Sanitation

Background

A comprehensive strategy on sanitation is one that views sanitation as a system; this system includes the elements of solid waste management, excreta management and waste water management, treatment and disposal. If a nation looks to improve the health of its citizens, sanitation and its various components cannot be ignored.

It has been shown that maintaining an adequate level of sanitation is significant in efforts to control diarrheal disease (Eisenberg 2007). Unlike hygiene, sanitation is a problem of infrastructure. Many nations of our world face a challenge in establishing any level of sanitation, much less a level which is acceptable in common public health arenas. Both the cost of instituting an adequate infrastructure and maintaining the system are the main obstacles for this type of intervention. Studies show that factors influencing this challenge are numerous and include: political, sociocultural, technical, human behavior, funding etc.

Here, we address the steps to be taken to check disease transmission by improving sanitation, an approach which studies show is critical to lowering diarrheal rates in the long term.

Control inter-home contaminations, flies & fomites

• A pathway model was used to analyze the different transmission pathways for diarrhea.
• The model found that when sanitation of a community is poor, that water-based interventions will have minimal if any affect on the diarrhea rates of individual households.
• To prevent household contaminations, flies and fomites need to be controlled through sanitation efforts as well as infrastructure and water quality improvements.

Provide Sanitation (Latrines and sanitation controls)

• In a review of 25 studies, the World Bank noted that sanitation supply resulted in almost twice the reduction in diarrhea incidence as water-based interventions alone.
• Another study found that children with access to latrines and sanitation controls had a reduced incidence of diarrheal disease, but this case-control intervention had serious methodological weaknesses due to the lack of control.
• A possible method of maintaining a sanitation infrastructure is to involve women, particularly mothers, in the management of this public good by educating and training them on all aspects of sanitation controls.

Policy Development

Adequate sanitation policies must have the following characteristics:

• Creates an environment that encourages stakeholders to take initiative to improve situations.
• It must be able to stimulate action on the local level by nudging communities to be proactive.
• It should set the platform for “more sustainable and effective programs.”
• It brings organizations and their programs together.

Intervention Programs

Population growth has lead to urbanization in certain nations; urbanization in turn leads to strained municipal resources.

Quetta Pakistan, with the help of funding from the government of the Netherlands, was able to cope with urbanization by mobilizing communities and constructing latrines and sewers suited to their circumstances.

The city serves as an example for how to test innovative solutions to the sanitation challenge. Results of the intervention showed:

• Improved hygiene in children; close to half of the mothers in these families reported that their children washed their hands with soap after toilet use.
• Decrease in incidence of diarrhea among children in intervention area versus control areas.
• The role of culture and the need for cultures to be flexible for the benefit of its people.
• The technology of sanitation must be adapted to the environmental, social and political circumstances of a region.




Reccomendations

Although sanitation has not been established to lower diarrhea rates singularly, it has been shown to be an integral part of any strategy to reduce diarrhea incidence in the developing world. Looking at a household water-based intervention model to lower diarrhea rates showed, that especially in communities that had high contamination rates and high community-level transmission probabilities, water interventions would not be sufficient to truly impact disease rates. Because sanitation and water quality are so highly intertwined, especially in communities with poor sanitation and hygiene conditions, successful interventions must focus on more than just water-based solutions. The presence of these water quality factors is non-negotiable in any intervention. Adding factors like sanitation practices needs to be done in conjunction with water strategies in particularly high-risk communities.

Policy development is a major factor that is often overlooked or underestimated in the effort to develop quality sanitation strategies. This must change. Nations with inadequate policies should work toward policy development, but the struggle should not stop there, implementation of policy must also be held in high regard, if change is to occur.

All efforts to provide comprehensive and sustainable sanitation strategies would be useless if governmental bodies do not understand and demonstrate to their citizens the link between sanitation and public health. Planning should therefore be made with public health and wellbeing at its center. Educational programs must be implemented to inspire and encourage individuals to change behavior and ultimately sanitation practices at the community level.

If these basic steps are taken, there would be a decline in the number of people without adequate sanitation in our world today.

References

Elledge, Myles F. Sanitation Policies. Delft: IRC International Water and Sanitation Center, 2003.Rpt. in Sanitation Policies. N.p.: n.p., n.d. 8 June 2008 <http://www.irc.nl/content/download/4000/46923/file/sanpolicy.pdf>.

Qutub, Syed Ayub, et al. "Subsidy and Sustainability in Urban Sanitation: The Case of Quetta Katchi." Beyond Construction Use By All . N.p.: n.p., 2008. 45-59.