Chapter 9

8. Management of WASH Programmes

WASH programmes in refugee settings often require large numbers of staff, vehicles, equipment, and materials to be mobilized in short periods of time. It is essential that these resources are management efficiently and that WASH staff are able to carry out their tasks competently and in safety. WASH programmes also typically require the construction of services infrastructure and it is essential that these facilities are kept in good operational condition.

Introduction

The importance of WASH programme management in refugee settings

During refugee emergencies it is essential that water supply, excreta management, solid waste management, hygiene items, and basic disease vector control interventions are well managed and WASH facilities remain in good operational condition. WASH facilities can quickly deteriorate if they are not carefully managed and maintained. Large numbers of WASH staff, vehicles, equipment, resources, materials, and stocks often need to be mobilized in short periods of time. It is essential that these resources are management carefully and efficiently.

The importance of seeking expert professional advice

The efficient management of large WASH programmes in refugee settings is not an easy task and can be complicated by additional constraints that include:

i) A lack of qualified or experienced WASH staff.

ii) Difficult access.

iii) A lack of back-up capacity or spare parts.

iv) Shortage of time to adequately train staff or build capacity.

v) A lack of willingness from the refugee population to take responsibility for WASH infrastructure.

In many refugee emergencies, the initial establishment of WASH services will require significant inputs during the initial few months and it will be essential to engage expert professionals who are familiar with starting large WASH programmes, recruiting and training WASH staff, drafting public works contracts, working with contractors, managing large workforces, and generally managing the scaling up of large WASH programmes in complex environments.

Priority actions

Immediate recruitment and training of WASH personnel

The establishment and management of water supply, excreta management, solid waste management, disease vector control, and hygiene promotion programmes often requires a substantial labour force in a short period of time. In many scenarios it may be possible to recruit many of the positions, including managerial positions, from among the refugee population. In most cases refugees may be willing to help since it gives people something to do, prestige, and possibly a small source of income.

Even if there is limited available time, UNHCR and WASH actors should ensure that all WASH staff, volunteers, or daily labour have received sufficient basic training for the tasks they are performing. Small investments in training WASH staff at the start of a refugee emergency can yield large benefits in productivity, prestige, and motivation over time. It is mandatory that WASH staff, volunteers, or daily labour undertaking WASH tasks with associated public health risks associated receive a basic training in health and safety and the infection control standard precautions (see section below)

Procurement and management of WASH equipment and supplies

It is typical that large quantities of WASH supplies (for example soap, jerry cans, household hygiene items, pumps, water reservoirs, pipes, water treatment chemicals, latrine slabs, materials for toilet and shower superstructures, vector control equipment and supplies, and refuse containers, etc.) will need to be procured, warehoused, and managed at the start of any refugee emergency. It is essential that the stock levels and logistical pipelines of these supplies are closely monitored by as ruptures of water treatment chemicals, fuel, or WASH supplies can have large implications on the public health of the refugee population.

Use of public works contracts for construction of WASH infrastructure

In most refugee settings there is typically a peak in the workload required to initially establish WASH services at the start of the refugee emergency. Generally, the construction of WASH infrastructure including water points, toilets, showers, laundering points, and solid waste collection systems requires a large amount of resources to establish services in a very short period of time. Options for quickly scaling up the provision of WASH services include:

i) Working with local WASH service providers to expand existing WASH services to the refugee population.

ii) Launching a series of small performance based public works contracts to the local private sector to install WASH infrastructure.

iii) Undertaking WASH construction in-house by engaging directly large amounts of daily labour.

Once target levels of WASH infrastructure have been established the level of human resources required to operate and maintain the WASH infrastructure is likely to be much lower. WASH programme staff are likely to be recruited for longer periods of time on a more permanent basis.

Assessment of WASH related health and safety risks

WASH staff, contractors, volunteers, or daily labour involved in the establishment or day to day running of WASH programmes - for example the collection and management of excreta, solid waste, or disease vector control activities all have elevated work related health and safety risks. UNHCR and WASH actors should ensure that an assessment of WASH related health and safety risks has been carried out and a plan is in place to mitigate and monitor priority risks. All WASH staff must have adequate personal protective equipment for the tasks they are performing and must have received a basic health and safety training for the tasks they are performing. WASH staff undertaking the following activities should be prioritised:

• Anyone cleaning toilets or other WASH facilities.
• Anyone involved in desludging toilets.
• Anyone involved in collection, movement, recycling, reuse or disposal of solid wastes.
• Anyone involved in collection and movement of excreta, infectious or hazardous wastes.
• Anyone involved in disease vector programmes.
• Anyone operating mechanical WASH related equipment.
• Anyone who may potentially come into contact with water treatment chemicals, vector control chemicals, excreta, sewage, wastewater, solid waste, medical waste or any other sources of potential infection.
• Anyone involved in the excavation of latrine pits, wells, or trenches deeper than 80cm.
• Anyone involved in the maintenance of excreta or solid waste related WASH infrastructure or equipment.

