Uber for sanitation

A number of my previous blogs have touched upon market based approaches and in this blog I will continue to do so with an alternative method to dealing with sanitation in Dakar, Senegal.

In the UN report on the Millennium Development Goals (2013), it states more than 89% of the population have access to a mobile phone, however only 63% have access to a safe toilet. Whilst this represents the great paradox of modernity, it has however been used to their advantage by populations in Dakar, Senegal.

A new ‘uber-like SMS service’ has been regarded as an innovative and highly successful scheme that is dealing with the sanitation crisis in Dakar. The scheme requires people to text a number, which then sends someone to come collect the excrement once their pit latrines are full. By attaching a small cost, and some profit for the business, pit latrines are being cleaned regularly and safely.

The scheme has seen great success over the past year and has driven the annual cost of collecting and emptying pit latrines from $150 to 90. In a developing country like Senegal, it is important that these market based innovations must work to drive down the cost of sanitation services, and in doing so, create effective demand for sanitation, whilst rewarding a profit at the end.  

Just like other market based approaches talked about in previous blogs, such as Sanergy, this market based approach does not only just remove the waste, it is then taken to a plant where it can be treated and turned into fertiliser, and sold for more profit. It has been evident throughout these posts that if you can attach value to sanitation, whilst also keeping it cheap for its users, you can create effective demand. If these schemes can be scaled up, sanitation targets of the updated sustainable development goals may very well become achievable.  

Despite this paradox of modernity it is evident that mobiles are paving the way for countries to achieve development. Mobile banking has mobilised thousands of marginalised people across Africa and the use of ICT has been described as the key to achieving goals set in the millennium and sustainable development goals (Hinson, 2011).

As mentioned previously in blogs, the success of these innovative market based approaches will hinge upon the ability for them to scale up and become more accessible to populations. However, these schemes tend to be more beneficial in urban settlements as opposed to rural.

Education and school led total sanitation programmes

Diarrheal disease, the second largest killer of children under five accounts for 760,000 deaths annually (WHO). Faecal material often comes into a child’s environment, and the most effective way of reducing the likelihood of a child contracting  a diarrheal disease is to prevent this from happening (Cutis, 2003).

The key to promoting change in attitudes towards sanitation and hygiene hinges upon education. Children have the most potential to influence these changes.  Sanitation and safe hygiene practices can be taught at schools. Children can be taught safe practices, which can benefit themselves and then be relayed at home to benefit their families.

A study carried out by Stanton and Clemens (1987) found that even simple education on sanitation and hygiene proved important in reducing the rates of diarrheal disease.  Further studies by Freeman et al (2012) found implementation of WASH (water, sanitation and hygiene) projects in schools led to a 58% reduction in absenteeism of girls.

It is clear that often, even the most basic sanitation and hygiene practices are being disregarded. However, with some simple changes and education, children in Africa can benefit greatly. Schools can provide a clean and safe platform for children to be taught basic sanitation and hygiene practices.

However, the World Bank notes a number of key points that will determine the success of education of hygiene and sanitation practices in school. Schools must have appropriate technology that suits the needs of children. Most importantly, there must be effective institutional framework to make this a reality, relying on the coordination of both education and health sectors of government to ensure a more comprehensive and effective provision of education on sanitation and hygiene.

Sanitation education can also benefit the wider community through participation. School-led total sanitation programmes are essential for triggering changes in attitudes and behaviour surrounding sanitation and hygiene (Joshi, Kooy and Van den Ouden, 2016). Changing attitudes and behaviour at school can be beneficial at home too. Children will learn about the importance of hygiene and sanitation at school and are more likely to encourage these practices at home and hopefully remove some of the taboos associated with hygiene and sanitation at home.  

An alternative market based approach to sanitation : microfinance

The previous blog looked at a market based approach to sanitation in urban settlements, whereas in this blog I will look at a potential option for sanitation in rural settlements. However this scheme is not restricted to only rural areas but it is likely to be more successful in rural areas as opposed to urban settlements.

Microfinance is a scheme employed globally which looks to offer small loans for marginalised and poor people to promote entrepreneurism and therefore help alleviate poverty through a markets approach. The schemes have had lots of success and therefore there is need to apply these scheme across other sectors, especially in health.

Water.org is a company who supply microfinance to people who are in great need of improved water and sanitation. They employ a scheme called Water Credit, which offers a financial solution to sanitation issues. The scheme allows people to borrow small loans directed at improving water and the health of populations. Water credit looks to ensure whole communities a safe and private place to go to the toilet, which is essential in relation to gender and sanitation. Loans are provided by the company and invested in providing and building private toilets for a family. Once the money is requited, a new loan can be issued to another family within the community.

The Water Credit scheme is having great success over parts of Africa, where in Ethiopia it serves over 32,000 people across a number of schools and communities.

Microfinance gives marginalised populations the opportunity to obtain a safe and healthy place to go to the toilet. Finance schemes can be provided to suit the financial capabilities of the beneficiary, allowing communities and families to obtain sanitation through their own means and not rely on poorly funded state, top down approaches. This is especially important in rural areas where these schemes are more likely to be employed.

