During the month of April, Sanitation and Water for All (SWA) is organizing 3 webinars to strengthen partners’ knowledge of and capacity to integrate water, sanitation and hygiene and climate … Read more
Humanity is emitting too much CO2 and using ever-increasing amounts of energy and water. The human population is set to swell for the foreseeable, requiring both more food and the water to grow it. At the same time, climate change is threatening progress across the board.
These trends have spurred a new way of thinking about the health of humans and our world: planetary health. First articulated in a Lancet commentary in 2014, the concept was expanded upon in a 2015 Lancet Commission, which defined planetary health as “the health of human civilisation and the state of the natural systems on which it depends”. This emphasises the interconnectedness of societies and ecosystems. Climate change understandably dominates planetary health discourse, but its other major themes include soil/food, water resources, and biodiversity.
How does planetary health relate to WASH?
WASH services, particularly sanitation, contribute to pollution of water and greenhouse gas (GHG) emissions, predominantly methane. On the other side of the coin, WASH services are likely to be harmed by climate change and other environmental degradation. I tried and failed to find an existing conceptual framework combining this “cause and consequence” perspective, so made my own (Figure 1).* Click here for a higher resolution version.
All of the consequences are likely to have knock-on impacts on human health, quality of life and livelihoods, which is part of the point of planetary health. Another angle is that better WASH services, including having multiple options available, can make people more resilient to shocks. However, in this post I focus on the consequences for WASH services to keep things manageable – this paper provides a useful review including some of the climate-related health consequences. I have seen little work explicitly applying the planetary health concept to WASH, though reams of it touches on the issues without using the term. Notable exceptions are this report on sanitation and planetary health, and this feature on planetary health approaches for dry cities.
Taking the climate aspect of planetary health first, sanitation is an important contributor to GHG emissions via methane (and nitrous oxide) from wastewater treatment and pit latrines. Methane emissions contribute to about a third of today’s anthropogenic warming, because it is about 30 times better at trapping heat in the atmosphere than CO2. Wastewater contributes about a tenth of all anthropogenic methane emissions globally. This is likely to grow (emissions more than doubled over 15 years in China), but the relative contribution of methane emissions from pit latrines and septic tanks remains unclear.
In considering the impact of WASH services on climate, recall that infrastructure development of any kind currently uses fossil fuels and concrete. Operating water supply and sanitation assets also uses energy. Turning to other aspects of planetary health, human urine and faeces also contain phosphates and nitrates which contribute to eutrophication if discharged untreated, potentially harming biodiversity.
Most planetary health consequences for WASH services are felt through water resources. The relationship between climate and water resources is reviewed in the World Water Development Report 2020, and this paper provides a useful WASH-specific review. Impacts are likely to vary by geography, but will be felt via changes in: (i) levels and intensity of precipitation (with snow melt also being crucial in some regions, e.g. South Asia); (ii) extent of aquifer recharge and surface run-off; and (iii) sea levels. These factors will interact on a local basis and may not reflect the standard newspaper image of dried-out mud. For example, groundwater is less vulnerable to changes in rainfall than surface water, and availability may be resilient in some areas, depending on precipitation-recharge relationships.
There are three major WASH-relevant areas of impact from these changes, taken in turn below.
Availability and quality of groundwater and surface water
First is the availability and quality of groundwater and surface water, and thence the amount of usable source water for water supply. Considering piped water systems, the further that source water is from being of drinkable quality, the more extensive the treatment processes needed. The less the surplus of water production potential over demand, the higher the risk of “day zero” (see Cape Town and Chennai). Users relying on point sources (e.g. wells, springs) may see changes in water quality or quantity making their lives much more difficult. The lower the water availability, the less likely handwashing becomes. The sanitation consequences of such fluctuations are discussed below.
Considering other areas of planetary health, the ways in which agricultural practices impact on water and soil can in turn affect the availability and quality of groundwater and surface water (e.g. contamination with fertilisers, impact of soil degradation on run-off and suspended solids). Less obvious is that greater biodiversity (e.g. in algae) can be beneficial for water quality. Also, despite most planetary health consequences for WASH being felt through water resources, climate can have a direct impact, for example through higher air and water temperatures affecting treatment processes.
Floods, droughts and storms
The second area of impact is through increases in extreme events like storms, floods, and droughts. The high flows and carried debris resulting from storms and associated abnormal rainfall can damage infrastructure, particularly for sanitation and drainage but also water supply. Storms can also interrupt power supply and in turn the operation of infrastructure. The onset of flooding can be rapid or slow, but either kind can contaminate water supplies and/or increase loading of suspended solids to levels exceeding the capacity of water treatment plants. Floods and pit latrines are not a good mix – contents can be inundated from above, or rising water tables can flood them from below. Droughts have obvious consequences for water supply, discussed above, but can also negatively affect sanitation, for example if there are insufficient water flows for sewerage operation. More detail on sanitation is provided in a WHO discussion paper.
Sea level rise
The third area of impact via water resources is sea level rise. This can affect source water availability and quality by saline intrusion. Longer-term sea level rises threaten to overwhelm existing water and sanitation infrastructure in coastal regions. Consider that the majority of Lagos, Nigeria, is only a few metres above sea level and the mega-city already suffers from flooding.
