and muscular disorders. Headache, muscle weakness, and fatigue increase progressively, followed by vomiting, abdominal cramps with diarrhea, heavy sweating, and salivation. In serious cases, paralysis and breathing problems can be observed, followed by convulsions and a loss of consciousness, leading to coma, respiratory arrest, and death.

PyrethroidsDeltamethrin, Permethrin and Lambda-cyhalothrin are pyrethroids.Pyrethroids have very weak toxicity if taken up through the stomach or skin. Only oral doses in excess of 15 g are poisonous to humans. However, pyrethroids can provoke dermatitis and if inhaled they can be dangerous. No case of pyrethroid poisoning has however been reported in humans.

First aidEverything must be done to maintain normal breathing in a poisoned person: place in a well-aired place and make breathing easy by moving the head slightly backward (to free the lung ways).

In case of poison contact with the eyes flush the eyes immediately with large quantities of fresh water for about 10 minutes, keeping the eye lids wide open.

Take the poisoned person to a health facility for further treatment if possible. For serious organophosphate poisoning cases: inject 2-4 mg of atropine-sulphate into the muscle or blood vessel as soon as possible; effects should then usually be apparent within 3-4 minutes (preferably by medical personnel). ///what are the effects if atropine is injected and it was not a case of organophosphate poisoning after all///


Form 6.1 : Example of report form to be filled in each day by team leadersCountry:______________________ Date:_________ Camp:_______________________

Name of team leader:____________ Name and type of insecticide used9:________________Concentration of insecticide in spraying solution (in gr. or ml insecticide per liter water):__________

Name of area where sprayed

Number of sprayers at work

Number of days that sprayers have been spraying at one go

facilities sprayed (fill in for each type of facility): no. of facilities sprayed

amount of spraying solu-tion used (in liter)

Was the insecticide well mixed with the water? (y/n). If no, explain.

Was all spraying done according to the spraying needs and the required spraying technique (see Box 6.4):Was the distance from the surface during spraying 45 cm? (y/n)Was the spraying speed right? (y/n)Was the spraying pressure right? (y/n)(control all these several times for several sprayers and the different facilities sprayed during the day). If any of the questions is answered with no, explain the problem.Was any spraying solution spilled or left over (y/n)? If yes, give explanation. What was done with left over solution?

Does the spraying kill the vector(s) targeted? (y/n). Check the just sprayed facilities and the ones sprayed a few days ago. Also ask the people. Give remarks.

Have people been informed to wait at least half an hour after spraying before entering a sprayed facility? (y/n). Did they really do this? (y/n). Observe twice a day! Also check whether sprayers are checking this.

Were all food and utensils removed or well covered before spraying started? (y/n). If no, explain. Also check whether sprayers are checking this each time before spraying.

How many hours were the sprayers really spraying (should not be more than 4-5 hours)?

Were the sprayers fully protected during spraying with rubber boots, an overall, eye protectors, mouth and nose mask, and gloves?

Did the sprayers and solution carriers wash their hands with water and soap each time after mixing chemicals, after finishing work and before eating)? (y/n). If no, explain.

9 Name of chemical product used and type of formulation (emulsifiable concentrate, EC, or wettable powder, WP, and indication of concentration). For instance: ‘pirimiphos-methyl 50EC’ means that the product is an emulsifiable concentrate which contains 50% of active ingredient; ‘deltamethrin 2.5 WP’ means that the product is a wettable powder with 2.5% active ingredient.


Did the mixer work safe (did he carry splashproof clothing, rubber boots, gloves, mask and eye protectors, did he wash his hands afterwards, did he mix with a stick, not touching the chemical with his hands)? (y/n) If problems were observed, explain.

Was all equipment well cleaned at the end of the day? (y/n) If no, explain.

Any problems encountered with the equipment? Explain.

Other problems encountered (explain)

//////Figures of different spraying pumps with names of all parts. see WHO 1990. Equipment for vector control, 3rd edition, Geneva: WHO [8]//////

Figure 6.2 The most suitable machines for internal residual spraying are hand-operated, continuously pumped or pre-pressurized knapsack sprayers. They should be cleaned daily and regularly serviced, with particular attention given to preventing and repairing leaks.

From ...


Box 6.4 : Aspects of importance for the quality of spraying

Spraying techniqueKeep the nozzle at 45 cm from the surface (gives a spraywidth of about 50 cm on the wall if the spray angle is right, i.e. 60-650). To practice keeping the exact distance place a cord at 45 cm from the wall or attach a 45 cm long pole to the nozzle. Spray in a vertical movement up and down (go down by bending through the knees and keeping the nozzle horizontal), constantly at the required spraying speed. This will ensure that exactly the amount needed to kill the vector is equally sprayed on the wall. Indications of the required spraying technique are often described in documentation from the manufacturer of the insecticide used or from the manufacturer of the pump equipment in use.

Determining the spraying speedBut the spraying speed (expressed in amount of surface to be sprayed per unit of time) can also be calculated:

Determine for each of a few pumps the pump discharge rate and take the average (Z, in l/minute). The discharge rate can be determined by spraying in a measuring cup during 30 seconds and multiply the amount with two. This gives the discharge rate in ml/minute. A standard figure to aim at is 0,760 l/minute! Make sure the nozzle is completely clean, the pump checked to be well working and the pressure in the tank sufficient (see manufacturer’s description).

Determine the amount of spraying solution per surface area (W, in l/ m 2 ) which should preferably be 0,04 l/ m2 (see also the specifications of the minimum objective).

Speed of spraying (in m2/minute) = Z/W which in an optimal situation would be 0,76/0,04 = 19 m2/minute.

Determining the required spraying time for a facilityOnce the spraying speed is known it can be determined for each type of facility what the required spraying time is:

measure the surface (in m2) to be sprayed in a few facilities and calculate the average (it is assumed here that per type the facilities will not have too many differences in surface, otherwise this is not a good method);

divide the average surface (m2) through the determined spraying speed (m2/minute) to get the required spraying times of that type of facility (in minutes).

Be aware though that the required spraying time does not include the time needed for other activities during the visit to a facility which also take time, such as walking from one surface to the other in the facility, talking to the people, nor the time needed between spraying the facilities, such as the time for walking from one facility to the next, taking brakes, etc.

The team leader can easily monitor the time it takes the sprayers to spray a facility (only measure when they are really spraying) and compare this with the required spraying time. In case these two figures differ more than about 20% he should assess what is wrong and correct the sprayers. Be careful also to keep controlling the quality of spraying and whether the sprayers cover the required surface properly, even if the spraying time is correct.


Box 6.4 continued

Example of determining the required spraying time of a facilitySuppose the spraying speed has been calculated to be 19 m2 per minute (see above). If sprayers are supposed to spray the walls of a latrine, rectangular in shape, up to a height of 1 m, plus its latrine floor, while the latrine floor is 1.2 times 1.2 m in size, then the spraying time for this facility can be determined as follows:Surface of latrine floor to be sprayed = 1.2 x 1.2 = 1.44 m2

Surface of walls to be sprayed = 4 x 1.2 x 1 = 4.80 m2

--------- +Total surface = 6.24 m2

Spraying time for the latrine = 6.24/19 = about 0,33 min or 20 seconds.

Controlling the spraying pressureThe pressure in a hand compression sprayer should be 25 to 55 psi. If there is no pressure gauge determine the number of strokes of the pump needed to produce a correct initial flow (this should be about 760 ml/minute; see above). Tank pressure drops during spraying, resulting in a decrease in flow, a wider angle of spray, and an increase in the size of droplets. When this happens, the tank needs to be pumped again. The pumps should be calibrated periodically to ensure the correct flow.

Other aspects of spraying qualityOften when flies or mosquitoes come back very soon after spraying it is said that this is due to the development of resistance against the insecticide. This is possible but it can also be due to poor application of the chemical to the surfaces. Example: in Benaco camp, Tanzania, it was observed that ‘a large quantity of the insecticide runs off from the plastic used for the construction of the latrines’ (Ivorra C. V. et al , 1994).


Box 6.5: Preparing the spraying solution

How to determine the amount of insecticide needed in the spraying solutionDetermine the amount of active ingredient needed per m 2 to kill the vector (Y, in gr. of a.i. / m 2 ). This figure is usually indicated on the insecticide container or in any documentation from the manufacturer (see also the list of minimum standards in Annex ..).

Determine the amount of active ingredient in the insecticide (U, in weight percentage, which is the same as 100 x (no. of grams of a.i./gram of insecticide). For example ‘Deltamethrin 2.5 WP’ means that the insecticide contains 2.5 weight% of active ingredient.

Determine the amount of spraying solution per surface area (W, in l/ m 2 ). Usually a standard figure is taken for this: 0,04 l/ m2

The amount of insecticide needed (V) to make the required spraying solution can be calculated as follows:

For insecticides in powder form:

V = (Yx100)/(UxW) in grams insecticide per liter of water, or

(10xUxW/Y) in liters of water that need to be added to 1 kg of insecticide

For insecticides in liquid form:

V = 1/{(10xUxW/Y)-1} in liter insecticide per liter of water, or

(10xUxW/Y) -1 in parts of water that need to be added to 1 part of insecticide

Examples:

For Deltamethrin 2.5 WP (wettable powder, an insecticide in powder form that can be suspended in water): Y = 0,05 gr. of a.i. per m2 (see the minimum standards in Annex ...)U = 2,5% (as indicated in the insecticide’s name ‘Deltamethrin 2.5 WP’)W = 0,04 l/ m2

With these figures the amount of insecticide needed can be calculated: V = (0,05x100)/(2,5x0,04) = 50 gr. insecticide per liter of water (or 20 l of water per kg of insecticide).

For Pirimiphos-methyl 50 EC (emulsifiable concentrate, an insecticide in liquid form that can be mixed with water to form an emulsion):Y = 1,0 gr. of a.i. per m2 (see the minimum standards in Annex ...)U = 50% (as indicated in the insecticide’s name ‘Pirimiphos-methyl 50 EC’)W = 0,04 l/ m2

With these figures the amount of insecticide needed can be calculated: V = 1/{(10x50x0,04/1,0) - 1} = 1/19 = appr. 0,053 liter (or 53 ml) insecticide per liter of water (in other words: mix 1 part of insecticide with 19 parts of water).

How to make a spraying solution out of a wettable powderWhen using powders for suspensions the powder should be put into a receptacle with a little water, and mixed to obtain a paste. This paste should then be thinned by adding small quantities of water until the desired volume is attained and the resulting mixture poured through a filter into the spraying tank.


Box 6.6 : Determining the number of sprayers needed

Depending on the spraying interval (which is determined by the required frequency of treatment as described in the specifications of the minimum objective) the number of sprayers needed can be determined if it has been determined for each facility type how many facilities can be sprayed per sprayer per day and how many facilities there are of each type:

No. of sprayers = A1/(B x C1) + A2/(B x C2) + ... etc.

where:A1 = total number of facilities of type 1A2 = total number of facilities of type 2, ..etc.B = the required spraying interval (in days) (which is the same for the different facility types if they are

sprayed with the same chemicals or with chemicals of the same required treatment frequency)C1 = Number of facilities of type 1 that can be sprayed by a sprayer per dayC2 = Number of facilities of type 2 that can be sprayed by a sprayer per day, ... etc.

The number of facilities of a certain type that can be sprayed by one sprayer per day depends on factors such as:

* the spraying speed

* the surface of the facility to be sprayed (with which the required spraying time can be determined if the spraying speed is known as shown above)

* the time needed in the facility for other activities than spraying (e.g. walking around, explaining things to people, covering things to protect them against the spraying solution if forgotten by the beneficiaries)

* the time needed to go from one to another facility

* the time lost due to delayed supply of the spraying solution (e.g. if logistics are not well organized, spraying solution not ready in time, or too few carriers for the spraying solution), or, if sprayers have to go back themselves to obtain new spraying solution each time when their pump is empty, the time needed for walking up and down, including the time needed for resting

* the numbers of hours per day (should be 4 to 5) and numbers of days per week (should be 5) the sprayers actually are allowed to work

In theory one worker can empty his handsprayer, containing 8 liters of spraying solution, 8 to 10 times a day which is enough to treat up to 2,000 m2 per day, or 40 dwellings of 50 m2 each. In practice however, this will be less, due to the factors described above. In each residual spraying program it should therefore be determined in practice how many facilities one sprayer can really spray per day.

Remark:Usually sprayers are told the number of facilities they have to spray each day. Because of this they may be tempted though to speed up their work in order to finish the number of facilities as quick as possible so that they can go home early. This will then probably affect the quality of spraying which should be prevented (among others through close supervision of supervisor and program manager).


6.2.4 Insecticide mixersTools/materials needed per mixer:One pair of rubber gloves, 1 pair of rubber boots, 1 comfortable long-sleeved cotton overall, soap, 2 reservoirs of 1 l with volume indication, 2 large reservoirs of 20 l, 2 buckets, 1 stick for mixing.

Each team of mixers should additionally have: 2 shovels, 1 pick, 2 brooms, a large enough, smooth and clean apron to work on, preferably close to where the chemicals are kept in stock and preferably covered with a roof, but well ventilated, a large bin, plastic bags, sand, water.

Number of team mixers needed:One per .........



Mix the chemicals

Mix the chemicals with the water in the large reservoirs according to the prescriptions received from the program manager. Avoid as much as possible to make too much (therefore mix in several rounds and base the amounts made on the amounts needed in former days).

Work according to the safety rules (drain wastewater away from water sources, soak up spilled solution with absorbent material, and place together with swept solid formulations and other chemical contaminations in plastic bags and bury safely; wash and destroy empty insecticide containers and then bury safely; make sure people don’t take the containers with them for personal use which is very dangerous; wear rubber gloves and boots; don’t let any unauthorized persons come near the chemicals).

Return unused chemicals back to the store at the end of the day.

Every day

See Box 6.5 for how to prepare a spraying solution with a wettable powder.

For safety rules see Box 6.1

Register the use of spraying solution

Register every day how much spraying solution each spraying team is using.

See Form 6.2

Fill in the daily report

At the end of every working day

See Form 6.2

Report to and discuss with field administra-tor

Report numbers of empty containers buried and the locations of burial to the field administrator every week and discuss with him in case his figures are different. Also discuss use of chemicals with him and compare with his administration.

At the end of each week

Report in case of serious problems

Report immediately to suitable persons (team leaders, sprayers, administrator, supervisor or the manager) in case serious problems are encountered.

Whenever serious problems occur


Form 6.2 Example of report form to be filled in each day by leader of mixers

Country:______________________ Date:_______________________

Camp:__________________________ Name of team leader:_______________

Name and type of insecticide used10:________________________

Concentration of insecticide in spraying solution (in gr. or ml of insecticide per liter water):________

Amount of spraying solution used per spraying team (fill in for each team)

Amount of insecticide used (in kg or liters).

How many containers were buried today?

Were all empty insecticide containers washed, destroyed and buried properly (this is a task of the mixers!)? (y/n). If no, explain. Write down location of burial.

Was all spraying equipment, mixing containers etc. well cleaned at the end of the day? (y/n). If no, explain.

If mixing is executed by the team leaders or the sprayers themselves, the information of this form should be included in the daily reporting forms of one of the team leaders of the sprayers or the form should be filled in by the supervisor.

10 see the specifications for the minimum objective and Box 6.5 for explanation.


6.2.5 SupervisorTools/materials needed per supervisor:One notebook, reporting forms, 1 pen, soap, 2 pairs of rubber gloves, 1 pair of rubber boots, 2 comfortable long-sleeved cotton overalls, 2 broad rimmed hats, 1 pair of plastic safety glasses, 2 /felt?/ masks.

Number of supervisors needed:One per ... spraying teams.

Tasks:


Control the work of sprayers, team leaders and other staff

Control whether the sprayers, team leaders and other staff execute their tasks well by visiting them, observing their work (use their task description as a checklist) and discussing about the work with them. Pay special attention to:

* safety of spraying, quality of the work done,

* opinions and remarks of camp inhabitants with regard to spraying,

* handling of chemicals, and

* right dosing and concentrations of chemicals used.

Discuss with the involved people how things can be done better/safer.

Check whether sufficient facilities are sprayed (it should have been determined how many facilities of each type a sprayer can spray per day).

Advise and correct where necessary. Follow up on problems encountered. Increase the observations with staff having or causing problems.

Control every day.

Visit staff as often as possible.

Visit each spraying team at least once every two weeks during half a day

See task descriptions of sprayers, team leaders and other staff

For safety aspects see also Box 6.1

Visit teams unannounced

Visit staff unannounced once in a while to check whether sprayers and other staff are really on site and not rushing their work to be ready as quick as possible so that they can go home early. If such behavior is observed or suspected it should be discussed with the team leader, sprayers and/or other staff and made clear to them that this is unacceptable. Then in the future check the concerned staff/teams more intensively.

Visit staff as often as possible. Visit each spraying team at least once every two weeks unannounced


Tasks (continued): Task Description Timing Specifications


Control equipment, tools, materials, chemicals

Chemicals must be stored correctly

Supplies must be sufficient for at least two weeks. If not available, discuss with administrator and ensure that new supplies are ordered.

Control regularly whether all equipment and tools are still there and in good condition. In principle the sprayers are responsible for the repairs and calibrations of their equipment themselves. They can use the tools from the store and ask the mechanic of the water program for help. Only in case of serious problems should the equipment be taken to a professional workshop.

Compare the figures about materials and insecticides used, in the bookkeeping of the field administrator, with the figures in the reports of the team leaders of the spraying teams and the mixers, and comment on the differences in the weekly report.

Once a month There should not be more than ///5 %??// difference between the figures from the field administrator and those from the spraying teams and mixers

Execute a mosquito survey

In case of spraying against mosquitoes, execute a mosquito survey. The assessment should be carried out in ...% of the huts which should be selected ad randomly.

If problems appear to arise in specific parts of the camp the assessment should focus on these parts. Make a separate report about the results (see the example in Appendix 8) and provide to the program manager (probably the survey will be done together with the program manager).

Once every two months and whenever a significant change in mosquito population or malaria (or other diseases caused by mosquitoes) is observed or suspected

Carry out the assessment following the descriptions of method 2 in Appendix 8.

For examples of ad random selection of huts see Box 7.9

Make weekly report

The report should contain a summary overview of the team reports of all teams together for the whole week.

Control the team reports on their correctness and quality, then sum up all the categories and include those in the weekly report.

Describe for instance the total number of facilities sprayed by all teams together, areas where sprayed, effectiveness of spraying (does it kill the vectors; do they spray all the surfaces to be sprayed well?), figures on absenteeism, other problems that have occurred during that week etc.

The report should also contain the findings of the supervisor himself (e.g. the observations he made during his field visits with the teams) and other issues the chief, team leaders, sprayers, mixers, carriers or others involved find important.

Weekly See Form 6.3


Form 6.3: Example of report form to be filled in each week by the supervisorCountry:______________________ Date:_______________________

Camp:__________________________ Name of supervisor:_______________Names of areas where sprayed

Number of spraying days effectively made (sum up the numbers of sprayers at work from all team leader’s reports of that week)

Total number of sprayers

Total number of team leaders (should be 25% of number of sprayers)

Total number of insecticide solution carriers

Total number of mixers

Number of days that sprayers have been spraying at one go

Total numbers of facilities sprayed (fill in for each type of facility; check if sufficient; if not discuss with team leaders how to increase spraying the next week and give comments):

Total amount of insecticide used (in liter or kg). Take the average of: 1) the figure from the field administrator, and 2) the sum of all mixer’s reports. If these figures differ more than 5% from each other describe them both; in such case it should be investigated with the involved team leaders, the mixers and the field administrator what the problem is.

Total amount of spraying solution used (in liters). Take the average of: 1) the sum of all team leader’s reports, and 2) the sum of all mixer’s reports. If these figures differ more than 5% from each other describe them all three; in such case it should be investigated with the involved team leaders and the mixers what the problem is. Describe the action undertaken/proposed in case of problems.

The average concentration of the insecticide in the spraying solution (in gr. or ml of insecticide per liter of water). Calculate by dividing the above figure for the amount of insecticide used by the above figure for the amount of spraying solution used. Control the outcome with the figures for the concentration determined to be necessary by the program and the figures written on the daily forms of the mixers and the team leaders. If there are differences discuss with team leaders, mixers and manager.

Problems encountered with the required spraying technique (distance of nozzle from surface, spraying speed, spraying pressure; see also Box 6.4). Describe the serious problems and the actions taken to solve them. If problems are not yet solved, describe what you have planned or what you propose to solve them.

Problems encountered with safety issues (see task descriptions of the different actors and Box 6.1). Describe the problems and the actions taken to solve them. Have the problems been solved? If not, describe what actions are, will be or are proposed to be undertaken to solve them.

Does the spraying kill the vector(s) targeted? (y/n). Check the teamleader’s reports and their remarks. Also observe yourself during the field visits in the


just sprayed facilities and the ones sprayed a few days ago. Also ask the people. Give remarks.

Are all equipment and tools still in good order? If not, explain.

Other problems encountered (explain + give recommendations on how to solve if not yet solved)

6.2.6 Program manager

Tools/materials needed:Notebook, pen, soap, 1 pair of rubber gloves, 1 pair of rubber boots, 1 comfortable long-sleeved cotton overall, 1 broad rimmed hat, 1 pair of plastic safety glasses, 1 /felt?/ masks.

Number of program managers needed:One plus possibly a counterpart.

