Emergency in Laos: staying safe with clean water and sanitation

By Simon Nazer

Many children like 12-year-old Khao Yai are struggling to come to terms with what happened late July when a dam breached in southern Lao PDR, displacing thousands of people. “I just remember water coming into my home and people shouting,” he says. “I don’t really remember much after that.”

Khao and his family are now staying in a temporary shelter in the remote camp of Ban Bok. The route to the village is treacherous: roads are knee-high in flood water and mud while the scattered remains of people’s household items – wardrobes, sacks of rice, televisions – lie strewn outside homes.

“We just had to go right away, we left everything,” recounts Khao. His experience is shared with over 4,000 other people who were displaced by the floods. During such emergencies, access to clean water and sanitation facilities becomes extremely important to ensure people stay healthy and clear of potentially life-threatening diseases.

That’s why UNICEF, with the support of USAID, is working to install water points (drilling boreholes with hand motorized pump) and toilets in camps like Ban Bok. In addition to this, USAID is supporting UNICEF to deliver psychosocial support to children affected by the floods.

“I’m just staying in a tent nearby,” says Khao, never short of a smile, while standing next to a newly installed water pump. “I’m spending time with friends and studying Lao language. I like football and we play a lot, although it’s very wet so it’s not easy.”

Together with the National and Provincial Centres in Saravane and Attapeu for Environmental Health and Water Supply, UNICEF has provided 35 water points (boreholes with hand and electric pumps and stand pipes) and constructed 13 latrines (7 in Ban Bok and 6 in Pingdong). Soap, tarpaulins, buckets, bowls and jerry cans have been distributed to all camps except those two inaccessible and 30 solar lamps from the Government of Australia will be soon installed in the camps, near the toilets. Hygiene promotion activities are also being carried out.

At times of crisis, children like Khao are more susceptible to illness and death from diseases that are often caused by lack of sanitation, inadequate safe water and poor hygiene. Without access to basic water and sanitation services, and without the practice of good hygiene, the danger of diarrhoea, cholera and other disease outbreaks is high.

The support from UNICEF and USAID is ensuring access of affected populations to safe drinking water through the distribution of 200,000 water purification tablets to treat water.   

In addition to installing taps and toilets, UNICEF also helps affected communities to teach children and families the importance of handwashing to help stay clear of disease and illness.

“Our teacher already taught us how to wash our hands at school and I use the new tap a lot,” says Khao. “I’m also using the new toilet here, it’s much better than going out in the open.”

While it’ll take time to rebuild after what happened, delivering safe water and sanitation facilities to children like Khao, and their communities, is the first step to ensuring they stay healthy and happy.

Smiling again after the flood in Laos

By Simon Nazer

Since a huge flood in the south of Lao PDR left thousands homeless, child friendly spaces have been set-up in remote camps to give children a safe area to learn and play with trained volunteer teachers.

UNICEF and partners such as Save the Children, Plan International and Child Fund led by the Ministry of Education and Sports and the Ministry of Labour and Social Welfare, with the support of the Australian Government and USAID, are supporting the Government to create a happy space to help children heal from the trauma of the disaster.

We recently visited some spaces and the smiles tell their own story.

Nado, 2, loved running around and using the slide. “I want to come back tomorrow,” he said before running off to join the queue for the slide. 

2-year old Donut, right, couldn’t get enough of the activities. “I like it lots,” she said. “I hope I can come again every day!”

One mother who was watching her child play really valued the child friendly space. “My daughter likes it here very much,” she says. “I think this is really great for the kids.”

“I think it’s good to bring the children together,” continued the mother of 4-year-old Vanmai. “It’s much more active here than just sitting in our tent, alone with her few toys. I can see she’s more active and happy here.”

The child friendly spaces allow children to heal after the trauma of the floods where thousands of people lost their homes and livelihood to huge floods. The tent is equipped with UNICEF’s School in a Box and volunteer teachers have be trained to give children and mothers support to move on from the trauma. 

As well as playing, children also learn while their schools are closed. This helps keep their learning on track before they can go back to school and restart their lives.

UNICEF is continuing its work for the many children affected by the floods to help them and their families get their lives back on track. 

Flood emergency in Laos: A haven for happiness in Laos

By Simon Nazer

For many children like 6-year-old Laura, the last month has been a distressing time. Huge floods in Southern Lao PDR triggered by a damn breaking have taken away her home and her parents’ livelihood, and her aunt remains missing. But today she is smiling again thanks to a new child friendly space in her camp that is bringing fun, games and learning to her each and every day.

“She’s really happy there, she never wants to leave,” says Laura’s mother while watching on. “As soon as she wakes up in the morning she asks to go right away.”

