Beating Ebola with clean water and soap

What would you do without water?

Some of us are lucky enough not to have to ask that question, but many around the world are not. Especially in emergencies, UNICEF’s water, sanitation and hygiene (WASH) teams work to make sure that water is available, along with hygiene measures and supplies to protect people from disease.

In disasters and emergencies linked to diseases that can be spread from person to person, the efforts of governments, NGOs and other humanitarian organizations will make little difference if citizens in the country don’t take up behaviour change to keep themselves and their families safe. 

Part of UNICEF’s important work is to help spread the word about how to keep safe and healthy in crises. We are starting a series of blog posts dedicated to telling the stories of how WASH helps keep children and their families safe during the most trying times. This is the first entry in that series. Enjoy it!

Fighting the Ebola epidemic was like nothing I’ve ever worked on. Initially, we thought we could contain it – then we realized it was spreading too fast, and we were caught inside.

We were afraid, given that it was a viral infection and there was no cure. People were fearful and were trying to protect themselves. They were barricading themselves into their houses and wouldn’t let outsiders in.

When the outbreak started, WASH wasn’t a major part of the response. The global community thought of Ebola as a medical situation. People forgot that you needed water to stop the infection from spreading.

One girl's hand opens a tap on a red plastic bucket with the UNICEF logo, while another girl's hands wash each other.
© UNICEF/UNI183170/BindraGirls wash their hands with soap and water at St. Joseph Secondary School in Makeni, Sierra Leone. Handwashing facilities in schools and other institutions were key to bringing the Ebola epidemic under control.

We needed the water to spray workers who were on the front lines of prevention; we needed water to clean health centres. So much water was needed in Ebola care centres – it became a critical part of the response. The health centres quickly ran out of water, because the demand was huge.

Increasing water services, and the number of Ebola care centers with water and sanitation, became one of UNICEF’s central concerns. There were a lot of challenges, because supplying water is one thing, but maintaining the water system is something else altogether. In the middle of this crisis, we were working with the Ministry of Water Resources to arrange hundreds of deliveries of water tanks and supplies and then keep water trucks moving on a daily basis. Protecting the drivers and workers was a huge job in itself.

At some point, the demand was outpacing what we could supply – because we needed 140 liters a day, per patient. That is a huge amount of water, and it’s expensive to put systems into place. But beyond just the delivery of water, the question then became, “How do you manage the wastewater from the amount of water that was needed?” So, we also needed to set up wastewater systems to make sure all the water from the centres was properly handled and didn’t go into the water systems to create an even larger outbreak.

All across the country, UNICEF and partners were drilling wells and putting longer-term, sustainable water systems into place. When we opened a new Ebola care or treatment center, we planned a water supply system as well. In places where we couldn’t put in a small well, we made sure that trucks could access the water tank and refill it easily.

We knew handwashing would help block Ebola infections. There was a massive handwashing push everywhere. It was incredible to see how fear of Ebola upped the handwashing rates; in some areas we found more than 90% of the population were washing their hands.

There are over 8,000 schools in Sierra Leone, and each of those schools needed a handwashing facility and enough soap for all the teachers and students. Organizing the distribution of these handwashing stations and getting everyone on board to use them was a huge challenge as schools reopened.

In addition to the schools, we also set up handwashing stations at markets, churches and mosques. These stations all needed buckets, clean water, soap and the support to ensure proper use. WASH played a really pivotal role in getting out to communities and giving them the right tools to stay safe. It was a massive logistical operation and a massive investment. It was expensive, but it saved lives.

During the Ebola outbreak, water and sanitation were as important as any other act of prevention, and every part of the response played a key role. Coordination with partners was a big reason for success, and many joined our team to improve WASH.

More than a year since the outbreak’s end, it’s great to see the lasting benefits of our WASH response. Health care centres are better equipped with WASH systems, schools have facilities for handwashing, and we have an enduring network of grassroots community health workers and WASH mobilizers that we can use in the future.

There is no silver lining, as the cloud of Ebola was a nightmare for the whole country, as was the fear it spread for children. But we are able to look back and see how we worked together to bring it under control. We carry these lessons forward. WASH has a big role to play in all parts of emergency response, and our success with Ebola showed the world how important it was.

Patrick Okoth is the Water, Sanitation and Hygiene (WASH) Manager with UNICEF in Sierra Leone. He was on the front lines of the Ebola response and helped coordinate a huge mobilization of water and sanitation projects for health centres, schools and communities. This large-scale expansion played a central role in bringing the outbreak under control.

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