ACF WASH Emergency Response Unit (WERU) Program
Summary of Lessons Learned
This report serves to summarize some of the key lessons learned from the experience of implementing the WERU program covering clinics and WASH emergency response.
The main focus is on the current WERU program, but also brings experiences gained from the program in general.
Key Lessons:
The concept of the ‘connected vessels’ approach for shifting resources between emergency response and preparedness can be challenging if overspending in ‘emergency response’, as works or procurement may have started already, making it difficult to reduce ‘preparedness activities’
Hygiene promotion activities in emergency response should seek to activate and utilize existing community based hygiene promotion resources (e.g. existing/previous health clubs, village health workers) to extend coverage and impact of the hygiene sessions. Village leaders/decision makers should be involved in the trainings to enforce/not block ensuing activities
A greater use of monitoring and evaluation data during the response would aid more customized and targeted emergency response. For example, earlier post distribution monitoring of NFI usage, analysis of EPI curves, use of epi-info software etc, and review of information in ACF and response coordination meetings
There is a need to constantly ensure field monitoring of WASH supervisors for quality control. Consider one supervisor for emergencies, and one for clinics, and ensure sufficient training/induction of staff and provision of field manuals/reference documents at field level.
The selection of Gutu as the district for ‘preparedness’ meant teams had to cover large distances between emergency response and Gutu. Future programs should aim to focus on preparedness activities in high risk areas for emergency response, for both relevance and efficiency (and supervision) purposes
ACF’s coordination role in emergency response has developed significantly in 2011. Continual commitment to this aspect during emergencies helps to maximize effectiveness of response, and utilizes other resources (e.g. other non-WERU partner PHHP capacity)
There is now a key need to work on targeted communities for ‘preventative’ WASH activities in high risk areas, as one of the exits for WERU activities in the future. ACF has developed a cholera recurrence map for Chipinge/Chiredzi and intends to use this to help guide future WASH interventions
The cholera response in Chipinge/Chiredzi could have requested other non-active WERU partners to support the response earlier in the outbreak (but was a judgment call based on an epi-curve that kept dropping and rising)
WERU partners should meet periodically to share information/tools developed, to capitalise on lessons learned/successes, and improve national coherence of systems being established by the WERU program
Research and development is needed to be undertaken together with the manufacturers for pressure pumps to ensure durability for installation for clinic water supply use
ACF and other WERU partners should develop/obtain common design standards for regular items (e.g. tapstands, tank/tankstand minimum criteria etc) to ensure consistent quality, and less reliance on field level staff designing such structures
Linking the clinic water point with economic activities such as gardens may improve the prospects of ongoing operation and maintenance. However yields of the source must be sufficient to meet the needs of the clinic and other uses
The medical solid waste disposal needs at clinics can be high, and are not being met consistently by the WERU program
To avoid mis-understandings in the field, all visitors should be consistently accompanied by either the program manager or WASH Coordinator.