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Editor's Note: In this post, Laura MacDonald, Knowledge and Research Coordinator at the Center for Affordable Water and Sanitation Technology (CAWST) provides an abridged summary of a conversation with a researcher about climate change and WASH. To dive into the technical details on this fascinating topic, please refer to Kristen Downs’ guest blog post: Ask a Researcher: Considering WASH in the context of climate change. This post originally appeared on the CAWST website, to view the original post please click here.

2016 has not been lacking in extreme events – the Fort McMurray wildfires, Winter Storm Jonas, Hurricane Matthew, record-setting average global temperatures – and it’s assumed that such events will be occurring with increasing frequency. Such extreme events are highly covered in the news and grab the public’s attention, often resuming the ongoing discussion around climate change and its potential impact on our daily lives. For water, sanitation and hygiene (WASH) practitioners, consideration of the potential impacts extends to vulnerable populations in developing countries and their access to safe water and sanitation. Given the inherent links between climate change and WASH, the increasing awareness of climate change and its impacts has led to a documented increase in requests to CAWST from WASH practitioners for more information on the subject. Specifically, CAWST clients are seeing a decrease in the reliability of water sources, leading to more people relying on surface water with a high level of microbiological and, increasingly, chemical contamination.

If you feel overwhelmed with the complexities of climate change, don’t worry – it’s normal.

Here are some basics you should know 
  • Weather, climate and climate change are different.
  • Climate change isn’t just about increased temperatures; it’s also about: (1) precipitation,  (2) sea level rise, and (3) extreme events.
  • Climate change will hit hardest in places where the population faces existing vulnerabilities, be they economic, social or environmental, and exacerbate these challenges.
  • WASH programs need to ensure they are ready to adapt to the local effects of climate. Because the effects can be so localized, it’s critical that local WASH practitioners observe climate-related impacts first-hand and take steps to integrate best practices into their programs to increase climate resilience.
What strategies, technologies and approaches can we use to address the WASH challenges posed by climate change?

When considering possible strategies and technologies to address the WASH challenges posed by climate change, it’s helpful to think about supply and demand. For example, from a supply side, as our clients have seen, an increase in temperature could reduce the availability and quality of surface water. On the demand side, higher temperatures could increase household demand for water to use for cooling, bathing, and watering crops. This is just one of many potential changes that can affect both the demand and supply side and will make it difficult to plan, implement, evaluate and support appropriate interventions. As WASH practitioners, however, we are equipped with a range of strategies and technologies that could be used to improve resilience. Strategies include protecting water sources to prevent water quality degradation and diversifying raw water supplies to address reduced water availability and quality. On the technology side, boreholes and rainwater collection could support diversification of supplies. These technologies, in addition to household water treatment, improved pit latrines and flood-proofed wells, could help protect against and address degradation of water quality.

What are the potential health impacts of climate change?

The health impacts of climate change will be both direct and indirect, and they are likely to be increasing and mostly negative. Specific to WASH, increasing water insecurity, degradation of water quality, and changes in the transmission of water-borne and water-washed infectious diseases are of particular concern. Researchers are working to better understand how climate change affects infectious diseases in different contexts. For example, some are studying the relationship between temperature and diarrhea as well as rainfall and diarrhea.

The hard truth is that climate change will make it more difficult to deliver sustainable WASH services. An uncertain question is when and in what situations climate change will go from exacerbating existing challenges to changing the game entirely, at which point the WASH sector would have to change paradigms and practices, not just put in additional effort and invest in best practices.

Encouraging recommendations

Ever-positive and insightful, though, Kristen wouldn’t leave us disheartened. Instead, she closed with the following recommendations:

  •  Increase the resilience of WASH systems and services.
  •  Increase the resilience of vulnerable populations.
  •  Contribute to gathering more information about the current and potential future impacts of climate change at the local level.

To learn more about these recommendations and dive into the details of what Kristen presented, you can read her technical blog post here.

Editor's Note: This post, written by Matt Hickman, discusses the partnership between Google and India’s Ministry of Urban Development (MoUD) to roll out a new Toilet Locator app in a country where only 36.4 percent of households have a toilet. This post originally appeared on Mother Nature Network, to view the original post please click here.


Finding a clean, public toilet in Delhi (and potentially other major Indian cities) will soon be less of a health-compromising hassle thanks to Google Maps. (Photo credit: jenny downing/flickr)

World Toilet Day, an annual United Nations-sanctioned day of observance drawing attention to the 2.4 billion people around the world without access to clean and safe sanitation, dropped this past November in typically splashy fashion: a Coldplay and Jay-Z concert, the unveiling of a Gates Foundation poop smell-blocking perfume and enough well-meaning potty puns to last well into the new year.

