Maintaining Hygiene and Sanitation in Disaster-Affected Areas

When disaster strikes, basic infrastructure often collapses within hours. Water systems fail, toilets become unusable, and garbage piles up. These might seem like inconveniences compared to immediate rescue needs, but poor sanitation quickly becomes a silent threat. Faecal-oral diseases can account for more than 40% of deaths in the acute phase of an emergency, with children under five being most vulnerable. Understanding how to establish and maintain hygiene and sanitation in disaster-affected areas isn’t just about comfort-it’s about survival.

Why sanitation fails after disasters 🔗

Disasters disrupt sanitation systems in multiple ways. Earthquakes crack sewer lines. Floods contaminate water sources with sewage. Cyclones destroy toilet facilities. Even when physical infrastructure survives, displacement of populations into temporary camps creates immediate pressure on whatever facilities remain functional.

Inadequate excreta disposal 🔗

The most urgent sanitation challenge is managing human waste. When normal toilet facilities become unavailable, people resort to open defecation, which rapidly spreads disease. The WHO identifies several conditions directly linked to improper excreta disposal: cholera, typhoid, dysentery, hepatitis A, and various intestinal infections. In crowded displacement camps, a single case of cholera can trigger an epidemic within days.

The risk intensifies over time. Prolonged mass settlement in temporary shelters with minimal sanitation provision creates conditions where epidemic outbreaks become increasingly likely. What starts as an inconvenience can become a public health catastrophe.

Garbage accumulation and environmental hazards 🔗

Solid waste management typically stops functioning after major disasters. Garbage collection services cease, and debris from damaged structures mixes with household waste. This accumulation creates breeding grounds for disease-carrying insects and rodents. Stagnant water in discarded containers, old tyres, and debris provides ideal breeding sites for mosquitoes that transmit dengue and other diseases.

Medical waste presents particular dangers. Damaged health facilities may lack proper disposal systems, and the surge in emergency medical treatment generates additional hazardous waste that requires special handling.

Increased vector activity 🔗

Standing water left by floods, combined with disrupted drainage systems, creates perfect conditions for mosquito breeding. Epidemics of malaria, dengue, and encephalitis typically appear about six weeks after a disaster if vector control measures aren’t implemented. Flies breeding in accumulated waste and faecal matter become disease vectors, spreading pathogens through contact with food and water.

Rodent populations can also increase when normal waste management breaks down. Rats and mice not only carry diseases directly but also contaminate food supplies and water sources.

Temporary sanitation solutions 🔗

Establishing emergency sanitation requires practical, rapidly deployable solutions. The Sphere Project handbook provides internationally recognised standards: one latrine or toilet should be available for every 50 people during emergencies, with the goal of reducing this ratio to 20 people per facility as the situation stabilises.

Defecation fields 🔗

In the immediate aftermath of a disaster, when construction of proper facilities isn’t yet possible, designated defecation areas provide a first-line solution. These work best in hot, dry climates and require clear marking, fencing where possible, and protection from flooding. They should be located at least 50 metres from water points, downwind from living areas, and away from water courses. Families receive shovels to dig small holes for defecation and cover waste with soil afterward.

Trench latrines 🔗

Deep trench latrines offer a more organised solution that can be constructed within one to two days. These consist of several cubicles aligned above a single trench, typically 0.8 to 0.9 metres wide and 1.5 to 3 metres deep. The top portion of the pit requires lining for stability, using materials like bricks, timber, or sandbags.

Trench latrines can serve communities of various sizes. A maximum trench length of 6 metres accommodates about six cubicles. End cubicles can be extended for accessibility or to provide washing spaces for women. Daily maintenance includes covering excreta with a 10-centimetre layer of soil to minimise odours and prevent fly breeding.

Pit latrines 🔗

For longer-term situations, simple pit latrines provide more sustainable sanitation. These involve digging a pit approximately 1.2 to 1.5 metres deep, covered by a slab with a hole for defecation. Ventilated improved pit (VIP) latrines add a ventilation pipe that reduces odours and traps flies inside the pit.

Site selection for pit latrines requires careful assessment. They must be positioned away from groundwater sources to prevent contamination-soil permeability and groundwater levels determine the minimum safe distance. Rocky ground or high water tables may require alternative approaches, such as elevated platforms or above-ground collection systems.

Alternative options for challenging environments 🔗

When ground conditions prevent pit construction-due to rocky terrain, high water tables, or flooding-other options become necessary. Bucket or container latrines provide portable solutions, though they require regular collection and safe disposal of contents. Biodegradable bag systems offer individual, single-use sanitation where infrastructure is impossible, though they need organised collection and disposal.

Chemical toilets can serve as temporary solutions in urban or semi-urban settings but require regular servicing and a functioning supply chain for chemicals.