Tasks:


Execute general tasks

Execute all manager’s general tasks See par. 3.5.4

see par. 3.5.4

Analyze reports

Obtain and analyze the weekly report from the supervisor of the residual spraying program and every few weeks crosscheck his report for instance with all weekly reports from the team leaders of the sprayers.

Every week

See the reporting forms in this chapter

Check new insecti-cides

Assess/determine each time when new insecticides arrive (often other brands/sorts of insecticides are sent than ordered) whether the insecticide can be used against the insects to be sprayed.

Control date of expiry, safety implications, dosage, whether it is allowed in the country, its compatibility with the spray machinery in use, etc.

Provide sprayers, chief and team leaders with new instructions if required. (it may be possible to let the logistician perform these tasks, but then he needs to be supervised carefully).

Whenever new insecticides arrive

See the labels of and documentation coming with the insecticides

See Thomson 1995

Visit all actors

Control the work of all actors in the program by visiting them during their work (use their task descriptions as checklists).

The spraying teams should be visited once a week to once every two months, depending on the situation (visit together with supervisor if possible; see also further on). Control whether the actors carry out their tasks correctly, (also whether they control safety, effectiveness and quality of the work).

Talk informally to all actors in the program and organize short meetings with them.

Stimulate people to come to you with their problems/remarks. Also ask some beneficiaries informally about their remarks/ideas with regard to the spraying activities (ask whether they think the program is executed safely, and whether they believe it is effective against

As often as possible. Visit each group of actors at least once a month

See also the remarks in Box 6…)


the vectors.

If any of the actors do not function well, assess (through discussion with them, observation etc.) whether this is caused by a lack of knowledge, poor motivation (e.g. due to low salaries), awareness problems, or other causes (e.g. poor equipment). Try to solve the problems together with the involved actors and provide training where necessary. If people continue to function poorly it may be necessary to fire them.


Tasks (continued):


Assist in Mosquito survey

Assist the supervisor with the preparation and execution of spraying and collection of mosquitoes. Analyze the results together with the supervisor and the involved sprayers and use the outcome, in accordance with the explanations in Appendix 8, to draw conclusions with respect to adaptations or further investigations needed.

Once a //month?// and whenever believed necessary

Work according to method 2 in par. A8.2, Appendix 8

Control the work of the supervisor

Control the work of the supervisor. Check the quality of his reports. Get an idea informally on how he functions. Go with him into the field during his visits to the spraying team and observe both the work of the sprayers and the supervisor.

Join the supervisor in the field once a week

Assess treatment frequencies

Determine how often facilities are treated based on the reports of the sprayers. Control whether this is frequent enough (usually the frequency should be once every two to three months). Discuss with the sprayers, team leaders and supervisor how the problems can be solved if the frequency is not high enough.

Every week See the specifications for the minimum objective

Analyze health statistics

Control health statistics (obtained from the curative health programs) for the diseases transmitted by the vectors sprayed against once a week.

Use the information to draw conclusions about the impact of the spraying program in combination with information about the effectiveness of the spraying program. Discuss the results also with curative health staff and other key persons. Assess whether spraying is still needed by looking at the health statistics and organizing insect counts. Be careful with seasonal fluctuations!

Every week See par. 3.2, Appendixes 11 and 12

Fill in weekly and monthly reports

//// form for residual spraying program part of the weekly and monthly reports still to be developed./// Include important findings in the weekly report: numbers of facilities sprayed, total numbers of facilities, spraying intervals (based on calculations with the numbers of facilities sprayed that week), amounts of chemicals used. Explain whether numbers of facilities sprayed was enough to assure the required treatment frequency (and what should be done if not), whether the amounts of chemicals used were sufficient (or too low or too high) for assuring the required doses of active ingredient on the surfaces sprayed that week, and other explanations about effectiveness of the program. Also comment on the believed impact of the program based on the developments in health statistics and information about the effectiveness of the program. Give a planning of actions needed and their timing. Also include a resume of the weekly reports in the monthly reports following the format in ......

One a week

Once a month

See Forms .. and …

Evaluate the program

Every 3 months + when believed that

See Box 6.8


the program does not achieve its objective

Box 6.7 Some remarks with respect to the effectiveness of residual spraying programs executed in plastic shelters

There are several questions regarding the effectiveness of indoor residual spraying in the Rwandan refugee camps which urgently need to be investigated:

* Do mosquitoes feed and rest in the plastic shelters?

* Do they rest on the plastic or on other available surfaces?

* Which insecticides and formulations are suitable for the plastic?

* How long does the residual effect last?

* Do the active ingredients remain on the surface if the facility is not covered (and are thus prone to rain and sunshine)?

(adapted from Cano V.I. et al 1994).

Box 6.8 Evaluating the residual spraying program

Once in a while it will be necessary to evaluate the program, i.e. to assess whether the objective set for the residual spraying program is achieved or, more specifically, whether the program is successful in certain aspects (looking at one or a number of the success factors as described in paragraph 2.8 of this manual). It is recommended to evaluate every 3 months whether the objective of the program is sufficiently achieved (thus looking specifically at the specifications determined for the objective) and whenever it is found or suspected that the program is not achieving its objective or certain aspects important for its success. Some idea is given below of how to do a general evaluation of the program (i.e. looking mainly into the extent to which the objective is achieved, thus looking into the specifications set for the objective, plus some additional aspects which are generally important for the success of the program).

To be evaluated How to evaluate

Effectiveness of spraying

1. Black box investigationWithout knowing anything about the Ins and Outs of the program you can execute a mosquito investigation as described in Box 6.9 in a number of ad randomly chosen huts (see Box 7.9 for examples of how huts can be selected ad randomly). If the results are OK (i.e. the


numbers of mosquitoes found are within the acceptable levels as indicated in Appendix 8) this gives an indication that probably the effectiveness of spraying is OK. It is not sufficient proof though and therefore additional aspects need to be evaluated as discussed in the following points. The information obtained with those points gives more insight in details of how the program functions which may allow for finding ways to further improve the program even if the overall effectiveness is already OK.



Effectiveness of spraying (continued)

2. Quality of spraying.

* spraying speed,

* distance from surface,

* extent to which facilities are sprayed completely

* proper functioning of equipment

Visit one or a number of teams at work and observe how they work. Check against the information in Boxes 6.2 and 6.4 and the task description of sprayers that contain details with regard to the required quality of spraying. Also discuss the work with the sprayers and the team leaders and ask them what can still be improved according to them.

3. Coverage of spraying

* number of facilities sprayed per time unit

Get information from the daily reports of the team leaders, the weekly reports of the supervisors and/or the weekly and monthly reports of the manager. Observe one or a few of the sprayers to see how many facilities they can spray in a day. Ask sprayers and team leaders how many facilities they can/do spray. Check that with the numbers sprayed per time unit the rotation is sufficiently quick to secure the required frequency of treatment as described in the specifications of the program objective.

* proof that all facilities are taken up in spraying rotation

Discuss with manager, sprayers, team leaders and supervisor. Ask beneficiaries during unstructured walk through the camp.

4. Effectiveness of the chemicals used

* Is the concentration of the chemicals used in the spraying solution right?

Calculate, based on the specifications of the program objective and the explanation in Box 6.5 whether the spraying solution has the required concentration of the chemical used.

* Is the lasting effect of the chemicals used on the sprayed surfaces sufficient?

A problem with the lasting effects of the insecticides on the surfaces sprayed (see also Box 6.7) is difficult to investigate. A conclusion of the evaluation may be that this aspect could possibly be the cause of poor effectiveness of the program when all other aspects related to the effectiveness of the program have been investigated and found to be in order.

Also a test can be done (but one should be sure then that the concentration of the spraying solution and the quality of the chemical used is OK and that the quality of spraying is Ok as well): take a piece of the material which is used as wall material in the facilities, spray it the way it is usually done when spraying the facilities, form the material into a small closed space and release mosquitoes in this space, then observe whether they die. Do this with different time intervals after spraying to obtain an indication (see Appendix …). In theory mosquitoes should die at least during the period covering the frequency interval of spraying. As indicated


in the specifications of the program objective.

Ask beneficiaries what they think about the lasting effects of spraying.

* Are the chemicals not expired or affected?

Control expiry dates and observe whether the chemicals are properly stored both in the field and office stores. Also observe how spraying solution is kept and whether left over spraying solution is stored properly and not too long.



Effectiveness of spraying (continued)

5. Provision of the spraying solution.

* Are the chemicals ordered in time?

* Are the chemicals available in sufficient quantity?

* Are the chemicals stored well?

* Are the chemicals mixed well and in the right concentration?

* Is the provision of the spraying solution to the sprayers well in time?

Observe how chemicals are stored and whether the chemicals are kept in sufficient quantity in store (the amount required in store should be indicated on the stock card of the chemical which again should have been determined by the program taking both operational and contingency aspects into consideration).

Discuss with sprayers, mixers, team leaders and field administrator about the availability (quantity, timing) of the chemicals and the spraying solution.

Observe how the spraying solution is prepared. Control whether sufficient chemical is added and whether mixing is well done.

6. Errors.

* facilities larger than anticipated (working with the determined spraying time for the facilities then results in a too low dose of active ingredient applied to the surfaces)

* wrong calculation of required concentration of insecticide in the spraying solution (resulting in too low or too high dose of active ingredient applied to the surfaces)

* wrong calculation of required spraying time of facilities

Look into these aspects if the earlier investigations regarding the effectiveness of the program have given indications in the direction of errors (if not yet done during these investigations). Measure spraying time for spraying facilities and control the surfaces to be sprayed in a number of the facilities. Make calculations based on the information in Boxes 6.4 and 6.5 and compare the results with what is practiced in the program.

Relevance Look into health statistics of the diseases caused by the targeted vectors of the period before the start of the program and possibly after the start and assess whether the incidences of the diseases caused by the targeted vectors are sufficiently high to justify the program (use paragraph 3.2). If possible also assess health statistics of the local population in the area to get further information on this aspect. Assess whether vector caused diseases found in the camp may have been imported from outside the camp.

Talk with key persons about the vector problems before the program started and/or the vector problems in areas adjacent to the


camp



Effectiveness of the control and information system

Assess whether log books, forms and reports as described in this chapter or in the operational protocols of the program have been filled in/produced as required (look in task descriptions how often reports should be made, check in logbooks whether they have been filled in on a sufficiently regular basis, etc.)

Take a few reports, logbook forms and other forms and study the details. Cross-check the information found where possible (e.g. with cross-check info from a logbook with info in reports and other logbooks, by visits in the field controlling things found in the forms, etc.). Pay special attention to subjects that with other investigations have shown to be problematic.

Safety Assess, based on the task descriptions, the information in logbooks and forms, the information in Box 6.1, and observations done during the work of all actors in the spraying program whether safety rules are sufficiently put into practice.

ImpactHealth statistics in combination with effectiveness and relevance of program

1. Health statistics. Evaluate health statistics with the methodology described in paragraph 3.2 of this manual.

Be aware though that also other factors than the program may have influence, for instance:

* diseases may be imported from outside the camp, for instance by new arrivals and people who move in and out of the camp frequently, visiting endemic areas where no protection is available.

* the vectors may be active and transmitting diseases in other places than the facilities sprayed (which would mean that the program could be effective in itself, but should be extended to those other places or, if this is not possible, be replaced by another kind of program).

* poor diagnosis of diseases (e.g. a fever is not always malaria; when a high percentage of fevers is misdiagnosed for malaria while in fact the fever is another disease which has nothing to do with a vector wrong conclusions about the impact of the spraying program may be drawn)

* diseases which can be transmitted to humans by vectors but also through other ways (e.g. diarheal diseases). If the disease has a high incidence it does not yet automatically mean then that the vector is not maintained at an acceptable level.

2. Effectiveness and relevance See earlier in this Box. Try to find arguments based on the health


of the program. statistics and information about the effectiveness and relevance of the program to what extent you believe the program has a positive impact on the health of the target population with regard to diseases caused by the vectors targeted by the program.


Efficiency1. Cost of chemicals (are there cheaper

alternatives?)

2. Numbers of staff

3. Is it necessary to continue spraying with the intervals determined (e.g. is it necessary to spray at all in the dry season)?

4. Is efficient use made of the spraying solution (not too much and not too little)?

Investigate costs of the chemicals and other suitable alternative chemicals that can be made available

Reportings on numbers of staff, if not available count

Try-outs for instance in one part of the camp of longer intervals during dry season (be careful for island effect, i.e. that in the test part it seems Ok but the reason is only that no vectors can enter there as it is surrounded by other, well-sprayed parts; be also careful not to use camp inhabitants as a testing ground)

Assess how much spraying solution would theoretically be required for the facilities sprayed and compare with what is used in practice.

Box 6.9

Two possibilities to test the effectiveness of spraying

1. Spray and collect mosquitoes using method 2 in par. A8.2, Appendix 8, in a selected number of dwellings a first time, then part of the same huts one week later, another part two weeks later etc. Compare the results (i.e. numbers of mosquitoes killed). If this investigation reveals that either the number of mosquitoes is high from the start or the numbers of mosquitoes are increasing within a couple of weeks (esp. if the number of blood containing mosquitoes increases; see also the explanations in Appendix 8) the program is probably not effective enough and action may be needed. However before drawing far reaching conclusions it should be kept in mind that other factors may play a role as well, for instance the fact that most problems with mosquitoes usually occur near mosquito breeding sites (thus in huts near these sites more mosquitoes are likely to be found even if effective spraying is done) and that due to seasonal influences numbers of mosquitoes may increase which may temporarily increase incidence levels of malaria despite the fact that spraying is well done. Before stopping or drastically changing the program ask for expert advise first!

2. Cut out a few pieces of just sprayed surfaces (if made of plastic or cloth) (make sure to provide new material to the owners). Form the material into a small closed space and release mosquitoes in this space, then observe whether they die. Do this with different time intervals after spraying. In theory mosquitoes should die at least during the whole spraying interval period (which should be indicated in the specifications of the program objective). Alternatively you can take a piece of the material similar to the wall material in the facilities and spray it the way it is usually done when spraying the


facilities.


6.2.7 Field administrator

Tools/materials needed per field administrator specifically for the residual spraying program://to be determined still///

Tasks with regard to the residual spraying program:* As part of the general administrative procedure to make a field stock overview report every

month (see chapter ....) determine the amounts of materials and insecticides used in the residual spraying program available in the field stock once a month. Control and short-cut with the supervisor that the amounts of insecticides still available in the field stock are sufficient to last for at least 2 to 4 weeks. If not, order new supplies for at least 1 to 2 months with the responsible person (office logistician, office administrator, or program manager). Report to the program manager and/or supervisor of the residual spraying program in case of problems.

* In case organophosphates are used (e.g. pirimiphos-methyl, malathion or fenitrothion) control that there is a stock of injectable atropine (to be used in case of organophosphate poisoning).

* Control proper storage of materials and insecticides according to the specifications by the manufacturers. Ensure that insecticides are always stored seperately from food stuffs and under lock and key, in a dark, dry and cool (but not cold) place. Report to the program manager in case of problems.

* Obtain figures about empty insecticide containers from the mixers every week, including information of the burial sites. Include in bookkeeping and compare the figures with the amounts still in stock according to the bookkeeping. Discuss with mixer and report to supervisor and/or manager in case of differences found.

6.2.8 Office administrator

Tools/materials needed specifically with regard to the residual spraying program://to be determined still///

Tasks within the residual spraying program:* Once a month control the supplies in all office stocks (both quality of storage and the

amounts in stock) and sum up the amounts with the amounts still available in the field stocks (obtain the monthly bookkeepings from the field administrator) as part of the standard administrative procedures described in Chapter .... Insecticides should always be stored according to the manufacturer’s specifications, and separately from foodstuffs, under lock and key, in a dark, dry and cool (but not cold) place. The amount of insecticide in the office stock should be enough to supply all spraying programs a supply enough for at least /////1 month//////. Make sure new supplies are ordered if needed. Report to the program manager in case of any problems detected.

* Control each field stock (both quality of storage and comparison of the amounts with the field administration) once every //two to three months/// as part of the standard administrative procedures described in Chapter .... Report to the program manager in case of any problems detected.

* Each time when insecticides arrive check whether they have been transported correctly. The containers in which they are stored should be secured properly and the vehicles should be well ventilated. There should be no food items in the same vehicle.


6.2.9 Logistician in charge of purchasing the insecticideTools/materials needed per logistician specifically for the residual spraying program://to be determined still///

Tasks with regard to the residual spraying program:* Each time when buying insecticides control whether the insecticide is accepted in the

country of application, has given satisfactory results in all four phases of the WHO Pesticide Evaluation Scheme (WHOPES) and complies with WHO specifications (see Specifications for pesticides used in public health, WHO, 1985, and subsequent issues for specific products and formulations), is new, suitable for use against the target vector(s) and for use in the spraying equipment available in the project. If there is any doubt, the quality of the insecticide can be verified by sending a sample, prior to buying, to an independent analyst.

///////////////

6.2.10 Recommended literatureDavis J. and Lambert R. 1995. Engineering in emergencies. A practical guide for relief

workers. RedR. IT publication.

Thomson, M.C. 1995. Disease prevention through vector control. Guidelines for relief organizations. Oxfam practical health guide no. 10.

UNHCR. 1997. Vector and pest control in refugee situations. PTSS/UNHCR, ISS/WHO. Compiled by G. Sabatinelli. Geneva, April 1997.

6.3Rodent control programs

6.3.1 IntroductionBecause documentation on rodent control in camps is limited first a general introduction is given to the subject (paragraphs .. to ..) after which the monitoring aspects for rodent control programs in camps are highlighted (paragraphs ... to ...).

The most common rodents are rats and mice. Rodents: consume large amounts of food foul stored food rendering it unfit for consumption damage stored products such as soap, blankets damage buildings and other structures transmit disease carry parasites that transmit disease damage electrical gear, computers etc.

WARNING

Killing rodents or removing their shelter areas may cause their parasites (e.g. fleas) to move on to humans and thereby cause increased transmission of disease such as plague or murine typhus. Therefore, if such danger exists it will be necessary to take action against the parasites first (e.g. by insecticidal dusting of rodent runs to kill the parasites on the rodents) before rodent control measures are taken.


In adequate presence of the three factors food, shelter and water, most rodent populations can rapidly multiply. In theory, that is if all these three factors are in ample supply, one couple and their offspring can produce several millions of descendants in a year!

In practise however, usually one or more of the factors become scarce resulting in a levelling off of the population growth until finally a maximum population has evolved which is in balance with the most limiting of the three factors. This process is represented in the upper part of the curve in Figure ... (next page). However, in case the most limiting factor (usually food, sometimes water) becomes more favourable this will result in an increased reproduction until the maximum population size is reached for the new circumstances. Vice versa, if one or more of the factors become more limiting, the maximum population size becomes smaller.

Time

Figure ... Rodent population growth curve.

The following should be taken into consideration when planning a rodent control programme:If a control campaign is inadequate the rodent population will not be reduced sufficiently (i.e. below 10% of its original level) and will end up somewhere in the steep part of the curve. A population in this part of the curve tends to increase in number very rapidly (because the circumstances for reproduction are optimal: there is no scarcity of food, shelter and water) which means that either a continuous and further increased effort will be needed to keep their numbers reduced or that the population will increase in number again even if continuing the control efforts at a certain level. To control rodents the right way and avoid the undesirable situation described above, two strategies can be followed:1. Reduce rodent access to one or more of the three factors food, shelter and water so that the

maximum population size will become smaller. This may be achieved through preventive measures limiting one or more of the three factors and therewith reduce the maximum rodent population. However, preventive measures may not be sufficient, not yield effects timely enough, or be difficult to implement in the short time available. For such situations the second strategy may be appropriate.

2. Reduce the rodent population to less than 10% of its original size (through which it arrives in the low, not very reproductive part of the curve). This may be achieved through trapping or chemical control measures.


6.3.2 Preventive measuresPreventive measures aim to reduce the access of rodents to food, shelter and/or water and therewith reduce their maximum population size. Preventive measures should include general measures to improve environmental hygiene (e.g. through improved toilets, water, hygiene education, solid waste disposal, burial of the dead, drainage of waste waters, and so on) of which the activities are described in other chapters of this document.

Other preventive measures are specifically implemented for rodent control purposes only. They sometimes aim at reducing the shelter or water factor but most are aimed at reducing access for the rodents to buildings, especially food stores (this is also called ‘rodent proofing’). With regard to this it should be taken into account that some rats can jump up to 75 cm and scramble higher if they get hold of anything. Other rats can burrow 30 cm below ground and even much deeper sometimes, can jump over long distances and can gnaw almost any material. Some of the specific preventive measures against rodents are: Construction of a concrete curtain wall of 10 cm thick and at least 60 cm below ground with the

base turned out some 30 cm away from the building in the shape of an L to make foundations rodent proof.

Proper maintenance and operation of food stores, kitchens, food distribution sites and other places were food can be found (through regular inspections, cleaning and sweeping of floors, proper waste disposal, and so on).

Ensuring that materials used in buildings are proof against gnawing by rodents and that all places where rodents could make holes to enter a building are reinforced with rodent proof materials.

Closure of all holes larger than 6 mm (the smallest hole that a young mouse can enter) with rodent proof material such as metal plates, cement mortar, concrete. Places to check in particular, as it may not be so obvious that they form potential entrances for rodents, are: gaps under doors, places where pipes and cables pass through walls or foundation, and windows and other openings used for ventilation.

