To control further spread of a deadly disease, USAID and its partners are pivoting to improve access to safe water, sanitation, and hygiene, bolstering public health at a critical moment as the worst pandemic in 100 years sweeps the globe.
Since it emerged in late 2019, COVID-19 has gained a foothold in more than 185 countries, claimed more than 645,000 lives, sickened more than 16 million people, and become the world’s worst public health crisis in a century.
Joining a fight that is at once global and local, USAID is marshaling its considerable expertise and resources in the field of water, sanitation, and hygiene (WASH) to help stabilize public health at a time of great uncertainty. The Agency is working in close coordination with communities, governments, development partners, and the private sector to help contain the spread of the disease. This all-hands-on-deck approach is working to flatten the infection curve, buying crucial time for local and national health care systems to increase testing capacity, improve contact tracing, and develop surge capacity at hospitals to treat serious cases.
USAID’s Water Leadership Council developed and released the “USAID Water, Sanitation and Hygiene: Strategic Approach to COVID-19 Response” in mid-April to shape the Agency’s global response to the pandemic and emphasize the vital roles WASH infrastructure and services play in reducing transmission risk.
In the absence of a treatment or vaccine for COVID-19, the strategic approach emphasizes that one of the greatest tools in the battle against COVID-19 is also one of the simplest — handwashing with soap — shown to be one the most effective behaviors for reducing the risk of infection and transmission.
In addition to promoting this vital hygiene behavior, USAID’s contribution to the global fight against COVID-19 includes facilitation of public education campaigns to improve personal hygiene habits, decrease transmission risk, and build communities’ resilience in the face of the ongoing pandemic.
Water service providers are also facing a perfect storm of declining revenues and sharply rising costs as a result of this pandemic. Sustaining water services is critical for public health and handwashing, and provides a foundation for safely reopening schools, businesses, and public spaces. USAID is leveraging its expertise in WASH to help service providers continue operations, secure critical supplies, and avoid financial collapse.
USAID missions around the world are putting the Agency’s new strategic approach into action every day in the fight to more quickly contain and control COVID-19. Read how in the stories below.
With more than 100,000 positive confirmed cases as of late July, Indonesia is grappling with an escalating crisis as increased testing reveals the extent of COVID-19’s spread across the country. Improving access to reliable water and sanitation services and championing regular handwashing with soap are two ways USAID’s IUWASH PLUS (Indonesia Urban Water, Sanitation, and Hygiene Penyehatan Lingkungan Untuk Semua) project is contributing to critical actions that will reduce the spread of the virus.
Working in 120 communities spread across 35 municipalities, USAID IUWASH PLUS and its partners supported the installation of 5,000 handwashing stations, more than 900 soap dispensers, and nearly 700 water taps. In March 2020, IUWASH PLUS began collaborating with puskesmas (community health clinics) to educate the public about handwashing with soap, using a variety of channels to reach residents including radio jingles and social media posts. These efforts are supplemented with strategic messaging emphasizing the importance of either remaining at home or physical distancing when in public.
Meanwhile, to ensure residents’ uninterrupted access to water, the government has mandated that local water utilities must provide customers with free water for the next three months. To support the 25 partner utilities affected by this new mandate and the resulting decrease in revenue, USAID IUWASH PLUS is assisting them to plan their capital needs and strategize how to meet those needs while providing more free water. This support is maintaining continuity of water supply and keeping faucets from running dry.
Improving access to hygiene-related infrastructure continues: IUWASH PLUS is setting up handwashing stations equipped with soap not only outside puskesmas, but also near other centers of community life, such as the local mosque.
“I hope the community understands the importance of clean and healthy behaviors,” says Wheny Susianti of Surakarta city in Central Java. “Hopefully, the handwashing-with-soap facilities will remind people to wash their hands with soap,” a key behavior for stopping the transmission of COVID-19.
In South Sudan, the world’s youngest country, COVID-19 threatens to overwhelm a fragile health care system. To curb transmission of the disease, USAID is helping distribute hygiene kits and soap while improving water and sanitation access in at-risk communities — as well as sending personal protective equipment to health care workers as hospitals prepare for a potential surge of patients.
Efforts to educate the public on best practices for avoiding COVID-19 infection target particularly high-risk communities, such as the densely populated sites hosting people displaced by the conflict that began in 2013. In these settlements, where donors provide safe water and sanitation, USAID support enabled UNICEF to recently reach nearly 30,000 residents in Juba with emergency WASH infrastructure and services.