Garbage control and waste management 🔗

Effective solid waste management in emergencies involves establishing collection points, organising regular removal, and ensuring safe disposal. The Sphere standards recommend providing one 100-litre waste bin for every 100 people, placed within 50 metres of living areas during the short-term phase. This ratio improves to bins within 15 metres during longer-term response.

Waste should be sorted where possible: organic matter can be buried or composted, while burnable materials can be incinerated in designated areas. Non-burnable, non-organic waste may need transport to landfill sites. Medical waste requires separate handling and high-temperature incineration.

Vector management strategies 🔗

Controlling disease vectors requires an integrated approach combining environmental management, personal protection, and targeted chemical interventions.

Environmental source reduction 🔗

Removing or reducing mosquito breeding sites forms the foundation of vector control. This means draining standing water, covering water storage containers, and clearing debris that collects rainwater. In areas at risk of dengue, special attention goes to artificial containers-the Aedes aegypti mosquito that transmits dengue breeds primarily in water collections around human settlements.

Personal protection measures 🔗

Insecticide-treated bed nets provide effective protection, particularly for sleeping. These nets not only prevent mosquito bites for those underneath but also reduce overall mosquito populations when widely used within a community. In emergency settings where nets may not be immediately available, spatial repellents-devices that disperse volatile chemicals to drive mosquitoes away-can serve as stop-gap protection.

Personal repellents applied to exposed skin offer additional protection, especially important for people working outside during evening hours when many mosquito species are most active.

Chemical control measures 🔗

When mosquito populations threaten disease outbreaks, chemical interventions become necessary. Larvicides applied to water containers and potential breeding sites prevent mosquito development. Indoor residual spraying applies long-lasting insecticides to interior walls and surfaces where mosquitoes rest. Space spraying with adulticides can rapidly reduce adult mosquito populations during epidemic threats, though this provides only temporary relief and must be combined with source reduction for lasting effect.

Community involvement in hygiene maintenance 🔗

Sustainable sanitation in disaster settings depends on community participation. External agencies can provide initial infrastructure and supplies, but maintaining these systems requires local engagement.

Health education and behaviour change 🔗

Handwashing with soap at critical times-after defecation, after handling babies’ faeces, and before preparing food-remains one of the most effective disease prevention measures. When soap is scarce, ash, sand, or other locally acceptable substitutes can be promoted. Educational messages must reach all community members, including those who cannot read, through verbal communication and practical demonstrations.

Volunteer networks for facility maintenance 🔗

Community volunteers can take responsibility for latrine cleaning, ensuring handwashing supplies remain available, monitoring facility conditions, and reporting problems. Clear assignment of responsibilities prevents the deterioration that often affects communal facilities. For collective latrines, designating specific individuals-whether volunteers or paid workers-to maintain them ensures consistent upkeep.

Participation in vector control 🔗

Community action groups play essential roles in controlling mosquito breeding sites around homes and settlements. Residents can eliminate standing water from containers, properly cover water storage vessels, and apply larvicides when provided. This household-level action, multiplied across communities, achieves far more than external interventions alone.

Integrating hygiene into disaster response 🔗

Effective sanitation response requires coordination from the first hours of emergency relief. Water, sanitation, and hygiene (WASH) must be treated as priorities equal to food, shelter, and medical care. The CDC emphasises that even limited water supplies must be allocated for personal hygiene to minimise health risks.

Planning for sanitation should anticipate the progression from immediate emergency through short-term and long-term phases. What works for the first week-defecation fields, basic trench latrines-must give way to more sustainable solutions as situations extend into months or years. Building community capacity from the start ensures that improvements can be maintained long after external support diminishes.

What do you think? How might communities better prepare their sanitation response capabilities before disasters strike? What role should local volunteers play in maintaining emergency hygiene facilities?

References

1. https://www.who.int/teams/environment-climate-change-and-health/water-sanitation-and-health/environmental-health-in-emergencies/humanitarian-emergencies
2. https://www.paho.org/en/health-emergencies/vector-control-disaster-situations
3. https://en.wikipedia.org/wiki/Vector_control
4. https://en.wikipedia.org/wiki/Emergency_sanitation
5. https://sanihub.info/topic/deep-trench-latrine/
6. https://sswm.info/water-nutrient-cycle/wastewater-treatment/hardwares/sanitation-emergencies/immediate-and-short-term-emergency-sanitation
7. https://archive.cdc.gov/www_cdc_gov/healthywater/global/sanitation/sanitation-emergency-response.html
8. https://www.unicef.org/supply/vector-control-prevent-mosquito-borne-diseases
9. https://www.ncbi.nlm.nih.gov/books/NBK143163/
10. https://www.cdc.gov/water-emergency/safety/guidelines-for-personal-hygiene-during-an-emergency.html