To reduce morbidity and mortality and to improve resilience of vulnerable populations in Leer and Mayendit counties by providing access to quality WASH services integrated with nutrition for SAM/MAM children and their families and improved WASH services for -IDPs/Host Communities The  project  will focus on two key thematic areas: 1) Provision of temporary and sustainable WASH services to address the vital water, sanitation and hygiene needs of displaced populations and host communities 2) Integrated WASH interventions for SAM/MAM admissions at OTP/SC targeting the patient and their household.  

WASH in communities- Medair proposes to improve access to safe water for conflict-affected communities (displaced populations and host communities) in Leer and Mayendit by constructing 5 new manually drilled boreholes or hand-dug wells fitted with hand-pumps and by rehabilitating or repairing 7 existing hand-pumps.   Medair will evaluate and select construction technology that is best suited for the hydrogeological conditions encountered and logistical constraints. Technologies proposed for water abstraction include a manual drilling rig or hand-dug well construction, all fitted with hand pumps. Water User Committees will be established at each newly constructed/rehabilitated water point, to provide ongoing maintenance of the water point and the fencing. Training will strengthen the capacity of the new and existing pump mechanics. Rehabilitations will be conducted by the existing pump mechanics whenever possible. A local reliable supply chain for spare parts is not feasible given the volatile context so items will be supplied and the project will ensure that the pump mechanics have the essential tools and access to a stock of essential spare parts .  Water quality testing will be conducted for newly constructed/rehabilitated water points to confirm safe water before opening to the beneficiaries. All new wells will aim for lt10 FCU/100ml (SPHERE 2018) . However, there may be instances when it is not possible to fully address water quality issues for some repaired boreholes (e.g. when they are located close to the swamp). Achieving the best outcomes from WASH infrastructure requires hygiene behaviour change to occur within the community. Medair proposes to carry out household level hygiene and sanitation promotion primarily in peer-based BCC through the CGM in Leer and Mayendit.

Integrated WASH and Nutrition: Within the context of extreme food insecurity, it is critical to ensure that households have access to safe drinking water for malnourished children. Medair aims to provide a minimum WASH package for all Medair-supported health and nutrition facilities in all the project locations. Medair proposes to provide Point of Use Water Treatment (PoUWT) such as PUR, Aquatabs or Sawyer filters, along with training of the mothers of MAM and SAM patients on their correct use. Each MAM/SAM patient will receive a 10L bucket, PUR sachets to purify drinking water for an average of 6 members of the HH, filter cloth, and storage container for storing clean/purified drinking water. Medair will consider Sawyer Point One filters where PUR is not accepted by the beneficiaries. Emphasis will also be placed on behaviour change communication (BCC) to improve hand washing at critical times and safe water storage within the households, which aims to reduce the contribution of diarrhoeal diseases/nematodes to child malnutrition. At the nutrition centres, Medair will provide drinking water for patients (appetite test), as well as for drinking for both patients and staff. Additionally, Medair will construct latrines and hand washing stations at health and Nutrition facilities for patients and staff to safely dispose of faecal matter and wash hands and carry out follow ups on correct use of PoUWT items. At Medair health and nutrition centres, the project will construct and/or rehabilitate waste pits install burn pits / simple drum incinerators or other appropriate combustion facilities, train clinic staff on proper use of solid waste management facilities and conduct clean up activity at each site to remove existing debris.