Lessons learned from conducting six multi-country mixed-methods effectiveness research studies on water, sanitation, and hygiene (WASH) interventions in humanitarian response.

BACKGROUND: Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions is needed in humanitarian settings. Between 2008 and 2019, we completed six multi-country, mixed-methods effectiveness studies in humanitarian response on six different WASH interventions. In each evaluation, we conducted: key informant interviews; water point observations and water quality testing; household surveys with recipients, including survey and water quality testing; focus group discussions; and/or, secondary data analysis. The research questions were: "What is the effectiveness of [intervention] in reducing the risk of diarrhea/cholera transmission; and, what programmatic factors lead to higher effectiveness?" DISCUSSION: In all six multi-country, mixed-methods evaluations, policy-relevant outcomes were obtained. We found, in our individual research results, that: interventions could reduce the risk of disease in humanitarian contexts; this reduction of risk did not always occur, as there were large ranges in effectiveness; and, implementation factors were crucial to intervention effectiveness. When collaboratively reviewing our research process across evaluations, we found strategies for successfully conducting this research included: 1) working with partners to identify and evaluate programs; 2) rapidly obtaining approvals to deploy; and, 3) conducting research methodologies consistently. Personal connections, in-person communication, trust, and experience working together were key factors for success in identifying partners for evaluation. Successes in evaluation deployment occurred with flexibility, patience, commitment of adequate time, and understanding of processes; although we note access and security concerns in insecure contexts precluded deployment. Consistent and robust protocols, flexibility, and a consistent researcher on the ground in each context allowed for methodological consistency and high-quality results. CONCLUSIONS: In conclusion, we have found multi-country, mixed-methods results to be one crucial piece of the WASH evidence base in humanitarian contexts. This is particularly because evaluations of reductions in risk from real-world programming are policy-relevant, and are directly used to improve programming. In future, we need to flexibly work with donors, agencies, institutions, responders, local governments, local responders, and beneficiaries to design safe and ethical research protocols to answer questions related to WASH interventions effectiveness in humanitarian response, and, improve WASH programming.

Plastics in biogenic matrices intended for reuse in agriculture and the potential contribution to soil accumulation.

The spread of biogenic matrices for agricultural purposes can lead to plastic input into soils, raising a question on possible consequences for the environment. Nonetheless, the current knowledge concerning the presence of plastics in biogenic matrices is very poor. Therefore, the objective of the present study was a quali-quantitative characterization of plastics in different matrices reused in agriculture as manures, digestate, compost and sewage sludges. Plastics were quantified and characterized using a Fourier Transform Infrared Spectroscopy coupled with an optical microscope (µFT-IR) in Attenuated Total Reflectance mode. Our study showed the presence of plastics in all the investigated samples, albeit with differences in the content among the matrices. We measured a lower presence in animal matrices (0.06-0.08 plastics/g wet weight w.w.), while 3.14-5.07 plastics/g w.w. were measured in sewage sludges. Fibres were the prevalent shape and plastic debris were mostly in the micrometric size. The most abundant polymers were polyester (PEST), polypropylene (PP) and polyethylene (PE). The worst case was observed in the compost sample, where 986 plastics/g w.w. were detected. The majority of these plastics were compostable and biodegradable, with only 8% consisting of fragments of PEST and PE. Our results highlighted the need to thoroughly evaluate the contribution of reused matrices in agriculture to the plastic accumulation in the soil system.

To spread or not to spread? Assessing the suitability of sewage sludge and other biogenic wastes for agriculture reuse.

Sewage sludge (biosolids) management represents a worldwide issue. Due to its valuable properties, approximately one half of the EU production is recovered in agriculture. Nevertheless, growing attention is given to potential negative effects deriving from the presence of harmful pollutants. It is recognized that a (even very detailed) chemical characterization is not able to predict ecotoxicity of a mixture. However, this can be directly measured by bioassays. Actually, the choice of the most suitable tests is still under debate. This paper presents a multilevel characterization protocol of sewage sludge and other organic residues, based on bioassays and chemical-physical-microbiological analyses. The detailed description of the experimental procedure includes all the involved steps: the criteria for selecting the organic matrices to be tested and compared; the sample pre-treatment required before the analyses execution; the chemical, physical and microbiological characterisation; the bioassays, grouped in three classes (baseline toxicity; specific mode of action; reactive mode of action); data processing. The novelty of this paper lies in the integrated use of advanced tools, and is based on three pillars:•the direct ecosafety assessment of the matrices to be reused.•the adoption of innovative bioassays and analytical procedures.•the original criteria for data normalization and processing.

