

When disaster strikes, preparation is key. After a natural disaster, communities may be left with no way to manage their wastewater, leading to an increased risk of the spread of diarrheal disease.
PHLUSH has compiled a variety of resources for how to prepare and respond to a sanitation-related emergency at home, in your neighborhood, or community-wide. These strategies give communities the capacity to arrest the spread of infection and to save each others’ lives.
If you are experiencing a sanitation-related emergency NOW, click here to learn what steps you can take to stay healthy and maintain a sanitary space.
* Sources, if using a graphic as above
Worldwide, the rate of natural disasters is increasing, and many major disasters disrupt sanitation systems to some extent and for some period of time. For example, large earthquakes can damage sewer pipes and infrastructure, impacting the efficiency of the wastewater treatment system (as in when a 9.0 magnitude earthquake hit Japan in 2011). Hurricanes and other wind events, besides tearing buildings apart, can disable sanitation by ripping up trees whose roots are tangled in water and sewer pipes. Severe flooding from heavy rains or storm surge following hurricanes can back up the wastewater system, as occurred after Hurricane Katrina hit New Orleans in 2005. And sanitation can also be dangerously inadequate following evacuations or required encampments due to natural disasters or war.
When disaster strikes, emergency conditions may ensue if we aren't prepared. PHLUSH has compiled a variety of resources for how to prepare in the case of a sanitation-related emergency at home, in your neighborhood, or community-wide.
THE POTENTIAL HEALTH RISKS IN A SANITATION-RELATED DISASTER
Simply stated, a properly working wastewater treatment/sanitation system works by protecting people from their (and others') poop. When this system fails, exposure to human waste becomes possible. This allows pathogens (e.g. norovirus, enterotoxigenic Escherichea coli (E. coli), Salmonella enterica, Vibrio cholerae, and Cryptosporidium parvus) to come into contact with the human digestive tract, causing diarrheal illness. The body produces diarrhea to "flush" the system of pathogens, but without treatment, excess diarrhea (dysentery) can be deadly. Furthermore, if diarrhea is allowed to mix with clean water, fecal-oral infections may continue to spread. Children and the elderly are especially susceptible to dangerous diarrheal disease, which in some instances has killed more people than the inciting catastrophe.
More info on incidences/types/examples of diarrheal diseases after disasters, i.e. Katrina. See sources page
The movement of pathogens from the environment into the digestive tract is called the "fecal-oral route." (IMAGE) To prevent transmission of pathogens along the fecal-oral route, it is necessary to prevent any contamination of food or water from fecal matter. To do so, remember the "Five F's."
The Five F's For Blocking the Fecal-Oral Route:
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Fingers: Wash hands after using the bathroom or touching any potentially contaminated surfaces
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Flies: Cover poop in buckets or latrines and cover food
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Fields: Manage latrines to prevent flow of waste into waterways
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Fluids: Never poop in or near water, and keep clean water containers sealed and stored away from waste
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Food: Keep food covered (to prevent flies) and separated from waste
The CDC lists steps to take to prevent diarrheal disease following an emergency, including avoiding defecation in open bodies of water. Ideally, a system, such as an emergency-ready toilet or latrine, is available to ensure that defecation of human waste (feces and urine) may occur separately from clean bodies of water following an emergency.
AGENCY RESPONSE VERSUS COMMUNITY PREPAREDNESS
Following a disaster, federal agencies and non-governmental organizations, such as the Federal Emergency Management Agency (FEMA) and XXX, are equipped to respond with aid. These groups are very well funded and capable of large-scale response. For example, warehouses of porta-potties and pallets of bottled water are consistently stocked in case disaster strikes (source). But despite being well-funded and stocked, these responses can be slow and are dependent on the transportation distance and methods between the location of goods and the disaster site. If roads, airports, bridges, vehicles, or fuel stations are jeopardized during the emergency, the response is slowed further.
Large-scale, federal response is very important, but the standardized protocol from these agencies results in a "one size fits all" approach to most disaster scenarios. As such, specific local needs may not be met by agency response. And in the time between a disaster and the arrival of agency aid, every minute counts. It is during the period of immediate response that local support groups step in.
Although community-led groups are less well-funded and provide a smaller-scale response than larger agencies, these groups tend to be aware of local needs and capable of providing support from the "bottom up." However, this response necessitates careful planning ahead of a disaster scenario. This requires combination of assembling materials to make DIY sanitation equipment (or even pre-fabricating these builds), distribution of these materials/equipment, and education on their use. Keep in mind that quick deployment of response saves lives, since fecal-oral infections rise exponentially (source). The quickest response is being prepared!
HOW TO MANAGE SANITATION IN A DISASTER
When in doubt, separate it out. Human waste (urine and feces) must be kept separated from clean water and human contact. Further, poop and pee should be kept separate from one another as much as possible. This is because feces is packed with pathogens and is dangerous when brought into contact with the human digestive system. Fortunately, it is compact, lightweight (especially when dried), and we don't produce much of it (average daily amount + source). On the other hand, urine is safe (sterile), but it is heavy and we produce a large quantity of it average daily amount + source).
