02/25/2011 08:45 am ET Updated May 25, 2011

Sanitary Water: The Key To Preventing Epidemics

We have recently been reminded of two of the biggest natural disasters of 2010. In January, it was one year since the earthquake in Haiti and six months after the worst floods in Pakistan's history.

Both disasters reminded us of the crucial role that access to clean water and sanitation plays, particularly in Haiti, where the initial devastation has been compounded by the ongoing cholera epidemic, which has taken almost 4,000 lives to date.

In Pakistan, such a far-reaching epidemic has thankfully so far largely been avoided, but as reconstruction continues, the importance of local community-based solutions for recovery is becoming more apparent.

An estimated 20 million people were displaced by the disaster and 2,000 lost their lives. In life the provision of safe, clean water and a safe, sanitary place to go to the toilet are essential. In a disaster area this is even more critical -- in crowded temporary shelters and camps, safe water, hygiene and sanitation facilities are vital to preventing the spread of disease.

In the wake of the Pakistan floods, millions of children and vulnerable adults were placed at immediate risk of diseases caused by dirty water and poor sanitation, in particular diarrhoea and cholera.

The flooding caused the destruction of water supply schemes, and without adequate sanitation facilities, scores of people were defecating in the open, spreading diseases around the makeshift camps.

WaterAid has been working in Pakistan since 1993 and in the aftermath of the flooding, our first priority was to focus on clean water and latrines for displaced people as they relocated to the relief camps.

However, there is no one-size-fits-all response to ensuring that people use safe water and sanitation facilities. Unfortunately traditional and cultural differences among the communities mean that it simply is not enough to build a latrine or provide clean water and expect people to use the services. Often deep-seated beliefs mean that even when a new toilet is available for use, community members will continue to defecate in the open, or use old water sources when clean water is newly available. This is compounded in emergency situations, where time constraints lead agencies to rush in, trying to reach people in the quickest way possible.

In Pakistan it meant that following the floods, some were unwilling to use emergency toilets communally. Many were not used to using latrines, or if they were, were not used to using shared facilities. Others were unwilling to drink purified water because of its unfamiliar taste. This meant that scores of people were defecating in the open, spreading human feces -- and disease -- around the camps.

Clearly, local knowledge is critically important -- simply building a latrine is only half the battle. And so in Pakistan we tried to overcome such challenges by involving the people living in the camps in the construction of emergency toilets in order to foster a sense of ownership and pride. This work was then replicated by other partners and agencies and it is notable that although around 30 deaths were reported due to diarrhoea in Sindh, there has been no major outbreak to date.

The situation -- particularly in Sindh -- is still dire, and we still have a long way to go before large numbers of people in Pakistan can return home. As reconstruction continues, we must remember that local solutions should always be at the heart of development. It is only through listening to the people in affected communities that we will be able to make long-lasting and sustainable progress in addressing widespread poverty. This is especially true when trying to inform people about sanitation and hygiene and bringing about a change in behavior. Local experience and capacity must be an integral part in work to restore everyday life.