11th CSFSR











Prepared and released by
Peoples Accountability Commission on Floods
(PACF)

www.pacf-pakistan.org

solutions
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Civil Society Floods Situation Report
(CSFSR)

11th Release
WASH Situation and Response in Sindh 2011









Prepared and Released by
Peoples Accountability Commission on Floods


Table of Contents













This report is 11th Civil Society Situation Report on Floods on the Wash situation in Sindh after the end of emergency phase in December 2011 and the expected start of the Early Recovery Framework from first of the January 2012.  Report contains the primary data collected by the Peoples Accountability Commission on Floods during the field visits of the PACF members and District Consultations in highly hit eight districts Mirpurkhas, Tando allahyar, Tando Muhammad Khan, Badin, Sanghar, Shaheed Benazirabad, Umerkot and Tharparkar of Sindh.
It has been intended by the Government authorities to launch the separate early recovery appeal for the period of January to September 2012 to be finalized yet by the steering committee Islamabad. New Coordination mechanism is to be developed by the UNDP in the place of UNOCHA for the ERF at all levels. As per Provincial Wash Cluster Coordination Meeting minutes conducted on 5th of the January 2012 ERF was to be finalized till 12th January but yet nothing has come out.  
Addressing the seriousness of the issue report says that people affected by disasters are more likely to become ill and to die from diseases related to inadequate sanitation and water supplies than from any other single cause. The most important of these are diarrheal diseases and others transmitted by the oral route. Their transmission is encouraged by inadequate sanitation, poor hygiene and contaminated water supplies. Other water and sanitation-related diseases include those carried by vectors associated with solid waste and water.
The Destruction and damages to the housing structures, Schools buildings, Health facilities, and Water and sanitation systems resulted in the complicated health and hygiene situations after the rain flood 2011 in Sindh. In highly affected districts due the fully and partially damages of 1,358,157 houses the toilets, bathing places, protected and piped water sources, huge displacement of the flood affected peoples, inadequate and unavailability of safe drinking water facilities in camp life, unhygienic conditions due to the stagnant water situation, absence of the solid waste management systems and proper drainage of the disposables. Open defecation has also increased due to the unavailability of latrines causing negative impact on environmental health and hygiene situation.
Safe Drinking water sources damaged 15% after the moon soon 2011 whereas before the flood over 50% peoples lacked the sources of safe water used through tub-wells, piped water sources, community taps, wells and bottled water. Health situation deteriorated and observed water and vector born diseases alerts and outbreaks.  During the relief period 729 water born diseases alerts and 202 vectors born diseases whereas 63 out breaks for water related diseases were reported. The WASH interventions are still at a very less focus and local media is regularly reporting the increased number of gastro/diarrhea cases leading to deaths among flood affectees.

