Author Archives: WASHplus

Aug 10 – Weekly Update of Selected WASH Studies

Effectiveness of emergency water treatment practices in refugee camps in South Sudan. WHO Bulletin, Aug 2015. Authors: Syed Imran Ali, Syed Saad Ali & Jean-Francois Fesselet.
Link: http://goo.gl/BtnQVh

Current guidelines for free residual chlorine in emergency water supplies are not based on field evidence and offer inadequate protection after distribution in refugee camps in South Sudan. We recommend that the free residual chlorine guideline be increased to 1.0 mg/L in all situations, irrespective of disease outbreak, pH, or turbidity conditions. This is a tentative recommendation because the degree to which these findings can be generalized to other camps in different settings is unknown.

Nutrition in Ethiopia: An emerging success story? Author: Headey, Derek D.
Link: https://goo.gl/tmMCqX

Research does not always provide the results that we expect. At the recent conference on improving nutrition in Ethiopia, Together for Nutrition 2015, we learnt about the rapid progress in Ethiopia in child nutritional outcomes that are linked to improved birth size and, hence, improved maternal health. However, most of the improvement in maternal health seems related to better sanitation, rather than to diet, care, or health factors.

Diet and specific microbial exposure trigger features of environmental enteropathy in a novel murine model. Nature Communications, Aug 2015. Authors: Eric M. Brown, et al.
Link: http://goo.gl/Sgx6XP

Here we demonstrate that early-life consumption of a moderately malnourished diet, in combination with iterative oral exposure to commensal Bacteroidales species and Escherichia coli, remodels the murine small intestine to resemble features of EE observed in humans. We further report the profound changes that malnutrition imparts on the small intestinal microbiota, metabolite and intraepithelial lymphocyte composition, along with the susceptibility to enteric infection. Our findings provide evidence indicating that both diet and microbes combine to contribute to the aetiology of EE, and describe a novel murine model that can be used to elucidate the mechanisms behind this understudied disease.

An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial. The Lancet, Aug 2015. Authors: Paul Little, Beth Stuart, et al.
Link: http://goo.gl/hHLnLI

Handwashing to prevent transmission of respiratory tract infections (RTIs) has been widely advocated, especially during the H1N1 pandemic. However, the role of handwashing is debated, and no good randomised evidence exists among adults in non-deprived settings. We aimed to assess whether an internet-delivered intervention to modify handwashing would reduce the number of RTIs among adults and their household members.

Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children. Parasit Vectors. 2015 Aug. Authors: Freeman MC, Chard AN, et al.
Link: http://goo.gl/HkdIyS

Results suggest mixed impacts of household and school WASH on prevalence and intensity of infection. WASH risk factors differed across individual worm species, which is expected given the different mechanisms of infection. No trend of the relative importance of school versus household-level WASH emerged, though some factors, like water supply were more strongly related to lower infection, which suggests it is important in supporting other school practices, such as hand-washing and keeping school toilets clean.

Modelling Optimal Control of Cholera in Communities Linked by Migration. Comput Math MethodsMed. 2015. Authors: Njagarah JB, Nyabadza F
Link: http://goo.gl/VU6I5G

A mathematical model for the dynamics of cholera transmission with permissible controls between two connected communities is developed and analysed. The dynamics of the disease in the adjacent communities are assumed to be similar, with the main differences only reflected in the transmission and disease related parameters. This assumption is based on the fact that adjacent communities often have different living conditions and movement is inclined toward the community with better living conditions. Our results indicate that implementation of controls such as proper hygiene, sanitation, and vaccination across both affected communities is likely to annihilate the infection within half the time it would take through self-limitation. In addition, although an infection may still break out in the presence of controls, it may be up to 8 times less devastating when compared with the case when no controls are in place.

WASHplus Weekly: Focus on Animal Waste Management

Issue 201 | August 7, 2015 | Focus on Animal Waste Management

This issue focuses on the management of animal waste and includes recent studies and resources on the environmental and health impacts of waste from domestic animals such as cattle, pigs, and chickens. Specifically, reviews of animal waste management by the International Livestock Research Institute, and diarrheal infections associated with animal husbandry are included, as well as aWHO fact sheet on Taeniasis/Cysticercosis, and country studies from Bangladesh, Egypt, Ghana, and more.

WASTE MANAGEMENT

Global Assessment of Manure Management Policies and Practices, 2014. E Teenstra. Link
The study assessed livestock manure policies in 34 countries in Asia, Africa, and Latin America, then looked in depth at manure management practices in Bangladesh, Vietnam, Ethiopia, Malawi, Argentina and Costa Rica. The authors found wide variations in practice, with particular challenges in the handling of liquid manure; they also found government policies and lack of coordination often hindered the implementation of improved practices.

Manure Management Practices in Urban and Peri-urban areas of Tanzania pose a Public Health Threat, n.d. University of Copenhagen. Link
Livestock are increasingly kept in urban and peri-urban areas as a consequence of the growing urban demand for fresh meat and livestock products. Manure is a valuable byproduct of livestock production, but if it is not treated according to good manure handling practices, it may cause a public health treat due to the presence of pathogenic bacteria in the dung. A recent international research project working with cattle farmers in urban areas of Tanzania has documented that good manure handling practices are not always followed, and that this lead to direct human contact and environmental contamination with cattle manure.

