Adaptation Action Plan title: Domestic hygiene and sanitation program for citizens affected

by floods that produce contaminated environments such as leptospirosis and dengue: A

pilot program for Barranquilla, Colombia.

1. RATIONALE

a. Climate and Health Prioritization

The city of Barranquilla is a coastal city in Colombia located at the mouth of one of the most
important rivers in the country, the Magdalena River. In addition, the city has a characteristic
tropical climate: with high temperatures, relatively high humidity and very heavy rainy seasons
that generate dangerous streams in some sectors of the city due to their drainage deficit (Lévine,
1914). This produces floods in the city that can affect the most vulnerable populations of the city
and creates a potential environment for the development of tropical diseases such as dengue and
enables the spread of zoonotic diseases such as leptospirosis.
Although there is very little documented and analyzed information on this situation, according to
an analysis of the health situation carried out by the Mayor's Office of Barranquilla in 2018, it
was found that the fatality rate due to leptospirosis has tended to increase (Alcaldía de
Barranquilla, 2018). It is important keep in mind that the general population is not aware of the
importance of hygiene and sanitation, especially after a flood. Clearly, the most affected
populations are frequently poor, without access to drinking water, natural gas and with high
exposure to vectors or animals, contaminated water or land.

b. Pathway
The populations most vulnerable to flooding are those located on the banks of the Magdalena
River or found in the peripheral areas of the city, such as the southeast, metropolitan and the
southwest. These populations, in addition to being affected by the climatic phenomenon, must
also fight with the lack of aqueduct and sewerage, the lack of natural gas supply (Alcaldía de
Barranquilla, 2018), thus increasing exposure to water contaminated by any bacteria such as
Leptospira interrogans (leptospirosis) or creating potential scenarios for the development of
dengue, which is another frequent disease in the region. Although the Mayor's Office has an
informational internet campaign on the prevention of dengue in urban areas (we do not know the
real scope in the population), there is no information on prevention at the level of hygiene and
sanitation with respect to leptospirosis or on how Both diseases can be increased in flood
scenarios.

c. Selected Adaptation Action

The domestic hygiene and sanitation program for citizens affected by floods that increase the
probability of exposure to contaminated environments has purpose train and inform in a
pedagogical and creative way the most vulnerable population of the city with a high exposure to
the climatic phenomenon. This hygiene and sanitation program has several elements of
traditional hygiene campaigns, such as hand washing. As a recent and high-impact example
worldwide, we have that of COVID-19, which encourages frequent hand washing to eliminate
and prevent the spread of the virus. Similarly, the program seeks is to train and inform citizens
about the epidemiology of diseases in order to acquire optimal hygiene practices when handling
or consuming any food, the measures to be taken into account when entering contact with
domestic or wild animals, frequent cleaning in recurring places, water purification practices,
avoid contact with stagnant water, etc.

d. Stakeholder Identification

Implementers: For the development of the program we have several sectors involved in the
management of the implementation: The public sector such as the local mayor's office,
specifically the secretary of health and social, in collaboration with the risk management office
should be the direct link for the structuring, management and continuity of the implementation of
the program. In addition, together with the education sector such as the city's universities, an
alliance allows access to the professionals necessary to train citizens, these implementers who
will have direct contact with the people can be from professionals in public health to
professionals in the natural sciences such as biologists or microbiologists who know about the
epidemiology of diseases.
Recipients: The hygiene and sanitation program should be open to the entire community in
general but should have a special emphasis on the most vulnerable populations of the city,
located in the highest risk areas and lowest income populations that do not have access to basic
services such as drinking water and gas.

e. Readiness Assessment
For the development of the hygiene and sanitation program was complemented with an
implementation readiness assessment to better understand the preparation capacity of the
implementers. The scores obtained for each of the constructs are as follows: 8/10 for motivation,
6/10 for general capacity and 9/10 for adaptation-specific capacity.
These results allow us to infer several things, first that the motivation is relatively high in the
population to be able to implement the program, this is due to the fact that the danger of
suffering floods, which can lead to an increased probability of developing diseases such as
leptospirosis or Dengue, both risks are interest within the population. Second, we also have the
adaptation-specific capacity is high given that there are local government agencies interested in
improving the public health of citizens, in addition to the collaboration of a professional expert in
the subject. Finally, we have that the general capacity has a moderate score because there are
interest and structure organizational but it is not enough and there is still a lot of bureaucracy and
an institutional weakness that not allow to have lot of scope for the initiatives that are developed.

Bibliography

 Alcaldía de Barranquilla (2018). Análisis de Situación de Salud con el Modelo de los

Determinantes Sociales de Salud 2018. Secretaría Distrital de Salud Barranquilla.
Available on internet:
https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-
distrito-2018-barranquilla.pdf
 Lévine, V. (1914). Colombia: physical features, natural resources, means of
communication, manufactures and industrial development (Vol. 1). Sir I. Pitman & sons,
Limited.