School sanitation * Why focus on School Sanitation and Hygiene Education (SSHE)? * What are the objectives of a SSHE programme? * What important lessons have been learned in SSHE so far? * What are indicators for a successful SSHE programme? * What is lifeskills based education? * Why is lifeskills based education encouraged in SSHE? * How do I develop lifeskills-based SSHE? * Can I get an example of lifeskill-based SSHE? * How do I check the quality of my lifeskills-based approach? * How do I include outreach activities without overburdening my programme? Small Communities * What are the main criteria in selecting a technology for municipal/small town wastewater treatment? * What is the difference between centralised and decentralised wastewater treatment and what are typical centralised and decentralised technologies? * Are septic tanks a suitable low-cost solution for urban areas? * Are conventional wastewater treatment technologies always the best choice? * What are the benefits of pollution prevention in wastewater management? * Which low-cost options are available for sewerage in developing countries? * How do you deal best with stormwater during rain storms in low-income areas? * Which low-cost wastewater treatment technologies are available? * Which systems are available for wastewater reuse? * Which technologies are used in conventional wastewater treatment? Frequently Asked Questions Why focus on School Sanitation and Hygiene Education (SSHE)? Topic: School sanitation In many countries throughout the world, schools have very poor sanitation environments: * They have no, or insufficient, water supply, sanitation and hand-washing facilities; * If facilities are present, they are often not adapted to the needs of children, broken, dirty and unsafe. Under these conditions, schools become unsafe places where diseases are transmitted, with mutually reinforcing negative impacts for the children, their families, the schools and overall development. Good health at school is essential for now and an investment for the future. Hundreds of millions of school-age children are infected by parasites and flukes. The infections and other sanitation related diseases are spread in schools The diseases cause poor health and lead to, or reinforce, malnutrition Poor health and malnutrition are important underlying factors for low school enrolment, high absenteeism, poor classroom performance and early dropout The provision of safe water and sanitation facilities is a first step towards a healthy physical learning environment. However, the mere provision of facilities does not make them sustainable or ensure the desired impact. It is the use of the facilities - the related hygiene behaviours -of all people that provides health benefits. In schools, hygiene education aims to promote those practices that will help prevent water and sanitation-related diseases as well as inculcating healthy behaviours in the future generation of adults. Therefore the combination of facilities, correct behavioural practices and education are meant to have a positive impact on the health and hygiene conditions of the community as a whole, both now and in the future. What are the objectives of a SSHE programme? Topic: School sanitation Commonly, the following three objectives are used for a School Sanitation and Hygiene Education or SSHE programme: * creating a healthy and safe learning environment; * helping children develop life skills (that is, skills to cope with life), including for hygiene and health; * stimulating that safe sanitation and hygiene reach and benefit their families and community SSHE programmes concentrate on the school environment, the water and sanitation facilities in this environment and the hygiene education in the education programs. They deal with the total package of sanitary conditions and facilities available in and around the school compound, the promotion of hygienic conditions at the school, and the fostering of practices of school staff and children that help to prevent water and sanitation related diseases. They also promote the linkage of improvements in school with improvements in the children's homes and community. Creating a healthy and safe learning environment Given this situation, the need to build school sanitation and water facilities, and ensure basic school infrastructure, is understandable. However, this is not sufficient. There are other vital tasks that schools must also undertake. A fundamental shift is required from the earlier emphasis on sanitation and water facilities alone toward combining this with behavioural change. Forming consistent behaviours and attitudes is one of the primary objectives of an effective school health programme. It is, important that children know about risks to their health and how to avoid these risks. This means that the focus on sanitation and water infrastructure must be combined with a broader agenda that includes education and consistent behaviours (Kohli, 2001). A healthy learning environment involves all three: * safe sanitation, water supply and handwashing facilities * hygienic use by everyone - children and staff - at all times * sound management to keep the facilities in proper working and hygiene conditions Promoting hygiene as part of lifeskills education Through hygiene education in class, SSHE programmes aim at promoting and preserving better hygiene conditions in schools. They also aims at improvement of practices of children and staff that help to prevent water and sanitation related diseases. Better hygiene practices do not develop just by learning about water and sanitation related diseases. They also cannot be imposed by prescriptions and punishments. New learning methods and tools have therefore been developed that help children to assess and improve their practices in an active way (See also What is lifeskills education and how is it done in SSHE?) Stimulate outreach to and benefits for families and community Outreach is important to ensure that children not only have a healthy school environment, but that home and community environments improve at the same time. By including activities whereby schoolchildren do certain activities (such as investigations) as homework in their home or community, teachers have linked SSHE with wider outreach activities without adding extra burdens to school programme. What important lessons have been learned in SSHE so far? Topic: School sanitation For SSHE, there are numerous lessons that have been learned so far. The answer of this question will only outline some of the key lessons that have been learned so far. School sanitation and hygiene education is more than construction and coverage. The impact of the programme comes through sustaining the facilities, using them as intended and the development of hygienic and healthy behaviours. Thus SSHE is basically an education programme with some construction. In successful programmes, people agree that SSHE is more than construction and include hygiene education, continued maintenance, the development of new behaviours and links with the community. Safe facilities, good management and proper hygiene practices need to go hand in hand. Integration becomes difficult when hygiene lessons on sanitation are given in class, but the school does not have the required facilities. For example, many lessons emphasise on washing hands but most schools do not have water nearby. The other way round, hardware facilities without hygiene lessons also occurs. For example, many schools have handwashing facilities locked up in their stores because they fail to understand the value of hand washing (NETWAS, 2000). The involvement of more actors and an effective communication between the different actors will lead to sustainability. The actors that can be involved include the following: Community members: * Children, Parents * Anganwadi workers * Teachers and head teachers * Masons Community groups and institutions: * Parent-teacher associations (PTA's) * Village Education Committee (VEC's) * Water and Sanitation Committee (WATSAN) * Village/Panchayat Development Committee * Gram Sabha * Panchayat authorities * Women's groups and Self-Help (and savings) Groups * Youth Groups * Contractors Block and district institutions: * District officials- Collector, Chief Executive Officer * Public health engineering department * Education department * Education officers, block education officer * Teachers * Child Development Service * Health department including District Health Officer * UNICEF personnel at district level * Rural development department * Various NGOs (non-governmental organizations) and their field workers Each country, state, district will have a considerable variation in the strength and activity levels of their actors and institutions. For example in India, in some areas women or panchayats may be stronger or weaker. The point is to have a structure in the detailed local planning which allows freedom to build on groups that are locally strong, and are also good representatives of the population. One of the most important lessons of SSHE is that there is a need for the integration and or co-ordination of inputs and outputs of different groups. The integration and co-ordination of the inputs and the outputs of different groups, at the right time, will result in a programme which has qualitative superior components for realistic investments in education, health and water and sanitation. The integration and co-ordination is particularly necessary among the different departments in the government, among different disciplines and among the hardware inputs, the educational software and the community organisation. Another important lessons regarding SSHE is the need for capacity building, using appropriate leaning methods and monitoring use, which is