While World Toilet Day is global in scope, much of the awareness-raising, activism-inspiring action this year — aforementioned Coldplay and Jay-Z concert included — was centered around India, a country where an estimated 70 percent of households in both rural and urban areas don’t enjoy the luxury of having a functioning commode. For a majority of India’s 1.2 billion citizens, defecating and urinating in the open is the norm.

Similar to other developing nations, cellphones are far more prevalent than toilets in India. As backwards as this may seem to Westerners, it’s a reality for millions of Indian households. According to a 2012 census, 60 percent of Indian households surveyed have one or more mobile devices while only 36.4 percent of households have a toilet.

Given these statistics, a new partnership between Google and India’s Ministry of Urban Development (MoUD) seems like a match in clean sanitation heaven: the introduction of a Google Maps tool that points users in the direction of toilets that are clean, safe and open for public use. As reported by the International Business Times India, the toilet-finder tool launched in December in Delhi, India’s second most populous city, before potentially becoming available in other major population cities, although the timeline is unclear.

How the app works

Of course, the tool, dubbed Google Toilet Locator, won’t solve India’s underlying toilet shortage problem or reverse cultural attitudes regarding al fresco urination. However, it does help on-the-go Delhi residents more easily find somewhere to go if need be. While we've written about urban toilet-finder apps in the past, those have been more or less spurred by convenience (and excessive drinking). Google Toilet Locator, piloted in a city of 25 million where public toilets are far and few between, is more driven by necessity.

An unnamed official with the MoUD explains to the IBTimes India that the Google Toilet Locator will pull up all known public lavatories — sulabh shauchalays — across the National Capital Region along with harder-to-find loos located inside of shopping malls, gas stations, hospitals, etc. Listing both deluxe flush situations and standard no-frills squat options, the tool itself is integrated into Google Maps. Mobile users simply must open the app and enter one of numerous keywords in English or Hindi — “toilet,” “restroom,” “lavatory,” “swachhata,” “shauchalay,” etc. — and they’ll be directed to the nearest option based on their location.

Just like a restaurant or retail establishment, Delhi residents — and visitors — can use Google Toilet Locator to rate and comment on specific public restrooms, either providing a glowing recommendation or warning others to stay away.

Explains an official with the MoUD: “The system being put in place relies heavily on crowdsourcing, with people's feedback helping fuel it. Therefore, if a person finds that a toilet is not clean, he or she can give it a bad review or rating, the facility for which is available on Google Maps.”

Considering that many Delhi residents who will be potentially using the app don’t have a toilet of their own at home, knowing if a public restroom is clean — or even open — is all the more important. Foreign tourists aside, for a large majority of folks using Google Toilet Locator, there isn’t the option of “holding it until I get home.”

Sanitation ... it's a work issue too

Google Toilet Locator is just one of many events and initiatives launched in conjunction with World Toilet Day, which as is tradition, boasts an annual theme. This past year, in order to spotlight the oft-overlooked link between economic livelihoods and sanitation, the theme was “Toilets and Jobs.”

For most, the topic of toilets and jobs usual revolves around ill-timed toilet paper shortages, privacy peccadilloes, rude noises or knowing to avoid the men’s room for at least 15 minutes after Ron from accounting goes in. For others, the workplace — and perhaps home, as well — might completely lack a clean, safe bathroom option. Poor sanitation has a direct link to economic well-being — that is, things like absenteeism, exhaustion and decreased productivity rise when employees don’t have access to a toilet at work or at home. In addition to impacting performance, the illnesses associated with poor sanitation keep workers off the job, sometimes temporarily and sometimes for good.

As the World Toilet Day website stresses, providing women with adequate and private bathroom facilities is of particular importance in developing areas.

And because it just wouldn't be World Toilet Day without a video featuring dancing animated poos, here's this past year's offering, which in keeping with the jobs theme, also features a variety of hard-working, life-saving "professional" toilets.

Editor's Note: In this post, Ammar Fawzi, Global WASH Advisor with GOAL, discusses the prospect of using smell-cancelling technology to combat global sanitation challenges in the future.

