WASH and IPC Logistics for an Ebola Response: What Field Teams Need Now

On 17 May 2026, WHO declared the Bundibugyo virus disease outbreak in the Democratic Republic of the Congo and Uganda a Public Health Emergency of International Concern (PHEIC) — the highest alert level in international health law. As of 16 May, 246 suspected cases and 80 suspected deaths had been reported across at least three health zones in Ituri Province, with two laboratory-confirmed cases already identified in Kampala among travellers from DRC. This is not a distant threat for programmes operating in East and Central Africa: it is an active regional emergency with confirmed cross-border spread.

For WASH officers and NGO procurement managers, the weeks following a PHEIC declaration are the most consequential. Treatment centres must be sited and built. Water supply to isolation units must be established. Chlorination stocks must be pre-positioned. Health workers need correct dosing protocols for a virus that kills through contact with body fluids, not contaminated drinking water. Getting the logistics wrong — the wrong chlorine product, inadequate water storage, insufficient handwashing infrastructure — costs lives among patients and health care workers alike.

This post sets out the WASH and IPC requirements for an Ebola Bundibugyo response, with specific attention to chlorine selection and dosing, water supply to Ebola Treatment Units (ETUs), and the role of rapidly deployable modular shelters. It is written for programme staff managing field operations in DRC, Uganda, South Sudan, and Kenya — countries either directly affected or designated at high risk by WHO due to land borders, population mobility, and trade linkages.

Quick answers for field teams:

• Ebola IPC requires two chlorine concentrations: 0.05% (500 mg/L) for hand decontamination and skin contact; 0.5% (5,000 mg/L) for surface disinfection, PPE, spills, and waste

• HTH Calcium Hypochlorite (65–70% available chlorine) is the most field-practical bulk chlorine source for preparing both solutions; store in sealed original drums, away from direct sunlight

• Sphere minimum of 15 litres per person per day applies to Ebola ETUs but is a floor — WASH Cluster guidance for VHF treatment settings requires 40–60 litres per patient per day when PPE decontamination, hand hygiene stations, and waste treatment are included

• Collapsible water bladders (500–10,000 L) are the fastest way to establish treated water storage at a newly identified ETU site where piped supply is absent

• WHO IPC guidelines require at minimum one handwashing station with chlorine solution or soap per ETU entry and exit point, per isolation room, and at every waste disposal area

The Bundibugyo Outbreak: Why Logistics Teams Need to Move Now

The Bundibugyo strain of Ebola is deadlier and more field-difficult than the more common Zaire strain in one specific respect: there is currently no approved vaccine and no approved therapeutic. The 2007 outbreak in Uganda recorded a case fatality rate of approximately 34%. During the 2018–19 Kivu-Ituri Ebola outbreak — the largest in DRC history — nearly 3,500 cases were recorded over 22 months, with health care worker infections a persistent problem directly linked to IPC failures. WHO's 17 May PHEIC declaration explicitly cited at least four deaths among healthcare workers in a clinical context suggestive of viral haemorrhagic fever as evidence of ongoing IPC gaps in health facilities.

The same WHO declaration also flags the structural factors that make this outbreak exceptionally difficult to contain: ongoing insecurity in Eastern DRC, high population mobility, urban and semi-urban transmission in Bunia, and a large network of informal healthcare facilities where IPC is minimal. South Sudan shares a land border with DRC's Ituri Province. Uganda and Kenya both have IOM and UNHCR operations managing displacement corridors. Kampala already has two confirmed cases.

Neighbouring countries — and the NGOs operating in them — have between days and weeks to establish readiness before the outbreak reaches their health facilities or displacement sites. The supply pipeline for PPE, chlorine products, and water storage infrastructure takes time to activate. WHO's PHEIC declaration specifically noted that a strong supply pipeline needs to be established to ensure that sufficient medical and laboratory commodities and other critical items, especially personal protective equipment (PPE), are available to those who appropriately need them.

Chlorine Products: Choosing the Right Source for IPC Protocols

Not all chlorine products behave the same in a viral haemorrhagic fever response. The WHO and CDC recommend two working concentrations for Ebola decontamination: 0.05% sodium hypochlorite equivalent (500 mg/L free chlorine) for handwashing and personal decontamination, and 0.5% (5,000 mg/L) for disinfecting non-living surfaces, PPE, waste, and remains. Both solutions are most reliably made from a high-strength bulk source — 65–70% Calcium Hypochlorite powder — rather than from household bleach, whose active chlorine content degrades rapidly in tropical temperatures and direct sunlight.