essential for school and pre-school teachers and their supervisors. This will enable them to assist in the implementation of the programme, to properly operate and maintain the facilities and to teach life skills based hygiene education. Even so important is the follow-up by supervisors and trainers at school level. Experiences have shown that the lack of follow-up after one short training event can seriously weaken programming in many places. The implementation of SSHE programmes should be subsidised but demand based. Schools and communities cover some of the costs and so demonstrate their demand for the programme. There is a need for competition and control in the construction activities. Construction monopolies (such as government departments or large contractors) are not always the most efficient, the least costly or most honest in the construction for school programmes. Sufficient facilities of good quality and adapted to the needs of all children of different sex and age groups should be made available at the schools. In the case insufficient facilities are available or facilities are not adapted to the needs of the children, the facilities will not be used by all the children, which can result that the provision of the facilities will not derive the full health benefits. What are indicators for a successful SSHE programme? Topic: School sanitation To be successful school sanitation and hygiene education must address a combination of hardware and software issues. Only in combination can the two conditions for better health of school children be met: 1. Availability of good facilities; 2. The adoption of healthy practices. SSHE programmes therefore should focus on both effective education and effective facilities. Other criteria for a sustainable and successful SSHE can be sub-divided in various categories, such as for the facilities, for hygiene education and for organisational issues at various levels. Criteria for the facilities: * Sufficient water and sanitation facilities (latrines, handwashing facilities and waste and waste water disposal facilities) available in the school compound; * The constructed water and sanitation facilities follow minimum specifications for design and quality of construction; * The water and sanitation facilities are child and gender friendly, which means that they are adapted to the needs and wishes of all the boys and girls of the different age groups attending school; * The water and sanitation facilities are (always) functional * They are used by everyone - no signs of non-use in and around school * The amount of water available is sufficient for drinking, handwashing as well as cleansing and cleaning of the facilities * The water and sanitation facilities as well as the classrooms and school compounds are properly operated and maintained; with other words they kept clean and in technical good condition; * The operation and maintenance of the facilities is well organised and is not the sole responsibility of one or more female teachers and female students, but if carried out by teachers and students shared equally between both genders, age, caste and class; * The cost of water delivery is affordable and paid; Criteria for life skills based hygiene education: * (Life skills based) Hygiene education is part of the curriculum of primary and secondary schools and teacher education (as a separate subject or as an integral part of other subjects, practical, methods used); * (Life skills based) hygiene education materials for the different age groups of primary schools and lower secondary schools have been developed; * Teachers and district education officers have been trained in the use of life skills based hygiene education materials and its curriculum; * Life skills based hygiene education is taught at schools on a regular basis, at least once a week per class; * Hygiene behavioural changes of the students and the teachers are achieved and kept up (sustained) over time; Criteria for the organisational issues at school level: * An active Parent-Teacher Association exist, which has been and is involved in all the stages of the SSHE programme; * Outreach activities to the communities and the school aged children not attending schools, via students and teachers take place on a regular base; * Different community members and groups are informed and support the SSHE activities; * SSHE activities in school are broadly supported and are not relegated to a small group of women teachers, parents, etc. Criteria for the organisational issues at national, regional/district and school/community level: * The various stakeholders on national, regional, district and community level (including children) are involved and are working together for amongst others the design of the water, sanitation and hygiene facilities (including their evaluation), the design of the curriculum, and the organisation of the operation and maintenance, and evaluation, of the facilities; * Policies for SSHE have been developed on the various levels: on national, regional, district level as well as in the schools; * Finances for the implementation of the SSHE programmes at different levels (national, regional, district and at school/community level) have been allocated and secured; * Construction of the water and sanitation facilities and the introduction of the teaching of life skills based hygiene education are introduced at the same time to the schools; * Construction does not take place in parallel and unconnected to education, but is used as learning and participation opportunity. * A monitoring system for the implementation of SSHE programmes as well as to safeguard their sustainability has been set up at the different levels (national, regional, district and school/community) as well as a system which makes it possible to act on problems when something is wrong; What is lifeskills based education? Topic: School sanitation The lifeskills approach to education is an interactive process of teaching and learning that helps children acquiring the knowledge, attitudes and skills which enables them to take greater responsibility for, and cope better with, their own lives. The purpose of the life skills approach applied to hygiene, water and sanitation is two-fold: * to enhance the already positive and healthy social characteristics of the majority of young people through�reinforcing and building knowledge, positive attitudes and values, healthy and pro-social skills and behaviours * to prevent or reduce risks to health to support social and emotional development through� reducing misinformation and preventing or reducing risky or harmful behaviours. Life skills education tries to give girls and boys the knowledge, attitudes, and skills that they need to lead healthy lives, and encourage others to do so. Its focus is the individual girl, the boy and the school- eventually reaching out to homes and communities. Lifeskills are general capabilities which the students acquire and which prepare them to cope better with life. They are useful general attitudes, skills and knowledge such as: * attitudes and skills to listen actively, * skills speak out and give and take feedback, * knowledge, attitudes and skills to identify and solve problems, * skills and attitudes to work together with others, * to deal with pressure, anxiety, grief, * knowledge, skills and attitudes to identify what is important, to understand and appreciate others with a different background, norms and attitudes, to recognise and deal with social, economic and gender inequalities and injustice. The life skills approach focuses on the knowledge, attitudes and behaviours that support people in taking greater responsibility for their own lives. It focuses on promotion, among children, of positive existing knowledge, attitudes, and skills as well as risk reduction. Life skills education recognizes that it is can be challenging for children to make healthy life choices, or resist negative pressures, or reduce risky behaviours. Since hygiene education also aims at changing risk-behaviour, the life skills approach is highly compatible with hygiene education. Why is lifeskills based education encouraged in SSHE? Topic: School sanitation Current insights show that in schools educational methods (including those for teaching health and hygiene) can be more effective. In many countries and schools the more traditional ‘information based’ approaches still dominate education systems. They give children academic knowledge, but do not prepare them for their current and future lives. More effective teaching and learning outcomes are likely to result from methods which address skills, values, and attitudes as well as information that is not only of use for them academically but also helps them to have better lives. This educational approach is also known as the life skills approach. Life skills education uses teaching and learning methods that are more than the transmission of information. The teaching and learning methods are meant to be interactive and participatory with room for both information-focused sessions and child-centred sessions. Through the use of participatory learning activities, such as games, exercises, and group assignments, the students acquire a wider range of life skills than on health and hygiene alone. For example, as part of the lessons on health and hygiene, children may develop attitudes of respect for the opposite gender, for older and younger people and people weaker or less fortunate than they themselves. They could practice activities that show openness to and respect for habits of other groups. Traditional approaches are often information-based and didactic, and often neglect the ‘real life’ applications of information and the role of attitudes and values or the need for interpersonal skills, especially