Water and sanitation in flood-prone regions of El Salvador

The Atlantic Ocean's great hurricanes whip up their worst wind damage on the Caribbean coast of Central America, but dump most of their rainfall on the Pacific side of the isthmus. Which is why
Hurricane Mitch not only hammered Honduras in 1998 but also sent torrents of rainwater south to El Salvador. Floods and mudslides forced 150,000 people to flee their homes in the densely-populated country. MSF responded immediately with medical and nutritional assistance, and to monitor possible disease outbreaks.

"The immediate medical emergency soon passed. In severe flooding, people either live or die. The numbers of injured often don't amount to much, so our goal quickly became combatting disease through providing clean water and latrines," explained José Lopez, MSF's water and sanitation project coordinator in El Salvador.

As the flood waters receded and the displaced returned to their homes, the MSF teams set to work in
rural communities cleaning wells with chlorine and drying out latrines toilets with quicklime. It then
became clear that a longer-term approach was needed to provide the basis for a secure water supply and good sanitation.

"We know the floods will be back and with them the further risk of disease as latrines overflow into water supplies," said José

Water-proof wells and sealed latrines

In February 1999, MSF began work constructing special latrines and wells in flood-prone coastal areas. The two-year project will benefit 13,000 families in 67 rural communities. Existing wells are lined with
cement pipe then topped by a wall extending at least one meter above ground level which, in effect,
protects them from surface water contamination.

The well water is kept clean naturally by filtration through the soil.

"We asked communities, 'How high did the waters rise during Mitch flooding?' and built the well walls even higher. It'll take quite some floods to contaminate them again," said José.


The top of the well is sealed and fitted with a Mecate hand pump, which raises water by a simple loop of cord fitted with lugs which trap the water in a plastic pipe. The design is cheap and uses materials readily available in the local market. The Mecate is also easy to use: a four-year-old can crank the handle and pump water.

MSF has also turned to another low-technology solution for its latrine design. Dry composting latrines are
toilets built over a sealed brick chamber. Each latrine consists of two toilets and two chambers, used
in rotation so that, as one chamber is being used, the remains in the other are left to naturally compost into harmless garden fertilizer.

Educational challenges

Though simple designs, the wells and latrines require essential maintenance to function. These simple
chores, such as regularly sprinkling ashes in the latrine hole to aid the compost process, are explained
at community meetings by a team of MSF educators who work closely alongside the engineers in the field.

"We cannot just build a latrine and walk away. We are breaking centuries of habits where people went to the toilet behind the nearest bush, or drew water from an open well with a muddy bucket," said Alfonso Gonzalez, who co-ordinates the educational side of the project.

The project is not forced on communities. Rather they are invited to take part in a series of shade-tree
meetings with MSF educators and engineers. Local co-operation is vital to the project's success.
Communities must also agree to provide labour to help the MSF engineers and bricklayers. In return, the
volunteers learn basic construction skills.

Families are supplied with posters and manuals with drawings on well and latrine maintenance. Another
initiative has been to print the instructions on the covers of exercise books and distribute them free to
local schoolchildren.

Says Alfonso: "We know children are more receptive to change. They are also the future generation."

MSF Project file

  • Start date: November 1998
  • End date: April 2001
  • Number of wells built:1140
  • Number of latrines: 2800
  • Beneficiaries: 71,000 people
  • International staff: 4
  • National staff: 20
  • Funding: 100% private funds

    Steve Hide is an MSF volunteer currently working in El Salvador