Due to the huge devastation in rain flood 2011 overall situation with regard to protected water, sanitation systems, Waste management, and Hygiene conditions deteriorated 65% exposing 84% food insecure and shelter less flood affected peoples vulnerable to health situation.
During the emergency period 2011 overall 70 flood affected peoples in organized or spontaneous camps had no latrines whereas 35% camps were lacking access to water. In Districts Sanghar, Tando Allah Yar and Umerkot latrines were generally quite rare. In Districts Badin, Sanghar, Tando Muhammad Khan and Umerkot 40% peoples in settlement relied on ponds or canals as the drinking water.     
As per survey out of the fifty lacks victims of the rain floods 2011 twenty lacks and fifty thousands (2.5 Million) are in urgent need of the life saving Wash interventions in Sindh. Immediate needs of flood affected peoples in Wash sector in Early recovery framework are restoration of basic structures for latrines, protected water for drinking, Sanitation /Drainages and waste management. Access to safe drinking water and sanitation facilities remains a critical issue in flood-affected areas. The findings of the MSNA indicate that the floods reduced access to piped drinking water among the affected people and increased the number of people relying on unprotected and untreated sources of water. A recent WHO report revealed that up to 87 per cent of water sources tested were unfit for drinking. The number of people practicing open defecation has also increased. Many returnees have found their primary settlements and structures damaged and in need of major rehabilitation and maintenance. As more people return to their homes, the focus shifts to critical early recovery interventions such as the restoration of damaged water schemes and social mobilization to support improved hygiene behavior.
During the emergency relief services more than 51% needs were not met in WASH sector multiplying the worst situation for early recovery interventions that have not started yet. Things would not come on pace if early recovery interventions are not made timely before the season of moon soon than situation would further worsen beyond the resistance of the flood affected peoples.
With regard to the dewatering situation Districts Mirpurkhas, Sanghar and Umerkot are reported the inundation situation in some areas of the flood affected districts and as per SUPARKO report currently 12% situation is yet inundated. Local Influential has obstructed the natural outlets sources of Water challenging the writ of the Government.  
District Consultations on Flood Situations in Districts Benazirabad, Mirpurkhas, Badin & Tando Allahyar. And Focus Group Discussions.
Secondary source of information includes NDMA WASH Strategy, Wash Cluster Meeting held on 5th of the January 2012, Rapid Wash Assessment Report (September 2011), WHO Rapid Assessment (Health), WASH Cluster Strategic Guidelines 13 November-UNICEF-NDMA1, Situation report No. 15 UNOCHA.
People affected by disasters are more likely to become ill and to die from diseases related to inadequate sanitation and water supplies than from any other single cause. The most important of these are diarrheal diseases and others transmitted by the oral route. Their transmission is encouraged by inadequate sanitation, poor hygiene and contaminated water supplies. Other water and sanitation-related diseases include those carried by vectors associated with solid waste and water.
The main purposes of emergency water supply and sanitation programmes are to provide a minimum quantity of clean drinking water, and to reduce the transmission of faeco-oral diseases and exposure to disease-bearing vectors. A further important objective is to help establish the conditions that allow people to live and to perform daily tasks, such as going to the toilet, and washing with dignity, comfort and security.
In most emergency situations the responsibility for procuring water falls to women and children. However when using communal water and sanitation facilities, for example in refugee or displaced situations, women and adolescent girls are also more vulnerable to sexual violence or exploitation. It is important therefore to encourage women’s participation in water supply and sanitation programmes wherever possible. Their involvement will help to ensure that the entire affected population has safe and easy access to water supply and sanitation services, and that services are equitable and appropriate. Women, adolescents, unaccompanied minors, children, elderly people and people with disabilities face the critical situation during the emergency period in wash situation.
The Destruction and damages to the housing structures, Schools buildings, Health facilities, and Water and sanitation systems resulted in complicated the health and hygiene situations after the rain flood 2011 in Sindh. In highly affected districts due the fully and partially damages of 1,358,157 houses the toilets, bathing places, protected and piped water sources, huge displacement of the flood affected peoples, inadequate and unavailability of safe drinking water facilities in camp life, unhygienic conditions due to the stagnant water situation, absence of the solid waste management systems and proper drainage of the disposables. Open defecation has also increased due to the unavailability of latrines causing negative impact on environmental health and hygiene situation.

