WASH expert Vincent Leray is for a 3-month mission in Chad since April 16th. He is deployed by the WHO to support in reducing the Hepatitis E outbreak in the country.
In his latest blogpost he shares some updates and experiences regarding his work in Chad.

Treatment of traditional wells to prevent Hepatitis E outbreak
‘It is my second visit to Chad. The first time was eleven years ago when refugees were coming in from Darfur. This new deployment in Chad started with two days in Ndjamena with a security briefing and a meeting with the WHO representative and the WHO Emergency Relief Co-ordinator. After the briefings I left by car to reach the project location. The project is based in the South-East region of Chad in an area called Salamat district. I am based in Am-Timan town.
The main objectives of my mission are to give support and give guidance to the Ministry of Health concerning an outbreak of Hepatitis E and offer expertise in the different WASH aspects regarding the water, sanitation and hygiene related assessment of health centres, training of health workers on infection control drafting plans to improve the water and sanitation in health structures and other aspects in relation to the Hepatitis E outbreak, as giving guidance to local NGO on how they can contribute in a Hepatitis E response.

My first week on the project was exclusively devoted to meetings with various authorities and stakeholders working in the Salamat district and with organizing a schedule for the assessments.
Within Salamat district the Hepatitis E outbreak is present in different locations: Am-Timan and Aboudeia. There are some actors already working to control the outbreak in Am-Timan town but in Aboudeia town the situation regarding the control of the outbreak is quite fragile.

Local coordination is done through the so called WASH cluster. During one WASH cluster meeting some dramatic information was reported stating that the “number of cases were increased radically in Aboudeia”. The following day after receiving the report, we decided to go to Aboudeia to collect more information and perform our own WASH assessment.

During the assessment we noticed that most cases of Hepatitis E are located in a specific area of the town. Hepatitis E usually spreads through contaminated water. The water supply in this area is via traditional wells. Currently the end of the dry season is nearing so the ground water level is very low and the turbidity of water is very high. One temporary solution to improve the quality of water with its high turbidity is to use Pure© sachets.
Pure© sachets treat turbidity by flocculation and decantation and provides enough chlorine to be sure that the water is safe to drink. If the water contains too much free chlorine residual, there is a high risk that the population will refuse to use the treated water. We performed a control of chlorine free residue and the result was within the WHO guidelines: between 0.6mg/l and 1mg/l.
Informing the population regarding the need to use the treated water in order to stay Hepatitis E-free was essential. For this reason a mass awareness campaign needs to be launched. The Chadian Red Cross is the main actor inside Aboudeia town. Fortunately they are already managing many parts of the water treatment and disseminating information via awareness campaigns.
Another solution is to deliver safe water to the population of Aboudeia town via the use of hand pumps connected to boreholes. An advantage of this method is that it reduces the risk of contamination considerably. However, the number of functioning hand pumps is very low and the number of boreholes is also very low and unlikely to increase in the near future due to difficult geophysical characteristics in the region.

When our assessment was completed the report was shared with the different partners to discuss how to offer more support and guidance to the Chadian Red Cross and the Ministry of Health in reducing the Hepatitis E outbreak.’