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Today — November 15th 2019Your RSS feeds

Moving Towards ODF Status in Cambodia: iDE Shares Findings in New Tactic Reports

By: iDE

3-2-iDE-Cambodia WASH DIB-PR-07_Photo by Chhom DinatSince the beginning of iDE Cambodia’s sanitation marketing initiative in 2009, we have facilitated the sale of over 325,000 latrines, while sanitation coverage has increased from 23% to over 70% in the provinces where we work. Our latest tactic reports provide new insight into how this expansion of sanitation coverage was achieved:

Reaching Open Defecation Free Status with Grassroots Partnerships

iDE is supporting the further development of a sustainable sanitation ecosystem, to and beyond Open Defecation Free status. Our Cambodia team’s Public Private Partnership Department is facilitating deeper connections between the private sector and government, while generating, sharing, and applying market data to help communities bridge the gap to ODF. 

Reaching the Poorest with Sanitation Through Targeted Subsidies

A recent World Bank report describes several common pitfalls of the delivery of WASH subsidies worldwide, including being pervasive and poorly targeted, non-transparent, expensive for implementers, and distortionary for markets. iDE developed its targeted subsidy model to address each of these issues and help poor household sustainably participate in the Cambodian sanitation market.

Addressing Fecal Sludge Management in Rural Locations

iDE is scaling supply and sales of a new type of Alternating Dual Pit product. Equipped with lime treatment service and a device to indicate when the new pit is filling, this technology allows customers to alternate pits back and forth and empty safely composted waste indefinitely. Guiding businesses deeper into the sanitation market has been a challenge, and in order to more smoothly facilitate this process iDE has increased support for businesses on ways to retain staff, provide adequate protection and equipment, and follow a cleaner, safer installation protocol.


iDE pioneered the market-based approach in sanitation, incorporating private businesses, NGOs, and government stakeholders. In 2003, iDE launched the world’s first market-based sanitation program in Vietnam, and, since then, the model has been successfully replicated across iDE’s global portfolio and by other organizations.

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3-2-iDE-Cambodia WASH DIB-PR-07_Photo by Chhom Dinat

Yesterday — November 14th 2019Your RSS feeds

Water Currents – World Toilet Day 2019

World Toilet Day 2019: Water Currents, November 14, 2019

Toilets are more than a household necessity—they save lives, protect dignity, and create economic opportunity. This November 19, join the annual celebration of World Toilet Day to raise awareness of the importance of sanitation to lift people out of poverty. This year’s theme “Leaving No One Behind” emphasizes the importance of expanding sanitation access to the more than 4.2 billion people living without safely managed sanitation options. wtd

USAID goes beyond toilet construction to address weak demand and low capacity for sanitation improvements. The Agency’s comprehensive approach includes engaging the private sector to develop aspirational and affordable products, unlocking financing, and strengthening sanitation governance, coupled with behavior change to encourage use and maintenance. To learn more about USAID’s sanitation activities, follow us @USAIDWater or visit Globalwaters.org.

This Water Currents contains recent studies and resources related to the sanitation issues facing marginalized or special populations, such as people with disabilities, refugees, sanitation workers, and the urban poor.

Read the complete issue.

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Burkina Faso: Innovative mechanism for community financing of sanitation

 

Nuits de l’Assainissement– nights for sanitation wherein community members, opinion leaders, and local authorities come together for a common goal: improving sanitation and hygiene conditions in the region. These nights are organized by the Regional Directorates of water and sanitation in collaboration with the Directorate general of Sanitation and a partner NGO. Sanitation night is part of the innovative Leader-led Total Sanitation (LLTS) approach.

 

LLTS was developed by the water, sanitation and hygiene (WASH) Ministry in Burkina Faso with the support of WaterAid in 2012. It aims to encourage leaders in Burkina Faso to support the populations in designing local responses to hygiene and sanitation challenges in their villages of origins or other villages of their choice. This initiative contributes to Government’s National Economic and Social Development Plan (Plan National de Développement Économique et Social, PNDES 2016 – 2020), especially to one of its strategic objectives to “improve living conditions, access to quality water, sanitation and energy services”. LLTS uses the tools of advocacy, community mobilization through gala fundraising evenings (e.g. SaniThon) and sensitization through targeted messaging. The Sanitation Nights have the following specific objectives:  

  • Increase the level of knowledge and involvement of regional populations and leaders in the promotion of hygiene and sanitation
  • Raise and collect funds to subsidize the building of latrines for the populations
  • Support local authorities (“collectivités territoriales”) in achieving the PNDES 2016-2020 objectives related to hygiene and sanitation. 

 

The organization of a Sanitation night requires three crucial phases: 

 

 

Sanitation night was organized last year in Boucle du Mouhoun region on the sidelines of World Toilet Day. Boucle du Mouhoun region of Burkina has sanitation access rates lower than the national average. Moreover, there are large disparities among the six provinces of the region – while 5 of these provinces have access rates lower than 15%, Balé reached 47.7% due to the interventions by the NGOs– WaterAid and Eau Vive, supported by funding from the European Union. Ahead of the Sanitation Night, an information campaign was launched for the regional leaders to mobilize funding for the implementation of these toilets. The strategy used for fundraising includes reservations for the gala dinner and leader subscriptions for latrines. The Sanitation Night also awards actors and entities who are working on hygiene and sanitation promotion in the country. 

The sector Minister, Honourable Ambroise Ouédraogo (Ministre de l’Eau et de l’Assainissement) participated in the Night, which was co-sponsored by the Ministry of Urbanization and Habitation and was held in the presence of Minister of Justice and Civil protection, the Garde des sceaux, and the State Secretary of the Minister for Women, National solidarity and family in charge of Social affairs, persons living with disability and the fight against exclusion. 

Results of the Sanitation Night in the Boucle de Mouhoun 

  • While the initial objective was to obtain contributions for 5000 latrines (corresponding to around 50000 beneficiaries), the final subscriptions attained were 5238 latrines. According to the sector Ministry, the total funds promised (on the Night, and over the telephone) amount to 392.850 million FCFA (USD 670,000). 
  • After the Night, a document entitled “Implementation strategy for the latrines of the Sanitation Nights” was drafted and validated (“Stratégie de mise en œuvre des latrines de la Nuit de l’Assainissement”). Six months after the Night, a sum of 73.855 million FCFA (USD 126,000) has been mobilised (this excludes budget allocations to the communes). The building of toilets is in progress and the mobilization is continuing. 