In the sector of the education the school is the second home for the children and per report in highly hit eight districts of Sindh namely Mirpurkhas, Sanghar, Tando Allahyar, Tando Adam, Tharparkar, Shaheed Benazirabad, Umerkot and Badin 2989 schools fully or partially damaged   due the moon soon 2011 resulting in the damages in safe drinking water sources, sanitation systems and toilets facilities for almost primary schools. As per situation more than ten lacks children in highly hit ten districts suffered wash facilities in their homes and schools.
With regard to the deterioration in heath facilities as per report 115 BHUs and RHCs were damaged in above mentioned eight districts of the Sindh affected forty lacks population with unavailability of health facilities. As per report of Daily Early warning system report over ten lacks peoples were affected with Acute Diarrhea, Acute Waverly Diarrhea, Bloody Diarrhea. Environment health teams reported 86% contaminated water due to the pre and post floods situations whereas 660,436 peoples are without latrines.                
Safe Drinking water sources damaged 15% after the moon soon 2011 whereas before the flood over 50% peoples lacked the sources of safe water used through tub-wells, piped water sources, community taps, wells and bottled water. Health situation deteriorated and observed water and vector born diseases alerts and outbreaks.  During the relief period 729 water born diseases alerts and 202 vectors born diseases whereas 63 out breaks for water related diseases were reported. The WASH interventions are still at a very less focus and local media is regularly reporting the increased number of gastro/diarrhea cases leading to deaths among flood affectees.
Due to the huge devastation in rain flood 2011 overall situation with regard to protected water, sanitation systems, Waste management, and Hygiene conditions deteriorated 65% exposing 84% food insecure and shelter less flood affected peoples vulnerable to health situation.
With regard to the relief response in food security, Water, Sanitation, Hygiene, Shelter/NFIs, Health the coordination mechanism between Government and Humanitarian partners failed to generate the funds for mitigation of the emergency situation 2011. Relief response over all suffered 54% gap against the emergency response plan 2011. Wash situation has suffered 83% less funding against the emergency requirement 2011. Government authorities has reported 99% evacuation by rain flood affected peoples from government established camps in emergency phase where as yet no development has been made yet to respond in early recovery phase in shelter, education, health and Wash components. Wash situation stability depends on the integrated approach between the shelter, Health, Education and cross cutting themes of protection and environment to assure the gender and environment sensitive approach. It is critically needed to initiate the practically the Early Recovery Framework for sustainable development to flood situation before the season of monsoon which is ahead after four months. Underlying is the Status of Funding status and appealing agencies.


Figure-2: Damages and Response status in Relief phase rain flood 2011.
Title
Appealing Agency
Covered
Water, Sanitation and Hygiene Cluster Coordination
UNICEF
00%
Emergency access to safe water supply and sanitation for flood affected people in districts Badin and Khairpur in Sindh Province.
Mercy Crops
00%
Immediate WASH assistance addressing the life saving needs of
26,440 most vulnerable flood affected families in eight districts
of Sindh Province
UN-HABITAT
19%
WASH Interventions for
Flood-affected Populations in Sindh

UNICEF
23%
Water quality surveillance,
waterborne disease prevention and
control
WHO
57%
Emergency Humanitarian Water, Sanitation and Hygiene (Wash)
Response for Vulnerable Flood Affected Populations in Sindh
Province
ACF
100%
WASH Assistance for Flood CW
Affected Populations in Sindh
CW
00%
Improving Water, Sanitation, Hygiene Conditions in
Flood-affected Lower Sindh
IMC
100%
Relief and Early Recovery WASH Interventions for flood-affected
populations in Sindh province
IRC
00%
Provision of basic WASH support to flood affected population of Sindh
Muslim Aid
00%
Pakistan Flood Emergency WASH Response in Sindh and Balochistan
Provinces
OXFAM GB
17%
Emergency WASH Assistance in Sindh

OXFAM NOVIB
00%
GBV prevention through gender sensitive WASH facilities
UN Women
00%
Rubble removal through cash for work and provision of de-watering
Units
UNDP
00%
WASH Emergency Support and Assistance to Pakistan’s Flood
Affected People in Sindh
WVI
15%
Emergency water supply, sanitation services and hygiene promotion
support for flood affected population in Sindh (Benazirabad Abad district, 4
talukas)
Solidarities’
00%
To provide assistance to the flood affected communities through
improved access to clean water, sanitation and hygiene practices
SC
00%
Total Funding Status
All Appealing Agencies
19%
During the emergency period 2011 overall 70 percent flood affected peoples in organized or spontaneous camps had no latrines whereas 35% camps were lacking access to water. In Districts Sanghar, Tando Allah Yar and Umerkot latrines were generally quite rare. In Districts Badin, Sanghar, Tando Muhammad Khan and Umerkot 40% peoples in settlement relied on ponds or canals as the drinking water.     
Lack of meaningful access of the flood affected peoples in camps to safe drinking water and unmet needs for hygiene promotion for the peoples in camps inflicted health issues and problems particularity for mall nourished children and elderly peoples. Dignity and privacy of the women were at stake in camp life as per observation of our PACF team.     

