4. What to do: Response options

The Emergency WASH Team is currently preparing sample proposal formats detailing response options in different emergency contexts (earthquake, floods etc). These will be posted here when finalized.

There are many different factors that will inform the response options to be selected. These can include:

  • location of population (in original home location, displaced—in the community, or in large camps, dispersed)
  • technologies or methods for WASH normally used by the community
  • cultural practices
  • resources available (e.g. surface water or groundwater)
  • space available and site dimensions
  • long-term operation and management considerations.

Timing and how to best stage different interventions over time must also be considered, especially to ensure immediate needs are met while preparing for transition and more sustainable solutions. For example, when people are immediately displaced into camps, a temporary sanitation design may be selected that can be implemented within days, which would be used by populations while semi-permanent toilets are being planned and constructed (materials being sourced, design of camp being developed, etc.).

The tables below outline common response options according to scenarios. This list is not exhaustive. The technical manuals in the annexes include more options. See Annex 24.1.3. Engineering in Emergencies, Annex 24.1.4 Excreta Disposal in Emergencies and Annex 24.1.5 Safe Disinfection Solutions.

1st phase options Uses and benefits Constraints and considerations

Water supply

Water tankering Effective in urban situations, camps or neighbourhoods


Chlorine dosage can be controlled at tanker level

Unsustainable and expensive, huge logistical challenge to ensure adequate quantity


Need to consider water storage at off-loading points


Access to fuel and tankers can be limited

Well protection and controlled distribution using pump and pipeline Protects and improves water source such as spring or well, reducing contamination


Chlorination can be controlled and water can be treated (to tank, or individual water containers)


Effective for both camp-based situations and dispersed populations by supplying in targeted locations for people to collect

May need continuous supervision and training of caretakers


Needs higher-capacity storage containers


Difficult to meet Sphere standards for distance and users per distribution point

Distribution of water purification product (e.g. Aquatabs, WaterGuard) with water storage containers and hygiene promotion at household level Effective in situations where people are spread over large areas, including home-based


Can reach large numbers of people and large areas, for example in flooding situations

Need to distribute jerry cans or storage containers with water purification product


More effective with sensitisation activities and follow-up


Rehabilitation of existing latrines, for example in schools or public spaces Quick solution and important if displaced people have gathered in public buildings May not be sufficient quantity of latrines available (so potential to combine this with temporary latrines).
Shallow or deep trench latrines Quick solution using simple materials (plywood, tarps, etc.), and can be used while longer-term options developed Short lifespan


Need large amounts of space


People may not be willing to use, and can lack privacy

Open defecation management (defecation field) Useful where there is a large population and no other option is possible (due to lack materials)


Immediate option when large numbers of people accumulate in a short timeframe

Difficult to manage; may need continuous supervision and signage


Is not preferable to people


Risk of cross-contamination

Bucket latrines Suitable for high water table, needing a rapid solution Need location to dump waste, as containers will fill quickly


Continuous attention to dumping

Chemical toilets Urban situations (can be used over constructed/concrete land) High cost


Need a contract that considers the frequent use and degradation of facilities


Challenged with de-sludging


2nd phase options Uses and benefits Constraints and considerations

Water supply

Piped water supply with tap stand, including treatment at storage level Provides 24-hour water supply


Storage provides buffer between source and distribution for settlement and treatment


Reduces walking distances, is an organised distribution with reduced concentration of people at water sources


Eliminates direct user contact with source, thus reducing contamination risk



Needs skilled engineers to set up


Needs continuous maintenance at all levels (e.g. broken taps)


Need to do calculations on yield of sources available to meet peak demand flow rate


Treatment system requires skills, logistics, fuel, equipment and chemicals


Need to train caretakers to do chlorination or other treatment and pump maintenance

Urban piped water scheme Is a more sustainable option in situations where a pipeline already exists


Will likely need to rehabilitate or repair existing pipeline to reach affected locations

Will likely need to support local authority/local water authority to maintain pipeline, or provide materials (e.g. chlorine)
Rainwater harvesting scheme Sustainable option in areas where rainfall is frequent


Fairly easy to control contamination sources

Suitable for remote populations that are ‘cut off’ from assistance

Can be expensive if being implemented at household level


Likely to need to also support a secondary source (e.g. water trucking) in case rainwater storage is depleted

Household water filtration and treatment programme Designed to meet large areas


Suitable where people are home-based


An effective disaster risk reduction measure for populations that are frequently affected by flooding, etc.

