SuSanA - Forum Kunena Site Syndication http://forum.susana.org/ Fri, 06 May 2016 03:35:22 +0000 Kunena 1.6 http://forum.susana.org/components/com_kunena/template/default/images/icons/rss.png SuSanA - Forum http://forum.susana.org/ en-gb Re: Important review on shared sanitation - by: JKMakowka http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17930 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17930
GEMS findings suggest access to private household latrines can provide protective benefits against MSD, even in communities like rural western Kenya, where open defecation and open child feces disposal was common. It is unlikely that private latrine access influences whether children play outside the home or not, so this protective effect may reflect protective benefits of private household latrine access on private (domestic) exposure pathways such as contaminated drinking water, food, household play areas, or hands.

This is interesting because it would go against common wisdom that the protective effect of toilets is mainly a community wide effect and thus full ODF should be reached. However I think they have cause and effect slightly confused in this paper with their narrow focus on household toilets Vs. shared facilities.
But a bit further down they seem to at least acknowledge that possibility:
The reverse explanation for this relationship could also be true: households that prioritize safe hygiene practices are more likely to invest in private sanitation facilities than those that do not prioritize hygiene.

And I would add: households that can afford private sanitation facilities are much more likely to be also able to afford other things that have a big effect on occurrences of child MSD.

Edit: they did some social-economic adjustments, but it seems to have been rather limited:
We selected two sociodemographic indicators, a wealth quintile index and having two parents in the home. Although wealth indices are widely used in WASH research, it may not be a robust way of adjusting for sociodemographic confounding.
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Health issues and connections with sanitation Fri, 06 May 2016 00:52:28 +0000
Re: Important review on shared sanitation - by: jonpar http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17929 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17929
As stated by Baker et al "This is a controversial topic, as communal facilities are the most economical and feasible solution for providing sanitation access to the 2.5 billion people without a private facility". Indeed this is the case if we compare the cost of installing one communal toilet compared with the cost of each family installing private facilities. But this does not take into account important issues of space and the fact that many families lack security of tenure and lack incentive to invest in improved latrines. Additionally, private landlords may raise the rent when there is access to a private facility. So, it's certainly a tricky one.

It is apparent why many organisations choose to use funds to construct communal facilities as well-constructed household toilets according to standards are so expensive. It is harder to adopt a CLTS approach and not offer any form of support to build the toilets.

Generally I think it is true to say that donors prefer to go for communal or private but not something in the middle. However container-based sanitation may turn this on it's head as it provides the privacy associated with private on-plot sanitation and is clearly much more affordable. Key factors are usage and quality of service. A poorly maintained facility is likely to become a loci of disease transmission whereas a well-maintained one, even if used by a large number of people, can be an effective means to reduce transmission of diarrhoeal disease provided of course that users practice good hygiene behaviour.

I do agree that with the conclusion that "shared facilities may still have a role in addressing open defecation in challenging settings" but I also agree that "For reasons beyond just health such as dignity and gender equity, we should advocate for private access whenever possible." And if Crocker & Bartram state that this is based on the best dataset yet on diarrheal disease associated with sanitation and hygiene, then that's a compelling case indeed !

p.s. I've attached the articles to this posting to make it even easier for you to find the paper, download and digest.]]>
Health issues and connections with sanitation Thu, 05 May 2016 22:23:45 +0000
Re: Important review on shared sanitation - by: eddyperez http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17928 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17928
This is a very important topic. I encourage all to take a few minutes to read the discussion and conclusion section of the actual paper ( not the review of the paper). It is only a couple of pages and written in accessible language and provides ( in my opinion) a well balanced and nuanced discussion of the issues of private vs. shared and also important to understand the articulated limitations of what the data was able to look at what is was not able to look at.