The next Sanitation Night is also being planned, and another region of Burkina Faso has volunteered to host it. This initiative has generated interest among SWA partners in neighbouring countries. 

 

The post Burkina Faso: Innovative mechanism for community financing of sanitation appeared first on SWA.

Poor sanitation is the shittiest consequence of climate change

By: Naafs

Why sanitation matters in the climate discourse.

This blog is co-authored by Ambrose Kibuuka, Peter Feldman and Arjen Naafs.

We recently participated in a planning meeting for various advocacy events in 2020, with  climate change as theme. The effects of climate change on water are fairly widely known with global warming sometimes leading to more water (more torrential rainfall and more floods as well as rising sea levels due to melting of ice caps), or too little water (longer droughts, hotter weather). There was much discussion to what extend climate change was enough of an issue in sanitation to make it also the theme for sanitation.

In this blog we challenged ourselves to understand the four interactions between climate change and the sanitation chain and how these potentially threaten safe sanitation service provision.

1. Water stress, drought and increased aridity: Although most places will get more rainfall, some areas may receive lower rainfall due to climate change and experience more droughts. Water stress can lead to insufficient water for pour-flush toilets and low flow rates in water-based sewage networks. Though the amounts of water needed for flushing are small (particular in comparison with large water users such as agriculture and power generation) water demand management in drought-affected urban areas has been a force for innovation and change in places like Chennai and Cape Town. A squeeze on water resources also has negative consequences for hygiene practices, including handwashing and anal cleansing. 

2. Increased rainfall and flooding. Intense rain can lead to flooding around rivers, flooding of low-lying and poorly drained areas, as well as a rise in groundwater levels. This can lead to flooding of unprotected pit latrines, overflow of and seepage from underground septic tanks. Poor communities and their toilets are unfortunately often found in locations vulnerable to flooding and are therefore affected disproportionately. The common practice around the world of combining stormwater drainage and sewerage can lead to sewage mixing with stormwater and entering nearby surface water. Existing sanitation technologies have different resilience (see table below). In regions with high water tables, or limited drainage channels, sanitation technologies must be water-tight and/or located above ground. Good examples are container-based toilets used in Kenya and raised dry urine-diverting facilities such as Eco-San toilets. Septic systems are considered vulnerable not only because of flooding and discharge of the tank contents into the environment, but also because of the risk of flotation due to rising groundwater levels. This is reported to be a problem in the U.S. state of Florida. 

Additionally, due to more intense storms or cyclones, latrine superstructures and conveyance pipes are at greater risk of damage - potentially resulting in a loss of functional service and a reversion to open defecation, leakage from pipes, and/or disruptions in treatment facility operations. Mass evacuations due to intense storms such as Cyclone Bulbul will require emergency sanitation facilities at shelter areas. 

Faecal waste collection, management, and treatment can also be affected by flooding, as emptying vehicles may be unable to access certain communities due to impassable roads and sewers may overflow due to solid/plastic waste blockage. 

As floods cause widespread damage and loss of infrastructure on a regular basis in both the developed and the developing world (Howard, et al., 2010), flooding is the most important and common linkage between sanitation and changing climates.

3. Sources of greenhouse gas. The decay of human excreta is a potential source of methane, which is a more potent greenhouse gas than carbon dioxide (by a factor of about 30) (Science News, 2014). Solid waste and wastewater combined currently account for 5 percent of global emissions, and with increases in population, emissions are expected to rise. Mitigation measures include use of composting toilets, using methane to generate energy in biogas facilities, regular emptying of septic tanks, and effective wastewater management. Sanitation treatment itself depends on processes of natural, living processes such as decomposition that are affected by temperature changes. 

On-site sanitation is prevalent in many developing countries and requires trucks to empty pits and septic tanks. Many are not currently being emptied and we are promoting improved collection and safe disposal, but this likely means putting huge fleets of trucks on the road. Considering the scale and future needs of emptying, mitigation to either reduce the need for emptying and/or empty in a more environmental way will need to be considered. 

4. Need for resource recovery. The climate change discourse is highlighting resource scarcity and this emphasises the need for resource recovery (fertilisers), recovering wastewater (particularly in water stressed areas) and recovering energy. These may require different treatment and reuse systems, which will potentially lead to a rise in costs. Initiatives on circular economies and energy recovery are examples of this getting increasing attention.

Emergent climate risks present a challenge for governments in drought or flood prone areas: make the systems that deliver water and sanitation services more resilient now, or deal with significant health consequences down the road. Such adaptations are not only about the infrastructure, but also about the management of the entire system, from household to municipal level (Barbara Evans, 2018). This also includes preparing for, and response to, extreme weather events. 

In conclusion, sanitation services are essential for human health, but their technologies and their management systems are indeed potentially vulnerable to climate change, yet in contradiction they also play a significant role in pollution and greenhouse gases. This discourse highlights that there are significant interactions and the momentum to address climate change presents an opportunity for WASH practitioners. New funding and activities focused on climate adaptation are driving pressure to try and do things differently and therefore deliver more sustainable, resilient services that could help lead the way to universal access as well as a range of public health benefits that have yet to be fully realised.

All systems go! WASH systems symposium : proceedings part 2

All systems go! was the first event of its kind dedicated explicitly to using systems approaches in the WASH sector. These symposium proceedings summarise the content of over 62 sessions and include a synthesis summary of the general programme and of each of the five major themes for the event—sanitation and hygiene, safe water, finance, fragile states, and measurement and learning.

The All systems go! WASH Systems Symposium took place from 12-14 March 2019 in The Hague. Close to 400 participants representing over 165 institutions from around the world participated, and over half of them made contributions in the form of presentations or session chairing and design. All systems go! was the first event of its kind dedicated explicitly to using systems approaches in the WASH sector. These symposium proceedings summarise the content of over 62 sessions and include a synthesis summary of the general programme and of each of the five major themes for the event—sanitation and hygiene, safe water, finance, fragile states, and measurement and learning. Summaries of each of the individual sessions from the programme, including the plenaries, grouped by theme and using the session numbers from the All systems go! Programme. The final section is a list of references and useful links.

