Emergency WASH response to cholera outbreak in West Bekaa, Zahle, Beirut, Chouf, El Meten, Keserwan, Aley, Baabda, and Palestinian Camps/Gatherings Naameh 001, Gaza Buidling Beirut, Said Ghawash Beirut, Daouk Beirut 001, and Burj el Barajneh camp Through this allocation, Save the Children (SC) aims to contribute to the interagency Health, WASH and RCCE operational plan to combat the spread of the cholera in Lebanon affecting vulnerable and marginalized communities. 

The proposed WASH project will seek to eliminate cholera transmission through the implementation of: a) case-area targeted intervention approach (CATI) or case-cluster targeted intervention approach (CCTI) to be deployed after 48 hours after a cholera case has been identified and b) preventive measures to ensure water safety in high-risk areas. 

SC will implement the proposed intervention in areas of Beirut, Mount Lebanon, Central Beqaa, and SC partner SAWA Group will implement in West Beqaa. Supported communities will be Syrian, Lebanese, Palestinians living in 5 Palestinian Refugee camps and gatherings (Naameh 001 – Gaza Buidling Beirut 001 – Said Ghawash Beirut 003 – Daouk Beirut 001 – Burj el Barajneh camp)as well as Informal tented settlements and residential households. 

All of the previously mentioned localities are part of the 3Ws of the WASH working group and WASH in Schools task force and assigned under SC geographical area of coverage. An expected total of 300,000 individuals will be supported through this project. 

Based on the Health sector guidance and the number reflected in the allocation paper, SC expects a 1% attack rate for a total population of 300,000 individuals with a total of 3,000 cases to be responded for as part of the CATI/CCTI approach. The attack rate is calculated based on MOPH and WHO projection in the Cholera National response plan. The two key epidemiologic indicators used during a cholera outbreak are the attack rate and the case fatality ratio or rate. These indicators are standard measures of epidemic intensity and impact. They allow for comparisons between different locations and previous outbreaks. The attack rate (AR) is the cumulative incidence of cholera since the start of the outbreak. 

SC and SAWA Group are going to follow the sector area-based targeting response through the implementation of the Case Area Targeted Interventions (CATI) with minor contextual adaptations. SC and SAWA Group will receive referrals from the RDMS platform, within a period of 24 to 48hrs, Rapid Response Teams will visit the suspected cases and provide the proper cholera kits, awareness and conduct the right intervention from water cleaning and chlorination. Following this, SC will close the case to reflect an accurate number of active cases that still require support. 

SC and SAWA will also implement preventative measures to ensure safe water at communal level through the support of Water Establishments, municipalities and public schools in monitoring quality by providing pool tester, tool usage training session and chlorine for water establishment, communal/municipal water sources and public schools, in addition to provision of Fuel for Pumping stations, water amp wastewater treatment plants. Furthermore, SC will implement decentralized water treatment solution such as UV sterilizers, dozing pumps that will be identified based on a needs/solution assessment.