Construction of flat or cone-shaped metal climbing guards up drainpipes etc. They should be placed sufficiently high to prevent rodents jumping beyond (and to avoid catching passing vehicles and workers) and made wide enough to prevent the rodents climbing around them.

Rodent proofing of roofs rodent and prevention of access through trees and cables leading to the building.

Application of smooth horizontal bands of cement at walls etc. painted with two coats of a high gloss paint to deter rodents from climbing brickwork or stones; alternatively on wooden buildings a strip of smooth metal sheeting can be applied. The bands should be about 20-30 cm wide and should be applied not less than 1 m from the base of the outside wall.

Insertion of drain traps in drain ways to prevent access through drains and sewers. Keeping doors closed and free of debris. Rodent infestations can effectively be discouraged if a cordon sanitaire of ground clear of weeds

and any possible harbourage is maintained around a building. Reduction and inspection of potential nesting sites such as discarded packaging, collections of

rubbish and stocks of firewood.

The identification of proofing needs and other specific measures for a building should lie with the person responsible for rodent control at that site. The simple measures should best be undertaken by the rodent control operator and/or the manager of the building.

////fig 12.1 page 282 CAB International 1994 ‘Rodent pests and their control’////


Figure .. Potential routes and sites of rodent entry into a storage facilityFrom CAB International, 1994

Important:Control programs aiming to reduce rodent numbers should always be followed / combined with preventive measures in order to prevent excessive rodent population growth in the future, especially if the control measures taken to reduce the rodent numbers are of a temporary nature.

6.3.3 Trapping and huntingTrapping and hunting are good options in case a rodent population is still small and confined to a certain area11. Continued trapping or hunting can in such circumstances keep the rodent population in the lower flat part of the curve in the graph. In many cases however the population is too large already. Trapping/hunting will then only temporarily reduce the population until it arrives at a level where the population is very productive (the steep part of the curve in the graph) as there will be more food, water and shelter available than is used by the rodent population. This will cause the rodent population to reproduce fast against which trapping and hunting can not compete. Another restriction of trapping or hunting programs is that they often cause unintended and counter-effective results if people are paid to eradicate the rodents. In camps near Goma for example a campaign to stimulate people to capture and kill rats (people were paid a small sum per rat tail they brought to the programme) stimulated people to breed rats so that they could easily make money by bringing many tails to the programme.A rule of thumb is that for effective trapping the number of traps used should be 2 to 3 times the estimated numbers of rodents present! Therefore trapping is only useful for: removal of a small number of rodents in food stores or domestic premises, where the carcasses are valued as food, control of a small population of large rodents, e.g. coypu rodents.

6.3.4 Chemical control measuresChemical control methods usually include two components being executed after each other:1. application of insecticides to kill the parasites carried by the rodents2. application of rodenticides to kill the rodents

6.3.4.1 Chemical control of the parasites carried by rodents//// to be worked on!!!//////

6.3.4.2 Chemical rodent control with acute poisonsAcute (single-dose) poisons: consider prebaiting with non poisoned food to acustom the rodent to feed on the same foodstuff at the same sites. The bait is easier and quicker to consume if it is slightly damp

11 In buildings where other methods are ineffective sometimes also use is made of sticky traps or glue boards, though this method is generally considered to be inhumane


The pattern of prebait uptake is usually one of gradual increase until, if the infestation is reasonably circumscribed, a plateau of consumption is reached. This may take several days for mice and up to two weeks for rats. The poison is then added to the bait and the poisoned bait laid in the same places, and in the same containers, as the prebait. Usually the quantity put out need be only half that of prebait consumed during the peceding 24 hours because the effect of the poison is quickly to curtail feeding. The majority of poisoned bait consumption will be during the fist 24 hours of the treatment, and, indeed, some authorities recommend that the duration of the poisoning phase should not extend beyond this period. Some individuals may not feed consistently though during baiting programmes and it may be advantageous to leave baits in position for two or three days, if it is safe to do so.

6.3.4.3 Chemical rodent control with anticoagulents (chronic or slow-acting poisons)Anticoagulents are slow-acting poisons which means that it takes some time, usually somewhere between 4 and 10 days, and usually several feedings, to cause death in rodents who have consumed sufficient of the poisoned bait. The delay prevents rodents from associating the symptoms of toxicosis with the anticoagulent and, therefore, bait shyness is unknown or much less of a problem than with acute poisons. Generally anticoagulent rodenticides are preferred to acutes for reasons of efficacy and safety.

Safety for humansBecause the functioning of anti-coagulents is based on interruption of the vitamin K cycle in the liver it is easy to provide an effective antidose for use in case of accidental poisoning: the administration of excess amounts of vitamin K1. Equally important, the chronic mode of action also allows enough time for the antidote to be administered.

First generation anticoagulentsFirst generation anticoagulents must be taken repeatedly for several days to have sufficiently prolonged effect to cause death. Therefore surplus baiting is needed for periods varying from several days to several weeks (depending on the rodent species). Baiting continues until the cessation of feeding which generally indicates that the infestation has been extinguished (called ‘saturation’ or ‘sustained’ baiting). Feeding on a bait should normally stop after 3-5 weeks. If feeding continues after this period this means that the poison or bait is not effective or new rodents have infested the area. The cause should then be investigated and more effective measures developed. Such measures may include extension of the area being baited, change of the bait, change of the poison, or putting more emphasis to other control measures.

Bait should be placed in small piles (100-200 g for rats and 25 g for mice) where rodents will easily find it and before they reach food stocks. Rodents begin to die after about 1 week when there should be a reduction in feeding. Mice can be more difficult to control than rats. They sample small amounts of food from different sources so a large number of bait sites is usually more effective for mice control.

First generation anticoagulents are effective against most rodent species although long periods of baiting may be required in some cases (Norway rat about 6 days, Rattus Rattus about 21 days). Warfarin is a much used first generation anticoagulent (very effective against Norway rat, but in Europe and the United States rodents become more and more resistent against it). Warfarin for rats and mice: dose 250 ppm or 0,025% active warfarin (250 ppm (0,025%) = 1 part of 0,5% concentrate to 19 parts of bait). Use a mixture of 0,025% warfarin and 0,1% calciferol against mice.

Where the newer anticoaglents are not available or are considered too expensive, warfarin and similar older anticoagulents are still widely used. They can be effective for at least occasional use if in palatable formulations and if used in areas where resistance to them has not been a problem. They will, however, require considerably more volume of bait and greater efforts to maintain bait points for the multiple feedings required.


Second generation anticoagulents

Advantages above first generation anticoagulents Disadvantageseffective against both warfarin susceptible and resistant rodents

attention must be given to apply the right amount of bait at each 'pulse' (see below)

less bait needed the poison is more expensive than first generation anticoagulents

no bait shyness ///(while there may sometimes be bait shyness with first generation anticoagulents ????)///some second generation anticoagulents are less toxic to non-target animals than to rodents

Small quantities of second generation anticoagulent treated bait should be applied at approximately weekly intervals. Dominant animals consume the baits completely over a short period of time, and die before another application of bait is laid for animals that were earlier prevented from taking the bait (sometimes rodents who consumed the poisoned bait die within a day). Further baits are subsequently applied weekly until the population is fully controlled. This system is called 'pulsed baiting'.

Difenacoum is a widely used second generation anticoagulent, used in baits containing 0,005% of the active ingredient (trade names: Ratak, Neosorexa). Average duration of treatment: 32 days, with 8 visits to obtain control of 96% average level of control, 146 grams eaten per bait point on average. Another widely used second generation anticoagulent is Brodifacoum which is effective against all common commensal and agricultural rodent pests. Treatment: 22 days, 100% control, 6 visits, average consumption: 82 grams of bait per bait point. Pellets, wax blocks and cereal baits containing 0,005% Brodifacoum are available under the trade names 'Klerat', 'Talon', 'Havoc', and 'Matikus'. Bromadioline is another much used second generation anticoagulent.

////??In urgent situations such as rodent caused disease outbreaks second generation anticoagulents are preferrable because they do not require repeated feedings and are thus specially useful where competing foodstuffs can not be eliminated or bait maintained or serviced over long periods (as is needed for Warfarin and similar first generation anticoagulents).?? p. 264 of CAB International, 1994///

6.3.4.4 BaitBoth acute and slow-action poisons are added to bait. Baits should be made out of high quality cereal. Maize oil can be added to make the bait more attratctive to the rodents. Many treated baits are delivered ready for use (can be used as bait without any further additions). Often they are coloured to prevent poeple from sampling and eating them. Pellets are preferred indoors and where the bait is deployed in bait boxes (disadvantages: poor weatherability and hazard to birds). Wax blocks are preferred baits. Although they are somwhat less palatable to rodents than those based entirely on cereals they are safer to non-target animals, more easy to apply and less weatherable. Therefore they are more suitable also for outside use, in damp locations as sewers, rodent burrows and for permanent baiting in bait boxes.

There are now baits which contain the human taste deterrent denatonium benzoate (tradename 'Bitrex') which is highly repellent to humans when included in baits at a strength of 0,001% but does not deter their consumption by rodents. The incorporation of this compound is unlikely to decrease the frequency of accidental exposure of humans to baits but it will help to reduce the quantity of bait accidentally consumed, and, thereby, the clinical severity of these incidents.

Bait stations are small boxes in which bait can be placed. They reduce the likelihood of bait spillage, help to keep the bait in good condition, provide a sheltered environment in which rodents can feed, preclude access to the bait by non-target animals larger than the rodents, above all, they preclude access to the bait by humans to a certain extent. Potential disadvantage: they may alter rodent behaviour and delay station utilization. They are also expensive.


Bait should be placed in burrows or otherwise out of sight in populated areas. However, in camps people will find the bait anywhere and therefore if bait needs to be used outside confined areas additional measures to secure safety may be needed, such as: the use of durable bait stations hiring people to watch over the bait and protect it from theft or vandalism

///figure 11.2 page 260 of CAB International, 1994: Rodent pests and their control/////

Figure .. Bait stationFrom CAB International, 1994

6.3.4.5 Recommendations for safety in chemical rodent control programs

Dangers of chemical rodent control programs

In camps people may eat dead rodents. If the rodents are poisoned the people will be poisoned too!

In camps people may eat the baiting material meant to poison the rodents if they find it and be poisoned through that!

In camps people may mistake the white insecticide powders used to kill parasites hosted by the rodents for flour and eat it and be poisoned through that!

The poisons may be dangerous to the staff applying them!

To improve safety in chemical rodent control programs the following measures are needed:1. Develop the program with the assistance of an expert.2. Restrict the program as much as possible to confined areas of the camp which are under

strict control (e.g. in foodstores).3. Execute a publicity campaign and warnings for the public. Principally chemical rodent control

should not be executed in areas where rats are or may be expected to be used as food, but even if the control program is executed in confined areas only, some poisoned rodents may escape before dying and be found and eaten by people.

4. Execute the program with skilled staff and train them to (further) raise their skills and awareness with respect to the poisons used and make sure they work safely. Staff should wear protective plastic or rubber gloves and dust masks when preparing baits as some poisons can


penetrate the skin. The poisons should not be inhaled. Staff should wear gloves and take care when handling rodent corpses.

5. Ensure proper disposal/destruction of poisoned rodent carcasses. Make absolutely sure that people can not come into contact with the carcasses or eat them: incinerate them or bury them in a deep hole.

6. Whenever possible use the less hazardous chronic anticoagulent poisons. These must be consumed for several days before they are effective and are therefore less dangerous (having a less poisonous effect after only one consumption and leaving more time to find medical help if poisoned).

7. Execute an awareness campaign among curative health personnel. Increases awareness about the possibility that people with symptoms of poisoning by rodenticides or parasites may attend their health centres, how to diagnose this and how to treat the poisoned people properly,

8. provide effective antidotes to the health centres (antidotes are medicines that can be used to neutralize //some of??/// the effects of rodenticides in case people are poisoned with them; e.g. Vitamin K; see also further on).

9. At the end of a campaign collect the remaining bait and incinerate or bury it.

6.3.5 Rodent control in food storesIn camps many rodent control activities will usually be directed to controlling rodents in food stores. In food stores the aim usually is 100% elimination of the rodent population. As preventive measures alone can often not fully achieve this chemical measures are needed in many cases. The bait should be so attractive to the rodents that they prefer it above the food stored. Anticoagulents are the best chemical for this purpose as the rodents will be able to take several feeds without starting to feel ill and bring this into connection with the bait (leading to bait shyness). Even if feeding is not (yet) lethal this will not lead to bait shyness.

The use of open bait points without trays (??) is probably best for effective control., but safety constraints may require the use of protected bait points such as covered trays or boxes in order to prevent access by non-target animals and/or humans. The bait points should be placed where rodents have been found to be active. Use of an unpoisoned water source adjacent to a bait point may increase bait intake from that point.

In addition to preventive measures discussed earlier food stores should always include the following preventive measures:1. Inside the store all equipment and material that is not required for the working of the store should

be removed. Materials that have to remain should be stored neatly, preferrably in manageable stacks, but never against walls, which would make inspection and survey for rodents difficult.

2. A walkable space of about 1 m should be left around the edge of all stacks.3. Position all materials on pallets, shelving or racking off the ground. 4. Ideally the stacks should be surrounded by a thin strip of chalk, dust or fine sand (see Figure ...

below) to show rodent footprints which can be used to identify if and where additional rodent control measures are needed.

5. Ensure good stock management and stock rotation.6. Keep the store clean and tidy: sweep the store clean at the end of every working day, remove or

burn all edible and inedible spillage.7. Outside the store remove all unnecessary material, don’t allow any edible refuse to accumulate and

keep vegetation as short as possible for as large a distance from the store as is practicle to discourage rodents.

8. Ideally the responsibility for both the store management and the rodent control should lie with the same trained manager, thus reducing the opportunity for any conflict of interest.


//Fig 12.2 page 286 of CAB International, 1994./////

Figure .. Tracking bands of fine sand or similar material can be placed around susceptible goods to show rodent tracks.

From CAB International, 1994

6.3.6 Sequence of activitiesBeside the building up of managerial expertise and training of staff rodent control strategies usually include the following activities: Survey to identify the severity of the rodent problems and develop the most suitable rodent

control program (usually started after initial signs of rodent problems which are often identified through informal information channels as described in chapter 3). A survey usually aims to identify numbers and sorts of rodents, sorts of damage/diseases caused by the rodents, rodent proofing needs of food stores and other buildings, causes of the rodent infestation (e.g. poor hygiene, easy acces to food, etc.), potential of different control measures (also taking into account that due to such measures behaviour and activity patterns of the rodents may change rendering the measures less effective). The survey should also provide the information basis for the evaluation afterwards of the effectivity of the control efforts. A survey and the preparation of a rodent control program should preferrably be executed by an expert.

Application of rodent control measures (preventive measures, trapping, hunting, chemical measures; see former paragraphs in this chapter)

Maintenance of activities (e.g. with anticoagulent treatments bait points should be visited regularly, once to twice a week, to replace bait, record activity, adapt treatment if necessary etc..; as a rule of thumb, treatments may be terminated once there have been two visits without a bait take and when no other indications of current activity can be found).

Monitoring to continuously know (and be able to react on) the status of rodent infestation, safety aspects, efficiency and so on (this element is further worked out in the following paragraphs)

Evaluation (regarding cost-benefit evaluations, a common characteristic of rodent control programs, especially those executed in stores, is that significant cost:benefits, varying from 1:2 to 1:51, have been reported even where original losses due to rodents were low).

6.3.7 monitoring aspects of rodent control programsAs monitoring aspects of preventive measures are already discussed in other chapters, this paragraph pays attentiononly to the monitoring aspects of trapping and chemical rodent control programs.

In the US several methods are used to discover actual or potential rodent problems. Two main methods are neighbourhood surveys where neighbourhoods are investigated and rated for their rodent threat potential, and complaint/response programs where monitoring in principle is done by the public who warn the specific authorities dealing with rodents in case of rodent problems. It was found that the complaint/response programs were more cost-effective. It is therefore recommended to use this as a monitoring as well as an executional tool in camps too. Important is that if complaints about rodents start to come in all people are informed that they can present rodent problems to the program and that an administration is kept of the locations where rodents are reported to be a problem.


6.3.7.1 Monitoring of trapping programsA typical organisational structure for a rodent control programme in a camp which uses rodent trapping is as follows:

6.3.7.2 Monitoring of chemical rodent control programs

A typical organisational structure for a rodent control programme in a camp which uses rodenticides and insecticides is as follows:

Measuring efficacy of the rodent control program:Measure at least two times: one just before the beginning of the treatment and one at the end of the treatment. However, when analysing the results at the end of the program always take into account that there may have been other factors other than the rodenticide that caused the rodent population size to fluctuate.

Measuring methods that can be used to get an indication of the efficacy of the rodent control program:

visual counting: 1. scanning from a fixed point (mainly for species active during the day)2. walk a predetermined route (mainly for species active during the night; use a spotlight)Do it the same time of the day or night by the same observer. To obtain a good representative value make at least three seperate counts to obtain a single index value (to average out all kinds of variations that may influence the numbers observed) and try to do the concequtive countings during days or nights when circumstances are comparable (esp. aim to count under the same wheather conditions and without any adverse conditions)

signs1. Counts of active burrows for rodents who live in burrows (close burrows with soil or other material at beginning of treatment and count the number reopened at the end to be the final level of rodent activity). May not be accurate where rodents do not all live in burrows.2. Counts of mounts for burrows who make mounts3. Opening of breathing holes in snow.4. Dropping counts: clear predetermined areas of droppings and count new pellets that accumulate during a given unit of time, or else use dropping boards.

TracksLay patches or plates of flour, sand, talc, chalk etc. in placves where rodnts are considered likely to be active. Count number of places with rodent footprints or e.g. intensity of food printing at places. Because of variation in rodent activity, in relation to factors such as wheather, record for three or more


seperate days in order to obtain a single index of activity. Possible biases: surviving animals expand their home ranges therefore marking more areas and due tot hat efficacy of the treatment may be under-estimated.Also the efficacy may be underestimated because the more wide-ranging rodents are most likely to succumb first leaving animals who walk less and thus give an underestimation of the population still alive in comparison to the situation before treatment started. These errors can be minimized if plates/patches are correctly placed. They should be not only be laid in association with bait points or bait stations but be placed independent of bait stations at a predetermined density (read Quy et al., 1993).

Food consumptionMake unpoisoned food (which is different from the bait used in terms of appearance, taste, texture and location) available and record consumption in a standard way before and after treatment, giving a measue of the change in rodent activity. There should be a lag period between the end of census baiting and the beginning of the treatment (for rats: pretreatment lag period of 14 days and a post treatment lag period of 7 days). The census baiting periods should be at least 4 days.An alternative is to persist with census baiting until daily consumption has leevelled off and take this asymptotic consumption as the census index.

EPA guideline: at least 70% absolute efficacy must be demonstrated by two independent techniques and no more than one rodent should be caught for every snap traps set at the end of the teatments.

Indicators recommended for rodent control programs(warning: first kill the vectors hosted by the rodents, and only then kill the rodents)

Indicator Descriptionnumbers or amount of rodenticide baits placed See par. ..numbers of traps placed See par. ...materials and consumables used and in stock See par. 3....percentage of area invested with or threatened by rodents covered by baits and/or traps

See par. ...

number of buildings that should be physically protected against rodents

The buildings where such protection measures are needed

number of buildings physically protected against rodents The buildings where such protection measures have been executed

numbers or signs of rodents observed/trapped/poisoned in buildings physically protected against rodents

See par. ...

financial indicators See par. 3...numbers of rodents killed and numbers of rodents alive See par. ....incidence rates of diseases caused by the vectors targeted by the rodent control programme

See par. 3...

6.3.8 Recommended literatureCAB International. 1994. Rodent pests and their control. Edited by A.P. Buckle and R.H. Smith.Davis J. and Lambert R. 1995. Engineering in emergencies. A practical guide for relief workers.

RedR. IT publication.


Thomson, M.C. 1995. Disease prevention through vector control. Guidelines for relief organisations. Oxfam practical health guide no. 10.

Par. ..Incidence rates of diseases caused by the vectors targeted by the control programme///Opmerkingen: 1) enkele van deze ziektes kunnen ook heel andere oorzaken hebben en vaak wordt er in de statistieken geen onderscheid naar oorzaak gemaakt (hetgeen vaak ook niet mogelijk is omdat de oorzaak van een ziekte in een kliniek vaak moeilijk te bepalen is); het is dan moeilijk te bepalen uit de statistieken welk deel door vectors en welk deel door andere oozaken wordt veroorzaakt. 2) Van veel ziektes worden geen statistieken bijgehouden (ze worden of op een grote hoop gegooid zoals verkoudheid, of ze worden geregistreerd onder een kopje undetermined o.i.d.). 3) vaak zijn statistieken niet goed bijgehouden///////

If you are new in the area and/or do not have good information about vectors in the camps under your management you will first have to get a general idea about the vectors prevalent in the camp and the seriousness of these vectors. You can do this by starting with a simple assessment which includes:1) asking your predecessor, people who work in the curative health and the food programme(s) in the camp about vectors in the camp and the diseases, damage and inconveniences they cause (but be careful about misconceptions; people often tend to overemphasize problems related to subjects they are asked about),2) asking local leaders and other key persons as well as the camp inhabitants what problems they have (see par. ...) anmd assess from their answers whether vectors are a problem perceived by them, 3) reading existing reports,4) analysing health statistics (get an idea about the importance of vectors in the diseases reported; look at the development of vector-borne diseases in time, assess the vector-borne diseases in the camp against such diseases present in the hosting area).If this does not give you a reasonable good idea, then carry out a thorough assessment (see Annex .... for examples on how this can be done). Preferrably get an entomologist to carry out the survey for you.If you get a strong idea through this assessment that one or a number of vectors are serious causes of disease, damage and/or inconveniences, then an entomologist should preferrably be contracted to further investigate the problems and recommend the remedial activities needed.

