Abstract
Abstract The Somali Region of Ethiopia has been affected by drought for several years. Drought conditions have led to food and water scarcity and a humanitarian crisis in the region. In January 2017, an outbreak of acute watery diarrhea (AWD) was declared in the region. AWD prevention and control activities include strengthening water, sanitation, and hygiene (WASH) services. Access to safe drinking water is critical in preventing transmission of AWD and chlorine is an effective chemical to disinfect water supplies. The US Centers for Disease Control and Prevention collaborated with the WASH Cluster and the United Nations Children's Fund, Ethiopia, to provide technical assistance to the Somali Regional Water Bureau to improve chlorination of drinking water supplies and quickly assess water quality improvements in Jijiga town, Fafan Zone. Timely sharing of surveillance and case investigation data allowed for the identification of gaps within the water supply system in Jijiga and implementation of centralized and decentralized chlorination interventions and monitoring systems. Pilot use of a rapid assessment to determine residual chlorine levels at various points in the city helped improve chlorination intervention impact. This work illustrates that rapid community-level water quality improvements can be implemented and assessed quickly to improve interventions during outbreaks.
Highlights
Groups visited and tested 179 water points in Jijiga during the free residual chlorine (FRC) rapid assessment: 36 tapstands from the piped network, 7 tapstands from boreholes, 47 donkey carts, 3 trucks that filled at trucking filling stations, 4 trucks that filled from surface water sources, 11 underground storage tanks connected to the piped network, 10 underground storage tanks filled with runoff water, and 61 household jerry cans
Tapstands connected to individual boreholes, underground storage tanks, and trucks that filled from surface water sources were not targeted by chlorination interventions, due to a lack of feasibility
This improvement in chlorination appeared to coincide with a stabilization of the incidence of Acute watery diarrhea (AWD) cases, there is no clear evidence that this was directly attributable to the intervention
Summary
The resultant impact on crop and livestock cultivation has led to food and water scarcity, population displacement, and a humanitarian crisis in the region. This crisis was further exacerbated by an outbreak of AWD that started in January 2017. From 1 January to 10 July 2017, there were a total of 33,993 cases in the region including over 1,000 cases in Jijiga, the capital of the region
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