related to sensitive issues and personal behaviour. Making healthy life choices, gaining greater resistance to negative pressures, and minimising harmful behaviour such as drug use and taking HIV/AIDS related risks is complex. The life skills approach is designed to reduce that complexity. Since hygiene education also aims at changing risk-behaviour, the life skills approach is perfect for application in this field. How do I develop lifeskills-based SSHE? Topic: School sanitation Culture and local environmental and socio-economic conditions determine diseases, attitudes and behaviours. This is why life skills materials cannot be standardised and externally developed materials. In other words, we need to identify for each region the specific behaviours and conditions that are the most relevant for the transmission and prevention of water, sanitation and hygiene related diseases. We also need to determine the specific factors associated with these behaviours and conditions. Having done so, we can delineate the specific knowledge, attitudes, beliefs and skills that students need to practice healthy behaviours and avoid unhealthy ones. Other important principles, although not exclusive, which should be taken into account when developing life skills hygiene education materials are the need for: * Integrated approach of 1. the technical interventions with 2. student/parent/teacher participation and 3. pedagogic activities. * Developing the context of life skills materials in collaboration with a variety of stakeholders who are directly and indirectly involved at the school. * Developing hygiene education methods and materials that are simple, inexpensive and'' culturally acceptable'' and therefore the most feasible to implement. * Implementing learning tools and games that do not require any external materials, such as printed and plastified tools, but that use what is already available in the school, such as slates, chalk, a blackboard, paper, sand, water, pebbles, local seeds, etc. * Designing and selecting educational methods in line with development stages of children'' to increase knowledge'', build positive attitudes and values, dispel myths, increase skills, and promote the reduction and prevention of water and sanitation related diseases. Can I get an example of lifeskill-based SSHE? Topic: School sanitation In dry areas, skin and eye diseases are common. More frequent washing and bathing can prevent their transmission. At the same time, societies where water is scarce often have cultures that discourage frequent washing and bathing. Boys and girls who want to wash their eyes and skins more often, and do the same for their younger brothers and sisters may get scolded by their mother, father and other relatives for doing so. A SSHE programme that encourages face washing and bathing must therefore address the attitudes, knowledge and practices in the cultural context by, for example, * Identifying with the children how common eye and skins diseases are and how they spread (knowledge development) * Identifying with the children what social and economic consequences these diseases have (social knowledge, attitude about importance of prevention) * Creating a practical understanding how washing eyes and skins can prevent infections and their spread (attitudes about feasibility of prevention, knowledge of reasons of prevention) * Trying out with the children how much water is needed to wash one's eyes and skin (practical skill of economic water use for hygiene) * Calculating, with the older children, how much extra water is needed for daily practices (knowledge of amounts of water involved) * Discussing who will do the extra water collection, what consequences this has in better off and poor families, and what solutions are possible (understanding of social and gender problems, development of problem solving skills) * Introducing a daily eye washing routing in school, while avoiding the creation of new risks, e.g. by drying eyes with a shared towel * Helping the children share the insights with their parents * Building, with older girls and boys, a simple bathing facility * Encouraging that students do a community project for the creation of bathing facilities and assess its impact by a simple before-after community survey * Having a meeting with the parents in which the children demonstrate their knowledge, skills and practices and parents discuss the promoted change Participatory tools and techniques that you may wish to use in your lesson plan: * Open plenary discussion * Small group discussions with result presentation in plenary * Making a (group) story that links a social problem (such as blindness) to problems of water scarcity, water collection work and personal hygiene * Doing an experiment: how many children can wash their eyes with 1 l. of water? * Doing a competition: how many children in two groups can do so? * Planning a face washing routine in school with the children * Planning a monitoring system for the facewashing routine * Helping students establish a knowledge/attitude/skill sharing activity with the parents * Helping students design low-cost washing and bathing facilities (incl. drainage) * Helping them build a low-cost washing and bathing facility (incl. drainage) * Helping students do a survey of the presence and types of facilities in the village * Assisting students to undertake a washing and bathing promotion project How do I check the quality of my lifeskills-based approach? Topic: School sanitation For the content the following questions may be asked about the SSHE programme: * Is the content relevant to the hygiene needs of the students? * Is the content related to the age and the interests of the students? * Is the content realistic, given the human and material resources available? For the use of the content the following: * Is the content effectively followed and thought out? * Is the time available managed adequately? * Are messages reinforced, where possible, across the curriculum? * Is there evidence of imagination and flexibility to meet changing needs and interests? For the methodologies and approaches used the following: * Are effective and challenging methods and materials being used? * Do they involve children not only in doing the activity but also in active learning and thinking? * Do they make learning enjoyable and interesting? * Do they involve all children and not just some of them? For the extension into school, home and community the following questions can be asked: * Do methods and learning materials link learning in the classroom with life skills at home and the community? * Does the programme effectively aim to complement classroom teaching with regular activity around the school? * Is learning in the school transferred through joint school/community activities, or less formal trough child to child activities? * Are children involved in planning community activities rather than merely carrying out a programme entirely designed by adults? * When activities are taken to the community, are cultural acceptable approaches being used? For the interest, attitudes and appearances of the students: * Are students interested in making their school a hygienic school? * Do they try to make other children hygiene conscious? * Do they try to promote good hygiene habits in others? * Are they fair and do they divide the tasks equitably, or do they, or teachers, pick on certain types of students such as those from poor families, younger or less popular children, girl? For the interest and attitudes of the teachers: * Do teachers understand the new ideas and are they committed to them? * Do they themselves set good hygiene examples? How do I include outreach activities without overburdening my programme? Topic: School sanitation Outreach is important to ensure that children not only have a healthy school environment, but that home and community environments improve at the same time. It is frustrating for children when they learn in school why and how to practice hygiene, but are not be able to practice what they have learned in their homes. It also means that the benefits of health and hygiene education cannot be optimally realised. Often, simple improvements are needed to reduce risky conditions and practices in the home and neighbourhood environment. Creating awareness, identifying problems and enhancing problem-reducing action can be sufficient to make measurable changes. Actions include improvements by the children themselves as they often look after younger siblings outside school hours. Teachers have fostered such changes without overload for their own programme by giving children simple assignments to carry out at home and in their neighbourhoods. For example: * Young children have made drawings of how drinking water is stored at home. The drawings have been used in class to discuss safe and less safe methods to store and draw drinking water and understand how unsafe methods can make drinking water unsafe. The children then group the drawings into safe and less safe and discuss results at home. The teacher encourages children to tell about any improvements made. * Groups of older children have surveyed water or sanitation conditions in their respective neighbourhoods using a simple observation format. The teacher has used the data for a lesson on statistics during maths and for SSHE. A delegation of children showed the results to the local leadership and discussed follow-up action. A follow-up visit and survey is agreed on to check what improvements have been made. One follow-up action in one Tanzanian community was that standard VI boy students helped several elderly couples who had no latrine because they had nobody to dig the pit, construct a simple pit latrine. SSHE programmes also offer excellent opportunities for parents� participation. Parents