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Chad: Host communities threatened by disease and unsafe water

© UNICEF Chad/2005/ Pittenger
A girl from the village of Kerfi, Chad, holds a bottle of river water. The villagers have since received supplies for treating water to make it safe to drink, and have been educated in hygiene practices for keeping disease at bay.

By Jasmine Pittenger

In south-east Chad, residents of temporary camps for people who have fled their homes have access to safe drinking water – which some of the permanent local residents do not. The shortage of safe water has contributed to a hepatitis E outbreak. UNICEF is working to provide assistance to everyone in the region, whether they are refugees or permanent residents.

KERFI, Chad, 1 September 2005 – Eight-year-old Fatime stands with a crowd of children on the bank of one of the flooded seasonal rivers, called wadis.

Fatime holds a worn plastic bottle in her small hands. The bottle is filled with murky water from the wadi – water that she plans to drink. But there is danger: Contaminated water and food are at the root of a hepatitis E outbreak that has killed an estimated 50 people in Kerfi and the surrounding villages.

On the opposite bank, cars with UNICEF logos pull up, and five workers emerge. They quickly load a raft with large boxes for transport to the other side and push it into the swirling waters of the wadi.

The boxes carry emergency supplies for water treatment, and instructional materials to help educate people about hygiene practices that can help prevent the spread of hepatitis E.

During the rainy season, some roads become impassable, so rafts and other methods of transportation must be used by UNICEF, the World Health Organization (WHO) and other partners working to provide assistance in the region. Whatever the difficulties, the work must continue – both to provide drinkable water and to educate communities so that disease transmission will stop.

Situation in the refugee camps

But while Fatime and other children in Kerfi are at risk, other children in Chad, living less than 50 km away, are not.

In the Djabal Refugee Camp, a girl named Mariam is getting clean water from a well. Her family fled the violence in Darfur last year and has been living in the camp, where they also have access to safe drinking water, soap and hygiene education.

Mariam’s family is part of the influx of the 200,000 Sudanese refugees into eastern Chad – a region with fewer than a million local inhabitants.

The steady influx of people is straining the scarce resources of the region to the breaking point.

“Chad is one of the 10 poorest countries in the world,” says UNICEF Representative in Chad Stephen Adkisson. “And within Chad, the eastern regions are among the most disadvantaged, with difficult agricultural conditions, a scarce supply of clean water, few schools and low access to health facilities.”

© UNICEF Chad/2005/ Pittenger
A boy from Kerfi village looks on as a raft loaded with water and sanitation supplies is floated across the wadi.

The emergency behind the emergency

While those living in refugee camps in eastern Chad have access to clean water, food, medical care and education, the local Chadian population is struggling to survive under conditions that, in too many cases, can only be described as unliveable.

Although attention has been focused on the desperate circumstances of those fleeing Darfur, it is clear that the host communities need support as well.

Dr. Camilo Kuan of WHO refers to the situation for residents of permanent communities in eastern Chad as the “emergency behind the emergency.” 

UNICEF is working to provide assistance to all children and families in eastern Chad – whether they live in isolated villages or refugee camps, whether they are permanent residents of Chad or refugees from Sudan. 

“UNICEF’s programme of support is for the populations in the eastern regions – Chadians and refugees – and is dedicated to introducing effective and sustainable interventions that can improve the lives of children and families in this remote area,” says Mr. Adkisson.

Stemming the hepatitis outbreak

In the village of Kerfi, UNICEF and WHO have led a vigorous response to the hepatitis E outbreak. In addition to the first shipments of emergency water and sanitation supplies which were sent by raft, UNICEF has now sent more than two tons of supplies via cargo planes.

The supplies include family water kits, chlorine, soap and 5000-litre bladders for water storage. Also included are instructional flashcards used in hygiene education. The cards use pictures to illustrate how to properly clean hands; they also show other ways to protect against water-borne disease. Pictures are used because many of the villagers are illiterate.

There is no available vaccine for hepatitis E, nor is there any cure. It is mainly transmitted through oral-faecal contamination, so hygiene education and safe water are crucial to stopping this disease.

UNICEF has led the water and sanitation response to the outbreak in Kerfi, developing emergency and middle-term response plans along with partners.

Maya Dollarhide contributed to this story from New York.



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