Monitoring WATSAN activities and infection controls In community quarantine centres
Communities affected by a disaster often lack basic water and sanitation facilities. They are also likely to be traumatised and vulnerable to disease.
Due to this current Covid 19 pandemic there are emergencies globally. Now India gradually becomes of the countries with highest number of cases. From less than 10 cases on 2 March, the country witnessed more than 1 Lakh cases by 20 May 2020 and highest number of positive cases in South East Asia. Thus became a threat to everyone’s day to day life in the country with current nationwide lockdown. Our state government is trying its best level to bring back all the stranded our peoples of Manipur to their home town from RED zones and other parts of country. Thus many of our peoples have already reached their home town with state government’s Standard Operating Procedure (SOP) at kept in community quarantine centres across the state.
Communities affected by a disaster often lack basic water and sanitation facilities. They are also likely to be traumatised and vulnerable to disease. The disturbance to familiar and safe practices or the relocation to new environments can result in hygiene behavior becoming unsafe. All these factors can contribute to the high risk of disease and epidemics.
Now my question is how they have set up community quarantine centres. Is there proper facilities for health and hygiene, apart from the government’s SOP? Are the inmates well brief or demonstrate steps to follow? Most important is all those volunteer of local clubs and CSO’s frequent accessing to support quarantine facilities, on their exposed risk and their responsibilities. How far are they aware of communicable disease and its route of transmission to avoid them as route of transmissions? There are comments in quarantine centre like concrete lack of proper infrastructure, abuse by medical staff and police, lack of care etc, as covered in media recently.
There should be strict on all means of accessing to the facilities. To answer above questions it might be a good idea to have a regular monitoring and evaluation by an expert team (medics and no medics or form a committee) to all the community quarantine facilities especially on water sanitation, proper waste management and process of disinfectant within the facilities since those are main route of transmission. They should follow World Health Organisation (WHO) or national or state health guidelines for such communicable diseases in emergency camp or set ups. In developed countries such WATSAN activities are always in place properly however in developing countries these are always been neglected. The current medical reality is; every eight seconds a child dies from water related diseases, 50 per cent of people in low-income countries suffer from one or more water related diseases and 80 per cent of diseases in low-income countries are caused by contaminated water. So, regular “Health Walks” is very important within the facilities with an objective of identifying priorities, indicators and security situation in such emergency situation. Many violations may happen in such camps when inmate numbers increased, including sexual violence. Indeed, there is demand few days back to segregate quarantine centres and room sharing for transgender in selected quarantine centres in Manipur.
During the assessment in the facilities the team should see physical environment, number of persons / patients their practices (related to hygiene & health), gender-specific issues (related to hygiene & health), motivation (related to hygiene & health etc. Technical data of number of toilet facilities available for used, available waters source and conditions of water e.i. liters per day, turbidity, FRC etc including the drinking water. This initial assessment or in-depth assessment can be done base on emergency or stabilised situations with participatory method.
If required team can be include community groups, coordinator, organisation, health workers, religious leaders, teachers and local authorities depending on the communities and area. They should know the importance of Water, Hygiene and Sanitation within the set ups, know the different activities and components of water and hygiene and sanitation know their responsibilities within water, hygiene and sanitation (WHS) activities. Also essential of water & sanitation requirements in the facilities and hygiene promotion. After assessment we would be able to find many that can be improve with minimum efforts that can be integrated within the SOP, with gender rights and sensitivity.
Primary prevention refer to procedure to be implement in all task including cleaning waste management to prevent any accidental exposure to body fluids etc infectious risk. All the measures must be explained to and understood by the entire team member.
Hand washing is one of the most important and most effective methods of preventing the spread of infection from one person to another or from one body part to another. Hand washing points should be installed and should be done before and after any contact of food, medicine and contact risked surfaces with soaps and sanitizer.
Always wear protective equipments when carry out activities inside the facilities.
Avoid direct contact any waste water from toilets, bathroom and levorotary etc.
Disinfectant with active chlorine solutions (0.5 per cent) to clean and disinfect surfaces, objects, and body fluid spills. Solutions should be prepared daily.
Regular health educations on hygiene promotions. Regular insecticide residual spraying IRS etc. are few steps to prevents the spread of coronavirus infections.
These participatory methods can improve with participatory learning. There are few steps that can improve in facilities, reduce contamination of surface waters by excreta, destroy breeding sites of insects, decrease need to visit breeding sites, use impregnated mosquito netting, water related insect vector, increase water quantity used, improve accessibility and reliability of domestic water supply, improve hygiene etc.
Hygiene promotion is a general term used to cover a range of strategies which aim to improve people’s hygiene behavior and so prevent the spread of disease and improve to reduce route of transmission. As we know implement an early response is the best and effective way in such situations. So start today tomorrow might too late.
A human rights based approach to handling covid responses, especially those quarantined and those suspected of infection is critical to ensure that all are treated with dignity, respect and as rights holders.