We live in the anthropocene, the epoch in which humans are putting huge pressure on the planet, threatening our own health and survival. WASH services are part of the problem, to the extent that wastewater treatment and pit latrines contribute to GHG emissions. However, better WASH services are part of the solution in that they make people more resilient to shocks. Climate change is important but it is not everything. Other aspects of planetary health such as biodiversity have important interactions with WASH services both as a cause and consequence. Furthermore, in many of the poorest countries, there is likely to be more strain on water resources and WASH services from population growth, urbanisation and economic development than from climate change. Regardless of climate change, people’s lives will be improved if we make WASH services more resilient, whether to existing variability in water availability and quality, or to existing extreme events. Taking a planetary health perspective can help with this.
*In this post I focus on the implications of planetary health for WASH services and vice versa, taking the impacts on health as given. I have also left out of the discussion (and diagram) how water demand might change in response to the trends described, e.g. through patterns of migration, urbanisation, population growth etc. Demand will also be affected by changes on the supply-side, including those influenced by planetary health factors. The diagram does not claim to be a complete picture of the relationships at play, just to capture the main ones. I also don’t consider this an area of much personal expertise. The main work I’ve done in this area was a three-country study with ODI focused on risk and options appraisal for climate adaptation in WASH. Therefore, I would welcome corrections or recommendations of things to read!
Sustainable Development Goal (SDG) 6 calls for universal access to water, sanitation and hygiene (WASH) services for all people wherever they are, including those living in urban areas. In the … Read more
The Hand Hygiene for All Initiative (HH4A) sets out to accelerate progress towards hand hygiene for all by 2030 and supporting the most vulnerable communities to protect their health, including … Read more
In labour economics, human capital is a worker’s stock of knowledge and skills which contributes to their productivity and earnings. Human capital accumulation is a process of developing skills within and beyond cognitive domains, in which the first 1,000 days of a child’s life are crucial.
In a note on this topic available here, I present a conceptual model (shown above) for the relationship between improvements in WASH services and increased human capital. Three pathways are proposed: early childhood development; all-age health capital; and school.
The early childhood development pathway is likely to be most important, due to its far-reaching and long-lasting implications for human capital. I also review some recent evidence linking sanitation and early childhood cognitive development published since the last systematic review on this topic.
[I’ve started writing longer “notes” like this on certain topics, which are not quite working papers but longer than blogposts. Feedback/critique is most welcome!]
The World Youth Parliament for Water host virtual General Assembly from March 22 to 26. The General Assembly aim to mobilize young leaders, connect with leading youth partners and stakeholders, … Read more
DORP is a long-time partner of WIN. We interviewed DORP’s Zobair Hasan, Director – Research, Planning and Monitoring, to learn more about Mother’s Parliaments and their role in strengthening women’s voices in the water sector in Bangladesh.
WASH challenges in coastal Bangladesh
Bangladesh’s south-west coastal region is quite vulnerable to effects of climate change; flooding, high levels of salinity in groundwater, soil, and drinking water due to sea level rise. Resulting reductions to drinkable water adversely affect health and sanitation.
Additional challenges in the region include:
38% of people live below the poverty
inadequate local government funding for WASH facilities
lack of local awareness of water rights
lack of understanding about how to effect change
Zobair Hasan of DORP explained the situation: ‘Transparency is a problem, and budgeting decisions are not participatory. Many elected policymakers don’t make time to engage people after elections.‘
Increasing participation to improve service
DORP began working with Helvetas Swiss Inter-Cooperation in 2016 on the Panii Jibon (Water is Life) project, which began as a four-year project to build resilience in climate change affected communities, especially for youth and women. The project area was to be disaster-prone districts of Bagerhat and Khulna in south-west Bangladesh. The partners prioritised work with local governments and empowerment of communities and women.
To raise awareness of the communities and create a space for their concerns to be discussed and resolved, 130 Health Village Groups (HVG) each consisting of 25 members, were established, representing the vulnerable and disadvantaged women households. Starting in 2017, they formed an apex body called Mother’s Parliament (MP), who meet 3 times a year. Each MP consisted of nine women elected at sub-district level. DORP had based this initiative on earlier experience in Bagerhat District in 2012, where they had worked at the lowest tier ward level.
Key organising measures of Mother’s Parliaments:
created space for inclusive discussion and problem solving
flagged up communities’ needs and concerns
made plans for awareness raising, especially for disadvantaged women
created cost-benefit analysis of solutions
developed advocacy plans, organised trainings on advocacy techniques
DORP’s Zobair Hasan explained, ‘The MP plays a key role advocating with their local governments and departments to solve water problems, for example reducing long distances needed to fetch water.‘ Reductions in the distance needed to fetch water are vital to women’s equality in Bangladesh, where women do this job 90% of the time for their families according to Unicef.
Improvements in integrity continue
Once better informed of their rights, women started raising their voices for WASH at local government budget meetings. The local government was forced to involve women in decision making, resulting in increased water budget allocation. In the 2018-19 fiscal year, the Mother’s Parliaments achieved an increased budget allocation or investment of up to 212%. With the MP’s now involved in multiple stages of planning and decision making, the entire process also has become more transparent. For example, budgets are now disclosed on public billboards and walls. The water system has benefited from improvements in integrity. Roughly 12,500 people now have better access to drinkable water at household and community level.