There has been increased attention applied to microfinance and its potential to aid development. A number of academic studies have looked at the potential of microfinance. White, Damodaron and Thorsten (2008), found that the majority of people interviewed were willing to take on a microfinance loan to secure their health through a private, safe toilet, finding that most of the participants were dissatisfied with their current water and sanitation facilities and the majority of people were humiliated by having to go the toilet outside in unsafe and unclean conditions.

Microfinance has the ability to be successful, however this is likely only to be the case in rural settlements as urban settlements lack the space to implement this infrastructure. It has the power to be successful as it helps families bear the burden of the costs of sanitation. Microfinance can support poor communities and advise them wisely on sanitation and appropriate technology, but its key lies in the repayment system. The loans allow communities or families to repay the investment in instalments to reduce the burden of investment (Tremolet, Mansour and Muruka, 2015). Reducing this burden is likely to encourage more people in rural areas to take on these microfinance loans.

For countries to meet the sustainable development goals and achieve sanitation targets, the emphasis has to be been placed upon households and communities. It is evident that the costs of implementing sanitation infrastructure is not going to be covered by governments and local municipalities. Microfinance can be used to support families and whole communities, creating demand for sanitation which will benefit them much more than the burden of the cost of implementing this infrastructure.

Microfinance can be applied in urban areas, except its real potential is based in rural areas. However, as previously mentioned, the company Sanergy is also another good example of the use of microfinance. Donators from around the world can provide interest free loans to business owners in informal settlements, therefore helping them develop their own business to achieve better health and economic growth, implying there is still some scope for microfinance to be successful in urban areas.
 

Sanergy: A market based approach

Sanitation success in urban settlements has proven hard to obtain.  With high population and building densities as well as many settlements being illegal implementation of sanitation services that are effective has had limited success. For most people in these informal settlements access to toilets is relatively low and the majority of people use communal toilets, however the cleaning and maintenance of these toilets is often too low and therefore the spread of disease is more common. In light of this, there is the need for innovation and new practices in the sanitation sector. Kenya is a great example of how a market based approach can benefit communities in Africa, especially in these informal settlements.

In Kenya a start-up called Sanergy is providing an innovative solution to Africa’s sanitation problems. The company implements cheap, low maintenance sanitation centres. Sanergy’s uniqueness lies in taking a systems approach covering the whole sanitation value chain (Auerbach, 2016).  The company offers local people in informal settlements the opportunity to buy and run a franchise, allowing them to sell and build toilets and sanitation centers at a very low cost. Sanergy is proving to be one of Kenya’s cleanest and most safe option for sanitation. Waste is collected daily, where it is then treated and can be reused and sold to farmers as fertilizers. The full value chain of Sanergy is shown in figure 1.

Figure 1 : Sanergy Value Chain

Economic incentives to franchise owners and workers through pay means daily cleaning and regular maintenance is keeping Nairobi’s Sanergy toilets clean, reducing the risk of contracting diarrheal illnesses.

Sanergy’s impact is substantial in informal settlements in Kenya and accounts for nearly 40,000 daily uses. Toilets are cleaned by Sanergy employees every day and have safely removed thousands of tones of waste. Sanergy also presents an economic opportunity for people living in informal settlements, providing jobs and helping start new businesses. Multiplier effects have come into play in informal settlement as these jobs provide an income which has created demand for other goods and services. 805 jobs provided by Sanergy has led to a further creation of 157 jobs for people in neighboring areas. A sustainable sanitation service has not only provided health benefits, but also has helped achieved economic growth within these informal settlements.

Sanergy is a perfect example of how market based approaches can be used to improve sanitation. Sanergy is a mid-point between a centralised and decentralised wastewater treatment manager, by which all component of treating the waste is carried out by the business from the toilets, treating waste and its reuse as fertilizer (O’Keefe et al, 2015).

This project has seen great success in Nairobi, Kenya and Kampala, Uganda. The key to its success will lie in the ability of projects such as Sanergy to scale up. By providing economic incentives, franchise owners at Sanergy are likely to grow and therefore provide services to more people in informal settlements, reducing health risks associated with other communal latrines available.

This blog has looked at a market based approach that has been successful in supplying thousands of people in informal settlements with sanitary conditions. However, the key to its success has been its engagement with local communities and in a sustainable way which pairs health with economic development, by creating demand within communities with a good business model that provides regular maintenance, care and cleaning. Sanergy can be deemed both successful and sustainable regarding to Montgomery, Bartram and Elimelech (2009) as it applies the key components of sustainability.

Sustainability in sanitation

Despite a large amount of focus on improving sanitation for the unserved, targets set in both the millennium and sustainable development goals are yet to be achieved. There has been a significant lack of a sustainable approach to sanitation. Montgomery, Bartram and Elimelech (2009) note that efforts made in the past twenty years of development in sanitation have been poor due to two factors, lack of maintenance and a disregard of sustainable approaches.