A One Health Perspective for Integrated Human and Animal Sanitation and Nutrient Recycling, 2015. H Nguyen-Viet. | Order from CABI | Free View/Download
This chapter discusses a conceptual framework for integrated health and environmental assessment that combines health status, and the physical, socioeconomic and cultural environments in order to improve human health and minimize environmental impact. This concept’s application in the management of human and animal excreta in Vietnam is then described.

Review of Evidence on Antimicrobial Resistance and Animal Agriculture in Developing Countries, 2015. D Grace, International Livestock Research Institute. Link
This short paper identifies key evidence gaps in our knowledge of livestock- and fisheries-linked antimicrobial resistance in the developing world, and to document on-going or planned research initiatives on this topic by key stakeholders. The antimicrobial resistant (AMR) infections in animals that are of most potential risk to human health are likely to be zoonotic pathogens transmitted through food, especially Salmonella and Campylobacter. In addition, livestock associated methicillin resistant Staphylococcus aureus (LA MRSA) and extended spectrum beta lactamase E. coli (ESBL E. coli) are emerging problems throughout the world.

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Community-led Total Sanitation in Cambodia: Findings from an Implementation Case Study

Community-led Total Sanitation in Cambodia: Findings from an Implementation Case Study, 2015.

This learning brief shares key findings from a case study of community-led total sanitation (CLTS) implementation in Plan International Cambodia program areas, focusing on the roles and responsibilities of local actors. Several implications are relevant for consideration by Plan International Cambodia and other sanitation practitioners. cambodia-brief-cover-255x300

The brief is part of the CLTS Learning Series, a collection of seven country case studies on CLTS implementation prepared by The Water Institute at the University of North Carolina at Chapel Hill as part of the Plan International USA project, Testing CLTS Approaches for ScalabilityThe 4-page brief is based on the 40-page Cambodia Country Report.

The Consequences of Deteriorating Sanitation in Nigeria

The Consequences of Deteriorating Sanitation in Nigeria | Source: Council on Foreign Relations Blog, July 23, 2015 |

This is a guest post by Anna Bezruki, an intern for the Council on Foreign Relations Global Health Program. She studies biology at Bryn Mawr College.

According to the final report on Millennium Development Goals (MDGs) released earlier this month, more than a third of the world population (2.4 billion) is still without improved sanitation.

Children play at a slum in Ijegun Egba, a suburb of Nigeria's commercial capital of Lagos, July 2, 2008. (Courtesy Reuters/George Esiri)

Children play at a slum in Ijegun Egba, a suburb of Nigeria’s commercial capital of Lagos, July 2, 2008. (Courtesy Reuters/George Esiri)

The target to halve the global population without adequate toilets by 2015 has not been reached. Consequently, sanitation has been pushed on to the post-2015 sustainable development goals (SDGs).

Although India is perhaps the most widely cited failure, accounting for roughly half of open defecation worldwide, it is at least making progress toward the SDG target. The same cannot be said for Nigeria. Lacking the political infrastructure to reform sanitation and faced with security and political concerns that overshadow development goals, Nigeria is struggling to reverse the trend.

Unlike in India, where the percentage of people with access to a toilet shared by only one family increased by eighteen points between 1990 and 2012, that percentage declined in Nigeria from 37 to 28 percent.

This incongruity is best illustrated by the fact that there are more than three times as many cell phones in Nigeria as people who have access to adequate toilets. This means thirty-nine million defecate outside, sixteen million more today than in 1990.

Poor sanitation contributes to diarrheal diseases and malnutrition through fecal contamination of food and water. One gram of feces can contain one hundred parasite eggs, one million bacteria, and ten million viruses.

Diarrheal diseases kill approximately 121,800 Nigerians, including 87,100 children under the age of five each year. Eighty-eight percent of those deaths are attributed to poor sanitation. Poor sanitation is thought to strain the immune system to the point that permanent stunting and other manifestations of malnutrition can result.

More than 40 percent of Nigerian children under the age of five are stunted, and malnutrition is the underlying cause of death in more than 50 percent of the approximately 804,000 deaths annually in the same age range.

The impact of inadequate toilets goes beyond hazardous exposure to feces. A survey conducted by WaterAid, a nonprofit organization focusing on providing safe water and sanitation access, in a Lagos slum revealed that the 69 percent of women and girls without access to toilets are at higher risk of verbal and physical harassment when they relieve themselves.

The effects of poor sanitation are also costing Nigeria economically. The Nigerian Water and Sanitation Program estimates that poor sanitation costs the country at least three billion U.S. dollars each year in lost productivity and health care expenditures.

While estimates vary, in 2011, Nigeria invested approximately $550 million, less than 0.1 percent of GDP, on sanitation, a number which has likely decreased since then. This is less than a quarter of the approximately $2.3 billion annually that would have been necessary to meet the MDG target.