The Mother’s Parliaments have come a long way, and now local families are able to access water points in their communities. The MP’s work is crucial to making government service providers more accountable.
Confronting Climate Uncertainty Head On in the Philippines
“With new and improved data-driven analyses capabilities and better, more frequent reporting accompanied by resonating public communication campaigns, local actors may be motivated — even compelled — to improve water resource management that can benefit all Filipinos.”
A changing climate is forcing a reckoning across the Philippines — a sprawling island nation spread across more than 7,500 islands in the western Pacific where water is virtually everywhere and informs every facet of daily life. As the Philippines finds itself on the front lines of climate change, the country’s proximity to water is both a blessing and a challenge. With government officials and water resource managers navigating complex and interwoven climate challenges — such as shifting precipitation patterns, intensified cycles of flood and drought, coastal erosion, sea-level rise, and stronger typhoons — it has become crystal clear that water poses a pressing national security threat.
Decision-makers in the Philippines increasingly view water and its sustainable management as foundational in any successful long-term effort to build a more resilient country capable of withstanding — and indeed thriving in the face of — future climate shocks. To support the Philippine government’s water security efforts, USAID, through its five-year, $18.4 million Safe Water Project (SWP), has been working with national and local government partners, community leaders, municipal officials, water service providers, businesses, nongovernmental organizations (NGOs), and other partners around the country since 2019 to strengthen the country’s Philippines’ water security and climate resilience. Implemented in the provinces of Negros Occidental, Sarangani, and Palawan, the project provides new sustainable water resource management technology and techniques, improves access to a reliable, resilient water supply, and incentivizes more accountable, sustainable, and financially-disciplined water sector governance.
On the Front Lines
The effects of climate change on the Philippines have been anything but subtle. The extraordinarily powerful Typhoon Haiyan that made landfall in November 2013 registered as one of the strongest tropical cyclones in recorded history and caused widespread devastation. A severe drought in 2015 led many cities and provinces to declare a state of calamity due to serious water shortages. More recently, Typhoon Vamco brought intense and sustained rainfall to the islands in November 2020, threatening dams and triggering devastating flooding of large and small downstream farming communities.
With its high degree of vulnerability and exposure to various climate change impacts, the Philippines has renewed its commitment, through a whole-of-government approach, to better plan for and respond to future natural disasters.
Adding further stress to the country’s overall water security is the fact that even during years of relative water supply abundance, water rights are often fiercely contested. Competing demands for allocating the country’s finite water supply are intensifying under the pressures of population growth, urbanization, and economic modernization. As if that weren’t enough, many people must contend with serious public health threats on a daily basis affecting tens of millions of Filipinos who lack reliable access to safe water and sanitation services.
“The Philippines faces a number of water-related challenges,” explains Lawrence Hardy II, Mission Director for USAID/Philippines, Pacific Islands, and Mongolia. “Recent studies show that the Philippines has the lowest water availability per capita among Southeast Asian countries [and] projections suggest the Philippines will continue to see a high degree of water shortages through 2040. About 12 million Filipinos do not have access to clean drinking water, while 80 percent of the country’s 100 million people are not connected to wastewater treatment services, [and] waterborne diseases remain among the top ten leading causes of morbidity in the country.”
“Challenges often present unexpected opportunities.”
In spite of the gravity of the Philippines’ water security and public health challenges, confronting and preparing for grave threats can also help open the doors to a more sustainable future. “Challenges often present unexpected opportunities for USAID to be adaptive, creative, and responsive in its interventions,” says John Edgar, Director of USAID/Philippines Environment Office.
Climate Is Water
While the relationship between climate change and water supply may not seem particularly obvious, the two are in fact deeply intertwined. Climate change can degrade water supply in a variety of ways.
For example, the heavy sustained rainfall that accompanies typhoons can trigger landslides, accelerate riverbank erosion, and wash agricultural chemicals and other contaminants into waterways as storm runoff — degrading water quality and threatening the health of communities that depend on these same waterways for their drinking water supply. Closer to the coast, intensified storm surges, sea level rise, mangrove habitat loss, and coastal erosion can accelerate saltwater intrusion into aquifers, which serve as key water sources for many towns and cities. And prolonged droughts can cause surface water levels to drop, concentrating harmful pollutants and encouraging overreliance on groundwater as an alternative water source.
Regardless of the cause of water supply degradation, water service providers across the Philippines are bearing much of the expenses. They are struggling with both higher water treatment and infrastructure maintenance costs due to damage inflicted during extreme weather events whose effects are felt for months or even years. Mounting operating expenditures are one of the many reasons SWP has been working closely with cash-strapped water service providers, and conducting financial stress tests to help steer them onto the path of long-term fiscal health. This is particularly important at a time when many service providers are experiencing significant revenue loss due to the COVID-19 pandemic and postponing improvements and expansions as a result.
Creating a Resilient Water Supply
Drawing on guidance from USAID’s climate risk assessment and planning tools, SWP has placed climate considerations at the core of its evidence-based interventions for creating a more resilient, reliable water supply. “Building on our past experience responding to the impacts of Typhoon Haiyan and severe droughts, USAID ensured that climate resilience is an integral part of SWP’s design,” Edgar says. “USAID applies climate risk assessment in all its projects to understand and mitigate risks from climate change. SWP benefited from USAID’s robust assessment of climate risks, making it well positioned to integrate resilience across interventions [including] integrating climate considerations in water-system engineering designs to ensure that systems can withstand impacts of typhoons and flooding.”