I recently attended the Global Toilet Business Innovation Summit hosted by The Toilet Board Coalition in Mumbai, India. The summit brought together key players from across the sanitation sector, but what was especially refreshing to see was the significant presence of the private sector – a sector often spoken of as the key to achieving success at scale, yet rarely actually in attendance at such summits. The range of the private sector attendees was broad, including large multi-nationals such as Unilever, Kimberly Clark Corporation, LIXIL and Firmenich, and over 75 small- and medium-scale entrepreneurs and businesses.


Undoubtedly, one of the highlights of the three days was a talk from Firmenich on Eliminating the “yuck factor” with smell science. You might have already seen the video that they premiered at the event, or read about it on Bill Gates’ Blog. Essentially, Firmenich is working with the Bill and Melinda Gates Foundation to tackle latrine malodour with “smell-cancelling” technology. The argument is that too often toilets don’t get used because they smell bad, and to combat this, Firmenich researchers are working on developing fragrances that block certain receptors in our noses, making us unable to register certain malodours. Think of noise cancelling headphones for example, but using your nose instead of your ears. As Bill Gates himself puts it, “The question now is whether this technology is good enough to make a difference in communities with poor sanitation.”

Innovative solutions to tackling global water access, sanitation, and hygiene (WASH) issues are often a cause of much excitement, especially when a large multi-national company is seen to be working on something as exciting as this and is backed by the Gates Foundation. There is, after all, plenty of depressing statistics and indicators on access to sanitation in our sector, so why not afford ourselves the opportunity to get excited by something as pioneering and potentially as game changing as this? I would agree, however, perhaps the question that needs to be asked is not whether this technology is good enough to make a difference, but instead how can it make a positive difference?

Although smell-cancelling technology is still a long way from being usable and available, let’s just assume that it is ready to roll out and let me play devil’s advocate for a moment to pose some key questions about the potential impacts of this innovation:

  • Would you still be keen on using a latrine if there was poop all around the toilet even if there was no smell? This technology could be seen as a substitute for Operation and Maintenance (O&M) which will be required, perhaps more than ever, if a latrine has more users. Caretakers might feel that they no longer need to keep up hygiene standards - there is no smell, so it must be clean! Effective O&M from caretakers is often needed (but not always) to manage the emptying of pits, ensure there is access to water and soap, maintain hygiene, and collect user fees where relevant. Can we expect them to do all of this if they can’t keep a latrine clean and smelling decent without the use of this technology? Are we addressing a simple problem with a complex technical solution? Should we also be concentrating on behaviour change (people are embarrassed to be seen going to a latrine), increasing capacity, and promoting adequate monitoring with suitable incentives?
  • How will this technology be rolled out and integrated into existing supply chains so that it is accessible in hard-to-reach places in sub-Saharan Africa?
  • Public latrines aren’t always used as latrines. I’ve seen them used as homes, storage, and even a pigeon breeding home. What will happen if we make them smell too nice?
  • Flies are attracted to strong smells and there is a direct correlation between smell and presence of flies. I wonder, would this technology also work on pathogen vectors? It would be fantastic if it did, but if it didn’t, people might think their toilet is lovely when really there are many vectors spreading disease. Our overall target as professionals is to improve public health – not to increase latrine use. There is a case to be made that there is a logical and evolutionary reason for smell. In 2003, researchers at the London School of Tropical Hygiene and Medicine carried out a study on smell and our association with disease. One of the researchers on the team, Val Curtis, echoes a suggestion that goes back as far as Charles Darwin: that we think poop stinks for our own good. Our disgust towards certain sights and smells, said Curtis, is a “behavioural immune system”: an adaptation—biologically rooted, but tweaked by culture and social conditioning—that evolved to keep us from coming into contact with infection and disease. Perhaps we shouldn’t be playing with this formula.

I don’t mean to be all doom and gloom. One area where this technology could really have an impact is in container-based sanitation. Many of the enterprises like Clean Team, Sanivation, SOIL or Mosan working in and pioneering this approach, rely on business models where the collection of waste from households is every two or three days. This is how long it takes it starts to smell and it doesn’t become something you want in your house. But what if this technology could be used here? Collection time could be increased to perhaps five days or more and this could be a successful method for scaling up access to sanitation by making business models more attractive and cost neutral.

Refugee camps and those for internally displaced people might also provide a great opportunity to trial this technology. The O&M works differently in this setting, there is a reliable supply of international products making their way to the camp from the implementing partners, and the focus here is less on behaviour change and more on public health impact.

I congratulate Firmenich and the Gates Foundation on this project and their early results. Let’s hope that if the opportunity comes, we as a sector can utilise it in the most beneficial way possible.

