Abstract
After the 2015 earthquake in Nepal that killed approximately 9,000 people, the country faced an increased risk of cholera outbreaks due to extensive destruction of water and sanitation infrastructure and massive displacement. The disaster revealed long-standing weaknesses in water and sanitation systems in the country. Anticipating a cholera outbreak in 2016, UNICEF, Johns Hopkins University, and the Group for Technical Assistance partnered to support the Government of Nepal to ensure a safe water supply and improve sanitation and hygiene. This article discusses challenges, gaps, lessons learned and recommendations that were drawn from the authors' experience in cholera prevention and control in post-earthquake Nepal. Challenges identified include lack of regular water quality testing and monitoring, inconsistent use of point-of-use water treatment products, and lack of a fast-track mechanism for rapid response. The article argues for building a resilient water and sanitation system to secure sustainable and equitable access to safe drinking water.
Highlights
On 25 April 2015, an earthquake of magnitude 7.8 hit central Nepal
Over 5 million people living in 31 districts were affected (National Planning Commission )
We present viewpoints and insights into cholera prevention and control based on our experience during that outbreak
Summary
An infectious disease caused by Vibrio cholerae, is endemic in Nepal. Outbreaks often occur during the Downloaded from http://iwaponline.com/washdev/article-pdf/8/4/799/512459/washdev0080799.pdf by guest. In 2016 in the aftermath of the natural disaster, the country experienced a cholera outbreak with a total of 169 confirmed cases Of those cases, 150 were detected within the Kathmandu valley. The three organizations above launched awareness-raising campaigns through community engagement in transmission hotspots where a cluster of cholera cases was detected. Prevention messages were aired on the radio and were spread through vehicles equipped with amplification equipment These information and awareness campaigns focused on five key messages: household water treatment, safe storage of water at home, handwashing, food hygiene, and basic sanitation. The results of simplified presence-absence fecal coliform tests were shared to sensitize community members on fecal contamination of their drinking water in the hope that this would trigger behavioral changes towards water treatment. Government water suppliers and water tanker associations were trained on water chlorination and testing methods
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