WASH interventions in urban areas aim to provide refugees with safe access to water of sufficient quality and quantity, and good quality sanitation; to improve hygiene practices; and improve WASH in hospitals, health and nutrition centres, schools and other institutions, in order to achieve the same quality of services as host communities and ultimately reach national WASH service standards.
This entry discusses WASH responses in urban areas. WASH interventions help to improve hygiene and health and reduce morbidity and mortality among both refugees and host populations. In the first phases of an emergency, a WASH response focuses on identifying WASH infrastructural gaps and needs, and software components required, as well as monitoring the WASH situation. The best outcome is to provide urban refugees with full access to national services. To achieve this, it is crucial to collaborate closely from the beginning with the ministries responsible for water, environment, and infrastructure, as well as with municipalities and development actors such as UNICEF, UN-Habitat, and bilateral donors.
The WASH sector works closely with health and nutrition to address potential causes of waterborne diseases and malnutrition, and reduce public health risks associated with poor services and practices with respect to water, sanitation and hygiene. At the start of an emergency, in addition, WASH works closely with physical/site planning and local authorities to select and allocate infrastructure and facilities that can accommodate refugees (unfinished buildings, schools, informal tented settlements, etc.).
It is frequently difficult to provide basic WASH facilities and a sustainable hygienic environment in urban situations, because official approval is difficult to obtain from local authorities or private landowners.
- To ensure that refugees and host populations in urban areas have safe access to sufficient water of good quality.
- To ensure that refugees and host populations in urban areas have safe access to sanitation and hygiene of good quality.
- To respect the right to safe water and sanitation.
- To ensure that women and girls of menstruating age, and males and females with incontinence, have access to hygiene products and WASH facilities that support their dignity and well-being.
Underlying principles and standards
UNHCR's Public Health Strategic Objectives 2014-2018:
1. Refugees have safe access to water of sufficient quality and quantity.
2. Refugees have access to quality sanitation.
3. Refugees have improved hygiene.
4. Improved WASH in institutions.
UNHCR and its partners should comply with the SDG standards of universal and equitable access to safe and affordable drinking water (6.1), and adequate and equitable sanitation and hygiene for all, ending all practices of open defecation (6.2). The specific targets linked to achievement of this standard should be in alignment with the local/national development plan and established targets.
During an emergency phase, UNHCR applies the globally recognized SPHERE standards. Following the 2018 update to the SPHERE manual, the following standards are directly linked to UNHCR's WASH Monitoring Systerm:
Hygiene Promotion standard 1.1: People are aware of key public health risks related to water, sanitation and hygiene, and can adopt individual, household and community measures to reduce them
Hygiene Promotion Standard 1.3: Women and girls of menstruating age, and males and females with incontinence, have access to hygiene products and WASH facilities that support their dignity and well-being
Water Supply Standard 2.1: People have equitable and affordable access to a sufficient quantity of safe water to meet their drinking and domestic needs.
Water Supply Standard 2.2: Water is palatable and of sufficient quality for drinking and cooking, and for personal and domestic hygiene, without causing a risk to health.
Sanitation Standard 3.1: All excreta is safely contained on-site to avoid contamination of the natural, living, learning, working and communal environments.
Solid Waste Management Standard 5.2: People can safely collect and potentially treat solid waste in their households.
The revised SPHERE Manual has 14 separate standards for WASH, with a total of 53 indicators. The above list of 6 standards which can be reported on using the 17 key indicators included in UNHCR's WASH Monitoring System. There are many other indicators which may be relevant to the particular context or emergency. UNHCR should work with partners to identify which other standards must be tracked as part of their monitoring programme.
In urban refugee operations, accessible and adequate WASH interventions have positive effects in numerous areas, and address important protection risks.
- When refugees do not have safe access to sufficient water of good quality, and sanitation, they are exposed to public health and nutrition risks (, water related diseases and risks of malnutrition).
- Refugees who do not have safe access to sufficient water of good quality, and sanitation, may adopt risky coping mechanisms.
If adequate WASH facilities are not available in urban areas:
- The host community may compete with refugees for resources, increasing tensions. Evictions may occur (often underreported because refugees fear persecution and lack personal protection).