The best way to undertake a public health and safety risk assessment of WASH activities is to analyse risks at each step of the water, excreta, solid waste, and disease vector chains from source to final use / disposal. At each step, risks should be analysed in terms of probability (rated from high to low) and likely impact (rated from high to low).

Mitigation of WASH related health and safety risks

Once the WASH related health and safety risk assessment has been completed a plan should be established to prioritise these risks and put in place a series of mitigative actions. Any risks that are rated either ‘high’ or ‘medium’ likelihood in addition to either ‘high’ or ‘medium’ health or safety impact must be mitigated immediately.

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Provision of personal protective equipment

UNHCR and WASH actors must ensure that staff working for the WASH programme have received a health and safety briefing and have adequate personal protective equipment for the tasks they are performing. Depending upon the tasks being performed this may include.. protective gloves protective overalls protective aprons face, mouth and eye protection protective footwear

UNHCR and WASH actors must ensure that staff, contractors, volunteers, or daily labour working for the WASH programme have adequate personal protective equipment for the tasks they are performing. A summary of the UNHCR health and safety precautions for WASH related activities can be found in Annex. These safety precautions include.

• Assessment of common health and safety risks for each type of WASH activity
• Standards for different types of personal protective equipment depending upon the level of risk
• How personal protective should be worn
• How to remove soiled personal protective equipment
• How to disinfect soiled personal protective equipment
• When and why hand washing should be carried out
• Management, cleanliness, sterilization and storage of excreta management, solid waste and vector control equipment
• Actions in the event of injury or occupational exposure
• Incident reporting and follow up procedures

Provision of health, safety and infection control training

UNHCR and WASH actors must ensure that all WASH staff, contractors, volunteers, or daily labour undertaking activities with potential health and safety risks receive a health and safety briefing related to the tasks they are performing on their first day of employment. All workers who may potentially come into contact with excreta, medical wastes, or solid wastes should receive a briefing on the infection control standard precautions (see Annex).

Ensuring water treatment chemical and vector control chemical safety

Many chemicals used in water treatment and disease vector control activities are potentially harmful to workers or the environment. Chlorine for example is highly corrosive and can cause burning or a toxic gas and must not come into contact with skin or clothing. Other chemicals used for disease vector control for example insecticides, rodenticides, or larvaecides are toxic and poisonous in concentrated amounts. UNHCR and WASH actors must ensure that all staff working with chemicals have the correct protective clothing for the tasks they are performing (e.g. gloves, goggles, apron, boots). All chemicals used in water treatment or disease vector control activities must be stored under dry, cool dark and ventilated conditions.

UNHCR and WASH actors should ensure that any chemicals being used in WASH activities have been approved for under international for the tasks they are being used for and they are applied following internationally approved protocols. Care must be taken during the transportation, storage, application to ensure there are no risks to refugees, staff, or the environment. UNHCR and WASH actors must ensure that all staff involved in handling water treatment and vector control chemicals have adequate personal protective equipment and safety training for the tasks they are carrying out.

Health and safety incident reporting and follow-up

Any incident where WASH staff contractors, volunteers, or daily labour have been involved in a work related physical accident, or they have come into direct contact with excreta, solid waste, sewerage, medical waste, hazardous waste, water treatment chemicals, or disease vector control chemicals must be reported to senior management and documented in a health and safety log book so that a review and policy change can take place. Any near misses (a physical, biological, or chemical work-related accident that was narrowly missed) should also be reported and logged.

The WASH related health and safety risk assessment, action plan, and the ongoing policy changes resulting from health and safety incident reporting should be fully documented as part of the site WASH strategy/plan.

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WASH programme management in refugee settings

Models for WASH service provision in refugee settings

The model used to deliver WASH services in a refugee setting depends upon the phase, the context, and the capacity of local actors. In settings where there are strong municipal or private sector WASH actors the best model is to work with these existing WASH service providers to extend existing WASH services to the refugees. However, in contexts where local service providers or local authorities are weak or non-existent, UNHCR and WASH actors may consider direct implementation of WASH services with a medium-term plan of transitioning WASH service provision to national water, sanitation and public health authorities, or a community based organisation (CBO) made up of members of the refugee community.

The importance of phasing into the construction of household WASH facilities as soon as possible

The burden of maintenance and upkeep of WASH facilities in refugee settings can take considerable amounts of time, effort and resources. Therefore, all WASH programmes should start or transition as quickly as possible into the construction of shared and household WASH facilities (in particular toilets and bathing facilities) if it is clear that the time-frame of the humanitarian situation will be longer than six months. While this is a good approach in theory it is not possible for all WASH infrastructure and in every refugee setting it is likely that a significant amount of public infrastructure (for example water collection points, public toilets in institutions, and public waste collection services) will need consistent WASH service provision – ideally through the refugees themselves.

Beneficiary participation in cleaning and maintenance activities

It may be possible for small communities to be more involved in cleaning and maintaining WASH infrastructure in settings where facilities have been established for their exclusive use (rather than public infrastructure that is open to all – see chapter 1). In these settings UNHCR and WASH actors may work with each group of users to prepare a WASH operation and maintenance plan defining the responsibilities of the different stakeholders e.g. cleaning, filling up the hand-washing water containers, keeping the surroundings clean, and providing preventative maintenance. An example agreement can be found in Annex.

