Mud/ash for handwashing | New research on diarrheal diseases | Nov. 2009 studies on urban sanitation, water treatment, etc.

[Campbell, Dan]

Use of ash and mud for handwashing in low income communities, 2009. International Scientific Forum on Home Hygiene (IFH)
       
Full-text:
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Professor Sally F. Bloomfield; Professor Kumar Jyoti Nath     

Epidemiological and microbiological data show that, in low income communities, as elsewhere, handwashing is particularly important in reducing the burden of infectious and parasitic diseases. These data also suggest that the efficacy of the handwashing process itself has a significant impact on the risk of disease transmission. A key factor is the extent to which pathogens are detached from the skin surface, by rubbing with appropriate materials prior to rinsing. In low income communities in developing countries, soil, mud or ash are still frequently used as an alternative to soap.

In using mud, soil or ash as an alternative to soap, it is important to weigh the potential benefits, against the fact that these materials can become contaminated with pathogens and helminths, and can themselves act as a vehicle and source of gastrointestinal, parasitic and other infections. These materials can also contain potential toxic heavy metals such as arsenic, lead and chromium, as well as pesticides.

The objective of this review is to bring together the available scientific data on the benefits and potential risks of using mud, soil and ash, as against soap, as against water only, for handwashing, and evaluate the factors which inform choice of the most appropriate agent in relation to the needs and constraints in different communities. The review was prepared by Professor Sally Bloomfield and Professor KJ Nath. The report was peer reviewed by Dr Stephen Luby (International Centre for Diarrhoeal Diseases Research, Bangladesh) and Dr Bilqis Hoque (Environment and Population Research Centre, Bangladesh).      

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Diarrhoea kills over a million over-fives each year, 30 October 2009

Source - http://www.scidev.net/en/news/diarrhoea-kills-over-a-million-over-fives-each-year.html

The number of deaths that could be prevented by basic hygiene measures is far greater than was thought.

[GENEVA] Diarrhoea kills three times more over-five-year-olds in Africa and South-East Asia than previously thought, new research finds.

Some 1.15 million over-fives — thought to be mostly adolescents and the elderly — are dying in these regions each year from diarrhoeal diseases, according to the research, commissioned by the WHO. Until now the death toll estimate for these regions came to 380,000.

Preliminary results from the study — which has yet to be published — were presented at this week's meeting of the Foodborne Disease Burden Epidemiology Reference Group (FERG) (29 October) in Switzerland.

"These estimates highlight the significant burden of diarrhoeal diseases in adolescents and adults in the developing world," said Martyn Kirk, chair of the FERG Enteric Diseases Task Force, who presented the results.

For the study, Christa Fischer-Walker and Robert Black from Johns Hopkins School of Public Health in the US searched 25,000 journal articles for information on diarrhoea in the over-fives. Only six of the articles contained reliable figures on diarrhoeal deaths in developing countries for this age group (compared to hundreds for younger children) — and there was no data for China, Latin America, the Middle East or South Asia.

The new estimate is on a par with the global annual death toll for malaria. It is also equivalent to nearly one-third of all HIV deaths and to almost half the number of global deaths from tuberculosis, says Claudia Stein, medical officer of the WHO's Department of Food Safety and Zoonoses.

"What makes the tragedy even greater is that many of these diseases are clearly preventable," said Jørgen Schlundt, director of FOS. Schlundt calls for policymakers to be alerted to cheap strategies known to prevent diarrhoea.

Improvements in food safety, sanitation and hygiene are critical, says Kirk. He told the meeting that nearly half (48.9 per cent) of diarrhoeal deaths in the developing world are caused by the bacteria Enterotoxigenic Escherichia coli and Vibrio cholerae, both of which are associated with poor sanitation and are common in resource-poor countries.

Stein says major gaps remain in scientists' understanding of diarrhoeal deaths. Research focusing on older people attracts little funding, as a result of which the problem has never been thoroughly assessed in this group.

But it is expected that some of these gaps will be filled next year, when results emerge from studies in China and India. The FERG is also planning country-level studies across the world, the results of which should begin to emerge in 2010.

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Abstracts of Recently Published Studies

1 - M. Ali, L. Stevens,

Integrated approaches to promoting sanitation: A case study of Faridpur, Bangladesh,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 1-7, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.030.