Montgomery, Bartram and Elimelech (2009) present three key components of sustainability that are needed to make sanitation successful. The components hinge upon the involvement of community, therefore creating demand for sanitation services, cost effective schemes that are funded through locality and maintenance. Their use of community is one that resonates with many other community led projects, where the key lies upon the involvement of local people to express their needs, to create effective demand. Sanitation can be successful in developing countries if the needs of local people are catered for and are the priority of projects at stake. If projects are situated within local context, sanitation can be appropriately provided for individual communities that suit their requirements, but are also based upon their financial capabilities.

Carter, Tyrrel and Howsam (1999) also present a key chain to sustainability shown in figure 1, which resonates with Montgomery, Bartram and Elimelech (2009).  

 

 

 

 

 

    

Figure 1. Sustainability chain. Carter, Tyrrel and Howsam (1999).

For sustainable projects, motivation is required to develop demand for sanitation. Motivation can be provided by presenting the benefits sanitation brings to communities. If communities can understand the available benefits, motivation of locals to achieve sanitation is likely. However, it is hard to overcome the fact that sanitation and water will come at a cost (1999: 294), but if the benefits are clearly presented people should be willing to take part in these projects to benefit their health. The second part of the chain includes maintenance, which is essential to sanitation. Communities need to understand the importance of maintenance as without it, projects will be unsustainable. The third element of the chain is cost recovery. To make a project successful it is likely that it will require funding, however cost must be determined by the community (1999:295), which provides a platform for appropriate technology that will suit the capabilities of communities. Despite a decentralised system which is likely to be put in place, the sustainability of the project in the long term will require input from local authorities or NGOs to continue with a follow up of the project, to maintain motivation and maintenance.

Projects will more than likely have to be decentralised. A lot of projects require large amounts of funding, such as centralised waste management and often fail because people cannot afford to pay for them, projects are not financially viable and maintenance and upkeep of these projects are likely to be disregarded (Patterson, Mara and Curtis, 2007). Context specific projects will promote pro-poor sanitation (2007:901). If these projects can take into account income and peoples willingness to pay for services, a more appropriate technology can be implemented which will be sustainable.  

An introduction to the water sanitation crisis in Africa

For the majority of people, you wake up in the morning, you turn on the tap and there you have readily available clean and safe water at your disposal, no purification is needed, no two mile trek is required. There is no need to worry about where you will go to go to the toilet.  For these people it is normal, they do not question it, they do not think anything of it. However, for many people in Africa this is not the case. Firstly, there is the burden of having to travel thousands of metres to access a water supply, not 10 feet into your kitchen or bathroom. But for these people as well as the distance, there is the uncertainty, the uncertainty that this water you are going to drink, to carry out your daily activities, may actually be a serious burden to your health, but they have no choice, these people have to drink this water. There is also the humiliation of public defecation and with public defecation brings more problems. The issue of contamination of water sources from this open defecation is also a serious problem.

Water and sanitation is one of the most pressing issues currently faced across the continent of Africa and governments have found this to be a major threat to their populations, however granting access is a serious issue (Salami et al, 2014). Water sanitation is directly linked to the health and welfare of populations. Without access to safe water, the likelihood of falling ill to waterborne diseases is exceptionally high (The World Bank 1976; Banerjee and Morella, 1973). Globally, nearly 2.5 billion people are without access to safe water sources and sanitation (Septien, 2015) .

Access to safe water is a serious issue for Africa, however since the establishment of the millennium development goals, there has been a clear divide on the continent. Despite being relatively close on a geographical basis, on a developmental basis it is clear that North Africa is making much greater progress than sub-Saharan Africa. The UN (2012) note that North Africa has a coverage of 92%, whereas sub-Saharan Africa has only 62% with over 783 million people in sub-Saharan Africa lacking access to an upgraded water source. They further state that sub-Saharan Africa only has 30% access to sanitary water conditions, therefore with 70% of the population lacking access to sanitary water, waterborne diseases are highly likely. In North Africa there are much higher rates of rainfall, therefore safe, potable water is more readily available.

A report carried out by the WHO and UNICEF (2015b) showed that sub-Saharan Africa was well below its target on sanitation coverage, with only 30% coverage, under half the target set out in the millennium development goals of 62%. This low coverage of water sanitation effects are evidenced as this lack of access accounts for over a million worldwide preventable deaths annually (Montgomery, Batram, & Elimelech, 2009), there is around 500 deaths daily in Sub-Saharan Africa directly caused by poor access to safe water (UNICEF). It is estimated that over 20% of the sub-Saharan African population has no toilet to defecate in, this has to be done outside and with 36 of the 69 countries that are off track to meet the MDG target (Nansubuga et al, 2016), serious work needs to be undertaken. Africa, and especially Sub-Saharan Africa are well below meeting their targets for sanitation.

This first blog has looked at a general overview of the sanitation problem faced in Africa. Throughout the duration of this blog, I will look at different aspects of sanitation in Africa and assess the efforts made to help with its success and for it to reach its targets.