By Mekonnen Teshome and Tesfaye Abate
Ethiopia has long struggled with access to clean water. But the spotlight that COVID-19 has shone on the sanitation and hygiene sector in Addis Ababa, the 133-year-old capital city, has presented an opportunity to place sanitation and hygiene at the center of strategies to protect people’s health.
Bekele Balcha, a security guard serving the Eka Kotebe Hospital, which is the main COVID-19 quarantine center in Addis Ababa, explains that since the pandemic hit, the water supply in the hospital and nearby community has been outstanding.
“If the tap water is interrupted, the Addis Ababa Water and Sewage Authority supplies with its water tanker vehicles, and they are at our disposal anytime to address water related problems,” he said.
“If you encounter any water related problem, you have a free call system at “804” and reach the concerned authority sections to inform the situation. I see a very encouraging responsiveness in the water supply services during this COVID-19 time.”
Despite long standing challenges, the fight against the Covid-19 pandemic is enabling wide availability of affordable hygiene products and services and embedding a culture of good sanitation and hygiene in Ethiopian communities. And such actions could facilitate building resilience against future hygiene diseases.
Unmet Water Demand
In the fight against the coronavirus pandemic, clean water is paramount. The World Health Organization (WHO) recommends installing hand hygiene facilities in front of public and private commercial buildings as well as at all transport hubs for people to wash their hands regularly to reduce the spread of infections.
However, access to clean water remains one of the challenges in the fight against this pandemic, and water demand is unmet in many countries around the world. Likewise, Addis Ababa, the capital of Ethiopia, shares this same problem as many of its residents lack access to safe water.
According to the World Bank, only 63 percent of Ethiopia’s 108,113,150 (July 2020 est.) population and just 4 percent of Ethiopia’s urban population of 24,463,423 (21.3 % of total population) have, “safely-managed water” available in their premises and free from contamination in Ethiopia.
Factors like recurrent droughts, floods, and rising temperatures make it more difficult to manage water resources effectively and to ensure continuity in water service delivery.
Addis Ababa Water and Sewerage Authority (AAWSA), a public utility that manages supply of piped water systems in the 133-year-old capital city is only able to supply safe water to two-thirds of the city population, pumping 575,000 cubic meters of potable water to its inhabitants daily. The demand for safe water by the remaining one-third of the city residents is not met. Their only option is to walk up to 2km to access water sources, some containing unsafe water.
Serkalem Getachew, the Public Relations Head of AAWSA, says, “the gap between water demand and supply,” in the city is now, affecting the city-wide COVID-19 prevention efforts.
Likewise, Kitka Goyol, the chief of Water Sanitation and Hygiene (WASH) at the UN children’s agency UNICEF in Ethiopia notes that the lack of access to basic hand-washing facilities extends beyond the home, to schools, workplaces, and healthcare facilities.
“Water access is also lacking in other public spaces where people gather such as marketplaces and transport hubs. In these settings, hand hygiene is critical to keeping children, teachers, doctors, nurses, and other workers safe from COVID-19 infection,” he insists further noting that, “in Ethiopia nearly half of the population (45 million people) do not have a place to wash their hands with soap in their homes.”
Zinabu Assefa Alemu and Michael O. Dioha in their recent study titled ‘Modelling scenarios for sustainable water supply and demand in Addis Ababa city, Ethiopia’ confirm the same challenge of water scarcity in Addis Ababa: “Addis Ababa city has very limited resources of surface and groundwater which plays an important role in the support of domestic needs in mass condominium houses.”
Actually what is not available is not only safe water but also soap.
In May 2020, the UN published a report after assessing the socio-economic impact of COVID- 19 in Ethiopia that indicated that hygiene is often not possible because safe water and soap are simply not readily available or are unaffordable.
The Cost of Poor Sanitation
According to the Ethiopian National Hygiene and Environmental Health Strategy, poor sanitation costs Ethiopia 2.1 percent of the national GDP. Yet, eliminating the bad practice would require only 6 million improved latrines to be built and used.
A report by UNICEF Ethiopia indicates that 60 to 80 percent of communicable diseases in the country are attributed to limited access to safe water and inadequate sanitation and hygiene services. Also, it says that there are strong links between sanitation and stunting, and open defecation can lead to fecal-oral diseases such as diarrhea, which can cause and worsen malnutrition.
“Diarrhea is the leading cause of under-five mortality in Ethiopia, accounting for 23 percent of all under-five deaths – more than 70,000 children a year,” the UN agency highlighted.
Similarly, Abireham Misganaw, a public health expert and a member of the waste management team at the Ethiopian health ministry, confirms that the prevalence of active trachoma for children in the age group 1-9 is 40 percent because of lack of improved access to water and sanitation in Ethiopia.
This time around, water has become the most basic need to combat COVID-19 as well as water-borne diseases, and of course, it is also vital in the fight against future pandemics not only in Addis Ababa but also elsewhere where it is very scarce.
Turning COVID-19 Challenges into WASH Opportunities
Immediately after the first confirmed case of COVID-19 in Ethiopia in March 2020, COVID-19 the government of Ethiopia and its development partners reviewed people’s access to water, sanitation, and hygiene (WASH) among other necessities using the latest round of the Ethiopian Demographic and Health Survey.
