SuSanA - Forum Kunena Site Syndication Mon, 22 Dec 2014 02:03:49 +0000 Kunena 1.6 SuSanA - Forum en-gb Requesting for suggestions - by: Yogish
Presently am doing my research in low resource setting. so i want to know
1. Have any standard questionnaire to measure WASH and Under five
Morbidity pattern.
2. It’s difficult to measure both chemical and biological
contamination of water, have any suggestions for this how to
proceed further?
3. What all the things to be consider while measuring the morbidity
4. How clinically measure helminth infection?
4. As Geographic information system is new to me Where can i get Resource person

Thank you
Health issues and connections with sanitation Wed, 17 Dec 2014 17:00:06 +0000
Links between WASH and maternal and newborn health - by: F H Mughal
High profile institutions, like DFID, WHO, LSHTM, SoapBox and WaterAid, will launch today (15 Dec 2014) the PLOS Medicine paper “From joint thinking to joint action: A call to action on improving water, sanitation and hygiene for maternal and newborn health;” and a discussion on how water, sanitation and hygiene (WASH) can accelerate progress on maternal and newborn health, at the John Snow Lecture Theatre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT.

While the event will be chaired by Oliver Cumming (LSHTM), there will be renowed speakers like:

Ms Jane Edmondson (Head of Human Development, UK DFID)
Dr Maria Neira (Director of Public Health and Environment, WHO)
Professor Oona Campbell (LSHTM)
Professor Wendy Graham (University of Aberdeen, & SoapBox)
Dr Paul Simpson (Deputy Editor, PLOS Medicine)
Ms Yael Velleman (Senior Policy Analyst, WaterAid)

Like other professionals, I look forward to their outcomes and presentations.

F H Mughal]]>
Health issues and connections with sanitation Mon, 15 Dec 2014 11:11:35 +0000
Re: Ebola KnowledgePoint - by: muench
Now that the panic around Ebola has quietened down a bit and much progress been made to contain the disease which is great (at least this is what I assume, unless media attention has simply weaned off and is now focussing on other things...), it could be time to reflect what we can learn about all this?

What has irked me right from the start is that Ebola got so much attention even though it kills far fewer people than diarrhoea does...

As one colleague put it:
"... Ebola is getting more attention than it deserves. This is partly because it is new and makes for good TV footage."

Comes back to the age old question, how to attract media attention (and the attention of decision makers) to WASH-related diseases (diarrhoea, worm infections, malnutrition, stunting) that are quiet and kills silently (our children)... Is there anything we can learn from the Ebola case?

One thing that I found interesting is that the Wikipedia page on Ebola developed into the most accurate, up-to-date source of information of all websites
(see "Wikipedia Emerges as Trusted Internet Source for Ebola Information" here: )

A related thread is here on the forum, started by Giacomo about "your brain on climate change" ( - also how to get attention and action for something that is easy to put at the back of your mind and try to forget about as it's slow and long-term.

Health issues and connections with sanitation Fri, 12 Dec 2014 10:55:59 +0000
Re: Articles warning that "Antibiotic resistance sweeping developing world" - lack of sanitation one likely culprit! - by: arno
Tsunami yes but it has been very slow in its development. The evidence was out and in publications 3-4 years ago as I wrote a few years back. See

Good to see there is better understanding about the need for containment and treatment of sewage. Could be that doctors and pharmaceutical companies will understand now that overzealous use of antibiotics can have global impacts at a scale of a Tsunami wave of incurable inestinal infection. And that medicine needs to start including sanitation systems in its realm of central concerns.

Health issues and connections with sanitation Mon, 08 Dec 2014 10:02:26 +0000
Re: Articles warning that "Antibiotic resistance sweeping developing world" - lack of sanitation one likely culprit! - by: KeithBell
So, we may minimize OD while still fostering antibiotic resistance. OD isn't the main origin of the problem. We need to develop waste processing systems that don't select for antibiotic resistant organisms via killing their competition. But how can we mitigate horizontal gene transfer between organisms?

"Nonetheless, much remains to be learned about how to prevent acquisition and transmission of resistance."
Antibiotic Resistance — Problems, Progress, and Prospects

Trend is to promote probiotics instead of antibiotics:
Probiotics as a Strategy to Improve Overall Human Health in Developing Countries

Phage therapy (use of viruses) along with probiotics:
Assessment of synergistic combination potential of probiotic and bacteriophage against antibiotic-resistant Staphylococcus aureus exposed to simulated intestinal conditions

Essay about using probiotics to combat antibiotic resistance:
Probiotics and Antibiotic-Associated Diarrhea]]>
Health issues and connections with sanitation Sun, 07 Dec 2014 23:30:19 +0000
Re: Articles warning that "Antibiotic resistance sweeping developing world" - lack of sanitation one likely culprit! - by: F H Mughal “The Road to Health Goes Through the Toilet,” and has given interesting figures.

