With the growing Ebola epidemic in West Africa now dominating global headlines, the crisis in South Sudan – only a few months ago labelled ‘the world’s worst humanitarian crisis’ has sadly slipped from news bulletins and out of much of the world’s minds.
Yet across the world’s newest nation, the response work continues. An estimated 1.5 million people remain in urgent need of food and nutrition support, and aid workers operate in extraordinarily challenging conditions, helping to provide medicine, food and safety to hundreds of thousands of people across the country.
There is one part of the response that many would argue remains as essential as medicine, food, water and security yet goes unheralded; bringing dignity, sanitation and ultimately, protection from potentially fatal disease outbreaks: the construction of emergency toilets.
“People were faced with awful, awful conditions,” said Kilong Alex Noel, a member of CARE’s Water, Sanitation and Hygiene (WASH) team who has spent most of this year working in and around Malakal, one of South Sudan’s largest urban centres in the country’s far north.
Following the outbreak of fighting late last year, much of the population of Malakal sought refuge in villages out of the immediate reach of soldiers and gunfire, or inside the UN’s hastily-built Protection of Civilian site, set up in what is effectively a giant swamp, and one that was never designed to cope with the extraordinary number of people that have sought refuge there.
“People really needed help,” said Alex. “They’ve been forced to live in the mud, without dignity, with very little support for the basic human need of hygiene.”
Women, children, fathers and mothers had run to the UN site seeking safety from the fighting, yet when the battles raged in December, January and into February, family after family found themselves building makeshift homes inside swampland that had very little natural irrigation. The smell of faeces was all-pervasive. Toilets were hastily constructed, yet provided no proper sanitation, no privacy, and many soon collapsed.
“We first constructed 112 emergency toilets,” explained Alex. “They were built quickly, but realistically weren’t able to cope with the huge of displaced people coming in each day to the site. These latrines were without lining, they were built only with simple sheeting; sheeting that was meant to stop the soil from collapsing.”
The arrival of the rainy season downpour quickly reduced the many of the hastily-built emergency toilets to piles of rubbish, mud and filth.
“When the rains first came to Malakal, [they] all collapsed and we were back to square one,” said Alex. “It was an awful situation.”
Alongside a number of other aid organisations, Alex and other members of CARE’s team went to work designing and constructing toilets that would help provide dignity, safety, and importantly, better protection from potentially-fatal diseases such as cholera.
“The pressure was really on us. We needed to move quickly, to help families cope, and to help prevent the outbreak of diseases.”
He said he and the team needed to think quickly – but think creatively – in order to create a solution that would be able to cope with the extraordinarily difficult conditions in Malakal, yet one that would be cheap enough to build in the hundreds.
“Ideally, latrines are to be lined using bricks or cement, or use maybe concrete in order to protect the soil from collapsing. But we’re operating in an emergency situation, without access to most materials. You cannot get bricks or sand here.”
“And the soil in Malakal is called black cotton soil, which is clay and highly-collapsible and it becomes soft when it gets wet,” explained Alex. “During the dry season, it cracks, then when the rains come, it just collapses.”
After a number of long days and late nights of planning, testing and re-testing their ideas, the team from CARE then got to work digging deep pits, six metres wide and nearly four metres deep, before constructing timber frames inside that would ensure the toilets would then retain their structure in the highly-collapsible soil they were sitting inside of.
A clean-up effort was launched, with hundreds chipping in make the Malakal site liveable again, and bringing clean water and safe conditions to a location that had become a sanitary nightmare. Within weeks, the team had dug, engineered and constructed hundreds of new latrines inside the Malakal camp, with a design that has received widespread praise and has now been replicated to other parts of the country.
And some months on, despite torrential rains and flooding inside the camps, the new toilets have retained their structure, to the clear relief – and quiet pride – of CARE staff such as Alex.
“The situation people are living in places like Malakal is very difficult,” said Alex. “The Protection of Civilian sites are awful places to be in, yet what’s outside is likely much worse, and that’s why people are still there.
“What we’re doing is giving people some dignity, safety and protection from disease. It is important work.”
CARE in South Sudan
Since the outbreak of violence across South Sudan in December 2013, more than 10,000 people have lost their lives, and an estimated 1.5 million people are now facing severe hunger and malnutrition.
CARE is providing healthcare, sanitation and the means to grow food to families living in South Sudan's three hardest-hit states of Jonglei, Unity and Upper Nile, and has already reached more than 250,000 people.
Read more about CARE's work in South Sudan