Organisation of WASH teams

An example organigram for running a typical refugee WASH programme for 20,000 people in a post-emergency setting can be found on the following page. The organigram gives an indication of how the WASH Team should be structured in addition to the tentative number of Coordinators, Team Leaders, Officer, and Assistant level staff that should be recruited. It should be noted that staffing levels are for planning purposes only and the actual staffing levels should be adapted to the context. In addition, staffing levels are likely to be significantly higher during the emergency phase due to the need to rapidly establish WASH services, Sample job descriptions for each of the staff positions in the organigram can be found on http://wash.unhcr.org.

In most cases refugees may be willing to work with the WASH programme since it gives people something to do, prestige, and possibly a small source of income. Salaries for WASH personnel should be in-line with other sectors and should follow the guidance given in the UNHCR Handbook for Emergencies (2007). It should be noted that in most settings, WASH activities such as clean-up campaigns, cleaning toilets, management of solid-waste, digging trenches, or disease vector activities will not be popular jobs and the refugee population cannot be expected to undertake these tasks on a voluntary basis.

Recruitment of WASH personnel

Efforts should be made primarily to identify refugee or national staff with pre-existing WASH experience or expertise. In many refugee settings it is surprising to find refugees who have worked in the WASH sector in their place of origin (typically as municipal pump operators, drillers, water officers, handpump repair technicians, municipal sanitary workers, or water quality technicians). Once efforts have been made to identify candidates with prior WASH experience, it is highly likely that additional candidates will be needed who do not necessarily have any prior WASH experiences but are sufficiently educated, motivated, and flexible to learn new skills. Time invested during the recruitment phase identifying the best qualified and most motivated candidates can yield huge savings benefits over the course of the WASH programme.

Making use of locally available human resources

UNHCR and WASH actors should try to make full use of locally available human resources. This includes using both skilled and unskilled labour from the refugee population, and national water supply, public health, sanitation, solid waste management, hygiene promotion and disease vector control institutions and regulatory bodies. Programmes should try to avoid relying too much on external expertise. Instead, programmes should aim to train up and build capacity of the refugee population, the surrounding communities, and representatives of national public regulatory bodies from the start.

Capacity building of WASH personnel

In many refugee settings, it will be necessary to not only implement a programme of WASH activities but also undertake an extensive programme of on-the–job and off-the-job WASH capacity building training for WASH personnel. All WASH staff should have received sufficient training for the tasks they are performing and should ideally have a good understanding of the importance of their work and their contribution towards ensuring the public health of the refugee population. Staff training initiatives can not only provide an opportunity to increase the skills of the WASH personnel but can provide other additional benefits including team building, a providing an opportunity for motivating staff, recognizing or rewarding their efforts, or providing a change of scene if staff have been working long hours or particularly hard.

Motivating WASH personnel

WASH programmes in refugee settings can be particularly hard work, particularly during the emergency phase, and WASH staff are much more likely to be motivated if UNHCR and WASH actors are able to meet the following:

• WASH staff are working in a professional and organised way and have the correct equipment, training, and materials to carry out their jobs.
• WASH staff have clear job descriptions and are working towards clear objectives.
• WASH staff have regular daily or weekly interaction with other WASH staff. There is a sense that everyone is working for the same WASH Team.
• WASH staff feel they are listened to and supported by senior management. There are mechanisms and opportunities to influence and improve the way that they work.
• There is a fair, clear, and transparent system of performance monitoring and rewarding of those staff that work hard.
• There are sufficient WASH staff to carry out the required activities without overworking.
• WASH staff have the opportunities for professional development or career advancement
• WASH staff are able to work in safety and security with the correct personal protective equipment for the tasks they are performing.

Operation and maintenance considerations

The importance of establishing a programme of preventative maintenance

It is well documented that money spent on preventative maintenance saves money in the long term on repairs and replacement. Preventative maintenance involves maintaining WASH infrastructure, vehicles, or machinery at planned intervals so that breakdown becomes rare. Preventative maintenance also aims to reduce wear and tear, to cut down oil and fuel consumption, to minimise pollution, and extend the service life of the infrastructure or equipment and promote reliability and safety of operation.

Two essential parts of any preventative maintenance programme for WASH machinery are cleaning and lubrication. Cleaning of water intakes, water filters, and sediment from water reservoirs and basins can reduce clogging and the risk of overloading, over-heating or erosion of water pumping equipment. If moving parts on waste collection vehicles, water tankers, water pumps, and electrical generators are not adequately oiled or greased then they wear more rapidly, overheat and may fail.

Preventative maintenance is often best organised around a system of daily, weekly, and monthly maintenance checks, scheduled typically based around the number of kilometres or hours a piece of WASH equipment or infrastructure has been in operation. Poor planning for operation and maintenance is one of the most common deteriorating factors for WASH infrastructure. UNHCR and WASH actors should ensure sufficient budgeting for preventative operation and maintenance in addition to back-up capacity for surges in new arrivals, and decommissioning and replacement of ageing infrastructure.

