Emergency Sanitation Research Articles

‘Eradication was a dirty word’: Anti-gambiae campaign, between cooperation and rivalry (1938–1940)

ABSTRACT This article analyzes the efforts of the International Health Division of the Rockefeller Foundation (IHDRF) in its project initiative that resulted in the extermination of the African mosquito Anopheles gambiae from Brazil in 1940. This species, which originated in Dakar, Senegal, was identified in the Brazilian city of Natal in 1930, where insufficient local emergency sanitation actions enabled it to spread into the interior of the Brazilian northeast, causing an unprecedented malaria epidemic in the Americas in 1938, after years of silent spread. We will analyse the formation of Brazil’s Malaria Service of the Northeast (MSNE), discussing its political and scientific controversies and how the transition from the idea of extermination to the idea of eradication was consolidated in the political process of creating this successful sanitation campaign. In addition, we will discuss how the integration and transnational development of medical entomology at the time was a fundamental factor in the cooperation and challenges among scientists involved in this campaign. The international cooperation of scientists, albeit oriented towards the project of eradication of this mosquito, organised different research agendas and gained new insights into the global dissemination of mosquito-borne diseases.

Preconditions, processes and structures: Interorganisational collaboration in the provision of post-disaster water, sanitation and hygiene (WASH) services

Emergency water, sanitation, and hygiene (WASH) interventions are critical to avoid transmission of infectious diseases and limit susceptibility to disease-bearing vectors. Non-Governmental Organisations (NGOs) play a critical role in developing WASH programs, working with government organisations (GOs), specifically during the post-disaster phase, whether during recovery or reconstruction periods. Developing effective collaboration between GOs and NGOs can form a well-focused relationship leading to effective outcomes. Lack of collaboration may result in negative outcomes, including significant infrastructure destruction, loss of life and property, and lack of access to WASH service. The aim of the paper is to identify the factors influencing collaboration between GOs and NGOs to provide WASH services in the post-disaster phase. The research methodology is underpinned by qualitative approach using data collected using semi-structured interviews. The result obtained from analysing data from thirty interviewees support the preconditions, processes, and structural factors of collaboration.The findings suggest that the increasing complexity of disasters and the lack of capacity of GOs alone to manage these disasters have created interdependency between GO and NGOs. Moreover, good relationship history and a shared vison between GOs and NGOs are key preconditions for effective collaboration. The structures for effective GO-NGO collaboration require good coordination, good legislation, and an administrative system with legitimised coordinators/administrators, backed up by clear descriptions of the roles and responsibilities of stakeholders. The processes relating to planning, developing mutual understanding, communication, and cooperation is key for collaboration between GOs and NGOs. Furthermore, the findings identified trust and power as the mediator factors integrating with the precondition, process, and structure variables for GO-NGO collaboration for the effective delivery of public services in times of crisis.

Government institutional emergent issues and gaps in disaster management mechanisms for WASH: a case study of Zambia's Kanyama peri-urban area

Abstract This paper endeavours to characterise emergent issues and gaps in government institutional disaster management mechanisms for water, sanitation, and hygiene (WASH) in peri-urban areas. It is a case of Zambia's Kanyama peri-urban area and focuses on disaster management issues related to prevention, preparedness, and response. To gain an in-depth inductive perspective of emerging issues and inferred gaps, the study used a Straussian Grounded Theory approach by conducting semi-structured interviews with government institutions. Following that, the qualitative data were analysed using open and axial coding. Emergent issues and gaps with regard to mechanisms for emergency sanitation in peri-urban areas have been characterised. The characterised emergent issues and associated gaps include the following: (a) mandate and institutional policy; (b) responsiveness of authorities; (c) community engagement; and (d) stakeholder engagement. Of these emergent issues, mandate and institutional policy is the most outstanding and the critical institutions in the disaster management mechanisms generally are the disaster management and local government authorities. Inadequacies and inefficiencies in the preparedness and response by institutions is highly influenced by the centralisation of preparedness for response. Furthermore, community engagement is cardinal in the effective implementation of preparedness, prevention, and response to disaster management mechanisms in peri-urban WASH by planning authorities.

