WASH and Disasters: The Critical Link for Health and Resilience

When disasters strike, the immediate focus often centers on visible destruction-collapsed buildings, displaced families, and urgent rescue operations. Yet one of the most critical but frequently overlooked aspects of emergency response is water, sanitation, and hygiene (WASH). The connection between WASH and disasters runs deep: inadequate access to clean water and sanitation can transform a natural calamity into a prolonged public health crisis, while robust WASH systems can significantly reduce suffering and accelerate recovery.

How WASH mitigates disease outbreaks in emergencies
The role of WASH in protecting vulnerable populations
Women and girls face unique challenges
Children bear a heavy burden
Psychological well-being and dignity
Disasters’ impact on WASH infrastructure
Earthquakes and structural damage
Floods and contamination
Conflicts and deliberate targeting
Building community resilience through WASH
Pre-disaster preparedness
Community engagement and ownership
Linking emergency response to development
Social cohesion through WASH

How WASH mitigates disease outbreaks in emergencies

Disasters create the perfect conditions for waterborne disease outbreaks. Damaged infrastructure, contaminated water sources, and overcrowded displacement camps combine to create health emergencies that can exceed the original disaster’s death toll. The Haiti cholera outbreak following the 2010 earthquake stands as a stark reminder of this reality-the outbreak resulted in over 820,000 cases and nearly 10,000 deaths, making it the worst cholera outbreak in recent history.

Before the earthquake, only 17% of Haiti’s population had access to improved sanitation facilities, and 37% lacked adequate drinking water. When the magnitude 7.0 earthquake struck, it further devastated the nation’s already fragile WASH infrastructure. Cholera spread rapidly because of Haiti’s uniformly poor water and sanitation infrastructure, with many people obtaining water from rivers that became contaminated. The unsanitary conditions in displacement camps, where millions were forced to live, further accelerated transmission.

Nepal faced similar challenges after the 2015 earthquake. The disaster killed nearly 9,000 people and inflicted grave damage on 7,741 water supply schemes and approximately 388,000 sanitation facilities. With nearly 600,000 homes destroyed and hundreds of thousands living in makeshift shelters, access to clean water became severely limited, and toilets were overwhelmed. These conditions heightened the risk of waterborne disease outbreaks.

However, Nepal’s experience also demonstrated that effective WASH management can prevent the worst outcomes. Although there was concern for diarrheal disease outbreaks immediately after the earthquake, the potential was prevented by effective WASH management. Organizations partnered with the government to ensure safe water supplies, improve sanitation, and promote hygiene practices, limiting the cholera outbreak to 169 confirmed cases in 2016.

The role of WASH in protecting vulnerable populations

Disasters do not affect everyone equally. Women, children, the elderly, and people with disabilities face disproportionate risks when WASH services fail. Understanding these vulnerabilities is essential for designing effective emergency responses that protect the most at-risk members of communities.

Women and girls face unique challenges

Women and girls are primarily responsible for water collection in 7 out of 10 households without water supplies on premises, according to WHO and UNICEF. This responsibility means that when disasters damage water infrastructure, women and girls must often travel greater distances to collect water, losing time for education, work, and leisure while putting themselves at risk of physical injury and dangers along the way.

The lack of adequate sanitation facilities particularly affects women’s safety and dignity. More than half a billion people share sanitation facilities with other households, compromising privacy and safety. Recent surveys show that among households with shared toilets, women and girls are more likely to feel unsafe walking alone at night and face harassment risks.

Additionally, women and girls are primarily responsible for domestic chores and caregiving, including cleaning and looking after the sick. Without proper handwashing facilities, they face increased exposure to diseases and health risks.

Children bear a heavy burden

Children, especially those already suffering from malnutrition and weakened immune systems, are particularly susceptible to waterborne diseases. UNICEF emphasizes that without potable water or adequate sanitation and hygiene facilities, children become even more vulnerable to water-borne diseases. In disaster settings, diarrheal diseases can quickly become fatal for young children who lack access to treatment.

UNICEF reached 11.6 million children with emergency WASH services in schools and temporary learning spaces in 2021, demonstrating the scale of need. The organization also provided 1.3 million girls and women with emergency menstrual hygiene health services, addressing a critical but often overlooked aspect of dignity in emergencies.

