A series of failures was the starting point for this analysis. Several outbreaks of hepatitis E, transmitted via the water supply, occurred in refugee and IDP sites in the Sahel (Sudan in 2004, and Chad in 2007) and in central Africa (Central African Republic in 2002, and Uganda in 2007). MSF was responsible for all or part of the water supply, as well as medical care. These outbreaks are a reminder that significant infectious risks persists even after we implement our usual procedures. Following a workshop held in Paris in 2011, this review of MSF WASH practices addresses the following questions:
- What are the difficulties we face in producing and distributing sufficient quantities of water?
- What do we know about the relationship between water and health?
- What role should the "beneficiaries" play in defining the quality criteria to be met?
- How do people working in a non-humanitarian context define water as fit for drinking?
- Do recent technological developments offer new prospects?
- Can we hope to improve water quality without making progress in terms of energy consumption?
- What are the social, economic and political tensions determining how water is managed and the relationship between users and agencies that deliver water?
- What are the main areas of focus of national and international public policy in this area?