IPAL Komunal dalam Mengolah Limbah Rumah Tangga di Desa Dutohe Barat

The village of Dutohe Barat is classified as an emergency sanitation area due to household waste produced by human activities (bathing, washing, and cooking). This activity aims to solve the problem by designing and making the communal wastewater treatment that has been standardized. The sample is liquid waste collected from 5 houses in section 4. Initial data on wastewater quality were obtained were BOD, which initially was 265 mg/l, COD was 290 mg/l, and oil and fat were 27 mg/l. The activity method is carried out in 3 stages (observation, socialization, and evaluation). After going through treatment with this communal wastewater treatment, the results of the reduction in waste pollutants were BOD decreased to 98 mg/l, COD decreased to 90 mg/l, and oil and fat decreased to 10 mg/l. In addition, the output from the wastewater treatment processing is used by farmers to irrigate crops.

Pandemic responses in vulnerable communities: a simulation-oriented approach

Abstract Populations living in favelas are facing even more vulnerabilities with the sudden escalation of the COVID-19 pandemic, as social distancing is challenging in such settings. Furthermore, these populations typically lack proper sanitation and hygiene conditions, which are requirements to adequately control the outbreak. This paper proposes the use of System Dynamics modeling to support the public policy-making process in order to avert negative effects of the pandemic in the Brazilian favelas based on measures elicited from the social movement named “Favelas Contra o Corona.” The simulation model assessed the effectiveness of strategies and policy bundles encompassing temporary transfer of the favela population, supply of hygiene products, emergency sanitation structures, and expansion of Intensive Care Units. Results indicate that a suitable combination of strategies can bring significant effects to the number of avoidable deaths and the availability of Intensive Care Units for the population.

User acceptance of the eSOS® Smart Toilet in a temporary settlement in the Philippines

Abstract An eSOS (emergency Sanitation Operation System) Smart Toilet experimental prototype, aimed at improving the provision of safe sanitation in emergency settings, was field tested in a temporary settlement in Tacloban City, Philippines. The design, usage, and user acceptance of the toilet were all evaluated. Quantitative and qualitative data were collected through interviews and questionnaires, supported by the research-team's observations. The survey results indicated that 98% of users (both first-time users and those who tried it a few times) intended to use the toilet again. There were more features that the users liked than disliked. The in-built water supply and user-operated smart toilet features were liked, but the bad smell was disliked. User-operated smart features were an important factor in user acceptance although they were not the main incentives. Key recommendations are to improve the toilet's design to address the odor and cleanliness issues, make handwashing more convenient, and lower the height of the toilet bowl.

Evaluation of a smart toilet in an emergency camp

An experimental prototype of the eSOS (emergency Sanitation Operation System) Smart Toilet® was evaluated in an emergency settlement in the Philippines. The toilet was equipped with sensors and information communication technologies (ICT) for an efficient operation in an emergency setting. The field testing aimed at evaluating the toilet's service capacity related to the user frequency/intensity obtaining insight on the usage patterns in an actual post emergency situation. In addition, the novel features and functionality of the toilet were assessed. Operational performance of the toilet was assessed based on data collected from nearly 700 users within a 7-weeks period. The eSOS Smart Toilet has been properly operating during the evaluation period. A methodology to distinguish defecation and urination activities was developed based on determining discharges to faeces and urine tank. The toilet achieved up to 97% savings on water consumption compared to conventional toilets. The application of sensors and ICT features, combined with manually obtained data informed comprehensive usages data e.g. 62% of identified users were female users, 40% children, and 60% of the visits were for urination and 40% and for defecation. The accumulation of urine, faeces and grey water was measured to allow for a responsive maintenance resulting in optimized operation and increased interest to use the toilet. The field evaluation generated ideas for further improvements in terms of cost savings, services, and an overall vision for sustainability.