Psychological well-being and dignity

WASH interventions extend beyond physical health to encompass psychological well-being and human dignity. Humanitarian standards require ensuring that all at-risk groups, including women, girls, older people, and people with disabilities, feel safe and are protected from discrimination and violence when collecting water or using sanitation facilities. This includes participatory planning that considers the specific needs of vulnerable populations and ensures facilities are accessible day and night.

Disasters’ impact on WASH infrastructure

Understanding how different types of disasters affect water and sanitation systems is crucial for effective preparedness and response. Each disaster type presents unique challenges that require tailored solutions.

Earthquakes and structural damage

Earthquakes can instantaneously destroy the physical infrastructure that delivers clean water and manages waste. The 2015 Nepal earthquake destroyed water systems across 14 districts, leaving around 1.1 million people without access to protected water sources. Significant damage to latrines left another 1.1 million people without safe, hygienic sanitation facilities.

Beyond immediate infrastructure damage, earthquakes can contaminate water sources through ground movement, pipe breaks, and sewage system failures. Research following the Nepal earthquake showed an 80% increase in communicable waterborne infections in the first six months of 2015 compared to the previous two years combined.

Floods and contamination

Flooding poses distinct challenges by contaminating existing water sources with sewage, agricultural runoff, and debris. Even when infrastructure remains physically intact, floodwaters can render water supplies unsafe for consumption. Cholera spreads quickly when people lack safe water sources for drinking and hygiene, making post-flood environments particularly dangerous.

In flood-prone areas, organizations work to reduce disaster risks by building raised toilets and water points, preventing contamination during flood events and ensuring communities can maintain access to essential services.

Conflicts and deliberate targeting

Water and sanitation systems are often vulnerable to attack during conflict, either as collateral damage or deliberate targeting. The destruction of WASH infrastructure in conflict zones creates prolonged crises that can outlast the fighting itself, as rebuilding requires stability and resources that may be unavailable for years.

Building community resilience through WASH

Effective disaster management increasingly recognizes that communities themselves must be equipped to manage WASH services before, during, and after emergencies. This community-centered approach builds long-term resilience rather than dependence on external assistance.

Pre-disaster preparedness

Governments and communities can manage disaster risk in WASH by designing, building, and maintaining water and sanitation systems with simple modifications to withstand disasters. This includes carrying out vulnerability assessments, engaging communities in planning, and ensuring multi-sectoral approaches to disaster risk management.

High-risk areas benefit from developing specific disaster preparedness plans. In West Africa, for example, communities and local authorities have established response plans specifically for diseases such as cholera, enabling rapid action when outbreaks occur.

Community engagement and ownership

Building community resilience implies that individual members should not be viewed as helpless in the face of disaster-instead, they can be informed, trained, and empowered survivors and a capable source of human capital for response and recovery. This shift from viewing communities as passive recipients to active participants transforms disaster response.

Research on community resilience in WASH during recovery emphasizes that longer-term and intersectoral recovery programmes reflecting community priorities through increased participation help transform pre-existing practices and attitudes toward sanitation. Integrated approaches considering pre-disaster practices, recovery, and development plans prove most effective.

Linking emergency response to development

UNICEF works with governments and humanitarian agencies to strengthen the capacity of WASH service providers and communities in building and maintaining resilient services during and before emergencies. By advocating for sustainable financing mechanisms and implementing systems strengthening, communities become better equipped to cope with future crises.

This approach recognizes that crises are not one-time shocks-their impact can last for years. Sustainable interventions serve vulnerable households both in the immediate crisis and the longer term, breaking the cycle of repeated humanitarian responses.

WASH interventions can also promote social cohesion in fragile settings. Providing water and sanitation services to both host and displaced communities encourages collaboration and strengthens social bonds that prove invaluable during recovery. High levels of civic engagement encourage feelings of ownership and collective responsibility, ultimately resulting in improved preparedness, response, and recovery.

What do you think? How can your community better prepare its water and sanitation systems for potential disasters? What role should local residents play in managing WASH services during emergencies?

References

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Table of Contents

How WASH mitigates disease outbreaks in emergencies 🔗

The role of WASH in protecting vulnerable populations 🔗

Women and girls face unique challenges 🔗

Children bear a heavy burden 🔗

Psychological well-being and dignity 🔗

Disasters’ impact on WASH infrastructure 🔗

Earthquakes and structural damage 🔗

Floods and contamination 🔗

Conflicts and deliberate targeting 🔗

Building community resilience through WASH 🔗

Pre-disaster preparedness 🔗

Community engagement and ownership 🔗

Linking emergency response to development 🔗

Social cohesion through WASH 🔗