Transcript Document

Course 4 Unit 2
Social, institutional, policy and gender aspects
Teacher
Mariska Ronteltap
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[email protected]
Course 4 Unit 2
Social, institutional, policy and gender
aspects
Part A: Social aspects and hygiene education
Part B: Institutional and policy aspects
Part C: Gender aspects (separate presentation)
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Course 4 Unit 2
Part A: Social aspects and hygiene
education
http://www.wsscc.org/
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Sanitation system boundary conditions
A sanitation system encompasses:
 the users of the system,
 collection,
 transport,
 treatment and
 management of end products of:
• human excreta
• greywater
• solid waste
• industrial wastewater
• and storm water
 so much more than just a toilet!
Source: Patrick Bracken (ex-GTZ) presentation at Stockholm Water Week,
2004
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Interactions of relevant systems in society
Economic
system
Social
system
Political
system
Water and
Sanitation
System
Educational
system
Health
system
Institutional
system
Housing
system
Source: Elisabeth Kvarnström
(SEI, Sweden)
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Cultural factors
“Faecophilia-faecophobia” continuum
 In many societies, there is a fear of human excreta (some people call
this: “faecophobia”) and many taboos around human excreta
management
 In other societies people have no problems talking about faeces (some
people call this “faecophilia”)
• one example is China*
 It is important to work with these cultural barriers and taboos and not to
ignore them!
Use participatory methods to facilitate change (“bottom-up” approach)
 One unavoidable draw-back is that this may well take longer than the
traditional “top-down” approach (see also Part B on participatory
approaches)
* Watch this video clips to hear from Uno Winblad about the special situation in China with regards to “
faecophilia” and “nutritional imperative” (see next slide):
mms://mediaserver.ihe.nl/course/video_general/ecosan/human_excreta18_256kbps.wmv
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The “nutritional imperative”
Societies that use excreta or have used it in the recent past in
agriculture or aquaculture are those which are most densely
populated: Europe, India, China and South-east Asia
 Economic appreciation of soil fertility
 Use of fresh excreta as fertiliser was often combined with the
practice to always cook the food and avoid eating raw vegetables,
thus reducing potential disease transmission
Societies with a low population density have not had the need to
use these nutrients in food production (e.g. countries in subSaharan Africa)
WHO (2006), Chapter 7, p. 109 (under Extra Materials)
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Perception (emotional responses) of faeces
versus water
Perceptions are not
always logical nor
rational !
Faeces
Water
• dark
• defiled
• evil dangerous
• bad
• repulsion
• clear - reflecting light
• pure
• God/heavenly - safe
• good
• attraction
Source: based on Heeb et al.
(2007) Module M4-2 on SocioCultural aspects
Associations
usually
negative
Associations
usually
positive
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People’s perceptions of urine and faeces
People’s perceptions of urine rarely documented:
 Presumably fairly relaxed
 Urine has been used to smear wounds and as an insecticide to kill banana
weevils in East Africa
• Disinfection property of urine is quite well known
 Some people even drink urine and view this as beneficial to their health (!)
 Urine’s richness in nutrients is not so well known (yet)
People’s perceptions of faeces:




Fresh faeces are perceived as abhorrent by most people
One’s own faeces are perceived as not so offensive
Dried and composted faecal material has a different appearance: soil-like
Projects with dry sanitation: cultural avoidance to handle the product may
still exist
“Stepping into urine on the ground is quite different from stepping into faeces!”
(Gumbo PhD thesis, 2005)
Source: WHO (2006), Chapter 7, p. 110
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Course 4 Unit 2
Hygiene education: overall aims
– To change hygiene behaviour for better
livelihood
– To improve water quality and the environment
through better hygiene practices
A very good source of information on this topic is
the website of the Water Supply and
Sanitation Collaborative Council (WSSCC)
http://www.wsscc.org/
• See their WASH campaign (WASH= water,
sanitation and hygiene)
www.usaid.gov/bj/images/hygiene
-bet.jpg
There is also a group of video clips produced by UNICEF which deal with hygiene education, you can view
them here: **
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Hygiene education: Key behaviours for
breaking the cycle of disease transmissions
Hand washing with soap (there may be a need to
subsidise soap):





