Sanitation Issues Research Articles

Problems of Solid Waste Management in Developing Urban Cities: A Case Study of Freetown, Sierra Leone

This study was designed to determine the existing problems of solid waste management in Freetown. The problems that were assessed were the factors impeding the effectiveness and efficient solid waste management and the wrong attitudes and perceptions of the people about sanitation issues which have contributed to solid waste management problems in Freetown. Structured questionnaires were administered with respect to socioeconomic and solid waste management data. Interviews and personal observations were also used to collect some of the data. Data analysis was carried out using the Statistical Packages for Social Sciences (SPSS) software. The results show that majority of the households did not educate their members on the need to clean their surroundings. Virtually, all the people depend on the Freetown Waste Management Company’s facilities for the disposal of their household refuse. The study concludes that solid waste management problems are partly the result of Freetown Waste Management Company’s inability to cope with the situation because of lack of equipment, personnel, and inadequate funding. Therefore, the study recommends that the waste management authority’s effort in the area of education should be intensified in order to sensitize the people on the need to keep the surroundings clean. The participation of the private sector, government, NGOs’ and the international community in offering adaptable solutions towards improving solid waste management situation in Freetown is also needed.

Rural Water Supply Management and Sustainability: The Case of Adama Area, Ethiopia

Wise utilization of water resources is becoming very important as world faces water crises. The main objective of this study was to investigate the rural water supply systems with case study in Adama area, in central Ethiopia. Both quantitative and qualitative data were collected and analyzed. Four sample water schemes were selected and totally 148 (63 were female) representative households were selected for answering the questionnaires. Key informant interviews and group discussions were also conducted. The study assessed issues such as community participation, water committee empowerment, management and governance of water supply schemes, women participation, functional status of water supply scheme, sanitation and hygiene issues, external support, and monitoring system of water supply schemes. The findings indicated that the community participation in planning and implementation was very good while monitoring mechanism of operation and management as well as community participation on choice of technology was poor. The water schemes were located at reasonable distances i.e. less than 2 km in most cases and the time taken for round trip to fetch water from source was less than or equal to 30 minutes in most cases, however the queuing time was more than an hour. The water supply was inadequate as only about 15% of beneficiaries could get 20 liters of water per day per capita. The water sources were exposed in many cases to human waste, wild life, livestock and uncontrolled flooding. Sanitary practices in the study area were poor as only about 3.4% had ventilated and improved pit latrine and open pit and/or open field defecation were widely practiced.

"I Will Make a Go of it Yet" Rena B. Jepsen and the Founding of the North Rockford Hospital

In 1935, in the midst of the Great Depression, Rena ?. Jepsen opened the North Rockford Hospital in Rockford, Illinois, as a convalescent hospital to provide nursing care for aged and convalescent patients. The idea for the hospital was born out of the need for a new approach to the care of aged and convalescent patients whose needs were not being met by either conventional acute care hospitals or the county almshouse; but for her, it was also a means to support her family of six children. This essay examines how the evolution of modern medical practice and the economics of the mid-1930s created the need for new types of hospital care in Illinois and led to new paradigms in healthcare delivery.From the mid-nineteenth century to the 1920s, care for the aged and convalescent had largely been provided in their homes by visiting nurses. Wealthy and middle-class families who were able to pay for the services of a visiting nurse would contract with a visiting nurses' association, which maintained a registry of available nurses. The poor and indigent, however, had to rely on the nursing support provided by the local public health department, or a charitable organization. For the indigent aged, the county almshouse became the home of last resort when they became unable to live independently.By the 1920s, the practice of sending out visiting nurses began to decline. It was becoming clear to many that a better place to practice medicine was the hospital; advances in medical practice required technology, skills, and an antiseptic environment not available in most homes. The visiting nurses found that more of their time was spent dealing with basic issues of sanitation and cleanliness than with actual patient care when caring for patients in the home.1The concept of the hospital itself was undergoing a radical change at this time. From the Middle Ages to the mid-nineteenth century, hospitals operated by religious orders and charitable organizations had been viewed as the last refuge of the indigent and the dying. A new model of healthcare delivery, based on a scientific approach to medicine and sound business management principles, began to emerge in the late nineteenth century. Pasteur's theory of germs and Lister's development of antiseptic practice, together with the discovery of x-rays and effective antibiotics, made the modern hospital a place where scientific methods resulted in recovery and cures. In this model, instead of providing a last refuge for the poor, the hospital became a place where a growing middle-class patient population could expect to receive effective treatment.The increasing sophistication of medical practice also led to greater specialization of hospital operations. While most hospitals provided emergency care, treatment of disease, and a sterile environment for performing operations, the need arose for specialized care facilities to care for specific patient groups such as children and the elderly, and to provide specialized treatment for specific diseases, such as tuberculosis.One such specialized facility was the convalescent hospital. In order to more efficiently use their technologically advanced facilities, hospitals tended to focus on short-term procedures, such as surgeries and caring for accident victims. Convalescent care - care for the chronically ill and the aged, who might require hospital stays of indefinite length, and patients recovering from medical procedures - was seen as an inefficient use of hospital facilities. This led to the development of the convalescent hospital as a separate entity in the late nineteenth century.2However, scientific medicine and specialization of medical practice came at a cost. Building modern facilities and equipping them with the latest technologies was expensive, requiring extensive outlays of capital. While the indigent patients of the earlier charitable hospitals had received minimal care for free, the increasingly middle-class patient population of the early twentieth century had to absorb the cost of advanced treatment, a burden for many in an age when healthcare insurance was largely nonexistent. …