It will take more than money and infrastructure to fix Nigeria’s sanitation. Even if investments were to sufficiently rise, the lack of a single government entity with complete responsibility for sanitation within the government, as well as widespread corruption and a lack of community support, would likely hamper efforts.

Providing latrines without first creating demand within the community has failed repeatedly, including in India, where latrines have been repurposed for extra storage. There are also other problems, like a treasury emptied by corruption and the war on Boko Haram, that top President Buhari’s agenda.

While these are immediate threats that require intense focus, sanitation is an essential long-term investment that will help Nigeria grow.  

Breaking the Next Taboo: Menstrual Hygiene within CLTS

Breaking the Next Taboo: Menstrual Hygiene within CLTSFrontiers of CLTS: Innovations and Insights, July 2015.

Authors: Sharon Roose and Tom Rankin, Plan International and Sue Cavill, Independent Consultant

Most adolescent girls and women menstruate. This means that for five to seven days each month they bleed through their vagina. This monthly bleeding is often accompanied by abdominal cramps, headaches, mood changes and general lethargy all of which can be exacerbated by social stigma, myths and a lack of requisite infrastructure to manage menstruation safely, privately and hygienically. Frontiers_Issue-6_MHM

The accumulated impact of these issues have significant implications for women and girls and the potential to limit their opportunity for education, equality, income generation and societal participation, all of which hamper self-worth and confidence.

This edition of Frontiers of CLTS illustrates how CLTS programmes can be expanded to address menstrual hygiene management (MHM) in schools
and communities to alleviate these stresses on women and girls.

Its specific objectives are to:

  • Increase the awareness of policy-makers and practitioners on MHM.
  • Engender change by highlighting the synergies between MHM and
    CLTS programmes.
  • Share examples of how MHM interventions have been incorporated
    into CLTS and School-Led Total Sanitation (SLTS) programmes,
    drawing on the innovations and experiences of several organisations.
  • Summarise what can be done to improve MHM through CLTS
    programmes.

WASHplus Weekly: Focus on WASH & Financing

Issue 199| July 17, 2015 | Focus on WASH & Financing

Thanks to Jonathan Annis of TetraTech for suggesting this week’s topic. Resources and studies in this issue include 2015 discussion forums and webinars hosted by the Sustainable Sanitation Alliance (SuSanA), a series of WASH financing briefs, and new USAID Urban Pathway manuals.

DISCUSSION FORUMS/WEBINARS

Urban Sanitation Finance – From Macro to Micro Level, SuSanA Thematic Discussion, June–July 2015. Link
This discussion forum was structured along three themes: Public Finance, Microfinance, andCity Level Sustainable Cost Recovery and was supported by six experts on sanitation finance who provided leadership and addressed questions raised by forum users. Summaries of the discussions are available here.

Webinar about Results-Based Financing (RBF) for Sanitation – April 29, 2015. SuSanA. Link
This webinar was organized under the knowledge management initiative of the Building Demand for Sanitation program of the Bill & Melinda Gates Foundation. Peter Feldman moderated the webinar with support from Pippa Scott and Pete Cranston of Euforic Services. The Stockholm Environment Institute and the SuSanA Secretariat served as hosts.

REPORTS/ARTICLES

Finance Brief 1: Domestic Public Finance for WASH: What, Why, How? 2015. G Norman. Link
This report defines domestic public finance as funds derived from domestic taxes, raised at the national or local level. Domestic public finance is only part of the solution to service delivery in poor communities; user finance and donor finance are also part of the mix. Likewise, domestic public finance forms part of a wider governance puzzle: improving WASH services requires not just more government investment, but also diverse other elements including (for example) clear institutional mandates.

Finance Brief 2: Universal Water and Sanitation: How Did the Rich Countries Do It?2015. Public Finance for WASH. Link
This finance brief briefly summarizes the history of water and sanitation services provision in the U.S., the U.K., and South Korea, and considers whether this historical experience is relevant to low- and middle-income countries today.

Finance Brief 3: Municipal Finance for Sanitation in Three African Cities, 2015. B Edwards. Link (Download free but registration required)
This discussion paper reports data on municipal public finance for sanitation in three African cities, based on in-country examination of available budget records: Ga West Municipality, part of the Greater Accra conglomeration in Ghana; Maputo, capital of Mozambique; and Nakuru County in Kenya, including the city of Nakuru.

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Funky Sink Gets Kids In Cambodia To Wash Up, Could Save Thousands Of Young Lives

Funky Sink Gets Kids In Cambodia To Wash Up, Could Save Thousands Of Young Lives | Source: Huffington Post, July 8 2015 |

Cambodia has the lowest access to sanitation in all of Southeast Asia, and as a result more than 10,000 children die every year due to diarrheal diseases, according to WaterAid. watershed

To help curb those figures, nonprofit WaterSHED recently released the LaBobo, a portable and inexpensive sink whose colorful design encourages kids to improve their hygiene habits.

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