Tricia’s snippets 2012-03-29


From Sanitation Updates:

Conference on Decentralised Wastewater Management in Asia – Meeting Urban Sanitation Challenges at Scale, Nagpur, India, 20-23 Nov 2012

Posted: 27 Mar 2012 04:52 PM PDT

International Faecal Sludge Management Conference 2012

Posted: 23 Mar 2012 09:34 AM PDT

From Water, Sanitation, Hygiene and Health Newsletter N° 154 / 28 March 2012: 

Water Safety Plan Quality Assurance Tool User Manual
With thanks to the National Institute of Public Health, Japan, the WSP Quality Assurance Tool User Manual is now available in Japanese. The tool, developed by WHO and IWA, supports the development, implementation and assessment of WSPs, the risk management approach recommended in the WHO Guidelines for Drinking-water Quality to ensure consistent supplies of safe drinking-water. The tool and user manual are available at:

Joint publication WHO/Secretariat of the Ramsar Convention now available
Healthy wetlands, healthy people: a review of wetlands and human health interactions is now available at:

A selection from email alerts:

Title: Assessing the management of healthcare waste in Hawassa city, Ethiopia
by Haylamicheal, Israel Deneke; Dalvie, Mohamed Aqiel; Yirsaw, Biruck Desalegn; Zegeye, Hanibale Atsbeha
Waste Management & Research [Waste Manage. Res.]. Vol. 29, no. 8, pp. 854-862. Aug 2011.
Article Subject Terms:; Hazardous wastes; Health care; High cycle fatigue; Legislation; Management; Training; Waste management; Wastes
Inadequate management of healthcare waste is a serious concern in many developing countries due to the risks posed to human health and the environment. This study aimed to evaluate healthcare waste management in Hawassa city, Ethiopia. The study was conducted in nine healthcare facilities (HCFs) including hospitals (four), health centres (two) and higher clinics (three) in two phases, first to assess the waste management aspect and second to determine daily waste generation rate. The result showed that the median quantity of waste generated at the facilities was 3.46 kg bed super(-1) day super(-1) (range: 1.48-8.19 kg bed super(-1) day super(-1)). The quantity of waste per day generated at a HCF increased as occupancy increased (p < 0.001). The percentage hazardous waste generated at government HCFs was more than at private HCFs (p < 0.05). The proportion of hazardous waste (20-63.1%) generated at the different HCFs was much higher than the WHO recommendation (10-25%). There was no waste segregation in most HCFs and only one used a complete color coding system. Solid waste and wastewater were stored, transported, treated and disposed inappropriately at all HCFs. Needle-stick injuries were prevalent in 25-100% of waste handlers employed at these HCFs. Additionally, low levels of training and awareness of waste legislation was prevalent amongst staff. The study showed that management of healthcare waste at HCFs to be poor. Waste management practices need to be improved through improved legislation and enforcement, and training of staff in the healthcare facilities in Hawassa.

Title: The semicentralized approach to integrated water supply and treatment of solid waste and wastewater–a flexible infrastructure strategy for rapidly growing urban regions: the case of Hanoi/Vietnam
by Bohm, Hans Reiner; Schramm, Sophie; Bieker, Susanne; Zeig, Carola; Anh, Tran Huy; Thanh, Nguyen Chi
Clean Technologies and Environmental Policy [Clean Technol. Environ. Policy]. Vol. 13, no. 4, pp. 617-623. Aug 2011.
Article Subject Terms:; Climate change; Economics; Infrastructure; Policies; Sanitation; Urbanization; Vietnam; Water supplies
The development of the world population is characterized by an absolute population growth and a rapid urbanization. This process, taking place in Asia, Latin America, and Africa, poses major pressure on the affected urban regions. In Asian countries, this development is combined with high economic growth rates. At the same time, the climate change is proceeding, and the energy supply is going to become an existential problem. The rapidly growing cities therefore face the issue that the supply of infrastructures and public services lag behind the rapid urbanization. The increasing energy costs and the imperative to reduce the CO2 emissions aggravate the situation. The centralized systems which started to be implemented in the industrialized countries more than 100 years ago are no longer the appropriate way to solve these problems. The semicentralized integrated approach, recently developed for rapidly growing urban regions in China, in contrast, offers with its flexibility a sustainable solution to cope with these developments. This article presents objectives and first results of an interdisciplinary R&D project aiming at the adaptation of the semicentralized integrated approach to the case of Hanoi, the rapidly growing capital of Vietnam, to contribute to the solution of the sanitation problems of both the old City Center and the urban expansions in conjunction. This article focuses on the planning and institutional aspects. The technical questions will be presented later in separate articles. The ongoing project is conducted by the Technische Universitat Darmstadt in cooperation with the National University of Civil Engineering Hanoi and an industrial partner.

