5 ways the WASH sector can prepare for the next crisis

BARCELONA — The emergence of COVID-19 caught many people and organizations off guard, leaving them little time to prepare. The water, sanitation, and hygiene sector was no different, with governments and groups scrambling to install critical water and hand-washing facilities — which can help slow the spread of the virus — in places where they were lacking. Globally, 2.2 billion people do not have access to safely managed drinking water, 4.2 billion live without safe sanitation services, and 3 billion lack basic hand-washing facilities. The sector was weak and unprepared, said Kariuki Mugo, director of WASH sector support at Water & Sanitation for the Urban Poor. It needs to envision what could have been done to better prepare for such circumstances, he said. Mugo blamed a lack of clear institutional mandates. “You have all manner of institutions claiming to be providing services or in charge of regulation, and that in itself makes it very difficult to coordinate,” he said. Susan Davis, global coordinator at Agenda for Change — a coalition of WASH organizations — said the sector was in fact prepared for a pandemic but that others were not. “For example, the health sector in the U.S. was saying, ‘Wash your hands,’ while we in the WASH sector were thinking, ‘There’s so many people who can’t do that.’ … We’ve been talking about hand-washing and hygiene for decades — it’s just hard to get people’s attention,” she said. The absence of hand-washing facilities in many health care centers also suggests a lack of coordination between sectors, while the challenges in accessing long-term funding make effective planning difficult. But lessons can be learned from COVID-19. “There’ll be cholera, there’ll be Ebola, there’ll be something else. There’s E coli everywhere all the time,” Davis warned. So how can the WASH sector be better prepared for the next crisis? 1. Plan better One of the things the sector needs to embrace is the planning of services, Mugo said. Poor planning can lead to a duplication or lack of services. “When you don’t plan for your population … or understand how many people you have and what they require, then even if you have resources for investment, you don't quite address the needs of those people, you don’t make strategic investments that can lead to catalyzing other investments,” he said. Big investments in the WASH sector have been wasted through poor planning, the absence of systems thinking, and a lack of capacity, agreed Nancy Gilbert, executive director of Transform International, a network of centers supporting development in WASH, agriculture, and energy. She called for a focus on sustainability to better prepare for future crises. “If we could take all that money and invest it wisely, not in aid or relief — except for those emergency situations where relief is needed — but in a sustainable development approach to WASH, we would be much farther down the road.” 2. Build relationships Better planning also means having resources, relationships, and systems already in place to respond, should a crisis occur. “We often think of emergencies as someone coming in from the outside. … But what if you already had supplies, relationships, and materials in place, and all you need to do is stimulate those and maybe fast-track those?” Davis asked. With travel restrictions and lockdown measures in place, many nongovernmental organizations were unable to mobilize their teams to distribute soap and set up extra hand-washing stations, but some were able to use existing relationships to fill in the gaps. CARE’s relationships with local communities meant village savings and loans associations could pivot to include WASH in their activities. “I heard another example where an NGO [Haiti Outreach] had great relationships with community members and were able to call them and help them build their own tippy taps,” Davis said, referring to a kind of tap built with local materials. “There’s some really creative things that happen when you have relationships in place.” 3. Improve coordination “You also need to be better coordinated to be able to respond to emergencies,” Mugo said, adding that when COVID-19 hit, the sector had to scramble to create ad hoc coordination mechanisms. “That type of confusion, where you don’t have clear responsibilities for a number of elements for service provision, creates an uncoordinated response,” he said, adding that policymakers must rethink the structure of institutions to clarify responsibilities and the allocation of resources. “We’ve been talking about hand-washing and hygiene for decades — it’s just hard to get people’s attention.” --— Susan Davis, global coordinator, Agenda for Change Gilbert urged WASH actors to “pull together,” agree on joint priorities, build local capacity, and learn from one another. “There’s still too much competition in the aid world — organizations competing for funds, which can make them less collaborative. This is a loss for us all,” she said. Davis recommended being better aligned with other sectors, such as health and food security, to prevent the duplication of efforts in another crisis. “If you’ve got somebody distributing food, could they also take soap with them?” she asked. 4. Use data and focus on cost-effective solutions With limited funding available, there is a need for high-impact yet cost-effective solutions to prepare for another crisis. For Gilbert, lessons from COVID-19 include the value of effectively coordinating donor funds, the importance of data collection for evidence-based decision-making, and the feasibility of simple, cost-effective approaches even when money is tight. Real-time data can help to identify where there are gaps in access to WASH and where there may be breakdowns so that these issues can be addressed, ensuring more resilience. “If being able to wash hands properly is a key factor in COVID-19 prevention, then ensuring existing systems are functioning properly as much of the time as possible is critical,” Gilbert said. Maintenance of local systems is easier and more cost-effective, she added. “There are many examples of complex systems installed with the best of intentions, which, when there is a breakdown, are simply left nonfunctioning, as no one locally has the knowledge or the funds to provide repairs,” she said. Training on developing alternative solutions or maintaining existing water sources can be a cost-effective solution to WASH access, Gilbert said. “We try to balance affordability with durability. For COVID, when money is tight, really simple options can work.” 5. Invest now as a safeguard for the future The fact that the coronavirus response was, in many places, inadequate due to a lack of access to WASH services underscores the failure to make a sufficient case to the public and politicians that it is an essential service, said Nathaniel Mason, a research associate specializing in water, sanitation, and climate change at the Overseas Development Institute. In the higher-income countries, there has been a tendency to avoid reinvesting in WASH infrastructure, Gilbert said, while limited funding in lower-income countries drives a focus on curative rather than preventive medicine. “WASH is necessary for both, in that effective treatment is less efficacious without safe water, sanitation, proper disposal of contaminated waste, and cleaning protocols. And good WASH is preventative medicine,” she said. The swift implementation of policies by some countries — such as Ghana and Burkina Faso — to provide free water access could indicate an acknowledgement of this and an opportunity for the sector to make its case for increased investment. Although WASH was overlooked by many donors in their COVID-19 commitments, the European Union, Gavi, and the U.K.’s Department for International Development are among those that have included it. UNICEF also launched a global initiative focused on "a culture shift around hand hygiene." Yet for Davis, the “artificial” division between humanitarian and emergency funding and development funding remains a challenge. “It speaks more to the motivation of donors than the actual needs of the people being helped,” she said. Donors should be more flexible to ensure that funding for WASH systems strengthening continues in the face of crisis, she added.