As per survey out of the fifty lacks victims of the rain floods 2011 twenty lacks and fifty thousands (2.5 Million) are in urgent need of the life saving Wash interventions in Sindh. Immediate needs of flood affected peoples in Wash sector in Early recovery framework are restoration of basic structures for latrines, protected water for drinking, Sanitation /Drainages and waste management. Access to safe drinking water and sanitation facilities remains a critical issue in flood-affected areas. The findings of the MSNA indicate that the floods reduced access to piped drinking water among the affected people and increased the number of people relying on unprotected and untreated sources of water. A recent WHO report revealed that up to 87 per cent of water sources tested were unfit for drinking. The number of people practicing open defecation has also increased. Many returnees have found their primary settlements and structures damaged and in need of major rehabilitation and maintenance. As more people return to their homes, the focus shifts to critical early recovery interventions such as the restoration of damaged water schemes and social mobilization to support improved hygiene behavior.
As per decision of the Government to stop the relief services in response to the emergency rain flood on 31st December 2011 and start of Early Recovery Framework from January 2012 it has been found that revision of the Flash Appeal for per early recovery Framework was put on hold at federal level. The Humanitarian Country Team (HCT) decided that all Clusters will continue with the original flash appeal Sep 2011 to March 2012 and revision on the basis of ER framework will be done for Jan – Sep 2012. WHO Representative presented the technical details of Cholera outbreaks, Epidemiology, sources of infection, symptoms, prevention, and Disinfection due to the unhygienic conditions in flood affected areas of Sindh. Keeping in view the last week cholera update in District Jamshoro and District Badin WHO representative suggested integrated approach to respond holistically to the emerging challenges in Wash and such outbreaks and alerts in health sector.
In the flood affected areas, many of the commonly used water sources, such as hand pumps and piped water, are no longer useable and people are resorting to alternative water sources, often unprotected. After the floods, an estimated one million people are using unprotected water sources. In addition, many people have been displaced and are currently living in roadside camps where water supply may be limited. Since the floods there is a 10 percent decrease in the number of people getting water from protected sources and 5 percent decrease in piped water sources.
Unfortunately, treatment of water before use is not widely practiced in Sindh and 91 percent of households in Sindh do not treat the water before drinking. Due to the decline in the use of protected water sources and the limited practice of water treatment it is likely that the incidence of water‐borne infectious illnesses will increase.


An estimated 40 percent of the protected water sources are not yet functional. 32 percent is partially damaged and 8 percent is fully nonfictional. Similarly, 49 percent of the piped water and 58 percent of the tanker sources were fully non functional.
Open defecation is the most common sanitation practice in Sindh and due to the damage incurred on sanitation systems in place the practice of open defecation has increased 72% among the flood affected population, mainly in Sindh. The health risk particularly for young children walking and playing around barefoot is obvious.
Hand washing is difficult. Most of the communities reported not having soap available in places of hand washing and there are few places for hand washing in the communities (14%) There are few communities with separate bathing facilities for women (7%).
In most of the flood affected areas the waste water (both grey and black) was openly released in water bodies such as rivers, streams, canals and water channels. After the floods this situation has even worsened. Ecological sanitation is also being hit by releasing the organic matter in environment.
Wash cluster members have provided clean drinking water to more than 1.2 million flood affected people in Sindh, sanitation facilities to about 480,000 families, family hygiene kits to nearly 1.3 million people and hygiene sessions to more than 1.5 million people. The table below summarizes the cluster’s overall achievement and gaps during emergency relief period 2011.
Figure-2: Assessed Needs, Response and Gaps
Assessed Needs
Response beneficiaries
Gaps
2.5 Million
Water: 1,220,549
51%
Sanitation: 479,209
40%
Hygiene Sessions
39%
During the emergency relief services more than 51% needs were not met in WASH sector multiplying the worst situation for early recovery interventions that have not started yet. Things would not come on pace if early recovery interventions are not made timely before the season of moon soon than situation would further worsen beyond the resistance of the flood affected peoples.