It is much easier to deal with human waste from both a safety and quantity perspective when poo and pee are kept separate -- especially because combining them is what leads to unpleasant odors (source/reasoning). If poo is kept away from pee, there is much less "unsafe" material to manage (feces). Pee, while large in quantity, can fortunately be disposed of much more easily than poop.
The separation of fecal contaminants from hands can be accomplished via sinks or washing stations, which may minimize water use (or recycle it), reducing the quantity of drinking water required to maintain sanitary conditions.
Although this separation of waste from water and hands can be accomplished by commercial portable toilets and sinks provided by FEMA (or another agency), these types of equipment are expensive and response is not immediate. Additionally, socioeconomic status may impact the quality of federal response to some neighborhoods (cannot make this statement without source). Fortunately, preparedness pays off in more ways than one: DIY sanitation equipment is very inexpensive and simple to make and store alongside an emergency kit.
The recommended minimum number of toilet units following a disaster is 1 toilet unit per 20 people, according to the UNHCR (define UNHCR, provide source, also what is time period?). PHLUSH recommends construction of an emergency toilet system, such as the Twin Bucket Toilet, or planning for a latrine location in case of disaster. A simple hand-washing station can also be constructed to keep hands clean of fecal matter and minimizing the use of clean water to do so. The key to encouraging larger-scale (neighborhood or community-level) preparedness is keeping materials SIMPLE, CHEAP, LOCAL, EFFECTIVE, and STURDY.
See the pages linked below for more information on how to prepare your household by constructing this equipment using simple, inexpensive, effective, and sturdy materials (many of which can be sourced locally).
Constructing a Twin Bucket Toilet
Preparing a Latrine Location
Constructing a Handwashing Station
Storage of Infectious Materials
PREPAREDNESS AT THE HOUSEHOLD, NEIGHBORHOOD, AND MUNICIPAL LEVEL
Ideally, these systems will be implemented at the individual (household) level, as well as more broadly within neighborhoods/social networks and ultimately across larger communities.
Disaster sanitation for mobility-impaired people, who are most at risk
- Need clear path to toilet/latrine, grab bars or side supports, WAG bags
Leadership, staffing, and the disgust reflex
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Volunteers who don't mind the poo & pee will save far more lives than medical team
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Evolution gave us instinctive disgust for poop, cuz dangerous. Yay!
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But big mistake, evolution: Disgust reflex extends to those who protect us from it
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Leadership will need to openly value sanitation volunteers, or it won’t happen
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Medical people know the urgency of sanitation, and suppress the disgust reflex in training
HOW IS PHLUSH INVOLVED IN
DISASTER SANITATION PREPAREDNESS?
PHLUSH has been an advocate of disaster sanitation preparedness since the 2011 earthquake in Christchurch, New Zealand. This event underscored the importance of being prepared on an individual and community level in case of a pipe-breaking disaster. We have published and translated content on building a Twin Bucket Toilet and handwashing stations, as well as participated in emergency preparedness events. We continue to learn from groups such as the Neighborhood Emergency Teams (NET) in Portland, Oregon and Community Emergency Response Teams (CERT) in other cities around the country.
WHO ELSE IS INVOLVED IN DISASTER SANITATION?
Sanitation justice has become more visible globally and nationally in the last few decades as policy-makers and activists work to increase access to equitable sanitation systems. Global policy-makers enacted an International Decade for Clean Drinking Water (e.g. which included targets for sanitation provision) from 1981-1990, instituted the Millenium Development Goals (MDGs) in 2000 with targets for water and sanitation under Goal 7 to Ensure Environmental Sustainability, adopted a resolution on the right to water and sanitation in 2010 with a separate distinct right to sanitation being acknowledged 2015, and enacted the Sustainable Development Goals (SDGs) in 2015 with Goal 6 for water and sanitation access.
Various US-based activists (e.g. environmental justice, housing and homeless, and sanitation) have also worked on sanitation access with an increasingly more prominent focus on equity. Environmental justice activists in the 1980s and 90s brought attention to the inappropriate citing of wastewater treatment facilities for communities already marginalized by race, ethnicity, and indigeneity. Housing and homeless activists have lobbied for group camps to have sanitation facilities like Port-a-Potties, and they have started providing hygiene facilities to individuals living outside beginning in the 2000s. Grassroots sanitation groups have popped up across America working on various topics such as public toilet design, public toilet provision, and code change for sanitation systems. These activists might not directly state sanitation justice as their goal, but their efforts at increasing access for vulnerable communities (e.g. Black, Latinx, low-income, rural, women, trangender, homeless) falls into the realm of sanitation justice.
Here are some organizations working on sanitation justice and their projects. PHLUSH thanks the US Water Alliance for informing us of some of the organizations on this list. For a comprehensive list of organizations working on the domestic WASH (Water, Sanitation, and Hygiene) sector, visit DIGDEEP’s WaSH Database.

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