Response phase

The next phase is the response phase which begins when an emergency strikes. An emergency response encompasses the decisions and actions taken to deal with the immediate effects of an emergency. For behaviour communication, UNICEF have described this phase in a number of steps, listed below (UNICEF, 2006; UNICEF, 2012). It should be noted that in some emergency situations, some of these steps may not apply.

1. Participate in rapid assessments

The first step is to assess the situation so that the scale of the emergency is understood. This involves assessments for different sectors including health, water and sanitation, child protection, food etc. When WASH rapid assessments are conducted in the initial phase of an emergency, it is critical that the assessments also identify any high risk practices that have implications for public health of affected communities. Rapid assessment for WASH behaviour is described in more detail in Section 14.3.1.

2. Conduct a rapid appraisal of communication channels and resources

Soon after an emergency is announced, efforts should be made to find ways to reach the vast majority of affected people quickly with information and key messages. This rapid appraisal will revisit the channels identified in the preparedness plan and assess if they are affected by the emergency and which will be the most effective.

3. Revisit and activate the detailed communication plan

Based on the preparedness plan, the details of the implementation of the communication initiative(s) should be activated. All partners should be mobilised to fulfil the roles that had been determined at the planning stage.

4. Focus on re-establishing existing behaviours and norms

In the initial phase, the focus would be on re-establishing the positive behaviours and social and cultural values that existed prior to the emergency. For example, providing handwashing facilities enables people to continue to practice good hygiene behaviour, as shown in Figure 14.8. However, depending on the situation, emergencies might also provide opportunities to promote new behaviours.

Figure 14.8 Latrines with handwashing facilities in a refugee camp help refugees to re-establish handwashing behaviours that existed prior to their displacement.

5. Forge additional alliances for communication

The emergency might provide opportunities to build additional alliances to include relief workers, service providers, journalists and others so that they are able to directly support desired behaviours among affected people.

6. Facilitate community and children's participation

Through established community level committees, pro-active efforts should be made to create opportunities for affected families and communities, including children and young people, to participate in the response.

7. Working with the media

As a priority, decision makers should come together and decide on what to communicate to the media. The communication should be frequent and effective and through a dedicated spokesperson.

8. Reach the poorest, most vulnerable and hard to reach

You should give particular attention to people who are more vulnerable or marginalised or those who are harder to reach, through special outreach activities.

9. Dealing with psychosocial impact

Emergency can have a variety of psychosocial impacts. People may have strong feelings of fear, insecurity and helplessness. People might not be allowed to undertake usual funeral and mourning practices. Community workers would have to be trained to deal with this situation and community leaders encouraged to help in supporting the community.

Figure 14.9 Children can be mobilised to help in an emergency situation.

Rapid assessment of hygiene behaviour

As noted above, when responding to an emergency, the first step is to make an assessment so that the situation is understood. Rapid initial assessments will provide information about the nature and scale of the emergency and the likely need for external assistance (WHO, 2002). There will need to be detailed assessments to plan, implement and coordinate responses to meet basic needs for water, food, shelter and medical care. Part of this assessment will be a behavioural situation analysis, such as you encountered in Study Session 8. This will provide understanding of current hygiene behaviours and identify where change is needed and how behaviour change could be achieved. In particular, the assessment should try to identify any key practices that may be putting people at risk, and any alternative or safer practices which would help to mitigate such risks. It should identify any barriers that might prevent people from adopting safer practices and any key motivating factors that will enable change. It should also ascertain preferred communication channels for different participant groups and identify any particularly vulnerable or high-risk groups.

The World Health Organization (2004) recommends the following checklist of questions for a rapid assessment of the public health situation in a community affected by an emergency:

• What health-related behaviours are contributing to public health risks faced by the affected population?
• What are the common health-related practices among the affected population and how have these been affected by the emergency?
• What are the current practices on key hygiene behaviours such as:
  • How is the community disposing of their solid waste?
  • Is there an understanding in the community of the relationship between water/sanitation/shelter/vectors and disease?
  • Does the community have access to water containers with lids/cooking utensils/mosquito nets/soap/sanitary protection/blankets/bathing facilities?
  • Are the users involved in the management and maintenance of water sources and latrines?
  • What health promotion media are available/accessible to the affected population (radio, posters/leaflets, local folk media and others)?

The answers to these questions will help you identify the key hygiene behaviours in the community affected by the emergency and therefore to target the high-risk behaviours for public health promotion activities. While designing the hygiene promotion campaign in an emergency situation it is important to consider the community’s traditional practices and the facilities available, as well as the damage caused by the emergency. You should also pay special attention to the needs of vulnerable groups such as the sick and wounded, children, the elderly and pregnant women.