have participated in explanations and demonstrations of different types of latrines, have helped improve local facilities in schools, have come to children's plays, concerts and art and craft exhibitions on themes of sanitation, water and hygiene and have assisted their children to assess and improve conditions and practices at home. The improvement of hygiene behaviour of school kids as well as the improvement of the school sanitary conditions may already have a positive impact on the health and hygiene condition of the community as a whole. The impacts increase when linked with simple improvements and risk reductions in the homes and neighbourhoods. What are the main criteria in selecting a technology for municipal/small town wastewater treatment? Topic: Small communities A technology should: * be appropriate to local institutional and technical conditions; * fulfill the expectations of the users and whenever feasible be used for productive purposes; * be affordable to those who must pay for the investment and services; * be environmentally sound, i.e. not polluting the environment or create unacceptable health risks, and meeting the �Closing-the-Loop� principle; * be applicable and efficient in the context of the entire river basin. Other aspects to consider during the technology selection process are: # technical performance and reliability (under variable wastewater flows, compositions and operational problems); # institutional manageability (planning, design, construction, operation and maintenance capacity, including local availability of skilled human resources); # involvement of the larger private sector companies and small and medium-sised enterprises; # investment, operation, and maintenance costs; # workable policies and regulations; # possibilities for enforcement; # awareness and the need for changes in behaviour of households and municipal staff. What is the difference between centralised and decentralised wastewater treatment and what are typical centralised and decentralised technologies? Topic: Small communities An overall good principle in wastewater management is to �close-the-loop� as near as possible to the location of production of the waste (Bellagio Principles). Then multiple benefits of such decentralised wastewater management can be gained, including that it: * broadens the technology options and permits tailoring the solutions to the prevailing conditions; * minimizes the freshwater requirements for waste transportation; * reduces the risks associated with system failure; * increases wastewater reuse opportunities; and * permits incremental development and investment in the community wastewater system. See also: Kalbermatten Associates (2002). Implementing the Bellagio Principles : provisional guideline for decision-makers: draft outline. [Decentralised wastewater treatment (DEWAT). Although centralised waste water treatment has been successful in densely populated urban areas of industrialised countries, it may not be feasible or sustainable for municipalities and small towns in developing countries. However, decentralised systems are not commonly accepted by planners and designers, mainly for financial and treatment efficiency reasons. This may be partly true but on the other hand the advantages are numerous (see above), therefore the potential is great. Increasingly, decentralised approaches are being used and for districts in larger cities they can complement centralised systems of the city centres. Common centralised wastewater treatment systems include: * waste stabilization ponds (WSP); * duckweed ponds; * wastewater storage and treatment reservoirs (WSTR); * constructed wetlands (CW); * chemically enhanced primary treatment (CEPT); and * upflow anaerobic sludge blanket reactors (UASBs). Common decentralised wastewater treatment systems include: # on-site sanitation and grey water disposal and treatment systems (VIP latrines; ecological sanitation systems; pour-flush toilets connected to septic tanks with anaerobic upflow filters); # condominial systems (shallow sewerage with small wastewater treatment); and # off-site wastewater systems (separated flow of grey and black water; the former to be infiltrated or used after basic treatment on-site; settled sewerage (shallow and small-bore sewerage) with reed/grass-bed treatment (constructed wetlands). Are septic tanks a suitable low-cost solution for urban areas? Topic: Small communities Simple septic tanks can, for instance, be introduced as a decentralised, on-site treatment system at household or, at most, block level. However, septic tanks alone usually do not provide a sufficient degree of treatment of the sewage received. The liquid effluent that leaves a septic tank usually needs to be purified first, through infiltration in soil or through storage in reservoirs, a process that requires relatively much space. Soil infiltration methods include soak-away pits, sub-surface perforated pipes surrounded by gravel and above-surface evaporation mounds where groundwater tables are high or flooding prone. The wastewater generated may exceed the capacity for ground infiltration while there is a risk of groundwater pollution and soil destabilization (affected by factors such as ground porosity, slope, and high water tables). In urban areas with higher water consumption rates and population densities, and thus a lack of space, wastewater usually needs to be collected and treated elsewhere in decentralised or centralised, off-site systems. The decentralised systems may meet the Bellagio principles when the wastewater is used as a resource (nutrients and water) for productive purposes and recharging the groundwater aquifers. Another household-centred sanitation option is to introduce ecological (dry) sanitation with a separation of dry faeces and urine. This eco-latrine concept has the added advantage of energy and nutrient recovery for productive use, and no water consumption. Crop farmers and aquaculture farmers and the municipal gardens department may be interested in the products. Are conventional wastewater treatment technologies always the best choice? Topic: Small communities Conventional treatment technologies do not necessarily provide better treatment efficiency than natural treatment systems. Low-cost, natural systems are easy to operate and virtually maintenance-free and therefore always recommended over mechanical systems when they will be effective enough and space is available. Natural systems such as wetlands and duckweed ponds also produce marketable products (reed, cattle fodder) that contribute to poverty alleviation. What are the benefits of pollution prevention in wastewater management? Topic: Small communities By reducing domestic water consumption, generating less polluted wastewater at the source, and using separate collection systems for different quality water: * less use of water which is a scarce source in many countries; * wastewater becomes easier to treat; * smaller, lower cost water supply and wastewater systems are required; * development of dry sanitation systems is stimulated; * waste components can be more easily recovered and re-used; and * wastewater of different quality can be re-used effectively for different purposes. Although the higher concentration/density of waste in wastewater is preferred, there is a trade-off because the wastewater needs to flow in the sewers; it needs to be water-borne waste discharge. Shallow and small-bore sewerage systems may face the problem of blockage. Pollution prevention and waste minimization, also referred to as cleaner production or source reduction, can reduce or even eliminate the need for investment in end-of-pipe treatment technology. As a rough guide, 20 to 30 percent reductions in pollution can often be achieved without any capital investment, and additional reductions of 20 percent or more can be achieved with investments that have a payback period of only a few months. Which low-cost options are available for sewerage in developing countries? Topic: Small communities There are two low-cost sewerage technologies: * Settled sewerage - also known as small-bore sewerage and solids-free sewerage , and * Simplified sewerage - also known as condominial sewerage, occasionally as backyard or in-block sewerage Settled sewerage is a means of conveying domestic sewage which has been settled in a septic tank (sometimes referred to, in this context, as a solids interceptor tank).The sewer roughly follows ground contours and the flow in the sewer is allowed to vary between open channel flow and pressure (full-bore) flow. Settled sewerage construction costs are typically 20�50 per cent less than those of conventional sewerage in the rural USA. In areas with existing septic tanks, the cost reduction will be higher, 40�70 per cent. Simplified sewerage collects all household wastewaters (WC wastes and sullage) in small-diameter pipes laid at fairly flat gradients. It is suitable for existing unplanned low-income areas and new housing estates with a more regular layout. How do you deal best with stormwater during rain storms in low-income areas? Topic: Small communities In low-income areas stormwater drains often also function as solid waste disposal areas. Solid waste needs to be removed from the drains to prevent them clogging up, flowing over and flooding the surroundings with litter and polluted water. Stormwater flows during rain storms can be attenuated by using basins and ponds. This allows control of flows downstream, while these basins or ponds also act as infiltration devices. Detention time is of the order of two to three weeks. Run-off water quality is improved during storage in such basins or ponds because of sedimentation of solids, bacterial action and nutrient uptake by vegetation. Water stored in ponds can