Cameroon: Water, sanitation and hygiene needs assessment (December 2018)



September 2017 marked an escalation of tensions in the North-West (NW) and South-West (SW) regions of Cameroon as part of the ongoing crisis opposing government forces against non-state armed groups. The number of security incidents in these regions has significantly increased, leading to the displacement of 437,500 people as of December 2018, both within NW and SW and to neighbouring Littoral and West regions.1 According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), an estimated 4 million people are affected by the crisis, including 1,3 million in need of assistance.2 However, insecurity and a lack of information on the needs of affected population have created significant challenges for the humanitarian response.

To address this information gap and enable a more effective response, the Shelter and Water, Sanitation and Hygiene (WASH) Clusters, with support from REACH, have conducted an assessment on the needs of conflictaffected populations in NW, SW, Littoral and West regions. Based on the Shelter Cluster strategy, the assessment focused on the needs of five population groups (displaced in makeshift settlements, displaced hosted, displaced renting, non-displaced hosting, non-displaced in partially damaged or destroyed accommodations3 ) in 18 divisions of SW, NW, Littoral and West experiencing internal displacement, and in three types of settings (urban or semiurban areas, villages in rural areas and non-village/bush in rural areas settings).4 In partnership with five local partners (Reachout, PEP, SUDHASER, COHESODC and Plan International), data was collected between 4 and 17 December 2018 through interviews with 157 key informants (KIs) providing information on their population group and their locality. Given the qualitative nature of the assessment, findings should be considered as indicative only.
This report focuses exclusively on the WASH-related findings.5

The assessment found significant WASH needs amongst assessed populations, regardless of displacement status or location. Nevertheless, important differences were observed between population groups, settings and regions.

Access to water is a key challenge across the area, both in terms of quantity and quality. Overall, KIs reported that only a minority of people manage to secure enough water to meet their needs and that a fifth of the communities rely exclusively on unimproved sources. Limited access to water is mostly due to the fact that people do not have enough containers to fetch and store water, and that existing waterpoints are not sufficient, or are too far. The situation is particularly concerning for certain strata of the population, such as people living in the bush and, to a lesser extent, in rural villages, likely due to the limited coverage of WASH infrastructure in remote areas.

Access to hygiene is very limited6 . KIs reported that only few people have soap at home and even less have handwashing facilities. This, along with factors linked to knowledge and attitude, contribute to poor hygiene practices, with the overwhelming majority of KIs reporting that only few people or nobody usually washed hands with soap, especially for communities living in the bush and in rural areas, as well as displaced populations. In addition, one out of ten female KIs reported “none” as preferred menstrual material, which is a concern, especially if KIs understood the question more in terms of current practice, rather than preference.

The overall sanitation situation is poor. Even though KIs reported latrines as a common place of defecation, half of them said that only few or nobody have access to them. Major issues reportedly limiting access to sanitation are unavailability of latrines, and the fact that the existing ones often do not ensure privacy and gender separation. As a result, open defecation is a widespread practice, especially among communities living in the bush and rural areas.

Ownership of key, basic WASH NFIs was found to be the exception, rather than the rule. Only few affected families have enough water containers, mosquito nets and soap. This can be explained by the fact that access to market is limited, especially outside urban centres, and in conflict affected regions (NW and SW). Even when markets are functional, key WASH NFIs, when available, are often unaffordable.

The precarious WASH situation is even more concerning considering the health conditions faced by affected populations and their access to health care. Water-related diseases are widespread, with more than half of the KIs reporting that malaria, respiratory diseases and watery diarrhea are the main health issues affecting children. Access to health care remains limited, with more the a third of KIs reporting that people do not visit any health service provider when children are sick, especially those living in the bush or in rural villages.

Overall the assessment has shown that the WASH response to the NW/SW Cameroon crisis should very much be tailored to the population group, geography and setting in which displaced and host communities are, based on the above needs and vulnerabilities. The findings from this assessment suggest that market-based interventions would be the most useful type of assistance in urban or peri-urban settings. Nevertheless, market-based assistance cannot be adopted systematically and should be considered in relation to the limited accessibility of functional markets, especially in rural settings and conflict-affected regions, which renders the purchasing of basic WASH items challenging. In addition, market-based intervention feasibility studies should be conducted to explore other key dimensions, including market supply, protection risks, and beneficiaries’ preferences.

In addition, findings from this assessment do not indicate a stabilisation of the situation in the short term. KIs’ answers with regards to the length of time that IDPs have spent in their current location highlight dynamic and ongoing displacements, also reflected by the fact that the majority of KIs reported being unsure of the intentions of the IDPs for the following three months. Insecurity and complete destruction of shelters – reported as the most common reasons for displacement – leave limited perspectives for return. As such, the situation and the needs of affected populations should be regularly monitored, to enable an effective humanitarian response.