The importance of responsive maintenance

In addition to preventative maintenance, refugee settings should also have the capacity to quickly and efficiently respond to WASH related problems as they occur. In a refugee setting, this is likely to consider of a mobile WASH team with the means and resources (spare parts, tools, knowledge) to make immediate repairs before the impacts become critical.

The importance of redundancy and back-up equipment and systems

In all refugee settings, WASH programmes should be prepared for potential problems with WASH service provision. All WASH systems should be designed with sufficient redundancy systems to that service coverage is not affected by either preventative or responsive maintenance activities. Every piece of critical water supply, water treatment, excreta disposal, or solid waste management equipment, machinery, or vehicle should have at least one backup system.

The importance of workshop facilities and a pipeline for spare parts

A well organised workshop managed by trained staff is vital for the proper maintenance of WASH equipment and vehicles. Separate areas should be established for cleaning, servicing, repairs, tools, storage for essential spare parts, storage for discarded parts, and storage for waste. Staffing of maintenance facilities depends on the size of the programme but typically there are three major functions including administrative (records keeping), storekeeping, and equipment maintenance (mechanics). To avoid delays waiting for spare parts, it is recommended that there is at a two month buffer stock of common spare parts that are re-ordered on use. Standardization is another important aspect of maintenance management. Using only a few types and models of handpump, centrifugal pump, or waste collection vehicle significantly reduces the number and type of spare parts that must be held in the stores and enables the mechanics to be very familiar with the maintenance procedures.

Monitoring of WASH personnel and WASH resources

Operation and maintenance activities can present one of the largest costs in WASH programmes and it is essential that budgets are developed with sufficient resources for spare parts, fuel, consumable materials and staff to undertake preventative and responsive maintenance.

Labour, vehicle costs, and WASH consumables make up a significant part of the expenditure associated with WASH service provision and small optimizations in efficiency of either the workforce, or the resources are used can make big cost saving. For example, the way that hygiene promoters, waste collectors, public toilet cleaners, or maintenance crews or organised to productively manage their time can significantly improve the productivity of the WASH programme. During the post emergency phase it may be helpful to analyse the efficiency of WASH activities to understand how time is allocated during the day and if there are ways of reducing non-productive time (for example time spent moving to or from activities).

In addition to looking at efficiencies in time, UNHCR and WASH actors should also consider interventions that bring efficiencies in costs of WASH interventions. The starting point for improving the financial efficiency of WASH interventions is to ensure that the actual costs of each of the WASH interventions (water, excreta management, solid waste, hygiene promotion, disease vector control) is fully documented in the site WASH plan/strategy, including an analysis of any trends over time. This should include at a minimum.

• The cost of water supply (cost per m3 for water abstraction, treatment and distribution up to the end user)
• The cost of excreta management (cost per person per year for excreta management services)
• The cost of solid waste management services (cost per tonne of managing each waste steam)
• The cost of hygiene promotion activities (cost per person per year for hygiene promotion interventions)
• The cost of disease vector control (cost per person per year for each disease vector control intervention)

These metrics WASH actors to track trends in the cost of water supply in addition to comparing the cost of water provision in one setting against another setting. In addition, they allow WASH actors to understand ways in which costs can be economised (i.e. by looking at options to reduce initial capital costs or the annual costs of fuel, electricity, consumables, staffing, logistics, or administration).

Documenting the operation and maintenance plan / strategy

A clear description of the operation and maintenance plan should be included in the site WASH plan/strategy. This section should include:

• A description of the short, medium and long-term operation and maintenance arrangements.
• A description of the short, medium, and long term WASH staff capacity building arrangements.
• A description of critical WASH backup and spare parts capacity planning.
• A presentation of the actual costs of operation and maintenance for each of the WASH interventions including an analysis of any trends over time and efforts to reduce operation and maintenance expenditure.

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Annexes

ANNEX: List of WASH programme management references

Management of WASH programmes key references

• ACF (2005), ‘Water, sanitation and hygiene for populations at risk – second edition’. ACF, Paris, France.
  http://www.actioncontrelafaim.org/publications/wsh_acf_0.pdf

• Evans, P. and Appleton, B. (1993) 'Community management today: The role of communities in the management of improved water systems'. International Water and Sanitation Centre (IRC), Delft, The Netherlands.
  http://www.bvsde.paho.org/bvsacg/fulltext/community.pdf

• Frolich, U. (2001), 'Water and sanitation management guide', Swiss Resource Centre for Development (SKAT), St. Gallen, Switzerland.
  http://www.rural-water-supply.net/_ressources/documents/default/1_Management-Guide.pdf

• UNHCR (2007), ‘Handbook for emergencies – third edition’. UNHCR, Geneva.
  http://www.unhcr.org/​472af2972.html

• UNHCR (1992), 'Water manual for refugee situations', UNHCR, Geneva.
  http://www.unhcr.org/3ae6bd100.pdf

• Lambert, R., and Davis, J. (2002), 'Engineering in emergencies 2nd Ed.', Register of Engineers for Disaster Relief (RedR), London.

