Quantifying the burden of disease associated with inadequate provision of water and sanitation in selected sub-Saharan refugee camps

Abstract

A WHO methodology is used for the first time to estimate the burden of disease directly associated with incomplete water and sanitation provision in refugee camps in sub-Saharan African countries. In refugee camps of seven countries, containing just fewer than 1 million people in 2005, there were 132,000 cases of diarrhoea and over 280,000 reported cases of malaria attributable to incomplete water and sanitation provision. In the period from 2005 to 2007 1,400 deaths were estimated to be directly attributable to incomplete water and sanitation alone in refugee camps in Ethiopia, Kenya and Tanzania. A comparison with national morbidity estimates from WHO shows that although diarrhoea estimates in the camps are often higher, mortality estimates are generally much lower, which may reflect on more ready access to medical aid within refugee camps. Despite the many limitations, these estimates highlight the burden of disease connected to incomplete water and sanitation provision in refugee settings and can assist resource managers to identify camps requiring specific interventions. Additionally the results reinforce the importance of increasing dialogue between the water, sanitation and health sectors and underline the fact that efforts to reduce refugee morbidity would be greatly enhanced by strengthening water and sanitation provision.

Sanitation practices and perceptions in Kakuma refugee camp, Kenya: Comparing the status quo with a novel service-based approach

“…[4] Increasing access to improved sanitation can reduce diarrheal disease morbidity and improve quality of life in refugee settings. [34] Collaborators worked together in Kakuma refugee camp to pilot a sanitation management system that incorporated service-based waste removal, treatment, and reuse. Overall, the system was well-received; however, the urine and liquid diversion feature presented a challenge for many Somali users.…”

Incidence and risk factors for malaria, pneumonia and diarrhea in children under 5 in UNHCR refugee camps: A retrospective study

“…Water quantity and accessibility were assessed, but water quality was not addressed. A previous study of refugee camps in sub-Saharan Africa highlighted the burden of diarrhea morbidity and mortality attributable to incomplete water and sanitation and the fact that mortality due to diarrhea was lower in camps than in the host country [21]. As shown in the maps, striking differences in disease incidence were observed at some UNHCR camps located in close proximity, and contrasted with national background rates of disease, suggesting that multiple local factors contribute to disease incidence within a given camp.…”

Role of noroviruses as aetiological agents of diarrhoea in developing countries

“…In most developing countries, especially those in Africa, the number of people living in a household is usually higher compared with those in industrialized countries and the water and environmental sanitation in these regions is less than optimal (Colombatti et al, 2009;Cronin et al, 2009;Montgomery & Elimelech, 2007;Nkwan, 2009). Poor environmental and water hygiene increase the persistence of norovirus in the environment (Mans et al, 2013;Nakamura et al, 2009;Seitz et al, 2011;Ueki et al, 2005).…”