Before yesterdayYour RSS feeds

Stop being a neo-liberal and embrace the sanitation system

Sanitation is chronically underfunded, perhaps that’s because we’re not asking for money in the right way or from the right source.

Loo with a view, Trawden, Lancashire, UK.  Photo: Flickr/David Nutter.

Loo with a view, Trawden, Lancashire, UK. Photo: Flickr/David Nutter. CC BY-NC-ND 2.0

A few years ago, when I was moving house from Dublin to The Hague, I fell into conversation with the owner of the company that was shipping my furniture. A late-middle aged man from the far west of Ireland, raised in a rural home, he’d only learned to speak English in his teens. When I told him what I did for work, instead of moving quickly onto the weather (which is what normally happens), he told me this story:

When I was growing up in the 1950’s many rural houses didn’t have modern indoor toilets. During one election, a politician came canvassing and talked to a neighbour, an old woman living in such a household. He asked for her vote, citing the work the government was doing to provide people like her with modern sanitation. To which she replied, “I’d rather die with the tracks of the bucket on me arse, than vote for you free-state bastards*”.

I honestly can’t vouch for the story, and it mainly stuck for the old woman’s pithy put-down to a smarmy politician. But on World Toilet Day it seemed apt to share, and because it illustrates a few (what should be) universal truths about sanitation, and because it reminds us that even in wealthy countries (which Ireland wasn’t in the 1950s), indoor flush toilets are a relatively recent innovation, particularly in rural areas. Perhaps most importantly though, it shows that politics and toilets have, and always, will be closely related; and that getting toilets to everyone requires government push.

No doubt this World Toilet Day there’ll be the usual appeals from the ‘sanitation community’ to give a thought to toilets, along with laments about why it remains so ignored compared to water. 

To the first of these I say – yes, let’s give a thought to sanitation – and not just on World Toilet Day - because it’s fundamental human right and it’s just outrageous and ridiculous that people have to live surrounded by their own and their neighbours filth in 2019. 

To the second – and to stir the pot a bit – I say because of the sanitation community is putting out the wrong messages.  Not about sanitation being important – we all agree. But on how to think about providing sanitation to people.  And because this is a blog and will be put up with another thousand blogs that no-one will read, I’m going to skip the part where I provide a carefully built and nuanced argument and skip to my recommendation. 

So, for World Toilet Day, three stops and a go to my sanitation friends and colleagues:

  • Stop saying it’s all about behaviour, and stop pretending that behaviour change is easy or permanent:  Of course behaviour is part of the mix, of course demand is needed. But the idea that once triggered everyone will bootstrap themselves to indoor plumbing is ridiculous, and demonstrably false. Delivering and then maintaining behaviour change means investing in pervasive messaging on public health: in schools; in public spaces; in places of worship.
  • Stop saying that sanitation is a ‘household issue’: It’s not, it’s a public health issue. You can have the cleanest shiniest toilet in the world, but if you flush it into the nearest drain and live surrounded by an environment pervaded by shit – in the air you breathe, the streets you tread and the food you eat – it won’t make a blind bit of difference to your health or the health of the community.
  • Stop saying that the private sector will provide: This is neoliberal bullshit (its World Toilet Day – I’m permitted!). Along with the ‘it’s all about individual behaviour and households’ piece, it is a toxic message drawn directly from the same evidence free ‘who needs a functional government anyway?’ book. I love the private sector, some of my best friends are the private sector!  The private sector has many critical roles to play in sanitation. But the private sector on its own will never provide sustainable sanitation services to everyone.
  • Go, and embrace sanitation as a public service.  After three stops – the go! The private sector will always make toilets, they’ll always run septic trucks, and they’ll often make and run treatment words. But policy, regulation, subsidy are the oil in the machine required to make the whole thing work. And government leadership and money, the motive energy that gets and keeps it rolling. So let’s demand both – leadership and – lots of money and spend it on the sanitation system: on behaviour change campaigns that aren’t one-off – but always on; on subsidies for improved toilets for the poorest and to make it financially interesting for the septic truck owner to drive to the treatment station rather than dump it in the stream; on creating enabling policy and regulation; and, on the people to enforce delivery of the policy and enforce the regulation. 

Why does water get more money than sanitation? Because it has an answer to the politician’s question ‘what can you spend it on?’.  And one that doesn’t involve wittering about not providing infrastructure or subsidy but instead doing behaviour change campaigns! Politicians like spending money, and they like opening things, and they like providing services that they can then parlay into votes. And yes, when I’m writing about water, I’m often writing that we need to encourage government to spend its money more wisely and not just on infrastructure. But at least the expectation of spending is there, and the water sector doesn’t keep telling government that it doesn’t actually need money because ‘it’s a household issue’.

Happy World Toilet Day – and here’s to getting lots of money spent on sustainable sanitation services!

* Note: If the term 'free-state bastard' is impenetrable and you feel like reading more – see this Wikipedia article on Ireland's civil war and its long political legacy

We are over-simplifying the global toilet issue

By: Kibuuka

A call for safely managed sanitation.

Children in Asutufi North, Ghana

Asutufi North, Ghana. Photo: IRC

Did you know that basic Water Sanitation and Hygiene (WASH) interventions alone may not have an impact on childhood diarrhoea and stunting?

A new study (Cumming et al., 2019) reflects on three recent trials conducted in Bangladesh, Kenya and Zimbabwe that looked at the impact of WASH interventions in communities with high burden of stunting. Expectant mothers willing to participate were enrolled along with their unborn baby, and then followed for 18 to 24 months. The study assessed a variety of health outcomes, including diarrhoea prevalence and child health. In the trials, nutrition was provided at cluster level (usually 1 to 2 villages), while WASH interventions were delivered at household level. WASH interventions included increased chlorination of drinking water at point-of-use, increased access to, and use of, improved pit latrines, including safe disposal of child faeces; and increased handwashing with soap through provision of handwashing facilities and a continuous supply of soap.