A few standards which you can use in your judgement whether activities in the field of vector control are needed:

Disease High incidence Low incidence(action needed) (no action needed)

Malaria in Africa ..... .....Malaria in AsiaSleeping sickness (Trypanosomiasis)ScabiesRiver blindnessFevers other than malariaDiarrhoea

Remarks: 1) The diseases marked with * are always fully vector-borne. The diseases not marked with * may be be wholly or partly caused by vectors or by other factors (the causes, thus also the extent to which vetors are involved, will then have to be assessed if the disease incidence is high)


2) control whether the statistics are correct. If high incidence of malaria is suspected or indicted in the health statistics make sure that you proof it is really malaria (through blood tests) before you start with massive spraying, bednet programmes, drainage campaigns or other activities. If a lot of fever is reported try to find out what the causes are, to what extent they are vector-borne. If high diarrhoea figures are reported find out if vectors are involved and to what extent.3) Be aware that the above figures are very rough. They should only be used as an indication. There are many exceptions.The indicators that should regularly be measured to know whether a vector programme should be started1) Look at the developments in the health statistics (you can use the above table to assess whether action is needed or decide for action even before high incidence levels are reached, when certain vector borne diseases show a sharp increase in incidence).

2) Observation of vector populations:

Mosquitoes: Method of measurement:High level:Low level:Intensity of measuring: only when mosquitoe-borne disease levels are rising and/or when

during the regular monitoring walks (see par. ) high mosquitoe densities (which means significant rises in a number of places in comparison to former walks) are detected, it is necessary to analyse which the mosquitoe sorts are (see Annex ....; is Appendix 3 in Thomson,s book) and measure the presence levels of each mosquitoe sort with the above method. Start measuring once a month and continue with this as long as the situation is significantly changing.

Measuring mosquitoes during the monitoring walks:count the number of mosquitoes in the 5 randomly chosen huts (where you also carry out all the other measurements as desribed in par. ...), or in more huts (according to your own judgement and the monitoring capacity in your programme) in different parts of the camp.

flies:tsetse flies

Every week: with the health statistics available assess whether diseases prevalent are vector-borne and which percentage of the diseases they cause in the camp.7.2 General indicators for spraying activities

* Indicators about staff and users safety* Indicators about amounts of chemicals used* Indicators about numbers of facilities, households, areas sprayed.

7.3 Indicators specific for the control of mosquitoes7.4 Indictors specific for the control of flies, .. and ...7.5 Indicators specific for the control of rats7.10 Recommendations for periodical and final evaluations

Literature used specifically in this chapter:1. Disease prevention through vector control; guidelines for relief organisations. Liverpool School of

Tropical Medicine. Madeleine Thompson. OXFAM practical health guide no. 10.2. Public health engineering in emergency situation; a handbook for implementing health programmes

in deprived environments, in particular in camps of displaced persons. 1st edition. Medecins Sans Frontieres.

3. Evaluation report of the OXFAM environmental health programme in Kibeho camp, January - April 1995. Tom de Veer. Kigali, May 1995.

4. Malaria. Principles and practise of malariology. Edited by W.H. Wernsdorfer and Sir I. McGregor. Volume 2. Churchill Livingstone.


7. Hygiene promotion

7.1Introduction.In many circumstances people’s poor hygiene behavior is a threat to their health. To facilitate that people become aware of this and improve their hygiene behavior a hygiene promotion program can be executed. Usually this is done in combination with drinking water and other sanitation programs to optimize the effects.

The recommended minimum objective of a hygiene promotion program is:To facilitate the targeted beneficiaries, through the execution of appropriate hygiene promotion methods, to improve their hygiene behavior, in accordance with the below specifications, in accordance with the facilities available to them and in accordance with their social, cultural and religious habits, beliefs and preferences.

Specifications for the recommended minimum objective of a hygiene promotion programSituation

Subject


Hygiene behaviors needed

75% of people drink water from sources with acceptable quality water (water for other uses, e.g. washing clothes and dishes, personal cleanliness etc. may be used from contaminated sources)

60% of people wash hands after going to the toilet and before eating and cooking (with soap or ashes)

80% of people defecate only in the areas or facilities designated for this.

(depending on the specific situation other hygiene behaviors may be more important).

The 3 to 4 most important hygiene behaviors identified to need attention should be improved among 80 to 90% of the people (see Box ... for an example list of hygiene behaviors that often need to be promoted in camps)

Information needed ensure that all key information needed to prevent the most threatening diseases is promoted to people

ensure that all information needed to prevent most diseases present or potentially present in the camp is promoted to people

Number of hygiene promoters

1 per 1,500 to 2,500 people 1 per 1,000 persons or per 200 families

Number of well organized/prepared group meetings

none 1 per two to three days per hygiene promoter

Number of household visits or small group discussions

100 short discussions with small groups per hygiene promoter per day

6 to 12 household visits per hygiene promoter per day

Chapter 7 : Hygiene promotionp. 151

The hygiene promotion program discussed here has the following organogram:

Figure 7.1 Organogram of the hygiene promotion program described in this chapter.

The main task of hygiene promotion teams is to promote hygiene in the area under their responsibility and feed back to the program about the results and the experiences, including recommendations for improvements.


Other programs

Field administratorof the field stock

Hygiene promotion teams with:team leaders, and

hygiene promotors

Manager of hygiene promotion program Office administratorOffice logisticien

7.2Hygiene promotersHygiene promoters work together with the camp inhabitants on the improvement of hygiene. Their role is to function as a two way information channel between the program and the beneficiaries and vice versa. They apply methods to promote improved hygiene behavior among the people and in the same time obtain information about the hygiene behaviors that need improvement, the reasons why people practice poor hygiene behaviors, the effectiveness of the hygiene promotion program and further improvements needed.

Hygiene promoters also assess with the people sometimes what other problems people face, even if these have nothing to do with hygiene issues, and feed this information back to the managers of the involved programs.

Because of their close contacts with the beneficiaries and the absolute necessity for a relation of trust and respect with them it is preferable that hygiene promoters are members of the target population themselves. The best way to assure such a relation is to have hygiene promoters being chosen by the beneficiaries. How this can be realized even within a very short time is explained in Box 7.1. If time is really too short for this (e.g. if hygiene messages need to be transmitted within hours in order to save lives) one can recruit hygiene promoters by asking around for people who are respected by their communities and who are capable of communicating hygiene messages to their people (don’t offer a salary in first instance, only some small incentives such as a piece of soap).

Tools/materials needed per hygiene promoter:One pen, one notebook, hygiene promotion materials as required (depending on the methods used)For each team there should preferably also be a megaphone with sufficient batteries.

Number of hygiene promoters needed:Emergencies: one hygiene promoter per 1500 to 2500 persons.Non-emergencies: one hygiene promoter per 1000 persons or per 200 families.

Especially in non-emergencies hygiene promoters will be organized as teams. A hygiene promotion team often consists of 8 to 12 hygiene promoters and one team leader. The hygiene promoters of one team often assist each other. The team regularly meets to discuss the specific problems in their part of the camp.




Communicate hygiene messages quickly to people

Promote short, simple and strong hygiene messages with short and simple explanations to as many people as possible as quick as possible (e.g. in case of cholera threat say ‘don’t drink from the lake: it will make you sick and you may die because of it. You can use it for washing and bathing but get your drinking water from the tap by the health center’).

Contact leaders to convince them to communicate the same messages to their people.

Feed-back to the manager about the reactions of people and whether people actually follow-up the advise given to them.

continuously

100 short discussions with small groups per hygiene promoter per day about the hygiene behaviors to be promoted

Assist in mass meetings

To prepare the meeting:1. Discuss with others involved about the need of the

meeting and the subject(s) to be dealt with.

2. Visit community leaders to inform them about the meeting, the time and location, and the purpose.

3. Go around to invite people to come to the meeting and explain them shortly what it is about.

During the meeting:1. Explain arriving people where they can sit or stand

2. Assist with translation if necessary (make sure to have the megaphone available)

3. If you are asked to do so, make notes of the things said.

See chapter 3 for a detailed description of this method.

During emergencies or periods with sudden large deve-lopments: timing depends on situation, needs etc.

See paragraph 3.3.4.4

Assist in the training of new hygiene promoters

If needed take new hygiene promoters with you, discuss with them the relations between hygiene and health by asking them questions and explaining things when necessary. Let them observe you and assist you during your work. If they can write, they can make notes of meetings etc.

Whenever asked by team leader, supervisor or manager.

Execute population census

Count households once every one to two weeks

See paragraph 3.4.1. Counting is done only by a few hygiene promoters possibly together with (some) sanitation workers


Tasks during non-emergencies:


Facilitate focus group discussions

Meet with 6 to 15 beneficiaries to discuss relevant hygiene issues. Work alone or together with another hygiene promoter.

Find out what the real reasons are for people to perform poor hygiene behavior (is their current behavior caused by a lack of knowledge, by cultural or socially based norms/habits/believes, a lack of possibilities to perform improved hygiene behavior or other causes?).

If applicable, inform people during these meetings about existing programs set up to enable them to create possibilities for improved hygiene behavior and ask them to feed-back their experiences with these programs to the involved staff or to the hygiene promoters.

one focus group discussion per hygiene promoter per two to three days

See the description of focus group discussions in paragraph 3.3.4.2.

Pay special attention to the way of discussing hygiene behaviors with people. Be careful not to create a feeling that you condemn them for their poor behaviors but analyze together what their views are with regard to certain behaviors. For a good understanding read Box 7.2 about the principles of KAP first!

Visit households

Discuss hygiene issues with household members (esp. women).

Also talk with them about their needs and priorities in general. Get a feeling for their knowledge, attitudes and practices with regard to the relevant hygiene behaviors.

Feed-back to the supervisor and program manager to what extent the messages of the program fit to the perceived needs of the people and to their knowledge, attitudes and practices with regard to hygiene behaviors and recommend how the program can be improved.

Inform people also about the existing programs set up to enable them to create possibilities for improved hygiene behavior.

5 to 12 households per hygiene promoter per day if no other activities are undertaken

See paragraph 3.3.4.1 and Box 7.2.

Facilitate open group discussions

Groups of 10 to 20 participants. Discuss with people what their general needs are (not restricted to sanitation issues) and feed back to the supervisor and managers involved in the subjects brought forward. Often this is done to get a general idea of the problems people are facing, and the priority people give to these problems. This will also give an impression about the priority people give to sanitation aspects in comparison to other aspects (usually priority for sanitation is low). The discussion can be followed by a focus group discussion. Be careful for the danger that people will expect follow-up on the problems brought forward (communicate very clearly to people what they can expect from your program).


Subjects decided on by the participants

Facilitate workshops

A workshop is a topic focussed group activity where people work together through discussions and actions towards a certain result, usually with regard to the development of something new.

Methods can include: 1) Map drawing by the beneficiaries of their area and other participative techniques where people work themselves on certain things. The activities usually stimulate people to discuss things and come forward with their needs, priorities, feelings about different programs in the camp, what they can do themselves to improve the situation etc.

2) Building together with the people a facility (e.g. a shower, a toilet, a tapstand, and so on) and discuss things in the same time in order to develop an optimal design (can best be done at a place where many people pass by so that everybody is stimulated to take part in the works and discussions).

whenever believed necessary, often in coordination with other programs

Subjects and method (open discussion or workshop) can be decided on by the beneficiaries, or the hygiene promoters or others depending on the situation. See Appendix 14 for some examples of participative techniques and the principles of PRA.




Execute household surveys

every 3 - 6 months. Coordinate with other teams and supervisor

See Box 7.7. Execute in 0.3% of all households with a minimum of 20 (ad random selec-tion; see Box 7.9)

Execute population census

Count households. once every one to three months

Done only by part of the hygiene promoters possibly together with sanitation workers. See par. 3.4.1

Execute other hygiene promotion methods

Other methods of hygiene promotion may be: radio programs, theatre, puppet plays, promotion through posters etc.

timing depends on program design

See Box 7.10 for some examples.

Execute structured continuous observa-tions

Additional remarks specific for continuous hygiene behavior observations in households:* Only observe in households where the behaviors play a role (e.g. only

observe defecation by children in households that do have children)

* Ask the families for their permission and explain that you are trying to find out about health problems

* If people don’t want to participate, thank them and try the next hut

* Observe for a standard period, e.g. from 6 to 9 am each morning

* Develop and test the observation format and revise them to suit the circumstances. Use the same methodology as for developing, testing and revising household surveys (see Box 7.7). In the same way make a list of written instructions for how to carry out the observations.

* Arrive at the household at getting up time, greet people politely and then sit down in an inconspicuous corner (if possible) where you can see what is going on

* Keep conversation to a minimum

* Try to obtain a feeling for whether people have changed their behavior because there is an observer present (comment on this in your report)

* Make a report of each household visited: note down the results of the observations done as according to the format and list, including any additional remarks believed important.

* Meet regularly with other hygiene promoters, team leader and supervisor to discuss specific problems or observations done

Other possible places to do structured continuous observations with regard to hygiene behaviors are:* Toilets (e.g. to determine what percentage of people wash hands after

toilet use, e.g. at public toilets where washing facilities are available)

* Water collection points (to determine for instance whether people use clean containers for carrying water, how many people wash themselves at the water point and how many use soap etc.)

Once every three months.

Coordinate with other teams and supervisor.

See paragraph 3.3.2 for explanation of the method. To be executed in about 0.2 to 0.5% of the households with a minimum of 15 (ad random selection; see Box 7.9)




Assist in the training of new hygiene promoters

If needed take new hygiene promoters with you, discuss with them the relations between hygiene and health by asking them questions and explaining things when necessary. Let them observe you and assist you during your work. If they can write, they can make notes of meetings etc.

Whenever asked by team leader, supervisor, manager

Fill in weekly report together with the team at the end of the week

To be able to fill in correctly each hygiene promoter should note down for himself each day the numbers of home visits and focus group discussions done (if things are done with two hygiene promoters then note down as one activity not as two!).

at the end of every week

See Form 7.1.

///remark with regard to handwashing after toilet use observations: very often there are no hand washing facilities by public latrines and certainly no soap (will then probably be stolen). another possibility is to observe at private latrines, only then longer observation times are needed and much less numbers of people will be observed to go in and out the latrine, therefore probably more latrines will have to be observed. Possible problems: 1) if people see the observer they may start to act differently as they usually do (washing their hands while normally they don’t do that), 2) it may be difficult to observe whether people wash hands if the latrine is a bot far from the shelter and/or if people wash their hands inside so that it is difficult to see whether they really wash their hands. Some field trials definitely are needed for this//////////////


Form 7.1 Example of report form to be filled in each week by each hygiene promotion team. (for non-emergencies)

Country:______________ Date:______________ Camp:_________________

Name of team:_____________ Camp part under team’s responsibility:_________

Number of hygiene promoters (including team leader)Did all hygiene promoters work all the work days (if not, explain who and why)Total number of working days by the team (including team leader)How many households were visited for short discussionsHow many focus group discussions were held with how many people all togetherDescribe other activities under-taken and the results (e.g. other promotion methods, structured observations done, trainings followed or trainings given, etc.)Formulate the main problems encountered with regard to hygiene promotion or related subjects

Formulate the main problems the people are experiencing in general, including the priorities of the people with regard to these problems (thus not necessarily hygiene or sanitation problems)

Formulate your ideas about how the hygiene promotion program could be improved


Box 7.1 Example of a method for the selection of hygiene promoters by the beneficiaries themselves

Minimum time needed: two days.

1. Contact the beneficiaries and ask them to come in a meeting to talk about selecting a hygiene promoter among them.

2. Ask people what they think the work of a hygiene promoter will be (stimulate people to talk about different hygiene problems in the community, about the need for hygiene promotion etc.)

3. Let people discuss among them what the criteria should be of a person who will work as a hygiene promoter (usually criteria should come up as: the person should be respected and trusted in the community, should be chosen from within the community, should be communicative, able to understand and explain hygiene issues, etc.). Make sure that during the discussion also attention is given to the fact that many hygiene issues are more important for women. Ask for instance ‘Who are mostly involved in fetching water?’, ‘Who take care of cleaning the house?’, ‘Who clean the baby’s bottoms and cleans the ground where they have defecated?’, etc. Then ask people what they think about a man or a woman being a hygiene promoter (does not necessarily have to lead to a conclusion that hygiene promoters should be women, but stimulates people to think about this

4. Invite persons who are interested to work as a hygiene promoter to put themselves forward as a candidate (hopefully the discussion has encouraged at least some women to put themselves forward as a candidate: the facilitator can stimulate this by proposing if necessary that at least a few of the candidates should be women).

5. Make an appointment with the people for a next meeting which will be to choose the hygiene promoter (preferably the next day) and ask people to stimulate as many people as possible from the concerned area to turn up.

6. In the next meeting the facilitator should repeat the criteria brought forward by the people in the last meeting concerning the kind of person they would like to choose as a hygiene promoter.

7. The candidates should step forward and present themselves shortly to the people, explaining why they feel they are suitable as a hygiene promoter.

8. The people are asked to stand behind the person of their choice.

9. After some time, when everybody has made their choice, the numbers of persons behind each candidate should be counted. The winner is the candidate with most persons behind him or her.

10. In case two candidates have the same number of persons behind them, people should do the same exercise again with only the remaining candidates until one candidate is chosen.


Box 7.2 The principles of KAPKAP stands for Knowledge, Attitude, Practice

These three words indicate the process that should theoretically lead to good behavior. The idea is that first people should know about the background and needs of the behavior. Then they will have to become convinced about the advantages of the behavior and become motivated to really practice it. Then, if they are motivated to practice the behavior, they should also be able, i.e. have the time and resources (access to facilities needed for the behavior etc.), to practice it. In this box we will show the importance and in the same time the complexity of the KAP principle.

KnowledgeFirst, if people don’t know about the backgrounds and need for a certain behavior (why is it important), they will not practice it. So, if people don’t know, the first thing to work on is to provide them with this knowledge (e.g. to let them discuss the issue with others and let them find out together the why of certain things, and, if necessary, explaining to them additional knowledge; see further paragraph 3.3.4.2 about ‘focus group discussions’). For instance, if people don’t know that bacteria that come on the hands after cleaning one’s bottom can transmit disease to them and others, people will have to obtain knowledge first of all about what diseases are, how such diseases can be transmitted and how this can be prevented.

However, it is important to know exactly what knowledge is lacking and how people use the new knowledge within their existing framework of knowledge, perceptions and habits. People will not so easily change this framework as it is usually based on a mix of habits, perceptions and beliefs (some of which are centuries old), and on their own practical experiences, all very much related often to the social, cultural and religious values and pressures in their societies. A few examples to further clarify this:

A woman living in a town in Burkina Faso was observed to take away the excreta from her child who had defecated in the yard of the house. She carefully washed the bottom of the child and after that her own hands with water and soap. But she threw the excreta of the child in a corner of the yard covering it with sand. Earlier she had participated in a meeting on excreta disposal and had picked out of it that hand washing and washing the child after contact with excreta is important. But she believed that this was all related to getting rid of the bad smells of the excreta which she thought was the main danger for health (which in her society was a common belief). In that sense the hygiene behavior message fitted well in her framework of habits and beliefs. She didn't know (wasn't told, didn't pick it up from the meeting, or simply rejected it because it didn't fit in her framework) that excreta are also dangerous when they are laying somewhere even if covered with sand and that it is not the smells of the excreta that is dangerous but the bacteria in the excreta.

Another issue was that in her society diarrhea was regarded as a symptom in 8 different types of diseases. But diarrhea was usually not regarded a disease itself. The common perception was that the 8 diseases all had different causes. Only one disease was actually considered to be diarrhea caused by dirt, feces and bacteria and to be treated by 'going tot he hospital'. It was called 'the white man's diarrhea'. The other diseases had, according to the people, other causes and needed to be prevented in other ways and cured with often traditional kinds of treatment.

The diarrheas perceived to be caused by breaking social rules (e.g. one type of diarrhea was said to be caused by breast feeding after having sexual relations or breast feeding while pregnant) or even sorcery (less common though) were believed to be much more serious and worrying than those caused by incorrect food, cold and dirt, feces and bacteria (thus also the white man's diarrhea). The diarrheas perceived to be caused by breaking social rules or sorcery were usually treated by local healers (because people believed that a doctor would be unable to diagnose the true cause). The local healers used local plants and other items and accompanied their treatments often by calls to supernatural forces through the use of amulets, ceremonies, incantations and prayer. The attitude of people was pragmatic though. If treatment through a healer didn't cure the disease they would go to the doctor and vice versa.

The example shows that people use the knowledge of the causes of diarrhea and fit it in their framework of Chapter 7 : Hygiene promotion

p. 160

existing perceptions. They have added one disease (the white man's diarrhea) to the list of diseases with diarrhea symptoms. But it has not changed their perception with regard to the other diseases with diarrhea symptoms and the ways they try to prevent and treat these. It was found that the above described concepts of illness did not differ in different social, ethnic or economic groups: a group of mainly professional women categorized diarrhea in exactly the same way as did women from the most traditional part of the town.

