Resilient WASH Services in Conflict: WHO’s Roadmap for Ukraine’s Emergency Response

The World Health Organization (WHO), alongside the Centers for Disease Control and Prevention (CDC) of the United States, Ukraine’s Ministry of Health, the Public Health Centre of Ukraine, and the Association of Vodokanals of Ukraine, has published a critical guidance document titled Checklists for Strengthening Water, Sanitation and Hygiene Emergency Preparedness and Response: Focus on Ukraine. The publication delivers a practical, action-oriented framework to assess and reinforce emergency readiness of water, sanitation, and hygiene (WASH) systems at the local level. Drawing from both global best practices and the realities on the ground in Ukraine, these checklists are designed for local officials, utility providers, and health responders to prepare for, respond to, and recover from conflict-induced WASH disruptions.

Developed in consultation with a broad base of local stakeholders and refined through a major workshop in Kyiv in April 2023, the document serves as both a diagnostic tool and a blueprint for action. Though tailored to the Ukrainian context, the checklists are adaptable to other conflict-affected regions around the world, offering structured guidance in navigating the chaos of emergencies while protecting public health and dignity.

War-Torn Infrastructure and a Mounting Health Risk

The war in Ukraine has taken a staggering toll on essential services. Water pipelines, sanitation systems, power grids, and supply chains have been repeatedly targeted or collateral casualties of conflict. As noted in the publication, this degradation of infrastructure has led to severe health risks from contaminated drinking water, interrupted hygiene practices, and overflowing waste systems. Especially in active combat zones and areas temporarily out of government control, the collapse of services has been particularly acute, while more stable regions face pressure from waves of internally displaced people that stretch local capacity to the brink.

The WHO classifies the Ukrainian WASH landscape into four categories: less frequently attacked zones, more targeted areas, active combat zones, and non-government-controlled territories. Each category requires a different strategic approach. In all scenarios, however, maintaining WASH services is essential to preventing cholera, typhoid, and other disease outbreaks. Contaminated water sources, power outages that disable treatment plants, and the lack of skilled personnel are cited as leading challenges.

Checklists as Catalysts for Community-Led Solutions

The heart of the publication lies in its five thematic checklists: leadership and coordination, drinking-water supply services, sewerage and sanitation services, hygiene, and additional considerations such as rural outreach. Each checklist poses key questions that local stakeholders can use to assess their current status and identify critical gaps. For instance, one checklist asks whether mobile generators are available for water treatment plants; another evaluates whether communities have stockpiled sanitation materials or have access to backup water sources in case of infrastructure failure.

These checklists are not passive surveys but dynamic planning tools. They invite local officials to hold inclusive stakeholder consultations, engage utility managers, health responders, and community members, and co-create action plans. Simple visual tools like traffic light coding (red for urgent, yellow for medium, green for low priority) support quick prioritization, while more advanced scoring systems assess each proposed action by its health impact, feasibility, cost, timeline, and availability of support.

Building Capacity from the Ground Up

The WHO strongly emphasizes that emergency planning must begin at the local level, where needs are best understood. The document encourages municipalities to conduct multistakeholder workshops using the checklists to build shared understanding and trust. These workshops also serve to clarify roles and responsibilities among different actors, from city vodokanals and local health authorities to national ministries and international donors.

A valuable outcome of this process is the “Improvement Action Plan”, a structured summary of needs and actions that can guide recovery and preparedness investments. In regions with limited capacity, a phased approach is recommended. For example, communities can begin by addressing drinking-water resilience and gradually expand into sanitation and hygiene planning as resources allow. There is also tailored guidance for Ukraine’s rural areas, which often lack centralized WASH systems entirely. Here, the document urges flexible, community-led strategies such as rainwater harvesting, decentralized composting toilets, and portable hygiene kits.

Communication, Hygiene, and Human Dignity

Perhaps most compelling is the publication’s focus on people. Clean water and proper sanitation are not just technical challenges, they are fundamental to health, dignity, and human rights. The hygiene section of the checklist addresses critical needs such as handwashing without running water, menstrual health in emergencies, and the provision of household cleaning supplies in displacement camps. It also stresses the need for culturally sensitive and accessible communication strategies, particularly for vulnerable populations such as the elderly, disabled, and people without internet or phone access.

The WHO recommends multi-channel communication, from SMS alerts to loudspeaker announcements, to keep communities informed during WASH emergencies. It urges consistency in public messaging, especially when water sources are compromised or alternative sanitation is needed. These actions, while simple in theory, can make the difference between containment and catastrophe in a conflict-affected setting.