Research published in PLOS ONE found that chlorine shelf-life in field conditions is a significant operational problem: solutions made from household bleach can lose more than 50% of free chlorine within 30 days when stored at typical ambient temperatures in the tropics. Calcium Hypochlorite powder, stored correctly in sealed original drums away from sunlight and moisture, retains effective activity for 12–18 months, making it the only practical option for pre-positioning rather than just-in-time supply. A separate PLOS ONE study on hand hygiene efficacy confirmed that 0.05% chlorine solutions are effective against Ebola virus but must be freshly prepared daily from properly stored stock for reliable decontamination.

HTH Calcium Hypochlorite drums — stocked and distributed by Specialized Logistics Solutions (SLS) — provide 65–70% available chlorine by weight, which is the standard formulation cited in field-level IPC guidance. A single 45 kg drum can produce approximately 64,000 litres of 0.05% handwashing solution or 6,400 litres of 0.5% surface disinfectant. For an ETU serving 20 patients with a complement of 30–40 health workers, a minimum of four drums per week should be planned during active response. Procurement teams can review available WASH products and chlorine options here.

Aquatabs 67mg tablets remain valuable for treated drinking water at community decontamination points and for providing individual households in the contact tracing ring with a point-of-use treatment option. They cannot substitute for bulk chlorine in the clinical IPC context — the concentrations required for surface disinfection and PPE decontamination are far higher than Aquatabs are designed to deliver — but they are an essential part of the community-level response package, especially given that South Sudan's WASH Cluster is already managing 535 tonnes of delayed NFI supply affecting over 575,000 people.

Water Supply to Isolation and Treatment Units

Establishing potable water at an Ebola Treatment Unit is a more demanding engineering task than standard emergency water supply. The reasons are threefold: high per-patient consumption due to continuous decontamination procedures; the requirement for water to be available at multiple points-of-use simultaneously (each isolation room, each entry/exit point, each waste treatment area); and the need for water supply to function without interruption, since a break in PPE decontamination during a patient-care activity can result in a health worker infection.

UNHCR WASH emergency guidance and the Global WASH Cluster's VHF response resources specify that ETU water consumption can range from 40 to 60 litres per patient per day, compared to the Sphere minimum of 15 litres per person per day for general emergency populations. This higher figure reflects chlorine solution preparation, PPE wash-down before doffing, waste decontamination, and general sanitation. For a 30-bed ETU — a typical initial deployment scale — daily water demand is 1,200–1,800 litres for patient-related consumption alone, plus staff hygiene, food preparation, and facility cleaning.

In Ituri Province and border areas of South Sudan and Uganda, piped water supply to newly established treatment sites cannot be assumed. Collapsible water bladders — ranging from 500 to 10,000 litres — provide the fastest deployable water storage solution. Butyl Products (UK) bladders distributed by SLS are fabricated from military-specification butyl rubber, which resists puncture, UV degradation, and the repeated disinfectant washes required when bladders are cleaned between fills. A typical initial ETU water system consists of a 5,000–10,000 litre main storage bladder filled by tanker or pump, with a gravity-fed distribution line to multiple 200-litre jerry-can points at each station. You can explore bladder and tank specifications on the pumps and equipment page.

Multiquip water pumps, also available through Specialized Logistics Solutions (SLS), are used to lift water from surface sources into bladder storage or to maintain pressure in distribution systems where elevation is insufficient for gravity feed. Selecting pump capacity correctly — based on source distance, lift height, and required flow rate — is critical. A pump undersized for the application will create supply gaps; a pump without reliable spare parts and fuel logistics will fail at the worst moment.

Modular Shelters for Rapid ETU Establishment

An Ebola Treatment Unit must be physically separate from general health facility wards, designed for unidirectional patient flow from triage to isolation to confirmed case management, and fitted with clearly demarcated zones that prevent cross-contamination between clean and contaminated areas. In Ituri and border counties, existing health facility infrastructure rarely meets this specification without significant modification. The fastest compliant solution is a modular, rapidly erectable shelter system.