- Security risks increase (riots, demonstrations, violent behaviour).
- Harmful short and long-term effects on health are likely, including severe diarrhoea, dehydration, malnutrition, and even death.
Key decision points
Refugees living in urban areas must always have access to safe water and sanitation, and structures to promote hygiene.
Where local and national water and sanitation services are available and adequate, UNHCR should encourage local authorities to grant refugees access to them. Where services are not adequate, UNHCR should work with local authorities, ministries responsible for water, environment, infrastructure, and energy, as well as UNICEF/UNDP/UN-Habitat and other development actors, to improve and/or extend those that exist, or create new structures for the benefit of refugees and host communities.
WASH interventions must always be:
- Evidence-based. Activities should be planned and implemented, based on the findings of the initial assessment.
- Needs-based. Interventions should be scaled and resources should be allocated to meet the needs of the population.
- Technically sound. Services should be based on current scientific evidence and operational guidance, and implemented by skilled staff.
- Impact oriented. UNHCR promotes the comprehensive WASH approach, which ensures that essential safe water, sanitation and hygiene needs of the entire population.
- Priority-based. Emergency WASH interventions and services should be prioritised to achieve maximum impact across the population. Interventions to address immediate health and WASH risks, such as disease outbreaks and malnutrition, must be priorities.
- Integrated. Avoid setting up costly parallel services. Assist the national waters authorities to extend its services to refugees.
To improve the effectiveness of WASH interventions, develop a clear WASH strategy as early as possible. All WASH actors should participate in this exercise.
Ensure that the strategy sets priorities and targets the needs of refugees appropriately. Focus on (a) geographic location - mapping where refugees are concentrated and WASH services are poor; (b) groups with specific needs; and (c) individuals and households who have poor socio-economic status.
- Establish strong co-ordination with municipalities, the ministries responsible for water, environment, infrastructure, and energy, development WASH actors, and municipalities to ensure wherever possible that national water and sanitation services are made available to refugees, and that all needs are covered, gaps identified, and follow-up is assured. Map services, including those provided by the private sector.
- Refugees residing in urban areas must have access to WASH services that comply with national standards. The services should be comparable with those available to the surrounding population. Where services do not exist or are inadequate, UNHCR and partners should encourage their creation or improvement, if necessary by enhancing the capacity of municipal services (for example by seconding experts).
- Ensure that refugees have access to information about services, know where WASH services can be obtained, and who is responsible for operating and managing them.
- Refugees with specific needs, who require assistance to access or use WASH services should be supported and prioritized.
- AGD: Apply an age-gender-diversity perspective and use community-based approaches in assessment and response analysis.
- Refugees may have to pay for their water in urban areas. Ensure that (through multi-purpose cash grants for example) those who have few resources can pay for their water needs.
- Experience has shown that water supplied by municipalities is cheaper than bottled water in shops or water sold by private vendors. Where fees are levied for maintenance or other water costs, seek to negotiate the charges with municipalities and water companies.
- In urban areas, hygiene practices should be marketed, not just promoted. Develop a hygiene promotion strategy based on a strong urban social marketing strategy that makes use of local communication channels. Use consultative processes to make sure that issues of gender are taken fully into account: the strategy should reflect the different needs, vulnerabilities, interests, capacities and coping strategies of women and men, girls and boys of all ages. Where possible ensure that refugees are included into ongoing hygiene programmes and campaigns, but take note of language obstacles and literacy levels.
- In urban areas, UNHCR and partners should map, explore and agree if assistance is provided through cash grants, vouchers or material incentives in relation to WASH services (to cover the costs of hygiene and baby kits, maintaining water and sanitation structures, cleaning, etc.).
- UNHCR and partners should work closely with the ministry of health to make sure that hygiene messages are harmonized, notably those disseminated via mass media channels
- If toilets are not in place, and no connection to the existing sewage network is possible, new toilets should be constructed. They should be evenly dispersed through the location in question. No dwelling should be more than 50 metres from a toilet facility.
- The usability of toilets inside dwellings should be verified. Check their connection to the sewage system or on-site final disposal point. Upgrade them if required.
- Ensure that all toilets can be used safely by all refugees and members of the host community, including children, older persons, and pregnant women. Gather data on refugees with disabilities and construct dedicated toilet facilities as near to them as possible.