Title: Making sanitation count: developing and testing a device for assessing latrine use in low-income settings.
by Clasen, Thomas; Fabini, Douglas; Boisson, Sophie; Taneja, Jay; Song, Joshua; Aichinger, Elisabeth; Bui, Anthony; Dadashi, Sean; Schmidt, Wolf-Peter; Burt, Zachary; Nelson, Kara L
Environmental science & technology, March 20, 2012, 46(6):3295-3303
While efforts are underway to expand latrine coverage to an estimated 2.6 billion people who lack access to improved sanitation, there is evidence that actual use of latrines is suboptimal, limiting the potential health and environmental gains from containment of human excreta. We developed a passive latrine use monitor (PLUM) and compared its ability to measure latrine activity with structured observation. Each PLUM consisted of a passive infrared motion detector, microcontroller, data storage card, and batteries mounted in a small plastic housing that was positioned inside the latrine. During a field trial in Orissa, India, with ∼115 households, the number of latrine events measured by the PLUMs was in good agreement with that measured by trained observers during 5 h of structured observation per device per week. A significant finding was that the presence of a human observer was associated with a statistically significant increase in the number of latrine events, i.e., the users modified their behavior in response to the observer. Another advantage of the PLUM was the ability to measure activity continuously for an entire week. A shortcoming of the PLUM was the inability to separate latrine events that occurred in immediate succession, leading to possible undercounting during high-traffic periods. The PLUM is a promising technology that can provide detailed measures of latrine use to improve the understanding of sanitation behaviors and how to modify them and for assessing the intended health, livelihood, and environmental benefits of improved sanitation.

Title: Sanitation behavior among schoolchildren in a multi-ethnic area of Northern rural Vietnam.
by Xuan, Le Thi Thanh; Hoat, Luu Ngoc; Rheinländer, Thilde; Dalsgaard, Anders; Konradsen, Flemming
BMC public health, 2012, 12:140
ABSTRACT:In Vietnam, efforts are underway to improve latrine use in rural and remote areas with particular focus on increasing coverage of sanitation in schools. However, there is a lack of information on how the school program affects latrine use by schoolchildren and at community level. This paper analyzes sanitation use among schoolchildren in a multi-ethnic area to inform future school-based sanitation promotion programmes.A combination of quantitative and qualitative methods was applied during a 5 months period in six primary and secondary schools and in the homes of schoolchildren in four different ethnic villages in Northern rural Vietnam. Using a structured questionnaire, 319 children were interviewed face-to-face to collect quantitative data. Qualitative methods included extensive observations at schools and in the homes of 20 children, a single day’s diary writings of 234 children, in-depth interviews with children (20), their parents (20) and school staff (10), and focus group discussions with parents (4) and teachers (6), and picture drawing with children (12).All surveyed schools had student latrines. However, the observed schoolchildren most commonly urinated and defecated in the open. Main barriers for latrine use included inadequate number of latrines, limited accessibility to latrines, lack of constant water supply in latrines and lack of latrine maintenance by school management. Programs promoting latrine use for children were not conducted in either schools or communities and were not established as a preferred social norm in such settings. Children perceived existing school latrines as unappealing and expressed a wish to have basic, functional, clean, and colorful school latrines with privacy.The paper shows that the current school based sanitation promotion is insufficient to change sanitation behavior of school children irrespective of their ethnicity. It is important that schools, households and communities work more closely together to increase use and uptake of latrine use among schoolchildren. Also, the contractors of latrine facilities must work more closely with local school management when constructing latrines, including identifying location, design and appropriate systems of water supply. A separate budget needs to be allocated to allow the school to maintain the sanitation infrastructure and keep it hygienic and appealing for users.

