1. Sphere Project & Transformative Agenda Roles & Responsibilities of the state the community Humanitarian practitioners Refugees IDP’s Shaped by lessons learnt from Tsunami, Kasmir/Pak earthquake, Myanmar cyclone, China earthquake Effective advocacy & ID gaps Joint preparedness Joint contingency planning Shared leadership & coordination at national & Sub-national Transitioning to early recovery Improved gender inclusion

2. Sphere Charter & standards http://www.sphereproject.org/resources/download-publications Cluster approach Quality programming Preparedness Improved initial assessments; RAT, CAT Water Safety Plan - Risk management of water sources - Long term use of water supply - cholera prevention & treatment Water Treatment - treatment decision tree - Household level - Point of use treatment with chlorine Sanitation - appropriate facilities & methods -Difficult environments (floods, high water table etc)

3. WASH Framework NORMAL ALERT EMERGENCY RECOVERY MONITORASSESSUPDATE Technical training; Contingency stocks, Consumables and supplies in good order. Chlorinate storage tankers & boreholes ID safe water points Lined septic tanks Advocacy: to improve quality and fill gaps Raised pump above flood level Emergency boreholes in safe water areas. Deeper boreholes & RO units for arsenic & nitrate Reduce proximity of excreta disposal & water points Waste water networks Water Tankering; Open emergency boreholes Chlorination of bladders & tanks Household safe practices and treatment Water Quality monitoring (HH & Source) Household awareness: hygiene, vector control Cluster Consolidated Data Sharing Improve Quality: Deeper boreholes Storage Capacity: New water points in safe tested locations above flood level. Lined latrines. Distribution of updated maps & lists Sanitation awareness raising installation of sanitary units

4. WASH Disaster Management & Response Framework

5. Before, After, During Improved baseline awareness Information flow Effective coordination Risk Mitigation Strategic planning Better provision of services/ Risk Mitigation Less duplication Less ambiguity Better partnerships Better resourcing

6. “Simply providing sufficient water and sanitation facilities will not, on its own, ensure their optimal use or impact on public health” SPHERE, 2011 People affected by disasters are generally much more susceptible to illness and death from disease, which are related to a large extent to inadequate sanitation, inadequate water supplies and poor hygiene. The most significant of these diseases are diarrhoeal diseases and infectious diseases transmitted by the faeco-oral route. Other water- and sanitation- related diseases include those carried by vectors associated with solid waste and water The main objective of water supply and sanitation programmes in disasters is to reduce the transmission of faeco-oral diseases and exposure to disease-bearing vectors through the promotion of good hygiene practices, the provision of safe drinking water and the reduction of environmental health risks and by establishing the conditions that allow people to live with good health, dignity, comfort and security. The term ‘sanitation’, throughout Sphere, refers to excreta disposal, vector control, solid waste disposal and drainage

7. What & Who to target Water Borne & Communicable Diseases 2010 over 300,000 reported AWD, of which half were within Punjab Women ranked health, water & hygiene as more important. Nearly double the rates of diarrhoea were seen among boys and men rather than girls and women. Even if source was clean, 50% of household water was contaminated Skin diseases ranked 2 nd highest reported cases BEFORE Awareness raising for men and boys More consultations with women for types of hygiene kits, water point & sanitation locations Increase soap in hygiene kits & water for washing Improved safe excreta disposal (lined septic tanks) DURING Close off or put signs where water sources are contaminated Cleaning of water tanks, jerry cans prior to filling Check water quality at HH & Source Basic sanitation to reducing vectors & protecting water quality

8. Baseline Public health Hygiene and public health is not well regarded by the population: 57% wash their hands before a meal, 66% wash their hands after using the toilet, 94% drink untreated water and 50% of the water is contaminated; Awareness raising Treatment at household level Monitoring at household level Support & guidance in construction at household level (SPHERE)

9. 12 of the 36 districts in Punjab are being provided water through PHED water supply schemes, of which only 50% of the population are supplied. Higher groundwater ratio Check GW quality in each district (maps, graphs & lists)

10. There are 2661 villages/locations that tested positive for bacteriological contamination which places 24,964,595 people at risk.

12. Majority of water sources used for drinking water are motorized pumps (39%) and handpumps (32%) bacteriological contamination 48% motorized pumps & 41% from handpumps Amongst all water sources tested, the greatest rates of bacteriological contamination was found in tubewells, 73% of which tested positive. RISK ANALYSIS Make exploratory boreholes Check aquifer quality & water quality at different depths Review location specific options WHO HAVE FULL MAPPING PER VILLAGE

13. “Humanitarian assistance in relief phase should not be wasted in emergency latrines construction except in organized camps with proper management responsibility” (donor feedback) “The main objective of water supply and sanitation programs in disasters is to reduce the transmission of faeco-oral diseases and exposure to disease-bearing vectors through the promotion of good hygiene practices, the provision of safe drinking water and the reduction of environmental health risks” (Sphere, 2011)

14. Excreta Disposal In 2010The following problems were encountered: AIM: Reduce Transmission of water borne disease Latrines not raised above flood level Lack of distance between groundwater and latrine Building latrines with un-lined pits close to water points. Knowledge between the design of cesspits and septic tanks & associated problems AIM: Reduce Exposure to vectors No cover on latrine allowing vectors to enter and spread disease Open roofs allowing more rainwater to enter latrine pit and fill up quickly AIM: Appropriate Services Subsidized latrines were not accepted VIP or direct drop pit latrines were not accepted by community Females however ranked sanitation as considerably higher (15%) compared to men (6%). Privacy, location, addressing menstrual hygiene and sufficient numbers of latrines should be key factors to include in future responses.