after using the toilet
after cleaning up the faeces of children or elderly people
after helping children to use the toilet
after handling animals
before food preparation or feeding children
Measures to keep drinking water clean
Hygienic food preparation and storage and reheating
(safe food handling)
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Hygiene education: Key behaviours for
breaking the cycle of disease transmissions
 Consistent use of toilets (for adults and children) to
keep faeces out of the environment
 Stop flies from coming into contact with faeces
 Stop children and animals from coming into contact with faeces
 Handling excreta only with gloves, rakes, shovels; and
wearing suitable footwear, e.g. boots
 Use of footwear to stop helminth ova infections via soil
attached to feet, and infections via the skin
 Availability of anal cleansing material at the toilet (toilet
paper, water, leaves, or whatever else is used locally)
 See also the PhD thesis of Susanne Herbst on hygiene issues
in Uzbekistan (see Course 1 Unit 2 Extra Materials)
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Source: Parts of this slide are from Winblad and SimpsonHebert (2004)
Reminder: Effectiveness of hardware and hygiene
interventions in reducing diarrhoea morbidity
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Hygiene education and water quantity
 Sufficient quantity of water is important (more important
than quality of the water)
 People don’t wash hands if water is too limited
 Water for handwashing can be lower quality than drinking water,
e.g. from rainwater harvesting or high salinity water
 See interview with Sumita Ganguly (UNICEF Delhi) on this
topic on this site:
mms://mediaserver.ihe.nl/course/video_general/ecosan/human_excreta16_256kbps.wmv
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Hygiene education and gender
Public awareness should be designed in consultation
with communities taking into account women, men,
children – their cultural differences, and behaviour
etc.
Focus on gender differences is of particular importance
– knowing that women influence the hygiene
behavoiur of young children – and men serve as role
models in sustaining changes in habits
See also Part C of this presentation
Source: United Nations Economic and Social Council (2005)
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Hygiene education and people living with
HIV or AIDS
For People Living With HIV/AIDS (PLWHA) (this
includes households/family members of HIV
positive people) hygiene education is even
more important
 Therefore, hygiene education must be
specifically targeted at caregivers and
volunteers involved in home-based care
and must be one of the elements in training
for home-based care
• Currently, this is rarely done
Source: Kamminga and Wegelin-Schuringa (2005), p. 13
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Course 4 Unit 2
Course 4 Unit 2
Part B: Institutional and policy aspects
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Overlapping responsibilities
For example: Ministry of Water, Ministry of Health, Ministry of Local
Government – who is responsible for sanitation?
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How is this for an ancient sanitation policy (from the
bible)…?
“Designate a place outside the camp where you
can go to relieve yourself. As part of your
equipment have something to dig with, and
when you relieve yourself, dig a hole and
cover up your excrement. For the LORD your
God moves about in your camp … your camp
must be holy, … “ - 5th book of Moses 23: 1315
This quote stems from a PhD thesis of Ibiyemi Ilesanmi (2006) “Prefeasibility assessment of decentralised sanitation systems for new
satellite settlements in Abuja, Nigeria”. TUHH (Hamburg-Harburg
Technical University, Germany)
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Purposes of awareness raising
Awareness raising:
 To elevate the level of knowledge
 To enable stakeholders to participate in decision
making
Two kinds of communications:
instructions on how to use the system, change
behaviour…
information or justification about why this is necessary,
desirable, morally appropriate, etc.
Source of this slide and next 2: Heeb et al. (2007) – they used the source
UNESCO/IHP and GTZ (2006) to create these slides
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Awareness raising for ecosan – why?
Awareness for ecological sanitation is
necessary:
 concept is relatively unknown
 not only to (potential) users, but also
amongst engineers, planners, architects,
decision makers, politicians, teachers, ...
Overall goal: spread knowledge among all
stakeholders
There is also a group of video clips produced by UNICEF which can be used for awareness raising for
water, sanitation and hygiene education, you can view them here: **
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Course 4 Unit 2
Awareness raising – how?
Strategy:
 De-construct and re-construct a particular discourse about
alternatives with new information, criteria, or factors with factors
that weigh differently from the conventional approach
 Information provided to the stakeholders should be tailored to their
specific information needs
Topics of the new discourse are e.g.:
 participation better than top-down approaches
 sanitation also for the poor – not only for the wealthy (“pro-poor
approach”)
 comparing the money invested in sanitation with the gains for the
national economy
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Awareness raising methods
• It is important to tell people about ecosan even if they don’t know
that they should know about it. Examples:
– When you tell your friends, colleagues, parents, children about
ecosan: they may be surprised but at least now they have heard
about it
• We need good tools and innovative methods, e.g.:



Television documentaries, video clips on
www.youtube.com, interviews on the radio
Books, pamphlets in local languages
Eco-Solutions book from Paul Calvert
(India) is a good example (see www.ecosolutions.org, and there are also a few
pages under Assigned Reading for this unit)
– unfortunately, this book is not for free or
available as soft copy
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The importance of stakeholder
involvement
• Stakeholders are those groups of individuals or
organisations who have an interest in the outcome of
a particular process
• Relevant stakeholders are those who should be
involved in a particular process, as well as those who
are mainly affected by it
• A detailed stakeholder analysis should be carried out
at the start of an ecosan project
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Course 4 Unit 2
Possible types of stakeholders
• Users of sanitation facilities
• Users of ecosan products (recyclates)
• CBOs and self-help groups (CBO = communitybased organisation)
• NGOs
• Local authorities and governments
• Service providers
• Developers and investors
• Financial institutions
• Research and educational/training institutions
Not all stakeholders will always need to participate in the programme – check on case-bycase basis
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Source: UNESCO/IHP and GTZ (2006)
Example 1 for stakeholders: Lusaka peri-urban areas
Stakeholder
Roles of each stakeholder in provision of
sanitation
Enforcement of the roles
Community


Beneficiary of service
Management of facility
Through CBO
Municipality

Local government by-laws


Service provider or contracting service
provision
By-law development and enforcement
Community health education (general
gathering and in schools)
Government ministries




Set policy and legislation
Mobilise funding
Regulate service provision
Coordinate all stakeholders
Through legislations
protocols
NGO



Provides funding
Capacity building of the community
Organising user demand and community
involvement
Through municipalities,
government ministries
Private Sector