AttitudeSecond, people should become motivated to improve their behavior. Knowledge often is not enough and, as we have seen above, knowledge is used by people in their existing framework of habits, perceptions and beliefs and because of that may not automatically lead to a motivation for changing their behaviors. Here also arises the question to what extent their practices need to be adapted. They often relate to centuries of local experience and may be optimal to some extent for the situation they live in. These things should first be assessed carefully. Possibly a combination of existing and new behaviors may comprise the best result and additionally have the advantage to fit better in people's existing frameworks and therefore be more easily accepted.

Another important aspect with regard to attitude is that people may be more receptive to arguments that fit to what they find important or what is regarded as an important social or cultural value in their society than the scientific arguments usually brought forward. For example, the nice smell of soap may be a stronger argument for people to use it than the argument of hygiene. In such a case it is more logical to emphasize the nice smell of soap than the scientific arguments in the hygiene promotion campaign.

Even if people really understand things well and interpret them in the right way it does not automatically mean that they will develop the motivation to change their behavior. For instance most people know that smoking is bad for their health, still they do it. People simply often do not like to change, especially if this means that they have to put energy into something or have to refrain from something they like (as with smoking). Related to this is that people may know but underestimate or undervalue the danger of not behaving in accordance with the knowledge. People may not believe or not want to believe that the results can be as dangerous/bad as the knowledge tries to let them believe, especially if the cause-effect relation is indirect or difficult to see clearly/immediately. If people don’t wash hands after toilet use for instance, because they don’t believe it makes a big difference, hygiene promoters could show health statistics showing how high the incidence of diarrhea is and explain what the incidence should normally be. They could also provide evidence that improved behavior does make a difference for instance by showing health statistics from other camps where people have improved their hygiene behaviors.

Another problem is that people often change their behavior only periodically, e.g. shortly after an intensive hygiene promotion campaign, but after some time fall back again in the old behavior. They know and were motivated but not enough to ensure sustained improved behavior.

PracticeThirdly, people should also be able to practice the behavior. For instance, if people are motivated to wash their hands after toilet use but don’t have soap, they will not be able to do it. Telling people that they have to wash hands with soap then doesn’t make sense. Only promote behaviors that people, in their situation, are able to practice! With regard to handwashing, if soap is not available, one could think of promoting handwashing with ashes, or, alternatively start to distribute soap to the people. If the aim is that people will continue to practice the improved hygiene behavior after returning home it makes sense to focus on those behaviors that people can really practice back home. This could also be an argument for not providing certain facilities to people as they will not have such facilities back home either. However, in camps people are often more vulnerable and living in more crowded conditions and therefore more stringent hygiene behaviors (and thus also the facilities to practice those behaviors) are needed than what people would normally need at home.

The need for good information


The above shows that it is extremely important to have good information about what exactly the problems are with regard to hygiene behavior. What knowledge is lacking? What are the current hygiene behaviors and what are the perceptions, beliefs, cultural, religious and social values and pressures that cause these behaviors? What do people do with new knowledge? What existing values could be built on by the hygiene promotion program to promote better behaviors? And what arguments would motivate people most to improve their behavior? Also the question of the resources people need to practice improved behaviors, or, the other way around, how behaviors can be improved within the context of existing possibilities needs to be answered. So.a lot of detailed information is needed to understand all the interactions of KAP and be able to design a hygiene promotion program that is optimally effective in promoting improved hygiene behaviors, i.e. using the messages and hygiene promotion methods that most optimally lead to improved behavior. It is also clear that there must be an interaction of trial and error in order to develop the most optimal program. This means that during program execution there must also be a well functioning system of information gathering with respect to the effects of the program and the ideas of people of how things can be improved and an interaction between the program and the information coming available. So both for the initial development of the program and the further optimalization afterwards good information systems are needed.

Some remarks about different information gathering methodsPractice has shown that interviews can give quick insight in things but that people often answer to questions as to what they think the interviewer would like to hear or what they personally believe to be ideal but do not bring into practice always (for different reasons). The same goes for group discussions. On the other hand continuous observations of people's behavior may lead to people behaving differently during the time they are being observed from what they usually do.

The best thing is to try to avoid these disadvantages as much as possible. For instance in interviews and meetings the quality of the answers depends often much on the quality of the questions asked and how they are asked and by who. Also the follow-up on questions is important, i.e. for instance asking for further details, asking related questions etc. in order to check whether the answers are genuine and to get more information about certain subjects (see further paragraph 3.3.4.2 on focus group discussions)

During the execution of continuous observations the observer should speak with the people observed as little as possible and sit in an inconspicuous corner. Also one can do follow-up observations etc. See also the task description for hygiene promoters (non-emergencies) and paragraph 3.3.2.

Another method is to talk to key resource persons which, depending on the persons, the trust and respect relations with them and the way of questioning, may give information of differing quality. A first resource group is of course the hygiene promoters, especially if they are members of the target population themselves. However, also the hygiene promoters may answer as to what they think you want to hear instead of giving detailed information about the actual behaviors of people. They may also lack knowledge but be afraid to admit so or interpret knowledge in their framework of beliefs and perceptions. They may also lack awareness with regard to the things they actually promote. A good example of this: when I went for lunch in a camp in Rwanda in 1995 with some of the hygiene promoters, none of them washed their hands before eating (which was an important message of the hygiene promotion program we executed in the camp) despite the fact that there was water and soap in the little restaurant!

Important is to realize that none of the information gathering methods is perfect and that often a combination of the different information gathering methods will yield the most comprehensive package of information. Hereby it is very important to assure the quality of information gathering. The people involved should be properly trained and supervised!


Box 7.3 Hygiene behaviors which are often promoted in camps

* Defecate in toilet facilities, not in the open.* Construct a pit latrine yourself.* Keep the toilet clean* Wash hands after going to the toilet with water and soap (or ashes if no soap is available)* Place back the lid on the hole after using the toilet (in case of a simple pit latrine)* Throw the child’s feces in the latrine and clean the place where the child has defecated, wash

the child’s bottom after it has defecated and then wash your own hands (washing with water and soap or ashes)

* Wash your hands (soap/ashes) before starting food preparation* Wash your hands (soap/ashes) before eating* Wash food (with water), peel fruits* Don’t drink from contaminated sources* Keep the yard and the house clean* Wash clothes and bedding regularly and dry in the sun* Wash yourself and your children every day with water and soap (or ashes)* Dig solid waste pits and use them properly (add ashes and/or cover with some sand each day)* Use improved cooking stoves* Improve drainage around your hut* Keep water in the house in closed and clean containers, close the water containers each time

after use* Never touch the water with your hands; pour it from the container straight into a cup or take it

with a clean cup and pour it in another cup* Collect water in clean containers. make sure not to make the container dirty during transport or

taking the water from the water collection point

A hygiene promotion program needs to examine the potential risk factors for diseases and pick out those which carry the greatest risk of disease transmission. Hand-washing with soap after stool contact, safe stool disposal and drinking clean water (i.e. use clean water sources and ensure that water is not contaminated during transport and storage in the household) are likely to be primary candidates for hygiene promotion! Hygiene promotion should only target a small number of practices (say 3 or 4) that are likely to be major causes of disease!

Box 7.4 A few examples of a hygiene promotion talk

//to be worked on still///


Box 7.5 A few examples of focus group discussions about hygiene subjects

////still to be worked on////

When preparing focus group discussions about hygiene topics the first thing one should do is to ask key persons and (other) hygiene promoters what they think about the knowledge, awareness and practices of the people with regard to those topics. Then develop an initial list of questions and messages and the methods to be used (e.g. using a blackboard to explain things, showing objects, doing practical exercises, asking questions). To test out whether the meeting as developed will indeed bring about a discussion and lead to better understanding of the subjects organize a few try-out meetings first with groups of beneficiaries and then evaluate afterwards how the sessions could be improved. Such an evaluation can be done together with other hygiene promoters and preferably also together with the beneficiaries (for instance directly after a meeting). In this way each time one learns more about what people know, are ware of and practice and based on this knowledge one can adapt questions, tools, and methods used. It may even be necessary to adapt the approach. Group meetings about certain behaviors are not always the best way to facilitate people in discussing and becoming aware about them. For instance,. when it concerns behaviors people are shy about it may not be the best method to discuss such behaviors in groups. Through the discussion the beneficiaries will improve their knowledge on the subject and become aware while it provides in the same time information to the hygiene promoter about what people do know and to what extent there is a problem with knowledge, awareness or practicing of the behavior.

This way of working will increase motivation and understanding of the methodology among the hygiene promoters, give them the ongoing opportunity to improve their skills as facilitators in such discussions, and with all that lead to more successful group discussions.

Below follow a few examples of focus group discussions and some lists of questions one could use in focus group discussions. One should keep in mind though that questions should always link to each and to the things answered and discussed by the people.

///An example of a discussion with the aim to raise awareness about handwashing after using the toilet

Facilitator: welcome to this meeting. Most of you already know me but I will introduce myself for those who don’t ….….…So let’s start the meeting with a first question.

What would be the use of handwashing after going to the toilet?

…….//////

Questions with regard to storage and use of water in the householdWhere do you collect your water? (drinking, washing, cooking, watering gardens)What do you think of the water? (taste, quality, distance, color)Who collects the water?What do they collect in it?


Do you transfer water to another container for storage?What do you store your drinking water in?Where do you do your clothes washing?What do you wash your clothes with?

///the above questions are too abstract: give an example of a discussion in which it becomes clear how the facilitator anticipates on the things said by the participants and adapts the questions to that etc.///////

Latrine use//////

Box 7.6 Discussing things with individuals: a few hints

Some hints are given here on how to discuss with individuals during household visits:* Come as a single person* Explain that you prefer to talk to one person (often the mother of the family) only. Try to avoid

that others will answer for them. It is best if you talk to the person only without others being around (although this can not always be avoided)

* Don’t write things down, just remember things of which you have the feeling they are important.

* Keep thinking about why you are there: to stimulate the person you talk with in a positive way to look at how they are behaving with regard to hygiene issues. It must be a positive and stimulating conversation with a lot of laughing if possible and about which people afterwards feel happy.

* Explain why you are there and that is all very informal* If people are shy try to make them feel more comfortable* Don’t upset people by telling them that their behavior is wrong, but ask questions to find out

why they are behaving like that in such a way that people do not get upset (examples: talk in the third person, e.g. don’t say ‘why don’t you do that’ or ‘you do that wrong’, but ask ‘why do people do that?’; don’t say ‘you do this wrong’, but ask ‘are there also other ways of doing this?’ and/or ‘have you ever tried to do it so and so?’).

Etc. //to be worked on further////


Box 7.7 Household survey

A household survey is an investigation in a number of households. It comprises questions posed to household members and spot check observations in and just around the households (see paragraph 3.3.2 for an explanation of ‘spot check observations’ ).

A household survey should be executed in a representative part of the households; we recommend 0.3% of all households with a minimum of 20, well spread over the camp. Household surveys should be executed with regular intervals in non-emergency situations (we recommend once every three to six months).

The survey provides quantitative information about how things are done or happen in the households with respect to drinking water, sanitation and hygiene behavior aspects. The information has an absolute value in itself but can also be used to detect trends in comparison to earlier household surveys executed.

The aim of a household survey is to verify whether objectives set by the program with regard to household topics are realized and learn about how things can be improved. The households to be visited should be ad randomly selected (for methods to select huts ad randomly see Box 7.9).

A household survey should preferably be developed, executed and the results analyzed by/with the involved staff and camp inhabitants. This can be realized as follows:

1. Hygiene promoters, manager and supervisor come together in a meeting

2. The supervisor (or manager) explains what the idea of the survey is

3. The hygiene promoters divide themselves in small groups. Each group discusses and puts on paper which subjects should to their opinion be included in the survey. They describe what information is needed about these subjects and how this information can best be obtained. If they want the hygiene promoters can already formulate the questions and observations they would like to include.

4. Everybody comes together in plenary

5. Each group presents their results

6. In plenary the outcome of the different groups is discussed and together it is decided which subjects will be included in the survey and how information will be obtained on them

7. In plenary the questions and observations to be done are worked out in further detail

8. The household survey is tested by a number of the hygiene promoters in a small number of households

9. The results are discussed in plenary and the survey adapted accordingly

10. Hygiene promoters execute the household survey


Box 7.7 Household survey (continued)

The role of the manager and the involved senior staff in this process is to act as facilitators. This means giving advise when asked for, providing additional information when needed or asked for and especially, asking the right questions at the right time. Asking questions is the best way to provide information or make people become aware of something. Good questions stimulate people to come forward with their own knowledge and to think things over (again). With for instance questions such as ‘Why do you think this is important?’, ‘Will this give us good information about... ?‘, etc you can make people realize that they have not yet covered a subject completely

During the development of the household survey the manager and senior staff should also check whether all important subjects are included (use for instance the behaviors listed in Box 7.3 and the subjects listed at the end of this box as checklists). If certain subjects are not brought forward by anybody they should ask the hygiene promoters during the plenary session about these subjects (ask for instance: ‘What about this and this subject? Do you think it is important in this camp?’). Make sure that all subjects and methodologies (e.g. on how to do the observations) are discussed and try to get a feeling whether everybody agrees and is happy with the final result. Make sure that especially the women among the staff have participated actively in the discussions and the decisions about what will be included and how the survey will be done.

A problem is that often too many questions and observations are formulated. Too many questions and observations will make the analysis of the results very complicated and time consuming. It is therefore an important task of the manager and supervisors to ensure that only very crucial questions and observations are included and that they are formulated crystal clear.

The whole exercise may take a few days of work for the hygiene promoters and about one day for the field manager. The manager does not have to be present all the time during the discussions. He should be there a few times during the exercise and at the end to check whether the survey is comprehensive and ask questions/give comments in case he believes things can still be further worked out. It is worth to invest his amount of time. It will yield a good household survey that can be used as a basis for the household surveys to be carried out every three to six months.

Each time before a next household survey is executed it will need to be adapted in order to fit better to the possibly changed circumstances and be further improved. It is however definitely worth the effort to already put in the effort initially to develop a household survey of a high quality. The reason is twofold:

1. The result will be that also the first household surveys will give such good results that the information obtained is really useful.

2. If the survey is of good quality it means that in the future adaptations can probably remain limited (unless of course the circumstances really change). This will spare time in the future, but more important, because the surveys will be almost the same, it will be better possible to compare the results of the different household surveys with each other (which makes them more suitable for evaluation purposes).

The people who have carried out the survey should preferably also analyze the results together with the manager and senior staff.



The advantages of the development process for household surveys as described above are:

1. staff and possibly also involved camp inhabitants will get very motivated and will improve their own skills and knowledge,

2. very good and important quantitative and qualitative information will be obtained (useful as information source for the management of the programs and as baseline information for evaluation purposes) without the need for the manager to put a lot of time and effort in it,

3. the process secures that the survey will fit to the circumstances (but be careful to leave out subjects when people think they are not important)

Although more difficult to realize, program staff can carry out the survey together with people from the communities in the camp. These could be for instance women groups, community committees or a committees selected by the different communities in the camp for this purpose. Involving the camp inhabitants will increase motivation, sense of involvement and especially also trust in the program among the beneficiaries. It will also contribute to better and more detailed information about the situation and problems in each part of the camp. The exercise itself will also increase knowledge among the beneficiaries executing the household surveys and stimulate to more motivation and discussion among these and other beneficiaries and further stimulate them to actually bring the new knowledge and insights into practice.

Don’t forget however that the aim of the household surveys is to get information. Don’t compromise on that in order to favor optimal participation by beneficiaries!

The people involved in the execution of the surveys should be literate if they are to write things down, but the survey can also be organized in such a way that no writing is needed (see further on).

The hygiene promoters may need to be trained with regard to posing questions. They should for instance only pose questions that can not be answered with ‘yes’ or ‘no’. For instance ask: ‘Which insects form a problem in your house?’, or, even better, ‘Could you mention me the two problems which hamper you most?’ But don’t ask ‘Are mosquitoes a problem in your hut?’ because on the last type of question people will probably answer what they think you want to hear and/or give an impression that it is more serious then it really is.

When the results of a household survey are obtained and analyzed it is extremely important to feed back the results to the beneficiaries and discuss with them what can and/or should be done to solve the problems found. Divide between what the program can do and what can be done by the people themselves! Then make plans together and implement the actions agreed on. This feed-back to and planning with the people can be realized through the normal discussions hygiene promoters have each day with the people in their areas or by special meetings organized to discuss the results.



Subjects that could be covered by household surveys:

* how and for which purposes water is used in households and how much is used for each purpose,

* where households obtain their water (source types, specific locations, distances),

* water quality in the household (free residual chlorine/fecal coliform),

* how water is transported (transport means, volume of container) to the household,

* how water is stored in the household,

* how much storage capacity households have,

* whether storage containers are covered/closed

* how household members get water out of the storage containers (do they get it out hygienically; although this subject is more suitable for continuous observations done in households),

* how much water carrying capacity households have,

* which water uses people find most important,

* whether households further treat the water themselves,

* how they get rid of their solid waste,

* whether they have a latrine and how they use it (identify, observe if possible, differences between men, women and children),

* how cleaning of the latrines is organized (who does it, how often),

* how, how often and where people clean themselves and their laundry,

* whether people wash their hands after going to the toilet/before eating food and what they use to wash with,

* whether they clean their hut and its immediate surroundings sufficiently,

* whether and how they clean up feces of children hygienically,

* whether they are aware of disease causing factors,

* which diseases they suffer(ed) from (who) now/recently,

* whether people recently died in the household (how many died, causes, age, sex, etc.) and how they were buried (were they officially registered; how?),

* whether the hut has good and poor general cleanliness in and outside,

* numbers of under and over fives in the household with poor (dirty/bad quality) and good (clean/good quality) clothing,

* good or bad cooking practices (cooking inside hut with a lot of smoke) and good or poor cooking stoves (how much wood do they use?)

* ……

// include:* a part about how to analyze the results of a household survey* a part on how household surveys can be executed by people who can't read and write ///////


Box 7.8 participative mapping

A good way of assessing a situation with beneficiaries and/or planning actions with them is by asking camp inhabitants to draw a map of their area. They can draw the map on paper or in the sand on the ground. They can indicate with different symbols, which they can also give different magnitudes if they want, the existing structures and roads, the locations, type and extent of the certain problems they face etc. The map should best be drawn after discussions are held and observations done by/with the inhabitants of the area. Program staff should support this exercise by giving explanation about the use of the map, and writing down the problems which people give the highest priority. It is best to draw the map on paper so that a copy can be made of it as important source of information. The good thing, beside the important information obtained through it, is that map drawing is usually conceived as a very stimulating exercise by all who are involved in it.

Let staff/camp inhabitants draw a map in which they indicate the locations with problems, using different symbols for the different problems and their severity. (see ‘Waterlines, vol. 15, no. 1, July 1996, p. 21-22). The magnitude can partly be assessed by using more or less objective scoring mechanisms, but can be subjectively be determined by the staff or camp inhabitants as well where they have to decide together in which locations the problems are largest compared to other locations. They should also be asked to indicate which problems should get more attention. More detailed assessments can then, if necessary, be developed together with the staff and/or with an expert if you feel you don’t have enough expertise yourself (e.g. when vector problems are observed or suspected), to get better information about the magnitude, locations and causes of those problems to enable you to develop the most effective and efficient measures to solve these problems.

Important here is that first discussions are held. In such discussions usually many problems come forward that are not directly water and sanitation related. These should be noted down as well, but do not necessarily have to be included in the map. Some advantages of this method:people don’t have to be literatepeople can do it themselves, including drawing of the map, making up the symbols etc.the magnitude of a problem does not need to be expressed in definite terms, but will give a good indication anyway in relative terms, making clearly visible the differences in magnitude of the problems at the different locations.it gives a very clear and quick overview of all problems discovered in the area.it can easily be included in the reports to the head office giving a clear illustration of the problems that can also easily be understood by someone who is not informed completely about all the details of the program and the circumstances in the area.if used with the community in an area people can directly draw the map usually without having to do a real survey as they are usually very familiar with the problems in their area. It will also reflect the priorities of these people as they will probably tend to overemphasize the problems related to these priorities in comparison to other problems. Based on the map a discussion with the community can be organized to further prioritize the needs and finding ways of solving the problems in a combined program/community effort (ask people to indicate the numbers 1, 2 and 3 of severe problems in their area). Be careful not to promise things or raise expectations that can not be fulfilled, especially if problems are brought forward that do not have anything to do with water and/or sanitation issues (see also paragraph ....). Prepare your staff for this.


An example of a map:

figure with map and symbols etc. of a part of the camp.

For his own interpretation and for reporting to higher levels, program staff and manager can draw an overview map of the whole camp, based on the maps drawn by the communities in the different parts of the camp and other observations. A check will then be needed however to compare the relative severity of problems as identified by the communities in the different parts. This can be done by executing additional camp walks by the manager together with program staff. An example of a map as described here is given in Appendix .... (the above participative map formed one part of it; notice the changes made)

Box 7.9 Selecting households ad randomly

Ad randomly means without any influence by the one who is selecting. Two ad random selection methods are described here:the pencil method,the transect method

Pencil methodStand in the middle of a number of huts. Rotate a pencil on a flat surface (e.g. a piece of carton); the hut standing nearest to where the pencil point directs, once it has come to a stand still, is the selected hut. It is important to use an ad random method for visiting households during surveys or observations because, often without knowing it, the people doing the work may tend to choose for a certain type of hut, for instance the biggest ones, when they would select the huts themselves. This is not preferable because it could influence the outcome of the survey (e.g. in big huts probably richer people live with other habits and problems than the people living in small huts).