The flood has affected over 13,000 people and left around a third of those in camps like Laura’s in remote Ban Bok. UNICEF and partners are working to deliver clean water, sanitation facilities, and non-food items such as hygiene kits, tarpaulins and medicines, among other things, to these hard-to-reach camps to help children and families stay safe and healthy. Nutrition screening of children in camps, treatment of malnutrition cases and promotion of exclusive breastfeeding are some of the priorities for UNICEF in the aftermath of the flash floods. 

UNICEF, with support from the Australian Government and USAID, UNICEF is working to provide a safe space for children to learn and play before they can go back to their schools. So far six child friendly spaces have been setup, supporting about 1,000 children. 

For Laura, coming here is the highlight of her day. “I really, really like it,” she says while finishing a reading activity. “My favourite thing to do here is the mango game!”

Volunteer teachers like 21-year-old Malaithone spend around four hours a day with Laura and her friends, teaching them games and songs as well as taking them through counting and reading activities. 

“This is really good for children and it’s important to give them a safe space after all the problems,” she says. “I’m actually very happy to be here to help – I just graduated from teacher training and I’ll be here for as long as I’m needed.” 

“It was a distressing time for them,” continues Malaithone while preparing for another activity. “This helps take their minds off of what happened – it’s making them smile again.”

A safe space for every child affected by disaster

Laura is shy at first but Malaithone leads her and the others through a series of activities to help them relax and open up. Sure enough, after a few minutes of introductions Laura is dancing and playing with all the other children.

“It’s difficult to stay in this camp, she misses her home,” explains Laura’s mother. “We don’t know how long we’ll be here and what the future holds. It’s hard here but I’m so thankful for this safe space for her to play and to help keep all the children happy.”

The tents are equipped with UNICEF’s School in a Box to help teachers bring the best out of children. “There are lots of materials in the box like books, blocks ad balls for games, colouring kits,” says Malaithone. “It’s very useful for us teachers and the children.”

Disasters such as these can have huge, long-term impacts on children’s mental well-being. This is why, with support from partners -  Save the Children, Plan International and Child Fund, under the leadership of the Ministry of Education and Sports and the Ministry of Labour and Social Welfare, the volunteers are also trained to provide psychosocial support to the children and women affected by the flood.

This space will give Laura and the many affected children like her a better chance to move on from the disaster and to start learning, and smiling, again. 

Laos 1,000 Days Program: Stories of Change

Lamvong and her son Sambom (1 year, 2 months) Vilabouly District

Lamvong sits at a health outreach site in Vilabouly District with her 14 month old son, Sambom. She has come to the outreach clinic today, as she does every three months, to ensure Sambom accesses regular health services as he grows through the critical first 1,000 days of his life.

The 1,000 Days Program is implemented in collaboration between UNICEF Lao PDR, the Ministry of Health and Lao Women’s Union, with support from long term partner MMG. Its aim is to improve the nutritional status of infants and young children in rural areas of Lao PDR. Good nutrition is critical to children’s physical and cognitive development and has long lasting impacts on children throughout their lives. In the province of Savannakhet, where Lamvong lives, stunting in children is high, at 30%. Stunting, is a result of chronic undernutrition and in Lao PDR presents a significant challenge. The 1,000 Days program aims to address stunting and micronutrient deficiencies through taking a broad approach to promoting care practices, such as exclusive breastfeeding until 6 months, ensuring children eat a diverse range of nutritious foods beyond 6 months, handwashing and hygiene practices.

Today, at the health outreach clinic, Sambom is weighed and measured to monitor his growth, and Lamvong collects a three month supply of Super Kid, a micronutrient powder especially designed to supplement the diet of children aged 6 months to 2 years to support their physical and cognitive development during this crucial period. Members of the Lao Women’s Union also give a cooking demonstration, showing how MNP can be added to different types of local food for best effect.

Lamvong proudly talks about the good health of her children. Recognising this, her friends and neighbours ask her for advice on how to keep their babies healthy and as we talk Lamvong asks for advice about what to do when children have poor appetite so that she can share this information with her peers. “I like to help others”, she says, knowing that successes with her children can inspire those around her.

The same day, Vice Chief of Village, Syda shares her experiences of the 1,000 Days Program. Syda has been closely involved in her role as Vice Chief, and also as an active member of the Lao Women’s Union, sharing important nutrition information with parents in her village.

Syda (right) – Vice Chief of Village (Muangluang), Vilabouly District

Since the 1,000 Days program began in her village, Syda has seen big changes. “Children are more healthy”, she says. Where in the past diarrhoea and fever were common, this is happening less and less as hygiene and nutrition practices improve.

