Safe Water for Refugees

WHAT IS THE HUMANITARIAN NEED?

Waterborne diseases are among the most significant health threats facing people in refugee and internally displaced persons settlements. Conditions in such sites allow diseases like cholera to flourish. And while chlorination – the most common water treatment method used in emergencies – is inexpensive and effective, its protection fades over time at rates that vary from site to site.

Global guidelines for water treatment do not consider post-distribution chlorine decay. They don’t account for what happens after water is collected, stored and used in the home over many hours, which is typical in humanitarian settings. This gap leaves communities vulnerable to the spread of infectious disease from water that has become re-contaminated after it has left water distribution points. Many outbreaks of waterborne disease in refugee camps have been linked to the recontamination of previously treated water. 

WHAT APPROACH ARE YOU TAKING TO BUILDING EVIDENCE AND HOW WILL IT HELP YOUR PROJECT TO SCALE?

The SWOT is a user-friendly web-based platform that unlocks operational insights from routine water quality monitoring data in humanitarian response settings. It applies cutting-edge modelling techniques to generate evidence-based, context-specific water chlorination targets. This information is critical for understanding public health risks and for identifying actions to improve water safety up to the point of consumption – where it actually matters for public health. We pilot-tested the SWOT in the Cox’s Bazar refugee camps in Bangladesh in 2019 and found that it produced substantive improvements in household water safety compared to the status quo chlorination guidelines.

The SWOT is a low-bandwidth web platform, designed to be accessible in remote and resource-constrained field settings. It’s free to use and comes with an online knowledge base, training and expert technical support.     

In this project, we aim to build evidence that will support the scaling of the SWOT across the global humanitarian sector. Using a mixed-methods approach, we will: 

1. Evaluate the SWOT in three new humanitarian water supply use cases—water trucking, medical facilities, and surface water supplies 
2. Improve the robustness of the SWOT’s numerical and machine-learning modelling tools 
3. Generate insights on how to improve the tool’s use-ability and functionality by learning from field users 
4. Create rapid tools for evaluating chlorine taste and odour acceptance thresholds and for characterising disinfection by-products in humanitarian water supply projects 

WHAT PROGRESS HAS BEEN MADE?

Evaluations have shown that the chlorination targets generated by the SWOT outperform global standards across a range of contexts, including with surface water and groundwater sources, and in piped networks, water trucking operations, and medical facilities.

The innovation has been used by seven humanitarian organisations – including Oxfam, Médecins Sans Frontières, and UNHCR – at 17 sites across nine countries, as part of water systems serving over half a million people. 

INNOVATION POTENTIAL

The SWOT is a valuable tool wherever water safety may be compromised by pathogenic recontamination. The team is scaling up the innovation and, in response to feedback from WASH teams, is developing new features. These include supporting water quality surveillance across multiple sites for coordinated risk assessment; integrated tools for addressing chlorine taste and odour and disinfection by-product concerns; and modelling the health outcomes of safe water interventions by integrating machine learning and quantitative microbial risk assessment techniques.