• House, S., and Reed, B. (2004), 'Emergency water sources 3rd Ed.', WEDC, Loughborough University, UK.
  http://wedc.lboro.ac.uk/resources/books/Emergency_Water_Sources_-_Complete.pdf

Operation and maintenance key references

• Brikké, F. (2000), 'Operation and maintenance of rural water supply and sanitation systems'. World Health Organisation (WHO), Geneva, Switzerland.
  http://www.who.int/water_sanitation_health/hygiene/om/omruralsystems/en/

• Davis, J., and Brikké, F., (1995) 'Making your water supply work: Operation and maintenance of small water supply systems'. International Water and Sanitation Centre (IRC), Delft, The Netherlands.
  http://www.wsp.org/Hygiene-Sanitation-Water-Toolkit/Resources/Readings/davis-brikke.pdf

• Harvey, P. (2004), 'Sustainable Handpump Projects in Africa'. WEDC, Loughborough University, UK.
  http://wedc.lboro.ac.uk/docs/research/WEJW2/Report_-_Uganda.pdf

• Skinner, B. and Shaw, R. (1989), 'VLOM handpumps: WEDC technical brief #41'. WEDC, Loughborough University, UK.
  http://www.lboro.ac.uk/well/resources/technical-briefs/41-vlom-pumps.pdf

• USAID (1984), 'Operating and Maintaining Handpumps', USAID, Washington USA.
  http://water.engr.psu.edu/hill/teaching/rural_water/rws4o3.pdf

• UNHCR Ethiopia, (2013), 'Guidelines for WASH implementation in camps’. UNHCR, Ethiopia.
  Guidelines_for_WASH_Implementation_in_Camps_(UNHCR_Ethiopia_2013).pdf

• UNHCR Jordan, (2014), 'WASH lessons learnt in camps for Syrian Response', UNHCR, Jordan.
  File:WASH Lessons Learnt in Camps for Syrian Response 16 Sept 2014.xlsx