This paper summarises the experience of Practical Action in promoting water, sanitation, waste and hygiene-related infrastructure and services in the town of Faridpur, Bangladesh. In addition to the improvement in health and local environment, the project attempted to increase income and employment through the provision and operation of services. Practical Action and its partners have organized community groups and developed participatory slum improvement plans. This then leads to the prioritisation of immediate needs and agreeing roles and responsibilities in the delivery. To address other needs identified in the plans, slum dwellers were encouraged to develop partnerships with the municipality and other service providers. The involvement of people and their empowerment has lead to better use and maintenance of water and sanitation-related infrastructure and services. Community members, once organized have also negotiated better deals with the municipality. However, income and employment from the services, appears to be a more complicated issue in practice as compared to what was planned in the project. This is because of social structures in the slum areas and community expectations. Overall, the Faridpur model appears as a potential model to improve access to services in urban slums of Asia to achieve health, environment and well-being outcomes.

2 - J.M. Arnal, B. Garcia-Fayos, G. Verdu, J. Lora,

Ultrafiltration as an alternative membrane technology to obtain safe drinking water from surface water: 10 years of experience on the scope of the AQUAPOT project,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 34-41, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.035.

Access to a sufficient quantity of water of adequate quality for human consumption is a global problem. Nowadays, among the 1 billion people estimated to lack access to improved water sources and sanitation worldwide, rural populations are disproportionately underserved. As a consequence, sustainable access to safe drinking water remains as an international target to be achieved before 2015, reflected in the Millennium Development Goals Declaration.Membrane's technology and specifically Ultrafiltration (UF) represents an effective alternative to obtain safe drinking water, due to its ability to remove microbiological contamination from surface water. Since 1996, AQUAPOT international project, developed in the Polytechnic University of Valencia works with the aim to design a fully autonomous UF-water system characterized by its modularity, low-cost, easy automation and simple maintenance. The present paper describes main work developed inside AQUAPOT project in the last 10 years and the most relevant results obtained as a consequence of the application of this innovative technology in developing countries.

3 - C.C. Dorea,

Coagulant-based emergency water treatment,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 83-90, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.041.

Emergency water treatment approaches relying on coagulation vary from centralised modular and portable 'kits' to 'point-of-use' or 'household' interventions. Typical coagulation practice in emergencies is reviewed in view of field constraints (e.g. equipment and resources) and contrasted with underlying theory and conventional water treatment procedures. Examples of coagulation in emergencies are also presented based on documented field experiences alongside the discussion of other relevant issues such as process control, sludge production and management, ease of use, and aluminium coagulant residuals in finished waters.

4 - R. Meierhofer, G. Landolt,

Factors supporting the sustained use of solar water disinfection -- Experiences from a global promotion and dissemination programme,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 144-151, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.050.

Every year, 1.8 million people, mainly children under the age of five, die of diarrhoea. Point-of-use water treatment methods, such as solar water disinfection (SODIS), reveal a great potential to reduce the global diarrhoea burden. Comprehensive microbiological research demonstrated the effectiveness of SODIS to destroy diarrhoea-causing pathogens in contaminated drinking water. Since the year 2000, SODIS is being promoted in developing countries through information and awareness campaigns, training and advising of the public sector (government institutions), networking activities, as well as user training at the grassroot level. The method is currently used in 33 countries by more than 2 million people. Several project evaluations and health impact studies reveal that the diarrhoea incidence of SODIS users has dropped by 16-57%. One year after project implementation, 20-80%of the trained people used SODIS on a regular basis. This paper looks into factors influencing acceptance and sustained use of SODIS on grassroot level, i.e. local availability of bottles, repeated promotion and training programmes, motivation and commitment of promoters, educational level of users, social pressure, and institutional aspects.

5 - F. Meinzinger, M. Oldenburg, R. Otterpohl,

No waste, but a resource: Alternative approaches to urban sanitation in Ethiopia,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 322-329, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.071.

To overcome the drawbacks of conventional sanitation systems, new approaches to sanitation are necessary. Human faeces and urine as well as greywater represent potential resources requiring efficient management. Thus, source-separating systems, which safe water and allow the recycling of nutrients to agriculture, can provide an alternative. These systems can even be integrated into multi-storey houses, therefore addressing the need for resource-efficient sanitation in new condominium housing programmes. Several urine-separating facilities are implemented in Ethiopia showing a high acceptance by their users. The cost comparison between source-separating systems and the conventional system for condominiumhouses shows an advantage for the new approach due to savings of water for toilet flushing as well as reduced costs for the treatment of the mixed wastewater in septic tanks. The use of human urine as fertiliser in several trials resulted in significant benefits in terms of improved crop growth.