With regard to the dewatering situation Districts Mirpurkhas, Sanghar and Umerkot are reported the inundation situation in some areas of the flood affected districts and as per SUPARKO report currently 12% situation is yet inundated. Local Influential has obstructed the natural outlets sources of Water challenging the writ of the Government.  
A House of Village Piro Lashari District Tando Allahyar
In Village Muhammad Yusuf Jamali flood affected people were observed shelter less with vulnerable tents and Wash situation. Mai Hajra complained with the Peoples Accountability Commission on Floods that privacy for using the latrines established is not intact because using latrines near the road is violating the privacy of the women. She cried that they did not have saving to build their house for the dignity sake. The use of the latrines established at spontaneous camps was not assuring the privacy and dignity of the women. She suggested that care of the privacy and dignity should be taken into account for establishing the temporary latrines.
Mr. Abdul Qadir belonging to the village Piro Lashari in District Tando allahyar was special with one leg was requesting for wheel chairs because he pointed out that the temporary latrines established by the UNICF could not be used by him due the his specialty. He demanded that special needs should be met so that vulnerable could also be benefited with the wash services being provided to the flood affected peoples.
While the field visit at Taluka Jhudo at Mirpurkhas flood affected peoples briefed that situation of inundation is yet prevalent in the some areas of the Taluka with the complicated situation of damages of houses and food insecurity peoples did not prioritize Wash interventions. Mr. Gulfam uttered that a man with empty belly and completely damaged house cannot prioritize the wash intervention in the area.
It was observed in District Badin that peoples were using contaminated water for kitchen, Cloth cleaning and drinking causing many health problems and diseases as gastro and Dhiarria. Contaminated water was the key challenge flooded peoples were undergoing.
Bathing and toilets facilities in houses and schools have been partially or fully damaged creating lack of the wash facilities in flood affected districts. The common demand from the flood affected peoples were raised in front of the Peoples Accountability commission on floods that shelter and reconstructions of the physical damages of the infrastructure should be prioritized so that sustainability can be assured.  Handicapped peoples should be prioritized for wash facility with assuring the privacy and dignity of the women and Girls for minimizing the vulnerable situation.            
There are four months left to the monsoon season. Sindh is already struggling with several challenges, including aftermath of two years of flooding in Sindh. Efforts should be prioritized to rehabilitate the flood survivors before next monsoon.
Reports find that still projects for early recovery framework are being discussed after the phase of relief phase on 31st December and yet projects have to go for final approval by steering committee and initiation. Efforts should be expedited to finalise the Early Recovery projects ($ 440 Million required) so that deteriorating situation can be curtailed after rain flood 2011.
Disaster Insurance for vulnerable communities should be introduced so that flood victims no longer depend on government response or donors for finance. In this regard World Bank can be contacted for financial model and mechanism to generate disaster risk financing.
Districts Wash profiles should be prepared and districts focal points for wash cluster should avoid their absence in the coordination meetings held at districts level.         
The early recovery sanitation related projects should ensure that direct release of untreated or partially treated sewage water in streams, rivers, irrigation systems and other natural habitats is not done. The approved national environmental quality standards should be followed in this regard.
The concept of ecological sanitation should be followed while designing a sanitation scheme during the early recovery and rehabilitation phases. The ecological sanitation takes into consideration prevention of diseases, promotion of health, protection of environment, conservation of water and recycling of nutrients and organic matter.
Keeping in view the population growth of Sindh, the challenges has been increased. It has been reviewed that addition in budget has been only 0.475 Billion to the water and sanitation under budget 2011-12. The government should include more than 5 billion Rupees to water and sanitation related Millennium Development Goals (MDG’s) to get the WASH sector back on the track in the situation of disaster.
While developing a sewerage system where possible grey water (i.e. water from laundry, dishwashing and bathing) should be separated from black water (water from toilets). Grey water requires less effort to treat as compared with to black water. The grey water can be made stable for irrigation purpose as well as pour-flush latrines after normal treatment.
In the rural and semi-urban setups treatment of wastewater through constructed wetlands can be easily done. The sanitation programs should preferably apply this system especially in the water deficient areas.
Where livestock is more biogas plants could be another option to deal with sanitation and energy needs. To avoid water contamination maintain at least 60 meter distance between latrines/ waste dumps/ sewerage system and water supply sources i.e. bored wells, dug wells, natural springs or streams. 

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