Editor's Note: This post discusses the method of Community Led Total Sanitation (CLTS) and how we can ensure that sanitation is both sustainable and inclusive. This post originally appeared on the website of Institute of Development Studies, to view the original post please click here

Great strides have been made in improving sanitation in many developing countries, not least through Community Led Total Sanitation (CLTS), an innovative method developed to address the behaviours behind ongoing open defecation. CLTS has spread rapidly over the last 16 years and is now present in over 60 different countries. However recent research shows that more thinking and action is needed to ensure that sanitation efforts are sustainable and inclusive. A new book, entitled Sustainable Sanitation for All, examines how CLTS and the WASH sector more generally has and needs to continue to evolve to meet these challenges.

Creating an Enabling Environment for CLTS Sustainability drawing - credit: Barney Haward

Creating an Enabling Environment for CLTS Sustainability drawing - credit: Barney Haward

The urgency of the sanitation crisis cannot be underestimated. An estimated 2.4 billion people worldwide still lack access to adequate facilities, of whom 1 billion defecate outdoors. Faecally transmitted infections, poverty, and undernutrition reinforce each other.

In December 2015, a UN General Assembly resolution defined water and sanitation as two separate rights for the first time while the Sustainable Development Goals (SDGs) include the ambitious aim of universal access to improved sanitation by 2030, with targets that include the elimination of open defecation.

The achievement of open defecation free (ODF) status is increasingly being recognised as only the first stage in a long process of change towards Total Sanitation.

“Open defecation free is just a start, we need to maintain the gains, deal with the faecal sludge, resolve problems of menstrual and hand hygiene, and see sanitation businesses spread around the world.” Professor Val Curtis, Director of Environment Health Group at the London School of Hygiene & Tropical Medicine.

New book “Sustainable Sanitation for All” looks beyond open defecation free

With a particular focus on sustainability of behaviour change as well as physical infrastructure, post-ODF follow up and monitoring, and ensuring equity and inclusion, Sustainable Sanitation for All includes 18 contributions which look at cases from Asia and sub-Saharan Africa. Edited by Petra BongartzNaomi Vernon and John Fox, the book was produced by the CLTS Knowledge Hub, based at IDS and published by Practical Action.

Exploring current experiences, innovations and insights, the book addresses two key questions:

  • How do we reach the poorest and most marginalized, with toilets that are suitable to their needs?
  • How can we embed hygienic habits and create new social norms around sanitation behaviour?

In his foreword to the book, Robert Chambers writes, “The empirical evidence and analysis in the eighteen contributions made in this book show just how much has been learned. We have learned that without losing its core essence, CLTS must be adapted and evolved to fit national and local conditions.”

One-day meeting brings water and sanitation experts together on how to take forward and expand on CLTS

On 23 November, the CLTS Knowledge Hub brought together over 20 experts on sanitation (CLTS and WASH) to discuss the challenges and opportunities for making sanitation sustainable and inclusive and to elicit views on how to better meet the needs of the sector through its activities.

participants at the CLTS workshop - credit: E.Wilson - IDS

participants at the CLTS workshop - credit: E.Wilson - IDS

Diversity of contexts requires adaptable and pluralistic approaches

The huge diversity in contexts within which CLTS has been used suggests that the traditional approach needs to be adaptable to respond to different needs. The range of different experiences to learn from is much wider than it was just 5 years ago. There are now opportunities for pluralism and with that more openness and learning.

Inclusion needs to remain at the forefront of efforts to sustain ODF communities When done badly, CLTS has been known to exacerbate existing inequalities. Whilst in an ideal case scenario, the poor or less able are helped by the better off, in practice, this is often not the case. Since the poor and less able people find it the most challenging to access and sustain adequate sanitation facilities and bear the highest burden of disease it is imperative that better ways of reaching them and meeting their specific needs are found.

Do subsidies need to be revisited?

Whilst CLTS has always maintained a strong position against individual household hardware subsidies, it may now be time to look at how smart financing mechanisms could support efforts to make sanitation more inclusive.

In many cases, maintaining a position against subsidies is the right thing to do, in order to achieve the behaviour changes needed to achieve ODF. However, many present at the meeting agreed that a more nuanced and targeted approach to subsidies, for example through a voucher or rebate systems as described by Andy Robinson's book chapter, may add value.

Sanitation Marketing

We have come a long way since some of the early meetings and discussions when CLTS and sanitation marketing were presented as opposing approaches with practitioners aligning themselves to the different camps. Now there is a far more nuanced understanding and discussions are evolving around ways CLTS and sanitation marketing can complement each other and be phased together to ensure sustainable ODF communities.