6 - A. Mels, D. Castellano, O. Braadbaart, S. Veenstra, I. Dijkstra, B. Meulman, A. Singels, J.A. Wilsenach,

Sanitation services for the informal settlements of Cape Town, South Africa,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 330-337, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.072.

Sanitation coverage in the informal settlements of Cape Town is severely lagging behind. A recent inventory showed that the main barriers to the implementation of proper sanitation systems are unsuitability of the location of many settlements (more than 40% of the sites are located on private land, wetlands and flooding prone areas), high settlement densities (55%), the nonpermanent status of the informal settlements and the distance to existing sewerage networks. The technical feasibility of 14 different sanitation systems was related to these general constraints. The feasibility assessment showed that only chemical toilets and container toilets were systems that could be applied on a larger scale. Both toilet systems, however, have high service and maintenance costs. Based on the evaluation, an innovative pilot project consisting of a mobile sanitation unit (MobiSan1) is being developed and will be piloted.

7 - J. Mtungila, V. Chipofya,

Issues and challenges of providing adequate sanitation to people living on the shore of Lake Malawi: Case of Monkey Bay, Malawi,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 338-343, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.073.

Coverage of adequate sanitation facilities in rural areas in Monkey Bay is low despite initiatives by Non Governmental Organisations (NGOs), government institutions and the local community. NGOs have donated cement, reinforcement bars, and moulds for making 4000 dome slabs. They also trained volunteers to help the communities construct latrines. In addition, they trained local leaders on sanitation and hygiene. The communities provided bricks, sand, quarry stone and labour as a prerequisite to benefit from donations by theNGOs. A follow up survey after the initial intervention revealed that out of 21314 (100%) households, 54.4% had traditional pit latrines of which 4% had dome slabs. Coverage of kitchens, bath shelters and refuse pits was 55%, 67% and 21%, respectively. This paper analyses sanitation initiatives by NGOs and local communities, factors attributing to lowcoverage of sanitation facilities and also sustainability of sanitation interventions in the area.

8 - C. Werner, A. Panesar, S.B. Rud, C.U. Olt,

Ecological sanitation: Principles, technologies and project examples for sustainable wastewater and excreta management,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 392-401, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.080.

In order to reach the UN Millennium Development Goals for significantly reducing the number of people without access to adequate sanitation, new holistic concepts are needed, focusing on economically feasible closed-loop ecological sanitation systems rather than on expensive end-of-pipe technologies, thus enabling all countries to finance and maintain sustainable sanitary systems. Such ecological sanitation systems advance a new philosophy of dealing with what to date has been considered as merely waste and wastewater. They are based on the systematic implementation of the reuse and recycling of nutrients, organics and water as a hygienically safe, closed-loop and holistic alternative to conventional solutions. Over the last few years an increasing number of pilot and demonstration ecosan projects have been implemented worldwide. These have contributed to the further development of a variety of ecosan technologies and operating and reuse options and have provided a large amount of experience with this new, holistic approach. In the following, the principles of ecological sanitation are presented, an overview on the range of ecosan technologies is given and several successful ecological sanitation projects are described.
Keywords: Ecosan; Sustainability; Best practices; Project examples; Reuse

9 - C. Zurbrugg, E. Tilley, A system perspective in sanitation -

Human waste from cradle to grave and reincarnation,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 410-417, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.082.

Reaching the Millennium Development Goals for Sanitation is a challenge. Numerous technological innovations have been developed in the last decade but, with innovation comes an increasing lack of consistency and increased communication difficulties. This is especially true in rural and peri-urban West Africa, where there is a desperate need for feasible sanitation systems and technologies which, in the site specific context, can achieve the intended objectives of health, hygiene and well-being. Network for the development of Sustainable Approaches for Large-Scale Implementation of Sanitation in Africa (NETSSAF) has developed a method for organizing and defining sanitation systems. The main goal is to assist in the decision making process to avoid fixed mind sets towards conventional solutions which to-date, have not always shown to be the best choice in a site specific context. The systematization shall also help avoid that some waste components (e.g. greywater or faecal sludge from on-site technologies) are forgotten in the planning and master plan development.

10 - S.A. Jones, C. Silva,

A practical method to evaluate the sustainability of rural water and sanitation infrastructure systems in developing countries,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 500-509, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.094.

