Water, Sanitation and Hygiene

Humanitarian Needs

The Whole of Afghanistan Assessment (WOAA) 2023 report estimates that up to 74% of rural communities have experienced drought in the past one year while the impact is higher in 19 provinces, resulting in dried up springs and lower groundwater levels of hand dug wells and shallow wells. Insufficient access to water has remained stable but at a very high level and worsening quality in both rural and urban areas, exacerbated by recurring drought. The proportion of HHs experiencing barriers to access water increased from 48% in 2021 to 67% in 2023 and will likely rise unless significant services improve. Increased HH monthly expenditures on water rose from 185 AFN in 2021 to 317 AFN in 2023. Inequitable access to WASH services also creates protection concerns, with women, adolescent girls, and people with disabilities being disproportionally affected. 64% females experienced some kind of barrier(s) to accessing WASH services. The challenge to access safe water for drinking, sanitation and hygiene has placed communities at heightened risk of displacements. Water collection takes up to a day's trek with or without donkey, exposing women to GBV, and general household impoverishment through the purchase of water or loss of asset through the sale of small livestock.

Noting the endemic nature Acute Watery Diarrhea (AWD)/cholera, in 2023, the disease spread to 333 districts across all 34 provinces, with 195,336 AWD Cases with dehydration and 94 deaths being recorded. Four (4) provinces have a catastrophic severity in terms of AWD among children under 5 while high caseloads were recorded in 6 additional provinces (rural or urban areas). The vulnerabilities and underlying/lack of infrastructure will see this trend continue and likely rise in 2024.

Almost two million people are at high risk of flood across the country while almost 17 million people are at high-risk earthquake districts along with the high drought stress observed in province which is predicted to continue in 2024.

WASH needs will continue to grow in the urban context and in the drought-affected areas, as well as in the areas of return at both community and institutional level (health care facilities, nutritional centers and schools).

Only 20% of households reported having enough water with most of them citing economic barrier to access while one fourth of the population use unsafe water sources. One third of the population in country has no access to soap while higher percentages (38%) in rural areas use unimproved latrines and 9% practice open defecation.

The shocks affecting populations and driving WASH needs are prolonged as well as short term transcending from season to season with others such climate vulnerabilities, droughts and economic shocks run throughout the year while floods and AWD/Cholera affecting populations in the spring and summer.

Limited capacity by water and sanitation authorities (AUWASS, MRRD RUWATSIP etc) to repair, operate and maintain water facilities has left about 60% non-functional or dried up water systems and a sub-optimal performance that puts more pressure on the few functional sources and negative coping mechanism for beneficiaries. Stalled projects such as multipurpose dam in Paktika and Arghandab in Helmand would have in a long term supported with artificial ground water recharge of aquifers not sufficiently recharged through rainfall due to drought in some of the provinces such as Kandahar, Kabul, Helmand that have experienced reduction in groundwater levels. Unless significant investment is made, this situation will leave over 10million people in urban and peri-urban areas exposed to mortality and morbidity vulnerabilities.

Response Strategy

WASH Cluster 2024 priority will be 1) Safe water supply for domestic use to focus on risk deduction, water surveillance, household water treatments, water network reinforcements, line chlorination, reverse osmosis plants, with focus on the urban context, mapping of networks/wells, and looking at mass response modalities. Water trucking in phase 1 emergency and as a last resort.2) Hygiene promotion focus on handwashing, personal hygiene, NFIs and a shift to more culturally appropriate messaging, evidence-based approach and 3) Safe sanitation on emergency latrines, improved access, risk factors and environmental sanitation.

The response will focus on delivering comprehensive WASH services to individuals in high and medium priority drought affected provinces, including safe drinking water either through rehabilitation (including deepening dried water points such as hand dug wells etc.), extension/new water points, and water trucking as a last resort, provide appropriate toilets and showers, functional hand washing facilities, supported by hygiene promotion and possibly hygiene kits distribution. The AWD response will focus on hotspot areas based on surveillance data from Health cluster/MoPH.

With a well-established GBV checklist, the WASH Cluster and partners will continue to engage and ensure the provision of WASH facilities such as water points, sanitary facilities and distribution of WASH NFIs are done in consideration of gender parity, consultations, as well as provision of feedback (through AWAAZ-feedback mechanisms). The WASH Cluster will work with the partners to ensure accountability where cases of GBV and SEA are referred in a prompt and safe manner. The PSEA team and WASH Cluster will closely collaborate to enhance the capacity of WASH service providers and frontline workers in PSEA prevention, risk mitigation, reporting, and response. Partners' staff will receive training and guidance on how to identify and refer allegations, along with supporting documents such as a PSEA risk mitigation checklist and a PSEA tip sheet safely and confidentially. Efforts will be made to advance the IASC monitoring framework on the ban, conduct technical reviews of existing documents (e.g., HRP, WASH GBV checklist, etc.), and develop WASH guidelines that integrate PSEA/GBV considerations and address alternative work modalities resulting from the ban on female humanitarian workers.