Handwashing CLTS must be better linked together with other sanitation and hygiene concerns. One crucial area that was identified as a frontier we have yet to crack was handwashing. It is clear that more innovation is needed in order to influence handwashing behaviour in communities.

Editor's Note: This post discusses the work of Water & Sanitation for the Urban Poor (WSUP) in Zambia to improve sanitation in low-income communities by trialing a pit-emptying service operated by a community-based organization. This post originally appeared on WSUP's blog, to view the original post please click here.

Providing sanitation services to unsewered parts of a city is complex. The challenge goes way beyond simply building toilets – its about finding financially viable ways to collect, treat, and dispose of waste.

WSUP’s new film tells the story of our work in Lusaka, Zambia, to improve sanitation in low-income communities by working closely with the utility, micro-enterprises, residents, and community-based organisations.

Because sewers haven’t been built where they live, low-income residents have to dig a pit for the waste from the toilet. When the pit fills up, residents have to dig another pit or empty the waste out by hand, sometimes dumping it illegally. This is clearly an unsustainable practice, made worse by the fact that in the rainy season, many of the pits flood – spreading faecal waste across the residential area.


So to tackle this, in Lusaka we’ve been trialing a pit-emptying service for low-income customers, operated by a community-based organisation, the Kanyama Water Trust in partnership with the Lusaka Water & Sewerage Company. The service enables customers to have the sludge from their pits safely transported to a treatment facility, where it is processed and safely disposed of or resold as a soil conditioner and fertiliser.

So far, the scheme has benefited 25,000 people, such as Shawa Margarete, who lives in Kanyama, one of the pilot communities. Shawa (pictured below) says in the film that she is positive about the benefits that the service brings: “The service is worth the money that we pay for it”, she says. Mbewe Brown agrees: “This has really made our lives easier, because we had a really big problem and now, with the pit emptiers we have a service which is easily available,” he says.


But the model still needs work. The service is generating income, but is not yet covering costs of collection, treatment and disposal. This is vital to achieve if the service is to be expanded to other urban communities in the country.

“Our priority at WSUP now is to see how this current model can be improved so that it can become more financially viable – because when it does so, we will be able to recommend it for scale up to other low-income communities,” says Reuben Sipuma, WSUP Zambia country programme manager.


This film was produced in partnership with Sandec, the Department of Sanitation, Water and Solid Waste for Development at Eawag. It will feature in Eawag’s new online course on Planning and design of sanitation systems and technologies. To sign up for the course, click here.

Editor's Note: In this post, Eve Mackinnon, a researcher working on innovative responses and evidence-based solutions to the sanitation crisis, discusses how WASH programs in nurseries or child care centers could protect child health. Eve is a water, sanitation and hygiene practitioner with over five years of hands–on emergency humanitarian response experience across Asia and Africa. Her current research focuses on more effective, sustainable and safer sanitation management, across the entire sanitation service chain to deliver positive changes to the way that human waste is managed. 


Although global death rates of children under five resulting from diarrheal disease has fallen from a global high of 1.2 million in 2000 to 500,000 in 2015, it still represents the second leading cause of morbidity for this age group. These deaths are mainly preventable; 88% of them are attributed to a lack of access to water, sanitation and hygiene (WASH). The significant decrease in the last 15 years is a major achievement largely due to improvements in access to better quality drinking water, toilets, and better hygiene and care practices. These changes prevent young children being infected with harmful microbes that come from drinking dirty water and living in dirty environments, and contracting severe diarrheal diseases, which without sufficient treatment or in vulnerable children ultimately leads to death. 

Of course diarrhea is not the only threat to infant and young children. Ongoing research indicates that the same WASH factors that lead to diarrhea, also lead to stunting and malnutrition in young children. This is because low level of exposure to harmful microbes damages the intestinal tract and prevents proper absorption of nutrients in children. Infants and children under five are more vulnerable to being infected by microbes and get ill far quicker. From a health perspective, the targeting of effective WASH infrastructure is crucial to reach the most vulnerable groups.