“Poor data availability, management, and accessibility have been hounding water sector planning and policymaking.”
Since its launch, SWP has been collecting climate and hydrological data to monitor and analyze the condition of watersheds that serve as critical drinking water sources. This ongoing effort to fill in longstanding data gaps will go a long way toward improving water management in the three project sites, as well as elsewhere across the country, according to Roderick Planta, Assistant Secretary for Infrastructure Development of the National Economic and Development Authority (NEDA). As the Philippines’ planning agency, NEDA leads and coordinates water sector programming and serves as SWP’s key implementing partner. “Poor data availability, management, and accessibility have been hounding water sector planning and policymaking,” he admits. “Through the collection and subsequent analysis of these various data, a more informed and sound, scientific recommendation or decision can be expected. While the data to be gathered under SWP are context-specific, the tools and methods that will be developed may be further enhanced and scaled up at the national level.”
This month, SWP will present that data for the first time in a series of hydrological studies that seek to shape decision-makers’ thinking about water and hopefully lay the foundation for more sustainable water management practices. “With new and improved data-driven analyses capabilities and better, more frequent reporting accompanied by resonating public communication campaigns, local actors may be motivated — even compelled — to improve water resource management that can benefit all Filipinos,” says Hardy.
The new data-rich hydrological studies will shed further light on the islands’ delicate water balance and serve as “baseline data for more accurate and reliable predictions in the future,” says Francisco Alolod, a manager with the General Santos City Water District. This information in turn will empower water officials like Alolod to more effectively manage water supply in a manner that can withstand climate shocks and extreme weather events.
The studies “are crucial in establishing the baseline water security situation” of the three provinces where SWP is active, explains Alma Porciuncula, SWP’s director. “The reports include analyses of land cover and temperature and rainfall variations in the watersheds as factors impacting surface water runoff and recharge rates, establishing the current and projected conditions of the water resources. The findings of the studies will feed into policy actions, plans, and programs of the provinces.”
According to local SWP partners, better data can also go a long way toward shaping the design and implementation of more sustainable water management techniques and enhancing watershed protections. “Our local government will surely benefit from these hydrological analyses by using them as the basis for our future water-system projects and designs,” says Israel Delvo, an administrative officer in Alabel municipality. Delvo added that better access to hydrological data can help local officials — including emergency response personnel — identify patterns and more accurately predict and respond to future climate disruptions.
Facing Uncertainty, Well-Prepared
The path forward will not be an easy one, with all forecasts appearing to indicate rough weather ahead. “The Philippines is one of the world’s most vulnerable countries to the negative impacts of climate change,” points out USAID’s Joanne Dulce, who manages SWP. “Climate projections from the Philippine Atmospheric, Geophysical and Astronomical Services Administration indicate that increases in temperature, changes in rainfall, and extreme weather events nationwide will intensify between 2020 and 2050 and are likely to cause more droughts, floods, and storms.”
Despite the looming uncertainty, USAID’s partnerships in the Philippines are built for the long haul, drawing on a history of cooperation. After all, SWP “builds upon USAID’s previous successes that have promoted water security in the Philippines,” says Hardy. “Since 2013, USAID has invested $30 million to increase access to water supply and sanitation services for underserved communities alone.”
In the years ahead, SWP will continue to help better equip and position water managers across the Philippines to successfully respond to climate disruptions. Thankfully, the future looks bright. After all, Filipinos have demonstrated their collective resilience time and time again in response to a wide range of recent shocks, from typhoons and floods to droughts and COVID-19. “I have witnessed the Filipinos’ incredible resilience to bounce back from the wave of disasters that hit the country,” says Edgar. “While the economic recovery from the pandemic will be slow, I am fully confident that the Philippines will be able to adapt to a new and better normal.”
SWP and its partners are well-positioned to meet the moment and have ambitious plans: By the time SWP closes its doors in 2024, it expects to improve water and sanitation services for more than 1 million Filipinos, laying the foundation for a more resilient and prosperous future.
Burkina Faso and Niger have some of the lowest rates of access to safe water and sanitation in the world. Water scarcity and water resource mismanagement in both countries undermine farming and livestock livelihoods, and sometimes create conflict. Growing risks associated with droughts and floods, combined with populations that increasingly face internal displacement due to violent conflict, undermine the prospects for economic growth and poverty alleviation. People in these Sahel nations who face these shocks and stressors often suffer through one humanitarian crisis after another, and the impact of the COVID-19 pandemic has intensified these challenges.
USAID is working to break this cycle through an approach that combines emergency humanitarian aid with long-term development assistance. It is doing so through the second iteration of its Resilience in the Sahel Enhanced (RISE II) program, a broad five-year, more than $700 million program that is being implemented in Burkina Faso and Niger. RISE II addresses governance; water, sanitation, and hygiene (WASH); health; family planning; nutrition; food security; economic well-being; and empowering women and youth.
Water insecurity and pervasive shocks and stresses are two of Burkina Faso’s and Niger’s most critical challenges. RISE II includes the TerresEauVie (TEV) activity, whose central focus is water security. TEV, started in 2019, also focuses on food security, land access, and natural resources management. The $39 million activity has helped vulnerable populations effectively manage shocks and stresses such as droughts and floods and pursue sustainable pathways out of poverty.