The discussion in the paper acknowledges that the private household vs shared latrine debate is not helpful in situations were private household latrines are not viable ( such as in extremely densely populated informal urban settlements where over 1 billion people live - see recent Habitat data on slums) and where shared sanitation is the only option - often as public latrines managed by local governments, NGOs or private sector operators. These are indeed often not safely managed and provide inadequate protection from fecal contamination. But given the lack of alternatives, reducing the discussion to HH v Shared often results in a disincentive by governments and development partners to invest in shared sanitation to make more hygienic and reduce public health risks.]]>
Health issues and connections with sanitation Thu, 05 May 2016 19:14:42 +0000
Examples of sanitation ventures producing and selling fertiliser products derived from human excreta - by: bertam http://forum.susana.org/forum/categories/17-fertiliser-soil-conditioner-production-of-crops/17927-examples-of-sanitation-ventures-producing-and-selling-fertiliser-products-derived-from-human-excreta#17927 http://forum.susana.org/forum/categories/17-fertiliser-soil-conditioner-production-of-crops/17927-examples-of-sanitation-ventures-producing-and-selling-fertiliser-products-derived-from-human-excreta#17927
I'm currently doing some research on to identify the enabling conditions and barriers to commercialising fertiliser products derived from human excreta. I am planning to do this by developing several case studies in cities where sanitation ventures are trying to sell the fertilisers they produce by evaluating the challenges and opportunities that exist when it comes to commercialising fertilisers derived from excreta at a large scale.

At this stage I'm identifying potential case study locations. I was wondering if anyone would have suggestions of sanitation ventures or municipalities that successfully produce and sell compost or other fertilisers from excreta?

The ones I am aware of so far are:
Loowatt (UK/Madagascar)
SOIL (Haiti)
Sanergy (Kenya)
Safisana (Ghana)
X-Runner (Peru)

I don't have any geographical restrictions so any suggestions will be very welcome.

Thanks a lot in advance,
Berta]]>
Fertiliser, soil conditioner, production of crops Thu, 05 May 2016 16:17:35 +0000
Re: Prototype Microflush-Biofil Toilet Facilities (Ghana Sustainable Aid Project, USA and Ghana) - by: adanesew http://forum.susana.org/forum/categories/205-vermicomposting-digesters-for-flush-toilets-wet-composting/4870-prototype-microflush-biofil-toilet-facilities-ghana-sustainable-aid-project-usa-and-ghana?limit=12&start=12#17926 http://forum.susana.org/forum/categories/205-vermicomposting-digesters-for-flush-toilets-wet-composting/4870-prototype-microflush-biofil-toilet-facilities-ghana-sustainable-aid-project-usa-and-ghana?limit=12&start=12#17926
Kindly yours

Adane Sewhunegn
Lecturer of waste management and treatment technologies
Hawassa University, Ethiopia]]>
Vermicomposting digesters for flush toilets (wet composting) Thu, 05 May 2016 14:05:28 +0000
Re: Latrine pits for loose soil and rocky soil? - Question from Nigeria - by: rochelleholm http://forum.susana.org/forum/categories/251-pit-latrines-eg-simple-pit-latrines-vip-latrines-dual-pit-pour-flush-latrines-ie-toilets-using-a-hole-in-the-ground/17905-latrine-pits-for-loose-soil-and-rocky-soil-question-from-nigeria#17925 http://forum.susana.org/forum/categories/251-pit-latrines-eg-simple-pit-latrines-vip-latrines-dual-pit-pour-flush-latrines-ie-toilets-using-a-hole-in-the-ground/17905-latrine-pits-for-loose-soil-and-rocky-soil-question-from-nigeria#17925 In Malawi, the corbelled pit latrine targeted for rural areas has been working well. It is low-cost and uses no cement. However, it is not designed to be emptied.

For more information on the corbelled pit latrine take a look at:
UNICEF Malawi, WASH Field Note: Going Beyond ODF: Combining Sanitation Marketing with Participatory Approaches to Sustain ODF Communities in Malawi, 2015.

