Dear All,

I currently have the task to develop a set of standards with respect to occupational health issues for pit emptiers and exhauster operators (public and private)for the GIZ water sector reform program in Nairobi. This document will assist in ensuring the safety of these operators during FSM.

Can you recommend any documents or provide me with information that highlights such standards internationally? The document I am currently reading are The Occupational Safety and Health Act, 2007 of Kenya (OSHA guidelines) I have also contacted the Ministry of Labour here in Kenya to send me documents that could assist me in developing these guidelines

I look forward to your input!

Best regards

Doreen

Dear Doreen,

I feel this should be/become part of a larger set of documents that you ought to consider producing -- detailing a "On-site sanitation management system". How effective procedures for pit emptying, etc will also depend to some extent on design of pits/septic tanks, etc themselves, and these could be codified. Specific procedures for pumping, and the transportation activities of the septage management program should be specified in a Manual of Practice. The Septage Program Managers could prepare a Manual of Practice by first reviewing the operations procedures for specific equipment and then documenting all aspects of the day-to-day procedures. These procedures include:

• Scheduling and routing for trucks
• Customer service protocols
• Locating tanks and cleanouts
• Probing tanks to determine sludge levels
• Proper pumping equipment operation and worker safety
• Site control, including post-pumping clean-up
• Transportation requirements, including rules of the road
• Disposal procedures at the treatment facility
• Routine service of equipment – greasing and oiling, minor repairs
• Recordkeeping for all tanks pumped and wastes discharged at the disposal facility

As each program is different and utilizes different equipment, the Manual of Practice is program-specific. A Manual of Practice is an important document since it provides guidance for the equipment operators. Furthermore, it is a valuable a training document for new employees. The Manual can specify set procedures that employees should follow so that their work is done within specified guidelines. The procedures should be recorded in a step-by-step field manual that becomes an addendum to the septage management regulations.
Operating septage-pumping equipment is dangerous.

Operators are responsible for their personal safety as well as safety on the road. Septage is infectious material. It can cause disease if ingested or if it comes in contact with broken skin. Hands must always be washed immediately after contacting septage or tools and equipment that may have contacted septage, and always before eating or drinking. I suggest that septage workers should be immunized for tetanus, hepatitis A, and hepatitis B. Smoking must be prohibited while operating seepage equipment -- septic tanks may generate methane, an explosive gas. Smoking also promotes the hand-to-mouth route of infection. Caution must be used around septic tanks and septic tanks must never be entered. People are killed every year in septic tanks, because tanks are confined spaces that may contain toxic or oxygen-limited atmospheres. Septic tanks also may collapse or break if excessive weight is place on the lid or manhole cover.

I think you will find codes of practice if you patiently search health/public health pages of several countries, including many in Asia. I do remember, for example that the Philippines had developed such a code under a USAID programme.

Regards,

Sunder

There are also many interesting publications available here: www.iwawaterwiki.org/xwiki/bin/view/Arti...ability+Case+Studies

Dear All,

I received the following email from Sjoerd Nienhuys(www.nienhuys.info)concerning my question regarding health guidelines and standards for pit emptiers and exhauster operators. I thought it might interest you all. I am posting it here with his permission. I look forward to further contributions and feedback.

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Hi, Doreen,

My first reaction is that the problem needs to be avoided by having UD toilets and dry composting or ecosan toilets. Although a good solution to the existing systems is required, the more sustainable systems that do not require to handle fresh toilet sludge need to be promoted.

The indications and information about avoiding the entire problem should be an important part of the introduction.In many cases full toilets are so dilapidated that reconstruction is necessary. In that case the ecosan toilet should be planned.

Regards
Sjoerd Nienhuys

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Dear All,

I received the following email from Paul van Beers from FairWater Foundation (www.fairwater.org)and I thought it might interest you all. I am posting it here with his permission. I look forward to further contributions and feedback.