TEV has three objectives: improved water security; productive land use; and improved management of shocks, risks, and stresses. “I think it’s actually the first [activity] of its kind in the Sahel,” says Maggie Janes-Lucas, director of the Sahel Collaboration and Communication project, which works in partnership with TEV. “It is quite unique and quite important.”
Building the Capacity of Local Government to Address Water Insecurity
TEV works mainly at the commune level — the rough equivalent of a county government in the United States. It also collaborates with other RISE II related projects as well as government agencies at the village, regional, and national levels. TEV’s goal is to build local capacity for long-term management of water and land resources along with shock preparedness and response. TEV focuses on 25 (out of 250) of Niger’s communes, or 4,100 villages, and 15 (out of 350) of Burkina Faso’s communes, or 700 villages.
As one of its first tasks, TEV assessed the capacity of commune officials to manage people’s concerns and expectations about water and land related issues. “With [commune officials], we are developing plans for their improvement, where they see their issues, where they see their strengths, and where they want to take this,” explains Harvey Schartup, TEV’s director. “Together, we develop a capacity-building plan.” He says that over the coming years, TEV will train commune officials and their staff to increase their management, collaboration, and planning skills. These enhanced skills are one puzzle piece in the overall systemic approach to help officials better manage and improve operations. They also allow them to better anticipate, prepare, and respond to the shocks associated with more frequent extreme climate events and insecurity situations.
Making Data for Planning Available and Usable
TEV is also working to improve the data available to communes so that they can make more informed decisions about water resources and WASH investments. In both Niger and Burkina Faso, communes are responsible for managing land, natural resources, and infrastructure development. These communes need to know the condition and location of all their health centers, water wells, roads, and cattle corridors. “All of this information that is dispersed, we are trying to bring it all together so the users would be able to have a systemic and long-range view of a particular geographic area,” explains Schartup.
Communes are particularly interested in using these data to develop local land use and natural resource and risk management plans that address water resources, whether for agricultural, industrial, or household use. Currently, local water agencies do not have this sort of management tool. “This is new for them, and they are very interested in using and adding to this information we are providing them,” says Patrice Beaujault, TEV deputy director.
For example, in southwestern Niger, officials in Filingué looked for ways to solve frequent conflicts over water sources. TEV, in collaboration with other RISE II implementers, helped communal authorities and stakeholders map out the various resources and competing interests in the area. Together they developed a plan and a series of administrative ordinances, called a Local Convention, that established fair water and land use. The commune adopted its Local Convention in January 2020.
Coping with the Pandemic
Burkina Faso’s capital city Ouagadougou reported the country’s first case of COVID-19 on March 9, 2020. In the days that followed, leaders from around the country struggled to respond. “I quickly issued a municipal order to close the markets and ban demonstrations that could potentially mobilize large numbers of people,” says Amadou Tamboura, mayor of Seytenga in the country’s north. “I also asked people to respect the measures taken by the government. But what more can we do with our resources? It was at this point that TerresEauVie proposed that we draw up a communal response and prevention plan to respond to COVID-19.”
COVID-19 plans like these serve as roadmaps for communes preparing for and implementing prevention and response. They also foster communal leadership in directing where development and government agencies should provide resources. For example, the Seytenga commune drafted its action plan by involving key actors at the communal level, including those in health services, aligning with existing national guidelines. A communal response committee also meets once a month to plan major activities.
“I also noticed that people now wash their hands when they arrive at the Health Center.”
As part of the resulting plan, TEV supported the commune in conducting an information campaign via local radio in partnership with the Ministry of Health. One program featured a local nurse, Ahmadou Maiga, answering questions from listeners. “Some people thanked me by phone and in person at the Health Center for the clarity of the explanations,” Maiga said. “I also noticed that people now wash their hands when they arrive at the Health Center.”
TEV is doing similar work in Niger. In the Maradi region’s Chadakori commune, TEV worked with local officials to develop a simple framework for their COVID-19 contingency plan. Community members, including youth and women’s groups, worked together and led the data collection and analysis process to draw up the plan. TEV brought together the Crisis and Disaster Prevention and Management Sub-Regional Committee, the mayor, and communal technical services to review the first version of the plan together. This allowed them to go into greater detail around the plan’s objectives, vulnerability factors, and expected results, and to develop a more concrete working relationship between local and regional authorities.
“We have a contingency plan that meets our standards,” says Zeinabou Ibrahim, the commune’s secretary general. “We have now mastered the methodology for developing good contingency plans.” TEV has now begun supporting communes to transform their COVID-19 plans into communal multi-risk plans, encompassing a long-term perspective for addressing broader shock preparedness and response.
Goal Is Self-Reliance
In all of TEV’s work, the hope is to have a wider impact on water security in more than just the target communes in Burkina Faso and Niger. “Our vision goes beyond our targeted communities and those three component areas,” says Schartup. “We work with the communes and their support structures from day one, facilitating, mentoring, and assisting their efforts with the goal of long-term sustainable self-reliance. The aim is to develop successful, locally adapted models that the government will be able to expand beyond the 25 communes in Niger and 15 in Burkina Faso.”