also be used for irrigation of parks and gardens or for fire-fighting and other purposes. One has to realize, however, that stagnant water enhances the development of mosquitoes thus increasing health risks. Slum improvement needs to include pavement and improvement of stormwater and wastewater drainage. This requires the participation of fully motivated stakeholders. Properly planned and implemented �alley� pavements may motivate people to further upgrade their housing and to maintain a better and hygienic house and street environment. Which systems are available for wastewater reuse? Topic: Small communities Integrated systems combine processes and practices to optimize resource use by recycling wastewater so that water, nutrients, and possibly other components (like clean sludge) can be re-used. Wastewater collection needs either to separate wastewater flows from households and from industries and institutes (such as hospitals) discharging chemically polluted wastewater or to reduce this chemical pollution by treatment at the source. Conversion processes for different sources of wastewater are set up in such a way that minimum inputs of external energy and raw materials are required and maximum self-sufficiency is achieved. To prevent toxic components from polluting bio-solids or sludge, these components should be retained at the source as much as possible. Clean bio-solids can be used in agriculture as fertilizer and to improve the soil structure. Examples of integrated systems include wastewater-fed aquaculture (e.g. for fish production) and duckweed-based wastewater treatment, which combines natural wastewater treatment with duckweed harvesting to feed fish. A more radical approach is ecological sanitation or �ecosan�. This is a cycle, or closed-loop system, which treats human excreta as a resource. In this system, excreta are processed on site until they are free of pathogenic (disease-causing) organisms. Thereafter the sanitised excreta are recycled by using them for agricultural purposes. Which technologies are used in conventional wastewater treatment? Topic: Small communities Conventional wastewater treatment can be divided into four treatment steps: Primary or mechanical treatment � involving the physical settlement of solids in sedimentation tanks. The treatment consists of screening and grit removal to eliminate sand, gravel and other coarse solids from the influent wastewater stream, followed by a gravity separation process to remove suspended solids (which settle at the bottom as sludge). Sludge is usually removed from tanks by simply opening a valve at the bottom which has steep slopes towards the centre. The sludge then leaves the tank through a pipe and is then further treated. Secondary, biological treatment � aimed at the removal of soluble biodegradable organic matter through biological degradation. Such treatment processes can be aerobic or anaerobic or a combination of the two. Aerobic processes use bacteria and other organisms that feed on waste products and break them down, using oxygen from their surroundings; anaerobic processes use bacteria that obtain the oxygen they require from the materials on which they are feeding. Tertiary treatment - aimed at the removal of nutrients (nitrogen and phosphorous) and disinfection. Phosphorous removal processes involve either the addition of chemicals to precipitate phosphorous or controlled biological reactions to grow bacteria with high phosphorous levels and settle them out. Nitrogen removal is based on biological reactions to convert ammonium and organic nitrogen into nitrate (nitrification) and then into gaseous nitrogen (denitrification). For disinfection chlorine or ultraviolet light can be used. Sludge management � aimed at the treatment (or stabilization) and disposal of sludge. Sludge stabilization by digestion is the process of BOD reduction (decomposition) that can take place under aerobic or anaerobic conditions. Aerobic stabilization requires less energy when carried out as part of a composting process. Anaerobic digestion produces biogas, a mixture of methane and carbon dioxide, and is the most commonly used process for sludge treatment. Digested sludge requires de-watering before its final disposal. If concentrations of heavy metals and toxic organics are below admissible standards, the de-watered sludge can be used for soil structure improvement and as fertilizer; if concentrations exceed these standards, sludge is placed in landfills or is incinerated. School/community sanitation 1 Page 4 SECTION 1. WHAT IS SANITATION, AND WHY DOES IT MATTER? Q: What do we mean by “sanitation”? 3 Q: What do we mean by “good sanitation”? 3 Q: Why does good sanitation matter? 3 Q: What is needed to achieve improved sanitation? 3 Q: What are the advantages of good sanitation behaviour? 3 SECTION 2: SANITATION, HEALTH AND HYGIENE Q: What is sanitation promotion? 4 Q: What is health and hygiene promotion? 4 Q: How do sanitation-related illnesses get transmitted? 5 Q: How can sanitation improvement be integrated into broader health improvement programmes? 5 SECTION 3: PLANNING SANITATION IMPROVEMENTS Q: What is the IDP? 5 Q: How can we use IDPs and WSDPs more effectively to promote planning and budgeting for sanitation? 6 Q: Who should be involved in decision-making around sanitation improvements? 6 Q: When will a common database be available to municipalities to share information? 6 Q: What are the key performance indicators of the sanitation projects? 6 Q: When will the people who need better sanitation have access to it? 7 SECTION 4: FUNDING AND RESPONSIBILITIES Q: Who is responsible for better sanitation? 7 Q: What are the roles and responsibilities of Local Government? 8 Q: What funding is available for sanitation projects? 8 Q: How do we access the funding for sanitation projects? 8 SECTION 5: SANITATION SERVICE OPTIONS Q: Why do we need alternatives to conventional water borne sanitation? 9 Q: What are the alternatives to conventional water-borne sanitation ? 9 Q: What approaches to sanitation are appropriate in informal settlements? 10 Q: How does the level of water service impact on the choice of toilet technology? 10 Q: How do we address and rectify non-functioning infrastructure? 10 SECTION 6: OPERATION AND MAINTENANCE Q: What steps can a municipality take to promote understanding among users? 11 Q: What steps can a Municipality take to ensure that it makes adequate provision for the costs of operating? 11 SECTION 7: PROTECTING GROUNDWATER Q: How can on-site sanitation systems pollute groundwater? 12 Questions and Answers in this booklet 2 Page 5 Section 1. What is sanitation, and why does it matter? Q: What do we mean by “sanitation”? A: Sanitation is any system that promotes sanitary, or healthy, living conditions. It includes systems to manage waste water, storm water, solid waste, and household refuse and it also includes ensuring that people have safe drinking water and enough water for washing. Here we focus on the safe management of human excreta. Sanitation includes both the ‘software’ of understanding why health problems exist and what steps people can take to address these problems, and ‘hardware’ such as toilets, sewers and hand-washing facilities. Together, they combine to break the cycle of diseases that spread when human excreta and waste are not managed properly. Q: What do we mean by “good sanitation”? A: Good sanitation refers to the appropriate behaviour and practices of the people living in a specific environment • The people know to avoid contact with human excreta and to hygienically dispose of human waste. • The people’s behaviour displays a responsible attitude towards the hygiene of their families, the community, and the environment. By being a responsible and hygienic individual you make sure that you do not spread diseases. Q: Why does good sanitation matter? A: The cholera epidemic has focused attention on the importance of good sanitation in breaking the cycle of diseases spread by human excreta. Poor sanitation: • promotes the spread of health problems - including chronic diarrhoea, intestinal worms, bilharzia, hepatitis, and scabies - that can lead to malnutrition and stunting, especially in small children. • places extra stress on the weakened immune systems of HIV positive people, accelerating the shift to full-blown AIDS. • has a major impact on the quality of life of people with AIDS, and the quality of life of those around them. Sanitation matters for a range of other reasons too: • privacy, dignity, convenience and safety for individuals. • pollution impacts, especially on water sources. • poverty reduction, through reducing vulnerability to disease and allowing low-income people to make better uses of their resources. For all these reasons good sanitation is an essential part of community development. Q: What is needed to achieve improved sanitation? A: Toilets are an important part of achieving good sanitation, but without proper public understanding about why sanitation matters, and what is necessary to achieve good sanitation, toilets are not enough to break the cycle of disease. Good sanitation is achieved when everyone in a community understands the health importance of safe excreta disposal, and takes the necessary practical steps to promote good personal hygiene and public health. This includes access to, and consistent use of, a safe and hygienic toilet. From the Municipality’s point of view, a sanitation improvement programme starts with a strong local health team that can identify local sanitation-related health problems and work with residents to remedy them. Key issues are poor hygiene practices, such as open defecation; contamination of water sources; malnutrition caused by worms or ongoing diarrhoea, lack of safe and hygienic toilet facilities, lack of facilities for hand washing and inadequate refuse removal. It is crucial to promote understanding of the linkages between water, sanitation, hygiene and health. Q: What are the advantages of good sanitation behaviour? A: • increased life expectancy with reduced morbidity and child mortality. • savings in health care costs. • reduced sick leave and higher worker productivity. • better learning capacities among schoolchildren - increased school attendance, especially by girls. • national pride and strengthened tourism. • reduced water treatment costs. 