Over one billion people are without access to safe water, while twice as many lack access to improved sanitation services, making these two of the world's most pressing issues. The sustainability of critical infrastructure systems, such as water and sanitation, is a necessary (though not sufficient) criterion for achieving sustainable human settlements since the lack of adequate services affects literally all aspects of a community's daily existence including health, education, family, surroundings, and employment. Despite several decades of development aid, infrastructure solutions have not significantly improved these water and sanitation problems (with few exceptions). In this paper, we consider the holistic nature of water infrastructure development in terms of rural areas in developing countries. We propose an outcome-based evaluation method using Life-Cycle Analysis to examine three categories of infrastructure sustainability metrics: technical, environmental, and economic; both froma community perspective, and a social-equity perspective. We demonstrate the method with a simple, generic example of arsenic treatment approaches in Bangladesh.

11 - J.O. Odhiambo, E. Martinsson, S. Soren, P. Mboya, J. Onyango,

Integration water, energy and sanitation solution for stand-alone settlements,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 570-577, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.103.

Lake Victoria basin has a large rural and rapidly growing peri-urban population that lacks sustainable solutions to safe and adequate water supply, energy and sanitation. Access to safe water and sanitation was 60% and 53%, respectively, by 2006. An Integrated Water, Energy and Sanitation Solution (IWESS) has been muted as a sustainable way of utilising the natural resources through a concept that turns waste into a resource thereby taking advantage of what is currently considered as problem sources and converting them into useful inputs. Tests from the Pilot sites developed show that grey and black water, kitchen and solid human waste can be used as separate inputs into an integrated waste management technological chain system that incorporates a constructed wetland-biogas-sand filter system to purify water and biodegrade solid waste to provide water for non-potable uses, biomass and biogas for energy and timber supply and manure for soil nutrient enrichment.
Keywords: Water; Sanitation; Integrated; Waste; Energy; Biogas

12 - Sameer Sah, Amsalu Negussie,

Community led total sanitation (CLTS): Addressing the challenges of scale and sustainability in rural Africa,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 666-672, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.117.

Despite all efforts and significant investment in the sanitation sector; sub-Saharan Africa is far behind its Millennium Development Goal (MDG) target. Community led total sanitation (CLTS) is a concept that revisits all the past approaches, particularly the promotion of household sanitation within the context of basic human dignity. CLTS emphasises community facilitation to assess their sanitation situation and promotes natural leaders. CLTS supports community action plans developed under their leadership. The main yardstick of CLTS achievement is totally open defecation free (ODF) villages and not numbers of toilets. This paper reviews Plan's experiences of promoting CLTS in Eastern and Southern African Countries. The potential of CLTS addressing the issue of scale and long term sustainability within the national planning framework is recognised and lessons learnt from ongoing programs in Ethiopia and Tanzania are shared. The challenges and some limitations of CLTS are critically assessed by this paper and issues needing more research and studies are presented.

13 - I. Sy, P. Handschumacher, K. Wyss, J.-L. Piermay, M. Tanner, G. Cisse,

Water and sanitation policies limits in Senegal cities: The case of Rufisque,

Desalination, Volume 248, Issues 1-3, 15 November 2009, Pages 673-677, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.05.118.

Potable water and sanitation facilities access constitutes one of the major problems faced by developing countries. In Senegal, more than 70% of urban centres lack drinking water distribution networks and satisfactory sewage systems. For this reason, public authorities have initiated series of institutional plans to strengthen the implementation of water and sanitation policies in various urban contexts as in the town of Rufisque. Geographical and epidemiological investigations were carried out from 2003 to 2005 to evaluate these policies impact in Rufisque. The goal was to assess health impact of various water supply and sewage management systems. Results show that operating different water supply and sewage management systems induces considerable variations on community's sanitary, environmental, social, economic and political development. Despite of some progress made, many areas in the town still have difficulties to access to safe drinking water and to satisfactory sanitation services. The behaviours of the communities are still lacking the right changes. Spontaneous and growing urbanisation has increased the financial and other capacity shortfalls mainly at municipal levels. This paper makes an inventory of areas where these policies were implemented, and emphasizes the important role that scientific research would better have to play to reinforce their achievements.

14 - J.M. Arnal, B. Garcia-Fayos, M. Sancho, G. Verdu, J. Lora,

Design and installation of a decentralized drinking water system based on ultrafiltration in Mozambique,

Desalination, In Press, Corrected Proof, Available online 16 October 2009, ISSN 0011-9164, DOI: 10.1016/j.desal.2009.09.035.

