There have been 26,339 cumulative Ebola cases as of 4 May 2015, with 10,895 deaths. However, the outbreak shows signs of subsiding. At the end of April, Guinea reported under 30 cases a week, Sierra Leone under 20, and Liberia declared the outbreak over on 9 May 2015. The crisis has highlighted the weaknesses of existing infrastructure and institutions, which have not been able to respond to the additional strain. Many, like the health system, have been weakened further.
The Ebola outbreak appears to have had a limited short-term impact on the WASH sector. Delivery of WASH services in Sierra Leone and Liberia were, for example, far more affected by civil war during the 1990s and 2000s. Despite WASH being addressed by the Ebola response , it necessarily remained secondary to the health sector. Assessments have been planned to scrutinise the impact of Ebola as a whole, at least in Liberia, but there are almost none completed to date. This, coupled with the limitations of available information, has led to a sporadic and an incomplete picture of the exact impact of Ebola on the WASH sector in all three countries.
Yet its impact must not be ignored. Pervasive unhygienic conditions and use of unsafe water have been identified as a key underlying factor in thousands of deaths prior and during the Ebola outbreak. In the medium to long-term, lack of development in the WASH sector is a constant burden to the three countries’ recovery and development. Addressing WASH development offers the opportunity to greatly increase the quality of life. In Liberia it has been estimated that improvements to the water supply could reduce diarrhoea morbidity by 21%, while improved sanitation facilities could reduce diarrhoea morbidity by 37.5%.
This document summarises the baseline data on WASH available for each country. It then provides an overview and analysis of the known and probable impacts of the Ebola outbreak on the WASH sector at both the community and facility level. Relevant aggravating factors not linked to Ebola are described, and WASH-related areas that present a possible risk to the people of Liberia, Sierra Leone, and Guinea are highlighted. Information gaps and lessons learned are outlined at the end.