Public consultation on artificial aquifer recharge using treated municipal wastewater

A questionnaire was prepared and distributed among professionals from various fields, in an effort to gather public perception regarding recharge of groundwater using treated municipal wastewater. This was done as part of a study to assess the feasibility of implementing Soil Aquifer Treatment (SAT) using treated municipal wastewater in parts of central India. This paper presents the perception of people toward artificial recharge and determines the primary concerns among members of the public, so that these can be addressed while carrying out pilot studies. This is the first such public survey that has been carried out in India.The questionnaire was sent to approximately 500 people through e-mail and was uploaded on a popular online portal that deals with water and sanitation issues. 194 correctly filled questionnaires were collected, the results of which are presented in this paper. 87 (45%) questionnaires were filled by environmental professionals including members of the research community, teachers and public health and municipal corporation officials. The rest were filled by members of the general public, including 15 students and 48 non-environmental professionals. Out of 194 respondents, 64.4% were in favor of using treated municipal wastewater for artificial recharge of groundwater, 28.4% opposed and 7.2% remained indifferent.This survey revealed that the primary concern among respondents was the effectiveness of wastewater treatment in India, and not the recharge technique itself. More than 50% of those who support SAT expressed uncertainty as to whether secondary effluent from wastewater treatment plants is being treated to a quality suitable for injecting into the aquifer.

The participatory process in environmental sanitation issues: how does it reverberate in printed media?

Participation in the field of environmental sanitation has low visibility and is little studied, especially in developing countries where democracy is a relatively recent reality. It is therefore pertinent to assess how social participation in sanitation occurs and how it is presented to society by the media. In this study, the participatory processes in environmental sanitation were assessed using newspaper articles published in the state of Minas Gerais, Brazil. Different categories, such as discrete or continuous processes, passive or proactive populations, and top-down or bottom-up models of governance, were established. Although participation in and conflicts regarding environmental sanitation have been considered to be scarce, they were still observed in some instances, indicating that they occur in a covert or even invisible manner.

Nutritional status, complementary feeding practices and feasible strategies to promote nutrition in returnee children aged 6–23 months in northern Uganda

Objectives: The aim of this study was to assess the prevalence of underweight and wasting, feeding patterns, water use and sanitation patterns in children aged 6–23 months in returnee villages in northern Uganda, and then to identify feasible strategies to promote nutrition. Perceived understanding of the presentation and causes of undernutrition was also assessed.Design: This was a descriptive cross-sectional survey, carried out in May and June 2010.Setting and subjects: The study was conducted in the districts of Agago and Pader in northern Uganda in 219 children aged 6–23 months.Outcome measures: Weight and mid-upper-arm circumference were determined for underweight and wasting, respectively. Focus group discussions were held with adults to determine perceived understanding, presentation and causes of undernutrition.Results: Over 11% of the children were wasted. Those aged 6–11 months were the most wasted. Eighteen per cent of them were underweight. Those aged 12–17 months had the highest prevalence of underweight. Eighty-three per cent of the children were still breastfeeding and 47% were exclusively breastfed. The largest proportion (38.8%) of children ate twice daily and 4.1% had not eaten any food on the day prior to the visit. The water usage rate was 13.3 litres/person/day. The majority (57.5%) of households did not have their own pit latrines and disposed of faeces in the bush (87%). Communities had good knowledge of causes of undernutrition, its consequences and the required practices to prevent and control it.Conclusion: This assessment has informed the need for holistic approaches to address the challenge of undernutrition in children aged 6–23 months in returnee villages in northern Uganda. Interventions that target improvement in complementary feeding, particularly between the ages of 6–11 months, while also addressing pertinent issues of water and sanitation, hold the most potential to address the challenge.