15. Early Recovery Solutions Septic tank vs cesspit -Septic tank design has two chambers; one for sedimentation treatment and settling of solids, the second used as a liquid over-flow chamber. -A septic tank is totally enclosed and lined at the base and sides to prevent contamination of surrounding soil. -Effluent then flows to secondary chamber or “leach pit” or infiltration field -Bacteriological action= no chemicals -A Leach pit or infiltration chamber is unlined and used only for allowing liquids to drain away. -Can be used as a soakaway AFTER pre- treament in a septic tank as in diagram. -Groundwater depth and soil percolation rates need to be calculated to prevent contamination of water.

16. Percolation & Infiltration Rates Distance between Excreta infiltration & Groundwater (UNHCR) Soil/Rock type Approximate minimum distance (meters) Silt 10* Fine silty sand 15 Weathered basement (not fractured) 25 Medium Sand 50 Gravel 500 Fractured Rocks Not feasible to use horizontal separation as protection 10m is the minimum distance an infiltration system should be from a water source

17. Nitrate Contamination

18. 16 Nitrate Contaminated Locations VillageTehsilDistrictSource of water SgalbandaiSwariBunner/RawlpindiSpring Kot GullahTalagangChakwalTube well UC Office DandotChoa SyedanChakwalSpring Bhati GujarKallar KaharChakwalInjector BharpurKallar KaharChakwalHand Pump RandheerKharianGujratHand Pump DhriangnwaliHafizabad Hand Pump Hazara ColonyRawalpindi Tube well Chak 136/NBSillanwaliSargodhaInjector Chak72/SBSargodha Tube well Chak70/SBSargodha Hand Pump Mohallah Manzoor parkFaisalabad Injector S.S.P OfficeGujranwala Tube well Mouza Pull Shah doolaKamokeyGujranwalaHand Pump CHAK 4 BCBahawalpur Hand Pump Chak # 192/PRahim Yar Khan Injector Pump

19. Arsenic in Water Supply Sources

20. The total population of these 656 villages is 6,173,680 that are at risk from exposure to arsenic in their water supply.

21. WHO HAVE FULL MAPPING PER VILLAGE

22. Water Tankering BEFORE BEFORE: Establish standby arrangement through MoU’s with suppliers Provide clear guidance and/or training for use of chlorination Translate guidance into local language Check pricing structure & companies used with WASH agencies to establish pricing structure and prevent monopolisation by sole supplier DURING DURING: Try to supply as many people as quickly as possible. Fill bladders and static tanks & provie extra taps rather than filling directly from the tanker. As a minimum requirement, residual chlorine should be measured prior to each delivery and verified by recipient/signatory. Source, tanker and storage points should also be tested to ensure no contamination during each stage of the delivery process Inform the WASH cluster of the trucking activities Inform communities of tanker delivery schedules Inform communities when trucking is to cease and location of alternative safe drinking water sources (check quality of water using maps and tables for arsenic, nitrate and salinity). Ensure water points are safe and operational prior to ceasing trucking AFTER AFTER: Review effectiveness of trucking with other agencies and local government to improve efficiency. Review quality and functionality of water points to ensure community continues to have sufficient quality and quantity of water from alternative sources.

23. What WASH Cluster can provide CD 1 WHO guidelines & standards for water quality Arsenic high risk locations (map, graph, list) WHO water quality mapping (arsenic, nitrate, bacto per district) Coverage of water supply schemes (map, list) Sanitation in Emergencies CD 2 New SPHERE handbook- on CD Engineering in Emergencies Handbook IEC materials for hygiene promotion Hard Copy List of MIRA trained focal points Cleaning & Disinfecting of water tanks (CDC & WHO guidance) WHO Chlorine testing (comparator use) guidance Consolidated table of locations with water quality issues List of DDRMC’s & PHED focal points – hard copy Arsenic high risk locations map (map, graph, list) Still to come Water Trucking water quality monitoring check list WASH Framework- what to provide when WASH cluster preparedness & response strategy for Punjab

24. How you can help us, to help you Per District Nominated (I)NGO/CBO focal points per district Update WASH Cluster/PDMA of changes in personnel Water data reporting ( List of water supply systems installed/rehabilitated with GPS or village name) Examples of good designs (& BoQ) Donor Briefing note

25. Useful websites Selecting Appropriate Designs http://waste-dev.akvo.org/dst/sanitation/technologies/ http://www.sswm.info/category/implementation- tools/implementation-tools-introduction http://www.sswm.info/category/implementation- tools/implementation-tools-introduction Technical Notes for Emergencies http://wedc.lboro.ac.uk/knowledge/notes_emergencies.html Cleaning & Disinfecting Storage Tanks http://www.searo.who.int/LinkFiles/List_of_Guidelines_for_Health _Emergency_Cleaning_and_disinfecting_water_storage_tanks.pdf http://www.searo.who.int/LinkFiles/List_of_Guidelines_for_Health _Emergency_Cleaning_and_disinfecting_water_storage_tanks.pdf Alternative Treatment www.sodis.ch/index_EN www.sodis.ch/index_EN www.peacecorps.gov/resources/media/medstories/1572/

26. On behalf of the WASH Cluster, NDMA, PDMA, PHED Thank you

27. National Cluster Begna Edo, WASH Cluster Coordinator bedo@unicef.org, 0345-500-6491 Ajmal Bhaddi, NDMA, co-chair ddlegal@ndma.gov.pk, 030096887087 Ali Rehmat, WASH IM/GIS Officer washimislamabad@gmail.com, 03445323009 http://pakresponse.info/MonsoonUpdates2011/Clusters/WASH.aspx Global WASH Cluster Rapid Response Team Damien Brosnan, WASH IM specialist dbrosnan@unicef.org Jola Miziniak, WASH Cluster Coordinator jomiziniak@unicef.org For more information please contact