The Need Hepatitis E Outbreak Spreading in Pader District In May 2008, the first cases of Hepatitis E were reported in Pader District. As of November, there were a total of 62 cases, with seven deaths in Pader District. Due to the long incubation period, six to eight weeks, efforts need to continue to contain the outbreak within Pader District. The infection route of Hepatitis E is predominantly faecal-oral, with evidence of infection via contaminated water. There is no vaccine available. The disease can cause jaundice, loss of appetite, abdominal pain, and vomiting. It severely impairs a person’s ability to work or care for oneself or one’s family. Though rarely fatal for most populations, pregnant women are at risk, with a death rate that can rise to 20 percent. In Uganda, the local water supply in villages and resettlement camps is frequently contaminated by human and animal waste. Safe drinking water can often only be found at distant sources, requiring a long walk from home. In order to gather this safe water, people need containers such as jerry cans to carry the water and store it for use. However, our surveys have shown that fewer than one-quarter of households have clean containers for this purpose. Even in cases where people do have such containers, they need a way to keep them clean to reduce the risk of contracting Hepatitis E through faecal contamination. The faecal-oral transmission route can also be reduced through hygiene, especially hand-washing. But in order for hand-washing to be effective, people need to have soap and an efficient way of using water for that purpose. Our Response Improve Water and Sanitation (WatSan) and Hygiene Supplies Medair is already running water, sanitation, and hygiene (WASH) programmes as well as health programmes in four sub-counties in the southeast of Pader District: Lukole, Lapono, Adilang, and Patongo. There are a number of simple interventions that we can implement immediately to reduce the spread of Hepatitis E in these communities – in addition to our on-going latrine-building project. By April 2009, we propose to equip 1,000 high-risk households with two jerry cans each (one for collecting water and the other for storing it). At the same time, we will supply 20,000 households with chlorine-based Aquatabs (80 per household), which can be used as a supplementary method of purifying the water for drinking. Each of those households will also receive three bars of soap to promote hand-washing. ]Medair will also distribute materials to make 1,000 Tippy Taps in highrisk areas. A Tippy Tap is a modified jerry can that is rigged to provide a small but steady stream of water for hygienic hand-washing. While Medair is already installing Tippy Taps alongside latrines, this additional intervention will get them into more places where they are needed. With Your Support We will reduce the impact of this Hepatitis E outbreak, and thereby prevent the suffering and the mortality risk for pregnant women it causes. That is our short-term objective. But this intervention also complements Medair’s ongoing activities in the area, where our longer term objective is to improve health, hygiene, and sanitation. Even after the danger of Hepatitis E infection has passed, we can expect to see a lasting improvement in hygiene habits like hand-washing as a result of these efforts. Jerry cans and Tippy Taps – and the knowledge of how to use them properly – can last a very long time, delivering benefits for many more people than just our direct beneficiaries. It is a simple gift, but for many, it could be the gift of life. The total budget for this project is US$ 117,231. Most of this amount has already been granted by governmental humanitarian aid organisations, but we are still seeking private support in the amount of US$ 14,000. This level of private support will enable us to meet our total budget target and complete this project to prevent the spread of the Hepatitis E virus in Pader district.