Provision of WASH programs for vulnerable children whilst at nurseries or child care centers could be the most efficient way to protect their health. In Naivasha whilst researching risks of diarrheal disease for my PhD case study, I was shown Vision Nursery. The nursery cares for on average around 40 children in one small room. There is no drinking water provision, only water stored in containers from a tap stand. The nursery has access to a child adapted toilet (a container based toilet, provided by Sanivation), a positive step in WASH provision, however, without handwashing or regular cleaning the use of the toilet carries its own risks. Moreover, the nursery is also host to resident chickens, which are major carriers of harmful bacteria and co-habitation with people is linked to malnutrition and stunting in children according to recent research. The mud and rough concrete floor means cleaning and hygiene is difficult to maintain. There is inadequate space and utensils to safely prepare the childrens’ meals, and food cannot be re-heated or stored in secure containers.

Despite all of these shortcomings, the nursery provides an essential service. The female entrepreneur who started Vision Nursery has been running it for almost seven years and rents the small space. She is constrained by small margins, high rents, and lack of borrowing power. Her operation is linked to the Kenyan flower industry- a global success story of export growth. Naivasha is an epicenter of this booming export center for flowers, and it is driven overwhelmingly by a female workforce.  The associated employment opportunities allow women to gain a regular income with positive consequences of independence, empowerment, and rising equality for women in Kenyan society. An unintended consequence of female empowerment is the growth in a secondary industry of local nurseries and childcare. There are little to no regulations for nurseries in Kenya, and if they do exist,  they are not enforced. This allows for poor standards to exist, particularly in regard to WASH provision.

Potential baby WASH strategies to combat infection at the nursery level focus on robust barriers to specific exposure pathways that are specific for infant behaviours. For example, ingestion of pathogens occurs indirectly when children place contaminated objects in their mouths. Termed ‘mouthing’ it is responsible for almost 90% of a child’s exposure in one study.

Other direct exposure pathways include placing of hands directly into mouths and touching dirty floors. It’s important to regularly disinfect toys and maintain hygienic floor surfaces—possibly through use of mats or plastic, washable floor covers. Informed WASH strategies should be developed which can identify a broad range of baby-specific exposure routes. Indeed these indirect routes may be far more of consequence for children than direct routes of drinking contaminated water and food, which are traditionally the focus of WASH household campaigns.

The safe disposal of faeces remains the primary barrier to prevent dispersal of pathogenic bacteria in the environment and subsequent exposure routes. Despite a recent systematic review of health impact from sanitation intervention that concludes there is a lack of robust evidence, provision of safe sanitation is ultimately necessary to reduce contaminated environments that occurs as a result of open defecation.

In addition to focusing on specific prevention strategies at the nursery level, it is also crucial to increase integration between WASH, early childhood development (ECD), nutrition, and maternal newborn and child health (MNCH) programming. In addition, it’s important that outcome and impact monitoring is not uniquely focused on reduction in diarrheal disease. Impact monitoring and value for money evaluations should also explore targets that are linked with nutrition, undernutrition, and height and weight. It is notoriously difficult to link specific WASH interventions with impacts, without radnomised controlled trials, due to the huge variety of exposure pathways and variables that exist.

The WASH and sanitation sector might consider moving its focus from mostly household WASH and school sanitation to specialist WASH needs during infant care. If children survive the first year they are less vulnerable to further infection or severe outcomes. Therefore, intentionally focusing on activities at this juncture, as well as better integrating our efforts with other sectors—as the new does—could have an enormous impact on child health.

Editor's Note: In this post, Georges Mikhael, Head of Sanitation at Water & Sanitation for the Urban Poor (WSUP), explores the importance of government buy-in for improving sanitation.


I think I may have recently witnessed a real toilet revolution! As Water & Sanitation for the Urban Poor’s (WSUP’s) Head of Sanitation, a general poop enthusiast, and having been born on World Toilet Day, I hope you can understand how exciting this is for me.

I recently visited Visakhapatnam (‘Vizag’ for short) for the second time to support the WSUP Advisory India team in their implementation of a USAID project supporting the Greater Visakhapatnam Municipal Corporation (GVMC). Vizag is the largest city in Andhra Pradesh state, found on India’s eastern coast.

The project aims to improve sanitation across the whole city – eliminating open defecation and making sure that all residents have access to a toilet.

Since my first visit, I found an unmistakable urgency and energy in the way sanitation is being tackled in India by different institutions as a result of Prime Minister Modi’s commitment to Swachh Bharat Abhiyan, a national campaign to clean up India in time for Mahatma Gandhi’s 150th birthday on  October 2, 2019.

I had heard reports from my Indian colleagues about the speed at which authorities are making decisions on sanitation issues, and I had seen maps showing the rapid progress being made on the ground - a lot of toilet building!