“The idea at the end of the day is for self-reliance at the communal level,” agrees Beaujault.
Imagine a river basin — the rivers, tributaries, creeks, and wetlands that gather water and deliver it to the sea — as the vital network that all things, living and nonliving, are connected to and dependent upon. This complex ecosystem is ever-changing from human and natural forces, and its management is complicated by the fact that it often crosses political boundaries — state to state, province to province, and country to country.
Southern Africa’s Limpopo River Basin, the fourth largest on the continent, supports more than 18 million people in four countries — Botswana, Mozambique, South Africa, and Zimbabwe. The basin is also home to most of the region’s largest cities and economies and boasts a rich diversity of flora and fauna. But the pressures on this transboundary system — which include pollution, climate change, and population growth — are immense. As a closed basin, the river basin’s inability to provide enough water to meet the growing demand has profound implications for livelihoods, wildlife preservation, and food production.
USAID launched the five-year, $32 million Resilient Waters Program in 2018 to improve transboundary natural resources management and increase the water security and resilience of communities and ecosystems that depend upon the Limpopo and nearby Okavango basins.
Along the Limpopo River, USAID is tackling severe water and sanitation challenges in targeted municipalities and protected areas from the river’s source in South Africa to its mouth at the Indian Ocean on the coast of Mozambique. These challenges range from industrial pollution and its impact on the health of the river and the environment and inadequate sanitation upstream, to saltwater intrusion and depleted groundwater downstream. More frequent droughts, stronger cyclones, and intensified flooding related to climate change are further straining this vulnerable resource.
Reducing Contamination Upstream
Combating pollution is one of Resilient Waters’ priorities for improving access to safe drinking water and sanitation services at key points in the Limpopo River Basin. “In South Africa, climate change effects, such as shortages in potable water due to prolonged droughts and minimum rainfall, have necessitated a change in sanitation sector planning,” says Lusanda Agbasi, acting director for the National Directorate for Sanitation at South Africa’s Department of Water and Sanitation. “This means reconsideration of on-site sanitation and decentralized sanitation technologies as viable options for the longer term.”
Case in point is Polokwane, South Africa, a burgeoning municipality in the middle of the basin. The majority of Polokwane’s residents are not connected to sewerage systems, and like many of the region’s rapidly urbanizing areas, the city has outgrown its existing wastewater treatment options. Further complicating matters, without a formal system for emptying, transporting, treating, or disposing of fecal waste originating from households not connected to the sewer network, Polokwane’s untreated waste is either overwhelming the limited number of wastewater treatment plants or being dumped illegally, contaminating waterways. A lack of infrastructure and regulation endangers the local water resources and supply and threatens water security for downstream users. To address the impacts on river resources upstream of the basin, Resilient Waters recently partnered with Polokwane Municipality to enhance its knowledge base for decision-making around fecal sludge management or non-sewered sanitation for the municipality.
Using an evidence-driven approach, this collaboration is piloting a series of tools — a climate delivery assessment, sanitation safety plan, fecal flow diagram, and an urban resilience toolkit — to improve the management of fecal sludge. Leonellha Barreto Dillon, a senior partner at Seecon and an expert in sanitation safety planning, is working on the pilot project in Polokwane, and says that greater recognition of the impacts of poor sanitation on water resources is needed. “The impact of unsafe fecal waste flows on people, and the environment is unknown, and therefore, not fully integrated in decision-making on sanitation management within the [Polokwane Municipality] Water Services Authorities.”
With support from the Regional Department for Water and Sanitation, Polokwane Municipality has committed to improve and refurbish its sanitation infrastructure. The evidence to improve fecal sludge management, collected through this pilot project, is expected to be integrated into the municipality’s overall planning and decision-making for sanitation service and infrastructure upgrades.
These newly embraced approaches have applicability well beyond Polokwane. “The lessons learned will be used to feed into the development of the fecal sludge management strategy for South Africa at large, because there are many other cities and other areas experiencing similar problems,” says Chief Technical Advisor for Resilient Waters Nkobi Moleele.
Because the Resilient Waters program is regional, Chief Partnerships Advisor Kule Chitepo adds, “Whilst we do have interventions that might be local in a particular country, we always want to see what the downstream and transboundary implications are of that localized or national activity. We’re also very interested to see how that contributes to building [the] resilience of the basin as a whole in terms of downstream implications of upstream or urban areas like Polokwane.”
Adapting to Change and Conserving Biodiversity
While it is crucial to safeguard the scarce water resources of the Limpopo River Basin from contamination, it is equally important to conserve and protect the high-elevation catchment areas that serve as water towers for the entire basin.
“The reason why a high-altitude catchment area is important is that it produces a lot of water per unit area for the basin [100 times as much as low-lying areas], but also these high-altitude areas are major storehouses of biodiversity,” says Moleele. Protecting diverse ecosystems upstream improves the quality and quantity of water flowing downstream, contributing to the sustainability of the community livelihoods that are dependent on these ecosystems.
To manage vulnerable areas more sustainably, Resilient Waters provided grants to local organizations working within a number of protected areas to improve catchment management; support sustainable use of natural resources; and help governments, park personnel, and communities prepare for climate change pressures on biodiversity and water supplies.