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Hi Doreen

I feel that it is crucial that you should stress that pit-latrines should now all have at least two chambers to allow the cretia to dry out which is so much easier to take out and clean up or have alternating latrines in use for the same.

obviously, the guidlines should include procedures for emptying these dry chambers as well!

as long as there is no severe policy that implement this, problems will be there and no or little progress will be made

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The double pit (and also the spilt-slab) is a far undervalued item in the discussion
most NGOs don't even know about it!

do you know the work of Waste in Gouda, Netherlands, also with the "Mapet"

see www.waste.nl/

By the way, there is nothing new about emptying pit latrines, we did this in Europe all over up to 1930 or so and there is a lot of procedures for that in old documents

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Thanks and best regards

Doreen

Hello Doreen

Guidelines for pit emptiers (do you talk about manual pit emptiers or about mechanical pit emptiers?) certainly is a very useful tool to help these people in their daily business. Nevertheless, don't forget, that often the people who do this job, socially are very marginalized. I worked with about 10 to 15 manual pit empties in Burkina Faso, to learn about how they work, and to teach them the idea and use of ecosan toilets. Of these 15 emptiers, only 2 or 3 spoke French, all the others speak their local language. Only one was able to write, only one had a mobile... All of them had at least one other job, to earn enough money. And: none of these 5 groups of each 2 to 3 persons knew another pit emptiers group, because they were not organized in an association, and each group tried not to be too much known as a pit emptiers in their society...

In general, I think writing working and health guidelines for pit emptiers can be something useful, but it has to be reflected on the reality of the pit emptiers' working conditions and their social and cultural reality. so my first recommendation to you would be: go out and try to accompany different emptier groups at their work, so you can sear their reallity with your own eyes.

I did this in Burkina and documented parts of my experiences. Probably this document can help you a bit:

www.susana.org/lang-en/library?view=ccbk...mp;type=2&id=736 (it written in French, I hope you understand French)

And there's a presentation of my ecosan project in Burkina that also gives you some insight in working problems of manual pit emptiers in Burkina:

www.susana.org/lang-en/library?view=ccbk...mp;type=2&id=516 (in English, there's also a French version, if it helps you...)

Anyway, about concrete health recommendations for manual pit emptiers, I would list these main problems:

- emptying in various steps, so the workers can take enough time to ventilate the pit to avoid ammonia (from anaerobic transformation of nitrate from the urine) gaseous intoxication and taking enough time to sterilize the sludge.
- working with gloves to avoid to be hurt by sharp objects thrown in the pit. There's nearly no sense to use boots, because the sludge often is to liquid, so at the beginning of the work, the men often sink until over their knees - so with boots, they wouldn't be able to do their work at all... But if ever possible, probably they could use shoes to get into the sludge. But it's definitely a question of money, if they can afford working shoes...
- using a face mask would help also, but often it's also a question of money and of accessibility. And of working comfort also, with 45°C in the pit...
- One of the main working accidents at emptying pit latrines happens as the wall of the pit collapses under the weight of the concrete base plate, because the pit is not constructed with concrete or bricks but just dug into the soil. Therefore it helps the working safety of the emptiers a lot, if there are at least two layers of bricks on the top of the pit, to hold the weight of the base plate.
- Another (public) health aspect in Burkina concerns the deposing of the faecal sludge after emptying, because the excreta often are deposed in the street or even in the courtyard. Therefore I would recommend that the faecal sludge should be deposed in a pit, that should be covered after filling, and where the excreta can transform during 6 - 8 month. Another possibility is to put the faecal sludge on a compost.
- At least in Western Africa, I would consider smoking no problem for working safety: No pit emptier would ever smoke during work, for practical reasons and also for religious reasons (in the animistic believing, the bad smell transmits evil spirits, so nobody would touch a cigarette and smoke it with dirty hands).

I hope, these inputs help you a little bit in your work.

Greetings
Florian Erzinger

Note from editor (Elisabeth): Florian has taken remarkable photos of the harsh realities of manual pit emptying in Burkina Faso and has made them available on the SuSanA flickr account. See for example this award-worthy photo (and see more by clicking on the link below):

Passing the faecal sludge to the top of the pit latrine by Sustainable sanitation, on Flickr
(I should add that Florian spoke to the pit emptyer if he would prefer his face to be pixelated out on this photo but the emptyer said no, he wants the world to see the conditions under which he has to work! I know other people have done this pixeling out of faces)
And more photos from Florian about pit emptying in several sets in the Burkina Faso collection here:
www.flickr.com/photos/gtzecosan/collections/72157624907659995/

You may already have considered this, but you could use the same thing the WHO does, the Stockholm Framework. See www.who.int/water_sanitation_health/wast...gsuww/en/index.html. Look forward to the report once you get it!