Transect methodWalk a certain route through the area and select every 4th or 5th hut along the route.


7.3Team leader///////////////////// still to be worked out from here onwards

Tools/materials needed per team leader:

Number of team leaders needed:One per 8 to 12 hygiene promoters (non-emergencies). In emergencies one works with hygiene promoters only if the structure of hygiene teams has not yet been established. There is contact between all hygiene promoters and the program manager (several times) every day in such situations.

Tasks:* Inform the hygiene promoters about all programs of importance with regard to hygiene

messages and how the beneficiaries can participate in, feedback to and influence those programs.

* Provide training to the hygiene promoters where and when needed, especially about how to communicate and have discussions with the beneficiaries (individuals and groups) and the principles of KAP (see Box 7.2).

* Each morning go with one of the hygiene promoters and observe the work he does, both discussions with individuals and with groups, and give feedback. Pay particular attention to the following points: 1) were all subjects that were meant to be discussed really discussed, 2) did the participants really increase their knowledge and awareness with respect to the subjects discussed, 3) what were the good things and what can be further improved.

* Organize a household survey once every three to six months (together with the manager) (only for non-emergencies). Work out the results together with a representation of the hygiene promoters (and the manager). Afterwards inform all hygiene promoters, together with the representing hygiene promoters, about the results of the survey in a general presentation to all hygiene promoters followed by a discussion with them (all in the local language). Draw conclusions together, put them on paper and make sure that these are followed up. The manager can be present in the meeting as an observer, not as a participant. Also the supervisor should be there mainly as an observer, may be only now and then asking a question to stimulate the others to think about certain things. Make a separate report about the household survey and the meeting(s) with the hygiene promoters together with the program manager. See further Box 7.7.

* Organize the counting of households every two (emergencies) to six (non-emergencies) weeks. Each person involved in the counting should get a certain part of the camp. The supervisor should crosscheck a few of the countings by counting the huts in a few parts himself and compare with the results of the persons who counted there. He should also ask in about 30 to 50 households (chosen from all over the camp without any preference; this can also be done by asking 30 to 50 people who walk at one of the market places in the camp) with how many people they are, write the numbers down and afterwards sum them up and divide the total by the number of households/persons questioned. This gives the average number of persons per household.

* Make sure that at the end of each day all hygiene promoters pass by to give you information about their work that day. Register each day who has worked, the number of households visited, the number of group meetings held and other activities executed.

* Organize together with the hygiene promoters structured continuous observation every ... to ... weeks. Call hygiene promoters together after first round of observations to discuss the results and problems encountered; the same after the second round. Prepare proposals for adaptations of the observation format and instruction list and bring in plenary with other


teams plus supervisor and manager when there is a plenary meeting. Visit hygiene promoters during the observations if believed necessary.

* Fill in the weekly report and discuss things with the manager.

///Box 7.10 about theatre: how to help hygiene promoters to prepare theatre, important features etc. (see the informal India documentation of IRC) and other hygiene promotion methods: radio programs, puppet plays, posters (see Helping Health Workers Learn)/////

////Box about planning and set-up of a hygiene promotion program based on the results of a KAP survey////


Form 7.2 Example of report form to be filled in each week by the team leaders of the hygiene teams together1

Country:_____________________ Date:_____________________________

Camp:_________________

Total number of group meetings heldTotal number of households visitedTotal number of hygiene promoters who workedTotal number of hours worked by all hygiene promoters togetherOther activities executed (describe shortly)Specific problems encountered (specify per team and/or per area in the camp)

Remark: In emergencies it may be extremely important to convey certain very basic hygiene messages and ensure that people change their behavior. In case of a (potential) cholera epidemic, for instance, it is important to warn people that they should not drink from the infected sources. Information is then needed to know whether such messages have been passed on and whether people really change their behavior as a result (i.e. in this case no longer drink from the infected water sources). Although during an emergency it may not be possible to obtain information about the contribution of health messages to the actual change in people's behavior, it may still be possible to measure several functionality indicators, such as the number of staff hours spent conveying the messages. This gives an indication about the extent to which the messages have been spread (this is also in line with the Minimum Evaluation Procedure; see Appendices 4 and 7). As none of the guidelines received from the participants contained any hygiene behavior indicators this is seen as an indication that the knowledge and experience with respect to this subject is still very limited. It is therefore believed that thorough investigations will be needed to determine: 1) whether it is possible and useful in emergency situations to measure certain hygiene behavior indicators, 2) which indicators should be measured for which camp situations, and 3) how they should be measured.

Give examples of numbers of hygiene promoters employed for different situations (per unit of population).

1 The form is meant for use in non-emergencies. Use the back of the form or add other papers for the explanations if there is not enough space. Try to answer brief and to the point.


8. Reporting formats

8.1IntroductionThis Chapter consists of an overview of subjects recommended for inclusion in different kinds of reports. Most of the information needed on the subjects included in the different report types proposed will have to come from the monitoring system. However, informal and ad-hoc or one off observations could and should also provide important information in all the reports./////////////Some comments on monthly reports:A distinction should be made between monthly reports that cover a number of water and/or sanitation programmes and monthly reports that cover different kinds of programmes (e.g. nutritional, curative health etc.). The distinction to be made is not so much in the subjects that should be included but how detailed the descriptions should be.

Some comments on periodic reports:A periodic report is written by programme field staff (usually the programme manager or coordinator), usually at regular intervals, for instance every three or six months or at any time when it is felt necessary. Also for these reports a distinction should be made between the reports covering a number of water and/or sanitation programmes and the reports that cover different kinds of programmes (e.g. nutritional, curative health etc.). The distinction to be made is not so much in the subjects that should be included but how detailed the descriptions should be./////////////////////////////////////////

8.2Weekly reportMain objective of the report: overview for programme management which can be used for daily programme management, information to head-office; information source for reports covering larger periods of time.Report produced by: programme manager(s)Subjects to be included:

1. Indicate: report type ('weekly report'), programme sort (e.g. "Drinking water programme", Water and Sanitation Programme(s)"), period over which reported, name(s) of programme area(s), author(s) of the report, date of finalization of report.

2. For each programme discuss progress and problems/constraints of the activities in relation to the programme planning (assess whether activities planned for that week have all been properly executed and explain why if not; pay special attention to indicator values measured during that week which differ a lot from the weeks before or which are not according to the quality standards set; also if indicators have not been measured according to the programme planning, explain why).

3. In cases of significant changes/problems in other organizations and/or their programmes which are in some way important for the programme(s) covered by the report, give a short explanation of these changes or problems and how they do or may influence the programme(s) covered by the report.

4. Describe other (potential) problems or issues important for the programme(s) reported on (e.g. security, (potential) problems with water and/or sanitation related subjects for which no programme activities exist, (potential) influx of new arrivals).

5. Describe all (unforeseen) activities carried out which are not standard (unofficial activities).

Chapter 8 : Reporting formatsp. 175

6. Activities planned for the following week.7. Miscellaneous.

8.3Monthly reportMain objective of the report: overview for programme management which can be used for daily management purposes; information to head-office; in some cases information to the donors; information source for reports covering larger periods of time.Report produced by: leader/coordinator of management team (programme managers responsible for delivery of the data/information needed).Subjects to be included:

1. Indicate: report type ('monthly report'), programme sort (e.g. "Drinking Water Programme(s)", "Water and Sanitation Programme(s)", "WatSan aspects of the Primary Health Care Programme", "WatSan, Nutritional and Curative health Programme") period over which reported, name(s) of programme area(s), author(s) of the report, date of finalization of report.

2. Executive summary.3. Short description of the history of the programme(s) reported on, including a broad outline of

the original strategies and planning, the changes made in the planning so far (and the reasons for them), and the current main objectives and time frame of the programme(s).

4. General description of the environmental health situation in the programme area(s).5. For each programme discuss progress and problems/constraints of the activities in relation to

the programme planning. Include an overview of all the indicators measured during that month, preferably in graphs against time also containing the results of former months, so that a comparison with those months is easy. Assess whether the programme results are according to the objectives and time frame planned. If activities have not been carried out or indicators have not been measured according to the programme planning, explain why.

6. Discuss progress, results, and problems of and coordination with other organizations/programmes as far as they are relevant/important for the programme(s) reported on.


8. Describe important (unforeseen) activities carried out which are not standard for the programme (unofficial activities).

9. Activities and changes planned/proposed for the following month.10. Miscellaneous.

8.4Periodic report (usually every 3 or 6 months)Main objective of the report: decision tool for programme management and head-office, providing an overview of the programme(s) results which can be used to assess whether course(s) of programme(s) should be changed, new activities included or old ones excluded; information and accountability to head office; in some cases accountability to donors; information source for reports covering longer periods of time and/or for external evaluation reports.Report produced by: leader/coordinator of management team and/or programme manager(s) (programme managers and accountant responsible for delivery of the data/information needed).Subjects to be included:

1. Indicate: report type (e.g. 'three monthly report'), programme sort (e.g. "Drinking Water Programme(s)", "Water and Sanitation Programme(s)", "WatSan aspects of the Primary Health Care Programme", "WatSan, Nutritional and Curative health Programmes") period over which reported, name(s) of programme area(s), author(s) of the report, date of finalization of report.


2. Executive summary.3. Description of the history of the emergency.4. General description of the programme(s) reported on, including an explanation of the original

strategies and planning, the changes made in the planning so far (and the reasons for that), and the current programme planning (a detailed overview of objectives, activities, time frame, indicators, resources needed for execution and assumptions made should be put in an Annex, preferably in the form of a Logical Framework).

5. General description of the activities of other programmes/organizations in the programme area(s).


the programme planning (give overview of all indicators measured during the period covered by the report, preferably in graphs against time that also contain the results of previous periods, to enable comparison with those periods, and assess (give textual explanation) whether the programme results are according to the objectives and time frame planned; if activities have not been carried out or indicators have not been measured according to the programme planning, explain why).

8. Describe important (unforeseen) activities carried out during the period covered by the report which are not standard for the programme (unofficial activities).

9. Discuss progress, results, and problems of and coordination with other programmes/organizations; put main emphasis on major problems and aspects relevant/important for the programme(s) reported on.

10. Assess for each programme area the combined impact of the activities of all programmes and organizations in that area and the specific contribution of the programme(s) covered by the report to that.

11. Describe other (potential) problems or issues important for the programme(s) reported upon (e.g. security, (potential) problems with water and/or sanitation related subjects for which no programme activities exist, (potential) influx of new arrivals).

12. Conclusions and recommendations. Include: lessons learnt, additional assessments or evaluations proposed, proposal and argumentation for adapted programme planning, if thought necessary, explaining the proposed changes in objectives, activities, time frame, indicators and resources (include a proposed new Logical Framework in an Annex when considerable changes are proposed).

13. Financial overview and analysis (Questions: should this not be done in a separate report covering all finances from field to head-office level, and if included in this report, which finances should be included / which not?).

14. Maps of the area(s), organigram(s) of the programme(s), job descriptions, monitoring forms used, description of educational material used, designs of facilities and textual explanation.

15. Bibliography with literature used and recommended.16. Miscellaneous.


8.5External evaluation report (executed in ongoing programmes when needed or at standard intervals)Main objective of the report: external control if everything is done as claimed, decision tool for programme management and head-office, providing an overview of the programme(s) results which can be used to assess whether course(s) of programme(s) should be changed, new activities included or old ones excluded; lessons to be learnt for future programmes and organizations' procedures, structures etc.; usually also used for accountability to donors.Report produced by: mission with people from head-office and/or the donor agency or agents temporarily employed by them for that specific mission (head-office staff, national staff, programme managers, leader/coordinator of management team, and accountants responsible for cooperation and delivery of data/information needed).Subjects to be included:

1. Indicate: report type ('External evaluation report'), programme sort (e.g. "Drinking Water Programme(s)", "Water and Sanitation Programme(s)", "WatSan aspects of the Primary Health Care Programme", "WatSan, Nutritional and Curative health Programme") period over which reported, name(s) of programme area(s), author(s) of the report, date of finalization of the report.

2. Executive summary.3. Description of the methodology, work schedule/ToR and purpose of the evaluation (can be

put in an Annex).4. Description of the history of the emergency.5. General description of the programme(s) reported on, including an explanation of the original

strategies and planning, the changes made in the planning so far (and the reasons for that), and the current programme planning (a detailed overview of objectives, activities, time frame, indicators, resources needed for execution and assumptions made should be put in an Annex, preferably in the form of a Logical Framework).



the programme planning (give overview of all indicators measured during the period covered by the report, preferably in graphs against time that also contain the results of previous periods to enable comparison with those periods, and assess (give textual explanation) whether the programme results are according to the objectives and time frame planned; if activities have not been carried out or if indicators have not been measured according to the programme planning, explain why).

9. Describe the contingency capacity and contingency plans (how much of which equipment is available and where; how much time is needed to mobilize equipment and human resources and get them in place).

10. Describe important (unforeseen) activities carried out during the period covered by the report which are not standard for the programme (unofficial activities).

11. Discuss progress, results, and problems of and coordination with other programmes/organizations; put main emphasis on major problems and aspects relevant/important for the programme(s) reported upon.

12. Assess for each programme area the combined impact of the activities of all programmes and organizations in that area and the specific contribution of the programme(s) covered by the report to that.

13. Describe other (potential) problems or issues important for the programme(s) reported upon (e.g. security, (potential) problems with water and/or sanitation related subjects for which no programme activities exist, (potential) influx of new arrivals).

14. Describe how programme staff measure the indicators and how their monitoring performance is controlled.

15. Explain security plans and describe whether they are adequate, how they could/should be improved.


16. Conclusions and recommendations. Include: lessons learnt with emphasis on application for the programme(s) evaluated (if relevant), future programmes, and the structures and procedures of the implementing agency; for ongoing programmes: description of and argumentation for additional assessments or evaluations believed to be necessary, proposal(s) and argumentation for adapted programme planning, if thought necessary, explaining the proposed changes in objectives, activities, time frame, indicators and resources (include a proposed new Logical Framework in an Annex if large changes are proposed).

17. Complete financial overview and analysis of programme(s) finances from field to head-office level according to the head-office's and/or donor's requirements.

18. Maps of the area(s), orginogram(s) of the programme(s), job descriptions, monitoring forms used, description of educational material used, designs of facilities and textual explanation.


8.6Handover and/or end of mission report for programmes which are not yet finishedMain objective of the report: information source for following manager, information to head-office.Report produced by: programme manager.Remark: this report should be as detailed as possible to facilitate the take-over by the succeeding manager and should preferably be finished (and be given to and discussed with the succeeding manager) before the manager leaves the area.Subjects to be included:

1. Indicate: report type ('Hand over report' or 'End of mission report'), programme sort (e.g. "Drinking Water Programme(s)", "Water and Sanitation Programme(s)") period over which reported, name(s) of programme area(s), author(s) of the report, date of finalization of the report.

2. Executive summary.3. Description of the history of the emergency4. Description of the programme(s) reported on, explanation of the original planning, the

changes made in the planning so far (with the reasons for that), and the current programme planning (a detailed overview of objectives, activities, time frame, indicators, resources available and assumptions made should be put in an Annex, preferably in the form of a Logical Framework).


the programme planning (give overview of all indicators measured during the whole programme, preferably in graphs against time, and assess, giving textual explanation, whether the programme results are according to the objectives and time frame planned; if activities have not been carried out or indicators have not been measured according to the programme planning; explain why).

7. Describe large (unforeseen) activities carried out during the period covered by the report which are not standard for the programme (unofficial activities) and explain to what extent they can be expected in the future.

8. Discuss progress, results, and problems of and coordination with other programmes/organizations; put main emphasis on major problems and aspects relevant/important to the programme(s) reported on.

9. Assess for each programme area the combined impact of the activities of all programmes and organizations in that area together and the specific contribution of the programme(s) covered by the report to that.



11. Conclusions and recommendations. Include: lessons learnt, description of and argumentation for additional assessments or evaluations believed to be necessary, proposal(s) and argumentation for adapted programme planning, if believed necessary, explaining the proposed changes in objectives, activities, time frame, indicators and resources (include a proposed new Logical Framework in an Annex if large changes are proposed).

12. Remarks about finances, book-keeping, administration (how is it organized, what has gone wrong in the past, how much budget is available for the various activities/purposes, etc.).

13. Maps of the area(s), organigram(s) of the programme(s), job descriptions, monitoring forms used and explanation of how and when indicators should be measured if not yet explained elsewhere (or referral to manual in which this is described), description of educational material used, designs of facilities and textual explanation.



8.7Final external evaluation report at the end of a programme or cluster of programmesMain objective of the report: accountability to the head-office and donor(s); external control to check whether everything has been done as claimed; lessons to be learnt for future programmes and organizations' procedures, structures etc.Report produced by: mission with people from head-office and/or the donor agency or agents temporarily employed by them for that specific mission (head-office staff, national staff, programme managers, leader/coordinator of management team, and accountants responsible for cooperation and delivery of data/information needed when they are still in place at the time of the evaluation).Subjects to be included:

1. Indicate: report type ('External final evaluation report'), programme sort (e.g. "Drinking Water Programme(s)", "Water and Sanitation Programme(s)", "WatSan aspects of the Primary Health Care Programme", "WatSan, Nutritional and Curative health Programme"), period over which reported, name(s) of programme area(s), author(s) of the report, date of finalization of the report.

2. Executive summary.3. Description of the methodology, work schedule/ToR and purpose of the evaluation (can be

put in an Annex).4. Description of the history of the emergency.5. General description of the programme(s) reported on, including an explanation of the original

strategies and planning, the changes made in the planning during the course of the programme(s) and the reasons for that (an overview of the final formulation of objectives, activities, time frame, indicators, resources needed for execution and assumptions made should be put in an Annex, preferably in the form of a Logical Framework).


8. For each programme discuss how the activities developed in relation to the programme planning (give overview of all indicators measured during the programme, preferably in graphs against time, and assess, giving textual explanation, whether the programme results are according to the planned objectives and time frame; if activities have not been carried out or indicators have not been measured according to the programme planning, explain why).

9. Discuss progress, results, and problems of and coordination with other programmes/organizations with main emphasis on major problems and aspects relevant/important to the programme(s) reported on.

10. Assess for each programme area the combined impact of the activities of all programmes and organizations in that area together and the specific contribution of the programme(s) covered by the report to that.

11. Describe other problems or issues which were important for the programme(s) reported on (e.g. security, problems with water and/or sanitation related subjects for which no programme activities exist, influxes of new arrivals).

12. Complete financial overview and analysis of programme(s) finances from field to head-office level according to the head-office's and/or donor's requirements.

13. Conclusions and recommendations. Answer to questions such as: has the programme achieved its objectives as was planned (assess for this purpose as much as possible the effectiveness, efficiency, relevance, impact and sustainability), was the contingency capacity sufficient throughout the programme, what are the lessons that can be learnt for future programmes and for improvement of the structures and procedures of the implementing agency.

14. Maps of the area(s) and organigram(s) of the programme(s).15. Bibliography with literature used and recommended.16. Miscellaneous


8.7.1.1.1.1 Examples of a water points map, water point sheet and water point table

WATER POINT TABLE

Water point table for ......... water system (describe which water system)Total number of water points: .....Number of water points investigated: ....

Water point

Group and its numbers

Water point(describe) Water point (describe) Water point(describe)

Estimated total water abstraction from whole system (based on the observations in the investigated water points)

Camp population (fill in: total number of people)

fill in the amount of water used by the use group of this row from the water point of this column

fill in estimated total amount of water obtained by the use group of this row

Other population groups (fill in: estimated total number of people)Health centres (fill in:1) total numbers of out patients, and 2) total number of in-patients, of all health centres together)Feeding centres (fill in: total number of patients of all centres together)


Cholera treatment centres (fill in: total number of patients of all centres together)Cattle (fill in total number of animals)Donkeys, mules, horses (fill in total number of animals)Sheep, goats (fill in total number of animals)Camels (fill in total number of large animals)Irrigation (fill in total irrigated surface)Others (explain)

Totalfill in total amount of water obtained from the water point of this column

fill in total amount of water obtained from the water point of this column

fill in total amount of water obtained from the water point of this column

fill in estimated total amount of water obtained from all water points of his system, based on the observations in the investigated water points.

Assess whether the amounts available to the different use groups are in accordance with the water quantity requirements of these groups!


2 DIFFERENT WATER POINT SHEET FOR WATER POINT SURVEY

Sheet 1: numbers of people and livestock countedCamp:Name of water point:Name of water system:Date:

put a stripe for each person or animal taking water from the water point Totals6 - 8 8 - 10 10 - 12 12 - 2 2 - 4 4 - 6 6 - 8

Number of people counted taking water from the water point during the two busiest hours of the dayNumber of cattle counted drinking water from the water point during the two busiest hours of the dayNumber of donkeys, mules and horses counted drinking water from the water point during the two busiest hours of the dayNumber of sheep and


goats counted drinking water from the water point during the two busiest hours of the day

Number of camels counted drinking water directly from the water point during the two busiest hours of the day

Estimated amount of water abstracted from the water point for irrigation, clinics, small industrial activities or other purposes (desribe)

Sheet 2:Name of water point:

Explanation: ask as many people as possible who have obtained water from the water point how much water they have


obtained, for what they are going to use the waterGroup number (one

stripe for each person interviewed)

amount of water obtained (fill in amount for each person interviewed)

purpose for which water is used (one stripe for each purpose)

household for livestock

other

Camp inhabitants

Other people


8.7.1.1.1.2 Environmental hygiene survey

Short explanation. A survey, executed with regular intervals, combining structured and formal observations and discussions about the camp environment. The survey should preferrably be developed, executed and the results analysed by/with the involved staff and camp inhabitants. The actions necessary to solve the problems should be determined and executed as much as possible by the people themselves as well with support from the sanitation or any other programme in the camp where necessary.