ANNEX: UNHCR health and safety precautions for WASH related activities

UNHCR and WASH actors must ensure that all programme staff receive a training in the infection control standard precautions and ensure they are familiar with these guidelines. This includes staff who are involved in either the cleaning of toilets, the maintenance of toilets, the desludging of toilets, the collection and movement of excreta, the collection or movement of solid wastes or staff who may potentially come into contact with excreta, sewage, wastewater, solid waste, medical waste or any other sources of (potential) infection. What are the infection control standard precautions? The infection control standard precautions are a series of procedures designed to prevent cross transmission from both recognised and unrecognised sources of infection. These sources of (potential) infection include excreta, sewage, wastewater, solid wastes, market wastes, and medical wastes in addition to any equipment or items which have been in contact with these items (such as shovels, waste containers, waste transportation vehicles). Why are infection control standard precautions necessary? The infection control standard precautions are necessary to ensure the safety of all staff involved in excreta management and solid waste management in the refugee setting in addition to protection the general population from disease. When should the infection control standard precautions be applied? All staff providing excreta management and solid waste related services in a refugee setting including within the host community must apply the principles of the infection control standard precautions at all times. A lapse in compliance must be reported to the excreta management senior programme staff immediately. Who has the responsibility for applying the infection control standard precautions? Senior programme management have the responsibility to ensure that all programme staff have the means and knowledge to apply the infection control standard precautions, however all staff themselves have the following responsibilities. To attend induction and refresher education sessions as required. To consider the elements of the infection control standard precautions as an objective within staff continuing professional development. To immediately report any lapse in compliance to senior management. To immediately report any illness which may be as a result of occupational exposure to senior management. The infection control standard precautions outlined in this guideline include: Personal protective equipment Hand hygiene Occupational exposure management Management, cleanliness and sterilization of equipment Safety along the excreta disposal and solid waste disposal chains Safe final disposal of excreta and solid wastes Personal protective equipment The use of Personal Protective Equipment (PPE) is essential for the health and safety of workers undertaking excreta management and solid waste related activities. Selection of PPE must be based on an assessment of the risk of occupational injury or the transmission of micro-organisms during working. The use of PPE is considered standard in situations where staff may come into contact with excreta, sewage, wastewater, solid waste or any other sources of (potential) infection. Everybody involved in providing excreta management and sanitation services should be educated about the infection control standard precautions, and trained in the use of PPE. For the purposes of this guideline, the PPE includes: Protective gloves Protective aprons and overalls. Protective Footware. Protective face, mouth/eye protection, e.g. masks/goggles/visors. Gloves How to choose the correct glove Gloves are available in a variety of materials. UNHCR and WASH actors should undertake a risk assessment to ensure that the physical characteristics and barrier properties are acceptable, and that the gloves selected provide protection against the risks encountered. Gloves must be well fitting to avoid interference with dexterity, friction, excessive sweating and finger and hand muscle fatigue. Gloves for handling waste should be sufficiently strong to withstand puncture (e.g. from bottles, tins, or any other sharp waste). When to wear gloves Gloves must be worn for all activities that have been assessed as carrying a risk of exposure to excreta, sewage, wastewater, solid waste, and when handling sharp or contaminated waste. Torn, punctured or otherwise damaged gloves should not be used and should be changed immediately. Spare gloves should be carried by crews that are mobile. Removal and disinfection of gloves Gloves should be removed promptly after use and before touching non-contaminated/clean areas/items, environmental surfaces, or other persons (including the person wearing them). Gloves which have (potentially) come into contact with pathogenic organisms during excreta management or solid waste activities should be cleaned with soap and water followed by rinsing in a 0.2% chlorine solution and then left to dry. Care should be taken when removing gloves to avoid contamination of hands and clothing. Hand hygiene should be performed immediately after the removal of gloves. Overalls and aprons How to choose overalls and aprons There are many types of work overalls and aprons available and they should be selected following a risk assessment to ensure they are appropriate for use and avoid any interference during excreta management or solid waste activities. UNHCR and WASH actors should ensure that hard wearing cotton overalls and plastic aprons are available to staff and they are worn for a wide array of excreta management and solid waste activities according to a classification of tasks. Full-body waterproof suits should be worn, rather than plastic aprons, when there is a risk of significant splashing of excreta, sewage or wastewater (e.g. when undertaking toilet desludging activities) as indicated by a risk assessment. When to wear overalls and aprons Excreta management and solid waste staff should generally arrive at work, change into clean overalls and aprons and undertake the work shift, changing overalls if they become soiled. During break times or at the end of the work shift they should then remove their soiled overalls and aprons, perform hand hygiene and (if necessary) shower, change into the clothes they came to work, and return home. Soiled overalls or aprons that have (potentially) come into contact with pathogenic organisms during excreta management or solid waste activities must not be taken home by the staff member. UNHCR and WASH actors should make arrangements for the decontamination, laundering, drying and storage of work overalls and aprons. Torn, damaged, or soiled overalls and aprons should not be used and should be changed immediately. Spare clean overalls and aprons should be carried by crews that are mobile. UNHCR and WASH actors should ensure that programme staff have their own dedicated, private, and fully functional showering facilities to allow staff to bathe before changing into their own clean clothes and return home. How to change soiled overalls and aprons All overalls and aprons (whether visibly soiled or not) that have been used in activities related to excreta management or solid waste management should be removed carefully avoiding contact with soiled areas. If visibly contaminated, the overalls and apron should be turned inward, rolled into a ball and then the item should be discarded immediately into an appropriate receptacle (for example a plastic bin) for disinfection and laundering. Overalls and aprons that are not visibly contaminated may be hung in a suitable closed locker in the sanitation yard for use the following day. Used overalls that have been used in excreta management or solid waste related activities should never be left on environmental surfaces. Used overalls that are not visibly contaminated should be laundered and disinfected at least once a week. Face, mouth and eye protection, e.g. surgical masks/goggles How to choose the correct protection and when and how to wear it Face masks and eye protection must be worn where there is a risk of excreta, sewage, wastewater, or soiled wastes splashing into the face and eyes, or there is a risk of occupational injury to the eyes (for example during the collection of solid wastes). Face