Rochelle]]>
Pit latrines (e.g. simple pit latrines, VIP latrines, dual pit pour flush latrines - i.e. toilets using a hole in the ground) Thu, 05 May 2016 03:45:39 +0000
Re: Important review on shared sanitation - by: JKMakowka http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17924 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17924
In general, I suspect that this is rather a correlation and not a causation. Communities that have a lack of private toilets and are thus resorting to sharing with direct neighbors are likely to be less well off economically and also likely more un-hygienic in other aspects as well.]]>
Health issues and connections with sanitation Thu, 05 May 2016 01:34:02 +0000
Re: Important review on shared sanitation - by: jonpar http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17923 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17923
i) Sharing a sanitation facility with 1-2 other households can increase the risk of moderate-to-severe diarrhea in young children, compared to using a private facility.

ii) Evidence confirms that private sanitation often provides greater benefits than shared sanitation.

>> Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of moderate-to-severe diarrhea in children.]]>
Health issues and connections with sanitation Wed, 04 May 2016 21:36:40 +0000
online sanitation textbook on Wastewater Treatment Plants by ICRC & IOWater (France) - by: AquaVerde http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17922-online-sanitation-textbook-on-wastewater-treatment-plants-by-icrc-a-iowater-france#17922 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17922-online-sanitation-textbook-on-wastewater-treatment-plants-by-icrc-a-iowater-france#17922
I recommend this online sanitation textbook about Wastewater Treatment Plants by ICRC & IOWater (France) (www.oieau.fr/?lang=en). You may save it in susana's online-library for easy access:
ia801308.us.archive.org/21/items/1Wastew...reatment%20plant.pdf

Difficult subjects made easy to understand by providing the most important "keys"...

Regards.
Detlef]]>
Health issues and connections with sanitation Wed, 04 May 2016 18:45:19 +0000
Re: IWA Conference: Water and Pharmaceuticals – insights and perspectives for health and environment (12–13 April, Uppsala, Sweden) - by: arno http://forum.susana.org/forum/categories/156-conferences-seminars-and-workshops/17458-iwa-conference-water-and-pharmaceuticals--insights-and-perspectives-for-health-and-environment-1213-april-uppsala-sweden#17921 http://forum.susana.org/forum/categories/156-conferences-seminars-and-workshops/17458-iwa-conference-water-and-pharmaceuticals--insights-and-perspectives-for-health-and-environment-1213-april-uppsala-sweden#17921
www.youtube.com/playlist?list=PL0gMdVBup...DzO5SH0e-Jef0EOeBCS9

and the proceeedings

www.svensktvatten.se/utbildning/konferen...t-vatten-utveckling/]]>
Conferences, seminars and workshops Wed, 04 May 2016 15:10:26 +0000
Re: 28 May - Menstrual Hygiene Day - Campaign materials and Planning Guide available - by: Shawn http://forum.susana.org/forum/categories/24-menstrual-hygiene-management-mhm/17884-28-may-menstrual-hygiene-day-campaign-materials-and-planning-guide-available#17920 http://forum.susana.org/forum/categories/24-menstrual-hygiene-management-mhm/17884-28-may-menstrual-hygiene-day-campaign-materials-and-planning-guide-available#17920 Menstrual hygiene management (MHM) Wed, 04 May 2016 13:19:53 +0000 Important review on shared sanitation - by: campbelldb http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17919 http://forum.susana.org/forum/categories/26-health-issues-and-connections-with-sanitation/17919-important-review-on-shared-sanitation#17919
Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children in the Global Enteric Multicenter Study, 2007–2011: Case-Control Study. PLoS Med, May 2016. Authors: Kelly K. Baker, Ciara E. O’Reilly, Myron M. Levine, Karen L., et al.
Full text: http://goo.gl/z0h9P0

Background - Diarrheal disease is the second leading cause of disease in children less than 5 y of age. Poor water, sanitation, and hygiene conditions are the primary routes of exposure and infection. Sanitation and hygiene interventions are estimated to generate a 36% and 48% reduction in diarrheal risk in young children, respectively. Little is known about whether the number of households sharing a sanitation facility affects a child's risk of diarrhea. The objective of this study was to describe sanitation and hygiene access across the Global Enteric Multicenter Study (GEMS) sites in Africa and South Asia and to assess sanitation and hygiene exposures, including shared sanitation access, as risk factors for moderate-to-severe diarrhea (MSD) in children less than 5 y of age.