Dear All,

First and foremost, I would like to thank everyone for the indispensable information and recommendations that you have provided to me over the past couple of weeks.
My task which involved developing health guidelines for pit emptiers, mechanical and exhauster operators has been a field and desk research that has provided me with extensive information about the challenges faced during on site sanitation.

Before the development of the standards, I had to make sure that I understand the difficulties on the ground first. In addition, I had to be realistic and reflect on the reality of the emptiers as Florian Erzinger advised me. This is something I thought about last week during my field work.

I had already gone through very useful information from authors such as BPD, Eales and Bondi, C. Buckley and K. Foxon. I also went through the interesting documents that a lot of you sent me. However nothing truly prepares you for what you see on the ground. The working conditions that manual emptier’s face during their daily job are very dangerous. The emptiers are aware and understand the risks involved when handling faecal sludge however due to lack of money, they are not able to afford the appropriate protective equipment required for the emptying of pit latrines. Faecal sludge contains dangerous pathogens that can remain active for a very long period of time and the lack of appropriate health guidelines leads to serious risks that are detrimental to the health of the emptiers.

I have decided to implement a tripartite approach to avoid very long posts. This post will only cover points on manual pit emptying. I will post again about mechanical emptying with a Gulper and my third post will involve motorised emptying using an exhauster (tank lorry)

On the 8th of March, I had the opportunity to visit manual pit emptiers and to see firsthand how they carry out their job. The waste is removed in a bucket and a rope. It is transferred to a drum that is on a makeshift handcart. The waste is then illegally disposed in the streams and rivers. From what I saw, the job of pit emptying is done by men. The men I spoke to told me that this is because “it is not a job for women”

I have posted all the pictures here in the SuSanA flickr account: www.flickr.com/photos/gtzecosan/sets/72157629202806662/

Here is a glimpse:http://

Patrick is not wearing any protective clothing. He has no gloves by Sustainable sanitation, on Flickr

See how the emptiers use the bucket, string method, pour the sludge into the drum and transport it to the river. Note the lack of protective equipment. This is the reality and these are the conditions that the emptiers face when carrying out their work. It is clearly a gross violation of human rights and needs to be addressed immediately. On site sanitation should not be characterised by such methods anymore.

Those involved in pit emptying are ostracized and stigmatized by their neighbours and usually carry out this type of work because they can't seem to find a job anywhere else. I spoke to some of the neighbours who knew the manual pit emptiers and there were mixed reactions. Others said “well they have no choice. They have to do the work because no one else will. We are thankful to them for emptying the toilets” Another woman said “no they are messy, they smell and they are always spilling the sludge everywhere. My children play here. They should not do this type of job during the day”

The pit emptiers had no protective clothing, no shoes. As you can see from the pictures, the emptier was holding the tin and container without gloves and his hands were smeared with sludge. They all said that they suffered from skin rashes. Their voices were hoarse because of constant inhalation of toxic fumes. They constantly had teary eyes and they also think this is attributed to the fumes. Typhoid is also a common problem. They have no place to discharge the sludge other than the river. They told me that everyone knows that they pour the sludge in the river but they have no other choice. One had gumboots before but they were stolen and since then he has not been able to buy new ones. Gumboots cost about 600 Kenya Shillings in Nairobi. They empty approximately 27 drums per month (See the size of the drum in the pictures)

Here is a glimpse of the emptiers discharging in the river:http://

Dumping the sludge in the river (Mbalo, D. 2012) by Sustainable sanitation, on Flickr

The services that are offered by manual pit emptiers should be legitimised and legalised. In addition, there needs to be the provision of permits to ensure regulations. Manual pit emptiers should be adequately protected with gloves, face masks, overalls and boots. They should be also be vaccinated to ensure that they are protected during their work.