But this urgency only really hit me once I got out to the Bnr Nagar community in Vizag. Everywhere I looked, literally every few steps I took, there was a toilet at a different stage of construction. I wasn’t taken to this community because it represented a standout example of progress on construction of toilets – there are plenty of other communities just like it around the city.

Of course, constructing toilets is just one part of improving sanitation, but GVMC, supported by WSUP, is already looking at the next steps, including how to deal with the challenge of emptying toilets on the hillsides around Vizag.

At WSUP, we always talk about this so called ‘enabling environment’, and how important it is to making progress in sanitation. It is core to our theory of change; it’s in all of our national business plans. But it can be hard to grasp what it actually is, and how to make it more effective.

It was obvious to me during this trip that an important part of the enabling environment is without a doubt government spending: the Government of India’s 2016 budget for the Swachh Bharat was US$ 1.3 billion. That’s about $1 per person across the country in just one year. As WaterAid’s recent study of East Asian countries has shown, it is obvious that commitment by political leadership is a major factor for improving access to safe sanitation.  

What could be done in Maputo if $1 per resident per year were spent on sanitation by the municipal authority? Lusaka? Freetown? Without a doubt, we could make much more rapid progress on Sustainable Development Goal 6 if this level of government buy-in were replicated around the world.

So if you’re curious what a real toilet revolution looks like, if you want some inspiration, consider a trip to Vizag. Maybe bring an aspiring politician with you.

Editor's Note: In this post, Edson Monteiro, a WASH Project Officer at UNICEF Angola, highlights UNICEF's partnership with Andrex to bring a Community Led Total Sanitation (CLTS) programme to rural villages in Angola. This post originally appeared on UNICEF's site, to view the original post please click here.


© Karin Schermbrucker. Eugenia, 11, washes her hands after learning about sanitation and hygiene during a ‘triggering’ meeting in Calipanguela Village, Angola.

I recently returned from a trip to visit rural villages in Angola to look at the impact that UNICEF’s sanitation partnership with Andrex is having on children and families there. It’s incredible to think that seven out of ten people living in rural Angola do not have a clean, safe toilet to use. This has a huge impact on the health of Angola’s children and is one of the reasons the country has the highest rate of child mortality in the world.

As I began my journey into the heart of Angola, I visited villages that were in different stages of learning about sanitation. Due to a number of reasons, such as the poor economic climate in Angola and the poverty that the country suffers, many people do not have access to basic sanitation. Without a toilet, the reality is that many people still have to go to the toilet out in the open, often in the bush or a lake and near their homes. This risks faeces contaminating their food and drink, causing sickness to children and families.

The first village I visited was called Calipanguela, located over an hour away from the nearest city, Nharea. The village is incredibly rural, with mud huts, dirt tracks and livestock. The process of educating the community about the importance of using a toilet, washing their hands and sanitation in general had not reached this village yet, but would start with a ‘Triggering’ meeting.

The meeting involves gathering all of the villagers together and sharing food and water between them. Then something shocking happens. To exemplify the danger of open defecation, the facilitators place fresh human faeces, found that day in the village, near the food and water they’d been sharing. The flies become instantly attracted and begin moving between the faeces, food and water. 

The method is deliberately provocative. People immediately understand the danger of going to the toilet outside and realize they may have been eating food contaminated by their faeces. The village then designs an action plan to tackle the reasons why so many people go to the toilet outside, and to improve the health of the community.

I went on to the village of Luwawa, which was triggered a year ago. After being monitored on a monthly basis to ensure the community were using and maintaining their toilets, it was about to be awarded a certificate. Villagers no longer went to the toilet out in the open, and Luwawa had been declared ‘open defecation-free’. This is a huge honour in Angola, and to mark the occasion, there was singing, dancing, and a party.


© Karin Schermbrucker. Sabina and two of her four children in their home in Waleka, Angola, where newly built toilets have made everyone healthier.

Finally, to complete my journey, I visited a village that had been declared ‘open defecation-free’ for a year. Here I met a wonderful family, with a mother named Sabina, who wanted to share her story. Sabina is 39, is married, has four children, and lives in a village called Waleka.

Sabina told me about life before her village was triggered and her family built a toilet. “Before we had a toilet, we went outside to the bush to defecate, which made me feel uncomfortable. When we went to the toilet outside, I was worried about my family getting sick or being bitten by a snake.

“Defecating outside made my children sick; they were always ill. When they were ill, they didn’t manage to go to school.”

Sabina told me that it always smelt before the village was triggered and the toilets were built. Sometimes there would be faeces all around the village, and it didn’t feel clean. Now that they have all built toilets and been declared open defecation-free, she feels happy, and can see that there has been a reduction in illness for all of the villagers.