With these interventions you would expect a reduction in childhood diarrhoea and stunting. However, disappointingly, results of the trials showed no effects on stunting and only mixed results on diarrhoea. Indeed, WASH interventions have shown noticeable results on diarrhoea and stunting in places where there was a significant reduction of open defecation (e.g. cases from Lao People’s Democratic Republic and Cambodia), but where the reductions are low, more intense measures are needed. In the three trials, sanitation interventions focused primarily on household interventions, and in some of the sample communities, open defecation prevailed. Thus, the study (Cumming et al, 2019) correctly highlights that low-cost basic sanitation services alone are not enough to impact diarrhoea and stunting if children are living in grossly contaminated environments where children are exposed to multiple disease transmission pathways. 

Figure: WASH intervention barriers preventing children from faecal pathogens

Figure 1: F-diagram. WASH interventions create barriers that prevent children from faecal pathogens. Sanitation and a clean environment is the primary barrier (Source: WHO, UNICEF & USAID, 2015, p. 5)

From toilets to systems

Chlorination has long been the WASH sector’s guardian angel to deal with environmental contamination, but there are now reports of diarrhoeagenic pathogen resistance to chlorine! This implies that WASH interventions should not only aim at reducing human exposure from contaminants in the environment, but also improving environmental health.

The study by Cumming et al. does not imply that WASH should not be relied upon as a public health intervention (and indeed such interventions are critical to prevent the risk of water-borne diseases), but rather a pointer for the WASH sector that it is high time to start prioritising community-level centralised or decentralised wastewater management systems, that separate faecal matter from the environment, to supplement provision of safe drinking water. Additionally, continued behaviour change, provision of simpler and cheaper improved toilet technologies as compared to those common in high income countries, and measures taken to reduce children’s exposure to animal and human faeces in their play areas. As such, we may be oversimplifying the current sanitation challenge in developing countries: it is not just about the toilet – it is about a functioning system.

Incremental improvements

In conclusion: although it is tempting to demand a radical transformation, we need to manage expectations. As mentioned in Ian Ross’ blog responding to the results of the three trials, safely managed sanitation may not be affordable to rural households nor funders in low middle-income countries in the short and mid-term. Incremental improvements towards achieving safely managed sanitation in the long term may be a way to go, e.g. introducing modular toilets that are upgradable along the sanitation service chain. Households could start with a basic module, and as finances become available, add a module. For example, a single pit pour flush toilet can be upgraded by constructing a second, alternating pit, when the first pit is almost full. Other households may also want to add a bathing cubicle and so on.

So, as long as shit remains in the environment, we will not see the impacts on health we all so desire ...

PS: This Faecal Waste Flow Calculator is a cool (free) tool to do a quick and dirty assessment of how much faecal waste in your community or town is safely managed.

Sources:

Cumming, O., Arnold, B.F, Ban, R., Clasen, T. et al., 2019. The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement. BMC medicine, 17 (173), pp. 1-9, DOI: 10.1186/s12916-019-1410-x

Dillingham, R. A., Lima, A. A., & Guerrant, R. L., 2002. Cryptosporidiosis : epidemiology and impact. Microbes and infection, 4(10), pp. 1059-1066, DOI: 10.1016/S1286-4579(02)01630-1

Kov, P., Smets, S., Spears, D.E. & Vyas, S, 2013. Scaling up rural sanitation : investing in the next generation - growing tall and smart with toilets : stopping open defecation improves children's height in Cambodia.  Washington, DC, USA: World Bank, Water and Sanitation Program (WSP) [More info]

Quattri, M., Smets, S. & Inthavong, V., 2014.Scaling up rural sanitation : investing in the next generation : children grow taller, and smarter, in rural villages of Lao PDR where all community members use improved sanitation. Washington, DC, USA: World Bank, Water and Sanitation Program (WSP) [More info]

WHO, UNICEF & USAID, 2015. Improving nutrition outcomes with better water, sanitation and hygiene : practical solutions for policies and programmes. Geneva, Switzerland: World Health Organization (WHO) [More info

Scaling up rural sanitation : investing in the next generation : children grow taller, and smarter, in rural villages of Lao PDR where all community members use improved sanitation

Sanitation criteria under the Model Healthy Village Program would best be harmonized with the Ministry of Health's Guideline for Open Defecation Free Village Status to adequately address stunting.

Lao People’s Democratic Republic (PDR) has made progress in expanding sanitation services during the last decade, especially in urban areas. However, access to improved sanitation remains low in rural areas: while 90 percent of the urban population used improved facilities, only 50 percent of the rural population did likewise in 2012. Widespread open defecation and unimproved sanitation in rural Lao PDR and high levels of stunting make question whether poor sanitation in a rural community is associated with stunting. An improved sanitation facility hygienically separates human excreta from human contact. This rules out both open defecation and unimproved sanitation. Finally, Lao PDRs national nutrition strategy and plan of action 2010-2015, which recognizes sanitation as a nutrition sensitive intervention, offers opportunities for multi-sectoral responses in order to overcome persistent stunting and to achieve community-wide improved sanitation. [author abstract]

Improving nutrition outcomes with better water, sanitation and hygiene : practical solutions for policies and programmes

Integrating WASH into nutrition policies and programmes provides a means to achieve greater health gains and reinforce the benefits of primary prevention.

Access to safe drinking-water, sanitation and hygiene (WASH) services is a fundamental element of healthy communities and has an important positive impact on nutrition. This document provides an overview of the evidence of nutrition gains that can be achieved with improved WASH, a description of key WASH practices, and practical knowledge and guidance on how to integrate WASH into nutrition programmes, including important monitoring and evaluation (M&E) aspects. The document concludes by providing a suite of case-studies and lessons learnt in integrating WASH with nutrition efforts.

Scaling up rural sanitation : investing in the next generation - growing tall and smart with toilets : stopping open defecation improves children's height in Cambodia

Improvements in sanitation access played a substantial role in increasing average child height.