Effectiveness of UV-C light irradiation on disinfection of an eSOS® smart toilet evaluated in a temporary settlement in the Philippines

Ultraviolet germicidal (short wavelength UV-C) light was studied as surface disinfectant in an Emergency Sanitation Operation System® smart toilet to aid to the work of manual cleaning. The UV-C light was installed and regulated as a self-cleaning feature of the toilet, which automatically irradiate after each toilet use. Two experimental phases were conducted i.e. preparatory phase consists of tests under laboratory conditions and field testing phase. The laboratory UV test indicated that irradiation for 10 min with medium–low intensity of 0.15–0.4 W/m2 could achieve 6.5 log removal of Escherichia coli. Field testing of the toilet under real usage found that UV-C irradiation was capable to inactivate total coliform at toilet surfaces within 167-cm distance from the UV-C lamp (UV-C dose between 1.88 and 2.74 mW). UV-C irradiation is most effective with the support of effective manual cleaning. Application of UV-C for surface disinfection in emergency toilets could potentially reduce public health risks.

Off-Site Lime Stabilisation as an Option to Treat Pit Latrine Faecal Sludge for Emergency and Existing On-Site Sanitation Systems

Off-site lime stabilisation for treating faecal sludge was assessed by undertaking small-scale (35 L) and large-scale (600 L) field trials in Blantyre, Malawi. Hydrated lime was dosed to maintain pH 10, pH 10.5, pH 11, pH 11.5, and pH 12 depending on the buffer capacity of the faecal sludge in the four replica small-scale field trials. Significant reduction of E. coli to below the detection limit of 104 CFU/100 mL within 1 hour of treatment was reported for pH > 11. Based on the small-scale findings, large-scale field trials were conducted and greater than 3 log removal of E. coli was observed under pH 12 conditions. Therefore, based on the study, off-site lime stabilisation by dosing lime in the range of 10–35% w/w (dry solid basis), depending on the buffer capacity and solids content of the sludge to maintain pH > 11, can be used to sanitise faecal sludge during emergencies, as well as for existing on-site sanitation systems.

Emergency sanitation: developing criteria for pit latrine lining

Pit latrine linings for emergency sanitation facilities require different performance criteria from those for pits used in longer-term development work. Various international initiatives are currently under way to develop new methods of supporting the pits used for latrines in emergencies, but before a solution can be found, the problem needs to be defined. Current field guidance lacks the level of detail required by humanitarian workers to construct durable pits in a timely manner. Consultations with international humanitarian field staff and UK-based geotechnical engineers were used in this research project to identify design, construction, and operational requirements of emergency pit-lining systems. However, rather than closely defined performance requirements, the study identified a wide range of criteria that need to be considered and clear distinctions between emergency and longer-term solutions. Latrines constructed in the initial stages of emergencies are likely to be communal, with long rectangular pits that require frequent emptying. Current knowledge of suitable pit support methods is sufficient to provide a limited range of standard designs that could be selected to meet local requirements.

Understanding how people innovate for emergency sanitation: A case study of a local NGO

Emergency sanitation technologies make up some of the most significant gaps in the water, sanitation and hygiene sector. Major initiatives to address identified gaps may be characterised as donor-funded, top-down processes driven by international or European-based non-governmental organisations. However, local organisations also innovate. To better understand how local organisations innovate for emergency sanitation, the paper presents a case study of an Indonesian NGO who had developed a toilet for use in emergencies. The NGO developed the toilet by modifying an existing non-emergency toilet. The process was unstructured and informal. When testing ideas, for instance, the NGO used their own methods rather than referring to testing protocols recognised by the industry. The NGO surveyed end users, but the respondents did not come from post-disaster settings. Compared to designs developed through international initiatives, the NGO's design deviated somewhat from internationally recognised standards, for instance, the size of the latrine slab. The paper also discusses differences between the way local and international organisations develop emergency sanitation products. Each approach has advantages and disadvantages in terms of methodology and access to resources and expertise. Therefore, there are potential benefits to the different organisations working more closely.

Lactic Acid Fermentation, Urea and Lime Addition: Promising Faecal Sludge Sanitizing Methods for Emergency Sanitation.