Book Reviews

Book Reviews

Natural market segments: religion and identity – the case of “zongos” in Ghana

Purpose“Zongos” are a part of the urban phenomena in Ghana that have escaped critical social inquiry. The purpose of this paper is three fold. It seeks insight into the reasons zongos continue to attract new dwellers despite their “unattractive” reputation; the role of religion in the choice of residential locations; and the role of Islamic marketingvis‐à‐viszongos.Design/methodology/approachAs an exploratory study whose objective is to generate insight, the study uses interview technique as an investigative tool. The researcher interviewed eight zongo dwellers from four different zongos (different parts of the country) and from different educational and socio‐economic backgrounds. The interviews were conducted individually with an unstructured format that provides for unlimited follow‐up questions.FindingsThe findings suggest that: religion and identity are the common threads that bind zongo dwellers together; zongo dwellers seem to be more religious than the average city dweller; religion informs the behavior of most zongo dwellers; though income plays a role, religion seems to be the overriding reason for the dwellers' choice of zongo as a place to live; and zongo dwellers are aware of the negative image that zongos have, but see their choice of living in a zongo as a step to better practice their religion.Research limitations/implicationsAs an exploratory study, the results of this study are not generalizable. Furthermore, the small sample size makes the findings tenuous. Nonetheless, the results are important in the sense that they uncover an aspect of zongos that has not received much attention from academic researchers.Practical implicationsBy virtue of not only sharing a common religion, but practicing the tenets of their religion in their daily lives, zongos constitute “natural” market segments that can be profitably addressed by Islamic marketing. The four “Ps” are used to illustrate a strategy that could be used by marketers who wish to serve zongo dwellers.Social implicationsBesides “guiding” the religious sensibility of non‐Muslem entrepreneurs who wish to serve zongo dwellers, Islamic marketing can play a role in educating zongo dwellers on health care, sanitation and environmental preservation issues that seem to be problematic with zongos. Furthermore, Islamic marketing can play a role in educating non‐zongo dwellers about the “positives” of zongos and Islam.Originality/valueThis paper takes an academic approach to studying zongos both as a social and a business phenomenon, and develops a sampler marketing strategy for zongo entrepreneurs based on the insight gained from interviews.

Water and sanitation issues for persons with disabilities in low- and middle-income countries: a literature review and discussion of implications for global health and international development

The critical importance of unrestricted access to clean drinking water and basic sanitation for all is highlighted in Millennium Development Goal 7, which calls for the reduction by half of the proportion of people without such access by 2015. Unfortunately, little attention has been paid to the needs of such access for the one billion people living with a disability worldwide, despite the fact that the right to equal access for all international development initiatives is guaranteed in the new United Nations Convention on the Rights of Persons with Disabilities. In this paper, we review what is currently known about access to water and sanitation for persons with disabilities in low- and middle-income countries from the perspective of both international development and global health, and identify existing gaps in research, practice and policy that are of pressing concern if the water and sanitation needs of this large - and largely overlooked - population are to be addressed.

