Prioritizing refugee health in Republic of Moldova through better water, sanitation and hygiene

Every day, thousands of refugees are crossing the border from Ukraine into the Republic of Moldova to flee the war. Such large displaced populations are particularly vulnerable to outbreaks of water- and food-borne disease, as they are often forced to live in crowded, temporary accommodation where access to safe water, sanitation and hygiene (WASH) can be difficult. This not only threatens the health, well-being and dignity of refugees, but could even endanger their lives.

To assess the situation in the Republic of Moldova, a team of WASH experts from WHO headquarters, Geneva, Switzerland, and the WHO European Centre for Environment and Health, Bonn, Germany, visited 3 temporary refugee accommodation centres in the country to identify the challenges and needs of refugees in terms of water supply, sanitation and hygiene, and to see what information management and surveillance systems were in place.

“WHO’s priority is to support local health-care authorities and the health system in the Republic of Moldova so they can continue to provide health care to incoming refugees and people in need. The WHO WASH programme aims to create a healthier environment for refugees and host communities during emergencies,” said Dr Miljana Grbic, WHO Representative in the Republic of Moldova.

Following the mission, a series of recommendations were drawn up to help the country’s authorities manage the hygiene and sanitation of their refugee facilities to protect the health of those staying there, including on:

• optimizing toilet ratios and location of hand hygiene products;
• ensuring a coordinated flow of hygiene/dignity kit supplies;
• developing regular cleaning and maintenance schedules, including emptying of portable toilets;
• strengthening coordination with international WASH and infection prevention and control organizations, and securing funding for supplies and service contracts;
• controlling the quality of procurement, for example of menstrual hygiene products to assure that they are culturally appropriate, and of water treatment devices to ensure that they meet safety standards;
• addressing inequalities in access to WASH services, particularly for people with disabilities, the elderly and minority ethnicities through adapted facilities and messages in relevant languages.

Svetlana Nicolaescu, Secretary of State for the Republic of Moldova, said during the debriefing meeting of the mission: ”The lack of WASH services and crowded environments create conditions for disease outbreaks. In this context, identifying evidence of good practices, but also challenges in ensuring the quality and safety of water, sanitation and hygiene facilities for refugees is very important”.

“We are committed to providing a safe environment for all refugees. At the Popeasca temporary refugee accommodation centre, we are doing our best to accommodate our neighbours, taking into account infection prevention and control measures, and encouraging people to respect public health measures,” highlighted Vasile Maxim, Head of Ștefan Vodă District, where the refugee centre is located.

WHO is working with the Moldovan authorities and partners to assess the needs of incoming refugees on entry and to ensure that the health system and services have the necessary capacity and are accessible to the large numbers of refugees arriving. Working in collaboration with development partners, WHO is leading efforts to strengthen the health, well-being and dignity of both the resident population and refugees from Ukraine.