As a result, the analysis shows that the current levels of access to water and soap are suboptimal to adopt the hand-washing recommendations.
Despite the huge challenges of safe water shortage in Addis Ababa, efforts are being made to keep water flowing in the city to curb the spread of COVID-19. Various local governments and non-governmental institutions as well as individuals are involved in making sure water supply is uninterrupted especially for hand hygiene purposes.
Serkalem Getachew, the head of Public Relations at Addis Ababa Water and Sewerage Authority narrates that since the first COVID-19 case confirmation, the city government is exerting maximum effort to produce water at its maximum capacity and to make the supply uninterrupted.
She says so far water supply is constant in most Woredas (the lowest administration body) of the city where hospitals and quarantine centers are situated, while other 104 Woredas out of the 116 get water in a shorter rotation possible.
Serkalem notes that the authority has established special water supply, sewerage services, information, and communication as well as logistics committees to coordinate the water and sanitation services provision in the city.
She says that special attention has been put to the supply of water at all district bus stations, hospitals, quarantine centers, and other public spaces using the authority’s 28 water tank trucks and others provided by Prime Minister Abiy’s Office and Ministry of water.
“In addition to revising the existing community-industry water supply sharing to enhance the service to the public, the city administration is developing additional groundwater sources/boreholes at more than seven spots in Addis Ababa,” she adds.
Serkalem points out that the authority is also ensuring effective management of liquid waste noting that its production has increased in the city due to the enhanced consumption of water for hand washing and hygiene to curb COVID-19.
The UN children’s agency- UNICEF is one of the several other partners that are actively contributing to the fight against the pandemic.
One of their initiatives, “resulted in the development of integrated risk communication messages that are being used. With government support the national telecoms company used one of the developed COVID-19 messages as its ring tone, reaching all the subscribers in the country,” Chief of Water Sanitation and Hygiene (WASH) at UNICEF Ethiopia Kitka Goyol says.
Goyol indicated that UNICEF is working to ensure even the poorest of the poor population continue to access hand-washing services throughout the COVID-19 pandemic.
“It is often these populations that lacked full access to WASH before the outbreak of this pandemic,” he adds.
He narrates that in Addis Ababa, UNICEF has so far provided and installed six pieces of ROTO water storage tanks (10,000 liters capacity each); five different motorized surface pumps fitted with switches and cables to improve water supply at the centers and various hygiene items, including 13,050 bars of soap, 250 bottles (150ml) of hand sanitizers to health workers.
Others include 250 plastic buckets; 130 jerry cans; 95 hand-washing containers fitted with taps ; 12 knapsack sprayers for environmental disinfection and 30 drums of water treatment Chlorine (HTH 70%) for cleaning and disinfection of surfaces.
UNICEF in partnership with the urban productive safety net program (uPSNP) supported the most vulnerable households in all the sub-cities of Addis Ababa through provision of 210,000 bars of soap and accompanying hygiene messages on the importance of hand-washing with soap.
Under its “Second Urban Water Supply and Sanitation Project in Ethiopia” the World Bank is working closely with the Addis Ababa Water and Sewerage Authority (AAWSA) to further increase water supply in the city.
“Activities include borehole rehabilitation for existing groundwater sources across the city as well as the replacement of 20 water pumps to provide safe and reliable services to densely populated areas,” the World Bank report indicates.
The project supports essential water supply and sanitation services for more than 3 million Ethiopians enabling more than 623,000 people in urban areas to access improved water sources. It has also aided 61,000 new piped household water connections; safe management of excreta for 2.7 million people in urban areas; more than 50,000 sewer connections in Addis Ababa, and construction of 1,000 public latrines.
Chief of Water Sanitation and Hygiene (WASH) at UNICEF Ethiopia Kitka Goyol says the UNICEF has developed and agreed on work plans with the Ministries of water, health, and education and their respective regional bureaus to implement a variety of WASH activities across the country during the next Ethiopian Fiscal Year.
However, some locals noted that after a concerted effort for several months, water supply services in Addis Ababa have recently declined.
Worke Debebe, a street vendor in the Arada Sub-City of the Addis Ababa Administration, says that people’s motivation in combating the virus has now declined and the water supply by the Addis Ababa Water and Sewerage Authority has seemed to follow the same trend.
“The supply and availability of water in water small tankers meant for hand washing in the streets of Addis Ababa is not continual. We used to get water in every corner of the city as water tanker vehicles were bringing and filling water in the containers here in the streets on a daily basis, but now this is mostly interrupted,” Worke said.
Still, many locals give due credit for the integrated efforts of development partners along with the city administration to provide water following the outbreak of the virus, urging the authorities not to back off from the drive.
Lakech Zeleke, an informal trader at Yeka Sub-City, said water supply has improved especially in selected areas like hospitals, train stations and market places. “I am really happy with the water supply effort of the city government and various institutions in our city,” she says.
“The hand washing and sanitizing culture which is now flourishing in Addis Ababa with all the water supply effort of the city administration needs to be a culture. It is vital to our health and that of our children,” maintains Lakech.
This story was produced in partnership with InfoNile with support from Code for Africa and funding from the Pulitzer Center and National Geographic Society.