This is a guest post by Bam Bam and entry for our non-fiction writing contest
As preppers we contemplate the likelihood of various SHTF scenarios. We are well versed in the kinds of natural disasters that impact our areas. If you live along the Gulf Coast, you are prepped for hurricanes. If you live in the Midwest, you are prepped for tornadoes. If you live along the San Andreas Fault, you are prepped for earthquakes. We calculate the likelihood of each SHTF scenario and plan accordingly.
We plan for natural disasters that have a probability >100 percent; yet many of us, myself included, are not fully prepared to deal with sanitization and hygiene issues post collapse. And here’s the kicker: in any significant event, we can expect on a loss of electricity and a subsequent loss of running water. Indeed, the probability that we will loose electricity and running water is very near 100 percent in a major event.
In this article I want to first take a look at the most common diseases brought on by lack of sanitization and hygiene, and then I want to review clear steps that can be taken to improve sanitization and hygiene in a collapse situation.
Water Borne Diseases
Lack of sanitization and hygiene will kill more people in a collapse situation than all other causes of death combined. People who have not researched and who are not prepared to deal with sanitization issues (such as disposal of human waste, food preparation and water purification) are going to die of diseases such as typhoid, cholera and other diarrheal diseases.
According to a UNICEF report, “Diarrhoea is the most important public health problem directly related to water and sanitation. The simple act of washing hands with soap and water can cut diarrhoeal disease by one-third. Next to providing adequate sanitation facilities, it is the key to preventing waterborne diseases.” 
Cholera is an infection of the intestine caused by the bacterium Vibrio cholerae. According to a WHO report,  cholera is a highly contagious disease. People become infected when they eat food or drink water that has been contaminated with feces of infected persons.
Typhoid fever is caused by the bacterium Salmonella Typhi. Typhoid is spread the same way Cholera is spread, by eating food or drinking water contaminated feces. According to a CDC report:
You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where handwashing is less frequent and water is likely to be contaminated with sewage. 
There are a host of other diseases that could be mentioned here: Yellow Fever, Dysentery, E. coli, Giardia, Hepatitis, as well as various types of worms. These diseases will kill; and they will kill quickly.
Practical Steps to Protect Your Family
Here are some practical steps you can take to protect your family.
1. After a natural disaster, such as a hurricane, a tornado or an earthquake, drinking water may not be available or safe to drink. There are three easy ways to make water safe to drink: treat it with chemicals, filter it with an adequate filtration system or boil. For more information on disinfecting water, see .
2. No electricity means no running water. And no running water means your toilet will not flush. In a short-term disaster you can flush your tank manually by pouring two gallons of gray water into your tank, provided of course that you have extra water on hand.
If you live in suburbia, the sewer system may back up, flooding your home with raw sewage. To prevent this make sure your backwater overflow device is in working order. If you live in the country and are on a septic system, you will be in much better shape.
In a longer-term emergency, it will be necessary to move the latrine outside. Here you can build an outhouse or dig a trench.  In either case, it is imperative that the waste is covered, as uncovered waste attracts flies and flies have a habit of landing on food and food prep areas. Make sure you have plenty of sawdust and lime on hand. (By covering the waste you block the feces-fly-food method of transmitting pathogens.)
3. Hand washing. This is a vital aspect of hygiene in preventing water borne diseases. If there is no running water, how will you wash your hands after defecating, dumping the toilet-bucket, or cleaning the outhouse? One idea here is to build a gravity- fed system with a quality water filter.  (Again, a primary mode of transmission of water borne illnesses is feces-hands-oral. You can break this chain of transmission by washing hands frequently.)
4. Food preparation. All food should be washed thoroughly, as food is a primary breading ground for bacteria. Food should be cooked long enough to kill harmful bacteria.
All food preparation instruments and surfaces should be thoroughly cleaned with soap and clean water. The easiest solution here is to stock dish detergent and both liquid bleach (for short-term emergencies) and pool shock (for longer-term emergencies). 
5. Shower. In both a short-term and a long-term emergency it will be necessary to devise some means of cleaning yourself, especially if you are a women. (Women have different hygiene needs than men.) A simple camp shower provides an effective means of cleaning yourself.
In a collapse situation, small cuts can become an entry point for pathogens. Keeping clean and having basic first-aid supplies available is crucial. All cuts should be cleaned with soap and potable water, treated with antibacterial ointment and covered.
Also, in a stressful situation where you have been working hard all day, do not underestimate the psychological impact a quick shower can have. Mental health is important too.
6. Trash. In a long-term event, it will be necessary to deal with garbage, as curbside pickup will likely cease. Food and non-food waste should be dealt with properly so as not to attract flies. (Again a primary means of transmission of pathogens is feces-fly-food.) Non-animal trash can be composted.  Paper products and animal waste can be burned in a burn barrel.
OTC Medicines and Antibiotics. The foregoing has convinced me of the need to stock significant amounts of OTC medicines and antibiotics. As careful as we try to be, someone may still get sick. When it comes to water borne illnesses, I think the most important OTC medicines are oral rehydration packets and anti-diarrheal medicine. As for the antibiotics, I would have no problem using Doxycycline or even Ciprofloxacin.