Urban Sanitation: New Terminology for Globally Relevant Solutions?

Progress toward Sustainable Development Goals for global access to safe sanitation is lagging significantly. In this Feature, we propose that misleading terminology leads to errors of categorization and hinders progress toward sanitation service provision in urban areas. Binary classifications such as "offsite/onsite" and "sewered/nonsewered" do not capture the need for "transport to treatment" or the complexity of urban sanitation and should be discarded. "Fecal sludge management" is used only in the development context of low- or middle-income countries, implying separate solutions for "poor" or "southern" contexts, which is unhelpful. Terminology alone does not solve problems, but rather than using outdated or "special" terminology, we argue that a robust terminology that is globally relevant across low-, middle-, and upper-income contexts is required to overcome increasingly unhelpful assumptions and stereotypes. The use of accurate, technically robust vocabulary and definitions can improve decisions about management and selection of treatment, promote a circular economy, provide a basis for evidence-based science and technology research, and lead to critical shifts and transformations to set policy goals around truly safely managed sanitation. In this Feature, the three current modes of sanitation are defined, examples of misconceptions based on existing terminology are presented, and a new terminology for collection and conveyance is proposed: (I) fully road transported, (II) source-separated mixed transport, (III) mixed transport, and (IV) fully pipe transported.

Manual emptying of ventilated improved pit latrines and hygiene challenges - a baseline survey in a peri-urban community in KwaZulu-Natal, South Africa.

The presence of Escherichia coli and Staphylococcus spp. was determined on the skin, personal protective equipment, the municipal vehicle, and various surfaces at ten households in a peri-urban community (KwaZulu-Natal, South Africa) before and after manual emptying of ventilated improved pit latrines. Surface samples (n = 14) were collected using sterile wet wipes, and target bacteria were detected using standard procedures. Additionally, E. coli was enumerated in soil samples from an area of open defecation (log10 3.7 MPN/g) and areas where geophagia occurred (log10 2.7 - log10 3.3 MPN/g), using a most probable number (MPN) method. The detection frequency for the target bacteria on household surfaces (e.g., the walkway between the pit latrine and the municipal vehicle) and on municipal workers' hands (which were frequently contaminated before pit emptying), occasionally increased after the pits were emptied, indicating that manual pit emptying might pose a potential health risk to workers and community members.

The role of emptying services in provision of safely managed sanitation: A classification and quantification of the needs of LMICs.

Classifications for onsite sanitation in terms of facility type (septic tanks, pit latrines) exist, but connecting these facilities to the wider sanitation value chain via improved containment, emptying, and collection has not been well explored. Using existing Joint Monitoring Programme facility classifications and secondary data on piped water access, a Service Typology was developed to classify and quantify the primary emptying service needs of household level onsite sanitation facilities. Facilities in six Sustainable Development Goal (SDG) regions were classified as Emptiable (faecal sludge can be removed either via Mechanized or Non-Mechanized means) or Unemptiable. Of the 722 million household level sanitation facilities assessed in these regions, 32% were found to be emptiable via Mechanized means, 50% via Non-Mechanized means and 18% were found to be Unemptiable pits. The volume (by number of facilities) and density (as a proportion of the full population) of each service type were estimated by SDG region and by country. Results from this study provide background data on the role of emptying sanitation facilities in achieving SDG6, and can be incorporated into investment priorities, policy framing, technology development, infrastructure development, and targeted behaviour change strategies.

Faecal sludge pyrolysis: Understanding the relationships between organic composition and thermal decomposition.

Sludge treatment is an integral part of faecal sludge management in non-sewered sanitation settings. Development of pyrolysis as a suitable sludge treatment method requires thorough knowledge about the properties and thermal decomposition mechanisms of the feedstock. This study aimed to improve the current lack of understanding concerning relevant sludge properties and their influence on the thermal decomposition characteristics. Major organic compounds (hemicellulose, cellulose, lignin, protein, oil and grease, other carbohydrates) were quantified in 30 faecal sludge samples taken from different sanitation technologies, providing the most comprehensive organic faecal sludge data set to date. This information was used to predict the sludge properties crucial to pyrolysis (calorific value, fixed carbon, volatile matter, carbon, hydrogen). Samples were then subjected to thermogravimetric analysis to delineate the influence of organic composition on thermal decomposition. Septic tanks showed lower median fractions of lignin (9.4%dwb) but higher oil and grease (10.7%dwb), compared with ventilated improved pit latrines (17.4%dwb and 4.6%dwb respectively) and urine diverting dry toilets (17.9%dwb and 4.7%dwb respectively). High fixed carbon fractions in lignin (45.1%dwb) and protein (18.8%dwb) suggested their importance for char formation, while oil and grease fully volatilised. For the first time, this study provided mechanistic insights into faecal sludge pyrolysis as a function of temperature and feedstock composition. Classification into the following three phases was proposed: decomposition of hemicellulose, cellulose, other carbohydrates, proteins and, partially, lignin (200-380 °C), continued decomposition of lignin and thermal cracking of oil and grease (380-500 °C) and continued carbonisation (>500 °C). The findings will facilitate the development and optimisation of faecal sludge pyrolysis, emphasising the importance of considering the organic composition of the feedstock.