Methods/Findings - The GEMS matched case-control study was conducted between December 1, 2007, and March 3, 2011, at seven sites in Basse, The Gambia; Nyanza Province, Kenya; Bamako, Mali; Manhiça, Mozambique; Mirzapur, Bangladesh; Kolkata, India; and Karachi, Pakistan. Data was collected for 8,592 case children aged <5 y old experiencing MSD and for 12,390 asymptomatic age, gender, and neighborhood-matched controls. An MSD case was defined as a child with a diarrheal illness <7 d duration comprising ≥3 loose stools in 24 h and ≥1 of the following: sunken eyes, skin tenting, dysentery, intravenous (IV) rehydration, or hospitalization. Site-specific conditional logistic regression models were used to explore the association between sanitation and hygiene exposures and MSD. Most households at six sites (>93%) had access to a sanitation facility, while 70% of households in rural Kenya had access to a facility. Practicing open defecation was a risk factor for MSD in children <5 y old in Kenya. Sharing sanitation facilities with 1–2 or ≥3 other households was a statistically significant risk factor for MSD in Kenya, Mali, Mozambique, and Pakistan. Among those with a designated handwashing area near the home, soap or ash were more frequently observed at control households and were significantly protective against MSD in Mozambique and India.

Conclusions - This study suggests that sharing a sanitation facility with just one to two other households can increase the risk of MSD in young children, compared to using a private facility. Interventions aimed at increasing access to private household sanitation facilities may reduce the burden of MSD in children. These findings support the current World Health Organization/ United Nations Children's Emergency Fund (UNICEF) system that categorizes shared sanitation as unimproved.

Interpreting the Global Enteric Multicenter Study (GEMS) Findings on Sanitation, Hygiene, and Diarrhea. PLoS Med, May 2016. Author: Jonny Crocker, Jamie Bartram
Full text: http://goo.gl/6SzZmr

The draft sanitation ladder for measuring SDG progress allows sharing of improved facilities by fewer than five households to count towards ending open defecation [19]. Higher rungs refer to private facilities and safe excreta management. The indicators also interpret access as including use, which was not included in GEMS. Future research should include indicators on use of facilities and excreta management.

Baker and colleagues provide valuable evidence that confirms that private sanitation often provides greater benefits than shared sanitation. Prior evidence suggests health benefits for use of any sanitation facility (including shared) when compared to open defecation [8–10]. This study will inform policy and programming, yet shared facilities may still have a role in addressing open defecation in challenging settings. For reasons beyond just health such as dignity and gender equity [20,21], we should advocate for private access whenever possible.

Baker and colleagues present the best dataset yet on diarrheal disease associated with sanitation and hygiene. They provide compelling evidence on sanitation and hygiene risk factors for MSD and variability in that risk. Importantly, they also demonstrate the feasibility and value of rigorous data collection on health outcomes, something that future studies should develop yet further.]]>
Health issues and connections with sanitation Wed, 04 May 2016 13:13:09 +0000
Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far? - by: DianeKellogg http://forum.susana.org/forum/categories/167-market-development-in-action/17872-is-our-approach-to-instituting-sanitation-programs-broken-how-efficient-have-the-ngos-been-so-far#17918 http://forum.susana.org/forum/categories/167-market-development-in-action/17872-is-our-approach-to-instituting-sanitation-programs-broken-how-efficient-have-the-ngos-been-so-far#17918
I find working to unravel causes and effects (chickens and eggs) valuable for the sake of finding a starting point. A first step. Something I can actually do, not just talk about doing. It’s the practical orientation I learned growing up on a chicken farm, with 40,000 of them laying free-range eggs. (No roosters allowed.) My father always shook his head at the absurdity of the question, though. "Chicken," he said over and over again. It takes a chicken to get an egg. End of story. There were no chickens inside our eggs.

