Emergency Shelters in Disaster Response in Global, Low Resource Settings




Intensify cleaning and disinfection. Frequently touched surfaces should be cleaned and disinfected at least twice a day, and more frequently if soiled. Railings, desks, tables, doorknobs and window handles; restrooms, toilets and latrine surfaces; toys and nap mats; and materials used/shared by shelter occupants (e.g. pens, pencils, art supplies, books, electronics), are examples of frequently touched surfaces.

 

Cleaning refers to the removal of germs, dirt, and impurities from surfaces. It does not kill germs, but by removing them, it lowers the risk of spreading infection. Cleaning is achieved with water, cleaning products (e.g., soap, detergent) and wiping or scrubbing soiled areas.

 

Disinfecting refers to using chemicals, for example, diluted sodium hypochlorite (bleach), to kill germs on surfaces. This process does not necessarily clean dirty surfaces or remove germs, but by killing germs on a surface after cleaning, it can further lower the risk of spreading infection.

 

Use a 0.1% solution made from bleach and water for disinfection. To mix, use the percentage found on the bleach bottle (for example, 5%) and follow these instructions: [% chlorine in liquid bleach ∕ % chlorine desired] − 1 = Total parts of water for each part bleach

 

Example of making 0.1% solution with 5% liquid bleach:

[5% chlorine in liquid bleach / 0.1% chlorine solution desired] – 1 = [5 / 0.1] – 1

= 49 parts of water for each part liquid bleach

If you are using a 20 L jerry can to mix, you will need 400 mL of bleach and should fill the rest of the jerry can with water.

 

Instructions for making 0.1% solution from 0.5% disinfecting solution, 70% high-test hypochlorite (HTH), or 35% chlorine powder can be found herepdf icon.

 

Cleaning and disinfection procedures:

1) Put on personal protective equipment (rubber gloves, thick aprons, and closed-toed shoes).

2) Mix 0.1% bleach solution using the procedures described above in well-ventilated area.

3) Clean with detergent or soap and water to remove organic matter.

4) Apply the 0.1% solution to the surface with a cloth and allow for a contact time (the amount of time that the disinfectant should remain wet and undisturbed on the surface) of at least 1 minute. Additional disinfectant may need to be applied to ensure it remains wet for 1 minute. After 1 minute has passed, rinse residue by wiping with clean water (this will also protect the surface or item from damage)

5) After cleaning and disinfection, carefully remove personal protective equipment (PPE) and wash hands immediately. Re-usable PPE (e.g. gowns) should be laundered immediately.

 

Cleaning and disinfecting procedures for various surfaces (hard surfaces, soft surfaces, electronics, and laundry) can be found here.

  • Cleaning staff should clean and disinfect high-touch surfaces at least once a day, or more frequently, if possible.
  • Shelter administrators and cleaning staff should walk through the shelter together and decide which surfaces are touched frequently by shelter occupants and staff and therefore should be the target of cleaning and disinfection efforts.
  • Provide the cleaning staff with cleaning supplies (soap/detergent, bleach, buckets, etc.) and personal protective equipment (PPE) to wear when mixing, cleaning, and disinfecting (rubber gloves, thick aprons, and closed shoes). PPE should be used for COVID-19 related disinfection only (cleaners should not bring home PPE – it should be stored at the shelter in a secure, designated area).
  • Provide cleaning staff with information (e.g. written or pictorial instructions) about when and how to clean with disinfectant and how to safely prepare disinfectant solutionspdf icon, as described in the leftmost column.

 

Increase ventilation and air flow.

  • Ensure ventilation systems are working properly, if available. Increase circulation of outdoor air within buildings by opening windows and doors and/or using fans.
  • Shelters should be equipped with air exchange systems, when possible.
  • Select upward airflow rotation if using ceiling
  • Thoroughly clean common areas, including play areas. Temporarily close areas frequently used by children and focus on cleaning items more likely to have frequent contact with the hands, mouths, or bodily fluids of children (e.g., toys).
  • Clean and disinfect toys.
    • Toys that cannot be cleaned and disinfected should not be
    • Toys that children have placed in their mouths or that are otherwise contaminated by body secretions or excretions should be set aside until they are cleaned by hand using gloves. Clean with water and detergent, rinse, disinfect for example with a diluted sodium hypochlorite (bleach) solution, rinse again, and air-dry. Be mindful of items more likely to be placed in a child’s mouth, like play food, dishes, and
    • Do not share toys with other groups of infants or toddlers, unless they are washed and disinfected before sharing.
    • Set aside toys that need to be cleaned. Place in a dish pan with soapy water or put in a separate container marked for “soiled toys.” Keep dish pans and water out of reach of children to prevent risk of drowning. Washing with soapy water is the ideal method for cleaning. Try to have enough toys on hand rotate when other toys are being cleaned.
    • Children’s books that are paper-based are not considered a high risk for transmission and do not need additional cleaning or disinfection
  • Stocks of soap, bleach, buckets, and other cleaning supplies (e.g. mops, cloths, etc.).
  • Designated cleaning personnel.
  • Personal protective equipment should be used by designated cleaners (rubber gloves, thick aprons, and closed-toed shoes).
  • Sufficient access to non-turbid water to meet all cleaning and disinfection needs.
  • Adhere to instructions describing the cleaning and disinfection process, including proper mixing of solutions, for use by designated cleaners.
  • Set-up schedule for increased routine cleaning and disinfection
  • Consider cost associated with purchasing the bleach, soap, cleaning supplies, and personal protective equipment. In addition, consider cost for printing instructional materials, and possibly having to pay additional staff to clean.
  • If no rubber gloves are available for cleaners, any kind of gloves can be used. If no aprons are available, cleaners can wear protective clothing (such as long pants and long-sleeved shirts) and launder after use.
  • If no rubber gloves are available for cleaners, any kind of gloves can be used. If no aprons are available, cleaners can wear protective clothing (such as long pants and long-sleeved shirts) and launder after use.
  • There could be further supply chain constraints on soap, chlorine products, and PPE as demand increases as COVID-19 spreads. Calcium hypochlorite (HTH) powder or bleaching powder can also be used to mix disinfection solutions if available.
  • If water supply is not available on site, it will be more challenging and costly to clean and disinfect daily. Water-scarce shelters may consider temporary solutions for water provision, such as water trucking.
  • There is potential for harm to users when making and using disinfection products, so it is important for cleaners to be adequately protected during the mixing and disinfection processes and for staff to be trained on how to mix and disinfect.

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