He says: “India has the highest level and number in the world of people who do not use toilets. Some 597 million people, or roughly 50 percent of the population, according to UNICEF and WHO's latest estimates, defecate in the open.”

I was under the impression that percentage of India’s population, resorting to OD is around 40. He has also given some statistics of other countries – interesting reading. According to him:

“The open defecation problem has got better in the world, but in 26 sub-Saharan countries in Africa, the numbers of people who defecate in the open are increasing. India and nine other countries make up 82% of the 1 billion people in the world who practice open defecation. The others are, in millions: Indonesia (54), Pakistan (41), Nigeria (39), Ethiopia (34), Sudan (17), Niger (13), Nepal (11), China (10), and Mozambique (10).”

On "superbugs" -- antibiotic-resistant infections in India, he says:

“People living in India are more prone to bacterial infections because -- due to open defecation -- the places where they walk, the water they drink, the food that they eat, is more likely to be contaminated with fecal matter. To address the infections, and other fecal-oral illnesses, doctors give them antibiotics. And then the infections become antibiotic-resistant. This is very dangerous to all, and particularly to children.”

It is appalling that doctors in India give antibiotic to the newborns. In Pakistan, antibiotics are freely used – no doctor’s prescription is required. Antibiotics are used by those who are infected and down with fever. But, generally, doctors do not prescribe antibiotics to newborns, unless there is some specific need.

While India is trying hard to end OD, it would be years before OD problems are minimized. Till then, the large-scale use of antibiotic will continue to be major problem for India.

F H Mughal


Note by moderator: in response to this post by Mughal (and in particular in response to his sentence "While India is trying hard to end OD, it would be years before OD problems are minimized"), a new thread was started here:]]>
Health issues and connections with sanitation Sun, 07 Dec 2014 05:46:46 +0000
6 Uses For Pee That You Probably Didn't Know About - by: Bhaskar

6 Uses For Pee That You Probably Didn't Know About

1. For Heating

The Barn House in Japan’s Memu Meadows is an award-winning experimental dwelling heated by urine. Designed by Keio University’s Co+Labo department, it shelters two humans and two horses, producing heating and organic plant fertilizer from the equines’ pee.

2. For Seating

The Dupe stool is a surprisingly sturdy, compostable seat made from bacteria, sand, and pee. Created by UK art student Peter Trimble using a self-made machine, this low-cost, low-energy sandstone design is the result of a biological reaction and can be broken up and used as fertilizer at the end of its lifetime.

3. Culinary Uses

“Virgin Eggs” are a very strange Chinese delicacy made by boiling chicken eggs in urine collected from boys under the age of 10. A traditional springtime snack from the city of Dongyang, this dish is said to have magical nutritional qualities that help to boost the immune system.

4. For Creating False Teeth

False teeth have always been made from all sorts of materials—like animal bones, wood or gold— but scientists have now crafted the very first urine-based teeth. Created by a research team at the Guangzhou Institutes of Biomedicine and Health, the innovative process consists of growing a tiny tooth-like structure from stem cells harvested from urine, and mixed with other organic material.

5. To Power Phones

While the idea of a pee-powered phone might sound gross, the good part is that it doesn’t require special atmospheric conditions like the sun or wind to work. Developed by a team of scientists at Bristol Robotics Laboratory, the world’s first pee-powered cell phone uses a system based on microbial fuel cells (MFCs) that feast on urine, creating electricity as a by-product.

6. As a Power Source

Four 15-year-old Nigerian girls have come up with a DIY generator that produces 6 hours of power from one liter of urine. Presented at Maker Faire Africa, the device has an electrolytic cell that removes hydrogen from the urine, which is then purified and squeezed through a cylinder full of liquid borax. This last step removes any excess humidity, so the hydrogen can be used for pee-power!]]>
Health issues and connections with sanitation Sun, 07 Dec 2014 04:59:04 +0000
Re: Articles warning that "Antibiotic resistance sweeping developing world" - lack of sanitation one likely culprit! - by: KeithBell microbial predisposition (my own term). This is truly a generational issue.