Assessment of water storage, treatment and use in the Semi Arid Kimana Area, Oloitokitok District, Kenya

This study sought to identify the methods and associations of water storage, treatment and use among residents in the Kimana Fenced Area, Oloitokitok, Kenya for comparison with current best practices in order to develop recommendations to improve water sanitation issues in this area. In a cross-sectional study design, 330 households were randomly selected and interviewed on water storage, treatment, and use practices. Eighty two percent of observed containers met CDC guidelines for improved water storage containers. Fifty seven percent of survey respondents reported not treating their drinking water, of which 49% indicated that they believed the water was already clean. Logistic regression showed that people who believed their water was unsafe were twice more likely to treat their water than those who perceived their water to be somewhat safe (p = 0.058). Those living outside the furrows were 56% less likely to treat their water in the home compared to those living along the furrow (p = 0.023). Respondents with a pastoral lifestyle were 69% less likely to treat their water than those with a non-pastoral lifestyle (p = .009). In terms of tribe, the largest treatment disparity was noted amongst the Maasai, with only 37.7% reporting any form of treatment. Tribe, pastoral lifestyle, proximity to the furrow and socio-economic status were found to contribute to water storage method and treatment within the Kimana fence. It is critical that these factors be addressed in future water storage and treatment interventions in this area.

The effectiveness and sustainability of two demand-driven sanitation and hygiene approaches in Zimbabwe

Since 2000 a number of community-driven sanitation approaches have emerged that counter a historical trend to subsidise the provision of latrines to the poor. This study reports on a set of findings and conclusions concerning the effectiveness and sustainability of two such approaches operating in Zimbabwe, the community health club (CHC) approach and community-led total sanitation (CLTS). Surveys, interviews and focus groups were conducted in a total of ten project communities from three districts. Results show that, despite little resistance to the idea, a household's ability to own a latrine depends heavily on its ability to afford one. Affordability is also key in moving up the ‘sanitation ladder’, which is necessary if behaviour change is to be sustained in the long term. Whilst both approaches effectively encouraged measures that combat open defecation, only health clubs witnessed a significant increase in the adoption of hand washing. However, CLTS proved more effective in promoting latrine construction, suggesting that the emphasis the CHCs place on hygiene practices such as hand washing needs to be coupled with an even stronger focus on the issue of sanitation brought by CLTS.

Microbial Safety of Tropical Fruits

There are approximately 140 million tons of over 3,000 types of tropical fruits produced annually worldwide. Tropical fruits, once unfamiliar and rare to the temperate market, are now gaining widespread acceptance. Tropical fruits are found in a variety of forms, including whole, fresh cut, dried, juice blends, frozen, pulp, and nectars in markets around the world. Documented outbreaks of foodborne disease associated with tropical fruits have occurred. Norovirus and Salmonella are the leading viral and bacterial pathogens, respectively, documented to have caused outbreaks of infections associated with consumption of tropical fruits. Sources of contamination of tropical fruit have been identified in the production environment and postharvest handling, primarily related to sanitation issues. Limited data exist on the specific route of transmission from these sources. Research on the microbial safety of tropical fruits is minimal; with the growing market for tropical fruit expected to increase by 33% in 2010 this research area needs to be addressed. The aim of this review is to discuss the foodborne pathogen outbreaks associated tropical fruit consumption, research previously completed on pathogen behavior on tropical fruits, preventive strategies for pathogen contamination, and research needs.

Provision of health services for microfinance clients: Analysis of evidence from India

Microfinance has proved to be an effective and powerful tool for poverty reduction. There is a greater reduction in poverty when microfinance programs are combined with increased access to basic social services, including health, than when the programs focus on credit alone. Studies have shown that illness and related expenditures are the leading cause for micro-business failures and loan default. This paper is an attempt to understand the health programs offered by MFIs in India, and build the case for wider integration of health into microfinance programs. A review of MFIs listed in the MIX Market database was done, followed by a search of individual MFI websites. One in every four MFIs in India offers some form of health services. These programs vary widely from small scale health awareness programs to complex health interventions. Health education is the most common health intervention by MFIs (58%), followed by health camps (24%), and health insurance (24%). 12% MFIs offer health loans in addition to the regular business loan. 38% of MFI-health programs attempts to address composite health needs of their clients. 11% of the MFIs addresses the issue of community hygiene and sanitation and nutrition, followed by awareness and control of HIV/AIDS, mother and child health, and immunization program (8%). Often MFIs struggle to design appropriate community sensitive health programs which can result in failures. Also the lack of evidence sharing in the sector, calls for more systematic efforts to strengthen evaluation and applied research.