Open defecation within a community harms the physical and cognitive development of children, even children living in households that use toilets themselves. Frequently digesting feces due to poor sanitation can cause diarrhea, malnutrition, and stunted growth-and thus impact negatively on a child's cognitive development. Experiencing these health hazards at young ages can ultimately limit one's earning potential later in life. In addition to the use of health services, mother and child nutrition practices and care, the immediate disease environment shapes early life health and ultimately a child's achievement later in life. Thus, elimination of open defecation makes a sensible priority for policy makers that are concerned with the next productive generation. This brief shows, the level of open defecation in a community is associated with shorter children in Cambodia. Moreover, the level of open defecation in a community is more important for a child's development than whether the child's household itself openly defecates. By looking at the change in defecation levels and average child height between 2005 and 2010 within Cambodian provinces, the study is able to show that improvements in sanitation access played a substantial role in increasing average child height over the same five years. [author abstract]

Strengthening Urban Indonesia’s Water and Sanitation Systems: Geser si Jahat (Out with the Bad)…

Strengthening Urban Indonesia’s Water and Sanitation Systems: Geser si Jahat (Out with the Bad) and the 1,000 Rupiah Healthy Toilets Movement

The municipal government in Surakarta, in Indonesia’s Central Java province, engages the private sector to deliver desludging services to the wider community. Photo credit: USAID IUWASH PLUS

In Indonesia, safe sanitation is a big challenge that goes beyond just access to a toilet. The vast majority of the country’s human waste is released untreated into the environment with devastating consequences — approximately 100,000 children across Indonesia die every year from diarrheal diseases. In fact, approximately 90 percent of groundwater in Jakarta, the country’s massive capital city, is contaminated with E. coli bacteria.

Some communities are still learning about the dangers of unsafe sanitation and the high rate of water contamination. “People in urban areas say, ‘But we do have a toilet, so we’re okay,’” says Lina Damayanti, advocacy and communication advisor with USAID’s Indonesia Urban Water, Sanitation and Hygiene Penyehatan Lingkungan untuk Semua (IUWASH PLUS) project. The problem is that most of these toilets empty raw sewage directly into the environment, not into a septic tank or municipal sewage system. The Government of Indonesia has committed to changing this and achieving the Sustainable Development Goal of universal access to safely managed water and sanitation by 2030. Through the five-year (2016–2021), $48.4 million IUWASH PLUS project, USAID is building the Government of Indonesia’s capacity to reduce barriers to safely managed water and sanitation services and improve hygiene practices. One of the main barriers is that the poor can not afford the cost to connect to the improved services and the utilities lack access to alternative financing.

IUWASH PLUS works with governmental and donor agencies, the private sector, NGOs, service utilities, and communities to strengthen the overall WASH ecosystem in urban Indonesia. The project, which has recently received additional funding from the Swiss Government State Secretariat for Economic Affairs, supports water and sanitation service providers to ensure that improved access is maintained over the long term.

Financing and Sanitation Expansion

“USAID IUWASH PLUS focuses on technical assistance, not physical construction,” explains Alifah Lestari, the project’s deputy director. An example of this is its partnership with 35 local governments in the provinces of North Sumatra, West Java, Central Java, East Java, South Sulawesi, Maluku, North Maluku, and Papua as well as Jakarta and Tangerang districts to improve household services, such as the availability of piped water and toilets with septic tanks. The project facilitates microfinance loans from financial institutions and subsidies from the government so that more households can connect to piping and vacuum truck operators. At the local level, IUWASH PLUS boosts local governments’ ability to better manage septage and improve operational and financial performance of sanitation utilities. The project also conducts formative research on the realities of sanitation conditions for low-income families so that utilities can make better management and programming decisions.

Veli, a sanitarian from Margahayu urban village in West Java province’s Bekasi City, initiated a community savings scheme called GESER SI JAHAT to help low-income residents build toilets with septic tanks. Photo credit: Siti Ngaisah, USAID IUWASH PLUS

To help households finance septic tanks, IUWASH PLUS is helping community health workers, also called Sanitarians, spread the word about GESER SI JAHAT, an acronym for Gerakan Seribu Rupiah Siapkan Jamban Sehat, which means “The 1,000 Rupiah Healthy Toilets Movement.” It is a locally developed program which promotes incremental savings — like 1,000 Rupiah, or less than $0.10 — for toilets and safe septic systems. In Indonesian, “Geser si Jahat” is equivalent to the English expression “Out with the bad.”

“The idea of GESER SI JAHAT came up when I met some community members who are motivated to have their own toilet with a septic tank but had limited financial capacity to build the facility,” said Muliastuti. “USAID IUWASH PLUS helped me to implement the idea by facilitating the discussion with communities to agree on the monthly saving scheme and establish the sanitation forum, [which] collected and managed the community saving,” said Veli Muliastuti, a sanitarian in Margahayu, Bekasi, West Java. “As a sanitarian, I am called to end this habit.”

Through the program, households contribute 1,000 Rupiah per month for five months toward the cost of a toilet and septic tank. Through their corporate social responsibility funding, local businesses including Mitra Keluarga Hospital and Bank Jabar also contribute.

Sludge Control

In many urban areas, entrepreneurs have stepped up to remove fecal sludge for a fee. Unfortunately, these companies often dispose of the sludge by dumping it, untreated, in local waterways. IUWASH PLUS helps local governments to develop regulations to curb these practices and ensure septage treatment plants for safe sludge disposal.

In East Java province, a private desludging operator signs a cooperation agreement with Malang city’s UPTD PALD, a municipal wastewater agency. Photo credit: Ristina Aprillia, USAID IUWASH PLUS

In Malang, East Java, for example, the project facilitated a series of discussions between the municipal wastewater agency known as UPTD PALD and 11 private desludging operators. These discussions resulted in a March 2019 cooperative agreement that will allow the private operators to connect with customers via the UPTD PALD, which will develop a customer database and promote desludging services to the wider community.

Both local government and the private operators expect to benefit from the agreement. “Private desludging operators have long been operating in Malang City and have served thousands of customers,” said Ari Kuswandari Yushinta, head of UPTD PALD. “It is necessary for UPTD PALD to establish a partnership with them to ensure that they meet environmental health and safety requirements when delivering their services, including disposing of the septage in the treatment plant.”