Waste water and solid waste management
- Wastewater is likely to be the most challenging sanitation-related issue in urban areas. Work closely with the ministry responsible for infrastructure to determine national standards for sewage discharge into the ground, after treatment in grease traps, soakpits or septic tanks. In highly populated areas, wastewater systems should be fully sealed and wastewater should be conveyed to and processed by a treatment system, to protect both the environment and public hygiene. Economies of scale offset the capital cost of building a treatment system; it is not sustainable to evacuate large volumes of wastewater by means of small, private drainage pits, septic tanks, etc.
- If demand exceeds the capacity of the wastewater network, consider upgrading its piping system, pumping stations, or de-sludging capacity. Subject to national regulations, treated wastewater may be used for irrigation purposes.
- As the density of urban populations rises, to control the risk of disease it is essential to remove solid waste regularly. Subject to funding, UNHCR can support municipal efforts to achieve this goal.
- When planning distributions and kit items, make every effort to reduce the use of packaging and non-biodegradable materials, to limit household waste that subsequently goes to landfill. Special consideration should be given to solid waste management for disposal menstrual hygiene materials. Women and girls should be consulted in the design of sanitation facilities and in the structuring of services for managing the related waste.
Sustainable WASH programming
- To satisfy principles of sustainability, when you plan any WASH intervention in urban areas, analyse carefully the long term consequences and draft an exit strategy. To avoid disruption in service provision when partners pull out, establish a strategy to handover services to local authorities.
- Involve local stakeholders and service providers from the start, so that they can take over. Make sure that UNHCR transparently informs municipalities of all the contractual or financial responsibilities that they may be expected to assume.
- In urban areas, donors tend to focus on a mix of emergency relief, development and blended (relief and development). Draw their attention to gaps in in the humanitarian response.
Monitoring and evaluation
- Conduct regular WASH surveys to monitor the situation (baseline assessments and ad-hoc household surveys during the emergency phase, subsequently KAP once a year). These make it possible to target and adjust WASH responses.
- In urban areas, WASH indicators are the biggest monitoring challenge because the upgrading of WASH facilities does not generate easily quantifiable results (number of people served, litres per person per day).
- The emergence and evolution of coping strategies among refugees certainly improves standards; but these improvements too are often not quantifiable.
- Use household assessment and utilization surveys to monitor the degree to which refugees are able to access water and sanitation.
Key management considerations
Early coordination and collaboration with the government, NGOs, and development partners is especially important. Where national WASH services do not exist or are inadequate, UNHCR and other UN agencies (UNICEF, UN-habitat, UNDP) should encourage their creation or improvement, to the benefit of refugees and the host community. When national programmes are overwhelmed by exceptional need, UNHCR and partners should establish additional services to complement national WASH programmes. The World Bank and bilateral donors may play a critical role in this.
Though the preferred option is to integrate refugees in national WASH services, challenges may arise. National services may be uneven, programmes may lack staff, access may be difficult (because of distance, for example), data may be lacking, and oversight of refugee access and health status may be weak.
Given that UNHCR has an overall accountability for the refugee response, UNHCR should deploy WASH staff as soon as possible to support the assessment, relevant WASH strategy and support the operational response.
WASH services and activities in urban areas should respect the guidance of the forthcoming UNHCR WASH Manual.
Resources and partnerships
The inputs required to set up and implement a WASH response in urban areas depend on the nature of the emergency and the degree to which refugee needs can be met by available national WASH programmes and services. Initially, an experienced WASH specialist should be present to assess the situation and need. If it is found that a comprehensive WASH response is necessary, the inputs below will be required:
- Experienced UNHCR WASH officers to support and coordinate the WASH response, as well as develop the WASH strategy.
- Experienced WASH partners, who also provide technical staff.
- Community outreach workers with experience in urban areas.
- Close collaboration with municipal and national water authorities is crucial.
- If it is necessary to establish new WASH services, WASH partners should be identified in association with the ministries responsible for water, infrastructure, and energy.
- Work closely with and link to development and UN supported programmes for WASH.
- Consider working with experiences foundations of city water councils from other countries.
UNHCR DPSM/PH Section. At: [email protected]