A Study on Planning Scheme to Improve the Living Environment through Safe Water Supply and Sanitation in a Rural Village in Bangladesh

Safe water supply and sanitation are basic human needs and the basis of sustainable social development. In Bangladesh, an urgent issue related to water supply is wide spread arsenic contamination of groundwater, on which most people in this country rely for drinking water through tube-wells. Although surface water is an alternative drinking water source, low coverage of improved sanitation and lack of appropriate human excreta management causes surface water pollution, which restricts the use of surface water for drinking. Through water quality conservation, safe water supply and improved sanitation should be integrated to obtain the better living environment. In rural areas of Bangladesh, people suffer from disease due to unhygienic environments, and medical expenditures burden family finances. Inappropriate human excreta management also hampers nutrient cycling and leads to soil degradation of farmland threatening agricultural productivity. Therefore, sanitary improvements with appropriate human excreta management relate to safe water supply and poverty alleviation.In this study, a project aiming to improve the living environment through safe water supply and sanitation was undertaken, establishment of a community based organization (CBO) was also incorporated. In the project area, all of the tube-wells were contaminated with arsenic. However, due to limited support from outside, most villagers were drinking arsenic contaminated groundwater. Under previous situations, although people were aware of the health risks of arsenic contamination, willingness to improve their hazardous situation was low due to a lack of prospects for obtaining a safe water supply. The purpose of this study was to present a scheme based on discussions on the locally appropriate technology options that consider continuous community based management. The pond sand filter (PSF) system was selected, PSF increases the local people's concerns on the quality of pond water, which is their drinking water source, and the sand filter targets community based management. Ecological sanitation was combined to prevent pond water pollution.The authors show how the local people have increased their awareness of water and sanitation issues and willingness to improve their living environment after installing the facilities. The results revealed that the present scheme has encouraged the local people to understand the perspectives of an improved living environment, which has accelerated an increase in their willingness to improve living environment.JEL Classification: I18, I38, R11

Habitat dégradé et santé perçue : une étude à partir des demandes de logement social

Poor living conditions and insanitary housing are important social determinants of health. This study examines health-related elements and risk factors linked to deteriorated housing as they appear in applications and requests for social housing from the tenants in Aubervilliers (93). 234 letters were analyzed, of which 50.4% mentioned a health problem related to habitat or housing. Somatic health problems and mental health problems, as well as problems related to well-being, are each present in at least a quarter of the cases. Half of the letters mention a sanitation problem; over-occupancy is abundant. The physical health problems seem to be linked to the unhealthy conditions and sanitation issues, while those of mental health and well-being are more closely related to the presence of high rates of overoccupancy. Despite the preliminary and empirical nature of this data collection process, the data confirm the necessity of addressing the link between housing conditions, requests for housing, and perceived health.

Incremental sanitation improvement strategy: comparison of options for Hanoi, Vietnam

Urban sanitation issues should be tackled strategically, and may be addressed effectively when sewage development is pursued in conjunction with complementary sanitation measures. Five sanitation improvement scenarios employing sewage, night-soil collection-and-treatment (NSCT) system, and/or septic-tank improvement by annual dislodging were analyzed from the perspective of COD loads, total nitrogen loads, and cost under the conditions found in Hanoi, Vietnam. Compared to the development of sewage alone, the scenario of developing NSCT systems in a complementary manner with sewage development was estimated to be the most effective for a rapid decrease of both COD and total nitrogen loads. However, it may be difficult in some cases to replace ordinary water-flush toilet by the micro-flush toilet that are used in NSCT systems. In this case, the scenario employing septic-tank improvement in conjunction with sewage development may be effective for a rapid decrease of COD in locations where septic tanks are widely used under poor maintenance conditions and nitrogen pollution is not serious compared to COD. It was calculated that the two scenarios above would respectively require cost increases of 16 and 22% over the sewage development scenario.

An Analysis of Public Health Policy and Legal Issues Relevant to Mobile Food Vending

Mobile food vending is a component of the food environment that has received little attention in the public health literature beyond concerns about food sanitation and hygiene issues. However, several features of mobile food vending make it an intriguing venue for food access. We present key components of mobile vending regulation and provide examples from 12 US cities to illustrate the variation that can exist surrounding these regulations. Using these regulatory features as a framework, we highlight existing examples of "healthy vending policies" to describe how mobile food vending can be used to increase access to nutritious food for vulnerable populations.

