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A new article has been authored by experts from the Dahdaleh Institute for Global Health Research and Médecins Sans Frontières in the American Journal of Tropical Medicine and Hygiene, exploring factors that protect or compromise the safe water chain in refugee camps.

The paper presents a secondary analysis of water quality and water handling data we collected in refugee camps in South Sudan, Jordan, and Rwanda and uses statistical and process-based modeling to explore how water handling practices affect chlorine decay and household water safety outcomes. We find that the two practices that consistently increased chlorine decay and compromised household water safety were storing water in direct sunlight and transferring water between containers during household storage. These findings indicate that humanitarian responders should provide additional water storage containers to prevent water transferring in households and encourage water-users not to store water in direct sunlight, as both practices severely compromise the safe water chain. 

While these two practices had strong, consistent effects, the effects of hygienic water handling practices including keeping containers clean, covered, and drawing by tap or pouring were mixed or inconclusive. This inconclusiveness may have emerged due to imbalances in the dataset or unreliability of subjective assessments of behavioural factors in the field. Given that hygienic water handling practices mechanistically provide a physical barrier against recontamination, they should always be promoted in refugee camps.

This study is, to our knowledge, the first to characterize and evaluate factors that protect or compromise the safe water chain in high-risk humanitarian settings and we hope will provide useful operational recommendations for humanitarian practitioners. 

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Ali, Syed Imran, De Santi, Michael, Monette, Georges, Khan, Usman T., Fesselet, J., & Orbinski, James (2024). Protecting the safe water chain in refugee camps: An exploratory study of water handling practices, chlorine decay, and household water safety in South Sudan, Jordan, and Rwanda. American Journal of Tropical Medicine and Hygiene.

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