In response to the challenges posed by the DFA decree banning female staff workers, the WASH Cluster will encourage partners to integrate WASH activities, especially hygiene promotion and distribution of kits, with health/nutrition programs for partners already engaged in such programs/projects. For partners who are not competent in health/nutrition, efforts will be made to complement WASH services (particularly the soft components) through collaboration with partners working in health and nutrition.

Provision of WASH infrastructures such as water points, latrines, bathing shelters and hand washing facilities that take into considerations needs of persons living with disabilities-such as ensuring provision of ramps at water points, or latrines (in addition to rails and door space etc.), ensuring water points or water fetching containers and hand washing facilities are appropriate to accommodate/handled with PWD.

WASH Cluster partners will keep improving and maintaining WASH facilities at border crossing points, nutrition centers, health facilities and schools, as well as ensuring that returnees are supported based on their needs. The border crossing points will receive great attention for AWD prevention and control as the 2023 returns already show cases of AWD at Takhar and Spin Boldak crossing points (already with reported AWD cases) and to respond to the acute needs of the more than 700,000 returnees at zero points.

Pre-positioning and procurement of core pipeline key supplies including bar soaps, hygiene kits, hand washing stations, chlorine, water kits, water purification tabs and sachets, pool testers and water quality testers, water networks spare parts, latrines slabs, bath-latrine set etc.

Targeting and Prioritization

In 2024, the WASH Cluster will continue to prioritize districts in severity 4 and 5 with high drought stress, limited access to safe drinking water, low sanitation coverage, locations with reported acute malnutrition, AWD Hotspots and service/gaps mapping through partners reports.

Limited capacity to repair, operate and maintain water facilities has left about 60% non-functional or dried up-non optimal performance, a situation that puts more pressure on the few functional sources and negative coping mechanism for beneficiaries. A neglect or absence of urban water networks reinforcements and adequate support to run the water plants will see a total collapse of the already struggling water system- leaving millions of people in desperate need.

Underfunding compounds the challenges faced by communities and lack of water supply exacerbates water scarcity, and potential displacement of nearly 1million people, leading to a vicious cycle of vulnerability. Water-borne, water related, water washed etc. and fecal-oral outbreaks will continue spreading in case of discontinuity of the drinking water, sanitation and hand washing services in urban cities, informal settlements and overcrowded urban settings and rural communities at risk.

In 2023, only 5 partners out of potential 40, responded to AWD/Cholera cases with 2 hotspot provinces without any partner responding and nearly half a million people not covered due to low funding. If less than 50% of the funding is received, about 4.3million people will be without safe excreta disposal, 3.5million will not be reached with hygiene promotion while 1.4million women, 3.4million children, and nearly 1million persons with disabilities, will face challenges in accessing water points, and safe sanitation facilities, increasing their risk to diseases and compromised dignity.

Quality and Inclusive Programming

WASH cluster will focus on both displaced and non-displaced sites where women and girls reported feeling unsafe to access water points and/or bath-latrines such ranked in catastrophic situation (>25%) in 9 provinces (Badghis, Baghklan, Ghazni, Herat, Jawzan, Kunduz, Nuristan, Takhar and Zabul) as per the JIAF indicators from the WoAA 2023 survey.

The WASH cluster through its Gender & Protection technical working group will advise the partners to follow the GIHA WG’s guidance on ensuring women’s safe participation in surveys. The cluster in this sense will namely consider women and girls with respect as leaders for decision making and not as passive sources of information.

The WASH Cluster will promote engagements at community level with gender focused approach, led by female staff to systematically consult the women and girls on the location of the WASH communal or sharing infrastructures (collective water points, toilets and showers, handwashing points) and design of the related equipment and content of the hygiene kits (sanitary pads, soaps, containers, purification tabs or sachets etc.). The use of female hygiene promoters and mahram will be emphasized.

The WASH Cluster will continue and expand the scope of the assessments and engagement through AAP platform/fora to ensure the specific needs of people with physical disabilities are appropriately addressed and disaggregated data collected will be used for capturing the true percentage of vulnerable in the field. Information on barriers and enablers will be collected at upstream level not only through assessments but also by knowledge, aptitude, and practice surveys, focus groups, pilot designs or prototypes, upon cultural preferences and feedback mechanisms involving the people in disabilities from a complete AAP perspective.

WASH facility designs will ensure disability friendly options are incorporated in the designs such as reasonable distance, clear routes free of obstacles, drainage systems to prevent surfaces from becoming slippery, provision of ramps, handrails, doorways wide enough for wheelchairs, cubicles big enough, markers for people with visual impairments, low-level and easy-to-use taps for handwashing.