I may not be able to make a dent in the problem, but I employ people inside the urban poor community as research assistants. That’s something. I admire anyone who is trying to do anything to make their own dent. Educating people about the real cost of flying toilets sounds worthwhile. Sometimes those programs can be so condescending, though--depending on who’s in charge. It won’t be me, as I’m in learning mode when it comes to urban sanitation. I’m learning as I go from the people who live closest to the problem, and getting more humble all the time about what I don’t know.]]>
Market development in action Wed, 04 May 2016 13:07:30 +0000
Re: Latrine pits for loose soil and rocky soil? - Question from Nigeria - by: muench http://forum.susana.org/forum/categories/251-pit-latrines-eg-simple-pit-latrines-vip-latrines-dual-pit-pour-flush-latrines-ie-toilets-using-a-hole-in-the-ground/17905-latrine-pits-for-loose-soil-and-rocky-soil-question-from-nigeria#17917 http://forum.susana.org/forum/categories/251-pit-latrines-eg-simple-pit-latrines-vip-latrines-dual-pit-pour-flush-latrines-ie-toilets-using-a-hole-in-the-ground/17905-latrine-pits-for-loose-soil-and-rocky-soil-question-from-nigeria#17917
It would be nice if you could provide the context to your question? Why do you ask and which resources you have already searched through to find the answer?

Have you looked through this sub-category on the forum about pit latrines?:
forum.susana.org/forum/categories/251-pi...a-hole-in-the-ground

You'll find some resources mentioned there that deal with pit latrines. Presumably they also include information on what to do about loose and rocky soil.

E.g. check out this thread by Peter Morgan:
Stabilising brick VIP latrines in softer soils (Zimbabwe)
forum.susana.org/forum/categories/251-pi...ofter-soils-zimbabwe

Seems like it should be helpful.

In general, loose and rocky soils can be one reason for changing from a pit latrine to a UDDT toilet (urine-diverting dehydration toilet) but you said in your post you're not interested in the "Eco-San Model" so I won't dwell on this further.

Regards,
Elisabeth]]>
Pit latrines (e.g. simple pit latrines, VIP latrines, dual pit pour flush latrines - i.e. toilets using a hole in the ground) Wed, 04 May 2016 12:45:08 +0000
Safepad Re-usable sanitary napkin - by: karthik http://forum.susana.org/forum/categories/24-menstrual-hygiene-management-mhm/17916-safepad-re-usable-sanitary-napkin#17916 http://forum.susana.org/forum/categories/24-menstrual-hygiene-management-mhm/17916-safepad-re-usable-sanitary-napkin#17916 During the menstrual period 75% of all women suffer from the infection Candidiasis, an infection that causes health issues and in worst cases will impact the fertility.
Safepad hygienic sanitary pads are designed with a permanently bonded antimicrobial technology that helps reducing vaginal infections caused by Candida albicans along with infections from other pathogens.
The antimicrobial technology is based on a treatment that leaves a positively charged layer on the fabric. This layer will attract and kill the negatively charged microbes, like bacteria and fungi.
The permanently bonded antimicrobial fabric along with a highly absorbent material provides a comfortable and hygienic experience for the women.
Antimicrobial Efficiency
Pseudomonas Aeruginosa 99,99% reduction
Escherichia Coli 99,99% reduction
Staphylococcus Aureus 99,99% reduction
Candida Albicans 99,99% reduction
Aspergillus Niger 99,99% reduction]]>
Menstrual hygiene management (MHM) Wed, 04 May 2016 11:32:56 +0000