An example of how an environmental survey can be developed and executed.

////Beschrijf onderstaande in de vorm van een case study!!///////

In a session with the involved programme staff (for instance hygienists or community health workers) the manager (or better, one of the leading staff who has prepared this session with the manager) explains what the idea of an environmental survey is and discusses (mainly by posing questions) why and how this can/should be done with large inputs from the camp inhabitants themselves (ask the staff why they think this is better; checklist: creation of knowledge and awareness with regard to environmental hygiene issues and motivation to detect their own environmental hygiene problems and also to solve them). After this plenary discussion a short introduction is given about the different methodologies that can be used to obtain information about environmental hygiene issues together with the people (checklist: questionnaires, group mapping, observations, etc.).

The staff are then asked to divide themselves in small groups and put on paper which subjects should to their opinion be included in the survey, what information is needed about these subjects and how this information can best be obtained. Then discuss in plenary the outcome of the different groups and decide all together in discussion how the final survey should be (i.e. which subjects will be included, how it will be executed etc.). Use the checklist of subjects in paragraph 3.2 and the methodologies for obtaining information as described above to discuss later in plenary what should be included in the survey and how the information should be obtained. If subjects on the checklist have not been brought forward then ask the staff during the plenary session whether these should not be included as well. Make sure that all subjects and methodologies are discussed and try to really get a feeling if everybody agrees and is happy with the final result. Make sure that especially the women among the staff have participated actively in the discussions and the decisions about what will be included and how the survey will be done.

The manager’s role in this process is to be a facilitator: give advise when asked for, give additional information if asked for (by asking questions like ‘why do you think this is important’, ‘do you think this will give us good information about... ‘, etc you can make people realize that they have not yet covered a subject completely and, if


they feel it is needed, ask you for information or advise). Make sure that at least all the above subjects are discussed and that decisions are made about whether and how they are going to be included in the survey.

A next phase is to test the survey and finalize it. This can be done in a view of the areas in the camp where the programme staff works with the people, executing the survey together with them following the designed set-up. After this in another plenary session the survey set-up can be adapted to the experiences obtained and finalized. This set-up can then be used as a basis for the environmental hygiene surveys that will be carried out with regular intervals.

The people who have carried out the survey should preferrably also work out the results and make conclusions themselves. The survey should be adapted/improved whenever felt necessary. The advantages of this process are:1)staff and involved camp inhabitants will get very motivated and will improve their own skills and knowledge, 2) you will get very important information without having to put a lot of time and effort in it yourself, 3) the process secures that the survey will fit to the circumstances (but be careful to leave out subjects when people think they are not important). Programme staff can carry out the survey together with the communities in the camp (for instance women groups, community committees or a committee selected by the community for this purpose). Involving the camp inhabitants will increase their motivation and sense of involvement and especially also their trust in the programme and will contribute to better and more detailed information about the situation and problems in each part of the camp. The people involved in the execution of the survey should be literate if they are to write things down, but the survey can also be organized in such a way that no writing is needed (see further on). Train the people formulating the questions that the questions should be open (e.g. which insects form a problem in your house, could you mention me the two problems which hamper you most) and not closed (e.g. are mosquitoes a problem in your hut) because on the last type of questions people will always answer what they think you want to hear and/or give an impression that it is more serious then it really is.

When the results of a survey in an area are obtained and analysed by and with the people it is extremely important to decide with the people what to do to solve the problems and make plans together with them and divide tasks between the programme and the people! The programme should then follow-up on these plans and make sure it carries out what it has agreed on.

How the results of the environmental survey can be documented.A very good way of documenting the results is by asking camp inhabitants to draw a map of their area in which they indicate with different symbols, which they can also give different magnitudes if they want, the locations, type and extent of the environmental hygiene problems. The map should be drawn after both discussions are held and observations done by/together with the inhabitants of the area. Programme staff should support this exercise by giving explanation about the use of the map, by making a list of the problems with the highest priority


Important here is that first discussions are held. In such discussions usually many problems come forward that are not directly water and sanitation related. These should be noted down as well, but do not necessarily have to be included in the map. Some advantages of this method: people don’t have to be literate people can do it themselves, including drawing of the map, making up the symbols

etc. the magnitude of a problem does not need to be expressed in definite terms, but

will give a good indication anyway in relative terms, making clearly visible the differences in magnitude of the problems at the different locations.

it gives a very clear and quick overview of all problems discovered in the area. it can easily be included in the reports to the head office giving a clear illustration

of the problems which can also easily be understood by someone who is not informed completely about all the details of the programme and the circumstances in the area.

if used with the community in an area people can directly draw the map usually without having to do a real survey as they are usually very familiar with the problems in their area. It will also reflect the priorities of these people as they will probably tend to overemphasize the problems related to these priorities in comparison to other problems. Based on the map a discussion with the community can be organized to further prioritize the needs and finding ways of solving the problems in a combined programme/community effort (ask people to indicate the numbers 1, 2 and 3 of severe problems in their area). Be careful not to promise things or raise expectations that can not be fulfilled, especially if problems are brought forward that do not have anything to do with water and/or sanitation issues (see also paragraph ....). Prepare your staff for this.

An example of a map:

figure with map and symbols etc. of a part of the camp.

For his own interpretation and for reporting to higher levels programme staff and the manager can draw an overview map of the whole camp, based on the maps drawn by the communities in the different parts of the camp. A check will then be needed however to compare the realtive severeness of problems as identified by the communities in the different parts. This can be done by executing additional camp walks by the manager together with programme staff. An example of such a map is given in Appendix .... (the above map formed one part of it; notice the changes made).


Let staff/camp inhabitants draw a map in which they indicate the locations with problems, using different symbols for the different problems and their severeness. (see ‘Waterlines, vol. 15, no. 1, July 1996, p. 21-22). The magnitude can partly be assessed by using more or less objective scoring mechanisms, but can be subjectively be determined by the staff or camp inhabitants as well where they have to decide together in which locations the problems are largest compared to other locations. They should also be asked to indicate which problems should get more attention. More detailed assessments can then, if necessary, be developed together with the staff and/or with an expert if you feel you don’t have enough expertise yourself (e.g. when vector problems are observed or suspected), to get better information about the magnitude, locations and causes of those problems to enable you to develop the most effective and efficient measures to solve these problems.


8.7.1.1.1.3 household survey

Household survey: a survey about the practises and behaviours of camp inhabitants related to water and sanitation in the households, combining questions and observations. It can be developed as described for the environmental hygiene survey but usually concentrates on issues related to the households12. During the survey only a part of the households is visited. They are usually ad randomly selected, for instance with the pencil-method. Appendix ... contains a more detailed description of how a household survey can be developed, executed and analysed.

Rotate a pencil on a flat surface (e.g. a piece of carton); the hut standing nearest to where the pencil point directs, once it has come to a stand still, is the selected hut. It is important to do this because, often without knowing it, people would tend to choose for a certain type of hut, for instance the biggest ones, when they would select themselves. This could influence the outcome of the survey (e.g. in big huts probably richer people live with other habits and problems than the people living in small huts). /////Preferrably the issues should be discussed with the female head of the household and the observations made in an informal way without writing down things; afterwards the answers and observations can be worked out on paper. Formal filling in of questionnaires and observation lists can scare people and take away their motivation to tell everything. In practise however this is often too much of a hazzle for the staff/camp inhabitants involved in the execution of the survey.

12 in a household survey for instance the following additional information can be determined: how and for which purposes is the water used in the households and how much is used for each purpose, where do households obtain their water, water quality in the household, how is water is transported (transport means, volume of container) and stored to/in the household, which water uses do they find most important, do households further treat the water themselves, how do households get rid of their solid waste, do they have a latrine and how do they use it (identify differences between men, women ad children; also observe if possible), which household members are practising open defecation (also observe!), how is cleaning of the latrines organized, how, how often and where do people clean themselves and their laundry, do people wash their hands after going to the toilet/before eating food, do they clean their hut and its immediate surroundings sufficiently, do they clean up faeces of children hygienically, are they aware of disease causing factors, which diseases did they suffer of (who) recently, did people recently die in the household, their opinions about the facilities present in the camp and how they can be improved, which needs they feel are not fulfilled, numbers of huts with good and poor general cleanliness in and outside, numbers of under and over fives with poor (dirty/bad quality) and good (clean/good quality) clothing, numbers of households that cover their water pots and their food properly, numbers of households with bad cooking practises (cooking inside hut with a lot of smoke), numbers of households with good and poor cooking stoves ......


Annex 1 Mosquito surveys

A 1.1 Initial mosquito survey

An initial mosquito survey needs to be executed in case no mosquito control program exists yet while there are indications that there is/could be a (potential) mosquito problem. Such indications could for instance have been obtained through initial analysis of health data, informal and unstructured information gathering, camp walks, environmental hygiene surveys, meetings, or household surveys (see Chapter 3).

Actions needed

1. list the locations where mosquitoes have been observed or are suspected.2. find out which type(s) and quantities of mosquitoes are present.3. complete the flow diagram to analyze the problems and determine the actions

required.

Action 1 : list the locations where mosquitoes and their larvae have been observed or are suspected.

A first idea of the locations with mosquitoes or their larvae can be obtained by further analyzing health data (looking for instance at the health statistics per health post, or listing the home locations of the malaria patients in the camp if these were registered), through informal and unstructured information gathering, or a camp walk specifically to detect the locations of mosquitoes and larvae. The locations should be plotted on a map of the camp (especially useful when mosquitoes are restricted to specific isolated locations). Such a map is very useful to verify later on whether the mosquito problems have extended to other areas as well, and for purposes such as reporting, communicating the problem with others and so on (don’t forget to put a date on the map). It is of course also possible that the mosquitoes and/or larvae are spread equally over the whole camp.

Simultaneously one should discuss the problems with curative health staff and ask them to take further action from their side, such as: identification of malaria through microscopic diagnoses, improvement of malaria diagnosis in the health posts, and so on. Don’t wait for the results however if health statistics are worrysome.


Action 2 : find out which type(s) and numbers of mosquitoes are present.

Execute the following methods according to their descriptions in paragraph A8.2: first observe at several locations the adult mosquitoes resting at surfaces and determine with

Figure A8.1 of which mosquito type they are (execute according to paragraph A8.2, method 1), then, to further verify,

catch larvae in a few glass pots at a few locations where larvae have been found or are suspected and determine with Figure A8.1 of which mosquito type they are (execute according to paragraph A8.2, method 5), and then

identify mosquito species, and determine their numbers as described in paragraph A8.2, method 2.

Action 3 : complete the flow diagram to analyze the problems and determine the actions required //here only a first draft chart has been included//.


A 1.2 Methods to identify mosquitoes and/or determine their numbers

The methods are:1. Observing adult mosquitoes resting at surfaces2. spraying and collecting adult mosquitoes3. body trapping of adult mosquitoes4. light trapping of adult mosquitoes5. simple catching and identification of mosquito larvae6. more accurate catching and identification of mosquito larvae

Method 1 : observing adult mosquitoes resting at surfaces

Find places where adult mosquitoes rest at a surface and determine with Figure A8.1 whether they are Anopheles or Culicines. If this is to be done by staff, make sure they are well trained for this purpose and their work well controlled. Make sure to observe mosquitoes at different locations as some species may stay more outside and others more inside dwellings, buildings etc.

Method 2 : spraying and collecting adult mosquitoes

To estimate the number of adult mosquitoes and their rate of aggressiveness against humans, mosquitoes at rest inside dwellings can be collected after spraying with synthetic pyrethroids.

Equipment needed: white sheets or light-colored plastic sheets pyrethroid insecticide dissolved in water at the required concentration hand operated equipment for residual spraying small containers for storage of the caught mosquitoes tweezers

Collection and analysis procedure: execute the method between 5 and 7 in the morning, before the mosquitoes leave

the dwelling close all openings as well as possible spread the sheets on the floor of each room spray sufficient insecticide in each room well spread over all surfaces taking all

safety pre-cautions into account (see also Chapter ....). wait 10 to 15 minutes; during this time, note the number of persons who slept that

night in each room


remove the sheets from each room, taking care that the fallen mosquitoes collect in the middle of the sheets

using tweezers, transfer the mosquitoes to the small storage containers (use one container for each room)

determine and note down per room the types of mosquitoes found (use figure .... for the identification of mosquito types) and their numbers (fill in in the below form).

determine and note down per room and for each mosquito type found the numbers of gorged mosquitoes (having blood in their abdomen; fill in in the below form).

in case there is doubt about the correct identification of the species, and if possible, the collected mosquitoes should be sent to a laboratory for proper species identification.

(source: adapted from UNHCR 1997)

Number of tests needed:The test should be carried out in ////5%//// of all dwellings or facilities that could be invested with mosquitoes in the areas that are under suspicion. To verify if other parts are not infested the test should also be carried out in ////1 to 3 %//// (the lower percentage for the larger camps) of all dwellings and facilities randomly selected and well spread over the camp.

Team organisation:The test can be carried out by a team consisting of one sprayer, 1 team leader and ..... A team can do ... tests per day, considering the fact that one can only work during two hours in the morning. All tests together should be carried out in a time span of maximum ..... subsequent days. Therefore usually several teams will be needed.

The tasks of the team members and others involved:

Sprayer Prepare the rooms (cover with sheets etc.) Spray the walls as described in Box 6.4. Put the mosquitoes in the containers (1 container per room) Monitoring tasks: make sure all mosquitoes fall on the sheets on the floor, control

whether the floor is completely covered, control that all food etc. is out of the room, control whether all openings are well closed before starting to spray. Report to team leader in case of any problems.

Team leader Inform the households on beforehand and explain the purpose of the test (avoid

raising expectations!). Help sprayer with preparations Tell people to stay out of the dwelling during and till half an hour after spraying Monitoring tasks: control the work of the sprayer, control whether all people have

left when spraying starts, determine the type(s) of mosquitoes, their numbers and the numbers with gorged stomachs for each room and fill in in the below form.

The following form can be used per dwelling, facility etc. investigated:


Date:

Location:

Type of dwelling/facility:

Mosquito type

Indicator

Anopheles

Culicines Other types (describe)

Total numbers

Total number of mosquitoes caught (fill in per room)Number of gorged mosquitoes caught (fill in per room)

Analysis of the results found:

If in more than ....% of the dwellings or facilities investigated the total number of one type of mosquitoes exceeds .... or if ......., then the mosquito infestation rate is regarded as high.

If ........ then the mosquito infestation rate is regarded as low.

If on average ....% of the mosquitoes found are gorged or in ...% of all rooms, dwellings, facilities investigated at least ... gorged mosquitoes were found then ....

etc.

Method 3 : body trapping of adult mosquitoes

Method 4 : light trapping of adult mosquitoes

Method 5 : simple catching and identification of mosquito larvae


This method is used only for the purpose of identifying the species of mosquitoes present in the camp.

Procedure:1. Take a clean glass pot (white glass so that you can easily look from the side into

the water in the pot). 2. Use the pot to scoop water out of the source where you expect the larvae to be. In

wide bodies of water the larvae will usually be mainly along the edges. Larvae of the Anopheles are usually only in reasonably unpolluted water such as swamps, still water and containers. Larvae of the Culicines sort may be found both in clean and in organically polluted waters. Make notes of the locations and types of the waters (polluted? Large pond, container?) in which you found the larvae (describe which larvae types you found in which waters) as this may be useful information for more accurate identification of the mosquito species and the design of a control program later on.

3. Look from the side into the pot and identify what larvae species are in it (use figure .... for this purpose).

Organization:The test can be executed by any staff or by the manager himself. The manager should control though that staff execute the identification of the species correctly.

Method 6 : more accurate catching and identification of mosquito larvae

If there is a need (for instance in case of doubt about the identification of the mosquito larvae as done with method 4 or if it is suspected that there are other species than Anopheles and Culicines as well) and if there is also a possibility to send the larvae to a laboratory for more accurate identification of the species the following procedure can be followed:

Equipment needed: a fine sieve with a long handle a light-colored basin a large diameter pipette bottles containing 70% ethyl alcohol or 4% formol

Larval sampling procedure: filter the collected water through the sieve pour the collected material into the basin containing clear water use the pipette to transfer the larvae to the bottles containing 70% ethyl alcohol or

4% formol send the collected specimens to the laboratory for species identification.


Figure : Identification of mosquitoes

//////Put here: the figure of Appendix 3 at page 116 of ‘Disease prevention through vector control; OXFAM Practical Health Guide No. 10’//////


Annex 2 An example of a monthly report

The report seems on first sight quite labour intensive to set up. This is true, but once it has been properly done the first time the same structure can be followed each month which will only take a marginal amount of time. For instance the ‘background’ section will only need to be changed on a few small things each month (the reason to include this section each time is to give the reader who is not familiar with the specific circumstances and who has read no other reports a reasonable overview; it is also useful for readers who are familiar with the programme but who have to deal with many other programmes as well, e.g. support staff at the head-office, that it is good for them to have a small section in each report to fresh up their knowledge of the programme). The ‘programme developments and problems’ section will each month largely contain the same elements and only the details per element will need to be changed each time. To a certain extent the same can be said for the other sections. The numbers in the margins in the below example report refer to the overview of subjects recommended for inclusion in monthly reports in paragraph ….

Monthly report of the environmental health programme in Kibeho camp

Date : 31-03-95 (week 13)Author : Tom de VeerProgramme parts : family latrines, public latrines, hygiene education,

vector control in latrines, solid waste, road drainage, camp lay-out

Country : Rwanda

SummaryThis month (March 1995) the camp population grew from 85.000 to 105.000 mainly due to closure of other camps and some incidents in a number of nearby villages. In Kibeho there were no security problems. The current number of family pit latrines is 1.800 (about 55 persons per latrine), which is more than was aimed at last month but which is still too low because of the high influx of new people in the camp. An environmental survey was executed by the hygienists (group discussions with the people, observations and map drawing by the people indicating and prioritizing their problems; see summary map).The general environmental hygiene situation is alright and open defecation is virtually non-existent. People would like to have public kitchens. Problems of the highest priority as indicated by the people: lack of sheeting for the huts, insufficient pots for cooking, difficulty to find wood for cooking. Solid waste is no problem in the households and neither at public places. Morbidity and mortality are low and still going down. Hygiene behaviour seems OK, although no good information is available and handwashing still seems to be a problem issue. Problems seem to exist as well with stealing of tools and soap. The subjects that need attention: latrine coverage, road drainage, effectiveness of spraying latrines, effectiveness of hygiene education, vector problems in the households, new hygienists in areas with new arrivals, stealing by staff. Activities planned for next month: motivation of especially new arrivals to build a latrine


(aim: 45 persons per latrine by the end of next month), develop and execute a household survey covering hygiene behaviour aspects and insect problems in the huts, facilitate selection of 5 hygienists by new arrivals, improve drainage along 400 m of road and at 2 important road crossings, and build 2 more culverts, set-up a monitoring system for the effectiveness of spraying latrines, increase slab production, solve problems of stealing by improving the administrative and control structures, look into problems prioritized by the people.

BackgroundAfter the genocide in 1994 many Hutu’s crossed the border to neighbouring countries, but about 300.000 fled to the by French and later UN military protected zone in the Gikongoro and Butare region. Kibeho developed as the largest of 9 camps in this area. It is divided in 5 parts: Uwarurayi, Mpunge, Gakoma-Viro, Kibeho-site, and Nyarushishi. Several of the other camps have now been closed and more and more people are settling in Kibeho. Up to date the area has been relatively calm. UN military have a permanent basis in the camp. The area is hilly, with sandy clay soils, two rainy seasons, rivers in the valleys. Access is by dirt roads which are in reasonable condition although during the rainy seasons usually heavy trafic becomes more difficult. OXFAM, as one of the agencies active in Kibeho, has been responsible for the water programme since the earliest days together with UNICEF, and took over the environmental health programme from MSF-France in November 1994. The general objective of the environmental health programme is: To secure environmentally hygienic conditions through good toilet and solid waste facilities, hygiene education and a proper camp lay-out.Programme parts and their specific objectives are:Family latrines. IDP’s are motivated by hygienists and sanitation workers to construct their own latrine in ‘sanitation corridors’ between the huts on the hills. Often several families own one latrine. People get a wooden slab when they have dug the hole and some pieces of soap once they have properly finished the latrine (this is controlled by sanitation workers). Objectives: everybody has acces to and makes hygienically use of a pit latrine,1 latrine of good quality (see standard design in the end of duty report of ...) per 25 persons, latrines are kept clean and slab holes are always covered with lids, full latrines are covered with sufficient sand and new latrines are built to replace them.Public latrines. Built at public places, e.g. markets, hospital etc. Objective: at least one well functioning public latrine per public place which is well cleaned and used, no lining up of people.Solid waste. Families are motivated by hygienists to bury solid waste. At markets large holes are dug and solid waste is collected by workers who are paid by the merchants. Objectives: 1 pit/family and all household rubbish burried in it hygienically, sufficient large pits per market and all market rubbish burried in them hygienically. Hygiene education. Provided by hygienists who transmit a number of messages to the people in their area (through group and individual discussions). The hygienists also execute a theatre performance once a week in which the hygiene messages are brought forward in a humorous way, based on the local circumstances (very popular). Objectives: assure appropriate hygiene education leading to a sustained improved hygiene behaviour (also when coming back home).Vector control in latrines. Latrines are sprayed with a 1: .... solution of deltamethrin (original strength: ....) once every ... weeks. The effectiveness of this activity is


doubtful however as flies are often observed in the latrines again after 2 to 3 days. Objective: ensure that the fly problems in latrines are kept within acceptable limits.Camp lay-out. Sanitation workers prepare sites for hut construction, explain people where they can built their hut and where and how they can construct a latrine (in sanitation corridors). Objectives: no huts in sanitation corridors, proper lay-out of huts and roads, assuring proper accessibility, drainage, prevention of erosion and so on.