Links to basic services and development programmes

While reinforcements and upgrades of the WASH infrastructures will still be undertaken and scaled up in both rural and urban areas with a significant shift to the major cities, the running costs of the governmental line ministries or state entities for the delivery of the water and sanitation services on the ground, direct costs will have to be covered by government/development funding.

Humanitarian WASH services need to work with and link to provision and support to basic needs in urban and peri-urban areas by partners/line ministries for urban water supply services and sewerage company to meet its customer base needs-noting the challenges due to funding limitation, AWD outbreak response and significant disrepair of facilities. The response in the urban setting remains a major gap and point of concern with continuous economic challenges, failure of development/government entity to sustain service provision, will lay a massive burden on WASH cluster leaving a significant population affected or in danger of slipping into humanitarian crisis in a prolonged drought.

To prevent urban/peri-urban populations from slipping into humanitarian crisis, WASH cluster plans to support government line ministries authority in major urban cities (UWASS) such as Kabul, Kandahar, Mazar-e-Sharif, Herat, Jalalabad etc. through provision of repair and maintenance of water reticulation networks and smaller water networks, power generation, supply, and installation/ maintenance of treatment plants. The cluster will make efforts to identify the opportunities of collaboration allowed by the de facto authorities for a common water resource management with community-based water surveillance and early warning system in the drought-affected areas and the traditional structures in charge of the irrigation systems or livestock.

Response Monitoring

The WASH Cluster will monitor the access to sufficient quantity of safe water and sanitation through updated data obtained from both Ministry of Rural Rehabilitation and Development (MRRD) and Urban Water Supply and Sewerage State Owned Corporation (UWAS SoC) – so as to triangulate with the findings received from the WoAA and SFSA along with partners’ assessments.

Through Awaaz, the cluster will track feedback and complaints on WASH needs from affected population and reported data on the cross-sectoral indicators on women and girls that feel unsafe to access to water points and bath/latrines and on number of children under 5 with AWD, as well as on people without soap and enough water for handwashing facilities, will be closely monitor through multi-sectoral assessments with GBV, Nutrition as well as Health Clusters’ partners.

Information from WASH partners rapid needs assessments and multi-sectoral needs assessments on affected areas will be used to collect data for monitoring needs indicators during emergencies.

The mapping of the functionality of the water points and urban water networks remains a major gap for the quantitative analysis on the water supply especially in the 2023 earthquake affected areas.

Need for robust quantitative and qualitative data/analysis on ground water monitoring as part of early warning, defining what constitutes early warning, temporal and spatial distribution of aquifer monitoring wells, nature of aquifers to be monitored etc. Dedicated water quality control activities will be undertaken by WASH partners in partnership with the National Water Affairs Regulation Authority (NWARA), to establish a water surveillance system for early warning on the groundwater levels and qualitative aspects of the various protected and unprotected water sources in the country.

WASH Cluster will monitor the needs in shock/ natural disaster affected areas through the Rapid Needs Assessments conducted by partners and a continuous monitoring of the movement trends especially for returnees through the regional coordination channels.

PiN Calculation Methodology

The PiN for WASH assistance was calculated based on the severity at district level disaggregated by urban and rural populations. Prioritization of the locations took into consideration severity 4, 5 and a percentage of the population falling under severity 3. The respective severity calculation was based on the three main JIAF indicators (sufficient handwashing facilities; sufficient quality and quantity of water for drinking, cooking, bathing, washing or other domestic use; and access to a functional and improved sanitation facility). This was overlayed with the perception indicators of women feeling safe to use WASH facilities, the AWD prevalence in 2023 and severity of AWD cases in children under 5 as reported in the WoAA, natural occurrences (flood and drought) severity and the SAM prevalence with different severities. The data was consolidated at provincial level and triangulated with MICS and mid-year WASH prioritization.

The cluster page, including indicators and activities, can be found online
The cluster page, including indicators and activities, can be found online here

References

  1. Badghis, Baghlan, Balkh, Bamyan, Daykundi, Farah, Faryab, Ghazni, Ghor, Helmand, Jawzan, Maidan Wardak, Nimroz, Nuristan, Paktya, Samangan, Sar-e-Pul, Uruzgan and Zabul. Source: WoAA/ REACH 2023
  2. Afghanistan: Infectious Disease Outbreaks Epidemiological Week # 43, 2023
  3. Badghis, Ghor, Kunduz, Sar-e-Pul, Urban Daykundi, Rural Helmand, Urban Kabul, Rural Kandahar, Urban Nangarhar and Rural Nimroz. Source: WoAA/ REACH 2023
  4. DRR and Seasonal Climate Analysis. iMMAP, https://hsdc.immap.org