“Being a partner of UPTD PALD, I hope we can serve more customers in the future. UPTD PALD will also train the operators to improve service quality,” said Johan Setiawan from CV Prayogo, a private desludging service operator.

“Together with the Government of Indonesia, USAID is creating a market for sanitation products and services to make sure that activities like desludging is self-sustaining beyond the project period because they are creating a market for those services.”

“Together with the Government of Indonesia, USAID is creating a market for sanitation products and services to make sure that activities like desludging is self-sustaining beyond the project period because they are creating a market for those services,” explains Trigeany Linggoatmodjo, senior WASH program specialist with USAID/Indonesia.

Creating this market demand for sanitation begins at the community level with people like Veli Muliastuti, the sanitarian. “We want to build the legacy for the future,” says Lestari. “People like Veli will continue to help after IUWASH PLUS is finished.”

“We are not working alone,” says Damayanti. “If it’s not done hand-in-hand with people who are living there, it will not be sustained.”

By Christine Chumbler

Additional Resources:

This article appears in Global Waters, Vol. 10, Issue 6; for past issues of the magazine, visit Global Waters’ homepage on Globalwaters.org.


Strengthening Urban Indonesia’s Water and Sanitation Systems: Geser si Jahat (Out with the Bad)… was originally published in Global Waters on Medium, where people are continuing the conversation by highlighting and responding to this story.

Out with the Bad: Strengthening Urban Indonesia’s Water, Sanitation, and Hygiene Systems

The municipal government in Surakarta, in Indonesia’s Central Java province, engages the private sector to deliver desludging services to the wider community. Photo credit: USAID IUWASH PLUS

In Indonesia, safe sanitation is a big challenge that goes way beyond just access to a toilet. The vast majority of the country’s human waste is released untreated into the environment with devastating consequences — approximately 100,000 children across Indonesia die every year from waterborne diarrheal diseases. In fact, approximately 90 percent of groundwater in Jakarta, the country’s massive capital city, is contaminated with E. coli bacteria

Some communities are still learning about the dangers of insufficient sanitation and the high rate of water contamination. “People in urban areas say, ‘But we do have a toilet, so we’re okay,’” says Lina Damayanti, advocacy and communication advisor with USAID’s Indonesia Urban Water, Sanitation and Hygiene Penyehatan Lingkungan untuk Semua (IUWASH PLUS) project. The problem is that most of these toilets empty raw sewage directly into the environment, not into a septic tank or municipal sewage system. The Government of Indonesia has committed to changing this and achieving the Sustainable Development Goal of universal access to safely managed water and sanitation by 2030. Through the five-year (2016–2021), $48.4 million IUWASH PLUS project, USAID is building the Government of Indonesia’s capacity to reduce barriers to safely managed water, sanitation and hygiene services.

IUWASH PLUS works with governmental and donor agencies, the private sector, NGOs, service utilities, and communities to strengthen the overall WASH ecosystem in urban Indonesia. The project, which is funded in part by the Swiss Government State Secretariat for Economic Affairs, supports water and sanitation service providers to ensure that improved access is maintained over the long term.

Financial issues and capacity building of local institutions are the biggest technical assistance challenges. As a result, “USAID IUWASH PLUS focuses on technical assistance, not physical construction,” explains Alifah Lestari, the project’s deputy director.

Financing and Sanitation Expansion

USAID works in partnership with 35 local governments in the provinces of North Sumatra, West Java, Central Java, East Java, South Sulawesi, Maluku, North Maluku, and Papua as well as Jakarta and Tangerang districts to improve household services, such as the availability of piped water and toilets with septic tanks. The project facilitates microfinance loans from financial institutions and subsidies from the government so that more communities can connect to piping and septage hauler systems. At the local level, IUWASH PLUS boosts local governments’ ability to better manage septage and improve operational and financial performance of sanitation utilities. The project also conducts formative research on the realities of sanitation conditions for low-income families so that utilities can make better management and programming decisions.

Veli, a sanitarian from Margahayu urban village in West Java province’s Bekasi City, initiated a community savings scheme called GESER SI JAHAT to help low-income residents build toilets with septic tanks. Photo credit: Siti Ngaisah, USAID IUWASH PLUS

On the microfinance side, IUWASH PLUS is helping community health workers, also called sanitarians, spread the word about GESER SI JAHAT, a locally developed program using community savings schemes to build toilets and safe septic systems. “It is sad to see some people dispose human waste directly to the environment,” said Veli Muliastuti, a sanitarian in Margahayu, Bekasi, West Java. “As a sanitarian, I am called to end this habit.”

GESER SI JAHAT is an acronym for Gerakan Seribu Rupiah Siapkan Jamban Sehat, meaning “The 1,000 Rupiah Healthy Toilets Movement,” which signifies that incremental savings — like 1,000 Rupiah, or less than $0.10 — can add up to big benefits. In Indonesian, “Geser si Jahat” is equivalent to the English expression “Out with the bad.”

“The idea of GESER SI JAHAT came up when I met some community members who are motivated to have their own toilet with a septic tank but had limited financial capacity to build the facility,” said Muliastuti. “USAID IUWASH PLUS helped me to implement the idea by facilitating the discussion with communities to agree on the monthly saving scheme and establish the sanitation forum, [which] collected and managed the community saving.”

Through the program, households contribute 1,000 Rupiah per month for five months toward the cost of a toilet and septic tank. Through their corporate social responsibility funding, local businesses including Mitra Keluarga Hospital and Bank Jabar also contribute.

Sludge Control

In many urban areas, entrepreneurs have stepped in to supplement the provision of services, specifically around removal of fecal sludge. Unfortunately, often these companies dispose of the sludge by dumping it, untreated, in local waterways. IUWASH PLUS helps local governments to develop regulations to curb these practices and ensure septage treatment plants for safe sludge disposal.

In East Java province, a private desludging operator signs a cooperation agreement with Malang city’s UPTD PALD, a municipal wastewater agency. Photo credit: Ristina Aprillia, USAID IUWASH PLUS

In Malang, East Java, for example, the project facilitated a series of discussions between the municipal wastewater agency known as UPTD PALD and 11 private desludging operators. These discussions resulted in a March 2019 cooperative agreement that will allow the private operators to connect with customers via the UPTD PALD, which will develop a customer database and promote desludging services to the wider community.