Programme developments and problemsEnvironmental hygiene situation: an environmental hygiene survey was developed with/by the hygienists and executed at the different sites of the camp together with the people (issues included: latrines and defecation, solid waste, drainage, quality of huts, vector problems, erosion). Conclusions: open defecation is virtually absent; the road towards Gakoma market and some other sites are severely flooded during rains, endangering quite a number of huts as well and causing severe erosion; in some places diarrhoea was observed; several places have severe shortage of latrines or are of poor quality or have poor hygiene, many huts lack sheeting, insects are a problem in huts and latrines. Despite these problems, for large part observed in Kibeho-site where there are many new arrivals, the overall environmental hygiene situation is alright (see also the summary map further on).Morbidity and mortality: the figures are low (normal figures for these parts of Africa), no problem.Camp population: growing fast due to closure of other camps and unrest in a number of nearby villages. Therefore the numbers of hygienists, latrines, digging tools, soap and wood for slabs are too low.Hygiene education: the theatre performances attracted many people who were all very enthousiastic. The hygienists seem motivated for the work they do in their areas and for the theatre they perform twice a week for audiences of often more than a thousand persons. The effects of hygiene education are not fully known although the hygienists have indicated that washing hands after going to the toilet is still hardly practised despite their efforts to make people aware of the importance of it. It is not known whether the hygiene messages are transmitted effectively, whether the right messages are transmitted, and whether they result in imporved hygiene behaviour.Other programmes: the water programmes seem to have problems which could pos-sibly affect the amount of clean water available to the people in the next coming weeks (see reports of the water programmes). Currently the amount of water is still sufficient.Solid waste: fully under control since at the central market the last hole is dug. The merchants really pay the cleaners while the programme provides tools.Materials and consumables: the amount of soap is insufficient (therefore people should be informed about the possibility to wash hands with ashes). Some staff stated that digging tools and soap were being stolen which was confirmed by a check of the administration.Vector control: there is doubt about the effectiveness of spraying latrines, insects seem to be a problem as well in people’s huts and clothes.Latrines: one public latrine was repaired after being destroyed by a large rain shower. The number of private pit latrines is too low; see also the statistics.


Statistics

Planning for next month

Especially in Kibeho-site, but also in Uwarurayi there are many new arrivals. It is necessary in these areas to increase motivation to build latrines as the current coverage in some of these parts is as low as 1 latrine per 100 persons. Therefore large meetings will be held with the people in these areas to discuss their problems and motivate them to build latrines. An effort will be made to let new arrivals choose a total of 5 new hygienists among themselves. These will be trained and initially accompanied during their work by more experienced hygienists. Latrine slab production will be increased and ICRC will be requested to donate more soap for distribution to those who have finished their latrine. The aim is to have an average coverage by the end of the coming month of 1 latrine per 45 persons. Other activities will include: develop and execute a household survey covering hygiene behaviour aspects and insect problems in the huts, improve drainage along 400 m of road and at 2 important road crossings, and build 2 more culverts, set-up a monitoring system for the effectiveness of spraying latrines, solve problems of stealing by improving the administrative and control structures, assess in more detail what can be done and by who about the problems prioritized by the people and make sure the people get feed-back about this.


Annex 3 Diseases that may be found in camps and which are or may be related to water supply and/or environmental hygiene

Diarrheal diseases (acute watery diarrhea, dysentery, cholera) Fevers (malaria, yellow fever, dengue, relapsing fever, typhus?, etc. etc.) Pneumonial diseases (upper and lower respiratory tract infections): people sick

due to cold and wet circumstances. Can be major disease and mortality cause in camps.

Tuberculosis Eye infections Skin infections (scabies) Hepatitis A Meningitis Measles Worms in feces (causes nuisance and probably makes people, especially children,

weaker. Problem: in camps ‘worms’ is often not diagnosed/taken up in health statistics).

Soil transmitted diseases (roundworm) that enter bare feet esp. in dirty latrines and areas with open defecation. Often not diagnosed/taken up in health statistics in camps though.

///Beef and pork tapeworms. transmitted by ingestion of beef or pork that has not been sufficiently cooked (problem: in camps not diagnosed and thus no info in health statistics). What are the symptoms????///

Schistosomiasis (water based). usually not critical in the short term. Not included here.

A 3.1 Diarrheal diseasesA distinction is usually made between acute watery diarrhea, dysentery and cholera.

Acute watery diarrhea can be caused by different organisms transmitted through polluted water, contaminated food, fecal-oral routes etc. Symptoms: loose or watery stools (usually several per day) resulting in dehydration which can, if the patient is not rehydrated in time, cause death, especially in children. Treatment: is let the patient drink sufficient and, if possible, clean water, preferably with dissolved Oral Rehydration Salts (ORS) to increase the effectiveness of the rehydration.

Dysentery is a diarrhea with visible blood in the stool. It is therefore also often called ‘bloody diarrhea’. The two major types are caused by amoeba and shigella bacils entering the body through contaminated water, food or fecal-oral transmission. The latter type (shigellosis) represents the greater health risk. It is endemic in many poor communities, and can occur in epidemic outbreaks, especially in conditions of overcrowding and bad sanitation. Curative treatment can be done with antibiotics, although resistance of the shigella bacillus against the drugs often develops.


Cholera is a diarrheal disease transmitted through the Cholera Vibrio bacterium transmitted by the fecal-oral route. It can spread extremely quickly. Symptoms are large amounts of very watery stools and vomiting, which, if patients are not quickly rehydrated with water and if possible dissolved ORS, can lead to death due to dehydration within hours. Often there is one or a small number of sources from which the disease is spread. It is the task of the watsan manager to find the sources and causes of cholera and eliminate them. The watsan programme will also often be responsible for buidling cholera centres, providing proper watsan facilities in these centres, including the required disinfection measures, and even the complete management of such centres.

A 3.2 FeversFevers distinguished in camps are usually malaria, yellow fever and dengue. The last two belong to a group of viral caused fevers, the viral haemorrhagic fevers. As proper diagnosis is difficult the diseases are often registered in health posts as ‘Fever of Unknown Origin’ (FUO).

Malaria is transmitted by female Anopheles mosquitoes that bite in the evening or by night and breed in still and unpolluted water. Symptoms are intermittent fever, ..... Proper diagnosis is by microscopic blood film examination. Malaria is most prevalent usually in areas where circumstances are optimal for Anopheles mosquitoes: small pools of clean and still water, humid and hot. Preventive measures: proper siting of the camp, closing water pools, bednets, residual spraying, preventive drugs.

FUO (Fever of Unknown Origin) is a group heading for all diseases diagnosed with fever but of which the origin is not known. In many health centres patients diagnosed with ‘FUO’ are treated as malaria patients while often only a fraction of these patients really has malaria (often only 10 to 35% of all FUO and ‘suspected’ malaria registrations really is malaria).

Viral haemorrhagic fevers are caused by a number of different viruses (see Table ... below), some of which are associated with rodents or mosquitoes. Symptoms: unexplained and unresponsive high fever, especially with bleeding (haemorrhagic) tendency. All VHF are capable of causing severe and fatal disease. They have a high epidemic potential and high case-fatality rates. Some of them, e.g. Ebola and Lassa Fever, are often transmitted in health facilities, for instance because of the re-use of non-sterile needles and inadequate barrier nursing precautions. Yellow fever and Dengue are usually the most frequent diseases. Both diseases can enter into a new area when infected people arrive there and are bitten by Aedes (mainly Aedes aegypti) mosquitoes (who will then start to transmit the disease further). Early detection of VHF is often missed by a routine surveillance system (e.g. because wrongly diagnosed as malaria or FUO; sometimes also resistant malaria can be wrongly diagnosed as Yellow Fever). Therefore it is necessary to have an idea about occurrence of VHF in the area (obtain info from local or regional health authorities). People can also bring the disease with them from outside the camp though. Preventive measures: vaccination, especially against Yellow Fever (to be started immediately after the first case is confirmed), and Rift Valley Fever (usually only provided to


people at high risk, e.g. staff); vector control to prevent transmission of VHF by mosquitoes, rodent or ticks (application of larvicides and spraying shelters to fight Aedes aegypti is often very effective against Yellow Fever), precautions in health facilties, isolation of cases, minimizing the handling of dead bodies, and provision of information to health staff, refugees and others involved, proper soldi waste disposal. The diseases transmitted by Aedes mosquitoes can not be prevented by bednets as these mosquitoes bite during the day!

VHF Distribution Natural host / vector

Lassa Fever

Junin/Machupo

Ebola/Marburg

Crimean-Congo HF

Rift Valley Fever

Dengue HF

Yellow Fever

HF with Renal Syndrome

Central / West Africa

South America

Central / South Africa

Africa / Asia

Africa

Africa/Americas/Pacific/Europe/Australia

Africa / South America

Asia / Europe

rodents (urine)

rodents (urine)

unknown

ticks

mosquitoes

mosquitoes

mosquitoes

rodents (saliva and urine)

Japanese encephalitisCaused by a virus transmitted mainly by Culex mosquitoes. One to two months after the onset of the rainy season is a common time for epidemics to start. Found in east, south-east and south Asia. In endemic areas incidence rates reach 1-10/10.000/year. Mainly affects children.. Every symptomatic case may hide up to 200 non-symptomatic cases. Case fatality rate is high: 25% (elderly up to 60%). Some 30% of cases are left with neurological disorders. Risk in camps in endemic areas is high, especially in rural areas, e.g. near rice fields during mosquitoe breeding time and among non-immune people. Symptoms same as encephalitis. The disease may be expected if 5 to 10 cases of meningo-encephalitis in same neighbourhood esp. in areas of unknown transmission. Prevention: destroying mosquitoe breeding sites by spraying is very effective; also bednets and spraying of shelters; some vaccins can be used (but several vaccinations needed, expensive and having side effects).

Typhus feverCaused by a //bacteria??//, Rickettsiae, transmitted through vectors such a lice, fleas or mites. Symptoms: fever.

Louse-borne typhus exists among louse-infected people. Transmission is enhanced by overcrowding and poor hygiene, especially during the rainy season when


more clothing and blankets are used. Case fatality varies from 10 to 40% and can rise above 50% in the elderly. In high risk areas, new arrivals should be screened for the presence of lice on arrival or in OPD’s. Prevention: delousing campaign and hygienic measures (as described for Relapsing fever).

Murine typhus is caused by fleas hosted by rats. Mostly in urban settings. Usually not a priority in emergencies as mortality is low (case fatality rate < 1%). Prevention: first eliminate fleas, then rats.

Scrub typhus is caused by mites. Endemic in small areas, mainly in Asia (‘typhus islands’). Case fatality is often high (up to 60%), pregnant women abort and die. In camps only a danger if located close to a ‘typhus island’. Prevention: elimination of mites, locating camps far from typhus islands, and if not avoidable, clear vegetation, spray the ground and impregnate clothing and blankets with insecticides.

Relapsing fever

A 3.3 Pneumonial diseases (upper and lower respiratory tract infections)mm

Tuberculosis

Eye infections

A 3.4 Skin infections (scabies)

A 3.5 Hepatitis A and EThese are both viral infections transmitted by feco-oral routes. Symptoms: any accute onset of jaundice by nausea, vomiting or anorexia, with or without fever, and no history of recent treatment with drugs causing jaundice. One should be aware though that often other diseases with similar symptoms (e.g. yellow fever) are misinterpreted, being diagnosed as Hepatitis. People infected with Hepatitis A usually recover without medical aid. Mortality is usually low. Hepatitis E is known to cause high mortality in pregant women but only low mortality in other people. Hepatitis A is often common where sanitation is poor. It mainly occurs at an early age; adults are usually immune. Transmission of the disease is especially enhanced by large concentrations of people with overcrowding, inadequate sanitation and poor water supply. Hepatitis E occurs primarily in areas with inadequate environmental sanitation


and is often associated with poor water supply. Preventive measures mostly involve ensuring an adequate water supply and good sanitation. For Hepatitis A also a vaccination exists which however is usually not used as an outbreak control measure because protection is only obtained 30 days after the first dose, the vaccin is expensive and the disease not severe while curing spontaneously in most cases. For Hepatitis E no vaccine exists.

A 3.6 MeningitisMeningitis is mainly caused by the bacteria meningococcus which is spread through ///contaminated food, through the air and through water????///. Symptoms are fever with bulging fontanel (??) among children under 12 months and sudden onset of fever with stiff neck and/or petechial or purpural rash (??) among older people. The disease can quickly develop into an epidemic. Factors enlarging the risk for an epidemic are overcrowding, poor hygiene and limited access to medical care (vaccinations), all of which are often apparent in camps. People under 30 years of age are most at risk (usually comprising 80% of the victims). The case fatality rate is 70% when no proper treatment is available and 5-15% with proper curative treatment. Routine vaccination is usually not executed because of the huge resources needed. Instead vaccination is usually started if an outbreak is suspected. To detect a potential outbreak at the earliest possible stage therefore medical programs in camps should always take up meningitis surveillance standardly in their routine surveillance system. The disease is defined to be an epidemic if there are 15 cases/100.000 persons/week during 2 consecutive weeks (for camps > 30.000 persons but not for extremely large camps as a low overall attack rate may obscure high rates within smaller population groups) or 2 consecutive doublings of meningitis cases from one week to the next over a three week period (for camps < 30.000 persons). In camps next to an epidemic area or in urban settlements 5 cases/100.000 persons/week is used. ///Measures that should be taken to prevent a meningitis epidemic are: spreading of population, improvement of hygiene and hygiene behaviour, and vaccinations if the potential for meningitis is believed to be high.////

A 3.7 Measles


Annex 4 Recommended minimum standards

Water quantitySubject Emergency Non-emergency

general Water quantity is more important than water quality Water availability must be: (water needed for people, including personal needs, health centres,

feeding centres etc. + water needed for livestock + if possible other water uses) x 110%. Give account to increases in population and livestock numbers in the near future (coming weeks to months). Assure sufficient clean water for people, esp. for drinking


person 3-5 l/person/day . 3 min cold wheather, 5 min hot wheather 10-20 l/person/day, depending on water availability, water use culture, climate etc.

health centre/hospital out-patients

5 l/patient/day 5 l/patient/day

health centre/hospital in-patients

40-60 l/patient/day 40-60 l/patient/day

cholera centre in-patients 60 l/patient/day 60 l/patient/dayFeeding centre therapeutic feeding

? 30 l/patient/day

Feeding centre supplemetary feeding

? 15 l/patient/day

Surgery/maternity 100 l/patient/day 100 l/patient/dayKitchen in health facility 10 l/patient/day 10 l/patient/dayFamily latrines none 2-8 l/cubicle/day for cleaning latrine ?

1-2 l/user/day for handwashing ?Defecation field none 1-2 l/user/day for handwashing ?Communal trench latrines none 2-8 l/cubicle/day for cleaning ?

2-8 l/m of trench/day for cleaning latirne ?1-2 l/user/day for handwashing ?

pour-flush latrine (1-4 l/flush)

don’t apply in emergencies, especially not when water is scarce and/or difficult to obtain 2-8 l/user/day

conventional flush (10-20 l/flush)

don’t apply in emergencies, especially not when water is scarce and/or difficult to obtain 20-50 l/user/day

Schools none 10-15 l/cubicle/day for cleaning the latrine1-2 l/user/day for handwashing


+ personal demands ?Mosques none 5 l/person/day ?Other communal units none 5 l/person/day ?Offices none 5 l/person/day ?Aid staff 30 l/person/day 80 l/person/daycattle 20-40 l/head/day ?? 20-40 l/head/day ?donkeys, mules, horses 10-40 l/head/day ?? 10-40 l/head/day ?Pigs ?Chicken 20 l/100 chicken/day?sheep, goats 1-5 l/head/day ?? 1-5 l/head/day?camels 40-90 l/head/day ?? 40-90 l/head/day ?irrigation In an emergency usually not a priority , especially if water is scarce. Therefore only apply if drinking

water requirements are covered and sufficient water is available for irrigation . If irrigation possible: 3-9 mm/day or 0.3 to 1 l/sec./ha, depending on climate, crop type and soil type.

3-6 mm/day or 0.3 to 1.0 l/sec./ha

Water quality Subject emergency non-emergencyNeed for disinfection



Faecal coliformexpressed in FC (= thermotolerant coliform = E.coli)

Chlorinated water: no need to measure faecal coliforms if a sufficient residual free chlorine level is available

Not chlorinated (or otherwise disinfected water) or chlorinated water with a too low residual free chlorine level: < 1000 FC/100 ml both in households and at watercollection points (for drinking water for people). No restrictions for water used by livestock, water for laundry, personal cleanliness, washing dishes, and household cleaning

Chlorinated water: no need to measure faecal coliforms if a sufficient residual free chlorine level is available

Not chlorinated (or otherwise disinfected water) or chlorinated water with a too low residual free chlorine level: < 10 FC/100 ml (for drinking water for people). No restrictions for water used by livestock, and to some extent for water for washing/bathing ????.

Conductivity < 4000 uS/cm ?? < 1400 uS/cm ??Odour no restrictions must be acceptable to the usersColour no restrictions must be acceptable to the userspH 6<pH<9.5 (if disinfection is needed pH should preferrrably be lower than 8.5) 6<pH<8 if coagulation with aluminium sulphate is needed.

< 8 if disinfection is neededTurbidity < 20 NTU

If turbidity > 20 NTU pre-treatment is required, i.e. eliminating suspended matter before chlorination

< 5 NTU< 1 NTU if disinfection is done/needed

Residual free chlorine

Beginning of chain (just after chlorination): high enough (measure after contact time of 30 min.) to assure a residual free chlorine level at the water points of 0,3-0,6 mg/l (if this turns out to be more than 1,0 mg/l check for contamination entering in the system’s chain after chlorination).


In the households: 0,2-0,5 mg/l just after collection from water point.

Beginning of chain (just after chlorination): high enough (measure after contact time of 30 min.) to assure a residual free chlorine level at the water points of 0,3-0,6 mg/l (if this turns out to be more than 1,0 mg/l check for contamination entering in the system’s chain after chlorination).


In the households: 0,2-0,5 mg/l just after collection from water point.

Other parameters Only monitor other parameters which have been found to be a (potential) problem and use the Only monitor other parameters which have been found to be a (potential) problem and use the maximum values as


maximum values as indicated in House and Reed 1997, p. 172-173 indicated in House and Reed 1997, p. 172-173

Water Literature sourceaccessibility Davis

and Lambert1995

MSF-F 1997 MSF-H 1995

ACF 95-96

Adams 97 Proposal

walking distance /time to/from water point

not more than 150 m

care should be taken that water points are installed at a reasonable distance from shelters for sfaety reasons (minimum of 30 m)

average collection time less than 15 to 30 ?? minutes per 10 lmaximum distance from a water point is 200 - 500 metres

Maximum distance between water collection points

500 m (or 15 min. walking)

Do not use as a standard. Often people are scattered over small areas and you can’t give a standard for the distance between water collection points in such situations.

Maximum number of people per handpump

500-750 200-250

Maximum number of people per tapstandMaximum number of people per wellMaximum number of people per water collection point

250 600 for tapstand with 8 taps with enough flow: 2000 for tapstand with 6 taps with enough flow: 1500for handpump: ??for well: ?for capped spring: ... persons if flow is ... - ..., ... persons if flow is higher

(e.g. tapstand with 8 taps, 5 l/min./tap, yields 2.400 l/hour, use of tapstand during 12 hours a day will give a total of 28.800 l which is with 2000 people 14,4 l/person, which is much more than the minimum required amount of 5 l/person per day. 2000 is also equalling the number of taps per tapstand times the number of people per tap as found in most guidelines.

Maximum number of users per tap

250 200-250 200-250 250

number of taps per tapstand

6 to 8 6 8

Maximum waiting time at water collection point

< 2 hours avoid queuing at water points

Minimum flow from tap the number of water points should be increased if the outflow is insufficient (< 5 l/minute/tap) in

5 l/minute


order to speed up the water distribution

Number of water collection points/size of water system

number sized to meet peak demand


Annex 5 Bibliography

Abrioux E. et al. 1997. KAP survey: water and sanitation. Lolle, Blosse, Kalle Cantons. Danane Sous-prefecture. ACF. Cote d’Ivoire. April 1997

Abrioux E. et al. 1997. KAP survey - water and sanitation. Prefecture of Tabou. Cote d’Ivoire. ACF. Cote d’Ivoire. May 1997.

Adams J. 1997. Minimum standards for water supply and sanitation in emergencies. Revised draft 16/12/97.

ACF. 1995. Les programmes eau et assainissement. Stratégie d’intervention. Eau et assainissemnt. Paris 1995.

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