Safe disposal of human excreta creates the first barrier to excreta-related disease, helping to reduce transmission through direct and indirect routes. Safe excreta disposal is therefore a major priority, and in most disaster situations should be addressed with as much speed and effort as the provision of safe water supply. The provision of appropriate facilities for defecation is one of a number of emergency responses essential for people's dignity, safety, health and well-being.

Key indicators (to be read in conjunction with the guidance notes)

Guidance notes

1. Safe excreta disposal: the aim of a safe excreta disposal programme is to ensure that the environment is free from contamination by human faeces. The more all groups from the disaster-affected population are involved, the more likely the programme is to succeed. In situations where the population has not traditionally used toilets, it may be necessary to conduct a concerted education/promotion campaign to encourage their use and to create a demand for more toilets to be constructed. Disasters in urban areas where the sewerage system is damaged may require solutions such as isolating parts of the system that still work (and re-routing pipes), installing portable toilets and using septic tanks and containment tanks that can be regularly desludged.

2. Defecation areas: in the initial phase of a disaster, before any toilets can be constructed, it may be necessary to mark off an area to be used as a defecation field or for trench latrines. This will only work if the site is correctly managed and maintained.

3. Public toilets: in some initial disaster situations and in public places where it is necessary to construct toilets for general use, it is very important to establish systems for the proper regular cleaning and maintenance of these facilities. Disaggregated population data should be used to plan the ratio of women's cubicles to men's (of approximately 3:1). Where possible, urinals should be provided for men (see Appendix 3).

4. Communal toilets: for a displaced population where there are no existing toilets, it is not always possible to provide one toilet per 20 people immediately. In such cases, a figure of 50 people per toilet can be used, decreasing to 20 as soon as possible, and changing the sharing arrangements accordingly. Any communal toilet must have a system in place, developed with the community, to ensure that it is maintained and kept clean. In some circumstances, space limitations make it impossible to meet this figure. In this case, while advocating strongly for extra space to be made available, it should be remembered that the primary aim is to provide and maintain an environment free from human faeces.

5. Shared facilities: where one toilet is shared by four or five families it is generally better kept, cleaner and therefore regularly used when the families have been consulted about its siting and design and have the responsibility and the means to clean and maintain it. It is important to organise access to shared facilities by working with the intended users to decide who will have access to the toilet and how it will be cleaned and maintained. Efforts should be made to provide people living with HIV/AIDS with easy access to a toilet as they frequently suffer from chronic diarrhoea and reduced mobility.

6. Children's faeces: particular attention should be given to the disposal of children's faeces, which are commonly more dangerous than those of adults, as the level of excreta-related infection among children is frequently higher and children lack antibodies. Parents or care givers need to be involved, and facilities should be designed with children in mind. It may be necessary to provide parents or care givers with information about safe disposal of infant faeces and nappy (diaper) laundering practices.