Title: Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap.
by Mahamud, Abdirahman Sheikh; Ahmed, Jamal A; Nyoka, Raymond; Auko, Erick; Kahi, Vincet; Ndirangu, James; Nguhi, Margaret; Burton, John Wagacha; Muhindo, Bosco Z; Breiman, Robert F; Eidex, Rachel B
Journal of infection in developing countries, 2012, 6(3):234-241
Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009.We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls.From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital.  Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42%) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p < 0.01), while presence of dirty water storage containers was a risk factor (AOR=4.39[1.12-17.14]; p=0.03).Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera.

• LANCET -LONDON- VOL 379; NUMB 9820 (2012) pp.978-978
Progress in sanitation needed for neglected tropical diseases
The, L.

On the diffusion of toilets as bottom of the pyramid innovation: Lessons from sanitation entrepreneurs
Ramani, S. V.; SadreGhazi, S.; Duysters, G.
There is an emerging body of literature on product innovations for the poor at the bottom of the income pyramid. However, there is little on why delivery systems succeed or fail in this context and the present paper attempts to fill this void by examining why and how sanitation entrepreneurs are succeeding in India to diffuse toilets – an innovation for rural households, which never had access to one before. The literature is analyzed and confronted with the actual field practices. We demonstrate that the common thread that unifies progressive sanitation entrepreneurs is their adoption of a ‘market based approach’. There are market failures stemming from the demand side due to problems in expression of demand and its mismatch with the perceived value of the innovation. In response, sanitation entrepreneurs go beyond the standard linear model of assessing need and appropriateness of technology. They create innovations in ‘technological design’ as well as in the ‘delivery platforms’ to include practices for ‘accompaniment’, ‘sustainable maintenance’ and ‘generation of knowledge’. Thus, they make-up for sluggish or missing markets and informational asymmetries to ensure sustained use of toilets.

VOL 14; NUMB 1; SUPP (2012)
ISSN 1366-7017
Whole issue devoted to ethics and religious aspects

VOL 46; NUMB 7 (2012)
ISSN 0043-1354
• pp.2344-2354
Continuous-flow solar UVB disinfection reactor for drinking water
Mbonimpa, E. G.; Vadheim, B.; Blatchley, E. R.
Access to safe, reliable sources of drinking water is a long-standing problem among people in developing countries. Sustainable solutions to these problems often involve point-of-use or community-scale water treatment systems that rely on locally-available resources and expertise. This philosophy was used in the development of a continuous-flow, solar UVB disinfection system. Numerical modeling of solar UVB spectral irradiance was used to define temporal variations in spectral irradiance at several geographically-distinct locations. The results of these simulations indicated that a solar UVB system would benefit from incorporation of a device to amplify ambient UVB fluence rate. A compound parabolic collector (CPC) was selected for this purpose. Design of the CPC was based on numerical simulations that accounted for the shape of the collector and reflectance. Based on these simulations, a prototype CPC was constructed using materials that would be available and inexpensive in many developing countries. A UVB-transparent pipe was positioned in the focal area of the CPC; water was pumped through the pipe to allow exposure of waterborne microbes to germicidal solar UVB radiation. The system was demonstrated to be effective for inactivation of Escherichia coli, and DNA-weighted UV dose was shown to govern reactor performance. The design of the reactor is expected to scale linearly, and improvements in process performance (relative to results from the prototype) can be expected by use of larger CPC geometry, inclusion of better reflective materials, and application in areas with greater ambient solar UV spectral irradiance than the location of the prototype tests. The system is expected to have application for water treatment among communities in (developing) countries in near-equatorial and tropical locations. It may also have application for disaster relief or military field operations, as well as in water treatment in areas of developed countries that receive relatively intense solar UVB radiation.