Qualitative and Quantitative Analysis of Latrine Management Approaches in Internally Displaced Persons Camps in Myanmar.

Water, sanitation, and hygiene (WASH) interventions provide dignity and prevent disease transmission. Sanitary facility provision (e.g., latrines) is a key WASH priority in all phases of humanitarian response. Currently, there are evidence gaps on field effectiveness of sanitation approaches, particularly in protracted crises. Thus, we conducted a qualitative and quantitative evaluation of sanitation approaches in internally displaced persons (IDP) camps in Myanmar. We conducted 36 focus group discussions, 65 household surveys, and 32 key informant interviews in Rakhine and Kachin states; results were analyzed qualitatively. We found family-shared, gender-segregated latrines were the preferred approach. Acceptance was a result of gender segregation, followed by lighting, state of repair, cleanliness, design, and distance from household. Contextual factors influencing sanitation approach development and acceptance were cultural and religious beliefs, community cohesion, camp size, livelihood access, land ownership and availability, and responding agency type. Overall, sanitation approaches generally met IDP needs; however, access was limited for children, the elderly, and people with special needs (including persons with disabilities). We recommend implementers of latrine programs in protracted contexts conduct community consultations, consider gender segregation, be flexible in considering context-specific solutions, prioritize access and dignity, and be inclusive of vulnerable groups.

Laboratory Efficacy of Locally Available Backwashing Methods at Removing Fouling in Hollow-Fiber Membrane Filters Used for Household Water Treatment.

Hollow-fiber membrane filters (HFMFs) for household water treatment (HWT) can efficaciously remove disease-causing organisms in laboratory settings. However, lower effectiveness in use in low- and middle-income countries (LMICs) and humanitarian contexts (HCs) has been observed and attributed to membrane fouling and the associated cleaning. In LMICs/HCs, it is not possible to prevent and control fouling using commonly known methods (e.g., testing influent water, maintenance regimes), and the literature on fouling/cleaning of HFMFs distributed in LMICs is scarce. As such, controlled laboratory experiments were conducted to determine the efficacy of locally available (in LMICs/HCs) backwashing solutions at removing fouling using different influent waters and HFMF types. Four commonly distributed HFMFs were selected; fouling layers were developed by filtering three influent water compositions, representing LMIC/HC waters, for 10-days, and bleach, water, or vinegar backwashing solutions were used for daily backwashing. Filter performance indicators included: fiber mechanical properties (strain at break, break force), water quantity performance (flow), water quality performance (turbidity, E. coli), and imaging. The study found fouling developed rapidly and altered mechanical properties and water quantity indicators within 200 h of filtration. Fouling did not decrease water quality indicators. Backwashing improved the filter's mechanical properties and water quantity performance, but it did not fully recover the initial performance. Additionally, recovery differed between backwashing solutions, and no universal cleaning recommendation appropriate for HFMFs in LMICs/HCs was identified. Overall, fouling development and control depended on HFMF type, influent water quality, and backwashing solution type; thus, caution before distributing HFMFs for long-term use in LMICs/HCs is recommended.

Activation of the heat shock response in plants by chlorophenols: transgenic Physcomitrella patens as a sensitive biosensor for organic pollutants.

The ability to detect early molecular responses to various chemicals is central to the understanding of biological impact of pollutants in a context of varying environmental cues. To monitor stress responses in a model plant, we used transgenic moss Physcomitrella patens expressing the beta-glucuronidase reporter (GUS) under the control of the stress-inducible promoter hsp17.3B. Following exposure to pollutants from the dye and paper industry, GUS activity was measured by monitoring a fluorescent product. Chlorophenols, heavy metals and sulphonated anthraquinones were found to specifically activate the hsp17.3B promoter (within hours) in correlation with long-term toxicity effects (within days). At mildly elevated physiological temperatures, the chemical activation of this promoter was strongly amplified, which considerably increased the sensitivity of the bioassay. Together with the activation of hsp17.3B promoter, chlorophenols induced endogenous chaperones that transiently protected a recombinant thermolabile luciferase (LUC) from severe heat denaturation. This sensitive bioassay provides an early warning molecular sensor to industrial pollutants under varying environments, in anticipation to long-term toxic effects in plants. Because of the strong cross-talk between abiotic and chemical stresses that we find, this P. patens line is more likely to serve as a direct toxicity bioassay for pollutants combined with environmental cues, than as an indicator of absolute toxicity thresholds for various pollutants. It is also a powerful tool to study the role of heat shock proteins (HSPs) in plants exposed to combined chemical and environmental stresses.