Sensitisation and follow-up by hygiene promoters is required to ensure filters are being used correctly


Likely to be very costly


Need to research local supply chains in case filter candles need to be replaced


Pit latrines Quick and relatively inexpensive


No need for de-sludging


Suitable for areas with low groundwater table


Possible to construct slab with locally available materials

Can be used only in certain soil conditions and creates implications for water supply and site planning


Can be problems with smell and flies, and if they are not maintained then people may not use them


VIP latrine Similar to pit latrine, but better quality (reduced smell and flies) with addition of vent pipe from pit Need availability of more materials and additional cost (due to pipes for ventilation)
Eco-san Closed loop system, and there is no need for de-sludging


Can have environmental benefits and is of use for compost


Suitable only if populations are already familiar with use

Needs intensive monitoring and sensitization


Should only be used in situations where families can be assigned to latrine, because dedicated daily maintenance is needed

Pour flush Less smell


Used in situations where it is culturally appropriate and commonly used (e.g. where people will not use toilets if they can see into pit)

Need water supply close by for flushing


Can be blocked easily

Septic tank Can be used in conjunction with pour-flush toilets


Useful in situations where there is a  high water table

Need de-sludging options, including dumping sites


Need skilled technicians/ contractors to build, and detailed drawings beforehand


Very costly and material-intensive

Hygiene promotion aims to enable people to take action to prevent or mitigate disease. It has been proven that the simple provision of water and sanitation facilities will not prevent disease, and that an integrated ‘hardware and software’ approach is the only way to ensure maximum impact of interventions.

The diagram below shows the different components of a hygiene promotion programme.

Typically, the hygiene promotion programme is designed after an in-depth baseline assessment on knowledge and behaviours of the affected population, so that the programme best addresses potential diarrhoeal disease transmission routes in the particular context. Other potential health threats are often addressed, including malaria.

For useful guidelines on the basic aspects of hygiene promotion, see Annex 24.1.6 Hygiene Promotion in Emergencies: A Briefing Paper (WASH Cluster Guidelines).

Source: WASH Cluster, Hygiene promotion in emergencies.

Coordination is essential both at a global level and on the ground during an emergency to ensure that agencies work together to achieve a more ‘predictable, effective, timely and coherent WASH humanitarian response’. CARE is an active participant in the Global WASH cluster led by UNICEF, and maintains an approach to emergency response consistent with the practices adopted by the cluster.

For in-country emergencies, the WASH cluster provides support in coordinating W3 information—who, what, where—as well as coordinating overall strategy, to ensure interventions amongst the humanitarian community are effective and adequate. In large-scale emergencies, technical guidance may be coordinated through separate Technical Working Groups (TWG), and overall response strategy may be coordinated through a Strategic Advisory Group (SAG). It is sometimes possible to access WASH-related non-food relief items (NFI) such as hygiene kits and water storage tanks through the WASH cluster, and donors often make active participation in the cluster a requirement for funding. CARE staff on the ground should actively participate in the cluster and maintain close contact with UNICEF to understand what can be accessed by members of the cluster.

One of the most important reasons for CARE to participate in coordination mechanisms is to advocate for solutions in meeting implementation challenges and barriers. It is essential that challenges are represented with other NGOs’ concerns to the higher level, i.e. to governments, to donors and to the UN Humanitarian Coordinator. The WASH cluster is an important forum for CARE and other NGOs to voice concerns and push for effective solutions. In many cases, concerns are jointly raised with other clusters, particularly shelter or the Camp Coordination and Camp Management Cluster (CCCM). Some examples of advocacy points include:

  • to remove barriers or restrictions for WASH-related supplies to be imported into the country
  • the right for IDPs to be provided with transitional solutions, or to return to their original locations
  • for more adequately sized lands to be designated for displaced people to remain
  • for displaced people to have access to adequate services.

UNICEF is responsible for providing leadership of the cluster on the ground during an emergency. If they are not present, it is appropriate for NGOs such as CARE to provide any necessary leadership around WASH coordination—even in small emergencies—to ensure there is effective coordination between humanitarian agencies, government and other local stakeholders. In a large emergency, it is likely that a dedicated Cluster Coordinator will be present either with or without a team of coordination staff. In these emergencies, there are many opportunities for NGOs to lead in either sub-national coordination or in the TWGs. For example, in the Haiti earthquake response, each municipality within Port au Prince had its own WASH cluster meeting, and some of these were led by NGOs. If CARE has the capacity to take leadership in any sub-clusters, this is encouraged.

Monitoring is an important aspect of any emergency WASH programme. For additional guidelines, see the Monitoring and Evaluation section.

The most appropriate indicators to collect data on should be decided at the outset of the programme, and be linked the project logframe if one exists. The following table provides some examples of WASH indicators. Sphere (Annex 24.1.1) should also be used to select appropriate indicators.

It is important that indicators from Sphere or elsewhere are always adapted to the local context.

For example, Sphere recommends one toilet for a maximum of 20 people as a target, but this may not always be possible in the local context. This is the indicator, but the standard is that the environment be kept free from excreta. It is important to meet the standard, but the indicator is adapted to the local context.