Manual pit emptiers are a vital contribution to on site sanitation in low income areas. If they don’t do the job, who will? They improve the public health of the residents by ensuring that the pits do not overflow especially during the rainy season. In addition it is a job opportunity for many youths in slum areas. If approached as a business and is institutionalised well, it could be integrated into a sustainable sanitation business model (I will talk about this a little bit more in my upcoming post about the use of a Gulper by a Community Based Organisation (CBO) in Kibera)

Many of the hazards can be prevented by adhering to simple precautions. Dangerous inhalation of toxic fumes can occur during the emptying of pit latrines. They can be highly poisonous and can lead to asphyxia. Asphyxia is a condition that develops due to deficient supply of oxygen the body. Therefore during the emptying of pit latrines, industrial nose masks should be worn to ensure that the toxic fumes are not inhaled. Most of the emptiers told me that they also constantly have headaches. This could be attributed to the inhalation of the toxic fumes.

According to Rodda, N. in WIN-SA, 2011, inhalation of Ascaris eggs can occur if appropriate protection is not used. Workers in Ethekwini were first given basic masks to wear. Analysis of the masks being worn after a cycle of emptying however revealed very high counts of Ascaris eggs on the masks. Those that empty pits are particularly at risk from infection and elevated number of eggs were found on the masks used by trained and professional pit emptiers employed by the city prompting them to be given additional training, more secure masks, as well as regular health checks and deworming tablets

Complete protective clothing is required to ensure that the workers are protected. As you can see from the pictures, none of the manual emptiers were wearing any protective clothing. The clothing should be impervious and should be light to ensure ease of mobility. Gumboots and overalls should also be light and impervious. The gumboots should be tightly fitting and ensure that no sludge enters. The gloves should fit tightly, should be heavy duty and should come up to the elbow. The nose mask should also fit appropriately.

Medical examination is required to ensure that the pit emptiers are free from diseases. The emptiers should therefore be subjected to a pre, mid and post employment examination. Hepatitis and Typhoid should be ruled out of the blood stream. Immunisation of Hepatitis B lasts 6 months-3 years. Typhoid immunization for 6 month’s costs 600 KSh, for 3 years costs 3000 KSh. Hepatitis A can be prevented by vaccination, good hygiene and sanitation. The vaccines should be given in the muscle of the upper arm and in two doses for the best protection. Protection begins 2 to 4 weeks after the initial vaccination; Protection is proven to last at least 10 years and is estimated to last 21-27 years if the full course is administered. Hepatitis E and Typhoid can be prevented by vaccination. Ascariasis can be prevented through hand washing after pit emptying to ensure that the food touched is not contaminated. Regarding Cholera, WHO recommends immunization only for children and people with HIV.

From the pit emptiers that I spoke to, they told me that there biggest problem is typhoid and skin rashes. However they are unsure about what else they might have contracted because they have never gone for a medical examination and were never vaccinated. The most common answer I got from them about their health is "We leave everything to God. He has been protecting us"

Ideally, the tools and equipment that they use should be sterilised and pre-treated with Jik (bleach) or solutions that can act to biotic substances. They should be rinsed, thoroughly dried and stored in a designated area. There should be no storage when they are still wet. In addition, they should restrictively be used for the purpose of waste collection and emptying. This is important to avoid contamination.
There should be provision of milk to the emptiers to neutralise anything that goes into the airwaves. Pre-placement medical examination, post-placement medical examination and midterm medical examination should be incorporated to ensure good heath and well being of the operators. Training is vital and indispensible in ensuring that the emptiers will adhere to the guidelines.
There should be no drinking, smoking, eating during emptying and operation. Unfortunately I did see some emptiers smoking in the vicinity which is very dangerous. Hands and Face should be washed on a regular basis therefore water and sufficient anti bacterial soap should be provided to ensure that the workers can wash their hands, faces and bodies on a regular basis.
At the end, it all resonates down to personal hygiene too. According to the National Environmental and Hygiene Policy (2007), approximately 80% of hospital attendance in Kenya is due to preventable diseases. Therefore proper hand washing with soap and water should also be ensured and strictly adhered to kill of any pathogens that might have come into contact with the hands. Hand washing with soap or ash is the single-most cost effective health intervention (Jamison et al 2006)

These are just some of the recommendations that I can put forward from what I saw in Korogocho. However none of them can be implemented if appropriate capacity building of the emptiers is not incorporated. Legalisation is required to ensure protection of the workers otherwise on site sanitation in developing countries will further be characterised by such which is a violation of human rights.