Pit Latrines: A Noninvasive Sampling Strategy to Assess Fecal Pathogen Occurrence in Low Resource Communities.

Limited understanding of disease in low resource communities continues to hamper improvements in health. We evaluated household pit latrine sampling as a non-invasive approach to investigate important fecal pathogens such as Giardia lamblia and Cryptosporidium spp. in impoverished communities where health-seeking behavior limits the sensitivity of health facility-based surveillance. Fecal samples were collected from pit latrines in randomly selected households and from patients presenting to the only hospital in the region during the same time periods. Samples were tested with a commercially available ELISA. Giardia household prevalence was 28.7% in 2016 and 48.4% in 2017, while individual samples from hospital submission had a Giardia prevalence of 2.4% in 2016 and 8.0% in 2017. Cryptosporidium was only found in one household. Results suggest that pit latrine surveillance for fecal-borne infections provide course estimates of community infection levels that are unbiased by health seeking behaviors and allow surveillance of vulnerable sectors of a population.

Wastewater-based epidemiology as a public health resource in low- and middle-income settings.

In the face of emerging and re-emerging diseases, novel and innovative approaches to population scale surveillance are necessary for the early detection and quantification of pathogens. The last decade has seen the rapid development of wastewater and environmental surveillance (WES) to address public health challenges, which has led to establishment of wastewater-based epidemiology (WBE) approaches being deployed to monitor a range of health hazards. WBE exploits the fact that excretions and secretions from urine, and from the gut are discharged in wastewater, particularly sewage, such that sampling sewage systems provides an early warning system for disease outbreaks by providing an early indication of pathogen circulation. While WBE has been mainly used in locations with networked wastewater systems, here we consider its value for less connected populations typical of lower-income settings, and in assess the opportunity afforded by pit latrines to sample communities and localities. We propose that where populations struggle to access health and diagnostic facilities, and despite several additional challenges, sampling unconnected wastewater systems remains an important means to monitor the health of large populations in a relatively cost-effective manner.

Groundwater implications on methane emission from non-sewered sanitation systems in Nepal.

Non-sewered sanitation systems (NSSS) are identified as significant contributors of greenhouse gases (GHGs), primarily due to biological processes occurring within the containment systems. In unsealed or unlined containment systems like pit latrines, the emissions are influenced by moisture. This work quantified the GHG emission from unlined or unsealed containments prevalent in Nepal and compared it with sealed containment-like septic tanks, where the chances of groundwater (GW) inundation are low. The modeled GW data extracted from the secondary sources were validated with available national data. The emissions were quantified using the Intergovernmental Panel for Climate Change (IPCC) model for different ecological and provincial divisions of Nepal. Spatial representation for the results was done using the Geographical Information System (GIS) tool. The total methane (CH4) emission occurring from the various NSSS was determined to be 2618 Gg CO2 e per year which is almost twice the emission from the waste sector in 2011, as reported by the recent national communication submitted to the United Nations Framework Convention on Climate Change (UNFCC). Variation of the CH4 emission was found to be prominent in lowlands (Terai region) with total national emissions of 1329.37 Gg CO2e per year. The lowland has a shallow GW table that can easily inundate the unlined containments like pit latrines thus contributing to more anaerobic conditions which may lead to higher CH4 emissions compared to containments in mid and highlands. This study concludes that the GHG emissions occurring from NSSS are substantial and addressing these emissions can help fulfil the Nationally Determined Contributions (NDCs) in the waste sector.

Exploration of appropriate media to influence sustainable on-site sanitation choices in Sri Lanka- visualization with still images or a video.

Pit latrines are the most common form of improved sanitation in many rapidly developing countries. However, they cause the highest amount of groundwater pollution among on-site sanitation (OSS) facilities. Many households in developing countries use groundwater as their main or sub-source, and pit latrines are not a sustainable solution. Thus, the conversion from pit latrines to septic tanks is required. We created two types of media, still images and a video, to illustrate the differences in functions and hygiene risks between pit latrines and septic tanks. Moreover, a survey was conducted in Sri Lanka to determine the media choice that would increase the people's preference for septic tanks as their next OSS, even weeks after the information is presented. The choice of the next OSS participants selected before they were presented with the images was the same as that currently in use, reflecting the belief that the problem of pit latrines was not currently apparent and need not be changed. However, a video presentation of the information made it possible for a larger group of people to choose the usage of septic tanks in the future, especially in suburban areas where the problems were likely to occur.

Acute health risks to community hand-pumped groundwater supplies following Cyclone Idai flooding.

