Back late last year in Jamam, we had been doing some ad hoc monitoring of the water that people store in their homes, and what we saw surprised us. Oxfam chlorinates the camp’s water supply before distribution, and because of the on-going Hepatitis E outbreak out here, chlorination levels had even been doubled in order to offer better protection. What we found, despite these outbreak measures being in place, was that many households — 40% to 60% – had no detectable free residual chlorine (FRC) in their stored water. This was corroborated by more systematic surveys done by Oxfam and CDC [Centre for Disease Control].
No doubt this was cause for concern. If the drinking water in people’s homes was unprotected, it could be an active pathway for the transmission of Hep E and acute watery diarrhoea — both water-related diseases and leading causes of morbidity and mortality amongst the refugee population. In partnership with Oxfam, we had been implementing a bunch of outbreak control measures to combat Hep E — water container disinfection campaigns, scaling up hygiene promotion activities in the camp, big sanitation build projects. Oxfam had been working hard too on improving the performance of the water system in order to stabilize chlorine levels at the tapstands. But the household FRC finding had got me wondering. Even if the chlorine was on point at the tapstand, what was happening to it by the time it was consumed at the household?
I started to dig around in the literature on this question. The guidelines for safe water supply in humanitarian responses, from MSF, from SPHERE, from others, stipulate acceptable ranges for FRC at distribution points. As far as I could find out, these guidelines were derived experientially and assumed that some residual chlorine would remain in the water to protect it until consumed. But studies had shown that water can be (re-)contaminated during collection and transport from distribution points, as well as during storage and drawing of water in the home, contributing to the diarrhoeal disease burden amongst vulnerable populations — especially those in refugee/IDP camp settings. This question of what happens to the protective FRC in camp water supplies, between distribution and consumption, had never been explored before.
This was a big question on all our minds out here, all the people and organizations involved in WASH [Water, Sanitation and Hygiene] in the Maban camps, so I proposed a study to investigate the fate of FRC to HQ in Amsterdam. I was curious to see what happens to the FRC — from the tapstand, to just after collection in the container, after being transported to people’s homes, and after several hours of storage and use in the household — and how different water handling practices correlate with different outcomes.
Amsterdam was down with the idea, so they shipped me the testing equipment I needed—turbimeters, photometers, chemical analyzers. For the past month now, I’ve been collecting data in the field with my team—Simon, Thomas, Kahlil, Issa, Abdalbagi, and Alfaki—first in Jamam camp, then in Batil, and now in Gendrassa. Today is our last day of data collection in the field (so I finally have some time to write about it!), and we’ve got more than 200 unique samples completed now.
After so many months here, and so many different projects, I’m finally wrapping up my time here in Maban. Next week I’m headed back to Toronto. End of mission … finally! But I’ve got a several weeks of work ahead of me once back to analyze the data and write up the research. I don’t know yet what kind of patterns will emerge from the data. Since it’s the first time this kind of investigation has been done in the field, it’ll at least help to build the evidential base on the safe water guidelines. But maybe, the research might even help to improve best practices for safe water supply in refugee and IDP camps the world over.
Maybe getting a PhD and heading out to the field was a good idea after all. Ha!