And we can't simply throw WWTPs at the problem, as wastewater is a known breeding ground for superbugs. Key is to keep waste out of water.!divAbstract

And, in my opinion, this problem of poor microbial predisposition results in increased vaccine injuries:


Note by moderator (EvM):

Just to avoid that we repeat too much a discussion we have already had:
See here for a discussion on the role of wastewater treatment plants and antibiotics resistance:

See here for a discussion about the vaccine injuries topic:

If anyone has more to add on those topics, please add them in those threads, keeping in mind that a general debate on vaccinations "yes or no" is not within the scope of this forum (see Rule 8 here:
Health issues and connections with sanitation Fri, 05 Dec 2014 14:37:17 +0000
Re: Articles warning that "Antibiotic resistance sweeping developing world" - lack of sanitation one likely culprit! - by: denniskl
"Collateral damage"

These are terms we hear (and deplore) when talking about war activities from developed nations.

We never hear the terms applied to the hordes of well-meaning NGO's, donors and agencies who are out there to do good.

But maybe we should; maybe we need to have a form of Environmental Impact Assessment (a Community Impact Assessment or something) that project promoters have to conduct before they launch their next "wonderful thing" on an unsuspecting world.

The cheap medicine bandwagon has been going on for years now, but if the results are highly antibiotic resistant bugs (which are not just a developing country problem, as you can see from the deaths in hospitals stats in every country, developing or developed), then certainly it's time to review the whole management issue/.

But I feel that part of the problem is money: it's easier and cheaper to just push a centralised drug manufacturer or a small number to pump out the cheap drugs (they still make a profit) than to solve the sanitation problems at source.

Maybe we need to provide a system where users have to prove they have adequate sanitation and hygiene facilities (and, of course the access to sanitation and hygiene mechanisms to make sure everybody can have them) as part of the trade off for free / cheap medicines?

It's a little simplistic but I do think that somewhere between "free & unconditional access" to benefits such as low cost medicines, and personal & community responsibility to protect yourself and the community, may be the right balance]]>
Health issues and connections with sanitation Thu, 04 Dec 2014 23:44:52 +0000
Re: Articles warning that "Antibiotic resistance sweeping developing world" - lack of sanitation one likely culprit! - by: Marijn Zandee
But that was an aside, I think a large part of the problem in South Asia is the fact that antibiotics are sold over the counter for cheap, without any prescription or instructions.

To re-supply our stocks, I recently bought 40 tablets of 500 mg Ciprofloxacine and 60 tablets of 400 mg Metronidazole for the grand price of 4 US$.

On the one hand it is great that poor people can get these medicines at an affordable rate, but there is absolutely no education. For example, some of my quite well educated Nepalese colleagues, will take 1 or 2 tablets of Metro to get rid of some mild stomach problem. And maybe 1 table the next day if complaints persist.

It is not only bacteria either, last year I had a multi-resistant strain of Giardia after a visit to India.

I don't want to say that sanitation is not an important link in this problem, but it is more complex than just blaming the lack of toilets. This should really be an issue, where different sectors in development join (washed) hands.

Health issues and connections with sanitation Thu, 04 Dec 2014 14:06:58 +0000
Sanitation linked to antibiotic resistance - NYT article - by: ggalli
Interesting article in the NYT on how antibiotic resistance is growing especially in India, resulting from a large use of antibiotics and low levels of sanitation.

“India’s dreadful sanitation, uncontrolled use of antibiotics and overcrowding coupled with a complete lack of monitoring the problem has created a tsunami of antibiotic resistance that is reaching just about every country in the world,” said Dr. Timothy R. Walsh, a professor of microbiology at Cardiff University.

It seems that the 'easy solution' of providing ever more antibiotics instead of tackling the root causes of poor sanitation, is starting to backfire. What are your thoughts on this?

Health issues and connections with sanitation Thu, 04 Dec 2014 09:18:05 +0000
Re: Sanitation interventions during Ebola epidemic - by: Roslyn
1) WASHplus Weekly and WHO WASH and Ebola FAQ

Dan Campbell recently made a post on the forum about the WASHplus Weekly Issue 167, 31.10.14 which has a focus on WASH and Ebola. There are several noteworthy articles and documents in this list, with over 20 articles and documents directly related to the subject (ranging from overviews of Ebola and WASH to handwashing to anthropological studies).