3 Page 6 Section 2: Sanitation, health and hygiene Q: What is sanitation promotion? A: Sanitation promotion describes a number of different activities that make up an effective approach to improving sanitation. These include: • Creating demand for better sanitation in communities through programmes which raise awareness about why sanitation is important. • Providing consumers with information about a range of sanitation options. • Building and upgrading existing toilets. • Promoting health awareness and safe hygiene practice. • Providing users with information about their toilets to ensure that they are well maintained. • Monitoring and evaluation to assess the impact of programmes and suggest changes where necessary. Effective sanitation promotion involves teamwork and co-operation within a municipality. Key people here include: • The Environmental Health Officer (EHO) - an outreach worker in communities who is responsible for education about, and protection of, public health. • The Community Development Officer (CDO), who is responsible for community liaison and community development. Development facilitators play a critical role in strengthening and clarifying relationships between individual household members, local government and all other roleplayers involved in achieving better sanitation. • The District Primary Health Care team, which is responsible for disease prevention and health promotion. • Technicians and engineers, who plan and oversee the development of sanitation infrastructure. Municipalities need to establish local sanitation teams to help co-ordinate sanitation activities, maximise resources and improve communication. There are six key tasks that face any Municipality setting out to promote improved sanitation: • Identifing what problems poor sanitation is causing, and developing a coherent strategy to address them. • Ensuring effective collaboration between the EHOs and the technicians who have traditionally managed sanitation. This could be within the local municipality, or with the provincial or regional environmental health service. • Ensure that the environmental health service has the resources to work in communities. Often EHOs do not have access to transport and this severely limits their ability to be effective. • Identifing and organising training opportunities for staff. This includes training in sanitation promotion and in new skills such as community education and research. Visiting successful sanitation projects in other areas is an excellent way of learning. • Ensuring that community education happens - either by providing training for EHOs and other community level workers, or by tendering work to non-governmental organisations (NGOs) and other agencies. • Ensuring that sanitation promotion is informed by a thorough understanding of local practices and local belief systems. Municipalities should assess local needs and priorities, provide baseline information, and evaluate work already undertaken. EHOs, NGOs and other agencies have a valuable role to play in working with local residents to identify problems and appropriate remedies. Q: What is health and hygiene promotion? A: Without safe hygiene practices, health benefits from better water and sanitation services will be limited. Hygiene promotion has a positive impact on health even without improvements in water and sanitation services! Hygiene promotion is mostly about changing people’s hygiene behaviour, a difficult and often slow process. It begins with working with local residents to understand their beliefs, practices, and problems, and raising awareness of the impacts of poor sanitation. Residents work with support teams to devise appropriate remedies. Hygiene behaviours can be divided into five main areas: • Safe disposal of human faeces. • Protection and use of water sources. • Home and environmental hygiene. • Water and personal hygiene. • Food hygiene. 4 Page 7 Education about how to maintain and care for toilets is often part of hygiene education. Key elements of a good hygiene promotion programme include: • Close interaction between local residents and support teams to identify a specific local problem or behaviour as the priority target. • Household participation in identifying problems and needs and in finding solutions for those problems and needs. • Development of an effective communication or education campaign. • Local level advocacy work. • Evaluating the impact of the programme. The best way to start a hygiene promotion programme is to understand local hygiene-related health problems and then identify one simple hygiene behaviour improvement goal as the target. Don’t overload communities with too many messages! Q: How can sanitation improvement be integrated into broader health improvement programmes? A: Good sanitation is an essential part of primary and preventative health care, and hygiene promotion is just one aspect of health promotion. All health programmes use the same approach of research, education and advocacy. One method of strengthening both a hygiene and sanitation promotion programme is to link it with other health promotion projects. In this way, staff gain skills and expertise more quickly and available resources can be shared. Complementary health promotion programmes are: • Promotion of breast-feeding. • Food hygiene education. • Prevention of TB. • Home-based care services, especially around caring for people with AIDS. Section 3: Planning Sanitation Improvements Q: What is the IDP? A: The Integrated Development Planning (IDP) process is the mechanism for deciding on priorities and for steering and co-ordinating service delivery. In order to plan for addressing the sanitation backlog, the IDP must at least show: • the existing service levels available to households. • proposed new service levels per household. • that health and hygiene education are to be provided. • estimated capital and recurring costs of providing these services. • cost to households for service payments. • availability of grant funding. • the implications for the overall municipal budget; and • how the service impact of the investment will be measured and monitored. WSDP is a component of the IDPS. 5 Disease transmission paths Waste and Excreta Fingers Flies Food Water Open Fields (Veld) New Host (People) Cholera Diarrhoea Various other ailments Q: How do sanitation-related illnesses get transmitted? A: Page 8 Q: How can we use IDPs and WSDPs more effectively to promote planning and budgeting for sanitation? A: Municipalities need to have a coherent, integrated sanitation strategy for all areas under their jurisdiction. At present, there is often one approach and funding mechanism for rural areas, and quite another for urban areas. Rural local government - assisted by DWAF - implements rural sanitation programmes based on VIPs and health and hygiene promotion. In urban areas, the municipality often works with infrastructure grants (such as CMIP), with greater emphasis on conventional water-borne sanitation. District municipalities are now responsible for all areas under their jurisdiction, and they need one coherent strategy to address the range of settlement types. There will obviously be differences in different types of settlement, but there needs to be a common objective with consistent priorities and equitable funding support. Municipalities must be able to demonstrate in their IDPs and WSDPs that any new sanitation installation they plan is sustainable in the long term. Q: Who should be involved in decision-making around sanitation improvements? A: Poor sanitation is often seen as a technical problem that requires a technical solution. But sanitation problems are often caused by people’s beliefs, preferences or habits, and any sanitation programme that does not take these into account will have no lasting impact. Councillors, professional planners, housing experts, engineers and financial officials all make valuable contributions to achieving better sanitation services - but the most important decision-makers are the residents themselves, the people who will have to live with the system and pay for it. Sanitation decisions in new urban developments are often taken by housing specialists who put in flush toilets without considering the range of other technical options available, and without considering whether the waste treatment works has spare capacity, whether the sewer system can cope and whether the new occupants will be able to afford their monthly service charges. Residents need to be closely involved in planning new settlements and upgrades to services in existing settlements. Municipalities need to ensure that residents have the information they need to explore the range of options open to them, and to assess the implications of those choices. Flush toilets are most people’s first choice - but this choice is not always informed by accurate information on the monthly costs of water-borne sanitation. In an urban area, sanitation is just one service among several, alongside electricity, water, roads and so on. Residents need to be able to decide what their service priorities are and what level of service they can afford. Q: When will a common database be available to municipalities to share information? A: A common database accessible by municipalities as well as provincial and national government is to be developed as a platform for the sharing of performance monitoring information. A date has not yet been determined. Q: What are the key performance indicators of the sanitation projects? A: The key performance indicators will direct the attention of the project leaders towards specific areas in need of attention. These are normally also the areas that will be measured for performance purposes. The indicators have not been identified as yet but all parties will be notified in due course as to the key performance indicators and on how to interpret them. Key performance indicators will be developed for each of the broad categories. Data collection and measurement will take place at the lowest practical level. The data collected must be evaluated, interpreted, summarised and reported on to the various spheres of government through the co- ordination structures. These structures are developed at local level to drive the IDP, the WSDP and Provincial Forums, as well as at the NSTT. The target turnaround time is: • 30 days for municipal to provincial reporting against the key performance indicators, and • a further 30 days for provincial to national reporting. 