Situation in Afghanistan
According to UNICEF-WHO joint monitoring report 2015, 68 percent of Afghans don’t have access to improved sanitation and nearly 15 million, 45 percent use unimproved water sources. The provinces with higher intensity of conflicts are also the ones with poor WASH indicators (ALCS 2014). Safe hygiene behaviours like handwashing with soap is practiced by less than 30% of people in 24 out of 34 provinces (ALCS). As a result disease like diarrhoea that has strong association with chronic malnutrition among children is a matter of concern.
In 2016 conflicts have further intensified resulting in unprecedented levels of displacement. Additionally, 2016 also saw influx of returnees from abroad, especially from Pakistan and the trend is expected to increase in 2017, especially from 1st of March when UNHCR opens its encashment centre for documented returnees. Most of the newly displaced population are settling in areas /communities already hosting large numbers of prolonged IDPs/returnees which is putting undue pressure on already limited and dilapidated water, sanitation and hygiene (WASH) infrastructure. Such conditions are pushing affected population (including host communities) to use unimproved water sources and practice risky behaviours like open defecation.
Population fleeing the conflicts as well as facing deportation (Pakistani returnees) often live in crowded squatters in cities or makeshift shelters in marginal lands with limited or no WASH facilities as a result people often use unprotected and distant water sources and practice open defecation. These conditions compromise the dignity of women and girls, put them at risk of harassment, and expose people to life-threatening diseases including outbreaks of acute diarrhoea, cholera, ARI and measles, especially to young children and sick and elderly people. The diarrheal disease if not treated trap young children into a vicious circle of malnutrition and diarrhoea leading to chronic malnutrition and potential death. The natural disasters force communities to abandon their homes and damage and contaminate water and sanitation facilities making them unsafe to use. Returnees and IDPs also cause additional pressure on local health facilities that provide essential life-saving health and nutrition interventions and in absence of reliable WASH services the effectiveness of services in these facilities is further compromised. According to OCHA lead HEAT survey of Sept 2016, 70% of the 5,934 returnee and IDP families assessed in eastern region lack container for water storage and have no proper hygiene materials.