In this research, three faecal sludge sanitizing methods—lactic acid fermentation, urea treatment and lime treatment—were studied for application in emergency situations. These methods were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi. Hydrated lime was able to reduce the E. coli count in the sludge to below the detectable limit within 1 h applying a pH > 11 (using a dosage from 7% to 17% w/w, depending faecal sludge alkalinity), urea treatment required about 4 days using 2.5% wet weight urea addition, and lactic acid fermentation needed approximately 1 week after being dosed with 10% wet weight molasses (2 g (glucose/fructose)/kg) and 10% wet weight pre-culture (99.8% pasteurised whole milk and 0.02% fermented milk drink containing Lactobacillus casei Shirota). Based on Malawian prices, the cost of sanitizing 1 m3 of faecal sludge was estimated to be €32 for lactic acid fermentation, €20 for urea treatment and €12 for hydrated lime treatment.

Cut the crap; design brief to pre-production in eight weeks: Rapid development of an urban emergency low-tech toilet for Oxfam

With the world becoming increasingly urbanised, emergency sanitation for these environments have been found limited and insufficient. Governments and NGOs are becoming aware that changes need to be made and innovative solutions developed fast. Oxfam GB in collaboration with C4D of Cranfield University undertook a design brief to develop a low-tech sanitation solution for urban emergencies to be completed within a limited time frame. A multidisciplinary team of designers and engineers developed a rapid, low cost, design-led innovation framework, which captured stakeholder knowledge to create a solution that addressed the problem and was feasible for production. This article reveals the journey from design brief to pre-production in eight weeks culminating in the successful creation of a new product.

Decision support system for the provision of emergency sanitation

Proper provision of sanitation in emergencies is considered a life-saving intervention. Without access to sanitation, refugees at emergency camps are at a high risk of contracting diseases. Even the most knowledgeable relief agencies have experienced difficulties providing sanitation alternatives in such challenging scenarios. This study developed a computer-based decision support system (DSS) to plan a sanitation response in emergencies. The sanitation alternatives suggested by the DSS are based on a sanitation chain concept that considers different steps in the faecal sludge management, from the toilet or latrine to the safe disposal of faecal matters. The DSS first screens individual sanitation technologies using the user's given input. Remaining sanitation options are then built into a feasible sanitation chain. Subsequently, each technology in the chain is evaluated on a scoring system. Different sanitation chains can later be ranked based on the total evaluation scores. The DSS addresses several deficiencies encountered in the provision of sanitation in emergencies including: the application of standard practices and intuition, the omission of site specific conditions, the limited knowledge exhibited by emergency planners, and the provision of sanitation focused exclusively on the collection step (i.e., just the provision of toilets).

ESOS® – emergency Sanitation Operation System

This paper presents the innovative emergency Sanitation Operation System (eSOS) concept created to improve the entire emergency sanitation chain and provide decent sanitation to people in need. The eSOS kit is described including its components: eSOS smart toilets, an intelligent excreta collection vehicle-tracking system, a decentralized excreta treatment facility, an emergency sanitation coordination center, and an integrated eSOS communication and management system. The paper further deals with costs and the eSOS business model, its challenges, applicability and relevance. The first application, currently taking place in the Philippines will bring valuable insights on the future of the eSOS smart toilet. It is expected that eSOS will bring changes to traditional disaster relief management.

Keeping it simple: a gender-specific sanitation tool for emergencies

Mainstreaming gender in an emergency water and sanitation (WatSan) response can be difficult as standard consultations and participation processes take too much time. To facilitate a rapid response that includes women's needs, a simple Gender and Sanitation Tool has been developed that can also be used by less experienced staff. The tool is a step-by-step guide on how to collect required data to define design parameters for sanitation facilities, based on ad hoc consultations with women who will be their users. In 2012 the tool was tested in South Sudan within the context of a Medecins Sans Frontieres (MSF) emergency intervention. Using the tool allowed for a quick and easy way to consult women about the design of facilities and consequently, after construction, an increased usage of facilities was observed in the intervention group compared with a control group where the tool was not used.