Both local government and the private operators expect to benefit from the agreement. “Private desludging operators have long been operating in Malang City and have served thousands of customers,” said Ari Kuswandari Yushinta, head of UPTD PALD. “It is necessary for UPTD PALD to establish a partnership with them to ensure that they meet environmental health and safety requirements when delivering their services, including disposing of the septage in the treatment plant.”

“Being a partner of UPTD PALD, I hope we can serve more customers in the future. UPTD PALD will also train the operators to improve service quality,” said Johan Setiawan from CV Prayogo, a private desludging service operator.

“Together with the Government of Indonesia, USAID is creating a market for sanitation products and services to make sure that activities like desludging is self-sustaining beyond the project period because they are creating a market for those services.”

IUWASH PLUS activities promote sustainability, both at the community and national government level, so that the impacts will last long after the project ends. “Together with the Government of Indonesia, USAID is creating a market for sanitation products and services to make sure that activities like desludging is self-sustaining beyond the project period because they are creating a market for those services,” explains Trigeany Linggoatmodjo, senior WASH program specialist with USAID/Indonesia.

Creating this market demand for sanitation begins at the community level with people like Veli Muliastuti, the sanitarian. “We want to build the legacy for the future,” says Lestari. “People like Veli will continue to help after IUWASH PLUS is finished.”

“We are not working alone,” says Damayanti. “If it’s not done hand-in-hand with people who are living there, it will not be sustained.”

By Christine Chumbler

Additional Resources:

This article appears in Global Waters, Vol. 10, Issue 6; for past issues of the magazine, visit Global Waters’ homepage on Globalwaters.org.


Out with the Bad: Strengthening Urban Indonesia’s Water, Sanitation, and Hygiene Systems was originally published in Global Waters on Medium, where people are continuing the conversation by highlighting and responding to this story.

The association of water carriage, water supply and sanitation usage with maternal and child health

The association of water carriage, water supply and sanitation usage with maternal and child health. A combined analysis of 49 Multiple Indicator Cluster Surveys from 41 countries. Authors: Jo-Anne L. Geere and Paul R. Hunter. International Journal of Hygiene and Environmental Health

Results: Compared to households in which no-one collects water, water fetching by any household member is associated with reduced odds of a woman giving birth in a health care facility. hw

Adults collecting water is associated with increased relative risk of childhood death, children collecting water is associated with increased odds of diarrheal disease and women or girls collecting water is associated with reduced uptake of antenatal care and increased odds of leaving a child under five alone for one or more hours, one or more days per week.

Unimproved water supply is associated with childhood diarrhea, but not child deaths, or growth scores.

When the percentage of people using improved sanitation is more than 80% an association with reduced childhood death and stunting was observed, and when more than 60%, usage of improved sanitation was associated with reduction of diarrhea and acute undernutrition.

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The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting : a consensus statement

A comprehensive package of WASH interventions is needed that is tailored to address the local exposure landscape and enteric disease burden.

Three large new trials of unprecedented scale and cost, which included novel factorial designs, have found no effect of basic water, sanitation and hygiene (WASH) interventions on childhood stunting, and only mixed effects on childhood diarrhea. Arriving at the inception of the United Nations’ Sustainable Development Goals, and the bold new target of safely managed water, sanitation and hygiene for all by 2030, these results warrant the attention of researchers, policy-makers and practitioners.

The authors report the conclusions of an expert meeting convened by the World Health Organization and the Bill and Melinda Gates Foundation to discuss these findings, and present five key consensus messages as a basis for wider discussion and debate in the WASH and nutrition sectors. The author judge these trials to have high internal validity, constituting good evidence that these specific interventions had no effect on childhood linear growth, and mixed effects on childhood diarrhea. These results suggest that, in settings such as these, more comprehensive or ambitious WASH interventions may be needed to achieve a major impact on child health.

These results are important because such basic interventions are often deployed in low-income rural settings with the expectation of improving child health, although this is rarely the sole justification. The authors' view is that these three new trials do not show that WASH in general cannot influence child linear growth, but they do demonstrate that these specific interventions had no influence in settings where stunting remains an important public health challenge. The authors support a call for transformative WASH, in so much as it encapsulates the guiding principle that – in any context – a comprehensive package of WASH interventions is needed that is tailored to address the local exposure landscape and enteric disease burden. [author abstract]

Menstrual health and hygiene at the Kenya Sanitation Conference

By: karanja

Special children's sessions on menstrual hygiene during Sanitation Conference show need for education and information on the topic.

It is estimated that 80 per cent of Kenyans do not have access to safely managed sanitation, 75 per cent do not have access to basic sanitation and 12.5 per cent practice open defecation. Additionally, over 75 per cent of the country’s disease burden is caused by poor personal hygiene, inadequate sanitation practices and unsafe drinking water (KESH Policy 2016-2030). Beyond these numbers, lies a grim picture of inaccessibility and unavailability of menstrual products coupled with partial or complete lack of information on menstruation. These elements have not only exacerbated vulnerability faced by menstruating adolescent girls and women, but have significantly contributed to promoting discrimination and non-inclusivity leading to undignified menstrual experiences.

In a ministerial communiqué by the Cabinet Secretary of the Ministry of Water & Sanitation and Irrigation, Mr Simon K. Chelugui pointed out that the Ministry will work closely with the Ministry of Education and Health and relevant stakeholders to enhance appropriate sanitation and hygiene practices in all schools. Further, the Ministry is cognizant of SDG 6.2 which aims by 2030, to achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.

Kenya Sanitation Conference 

During the recent Kenya Sanitation Conference, the Ministry presented Menstrual Hygiene Management (MHM) sessions during the children’s conference facilitated by the Water Supply and Sanitation Collaborative Council on the first day of the conference - 28 October 2019. “Is it true that using pads before you start menstruating will trigger menses?” Asked a grade six pupil from Murang’a County. “There are girls in my school who use pads yet they have never menstruated, they do this because of peer pressure. These girls feel left out when others use pads, they are under duress to fit in the group of menstruating girls”, she concluded. The MHM lab where these sessions were conducted is considered a safe space for women and girls to talk freely and openly about menstruation. The conference took place barely two months after an incident in Bomet County where a girl, aged 12, committed suicide allegedly after period shaming in early September. It was Jackline’s first time.