masks should always fit comfortably, covering the mouth and nose. Goggles must ‘wrap around’ the eye area to ensure side areas are protected. Face shields/visors should be considered, in place of a face mask and/or goggles, where there is a higher risk of splattering/aerosolisation of sewage or wastewater. Face protection should not be touched while being worn and should be removed immediately following an activity. Face protection should be removed immediately once an activity has been completed. If face masks become soiled they should be changed immediately. Torn or otherwise damaged face protection should not be used and should be removed immediately. Spare clean face protection should be carried by crews that are mobile. How to remove face, mouth and eye protection Remove face, mouth and eye protection promptly after use, avoiding contact with any soiled areas, and placed in a designated location (e.g. a plastic bin) for decontamination, cleaning and drying or disposal. Hand hygiene should be performed immediately after removal/disposal of face, mouth and eye protection. Soiled face, mouth and eye protection should never be placed on environmental surfaces. Soiled face, mouth or eye protection should not be taken home by staff members. Footwear Correctly fitting, waterproof, durable protective steel reinforced work boots must be worn where there is a risk of contamination from excreta, sewage, wastewater, or soiled wastes, or there is a risk of occupational injury to the feet (for example from glass, tins, razor blades, or syringes during the collection of solid wastes). Excreta management and solid waste staff should generally arrive at work and change into their overalls and boots for the work shift. At the end of the work shift they should then remove their soiled overalls and boots, perform hand hygiene and (if necessary) shower, change into the clothes they came to work, and return home. Soiled footwear that has (potentially) come into contact with pathogenic organisms during excreta management or solid waste activities must not be taken home by the staff member. The organisation should make arrangements for the decontamination, drying and storage of work footwear. How to remove footware Care should be taken when removing footware to avoid hand contamination. Hand hygiene should be performed following the handling of footwear.   Hand hygiene Hands are the most common way in which staff involved in the excreta management or solid waste collection programme may come into contact with infectious agents. Good hand hygiene is the most important practice to remove or destroy transient micro-organisms and reduce the transmission of infectious agents. Hands should be decontaminated at a range of times in order to remove or destroy infectious agents. UNHCR and WASH actors should ensure that programme staff have their own dedicated, private, and fully functional handwashing facilities to allow staff to comply with hand hygiene procedures. When? Decontaminate your hands after direct exposure risk to excreta, solid wastes, medical wastes, body fluids Why? To protect yourself and others from infectious organisms. When? Decontaminate your hands on completion of touching or using waste collection equipment or vehicles. Why? There is a high potential risk that waste collection equipment and vehicles are contaminated with infectious organisms. When? Decontaminate your hands every time you take a break from your work for example during tea breaks, toilet breaks or any other breaks. Why? To protect yourself and others during your work break. When? Decontaminate your hands at the end of your work shift before you go home. Why? To protect yourself and others once you leave the work environment. When? Decontaminate your hands directly after removing personal protective equipment. Why? There is a high potential risk that personal protective equipment is contaminated with infectious organisms. Occupational exposure management Injuries from sharp objects (for example glass, tin cans, razor blades, or syringes) are the most common types of injury to be reported by staff involved in solid waste collection services. In all cases, correct use of PPE in particular protective gloves and boots should help to reduce the risk of injury and exposure to infectious agents. Any incident where occupational exposure has occurred must be reported immediately to senior management. UNHCR and WASH actors should ensure that all staff immunisations are up to date (e.g. hepatitis B). Actions in the event of a sharps related injury Skin/tissues should be gently encouraged to bleed. Do not scrub or suck the area. Wash/irrigate with soap and warm running water. Do not use disinfectants or alcohol. Cover the area using a waterproof dressing. Eyes and mouth should be rinsed/irrigated with copious amounts of water. There are often eyes/mouth washout kits available in clinical areas. Report/document the incident to the local healthcare facilities. Urgency is important as post exposure prophylaxis (PEP) for exposure to medical wastes for HIV or other treatments may be available (i.e. ideally PEP should be commenced within 1 hour of the incident having taken place, but is not advised if exposure time exceeds 72 hours). Near misses should also be clearly reported/documented. Ensure that the item that caused the injury is disposed of safely to ensure that a further incident is avoided. Report the incident to senior management. Management, cleanliness and sterilization of excreta and solid waste equipment Equipment (or vehicles) used to move, contain, store, or maintain excreta, sewage, wastewater or solid water can easily become contaminated with excreta, or other body fluids. Therefore excreta and solid waste management equipment (e.g. bins, trucks, containers, buckets, pumps, shovels, wheelbarrows) must be appropriately cleaned, disinfected, and stored in order to limit the risk of transmitting pathogens and attracting disease vectors (in particular flies and vermin). How should excreta management and solid waste equipment be cleaned and stored? Equipment used in the handling, storage, or transportation of excreta, sewage, greywater or solid waste must be cleaned on a daily basis or when visibly dirty with detergent and water, disinfected with 0.2% chlorine solution, dried and stored following each use. A dedicated cleaning facility may be established (sanitation yard) with cleaning tools (e.g. high pressure sprayers). A refuse truck decontamination station may be established at the exits of landfill sites / sewage lagoons. A static garbage bin cleaning facility may be established at the landfill area. Excreta and solid waste management equipment and tools should be checked for cleanliness prior to use, e.g. when being removed from storage. Equipment and vehicles used in the storage or transportation of excreta or solid waste must be checked for leaks and cleanliness. Wastewater from cleaning activities should be carefully disposed into a properly designed soak pit or infiltration trench that does not contaminate ground water or other water supplies. Storage, e.g. shelves, units, lockers should have easy-to-clean, smooth impervious surfaces and should be water-resistant and durable enough to tolerate repeated disinfection with mild chlorine solutions. All sanitation items, must always be stored off the floor to facilitate effective cleaning. Safety along the excreta disposal and solid waste disposal chains The management and reduction of risks along the excreta disposal and solid waste disposal chains is an important element of the infection control standard precautions. At each step (collection, transportation, processing, storage, disposal) in the chain a risk assessment (sanitary survey) must be carried out to identify risks to staff, the public and the environment in addition to any control measures. Final disposal of excreta and solid wastes must be in a location that eliminates all risk to the population and the environment. Incident reporting Any incident where inappropriate excreta or waste management has occurred or there has been a near-miss (a public health incident concerning excreta, sewerage, wastewater, solid waste nearly occurred but was narrowly missed) should be reported immediately to senior management so that a review and policy change can occur.