Hallgruppen modular warehouses and shelters — represented in East and Central Africa by Specialized Logistics Solutions (SLS) — are used by humanitarian programmes for exactly this purpose. The panels are pre-engineered for field assembly without specialist tools, transportable in standard containers, and dimensionally flexible enough to configure as a three-zone VHF treatment facility. Key features relevant to an Ebola context include: cleanable non-porous interior surfaces compatible with 0.5% chlorine washes, sealed panel joints that prevent fluid infiltration into structure, and modular expansion if patient numbers increase beyond initial design. Procurement managers can find full specifications on the warehouses and shelters page.

WHO's PHEIC temporary recommendations require that suspected cases be safely transferred to specialized clinical units for isolation and management and that such units be located close to outbreak epicentres. In Ituri Province and the border areas of South Sudan and Uganda, where road access is seasonal and air transport limited, the ability to ship a shelter system in containers and assemble it on-site within 48–72 hours of arrival is not a convenience — it is the only realistic way to meet WHO's requirement for timely, fit-for-purpose treatment infrastructure.

What This Means for Your Programme

The window between a PHEIC declaration and the arrival of an outbreak at a programme health facility can be as short as two to three weeks in a high-mobility corridor like the DRC-Uganda-South Sudan border region. The supply decisions taken now — chlorine product selection, water storage capacity, shelter procurement — will determine whether health workers have the tools to protect themselves and their patients.

Pre-positioning high-strength Calcium Hypochlorite ahead of confirmed local transmission gives WASH teams the flexibility to respond to an alert within 24 hours rather than waiting for a supply convoy. Collapsible water bladders can be staged at district health offices and deployed to an ETU site by motorcycle or light vehicle. Modular shelter sections pre-positioned in a country warehouse can be trucked to an identified site without waiting for a cross-border customs clearance.

The 2018–19 DRC Ebola response taught the humanitarian system several hard lessons about logistics lead times. The supply pipeline gaps that contributed to healthcare worker infections during that outbreak were not primarily failures of protocol knowledge — responders knew what was needed. They were failures of supply chain readiness: the right products were not in-country when the outbreak accelerated. Programmes in Uganda, South Sudan, and Kenya should treat the current PHEIC as a signal to audit their stocks and procurement frames now.

Specialized Logistics Solutions (SLS) holds pre-positioned stock of HTH Calcium Hypochlorite, Aquatabs 67mg, Butyl Products water bladders, and Hallgruppen shelter components in Juba and Kampala, available for rapid dispatch. Contact the team at sales@maji-safi.org.

Frequently Asked Questions

What chlorine concentration do I use for hand decontamination in an Ebola setting?

WHO and CDC guidelines specify 0.05% sodium hypochlorite equivalent (500 mg/L free chlorine) for hand decontamination and contact with living tissue in an Ebola response. This is made by diluting Calcium Hypochlorite powder: approximately 0.75 grams of 65% HTH to one litre of clean water. Solutions must be freshly prepared daily, as free chlorine degrades rapidly — especially at tropical temperatures above 30°C.

What chlorine concentration do I use for surface disinfection and PPE decontamination?

Use 0.5% (5,000 mg/L free chlorine) for disinfecting non-living surfaces, spills of body fluids, PPE before doffing, waste treatment, and safe burial procedures. This is ten times stronger than the handwashing solution. The same Calcium Hypochlorite source is used, just at a higher dilution ratio — approximately 7.5 grams of 65% HTH powder per litre of water.

How much water does an Ebola Treatment Unit need per day?

Plan for 40–60 litres per patient per day for IPC procedures alone, plus standard consumption for staff hygiene, food preparation, and facility cleaning. A 30-bed ETU will require a minimum 2,000–3,000 litres per day in total. Gravity-fed collapsible bladder systems are the most practical water supply solution in areas without piped infrastructure.

Can I use Aquatabs for ETU surface disinfection?

No. Aquatabs 67mg tablets are designed to deliver 0.5 mg/L free chlorine in 20 litres of water — a concentration appropriate for drinking water treatment, not for the 0.5% solutions required for ETU surface disinfection and PPE decontamination. Use Calcium Hypochlorite powder or pre-diluted high-strength hypochlorite liquid for IPC applications.

What modular shelter specifications matter most for an Ebola isolation unit?

Prioritise: cleanable interior surfaces that can withstand repeated 0.5% chlorine washes without structural degradation; sealed panel and floor joints to prevent fluid infiltration; a layout that permits unidirectional patient flow from triage to suspected to confirmed zones without backtracking; and a clearly defined donning/doffing area with wash-down stations between the contaminated and clean zones. Hallgruppen modular systems are designed with smooth internal panel surfaces and tight-sealed assembly that meet these criteria.