Last month, Timothy Hayden returned to Australia (where I’m currently based) after coordinating the WASH activities Aspen Medical for four remote Ebola Treatment Units in Liberia. I interviewed him about his work there and in other regions of the globe—including the Philippines, the Solomon Islands, East Timor, Namibia, Kenya, and Turkey. Hayden has worked for various organizations over the years. We finished this interview just as he was preparing for a deployment to Nepal (with Oxfam UK) in the wake of the earthquake.

Janet Golden: What is WASH?

Timothy Hayden:  WASH stands for Water Sanitation and Hygiene. According to the latest estimates of the World Health Organization/UNICEF Joint Monitoring Program for Water Supply and Sanitation, released in early 2013, 36 per cent of the world’s population – 2.5 billion people – lack improved sanitation facilities, and 768 million people still use unsafe drinking water sources. Without access to safe water, sanitation services, and proper hygiene practices, thousands of people die or get sick every day especially children. Lack of WASH services also leads to poverty and significantly limits life opportunities.

We have heard a lot about the work of physicians and nurses treating individuals with Ebola. What are the duties of public health officers responding to an Ebola outbreak? What was a typical week in Liberia like for you?

WASH services are very important when responding to an Ebola outbreak. The main focus for WASH officers in an Ebola Treatment Unit (ETU) is infection prevention and control. This includes advising on environmental risks including proper drainage, sanitizer availability, safe body storage and transfer, and decontamination processes. WASH officers are also responsible for training of hygienists that work hand in hand with the clinical teams. Outside of an ETU, WASH professionals are involved in reducing the spread of Ebola in communities. This includes dissemination of health information, contact tracing of confirmed cases (finding and diagnosing people who have come into contact with an infected person), and monitoring and evaluation of WASH facilities and hygiene behaviors.

Do you think Ebola will be back? And what can we do to prevent its return?

Ebola doesn’t really go away. It will remain endemic to specific areas in West and Central Africa. The best way to prevent Ebola spreading to disastrous levels in endemic countries would be strengthening surveillance systems and having the ability to respond very quickly. This would mean strengthening the health facilities in endemic countries through health funding support and expanding the ability to respond to outbreaks.

In the past few years you've been involved with natural and manmade public health disasters. Can you tell us what you did as a WASH leader responding to Typhoon Haiyan in the Philippines?

I had two different jobs in the Philippines in response to Typhoon Haiyan (named locally as Typhoon Yolanda). The first was as a team leader for a humanitarian training team. In this role I led a professional training team to design and deliver custom training packages for both Non-Governmental Organizations and local governments that were responding to the emergency. In my second job, I worked with the World Health Organization to provide health promotion and risk communication capacity to all the programs in the affected region. This included working with a variety of programs that supported Yolanda victims, including water testing, Dengue Fever (a viral disease spread by mosquitoes) prevention through community mobilization, Schistosomiasis (a parasite disease from contaminated water) prevention through reducing open defecation, and mental health promotion capacity-building to name a few.

And what kinds of activities did you undertake as a WASH coordinator helping individuals living in Internally Displaced People (IDP) camps in Turkey?

While the organization was based in Turkey, all our response efforts were supporting the Internally Displaced People of Syria (currently numbering 7.6 million) – specifically the rebel-held territories to the north of the country. Due to the complexity and security of the area, 90 per cent of this coordination had to be conducted remotely at the start until we were able to develop the management and coordination skills of the Syrians that we employed. While initially the main focus was to support the IDP camps, it was soon discovered that many WASH facilities in remote towns and cities needed ongoing maintenance and repair. We prioritized our response to areas where WASH-related diseases were most prevalent.

What are the most rewarding parts of your work in global public health?

The most rewarding part of my job is being able to help people who are not in a position to help themselves. It is also heart lifting when you see communities helping themselves from your capacity-building activities. Another perk of my job is all the wonderful people I have met and the amazing places I have worked in. I have learned many things on my way.

And what are the most frustrating parts of your work?

Probably politics. Many politicians in developing nations are openly corrupt and seem not to care at all about the people that they are supposed to serve, protect and support. While I wouldn't explain it as frustrating, it is very sad to see what direct and indirect effects that war has on the most vulnerable.

How did you become a public health specialist? What was your background and training?

I was introduced to public health as a medic in the Australian Army, where it was important to understand how specific environments and personal behaviors influenced health and to work out ways to reduce the spread of disease. I completed a Health Science (Environmental Health) degree in 1999 at the age of 30 (a late starter…) and I completed a Masters of Public Health in 2006. I still believe, however, that I learned the most by getting out there and giving it a go.

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