For this emergency project, MSF constructed AWD (Acute Watery Diarrhea) treatment units (smaller versions of treatments centers) in some of the surrounding towns and camps for internally displaced people (that's people who have had to move away from their homes, but are still in their own country). This week, I visited the treatment unit in the town of Wal Wal (30 minutes northeast of Wardher).
Driving to AWD treatment unit in Wal Wal with WATSAN colleague Mansur
Upon entering the unit, I was greeted by a large tree resembling the shape of an umbrella. Beside the tree was a clean, yet empty, large tent. Surrounding the tent however were a dozen baby blue mosquito nets strung up by twigs from the central tree and nearby bushes. The patients, all elderly and children under five, rested on mats with IV bags dripping from the above branches.
Despite having less resources compared to the main treatment center, I thought this outreach unit was running efficiently. There was a vomit pit for fluids and a pit for burnable waste, a latrine, and hand washing and oral rehydration points.
While Mansur and I were inspecting the water, hygiene and sanitation needs of the unit, we noticed four children who looked extremely sick and malnourished. We decided to call an ambulance to take them to the main treatment center in Wardher, which also has nutritional support.
I’ve been adjusting well to Wardher life and my role managing the WATSAN staff at the AWD treatment center. The team is composed of locals from the region who work various positions such as disinfection sprayers, chlorine solution technicians, guards and hygienists.
Aprons worn by all the WATSAN staff for protection in the AWD treatment center
Rubber boots used by all WATSAN staff in the AWD treatment center
Chlorine solution technician preparing 2% chlorine solution to disinfect vomit and diarrhea buckets
Three different concentrations of chlorine solution are made everyday by the chlorine solution technicians. The weakest solution (0.05%) is for hand washing at the entrance and exit of all wards (tents), latrines and waste area, as well as for disinfecting plates used by patients.
Hygienist spraying an AWD bed after the patient has been discharged
Next is a slightly higher concentration of chlorine solution (0.2%), which is used to disinfect floors, beds, latrines, laundry and the soles of shoes when entering and leaving areas of contamination. The highest concentration of chlorine solution (2%) is used for disinfecting vomit and diarrhea buckets, as well as the bodies of the deceased.
Chlorine solution technicians mixing various concentrations of chlorine solutions
The inevitable has happened. I have diarrhea. Even though I’m dancing between bed and the toilet, I’m thankful that it isn’t AWD. (Or else I’d have a hole cut in my mattress with a bucket underneath to catch the diarrhea and another bucket beside me to collect my vomit).