At the sessions, it became clear that there is need to provide reliable, pragmatic and factual menstrual information to girls before they experience their first menstruation. When having their first period (menarche), girls go through embarrassment, shame, anxiety and confusion simply because they don’t know what is happening to their bodies. According to situation analysis by the Ministry of Health 2016, the median age for menarche in Kenya stands at 14.4 years. 87.7 per cent of girls receive the information about menstruation from their mothers and 15.5 per cent from teachers. While parents remain the primary source of information, they are mostly concerned with ensuring that their daughters avoid teenage pregnancy. Minimal attention is given to menstrual health and hygiene with adolescent girls and boys reporting that it is shameful to discuss menstruation.

Daniel Karanja talking to women at the Kenya Sanitation conference 2019

In the exhibition area, conference participants and the public visited the MHM lab.

Provision of information and materials

Kenya has adopted the three-pronged approach to MHM that include:

  • Breaking the silence on menstruation
  • Safe and hygienic management of menstruation
  • Safe disposal/reuse of menstrual materials

Adolescent girls and women need to have information on various options available to manage menstrual flow. Of importance is provision of information on a variety of menstrual products and materials (both disposable and reusable options) that can be used to manage menstruation so that girls and women can make informed choices.. They also need access to bins for disposing of sanitary material, facilities that provide privacy for changing. They need access to soap and water. The lives of women and girls should not be impeded simply because they are menstruating.   

What does sanitation systems strengthening mean?

Watch this animation and sign up for our free basic course on WASH Systems strengthening!

Sanitation is a service and does not consist solely of the provision of a sanitation facility. A sanitation facility is the infrastructure necessary to capture human waste (i.e. faeces and urine).

Sanitation systems strengthening means making sure that all the links in the sanitation chain (see image below) are in place, that the chain is not broken, and that all the links are working as they should.

sanitation chain
Image. the sanitation chain

This should result in the safe management of human waste from capture all the way through to safe reuse or disposal processes. You want know more? Watch this short animation (1.45 mins) which explains what sanitation systems strengthening involves.

The animation is part of the WASH Systems Academy’s free basic course on WASH systems strengthening. The basic course has an entire session dedicated to systems strengthening for sanitation.

Find out more about the Academy and how to register for one of the courses now!

Go to the WASH Systems Academy landing page

Webinar: Examining the Sustainability of the Millennium Water and Sanitation Program (PEPAM/USAID) in Senegal

Webinar: Examining the Sustainability of the Millennium Water and Sanitation Program (PEPAM/USAID) in Senegal. Globalwaters.org, November 11, 2019.  Pepam.png

This evaluation addresses the Millennium Water and Sanitation Program (PEPAM/USAID) in Senegal. Implemented from 2009–2014 by Research Triangle Institute and a consortium of partners, PEPAM/USAID aimed to improve sustainable access to water, sanitation, and hygiene (WASH) in four regions of Senegal.

About the PEPAM Evaluation

This evaluation assessed PEPAM/USAID’s implementation approaches to understand the extent to which increased access to WASH services was sustained several years after the activity ended and why or why not these interventions endured over time.

In November and December 2018, an evaluation team (ET) conducted observations of 169 water points (WPs); water quality testing of 105 functional WPs; 514 water user surveys; 617 household sanitation/hygiene surveys with observations; and 56 qualitative interviews with government officials, implementers, local entrepreneurs, water committees, and community members.

Read the complete article.

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Celebrating the Sanitation Learning Hub’s new lease of life

Celebrating the Sanitation Learning Hub’s new lease of life. CLTS Knowledge Hub, November 2019.

Over the past few years, the Sanitation Learning Hub has responded to this challenge by broadening its focus to include an array of community-focused approaches, as an innovator within the sector. clts

The Community-Led Total Sanitation (CLTS) approach still plays an important part but is no longer the sole focus of the Hub, and a new, more encompassing name, the Sanitation Learning Hub, promotes and reflects this change in focus.

Going forward, the thrust of the Hub’s work will be to promote timely, rapid and adaptive learning and sharing, alongside honest reflections of what works and what doesn’t.

The Hub will also be playing an important role in tackling essential emerging questions and issues within the sector such as:

  • How to achieve safely managed sanitation for all
  • The complex and different challenges of urban, peri-urban and rural settings
  • How to ‘Leave No One Behind’ in programming
  • The value of gender transformative approaches
  • How to strengthen supply chains in order to climb the sanitation ladder
  • Better understanding of the links between sanitation, hygiene and other endemic issues such as undernutrition
  • The need to prioritise hygiene practices, especially handwashing
  • How to tackle ‘slippage’ back to open defecation.

Read the complete article.

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Water, sanitation and hygiene in arid and semi-arid lands: What can we learn from the DREAM ASAL Conference 2019?

Water, sanitation and hygiene in arid and semi-arid lands: What can we learn from the DREAM ASAL Conference 2019? CLTS Knowledge Hub, November 2019.

From 29th September to 3rd October the DREAM ASAL (Development of Resilience Empowering Alternative Measures for Ethiopian Lowlands) Conference 2019 took place in the Ethiopian city of Samara, capital of the Afar region. asal.jpg

The five-day conference reunited key stakeholders from government, INGOs and CSOs not only from Ethiopia but also from Kenya, Pakistan, Rwanda and Somaliland.

It was organised by the Ethiopian Ministry of Agriculture and facilitated by the GIZ- Strengthening Drought Resilience (SDR) programme.

The DREAM Conference had two major aims: 1) discuss ways to control, eradicate and make beneficial use of invasive species in the arid and semi-arid lowlands (ASAL), and 2) gather innovative and tested methodologies and technologies in the area of community planning, land rehabilitation, livelihood development, rangeland development, and water, sanitation and hygiene (WASH) including disaster risk management, in the lowland areas of the horn of Africa.

Read the complete article.

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