Access to drinking water is a human right that has turned into an international aim included in the Millennium Development Goals. However, at present, more than 1 billion people live with no access to drinking water, especially in developing countries. Particularly, in Mozambique, where this work has been performed, 43% of the population can only access to improved water sources and 32% of the population live with access to improved sanitation. Main reasons that explain lack of drinking water in developing countries are: absence of proper infrastructures and chemicals, deteriorated distribution network or interrupted service that encourages stagnancy of water and growth of pathogens.
The AQUAPOT project was developed in Polytechnic University of Valencia (Spain), and it is intended for the installation of decentralized drinking water systems based on membrane technologies as an alternative of the current water management in developing areas. At present, this project is being satisfactorily applied in rural areas of Ecuador (South America) and Mozambique (Africa). This work describes the evaluation of drinking water system, main characteristics of the UF-purification plant placed at Ressano Garcia (Mozambique), and assesses the main results obtained since the plant is working from the point of view of membrane performance and drinking water quality.

15 - M.D. Sohel Rana,

Status of water use sanitation and hygienic condition of urban slums: A study on Rupsha Ferighat slum, Khulna,

Desalination, Volume 246, Issues 1-3, 30 September 2009, Pages 322-328, ISSN 0011-9164, DOI: 10.1016/j.desal.2008.04.052.

The number of slums has significantly increased in Bangladesh over the last three decades along with the expansion of cities and towns. Rapid urbanization, caused largely by heavy influx of migrants from rural areas, has exerted severe pressure on urban housing and public services in the metropolitan city of Khulna with which the expansion of infrastructure and basic urban services could not cope. This situation coupled with the destitute economic condition of poor migrants has given rise to the formation of a large number of slums where service inadequacies have been compounded and multiplied on a massive scale, resulting in hazardous environmental condition. Against this background the study was performed. Data has been collected from field survey, some secondary sources and focused group discussion. Some experts and several officials were also interviewed whose agencies are likely to responsible for the extension of the services to the slum in the event of upgrading work being taken up. The study reveals that status and practice regarding water, sanitation and hygiene. This paper has also explored that assessment of water resource availability and quality at source point of consumption; problems faced in getting safe drinking water; and knowledge of the features of hygienic latrine; awareness about health. In addition to the above, the survey maintained a specific focus on adult man, women and young generation. The paper may attribute to further research on water supply and sanitation study it will guide those who will work to improve the present.

16 - M. Pritchard, T. Mkandawire, A. Edmondson, J.G. O'Neill, G. Kululanga,

Potential of using plant extracts for purification of shallow well water in Malawi,

Physics and Chemistry of the Earth, Parts A/B/C, Volume 34, Issues 13-16, 9th WaterNet/WARFSA/GWP-SA Symposium: Water and Sustainable Development for Improved Livelihoods, 2009, Pages 799-805, ISSN 1474-7065, DOI: 10.1016/j.pce.2009.07.001.

There has been very little scientific research work into the use of plant extracts to purify groundwater. Research studies on the purification of groundwater have mainly been carried out in developed countries and have focused on water purification systems using aluminium sulphate (a coagulant) and chlorine (a disinfectant). Such systems are expensive and not viable for rural communities due to abject poverty. Shallow well water, which is commonly available throughout Africa, is often grossly contaminated and usually consumed untreated. As a result, water-related diseases kill more than 5 million people every year worldwide. This research was aimed at examining natural plant extracts in order to develop inexpensive ways for rural communities to purify their groundwater.

The study involved creating an inventory of plant extracts that have been used for water and wastewater purification. A prioritisation system was derived to select the most suitable extracts, which took into account criteria such as availability, purification potential, yield and cost of extraction. Laboratory trials were undertaken on the most promising plant extracts, namely: Moringa oleifera, Jatropha curcas and Guar gum. The extracts were added to water samples obtained from five shallow wells in Malawi. The trials consisted of jar tests to assess the coagulation potential and the resulting effect on physico-chemical and microbiological parameters such as temperature, pH, turbidity and coliforms. The results showed that the addition of M. oleifera, J. curcas and Guar gum can considerably improve the quality of shallow well water. Turbidity reduction was higher for more turbid water. A reduction efficiency exceeding 90% was achieved by all three extracts on shallow well water that had a turbidity of 49 NTU. A reduction in coliforms was about 80% for all extracts. The pH of the water samples increased with dosage, but remained within acceptable levels for drinking water for all the extracts. Overall, M. oleifera powder produced superior results, followed by Guar gum and lastly J. curcas. There is a need to carry out further more detailed tests, which include toxicity to guarantee the safety of using plant extracts as a coagulant in the purification of drinking water for human consumption.

 

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