Construction of toilets
Emptying of toilets
Community social structures,
CBO
Source: MSc thesis Kennedy Mayumbelo (2006)
See reference details in Course 4 Unit 1
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Example 2 for stakeholders: faecal sludge management in
Kumasi, Ghana
Stakeholder
category
Stakeholder
National government
Government of Ghana
Local government
Kumasi Metropolitan Assembly
Waste Management Department
Regulator
Environmental Protection Agency
Donors
Worldbank
Research institutions
International Water Management Institute (IWMI) – representation of
West Africa
Sandec
Private sector
Faecal sludge collection companies (17 in total)
Dompoase faecal sludge treatment plant operator
Manhole managers (informal operators providing a collection service
to bucket latrine owners)
Beneficiaries
Households in various residential areas
Farmers
Recognised as potential stakeholders (they are not yet direct
stakeholders)
Source: MSc thesis Anselme Vodounhessi (2006)
See reference details in Course 4 Unit 1
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Example 3: stakeholder analysis and relevant
communication strategies
Stakeholders
A. Investors, Regulators
(state, communes, private)
B. Planning (architects,
engineers, project managers)
C. Execution (sanitary firms)
D. End user (individuals,
families, farmers)
Communication strategies
• seminars
• workshops
• semi-structured
interviews with
key actors
• Newsletter
EcoSanLux
• workshops, fairs
• survey (end user
attitude & behavior
towards water)
• Internet
• Articles in national
press
Source: Paul Schosseler presentation at Aachen Advanced Sanitation conference (March 2007)
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“Implementing sustainable sanitation concepts in Luxembourg – methodological approach and
outcomes”– also on Extra Materials
Course 4 Unit 2
Participatory methods
Health interventions may work better if social and
cultural reasons for changing hygienic practices are
emphasised rather than motivation building on health
benefits
Users should be given the opportunity to examine and
identify their own problems and be offered a wide
choice of sanitation systems
Pilot projects can be useful within participatory methods
 Remember: “seeing is believing” (or “seeing - and not
smelling – is believing”)
WHO (2006), Chapter 7, p. 112
(under Extra materials)
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A participatory tool: PHAST
PHAST = Participatory Hygiene and Sanitation Transformation
(WHO 1998)
PHAST tools are designed to aid discussion and decision making
by using pictures and working
in the third person
 Pictures avoid issues around literacy and must depict the
environment of the participants so that they can relate to it.
PHAST is a tool that helps people participate in decision making in
a non-threatening way.
PHAST is a tool used inside the SARAR* philosophy
It is important that PHAST is implemented correctly with trained
facilitators - otherwise it risks the danger of not being very
effective
•SARAR = Self-esteem, associative strengths, resourcefulness, action-planning
and responsibility
•Source: Mayling Simpson-Hebert and Richard Holden on EcosanRes
Discussion forum in March and May 2007
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PHAST: Diarrheal Disease Transmission
Routes
“PHAST has an activity called Diarrheal Disease Transmission
Routes whereby people learn how faeces from open defecation
can spread through the environment to eventually infect another
person.
In our experience in several countries, this activity is quite impactful
in helping people
realize how faeces spread in the environment.
Without actually mentioning germs, this activity gets the point
across. Always someone in the group knows that most diarrheal
diseases and worms are spread by faeces.”
Source: Mayling Simpson-Hebert on EcosanRes Discussion forum on 20 March
2007
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Who is using PHAST (example in
Ethiopia)
“CRS is using PHAST in our projects in Ethiopia. It works well to introduce
communities to ecosan. We are getting 100% coverage with Arbor
Loos, mainly, although we offer choices including traditional pit latrines.
In areas where we do PHAST in Ethiopia, we get 100% toilet coverage
within a few months. This is led by the community group that went
through the entire PHAST planning. We do help and support them with
slabs and information about building a toilet correctly, and we have
moved almost entirely to Arbor Loos and Fossa Alternas - ecological
toilets -which also are very popular with farmers.
We are really successful with PHAST. It is our key method for working with
people and it works well. I know I am biased, as an author of PHAST,
but
the proof can be seen in community after community.”
Source: Mayling Simpson-Hebert on EcosanRes Discussion forum on 7 March
2007 and on 26 April 2007
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Course 4 Unit 2
Who is using PHAST (example in South
Africa)
“PHAST is not a tool for teaching people. Once a decision has
been made using the tools then it is acted on. Too often the
tools are used again and again in a community and no effort is
made to implement the decisions made, or worst of all, the
facilitators disagree with the decisions made and implement
what they want rendering the whole process irrelevant.
The results can be interesting. On the sanitation ladder we had
depicted the burying of human faeces just above open
defecation in terms of hygienic practice. It was pointed out by
community members that burying is a very safe practice,
particularly in the rural areas where there is space, all a toilet
structure gives you is more convenience.”
Source: Richard Holden on EcosanRes Discussion Forum on 3 Oct 2006