Construction of the School Physical Environment Standardized Features Tool

Objective: A descriptive design, using the methodological approach, is carried throughout the presentstudy from April 1st 2012 to May 20th 2013 to construct the school physical environment standardizedfeatures tool.Methodology: An instrument of (141) item is constructed for the purpose of the study. A purposivesample of (44) school; (22) public and (22) private ones is selected. Content Validity of the instrument isdetermined through the use of panel of (11) expert who are specialists in Community Health Nursing andCommunity Medicine. Internal consistency reliability, using the split-half technique, is employed throughthe computation of Cronbach alpha correlation coefficient of (0.93) for internal scale. Data were collectedthrough the use of the instrument and the schools' visits as means of data collection. Data are analyzedthrough the application of the inferential statistical data analysis procedure of simple Pearson’scorrelation coefficient and factor analysis (principle component) method.Results: Findings of the study reveal that the features are presented, post their rearrangement, under fivefactors that include school services, emergency and school sanitation, food and protection services, safeschool environment, and school environment. So, the new tool can be structured, tested and used asguide for new investigations. Such presentation of factors reflects the actual model by which the school'sphysical environment features can be considered as essential elements for future evaluation through theutilization of the constructed tool.Recommendations: The study recommends that the new discovered tool can be used as measure forfuture work, and further studies can be carried out on large sample size and nation-wide base.

Employing a systems-based perspective to the identification of inter-relationships within humanitarian logistics

Abstract The term Civil Military Co-ordination (CIMIC) suggests the seamless division of labour between aid workers and international military forces. The images of humanitarian organisations distributing food and medicines under the protection of military forces, or aid workers and military working together to construct refugee camps, set up field hospitals, provide emergency water and sanitation, has become more frequent. The media coverage from natural and man-made disasters in recent years, has heightened the expectation of a smooth interaction between humanitarian organisations and military forces. Due to fundamental differences between international military forces, humanitarian and development organisations (in terms of the principles and doctrines guiding their work, their agendas, operating styles, and roles), the area of civil military coordination in disaster relief has proven to be more difficult than other interagency relationships. In order to address this, the authors outline the usage of systems analysis and design technique (SADT) to explain how a more effective coordination of humanitarian operations by military and civilian organisations involved in disaster relief can be achieved across the range of humanitarian aid lifecycle phases. Furthermore the authors provide an empirical comparison of military and humanitarian organisation partnership evaluation criteria for (CIMIC). Finally, the authors then develop and present how the SADT approach can inform the development of a systems dynamics model using systems archetypes (SA) to describe the rich interactions between stakeholders and involved components. The authors propose a framework which identifies these facets as a result.

Biodegradable bags as emergency sanitation in urban settings: the field experience

In addition to the dire medical needs resulting from the 2010 Haiti earthquake, over 1.5 million people were left without access to sanitation facilities. In the second phase of the overall emergency response, Médecins Sans Frontiéres-Operational Centre Brussels attempted to address the urgent need for safe and sanitary human excreta disposal in some of the most neglected camps for displaced people in Port-au-Prince, by implementing an approach consisting of defecation in single-use, biodegradable plastic bags. Construction and maintenance of facilities for this intervention was undemanding and cost-effective, and the approach offered a suitable solution to a number of technical constraints encountered in this urban setting. However, immediate acquisition of ecologically appropriate bags proved troublesome. Furthermore, a relatively low bag usage rate of 13 per cent (8-18 per cent) was observed, differing considerably from the rates reported in more controlled evaluations of such approaches, reflecting the operational limitations to this intervention. We therefore recommend this sanitation approach in urban settings only as a stop-gap approach when other interventions are not possible.

Innovative designs and approaches in sanitation when responding to challenging and complex humanitarian contexts in urban areas

As recent emergencies have shown, there are still significant challenges in the timely provision of safe sanitation in natural disasters or conflict situations. In urban emergencies or areas where it is impossible to dig simple pit latrines because of high water tables, hard rock, or lack of permission, it takes agencies considerable time to construct elevated latrines or alternative designs such as urine diversion toilets. This paper describes the challenges often faced in the rapid construction of latrines in emergencies and then looks at a number of case studies, from the Haiti earthquake and the 2010 floods in the Philippines, of how these obstacles were overcome. It also documents some of the recent innovations and improvements suppliers have made in increasing the scope of their emergency sanitation equipment.