hepatitis e

It’s #WorldWaterDay - Follow the journey of a Water Sanitation Specialist

The River

The city of Am Timan has a population of 70,000 with an estimate of 8 people per household. As part of our Hep E emergency response, our vision is to ensure that all 8,750 households have adequate (chlorinated) drinking water. 

The river is used for bathing, washing, drinking and playing!

Holes are dug on the river’s edge to collect drinking water.

Open defecation is a huge problem as most communities lack basic latrines. (Hepatitis E is contracted via fecal matter).

Public well with a hand pump.

Buckets, containers and jerry-cans are plunged into open-air pools to collect water.

The plan is to have 2 chlorinators working 6 hour shifts to makeup 12 hour days at each of the 120 water points around the city. We are also going to have a hygiene promoter at each water point to promote the importance of good hygiene. To map the 120 water points in Am Timan, we sent two teams to the field to collect their respective GPS locations.

Life as a WATSAN

I’m Alex and I’m an Engineer from Canada on my first mission with MSF. I have a Bachelors in Mechanical Engineering and have spent the last few years working in the Oil & Gas Industry. As a Water and Sanitation Specialist, I am helping plan, implement and monitor the water, hygiene and sanitation activities of the Hepatitis E Virus outbreak response project in Am Timan, Chad.

Request: “Killer Croc is hiding in the sewers and is depressed, he suddenly helps a punk girl who in return helps him have fun along with harley :)”

A/N: Photo belongs to @brvcewayns

“Nice work, butter fingers.” Harley harshly whispered to you. Rookie mistake both of you crouching behind a counter. You cursed to yourself, rookie mistake. Robbing the damned stores jewels was going perfectly well until you decided to blankly trip the alarm without looking.

“I wasn’t trying to get us caught.” You mumbled, not even bothering to look at the harlequin. Harley scoffed and rolled her eyes, letting you guilt trip her.

“Okay.” You readied yourself grabbing you duffle filled with the expensive jewelry. “Let’s grab the bags, we can go through the back.” Harley nodded in agreement, taking lead and running to the back entrance. Alleyway, left side blinking with red and blue lights. Snow prickling down around you as you ran opposite of the lights, rounding the corner.

“Oh, fuck!” You slid a on the frozen sidewalk, ass hitting the concrete. The alarms from the jewelry story blaring behind. You heard the heels from the harlequin slide in front of you, rushing to help pull you up.

“C'mon!” She yelped. “B-man could be coming!” She gripped her duffle tightly, as if it was their lifeline.

“I’m coming!” You stood, continuing to run, your lungs beginning to hurt, desperate for proper breathing and warmth. Your stomach began to turn into a knot from the whirring and blinking lights of distance police cruisers.

Harley gripped onto your arm, pulling you between a sportswear and coffeeshop. Dead end. You could hear the cruisers getting closers. You cursed to yourself, oh shit you felt dizzy. Fuck, what was that smell? You look up finding Harley dropping her duffle into a manhole.

You stepped towards her, giving a disgusted look as they began to climb down, she looks up at you. “What?” She questioned with the same disgusted face. “You can stay here if you want, just give me the bag.”

“Sure, if I don’t have to get hepatitis a through e.” You shook your head, dropping the bag, climbed down, pulling the cover before you deepened into the hole.

“Ugh!” You picked up your bag, covering you nose with your other hand. Harley gracing you both with her phone’s flashlight. “What street were we on?” You questioned.

“Uhh…” They skimmed the area. “Super dark. Um.. Dent Street. Why?”

“Our friend is nearby.” You nodded. “Okay, I know where to go.” You began to point, unsure. “That way? I know that sounded like a question but I know.. I know what I’m doing.” You began to lead, glancing at the dreadful ground you were quickly but carefully trying to walk upon. Black, greasy, goop of pus. The whole area smelt of death.

“Oooh.” Harley groaned in disgust. “My new shoes.” She gave a saddened look at her boots

Choking on your gag, you followed a specific route, turning. The closer you got to the destination, the more the smell died.

“We’ve been walking for at least two hours,” she exaggerated. “You sure you know where K.C is?”

“Yeah! He’s..” You gave a shy smile, recognizing that anticipating growl. You turned to your side, eyes pointing at a seven-foot scaled creature, sharp eyes glowing yellow. “Riiiight heeree.”

“I don’t like guest.” He snarled, dipping his head before entering the hideout. “Especially not crazy ones.”

Dim Christmas lights being the only source of light, a beaten couch (literally had a spring poking out of it), four mattress stacked upon another, not to mention the beer filled fridge in the corner, along with packaged, pink chicken breast.

“We got pretties!” You looked at Harley, her voice echoing with excitement. “We’re not sharing.”

“We just need to lay low.” You set your duffle behind the couch once you got comfortable. You wiped the sweat from your face. “Harley believes Batman was behind us. You won’t tell will you?” You leaned, begging eyes at the giant man.

He simply shook as a response.

Nearly an hour later, Harley fell asleep in a corner, hugging her duffle, talking to it. You looked at your scaled friend. “Croooc.” You sung, his attention shifting towards you. “Will diamonds turn that frown into a semi-smile?”

You reached into your duffle, a diamond and amethyst necklace gleaming whatever light it could. “Why the hell would that make me happy?”

“Money? Food? An actual place? I don’t know, pick one.” You threw the necklace back down.

“Because that’s really gonna let me live normal.”

“K.C? What’s going on man?” You gave weary eyes.

“It’s… Nothing.”


“Stupid doc’s hit me with meds before I left.”

“Ahh… Dull mind right now?”

“Its killing me.”

“You’ll tough it out as usual gorgeous.” You smiled.

He scoffed at you.

“What if I got you something?” Your head tilted.


“A radio.. Small one though. Jam to some tunes. Only if you tell me your birthday.” You point a finger.

“Tomorrow.” He grumbled.

“Ha!” You rolled your eyes. “I’ll get you some Prince, too. Maybe some Janet J. as well.”

“Better than echo’s.”

You felt a smile.

Photo: A doctor does his rounds in MSF’s Hepatitis E ward in Maban County’s Batil camp. South Sudan 2013 © Corinne Baker/MSF

MSF Responds To Hepatitis E Outbreak In South Sudan Refugee Camps

An epidemic of hepatitis E is escalating across refugee camps in South Sudan’s Maban County. To date, Doctors Without Borders/Médecins Sans Frontières (MSF) has treated 3,991 patients in its health facilities in the camps and has recorded 88 deaths, including 15 pregnant women.

Hepatitis E is a virus that causes liver disease and can lead to acute liver failure and death. It is particularly dangerous for pregnant women. Like cholera, the virus spreads in environments with poor sanitation and contaminated water. There is no cure, but its symptoms are treatable.

“We have been doing everything we can to care for people with hepatitis E, but there is no treatment for the disease,” says Dr. José-Luis Dvorzak, MSF Medical Coordinator in Maban County. “We suspect this outbreak is far from over, and many more people will die.”