The first challenge for most countries is to define what sanitation really means. The second challenge is to decide what aspects are most important. Sanitation as a whole is a “big idea” covering everything from safe collection, and disposal of human excreta (faeces and urine); to the management of solid wastes (trash or rubbish.) Each community, region or country must understand the most sensible and cost-effective way of thinking about sanitation, both in the short and long term, then establish appropriate national plans and priorities, and last but not least – implement!
It is important to understand that sanitation can act at different levels, protecting the household, the community and society. In the case of latrines it is easy to see that this sanitation system acts at a household level. However, poor design or inappropriate location may lead to migration of waste matter and contamination of local water supplies putting the community at risk. Further down affects of waterborne sewage contamination affect the entire society by ill health and environmental damage.
For countries with very low access to basic sanitation, the effective management of excreta at the household level may have the greatest health implications and benefits but may also be the biggest challenge. In other cases, for example, in a particularly congested urban community, some form of off-site (sewerage) sanitation may be the only viable choice. Yet, in other countries or communities a more complete solution might include a focus on protecting the environment.
Open defecation is defined as defecation in fields, forests, bushes, bodies of water or other open spaces.
Community-led and driven programmes that utilize local, sustainable technologies, coupled with an enabling environment and good partnerships between public and private sectors are the key factors in achieving universal sanitation and eliminating open defecation.
The main objective of a sanitation system is to protect and promote human health by providing a clean environment and breaking the cycle of disease. In order to be sustainable a sanitation system has to not only be economically viable, socially acceptable and technically and institutionally appropriate, but it should also protect the environment and natural resources.
Lack of improved sanitation is a global crisis directly impacting the health, education, productivity and economic status of a household and often becoming the catalyst towards propelling a family out of poverty.
Improved sanitation and hygiene education will speed the achievement of all MDG’s, helping eradicate extreme poverty and hunger; achieve universal primary education; promote gender equality and empower women; reduce child-mortality; improve maternal health; combat HIV and AIDS; malaria and other diseases; as well as ensure environmental sustainability. See the Why We Care section for more details.
1.1 billion people still practice open defecation and 2.5 billion people still lack access to sanitation. Most countries that are not on track to meet the MDG target are in sub-Saharan Africa and Southern Asia.
Human excreta have been implicated in the transmission of many infectious diseases including cholera, typhoid, infectious hepatitis, polio, cryptosporidiosis, and ascariasis. Undernutrition, pneumonia, worm infestations, are also associated with unsafe water, poor sanitation and hygiene resulting in reduced physical growth, weakened physical fitness and impaired cognitive function, particularly for children under the age of five.
Infectious agents are not the only health concerns associated with wastewater and excreta. Heavy metals, toxic organic and inorganic substances also can pose serious threats to human health and the environment – particularly when industrial wastes are added to the waste stream.
Without adequate and separate sanitation facilitates in schools, attendance for girls is impossible, especially when they start to menstruate.
The world has met the MDG target of halving the proportion of the population without access to safe drinking-water. However, current trends show that the MDG sanitation target will likely be missed. Regarding open defecation – the riskiest practice – there is some good news. The proportion of the world’s population that practices open defecation is on the decline, although 1.1 billion people are still practising open defecation.
A lack of understanding at the individual, community and societal level regarding adequate sanitation is at the heart of this issue.
Although most people are aware that poor sanitation has an adverse health impact, there is a lack of awareness as to its extent. Improving sanitation is often low on the list of priorities for governments due other pressing needs i.e., food supply, education, medical treatment and dealing with war and conflict.
While sanitation is usually paired together with safe water as a single development goal, water has traditionally received greater emphasis and more resource allocation. Financing for sanitation comprises 37 per cent of total aid funding for sanitation and drinking water. The breakdown of country expenditures between sanitation and drinking water shows that funding for drinking water is often 3 or more times higher than that for sanitation.
Sanitation and hygiene education is especially difficult to place as a priority area due to the lack of clear identification of institutional roles and responsibilities for sanitation, resulting in the merging of sanitation with drinking water services and the perception in some countries that sanitation is mainly a household issue.
Additionally, society regards the issue of untreated excreta with either deep disgust, as culturally unacceptable, or at best with indifference.
Financing sustainable sanitation is an investment in human development that yields high economic returns. Improved sanitation in developing countries yields an average of about US$9 for every one dollar spent. Increases in female literacy (due to increased school attendance where proper sanitation facilities exist) contribute to economic growth.
Inadequate sanitation leads to a number of financial and economic costs including, increased medical costs as well as lost income through reduced or lost productivity. Sanitation also leads to time and effort lost due to distant or inadequate sanitation facilities, reduced income from tourism (due to high risk of contamination and disease) and increased resilience to withstand extreme weather conditions.
Inadequate sanitation, particularly in the context of urbanization, allows for sewage or waste to flow directly into streams, rivers, lakes and wetlands, affecting coastal and marine ecosystems, fouling the environment and exposing millions of children to disease. Improved sanitation reduces environmental burdens, increases sustainability of environmental resources and allows for a healthier, more secure future for the population.
Eliminating disparities in access to sanitation are critical to achieving equitable access for all. Despite the fact that billions have gained access to improved sanitation, distribution to access is far from equitable. Ninety-nine percent of the population in the developed world use improved sanitation facilities as compared to 52 percent in the developing world. In addition, rapid population growth and climate change also hinder progress.
A government’s role in providing sanitation is to set policy and regulate the sector to ensure a clean and healthy living environment for its people. At the same time, individuals and households bear responsibility for their own well-being by adopting improved sanitation and hygiene practices. A combined and united effort is key.
Every government should have a national plan of action that indicates how they are going to keep on track or speed up progress to meet the MDG target. These plans should include innovate local solutions that are sustainable and affordable for the poorest communities. At the national level create coordinated, intersectoral plans and policies with adequate budget allocations. At the local level effective delivery of services, operation and maintenance of existing systems and services.
Organizations around the world are leading pro-poor, affordable and sustainable sanitation programmes that prioritize the rural areas in developing countries
Programmes focus on:
For practical purposes sanitation can be divided into on-site and off-site technologies.
Numerous examples of successful change exist. More and more communities pride themselves in achieving the Open Defecation Free (ODF) status. Community-led Total Sanitation approaches that educate households, along with the availability of local and sustainable solutions and services, are a first step towards changing entrenched habits. Additionally, teaching school children facts about health risks and safe hygiene practices helps them develop essential life skills that they share with their families. These life skills also enable them to acquire and maintain healthy lifestyles, and to take greater responsibility for their own lives, as they become adults with families of their own.