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Planning for sanitation or ecosan projects
Planning of councils
 City council needs to evaluate whether to incorporate
ecosan options in the existing system, or to maintain and
extend an aging sewerage system
A number of planning tools have been proposed:
 Open Planning of Sanitation Systems (EcosanRes –
Kvarnström and af Petersens (2004))
 Household Centred Environmental Sanitation Approach
(HCES) – WSSCC/Eawag/Sandec
 The ecosan project steps (UNESCO/IHP and GTZ, 2006, p.
20)
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Required changes to institutions
Municipalities may need to create new
institutional arrangements, e.g. “Department
of Sanitation and Solid Waste” instead of
“Department of Water and Sewerage”
 Excreta management may fit more logically
together with solid waste management
rather than with water supply
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Training, promotion and education for ecosan
• Training and education is needed at
various levels:
– Key local authorities
– Builders
– Staff responsible for collection,
transport and secondary treatment
– Household members
• Visits to local demonstration sites
• Promotion to the public and staff of
urban services
• Online ecosan courses
• Leading by example (“practise what
you preach”), e.g. people in prominent
positions, staff members at sanitationrelated organisations
MSc student Kennedy Mayumbelo speaking to
residents in peri-urban settlements in Lusaka,
Zambia (December 2005)
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Course 4 Unit 2
Education for ecosan
Ecosan projects are more complex than
conventional sanitation systems, because:
 they are trans-sectoral
 they include topics ranging from (for example)
calculating diameters of pipes to the analysis of
cultural habits
Ecosan awareness needs to be included in the
curriculum of many different professions, e.g.
engineers, planners, architects, health
professionals, agricultural engineers
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From Course 1 Unit 2
Remember the bubble diagram: Ecosan is an inter-disciplinary field
.
Logistics
Civil/sanitary
engineering
Social and
political
sciences
.
Financing,
management,
business
Ecological sanitation
Integrated water
resources
management
Agriculture,
soil fertility
Public health,
hygiene
education
Policy,
Advocacy,
Communication
Many different professions need education/training about ecosan
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Codes and regulations
There is a need for specific regulation of the use of human excreta and
greywater, as inputs for agriculture
Regulations should be based on technology-neutral functional criteria,
stating the required performance of the sanitation system
We now have the new WHO Guidelines for the safe use of
wastewater, excreta and greywater (Volume 4: excreta and
greywater use in agriculture)
 See Chapter 10 on Policy Aspects
 http://www.who.int/water_sanitation_health/wastewater/gsuww/en/
 This chapter is also available under Extra Materials
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The need for legislative aspects to be part of both pilot projects and
capacity building activities
Source: Johansson
and Kvarnström
(2005), p. 41
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Course 4 Unit 2
Target areas for reviewing of relevant
policy/legislation/regulation
• Identification of opportunities for the promotion of
ecological sanitation within existing regulatory
framework
• Lobbying for implementation and enforcement of
existing legislation that is supportive to ecological
sanitation
• Proposal of reforms of parts of the
legislation/regulation that have been identified as
crucial to embrace ecological sanitation
• Work with demand-driven approaches to sanitation
Source: Johansson and Kvarnström (2005), p. 48
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Course 4 Unit 2
Example for policy and legislation: South
Africa
“At present policy and legislation allow the use of urine diversion.
The building standards do not preclude the use of UD but
neither do they sanction it and the approach by municipalities
tends to be unless it is sanctioned they will
not permit it. (never mind they are breaking all the regulations by
discharging below standard effluent into the environment)
By getting all the elements of UD into the Standards we hope to
overcome this
argument and allow economics and water scarcity to do the
rest.”
Source: Richard Holden, EcosanRes Discussion Forum on 10 August 2006
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Example for a water and sanitation policy that includes
ecosan in Tanum Municipality, Sweden
Example section from this policy:
 a) Sewerage within the area of duty for the municipality
New detailed physical plans shall include a clause on urine to be
discharged separately (urine diversion) in new houses and in houses that
are being rehabilitated. The regulation requests that a connection to the
communal water and sewage system shall be made with a separate
urine pipe to the border of the premise. The municipality is responsible
for the emptying, storing, and disposal of the urine. The house-owner
pays the ordinary fees for connection and operation.
 b) Sewerage outside the area of duty for the municipality
In areas outside the area of duty for the municipality there are two
alternatives:
• b1) The toilet is diverting the urine or is of the dry kind, while the remaining
sewage is discharged to a private or cooperative unit for infiltration or soil-bed
treatment.
Source:
http://www.tanum.se/vanstermenykommun/miljo/toaletterochavlopp/waterandsanitationpolicy.4.8fc7
a7104a93e5f2e8000636.html
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