For example, the Waterberg Biosphere Reserve, home to 5,500 species of plants as well as the endangered black rhino and wild dog, serves as an important water tower for three major catchments flowing into the Limpopo River. Resilient Waters is equipping staff with skills spanning field work, surveying, and Geographic Information System usage that will inform the implementation of a Strategic Environment Management Plan. A grant is also helping to engage traditional leaders and local municipalities to conduct socio-economic and water, sanitation, and hygiene surveys to determine upcoming climate change adaptation activities.
“This Strategic Environmental Management Plan is trying to look at all these challenges holistically with a view to ensure that water for all these different purposes is assured,” says Moleele.
To the east of the Waterberg lies another high-altitude catchment area, the Kruger to Canyons (K2C) Biosphere. This area is home to two of South Africa’s biggest tourist attractions in the basin, Blyde River Canyon and Kruger National Park, and it functions as a critical water source for a number of agricultural hubs. Pollution, invasive species, contaminated mine drainage, and poor waste management and sanitation are all threats to water security in the reserve. Resilient Waters supports the biosphere’s community-based environmental monitors to conduct village patrols, monitor river health, and raise awareness among the adjacent communities to increase the availability of clean water both locally and downstream. A recent clean-up campaign that involved more than 100 community members has led to some promising changes in waste collection and disposal practices. The program also supports restoration activities in the rivers, wetlands, and grasslands of the catchment.
Environmental stewardship is not limited to the high-catchment areas, however. The Limpopo River Basin is also home to numerous other parks and preserves, including the Greater Limpopo Transfrontier Conservation Area, shared among Mozambique, South Africa, and Zimbabwe, which connects almost a dozen parks and biodiversity hotspots adjacent to Kruger National Park, including Mozambique’s Limpopo, Banhine, and Zinave National Parks and Zimbabwe’s Gonarezhou National Park.
Climate change is wreaking havoc on these unique landscapes; the weather has become hotter and drier, depleting food supplies for grazers and watering holes. As part of its mandate to strengthen the ability of communities and key institutions to adapt to climate change, Resilient Waters co-hosted a training workshop with UNESCO on Climate Risk Informed Decision Analysis for South Africa’s parks department, local NGOs, and other regional institutions. These parties now have access to more than 40 global climate models and visualization tools that enable them to make data-driven decisions on local and regional water resources management. Putting its newly acquired knowledge into action, Kruger National Park management used the content of the training workshop to start planning for climate-related impacts on freshwater ecosystems. Resilient Waters also supported the participation of professionals from across southern Africa in the UNESCO Mozambique Flood and Drought Monitoring training, which uses global best practice systems and data sets to predict water-related natural disasters.
The Livelihoods Connection
Local communities are more likely to protect biodiversity and freshwater resources if doing so is connected to job creation and income generation. Supporting new livelihood strategies also helps people reduce their risk exposure in the face of a changing climate and increased water scarcity. Resilient Waters is building on livelihood strategies put in place by its USAID–funded predecessor, Resilience in the Limpopo River Basin (RESILIM), throughout the basin in locales as diverse as Polokwane, the buffer zones between communities and protected areas, and at the mouth of the Limpopo River in Xai Xai, Mozambique.
Upstream, a Resilient Waters grant is sharpening farmers’ skills to practice climate-smart agriculture and use water-wise farming techniques in an effort to boost income generation in areas where more severe droughts are predicted.
Downstream, the Limpopo River empties into the Indian Ocean in Xai Xai, a city of 120,000 people whose income depends upon viable fisheries and whose water supply depends upon available groundwater. All of the inputs upstream impact Xai Xai, including a heavy concentration of nitrates from poorly managed fecal sludge and reduced water flows from the Massingir Dam to the north. Saltwater intrusion from the sea further disrupts Xai Xai’s water supply, and the coastal town is increasingly vulnerable to flooding from more frequent and violent cyclones. The mangroves that once served as a natural buffer between the ocean and the river have been vanishing, eroding the area’s identity as a thriving estuary and limiting the ability of these vital coastal forests to provide natural flood protection.
“We are working to find ways to establish ecotourism activities that will also generate money for the communities so that they remain motivated to conserve the mangroves.”
“Mangroves are very productive ecosystems, they are also good spawning grounds for fish and many other things,” notes Moleele. “They also buffer the agricultural land from the intrusion of seawater…[and provide] many benefits. But as a result of a history of degradation from unregulated land uses as well as destruction from floods, the integrity of the Xai Xai mangrove ecosystems has been compromised.”
Through a grant to a local NGO, Resilient Waters is supporting local communities to restore the mangroves, work that began under RESILIM and which includes a strong livelihoods component. Women’s cooperatives are participating in conservation-based income-generation activities associated with the estuary, for example. “We are working to find ways to establish ecotourism activities that will also generate money for the communities so that they remain motivated to conserve the mangroves, because the mangroves play a critical function in that estuary,” says Moleele.
The Pandemic Challenge
A new challenge facing the basin emerged in 2020 — COVID-19. Activities previously seen as win-win approaches, such as linking biodiversity conservation with income-generating ecotourism in buffer zones, have ground to a halt.
“In this part of the world, in the Limpopo River Basin, a lot of the rural economies around the protected areas are built upon or reliant upon the ecotourism industry,” explains Chitepo. “And as you know, tourism has been very hard hit by the pandemic. So this has a direct effect on the livelihoods that are reliant upon the conservation area.”