6 Page 9 Q: When will the people who need better sanitation have access to it? A: This process has been under development since 1994 and the target for clearing the sanitation backlog is aligned with the Integrated Sustainable Rural Development Programme (ISRDP). The State President’s Office indicates that, by March 2010, all South Africans must have access to a basic minimum level of sanitation. With adequate integrated planning and integration of resources it may be possible to reach the target by 2008. Section 4: Funding and Responsibilities Q: Who is responsible for better sanitation? A: Good sanitation starts at home with individual household members taking responsibility for hygienic disposal of their excreta and household waste, and for good basic health practices. The local authority is responsible for ensuring safe disposal of the excreta and waste of the community as a whole, as well as promoting hygienic behaviour. In an urban area, high settlement densities mean the sheer volume of waste generated (excreta, dirty water, household waste, industrial waste etc) has to be managed closely to prevent public health problems. For this reason the local authority runs sewage collection, treatment and disposal systems, waste collection, water treatment works and so on. It has complex administrative systems to recover the costs of these services, including meter readers, billing mechanisms, payment offices and credit control measures. In less densely settled areas, waste disposal can usually be managed with far simpler systems - for example, on-site latrines (VIPs, desiccating (drying) toilets, aqua-privies or septic tanks), soak-aways for waste water and communal pits for burning or burying waste. Good sanitation is achieved through a partnership between individual households and government, with support from NGOs, CBOs and the private sector. 7 These Ventilated Improved Pit (VIP) toilets were built by members of the community who received training from NGOs and the local authority in their area. The bricks used in their construction were made by members of the community. Page 10 Q: What funding is available for sanitation projects? A: Lessons learnt have shown that basic sanitation services can be provided at a capital (input) cost of below R1000 per household. The cost of operating a basic level of service is approximately R5 per household per month or R60 per household per year. The sources of funding available to a municipality include: • the Equitable Share subsidy; • infrastructure grants; and • the municipality’s own revenue. Equitable Share subsidy The Equitable Share subsidy was introduced to allow the local government sector to overcome the burden of service delivery to the very poor. The Equitable Share subsidy is calculated to ensure that the operating cost of basic services can be covered. A subsidy will be used to contribute towards the general operating account of a municipality when the municipality does not recover costs from very poor households. Infrastructure grants and the requirement for rationalisation If municipalities are going to be responsible for driving development, then they must have effective control over their resources. Existing financial obligations (projects in process) will, however, be honoured and National Departments will be given a period of at least three years to complete ongoing municipal infrastructure projects. Currently the Department of Water Affairs and Forestry provides a once-off sanitation subsidy. This is divided into R300 for community development and R900 for the basic toilet structure. The total subsidy is therefore R1200 per household. There may continue to be a need for dedicated funding for specific projects and programmes, for instance the demonstration of low cost sanitation interventions. Municipality’s own revenue The municipality will need to ensure that the services it delivers are sustainable both with regard to delivery and the payments received, i.e. cost recovery. Q: How do we access the funding for sanitation projects? A: Funding has to be applied for through the local authority. The local authority will, in turn, apply for funding from the provincial and national government. Projects are being planned for and prioritised on local level and it might take some time before a project is implemented. Q: What are the roles and responsibilities of Local Government? Identify local sanitation problems Prioritise these problems 1. 2. Plan to tackle these problems within IDP/WSDP 3. From the start ensure long-term sustainability at a planning level 4. Align budgets 5. Ensure sufficient human resources, or make interim plans 6. Implement the plan starting with... 7. Creating demand 8. Monitor and report 9. Provide appropriate support to ensure ongoing sustainability 10. 8 A: Page 11 Section 5: Sanitation Service options Q: Why do we need alternatives to conventional water-borne sanitation? A: More and more municipalities in South Africa are exploring alternatives to conventional water-borne sanitation. Simply maintaining the infrastructure already in place is a huge challenge for municipalities having to deal with restructuring, staff shortages and budget cuts. Municipalities are struggling to reduce the housing backlog, while the rapid growth of informal settlements on the edges of towns is putting huge pressure on service delivery. Many local authorities resort to ‘temporary solutions’ such as bucket systems and chemical toilets. These are unpopular with residents, expensive to run, and often remain in place for years. Even if a municipality is committed to providing flush toilets for all, this may take many years to achieve. High capital cost, lack of water, no spare capacity in the treatment system, difficult terrain and a range of other issues can all rule out provision of flush toilets in the short term. Lack of money for new works is not the only constraint! Affordable, sustainable and acceptable options are needed in the interim. Water-borne sanitation is a ‘high investment, high risk’ sanitation technology. Flush toilet systems offer high status and great convenience, but they are expensive to install and complex to maintain. If sewers block or leak, and if the treatment plant breaks down, the health and pollution impacts can be far worse than a breakdown in a simpler system. Maintaining high levels of service involving complex technology places greater technical, managerial and financial burdens on the municipality. Simpler systems offer ‘lower investment’ or ‘lower risk’. Residents need to be able to select from a range of affordable choices. Even with a rebate for indigent households, the cost of a high level of service may still be too much for a poor family. If they cannot afford to pay their municipal service bills, they fall into arrears, and then face cut-offs. Once disconnected, some cannot afford to reconnect. A municipality is not serving its residents well if the services it provides are not affordable. Q: What are the alternatives to conventional water-borne sanitation? A: Sanitation technologies are often reduced to just two choices: full flush toilets, or VIPs. In fact, there are a range of alternatives in use in South Africa - double pit VIPs, desiccating (drying) toilets, urine diversion systems, low flow systems, shallow sewers, solids free systems and so on. There is no one ‘best option’ - each situation has its own needs and every technical option has its place and functions best in the environment it was designed for. Decision-makers need to familiarise themselves with these options, and understand their particular operating requirements, cost implications and limitations. They should then share this information with users and involve them in decision-making around service options. In South Africa there is an urgent need to learn from other countries facing similar challenges, and to adapt their experience to local conditions. Simply transplanting the technology, without addressing the political or social factors that explain its success elsewhere, is a recipe for failure - and South Africa has had its share of failures. A technology is only as effective as the way people use it. 9 The full bore waterborne sewerage options require fully functioning wastewater treatment facilities. The health consequences of failure of the system are devastating in comparison to on-site, dry sanitation. Page 12 Q: What approaches to sanitation are appropriate in informal settlements? A: There is an urgent need for municipalities to develop coherent and affordable