Particular emphasis is required to ensure that IASC Gender and Gender Based Violence (GBV) minimum standards are addressed. A CARE/OCHA study (2011, see Annex 24.1.7) found that in Haiti after the 2010 earthquake, 83% of latrines were not adequately lit and 84% were not gender-separated, creating risks for women and girls.


4.5.1 Sample WASH indicators

Hygiene behaviour Sample indicators (adapted from Annex 8.1.8 WASH cluster hygiene promotion guidelines)
Safe drinking water ·    Adequate water handling practices to minimise contamination practised by x% of the population

·    X% of the population uses safe water for drinking (determine percentage according to situation)

Safe excreta disposal ·    X% of children’s and babies’ faeces are safely disposed of

·    Y% of latrines have lighting sufficient for safe night-time use

·    Z% of latrines are arranged in a gender-segregated configuration

·    Y% of latrines have locks on the inside for safe use

·    Toilets are used by the majority of men, women and children

Hygiene practices ·    X% of the population wash their hands with soap or ash at least after contact with faecal matter and before handling food

·    Soap or ash for hand washing is available in all households

·    Hand washing facilities are available and in use at 100% of communal latrines or in the majority of homes

Women’s privacy and dignity around menstrual hygiene ·    Appropriate sanitary materials and underwear for all women and girls are available

·    Women are enabled to deal with menstrual hygiene issues in privacy and with dignity

Community participation and representation ·    All sections of the community, including vulnerable groups, are consulted and represented at all stages of the project

·    The majority of community members are satisfied (defined in terms of access, safety, privacy, systems for cleaning, etc.) with the provision of facilities

·    Users take responsibility for the management and maintenance of water supply and sanitation facilities

·    All sectors of the community, including vulnerable groups, are enabled to practise the target hygiene behaviours


See also Annex 8.1.8 WASH Cluster Hygiene Project: Indicators for Monitoring Hygiene Promotion in an Emergency.

CARE is accountable to disaster-affected communities, as well as to donors and other stakeholders, for meeting standards for quality and effectiveness in our assistance. The standards CARE is accountable for are described in CARE’s Humanitarian Accountability Framework (for more information, see the Quality and Accountability section).

CARE needs to ensure that all emergency WASH programmes are accountable to the people affected by the emergency, and that the effectiveness of our response is monitored and measured. The WASH cluster has developed a useful checklist and a guide to accountability in WASH programmes (Annex 24.1.9 and Annex 24.1.10).

In designing and managing WASH programmes, pay particular attention to the equitable participation of women and men in the planning, design and management of water facilities. Consideration also needs to be given to ‘vulnerable’ populations—namely women, children, the elderly, the disabled, and people living with HIV/AIDS and other chronic illnesses such as tuberculosis—to ensure that everyone has access to WASH services that meet their needs.

The 2010 earthquake struck Port au Prince and adjacent areas shortly after 5:00 pm on 11 January, affecting the entire population of this city of 2.25 million and killing over 200,000.  Survivors fled into the streets and set up temporary shelter in every square metre of open space in the city.

The CARE Haiti office, although damaged, was able to remain operational throughout.  Immediately after the earthquake, CARE staff mobilised water storage tanks and delivery vehicles, and commenced supplying safe drinking water to the spontaneous camps nearest to the Port au Prince office. This source of water was established within hours of the disaster and maintained for the following months.

Support personnel, including WASH specialists, from CARE USA and CARE International mobilised to assist immediately and arrived in Port au Prince over the following week. The WASH needs of the affected population were comprehensive—especially water, hygiene materials, and instruction and sanitation assistance.

CARE WASH staff connected immediately with the WASH Cluster, and obtained the latest data on the location and needs of the affected population, and details of the response plans of other agencies responding to the disaster.

The CARE Emergency Response Team promptly addressed the need to define the target population and settled on areas in Port au Prince and Leogane. Assessment teams were formed and began systematically enumerating number and condition of the people in the target areas, and assessed the availability of relief materials from UNICEF and other agencies.

Once the supply of safe water was established for CARE’s target group, the WASH focus concentrated on the delivery of hygiene information and the distribution of hygiene kits. It was clear from the outset that the need for sanitation was massive—open defecation was widespread and very few latrines were available, and the rate at which they could be supplied was not going to meet the demand. The risk of a major disease outbreak was high.

In consultation with other members of the WASH Cluster, CARE WASH personnel prioritised the provision of hand washing materials, the collection of excreta accumulating with solid waste, and intensified action on hygiene promotion. This approach was successful in maintaining the health of the population while the much slower task of building latrines and managing the removal of human excreta was addressed.

See the Emergency WASH wiki for other case studies.