A cultural–spatial analysis of excreting, recirculation of human excreta and health—The case of North West Frontier Province, Pakistan

The sanitation issue is entering the development discussion and the UN proclaimed 2008 the year of sanitation. The study aims to understand the cultural–spatial dimension among Muslim communities of excreting and recirculating human excreta in North West Frontier Province in Pakistan. Information on local perceptions and cultural understanding was collected through interviews, group discussions and observations in four selected villages. The study identifies a diversity of excreting practices among age groups and sexes, and varied adherence to expressed cultural norms. Interviewees express less resentment towards urine compared to faeces, however, their negative attitude subsides when faecal matter is mixed with water since this changes appearance, odour—and cultural meaning. Religious dictums about excreta and sewage accommodate contradicting routine behaviours to cater for needs of residents and farmers. For example, when mothers pray wearing soiled clothing, and in the use of wastewater as fertiliser for food production. The excreta-related practices are compatible with good hygienic behaviour as outlined by WHO Guidelines, except for children who are allowed to defecate anywhere.

Book Review Essay: Calling for an End to Second-Class Shitizenship

Recent publication of two books and a technology compendium signal the urgency of devoting public attention to the lingering issue of inadequate sanitation for 40 percent of the world’s people living in many of the world’s cities and rural areas. The Last Taboo and The Big Necessity explore in detail the history, current predicaments, and future prospects for improving sanitation. The compendium describes a full range of technologies available to implement this improvement. JEL codes: I18, Q56, Q57

KfW Water Symposium 2009 Financing Sanitation: “Improving Hygiene awareness and sanitation” Frankfurt, 8-9 October 2009

The central objective of the International Year of Sanitation was to put the global community on track to achieve the Millennium Development Goals MDG sanitation target.However, one year later, it is still difficult to keep sanitation high on the agenda, while practical action is required to encourage demand driven and sustainable solutions. With the support of the German Ministry for Development and Cooperation and together with the European Investment Bank EIB and the French Development Agency AFD, KfW organised a two day Symposium to specifically address ways in which financing institutions can better promote the achievement of the MDG sanitation target. More than 70 experts from various backgrounds explored the challenges of sanitation and discussed ways to further develop innovative financing mechanisms for improved hygiene, sanitation and wastewater management in low-income countries. Four thematic areas were tackled by detailed background papers, presentations and high-level open floor discussions. Session 1: Financing Change in Personal Hygiene Behaviour and Demand Creation for Sanitation Motivation This section contains a rapid review of past experiences in developed countries and the evolution of methods used in developing countries to change hygiene and sanitation behaviors, including successes and failures. Relative costs and impacts, the role of institutional arrangements and actors, as well as approaches for linking hygiene behavior change and sanitation demand creation (so called software investments) with hardware investments are examined. Finally, considerations and opportunities for development banks and other financing agencies to become engaged in the scale-up of hygiene behavior change and sanitation demand creation approaches which have demonstrated success are presented. Session 2: Targeting the Poor with Facilities and Improved Services Motivation The interventions that can help poor people to access sanitation goods and services are examined. The focus is on three types of interventions: the use of low-cost technologies, the use of micro-credit and the use of targeted public finance (or subsidies) to reduce the funding gap that poor people face to meet the capital and recurrent costs of sustainable sanitation. Targeted public finance, performance assessment, effectiveness, sustainability, public funding strategies and performance are analysed. Session 3: Urban Spaces – How to Provide and Finance Service to Peri-urban Areas New approaches to meet sanitation challenges arising from absolute population growth and rapid urbanization are examined from a technical point of view. Simplified solutions and semicentralised supply and treatment systems are examined in detail and with the help of examples. Session 4: The Potential Role of Utilities in Sanitation Provision for Peri-urban Areas and Poor Target Groups The question why sanitation service provision by local government authorities is poor is addressed. Examples of how water supply and sanitation utilities are being encouraged to support peri-urban areas and poor target groups with the provision of sanitation services are provided. The difficulties of utilities to provide piped water and sewers in a commercially viable manner is addressed. The role of local government authorities, of the regulatory framework, of education and public awareness is highlighted. A theme that appeared in all four sessions concerned the process of project design by development banks. Recommendations to improve it in order to best tackle sanitation issues were as follows: 1. address the entire sanitation chain 2. plan for all urban areas including informal housing areas and slums 3. ensure the sustainable operation of all sections of the sanitation chain (long-term effectiveness). ISBN: 9781843393603 (Print) ISBN: 9781780401515 (eBook)