Infection Prevention Precautions for Fecal Camps
The most critical precautions for preventing infections in a fecal camp include providing adequate clean water supplies, implementing proper sanitation systems, promoting handwashing with soap, and maintaining clear separation between waste disposal areas and food/water sources. 1
Water Supply Management
- Ensure adequate quantity of water (minimum 20L per person per day) as this has greater overall health impact than small quantities of microbially pure water 1
- Identify appropriate water sources before camp establishment, with water sources located no more than 150m from any dwelling 1
- Protect water sources from contamination through measures such as:
- Spring protection boxes
- Wells with proper heads, drainage aprons, and pumps
- Surface water drawn upstream from contamination sources 1
- Test water quality before use, at regular intervals, and during any diarrheal disease outbreaks 1
- Consider water treatment methods like filtration and chlorination when necessary 1
- Use covered storage containers with narrow necks to prevent hand contamination of stored water 1
Sanitation Implementation
- Develop camp sanitation plans before arrival of camp inhabitants 1
- Separate human waste and garbage from water and food supplies 1
- Contain excreta within specific designated areas 1
- For short-term measures in hot, dry climates, designated defecation fields may be used temporarily 1
- Design and install latrines with consideration of:
- Cultural attitudes and practices of the population
- Location that prevents water source contamination
- Ideally, personal or family latrines (preferred) 1
- If communal latrines are necessary, limit to no more than 20 people per latrine and clearly assign maintenance responsibility 1
- Regular maintenance of latrines is essential for continued use 1
Personal Hygiene Promotion
- Implement community health education emphasizing handwashing with soap 1
- Ensure soap is readily available to all camp inhabitants 1
- Promote general domestic and personal hygiene practices 1
- Emphasize safe food-handling practices 1
- Encourage exclusive breastfeeding for infants 4-6 months and continued breastfeeding until 2 years of age 1
- Restrict distribution of milk products and never distribute feeding bottles 1
Disease Surveillance and Management
- Establish surveillance systems for monitoring diarrheal diseases and other enteric infections 1
- Aim to maintain diarrheal case incidence below 1% per month 1
- Target a case fatality rate of less than 1% for diarrheal cases, including cholera 1
- Create oral rehydration therapy (ORT) centers throughout the camp 1
- Train community health workers in proper assessment and management of diarrheal diseases 1
- Establish protocols for managing dehydration in patients with diarrhea 1
Common Pitfalls and Special Considerations
- Vaccination for typhoid or cholera is not recommended in refugee/camp situations - resources are better used for improving sanitation 1
- Boiling water, while effective for pathogen removal, is often impractical in camps with limited fuel supplies 1
- Environmental persistence of pathogens can be prolonged - E. coli O157:H7 can survive in soil for months 1
- Airborne transmission from dust in animal areas has been documented in some outbreaks 1
- Poorly maintained latrines will not be used, defeating their purpose 1
- Inadequate separation between waste disposal areas and food/water sources increases disease transmission risk 1
By implementing these precautions systematically, the risk of infectious disease transmission in fecal camps can be significantly reduced, leading to improved health outcomes for inhabitants.