strategies for informal settlements and peri-urban areas. Settlement densities are often high, and this increases the need for effective sanitation, health and hygiene promotion programmes to maintain good public health. Bucket systems and chemical toilets are often installed as a short-term emergency measure - but many remain in place year after year. They are very expensive to run, unpopular, and pose a number of health risks to users and sanitation workers. Communal toilets should be avoided wherever possible. Shared toilets get dirty very quickly, so residents stop using them. What often happens in practice is that a few individuals take responsibility for keeping the communal toilet clean, and then lock it and keep it for own use, excluding others who also need safe and attractive facilities. Informal settlements are likely to be a feature of the urban landscape for the foreseeable future. High level services are unlikely to be affordable or sustainable. It is essential that municipalities work closely with residents in assessing the range of possible toilet technologies so as to ensure that users understand and accept the implications of any decision around service levels. Q: How does the level of water service impact on the choice of toilet technology? A: Local authorities need to think carefully about the kind of water supplies they provide in a settlement because this has a big impact on the kind of sanitation systems that will be viable. The level of water supplies provided needs to match the sanitation technology. If residents cannot afford the monthly running costs of conventional flush toilets, the local authority should think carefully before installing high-pressure house connections. On small stands where households consume less than 200 litres of water per day, household VIPs work best with standpipes. Depending on soil type, 200l per day is the most a soak- away can absorb. The more water you bring on to a plot, the more important it is to think about how you will manage wastewater. Managing wastewater is an integral part of good sanitation - dirty water smells, can contaminate water sources, and is a breeding ground for diseases. Q: How do we address and rectify non-functioning infrastructure? A: Where infrastructure is not functioning properly (eg. blocked or broken sewer pipes, full VIP toilet pits), the first requirement is a socio-economic assessment of why this is the case and whether the infrastructure provided is the most appropriate for the situation. The rectifying of such infrastructure should then follow exactly the same development processes as for the provision of new sanitation facilities. 10 Local resources are being used for the construction of toilet facilities. Page 13 Q: What steps can a municipality take to promote understanding among users? A: Residents are responsible for maintaining toilets, pits, pipelines and sewers within the boundaries of their property. Yet many users believe that if they pay the municipality a monthly fee for water and sanitation, the municipality should fix their toilet when there is a problem with it. Misunderstandings can lead rapidly to resentment and malfunction. Any toilet system needs basic maintenance. Keeping it clean, understanding what repairs and replacements will be needed, and understanding its weak points, are all essential. For example, pit latrines should not be used for household refuse as they then fill up quickly; flush toilets block easily if coarse or bulky cleaning materials are used and many users are not aware that a sewer pipe is much narrower than a manhole cover. Providing this information needs to be an integral part of any sanitation improvement programme. Education programmes aimed at schools are one of the most effective ways of reaching all residents, as scholars take the message home with them. Section 6: Operation and maintenance 11 Q: What steps can a Municipality take to ensure that it makes adequate provision for the costs of operating? A: Keeping a sanitation system functioning well is as important as installing it in the first place - whether it is a stand-alone VIP or a town’s entire sewerage network. Once the system is in place and in use, it needs to be kept running; if funds are not set aside and used for regular maintenance, the system will slowly deteriorate until it breaks down. The capital cost is only one aspect of the total cost. It is essential that the municipality has a clear understanding of the full lifecycle costs of the system - including interest on any loans used to install the system, regular maintenance and refurbishment. User tariffs must meet these costs, and effective cost recovery measures must be in place. All too often when there is a cost recovery shortfall, maintenance is one of the first costs to be cut. Decision- makers need to be made aware of the high cost of system failure in terms of public health and environmental disaster. It can cost as much to rehabilitate a failed system as it does to install an entire new system. The Archloo is one of the options provided to cholera affected areas. Health and hygiene programmes are also being presented to ensure health improvements. Page 14 F O R A H E A L T H Y N A T I O N A: On-site sanitation systems are a viable, lower-cost alternative to water-borne sewerage. There is a risk that they will pollute groundwater, particularly where they are situated very close to boreholes or in areas with a very high water table. For this reason, many insist that flush toilets should be installed instead to protect groundwater quality. However, flush toilets might not be affordable to the local authority or to users, and a poorly managed sewer system is a much greater pollution hazard than a poorly managed on-site system. Each situation must be assessed on its own merits. Decision-makers should consider the following: • Is the health risk of groundwater contamination from on-site latrines worse than the health risks of open defecation? • How polluted is the groundwater already? Is on-site sanitation the biggest polluter? Are people using this water for drinking? • If a flush system is installed, can it be maintained adequately to prevent pollution? Any sanitation system poses a potential pollution threat and a sewer system can contribute significantly to contamination of the environment and both ground water and surface water sources unless it is well constructed and well maintained. Water-borne systems tend to concentrate raw sewage, with a high pollution risk in the event of malfunction. • Can the design of the on-site sanitation system be modified to lessen the risk - for example, a lined pit or conservancy tank? Can the water supply system be modified so that drinking water is sourced from a ‘safer’ area? It is always cheaper to treat the water - for example, to chlorinate it - than to change the sanitation system to something more expensive. Strategic sources of good quality groundwater must be protected. Where the groundwater is already contaminated, greater pragmatism around on-site sanitation is appropriate. Section 7: Protecting Groundwater Q: How can on-site sanitation systems pollute groundwater? 12 Any toilet needs basic maintenance. Keeping it clean, understanding what repairs and replacements will be needed, and understanding its weak points, are essential. Page 15 National, provincial and local government follow an integrated community-based approach to ensure that households in rural areas will have access to basic sanitation facilities. Without proper understanding about why sanitation matters, and what is necessary to achieve good sanitation, toilets are not enough to break the cycle of diseases. Page 16 Who can be contacted? Department of Water Affairs and Forestry Ms T Mpotulo (012) 336 8811 xga@dwaf.pwv.gov.za Private Bag X313 Pretoria, 0001 Department of Health Zama Zincume (012) 312 0503/(012) 323 0796 zincuz@health.gov.za Private Bag X828 Pretoria, 0001 Department of Education Charles Sheppard (012) 321 5470/(012) 321 5478 ShepperdC@edu.pvw.gov.za Private Bag X895 Pretoria, 0001 Department of Housing Johan Wallis (012) 421 1440/(012) 341 2560 johan@housepta.pwv.gov.za Private Bag X655 Pretoria,0001 Department of Provincial and Local Government Zama Nofomela (012) 334 0750/(012) 334 0769 zama@dso.pwv.gov.za Private Bag X804 Pretoria ,0001 Department of Environmental Affairs and Tourism Lucas Mahlangu (012) 310 3536/(012) 320 1167 Imahlangu@ozone.pwv.gov.za Private Bag X447 Pretoria, 0001 Department of Treasury Simon Maphaha (012) 326 6311/(012) 315 5151 simon.maphaha@treasury.co.za Private Bag X115 Pretoria, 0001 Department of Public Works Lorraine Malebo (012) 337 2764 lorraine@dpw.gov.za Private Bag X65 Pretoria, 0001 SALGA Mr Thabo Mokoene (CEO) (012) 338 6700 / 29 tmokeena@salga.org.za PO Box 2094 Pretoria, 0001 National Sanitation Task Team DWAF Regional Offices WESTERN CAPE Lionel Visagie (021) 950 7152 odg@dwaf-wcp.wcape.gov.za Private Bag X16 Sanlamhof 7532 MPUMALANGA Richard Mbambo (013) 752 4183 6bc@dwaf.mpu.gov.za Private Bag X11259 Nelspruit, 1200 KWAZULU-NATAL Viv Naidoo (031) 336 2763 Naidoov@dwaf.kzntl.gov.za P O Box 1018 Durban, 4000 FREE STATE Gabriël Hough (015) 430 3134 4bj@dwaf.ncape.gov.za P O Box 528 Bloemfontein, 9300 NORTHERN CAPE Antonino Ross (053) 831 4125/(053) 831 5682 rossa@dwaf.ncape.gov.za P O Box 416 Kimberley, 8300 EASTERN CAPE Mfusi Mpendu (043) 643 3011 mpendud@dwaf.ecape.gov.za Private Bag X7485 King Williams Town, 5600 GAUTENG Johan Enslin (012) 392 1300 enslinj@dwaf-nuc.pwv.gov.za Private Bag X8007 Hennopsmeer, 0046 NORTH WEST Logogang Bogopa (018) 384 3270/(018) 392 2998 mochethandi@dwaf.pwv.gov.za Private Bag X5, Mmabatho, 2735 NORTHERN PROVINCE Masia Mgwambani (015) 290 1238/(015) 295 3250 mgwambm@dwaf-ptg.pwv.gov.za Private Bag X9506 Pietersburg, 0700