Phone, with Bounmy (9 months)

In a nearby district of Atsaphone, Phone is receiving Super Kid for the first time. This is the first time the micronutrient powder has been distributed to her village and the health outreach clinic commences with an information session from Lao Women’s Union volunteers on infant and young child feeding practices.

For many parents in her village, knowledge of nutrition requirements for young children is limited and these information sessions provide an opportunity to build knowledge around these needs, particularly during the 1,000 Day period.

Phone says that she appreciates receiving this extra information about her daughter’s growth and development and is ready to start adding Super Kid to meals for Bounmy.

“I will use Super Kid to make my baby healthy and strong” she says.

Press release: Lao PDR’s First Ever Cholera Vaccination Campaign Launched in Flood-hit Sanamxay District

Vientiane Capital, 25 August 2018 – The Ministry of Health with support from UNICEF and the World Health Organization has launched the first ever cholera vaccination campaign in Lao PDR targeting flood-affected communities.

The OCV campaign has begun at the main camp at Sanamxay District. 

Photo credit: Simon Nazer (UNICEF)

During the first phase of the cholera vaccination campaign from 23 to 30 August, about 5,000 doses will be administered to flood-affected communities in Sanamxai district.  An additional 19,700 doses will be used in a second round. In total, 12,350 people will receive the two doses of the vaccine administered in two phases of this campaign until September 2018.

“Cholera is a devastating disease which can spreads quickly and kills fast. Increased risks can be seen after severe flooding. The Ministry of Health has been monitoring 15 communicable diseases to protect against potential outbreaks, and this vaccination campaign along with the efforts made to improve water, sanitation and hygiene (WASH) will protect the people living in the shelters,” stated Assoc. Prof. Dr Bounkong Syhavong, Health Minister.

Cholera is a serious bacterial disease that usually causes acute severe diarrhoea and dehydration. It is caused by ingestion of food or water contaminated with faecal material that contains the bacterium Vibrio Cholera. It affects both children and adults and can kill within hours. The short incubation period of two hours to five days, enhances the potentially explosive pattern of outbreaks.

“Considering the water and sanitation conditions in the overcrowded shelters and the increased risk of disease outbreaks during this rainy season, we need to support the Ministry of Health to take all possible measures to prevent cholera and other water and vector borne diseases. There is not currently a cholera outbreak in the country, but preventive measures are to be taken given the circumstances,” said Dr Juliet Fleischl, WHO Representative to Lao PDR.

Cholera occurs mainly in areas where there is open defecation, poor sanitation and personal hygiene, and a lack of clean drinking water. In some areas where latrines and toilet areas are in close proximity, it can contaminate surface water, shallow dug wells and boreholes including piped water; when a person’s hands contaminated with faecal material touches food, fruits or in contact with stored water.

“UNICEF is working with partners to provide training and support for activities that engage and educate communities about communicable diseases including cholera, putting emphasis on hygiene promotion. Trained staff have been deployed in the affected area to spread the word through social mobilisation in the camps. In addition, we are scaling up water, sanitation and hygiene efforts to ensure affected populations have access to clean water and sanitation facilities,” explained Myo Zin Nyunt, UNICEF Acting Representative to Lao PDR.

For the cholera vaccination campaign, seven mobile teams, comprising of 3-4 members, and other two teams based in the primary camp in Sanamxay district are carrying out the vaccination activities covering emergency shelters and host communities through door-to-door service. Teams are also organising awareness sessions and spreading messages on hygiene, food preparation, management of acute diarrhea and oral rehydration.

WHO recommends that vaccination against cholera be considered in emergencies like severe flooding where there are increased threats of outbreaks, when combined with standard prevention and control measures for the disease. These measures include readiness to provide adequate testing and treatment, steps to ensure access to safe water and sanitation, and community mobilization to engage the public in preventing infection.

Data have shown oral cholera vaccines to be safe and effective in humanitarian crises with high risk of cholera. The vaccines should always be used in conjunction with other cholera prevention and control strategies.

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About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children in Lao PDR, visit http://www.unicef.org/laos   

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About WHO

We are the directing and coordinating authority on international health within the United Nations’ system. We do this by: providing leadership on matters critical to health and engaging in partnerships where joint action is needed; shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge; setting norms and standards and promoting and monitoring their implementation; articulating ethical and evidence-based policy options; providing technical support, catalysing change, and building sustainable institutional capacity; and monitoring the health situation and assessing health trends.

http://www.wpro.who.int/laos/en/

For more information, please contact:

Maria Fernandez, UNICEF Lao PDR, (+856) 2055519681, mfernandez@unicef.org

Irene Tan, WHO Lao PDR, 856-2078113933 tanir@who.int