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ANNEX: Sample sanitation related job descriptions

Camp block cleaner

TITLE: CAMP BLOCK CLEANER LOCATION: [XYZ CAMP] REPORT TO: SANITATION OFFICER PROGRAM SUMMARY: [INCLUDE A BRIEF DESCRIPTION OF THE CAMP SANITATION PROGRAMME HERE]. OBJECTIVE: The Camp Cleaner will ensure that all communal areas, market areas and main roads within the designated camp block are kept clean - free from litter and refuse; in addition to ensuring that designated communal toilets are kept clean and fully functional. RESPONSIBILITIES: Daily cleaning (at least four times per day) of communal toilets with detergent and 0.2% chlorine. Daily topping of handwashing water (via wheel barrow), and soap in communal toilets as required. Collection of any wastes in the communal space, and roads in the camp, including market wastes (slaughter wastes), organic wastes, animal wastes and human wastes (human excreta). Ensure safe final disposal of all waste. Loading and offloading of waste in the pick up truck from the waste bins Reporting any damage and/or loss of excreta or waste disposal infrastructure immediately. Assist with any other duties as required by the Sanitation Officer. REQUIREMENTS: Physically strong and capable of walking long distances. Capable of working with all community groups. Self-motivated and capable to work with minimum supervision. Female candidates are welcomed and encouraged to apply.

Sanitation Officer

TITLE: SANITATION OFFICER LOCATION: [XYZ CAMP] REPORT TO: SANITATION PROGRAMME MANAGER PROGRAM SUMMARY: [INCLUDE A BRIEF DESCRIPTION OF THE CAMP SANITATION PROGRAMME HERE]. OBJECTIVE: The Sanitation Officer will oversee all aspects of operations and maintenance of the camp’s sanitation program within a camp sector (5,000 persons). This involves excreta disposal, solid waste separation, recycling, collection and disposal, water point drainage systems, and disease vector control. RESPONSIBILITIES: Supervise 4 camp cleaners, 1 waste collection technician, 1 communal toilet maintenance technician, and 1 household toilet construction promoter. Serve as the focal point for all activities related to communal toilets, household toilets, solid waste separation, recycling, collection and disposal, water point drainage and disease vector control within the camp sector (16 blocks i.e. 5,000 persons). Ensure excreta, solid waste and vector control activities comply with appropriate standards. Supervise installation and start-up operations of new sanitation infrastructure. Supervise activities related to household, communal, shared and public toilets. Supervise the collection, removal and disposal of solid and liquid waste. Supervise activities related to collection and disposal of medical wastes. Ensure vector control activities are properly targeted. Collect data and maintain records related to camp sanitation systems. Initiate procurement to ensure adequate supplies for sanitation activities. Participate in any data collection meetings, surveys, and focus group discussions as required. Write progress reports and keep the Sanitation Manager informed of the sanitation situation. Assist with any other duties as required by the Sanitation Manager. QUALIFICATIONS: Knowledge and experience in excreta disposal, solid waste and vector control activities; Excellent interpersonal, organizational and time management skills; Capable of training refugee groups and motivating community support; Education to secondary level – ability to write basic activity reports; Female candidates are welcomed and encouraged to apply;

Sanitation Programme Manager

TITLE: SANITATION PROGRAMME MANAGER LOCATION: [XYZ CAMP] REPORT TO: WASH COORDINATOR PROGRAM SUMMARY: [INCLUDE A BRIEF DESCRIPTION OF THE CAMP SANITATION PROGRAMME HERE]. OBJECTIVE: The Sanitation Programme Manager will oversee all aspects of operations and maintenance of the camp’s sanitation program within the camp (20,000 people). This involves excreta disposal, solid waste separation, recycling and disposal, water point drainage systems, and disease vector control. RESPONSIBILITIES: Supervise four (4) sanitation officers covering each camp sector (5,000 persons). Serve as the focal point for all activities related to excreta disposal, solid waste disposal, water point drainage and disease vector control within the camp. Ensure excreta, solid waste and vector control activities comply with appropriate standards. Manage start-up operations of new sanitation infrastructure. Manage programme staff, activities, budgets, resources, training, surveys and reporting related to excreta disposal, solid waste disposal, water point drainage and disease vector control. Manage activities related to collection and disposal of medical wastes. Ensure vector control activities are properly targeted. Serve as technical advisor for all sanitation related activities. Collect data and maintain records related to camp sanitation systems. Monitor programme progress to include communal toilet coverage, household toilet coverage, waste disposal habits and existence of vectors. Conduct needs assessments including focus groups, key informant interviews, observation walks and household surveys as required. Initiate procurement to ensure adequate supplies for sanitation activities. Write progress reports and keep EH manager informed of the sanitation situation. Assist with any other duties as required by the WASH Coordinator. QUALIFICATIONS: Advanced education in sanitary engineering (university or advanced qualification a plus). Two years of experience managing sanitation programs; NGO experience preferred. Knowledge and experience in excreta disposal, solid waste and vector control activities; Experience working in refugee settings; Excellent interpersonal, organizational and time management skills; Fluency in spoken and written English; Operational knowledge of Microsoft Office software; Female candidates are welcomed and encouraged to apply;

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» Ben Harvey - UNHCR Consultant