Resilient Waters is having to adjust to this new normal, but with challenges come opportunities, according to Moleele. “We’re not just operating in a vacuum of what the needs are on the ground. And I think now more than ever, we have an opportunity to really ramp up our livelihoods work, especially given the impacts of the pandemic.”
Enhancing Transboundary Coordination
While many of the upstream and downstream challenges can be tackled at the local level, engaging national structures, such as water authorities, is critical to addressing water resources management and disaster risk reduction in the basin. Ultimately, the most pressing concerns must be coordinated at the transboundary level, whether such steps involve mapping an aquifer to explore groundwater depletion in each member country or devising robust early warning systems for the basin. To that end, Resilient Waters has embedded two technical experts within the Limpopo Watercourse Commission Secretariat, the structure put in place by the member states to govern the basin.
This level of coordination is “a lot of work,” admits Chitepo. “But the relationships are there, the intention is there, the political will is there, the countries themselves are contributing towards the costs. Obviously, some countries have got more resources than others to be able to contribute towards this functionality, but they work very well in terms of leaving no one country behind in their cooperation.”
Resilient Waters’ work to strengthen institutional connections, build up its partnerships, and address the shocks and stresses of climate change will help mitigate the pressures on the Limpopo River Basin for years to come. As the health of this vital ecosystem improves, so too will the resilience of the humans and natural systems that depend upon it.
I’ve been doing a fair amount of work on hand hygiene since November, e.g. this piece on the economics of hygiene for the Hygiene Hub and some costing work for WHO/UNICEF. It bothered me that definitions were not clear, so I put together this Venn diagram. It aims to be a broad means of categorisation, rather than a comprehensive listing of all possible aspects of hygiene. I had domestic settings in mind, and other factors may be more important in other settings, particularly health care facilities. Please flag other resources on this definitional question in the comments below, if you know of them!
Within and beyond the WASH sector, “hygiene” has often been taken to be synonymous with handwashing. However, it is really a broader concept than this, but how broad? At the extreme end of the spectrum, hygiene is “the practice of keeping oneself and one’s surroundings clean, especially in order to prevent illness or the spread of diseases” (Boot and Cairncross, 1993). This aligns with the adjective hygieinos in Ancient Greek, meaning good for health (Liddell and Scott, 1889).
Taking the broad Boot & Cairncross definition, many behaviours and practices would fall within the scope of hygiene, including: (i) excreta disposal; (ii) use and protection of water sources; (iii) personal hygiene (e.g. hand hygiene, menstrual hygiene management); (iv) food hygiene (e.g. handling, preparation and storage); and (v) environmental hygiene (e.g. surface wiping, solid waste disposal, animal management).
Personally, I think including sanitation and water within hygiene is so broad as to be unhelpful. It is more typical to take a narrower approach. For example, UNICEF and WHO (2019) define hygiene as comprising “a range of behaviours that help to maintain health and prevent the spread of diseases, including handwashing, menstrual hygiene management and food hygiene”. Some studies also note face hygiene and bathing (Prüss-Ustün et al., 2019). You could argue for separating out other things like surface cleaning, toy cleaning etc. The various aspects are discussed in more detail by Curtis et al (2001) This and a suggestion from my colleague Karin Gallandat led me to separate out personal, domestic and food hygiene in the above diagram, but I am sure there are many other ways to cut it. More environmental aspects might be included, but then overlap with environmental sanitation (also ill-defined) would become more problematic. Another argument might be to include disease prevention behaviours such as wearing a face mask when exhibiting respiratory symptoms.
Zooming in on hand hygiene
The final definitional twist to note is that hand hygiene comprises not only handwashing with soap and water, but also handrubbing with alcohol-based hand rub (not technically “washing”). These WHO guidelines have lots of definitions along these lines. Ash can also be used as a last resort. For all your questions on rubs vs. soaps, see the Hygiene Hub, especially this piece. In short, soap is just as effective, relatively cheap, and more widely available by comparison to rubs – it is also more gentle on hands. However, the calculus is likely to be different in health care facilities where rubs are often considered more appropriate, for various reasons.
From an infectious disease perspective, focusing on clean hands (vs. other hygiene behaviours in the venn diagram) is warranted. Hand hygiene is likely the hygiene behaviour that makes the most important contribution to preventing faecal-oral disease and, annually, 165,000 deaths from diarrhoea are attributable to inadequate hand hygiene behaviours (Prüss-Ustün et al., 2019). However, food produce may be an important exposure pathway in many settings, and more evidence is needed on this (WHO and UNICEF, 2019).
Hand hygiene can prevent faecal-oral diseases by removing pathogens after fingers touch faeces (or things which have touched faeces) and before those fingers touch food, fluids, or the new host’s mouth. See the famous F-diagram below (Wagner and Lanoix, 1958). Human faeces might touch hands directly, before entering the environment (e.g. after defecation or child faeces management). Crucially, however, they are also transmitted indirectly once pathogens are already in the environment (e.g. surfaces, other people’s hands, animals and their faeces). Therefore, even with good water supply and sanitation services, pathogens can still circulate and hand hygiene is necessary to reap the full benefits of WASH.
[note – this post was updated after helpful suggestions in replies to this tweet – thanks!]
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