When I arrived here just over a month ago, the HERP (Hepatitis E Emergency Response Project) team was made up of 5 people: The Medical Team Leader, a Nurse, a Chad WATSAN, a Logistician and a Project Coordinator. Today it has grown to 15 people with the addition of an outreach nurse, three more logisticians, an epidemiologist, two administrative and finance staff, an emergency coordinator, a doctor, and another WATSAN.
The security threat in Am Timan is relatively low. As long as I have a radio, I am able to walk around the city on my own from 6am till dusk. This has been quite useful since it means I can make surprise visits to nearby water points to see if they are actually being chlorinated!
Modeling our Hepatitis E prevention shirt
My WATSAN Life: Week 5
This week we started our Hygiene Promotion (HP) program. These twenty-four Hygiene Promoters (HPs) are stationed at Water Points in Am Timan. Each HP is responsible for explaining the importance of hand washing with soap and using chlorinating water at three designated water points.
Hygiene Promoter advocating the importance of good hygiene and why we are chlorinating the water
This week they counted the number of people who agreed to have chlorine added to their water, and the number who refused. The majority of those who said ‘no’ were children. The initial results showed that on average the percentage of people who refused at each water point was around 0-4%, with a couple of outliers having a 20% refusal average.
This week we had 100% chlorination coverage at all 72 identified water points for our Chlorination Program! We also started collecting FRC (Free Residual Chlorine) data for each of the water points to determine if the amount of chlorine added is sufficient to kill the Hepatitis E virus. For this Hepatitis E outbreak, our aim is to have the FRC between 0.5-1.0 ml/L. Based on initial tests, we observed that on average 20L of water required 2ml of 1% chlorine solution to yield a FRC of 0.5 ml/L result. However, this week’s FRC results exposed about a dozen water points yielding results between 0.1-0.3 ml/L.
Bucket tests were performed to determine how much more chlorine was needed to reach a sufficient FRC result.
We got bikes this week! We took them down to the river on Friday afternoon. It was such a significant change from when I first got here and the river was a couple of meters deep. Now it’s barely a few inches and people are able to play soccer in the dried up riverbed. Also, the camel novelty still hasn’t worn off.