Waterlines

Volume 27 Number 3 July 2008

Editorial
Richard Carter

Contents

What can the world learn from achievements and challenges in the field of South Asian sanitation provision? Considerable progress has been made in 10 subject areas: policy development, low-cost solutions, user choice, decentralization, mapping poverty areas, funding of demand creation, motivating users, local production and supply, phasing out ineffective subsidies, and going beyond numbers to healthy practices. Ten others are still under-developed: diversification between and within households, cost-effective promotion, targeting remaining subsidies with equity, upgrading toilets over time, environmental safety, scope for dry toilets, sanitation in urban slums, short-term versus long-term programmes, sustainability of facilities and programmes, and organizational and human capacities, especially at intermediate level. This paper provides an overview of the South Asian Sanitation & Hygiene Practitioners’ Workshop organized by IRC, WaterAid and BRAC in Dhaka, Bangladesh, 29–31 January 2008.

Rapid urbanization has increased the need for an adequate sanitation system in Quetta, Pakistan’s 12th largest city. However, inadequate institutional capacities have hindered its development. Between 1997 and 2003, the Netherlands government funded a local environmental management programme which involved a partnership between city governments, community and non-governmental organizations. This paper offers more details about the programme, specifically its institutional framework, technology options, implementation, hygiene promotion and cost and tenure issues. A survey conducted after the project had finished details the outcomes of the programme. Across the range of indicators adopted the outcomes are generally positive. This document also outlines factors in the success of the programme as well as some of the constraints faced, challenges that need to be confronted and issues for future scaling up.

School-based, activity-oriented, hygiene education techniques – if appropriately implemented – can lead to sanitation and hygiene improvements beyond schools, into households and wider communities. Teachers and students can help parents and communities at large to realize and adopt better practices. In turn, once realization is there communities can be innovative in appropriate sanitation solutions, which are affordable and hence sustainable. The challenge is adoption of consistent policies and strategies by the key players and capacity building of implementers and facilitators. In particular there is a need to focus on total sanitation and open defecation-free status as the objective and a criterion for success, rather than the numbers of latrines constructed.

The study included:( a) an epidemiological investigation based on a study population of 1,245 individuals; (b) microbiological and parasitological examinations of 10 per cent of stool samples from study population; and (c) water quality and sanitary inspection analysis. Results from the study indicate that both diarrhoeal morbidity and overall worm infestations from stool samples reduced in the ODF villages. Results however indicated high levels of microbiological contamination of the water supplies in ODF villages as well as an increased prevalence of hookworm (Ancylostoma duodenale) infestation in 16 per cent of the population. These results reflect  that, as revealed by interviews, despite improved latrine coverage, many ODF villages are still practising open field defecation resulting in the transmission of hookworms through the human–soil–human contamination route. The study concluded that, to maximize the health benefit of ODF, a choice of alternative sanitation technology options combined with appropriate hygiene promotion must be undertaken.

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