In particular I would like to bring attention to the WHO document “Ebola Virus Disease (EVD): Key Questions and Answers Concerning Water, Sanitation and Hygiene”
It relates to several points which were discussed here, in particular in relation to the 5 questions that I had previously extracted from the conversations. The key topics which relate to sanitation in this WHO document include:
  • Infection, and survival of the virus in drinking water contaminated by faeces/ urine (p. 1)
  • Minimum WASH requirements (and separation of excreta and drinking water) (p. 1)
  • Recommended handwashing procedures (p. 1)
  • Recommended sanitation facilities (p. 2)
  • Treatment requirements of faeces and urine in health facilities (p. 2)
  • Emptying of latrines/ septic tanks and excreta transportation (p. 3)
  • Wastewater and greywater treatment (p. 3)
  • Surface, bedding, health care waste disposal considerations (p. 4)
  • Additional considerations in handling faeces and urine (p. 4)
  • Key references with links (p. 5)

Perhaps if someone is interested to further discuss this document and the recommendations provided, a separate thread could be made.

2) 2014 Water and Health Conference Ebola and WASH Session

The 2014 Water and Health Conference (13-17.10.14 in Chapel Hill, USA) held a special Ebola and WASH session. Here is the link to the session discussion:

They also have a PDF available of the presentation from the panel. Here are some highlights from the document:
  • p. 12: discussion on transmission
  • p.19: discussion on “Survival of Ebola virus and other viruses in human wastes and in environmental media: what we do and do not know”(presented by Mark D. Sobsey, University of North Carolina)
  • p. 30: Ebola and WASH: Water, sanitation and hygiene measures to control the spread of Ebola virus from patients through environmental media to other people. What do we know? (presented by Huw Taylor, University of Brighton)

This discussion thread has now become quite long - for any particular topics which come out of this discussion and these articles, perhaps a new thread(s) could be started to further focus on particular aspects?

Thank you again for the input, links, and resources that have been provided in this thread!

Health issues and connections with sanitation Wed, 05 Nov 2014 10:34:22 +0000
WASHplus Weekly: WASH and Ebola - by: campbelldb Issue 167| Oct 31, 2014 | Focus on WASH and Ebola

This issue contains updates on Ebola outbreaks and other recent journal and newspaper articles as well as links to World Health Organization (WHO), UNICEF, and Centers for Disease Control and Prevention (CDC) websites on Ebola. Included are WHO/UNICEF factsheets, guidance on making chlorine solution from Tufts University, articles from the Global Public-Private Partnership on Handwashing, a summary of water and Ebola issues from the Pacific Institute, Ebola-related anthropological studies from the Institute of Development Studies, and other resources.

Health issues and connections with sanitation Fri, 31 Oct 2014 20:06:25 +0000
Re: Ebola KnowledgePoint - by: ulrichl
Thanks for this information!
The following has nothing to do with the website, but I found it fits nicely into this thread and it could be of interest to the sanitation community:
The Guardian created an excellent visualization of how Ebola compares to other infectious diseases:

A guote from that site:
With Ebola panic spreading, we thought it might be timely to visualise the data on the infectiousness of various pathogens.
To give a universal metric for infectiousness, we’ve used the average ‘basic reproduction number’ (also ratio or rate). It’s a statistical measure of how likely and widespread an infectious disease outbreak might be - if nothing is done to control the situation.
Every disease has a basic reproduction number but the numbers are scattered across the literature. We’ve web-crawled and gathered them all here in one graphic, plotting them against the average case fatality rate - the % of infectees who die. This hopefully gives us a data-centric way to understand the most infectious and deadly diseases and contextualise current events.

Health issues and connections with sanitation Wed, 22 Oct 2014 14:41:36 +0000
Re: Ebola KnowledgePoint - by: rkaupp
Thank you for moving the thread. KnowledgePoint is an initiatie by a few NGOs (WaterAid, RedR, Practical Action, EngineerAid, IRC...) to provide a place to ask technical questions, where specialists can answer. This is because these NGOs all had their internal "technical support" services, but without good platforms to do so). So KnowledgePoint is used both internally (for instance in WaterAid we use it to link fundraising and comms teams to technical advisors), and to allow people from other NGOs or the public to ask questions as well.

The main website is on where you can ask questions anonymously or register, and there are sub-sites for specific organisations, and for instance for Ebola as well.

So, to use it, just search for existing answers, or ask a new question, it's free to use! There are no dedicated times for Q&As as it is not "live", more a repository of knowledge. As it is broader than WASH as it goes into energy, infrastructure, organisational issues, etc.

Best wishes,
Health issues and connections with sanitation Wed, 22 Oct 2014 10:31:26 +0000