Benefits of legalising and regulating this job is to improve the quality of life for those involved. It increases their self esteem and prevents them from being ostracised by the residents who are benefiting from the services that they providing. Pit emptying is a very hard job and most residents seemed not to respect what the workers were going through to empty the latrines in Korogocho.

Legalising and regulating improves their income by ensuring that set rules are available to avoid exploitation and to avoid incomes below the minimum wage. In addition, it helps in the development of networks which can lead to the formation of CBOs assisting workers to collectively fight for their rights, take care of each other and protect themselves from health risks.

My next post will cover mechanical emptying with a Gulper. Here I shall post about a group of young men, formally manual pit emptiers who have joined together in Kibera to form a CBO known us Kara Group.I shall inform you about how they empty pit latrines with a Gulper, where they received the Gulper, challenges that they face and ways forward.

Dear Doreen,

Thank you so much for your photos and postings! I hope lots of people have treated themselves to a slide show of your photos of manual pit emptying in Nairobi. I repeat the link here:
www.flickr.com/photos/gtzecosan/sets/72157629202806662/

You have told a fascinating story with your photo documentary - we know it all from theory but to see it in real life and to read your words has really impacted on me! I urge everyone else who has anything to do with pit latrines or sanitation in general to take a look. It is like a story from start to end in the day of a pit latrine emptyer including dumping the whole shit in the nearest river which is like an open sewer plus rubbish dump in one.

I have posted some questions in the flickr set description and copy them here as well:
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1) How did they liquefy the content of the pit latrine so that it is so wet? Did they add water to the pit?

2) How much do they get paid for this job and how many pits do they have to empty in one day to make enough money for the day?
How are they organised?

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My other question is, what was it like for you to watch them so closely? I mean as a women (middle class) whereas they work in these terrible conditions with little chance to escape. Did they find it odd that you took photos? Or were they happy that you are documenting this? Did they ask you about the organisation who you work for (GIZ)? Does it happen often that someone takes an interest in their work?

I reckon you should become a journalist, you are very good at telling such important stories!

Regards,
Elisabeth

P.S. Good idea to split your posting in 3 and to feed us the information bit by bit and not all at once. You are giving us a lot to digest! (pardon the pun)

Hi Doreen

Just a quick question, your recommendations in your post above, can all be put in place in theory, but require money to be implemented. What ideas have you had with respect to sources of funding for implementation of some of your recommendations? i.e. where is the money going to come from?

Rgds
Trevor

Dear Elisabeth,

Thank you for your questions.

I am very thankful to the pit emptiers for allowing me to get a glimpse of what they do. They were very nice and answered my questions honestly and patiently. They asked me why the interest as no one ever talks to them about their job. I informed them that I was developing health guidelines for pit emptiers for my organisation and needed to understand their challenges. I asked them if I could take their pictures and use them for my work. They agreed as they would like people to know their problems so that they can get assistance. I spoke to them in Swahili. Patrick for example spoke good English(the one emptying in my pictures) I have their contact details and we have communicated since then.

There are 20 manual emptiers in Korogocho slums. They are loosely organised but they all know each other as the type of job requires at least 2 people. They keep in touch and know where they all live. They sometimes provide assistance to each other. The residents are aware that they are pit emptiers. Sometimes they can even go all the way to Kibera to carry out manual pit emptying. They get KSh 150 (1.30 EUR) per drum. Therefore Patrick and Waweru each received KSh150 that day. They told me in a month they get approximately KSh 1,500-2,000 (14 EUR-18 EUR). This is peanuts. 1.30 EUR can buy you a mini burger at Mcdonalds in Germany.