USAID funding is also helping ramp up additional infection prevention and control measures such as routine cleaning and disinfection of sanitation facilities and water points. “USAID’s continuing support,” says Tina Yu, head of the USAID Disaster Assistance Response Team in South Sudan, “will allow frontline workers to continue combating COVID-19 in the places at greatest risk of infection.”
USAID support is empowering other development partners to make a substantial impact, such as Action Against Hunger International, which now provides handwashing demonstrations to community members visiting its health and nutrition centers. Meanwhile, USAID partner International Organization for Migration installed handwashing stations in high-traffic areas such as transportation hubs and marketplaces. This USAID implementer also focuses on building leadership capacity and holding training sessions with local community leaders so that they may educate their neighbors and spread the word about healthy hand hygiene.
After a months-long national lockdown extending from late March through the end of May, India continues to grapple with the rapidly intensifying spread of COVID-19. Currently, India is experiencing the world’s third highest number of confirmed COVID-19 infections with more than 1.4 million cases nationwide as of late July.
To help reduce the risk of unchecked disease transmission, USAID/India and local partners are working to improve conditions in the country’s densely populated urban informal settlements. Through its Moving India Towards Sanitation for All (MISAAL) activity, USAID/India empowers sanitation committees to improve access to vital hygiene and sanitation services. In addition to promoting healthy sanitation and hygiene habits among residents of slum settlements, these committees serve as intermediaries between residents and local government bodies, facilitating the installation of in-home toilets and improving upon existing sewer infrastructure.
Beyond its push to strengthen WASH in urban settlements, USAID/India teamed up with the Ministry of Health and Family Welfare to facilitate a government public education campaign to help protect frontline health care staff and quarantined households from prejudice. Since March 2020, USAID has trained close to 40,000 health workers on COVID-19 prevention and response in the 12 states where it implements programs, directly benefiting 2.5 million people in India.
Africa’s most populous country, Nigeria, confirmed more than 41,000 cases of COVID-19 as of late July. In a country where one in three people is without access to safe water and more than half of residents are without access to basic sanitation, the potential for transmission of the virus is widespread, as reliable water access is a key ingredient for creating sustainable changes in handwashing habits.
“The importance of water, sanitation, and hygiene has been emphasized by the COVID-19 pandemic,” noted USAID/Nigeria Mission Director Stephen Haykin in May, as the outbreak spread.
Ever since the earliest known confirmed COVID-19 infections in Nigeria, USAID’s Effective Water, Sanitation, and Hygiene Services (E-WASH) program, which partners with utilities in six Nigerian states to improve water access, intensified efforts to improve WASH services. For example, Nosa Okoh, general manager of the Delta State Urban Water Corporation, pledged to provide a “constant safe water supply” in his jurisdiction, to decrease transmission risk. E-WASH is also supporting the digitization of payment services; e-billing enables customers to reduce unnecessary visits to the utility to pay their bills to better promote social distancing.
The state water utilities that E-WASH partners with are shaping other aspects of Nigeria’s evolving response to the pandemic as well. USAID and the Taraba Water and Sewage Corporation recently helped convene Nigerian media professionals, who exchanged ideas on how to combat COVID-19 misinformation and shared best practices for responsibly informing the public about the nature of the disease. Apart from its support to water utilities, USAID/Nigeria also collaborated with telecommunications firms to deliver messaging about safe hygiene habits to millions of Nigerian cell phone users and provided direct technical support to the National WASH Response on COVID-19, including implementing risk communication interventions such as signs and pictorial guidance on the proper use of masks and information resources for hand hygiene.
The Path Forward
As the pandemic continues to evolve, USAID and its many partners across the U.S. Government collectively pledged more than $1 billion to the effort to combat COVID-19 as of late June 2020. Whether it involves installing soap-equipped handwashing stations, refurbishing water and sanitation infrastructure, or delivering ventilators to overburdened hospitals, USAID stands committed to helping protect the communities it serves as they endure some of their most uncertain hours. Thanks to the transformative power of improved WASH, the Agency and its partners are already helping some of the world’s most at-risk populations stay one step ahead of the disease.
By Russell Sticklor
This article appears in Global Waters, Vol. 11, Issue 3; for past issues of the magazine, visit Global Waters’ homepage on Globalwaters.org.