Sabina said: “Now there is a real change in the village. Now everything is OK.”

The Andrex partnership raises funds for UNICEF’s Community Led Total Sanitation (CLTS) programme, which empowers communities to build, maintain and take pride in their own hygiene and sanitation. The great work that the partnership has helped to fund was clear to see in all of the villages that we visited, no matter what stage of the journey they were in. 60,000 lives will be impacted this year thanks to the funds raised by Andrex for the UNICEF programme.

As I plan my next trip back to the villages, I feel confident that thanks to this partnership, villagers will continue to feel empowered to use their toilets and benefit from the programme.

Editor's Note: In Part Two of this series on wastewater treatment, Craig Fairbaugh, a Research Fellow at Engineering for Change, highlights technologies that meet the challenge as described in E4C’s Solutions LibraryPart One of this series can be found here.

Designers and engineers have long recognized the need for wastewater treatment in developing communities but often are met with the challenges of no piped sewer system, high capital investment, and limited technical skills necessary for operation and maintenance. Enter decentralized wastewater treatment; a solution that treats waste effectively on site and requires no existing piped infrastructure. Decentralized anaerobic treatment systems have existed since the 1800s as septic tanks, but in order to meet the Sustainable Development Goals with a rapidly growing population in the developing world, engineers are attempting to design solutions that are affordable, scalable, more effective, and easier to maintain.

The Engineering for Change Solutions Library features technology reviews of three solutions for decentralized wastewater treatment: Biopipe, the Biofil Digester, and DEWATS.

Biopipe is a decentralized pipe network that treats domestic wastewater for reuse in irrigation and secondary applications (but not for drinking). The system is comprised of a tank, pipe modules, circulation and water pumps, and a UV filter. Bacteria lining the inside of the pipe remove microbiological pathogens, similar to the treatment processes that occur naturally in river beds. 


Biopipe uses aerobic treatment, filtration, and UV sterilization to treat domestic wastewater.

Biopipe is making the transition out of the prototype phase with a recent exclusive distribution deal for Asia and Africa with Metito, a water management design and engineering firm in emerging markets.

Biofil Digester
The Biofil Digester mimics the natural world with a process similar to the natural decomposition that occurs in soil on a forest floor. Developed in Ghana, the typical digester is housed in a 2’ x 2’ x 6’ concrete structure. Liquid waste rapidly separates from solid as it filters through a layer of permeable pavement. Macro-organisms in the soil below break down pathogens. The digester can be connected to an existing toilet or septic system, is scalable to meet small or large demands, and produces no waste product. The Biofil Digester can be installed above or below ground in a concrete structure with a “microflush” option which conserves the amount of water needed for flushing. Since 2008, more than 4500 Biofil Digesters have been installed across Africa and South Asia.

The Biofil Digester uses aerobic treatment and macro-organisms in soil to break down and remove harmful pathogens in domestic wastewater.

While the Biopipe and Biofil Digester are manufactured treatment systems, BORDA’s Decentralized Wastewater Treatment System (DEWATS) is a technical design approach to treating wastewater at the household and community level. Founded by the Bremen Overseas Research and Development Association, DEWATS uses physical and biological treatment mechanisms such as sedimentation, floatation, aerobic, and anaerobic treatment to remove pathogens from household wastewater. These treatment stages are commonplace in centralized systems, but what separates the DEWATS design approach is employing a passive system (no power required), low maintenance requirements, and construction from affordable and locally available materials. Hundreds of DEWATS treatment systems have been implemented and are currently operational across Africa, South Asia, and Southeast Asia.


DEWATS design methodology employs a series of baffled chambers and planted horizontal gravel filters to promote removal of pathogens by anaerobic and aerobic processes.


A DEWATS treatment facility in South Africa serves as an educational treatment system for neighboring communities. A primary treatment vault (top) and horizontal gravel filter (bottom) are constructed and inspected by local officials and tradesmen.

In a recent expansion of our Solutions Library, E4C added these three technologies as examples of decentralized treatment, which has the potential to scale up and meet needs in cities and rural communities. Visitors to this web site know better than most that wastewater treatment is often overlooked in discussions about global development. With these new additions and more sanitation technology planned for the future, we hope to draw attention to the options available to those in need.

For more on wastewater treatment technologies, including the EkoLakay Toilet, the Easy Latrine, the Elephant Toilet and others, please visit E4C’s Solutions Library

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