Ok to show you how little KSh 150 (which is the amount they get per drum):
500 ml of milk costs KSh 40, Bread costs KSh 46, 2kg of Maize Flour (for Ugali which is our staple food)costs KSh 100 and 1kg of Maize Flour costs KSh 56.

They therefore have to carry out other jobs to ensure that they can sustain themselves. Many have families and children.
Regarding the content of the sludge, they liquefied it by adding water that was from the river.

Unfortunately we had to leave prematurely because of security therefore after the emptying we didn’t have time to sit down together as I would have liked to ask them everything in a bit more detail and get to know them and understand their situation more. I would really like to do this soon.
Korogocho is known to be a dangerous slum in Nairobi (it was my first time there) and there were some problems a couple of km away on that day. Someone had been killed the day before and the suspected killer had been captured. The crowds were about to carry out mob justice but the police intervened with tear gas, holding huge guns and rungus (sticks)so we were then advised to leave.

Regarding Trevor’s question:


Trevor first and foremost, I believe that formalisation of services is paramount to ensure tariffs and proper licensing for pit emptiers. If the job is regulated and licensed appropriately, then many of the problems will fade away. The condition is that everything should be done according to NEMA National Environmental Management Authority (NEMA) standards, Ministry of Public Health and Sanitation, and Kenya Bureau of Standards (KEBS). Once they are institutionalised and embedded within the system of the Water Services Providers WSPs, they would then automatically be equipped. In addition, the WSPs have the responsibility of providing appropriate dumping outlets plus onsite treatment facilities in low income urban areas and informal settlements.

Tariffs for offering these services should be regulated to be in line with the requirements of the emptiers. The tariffs charged should be able to allow them to buy the basic protective gear like gumboots, gloves, masks, overalls and to ensure vaccinations. If they are embedded in the WSPs, they would then be protected and provided with appropriate equipment as per the rules and regulations that need to be adhered to by WSPs.

Therefore the two options are as follows: They could either be linked to the water utilities or they could be promoted to work as service providers within the private sector. If approached as a business it could then be integrated into a sustainable model which can even be supported by the government e.g. the Youth Development Funds. K-Rep, a pro poor bank in Kenya even gives loans for sanitation.

There is therefore a need to regulate these services and enforce the health and hygiene standards as recommended by the Ministry of Public Health and Sanitation. The rights of emptiers are violated as per article 43 of the Constitution of Kenya with regards to attainable standards of health.

It is deplorable to know the pit emptiers dispose into Nairobi River without any concerns from either NEMA or Water Resource Management Authority (WRMA) As a result of this, all the rivers passing through informal settlements are completely polluted with solid waste and faecal sludge emptied from the numerous pit latrines as you can see in the pictures.Here they are again: www.flickr.com/photos/gtzecosan/sets/72157629202806662/

Here is a glimpse of the river:
http://

This is a situation which needs to be addressed urgently e.g. by providing better localised sludge dumping sites within the informal settlements. This could be improved further by developing decentralised waste systems (Digestor/Anaerobic Baffled Reactor)

Legalising and regulating this job will bring sanity into sanitation provision in informal settlements and contribute to long term reduction of surface and groundwater pollution. The current way of doing things is a big threat to water supply in Kenya since our rivers that are being polluted eventually converge into the big rivers which have intakes for water supply for our major towns and cities.

In addition, regulating ensures proper tariffs which can sustain the toilet emptiers to meet their needs and to be able to provide better and quality services for the residents of the low income settlements.

I wish there was away that their situation could change immeadeately. The faster we spread information about the current situation to stakeholders who have the ability to make a change, the faster we will be able to assist them in their work. They are a vital contribution to onsite sanitation and should be respected and taken care of.

Thoughts, comments and information will be highly appreciated and thank you for looking at the pictures.

Best regards

Doreen

Good day! Thanks for sharing this with us and to the public discussion. Hoping that all people must have a pit emptiers and exhauster operators so the the garbage or wastes will be lessen and especially to prevent any kinds of pollution in the environment.

Best wishes,

xxx

Note by moderator: please sign with your name and put a link to your company (if you want) into the footer of the posting - but not instead of your name. The way you have done it now is too much like plain advertising.