This longitudinal flood-relief study assessed the impact of the March 2019 Cyclone Idai flood event on E. coli contamination of hand-pumped boreholes in Mulanje District, Malawi. It established the microbiological water-quality safety of 279 community supplies over three phases, each comprising water-quality survey, rehabilitation and treatment verification monitoring. Phase 1 contamination three months after Idai was moderate, but likely underestimated. Increased contamination in Phase 2 at 9 months and even greater in Phase 3, a year after Idai was surprising and concerning, with 40% of supplies then registering E. coli contamination and 20% of supplies deemed 'unsafe'. Without donor support for follow-up interventions, this would have been missed by a typical single-phase flood-relief activity. Contamination rebound at boreholes successfully treated months earlier signifies a systemic problem from persistent sources intensified by groundwater levels likely at a decade high. Problem extent in normal, or drier years is unknown due to absence of routine monitoring of water point E. coli in Malawi. Statistical analysis was not conclusive, but was indicative of damaged borehole infrastructure and increased near-borehole pit-latrine numbers being influential. Spatial analysis including groundwater flow-field definition (an overlooked sector opportunity) revealed 'hit-and-miss' contamination of safe and unsafe boreholes in proximity. Hydrogeological control was shown by increased contamination near flood-affected area and in more recent recharge groundwater otherwise of good quality. Pit latrines are presented as credible e-coli sources in a conceptual model accounting for heterogeneous borehole contamination, wet season influence and rebound behavior. Critical to establish are groundwater level - flow direction, hand-pump plume draw, multiple footprint latrine sources - 'skinny' plumes, borehole short-circuiting and fast natural pathway (e.g. fracture flow) and other source influences. Concerted WASH (Water, Sanitation and Hygiene) sector investment in research and policy driving national water point based E. coli monitoring programs are advocated.

Groundwater contamination assessment in Ulaanbaatar City, Mongolia with combined use of hydrochemical, environmental isotopic, and statistical approaches.

Ulaanbaatar City, Mongolia is rapidly becoming urbanized and attracts great attention because of environmental issues. This study was performed to assess the status of groundwater quality in Ulaanbaatar at an early but growing stage of urbanization, focusing on nitrate contamination in relation to land use. Along with high total dissolved solids and NO3- concentrations, significant contamination of groundwater is indicated by positive loadings of NO3-, Cl- and δ15N-NO3- along the first principal component of the principal component analysis (PCA). Based on the concentrations and δ15N values of nitrate, groundwater is classified into two groups: Group I (baseline quality) and II (contaminated). Nitrate in Group II water in urbanized (esp. peri-urban) areas is higher in concentration (> 10 mg/l NO3-) and N-isotopic values (> 10‰ δ15N-NO3-), while pristine hydrochemistry is observed restrictedly in grassland and forest areas. Other ions (e.g., Cl- and SO42-) are also higher in Group II water. The δ15N-NO3- values in Group II water in combination with the spatial distribution on the land use map indicate that nitrate originates from untreated sewage effluents including pit-latrine leakage in peri-urban areas, while nitrate in Group I water originates from soil organic matter. The relationship between nitrate concentrations and δ2H (and δ18O) values of water suggests that nitrate enrichment is also influenced by evaporation during groundwater recharge. With the help of PCA for compositional data, we suggest a hydrochemical index for groundwater contamination assessment; i.e., the Groundwater Quality Index (GQI) that consists of three variables (concentrations of dissolved silica, nitrate and chloride) and can be used to delineate zones vulnerable to nitrate contamination as a crucial step for the efficient monitoring and management of groundwater quality. The study results suggest an urgent need for the management of unsealed pit latrines that are common in peri-urban areas with high population density.

Community Faecal Management Strategies and Perceptions on Sludge Use in Agriculture.

Most people in rural areas in South Africa (SA) rely on untreated drinking groundwater sources and pit latrine sanitations. A minimum basic sanitation facility should enable safe and appropriate removal of human waste, and although pit latrines provide this, they are still contamination concerns. Pit latrine sludge in SA is mostly emptied and disposed off-site as waste or buried in-situ. Despite having knowledge of potential sludge benefits, most communities in SA are reluctant to use it. This research captured social perceptions regarding latrine sludge management in Monontsha village in the Free State Province of SA through key informant interviews and questionnaires. A key informant interview and questionnaire was done in Monontsha, SA. Eighty participants, representing 5% of all households, were selected. Water samples from four boreholes and four rivers were analyzed for faecal coliforms and E.coli bacteria. On average, five people in a household were sharing a pit latrine. Eighty-three percent disposed filled pit latrines while 17% resorted to closing the filled latrines. Outbreaks of diarrhoea (69%) and cholera (14%) were common. Sixty percent were willing to use treated faecal sludge in agriculture. The binary logistic regression model indicated that predictor variables significantly (p ˂ 0.05) described water quality, faecal sludge management, sludge application in agriculture and biochar adaption. Most drinking water sources in the study had detections ˂ 1 CFU/100 mL. It is therefore imperative to use both qualitative surveys and analytical data. Awareness can go a long way to motivate individuals to adopt to a new change.

Impact of an intervention to improve pit latrine emptying practices in low income urban neighborhoods of Maputo, Mozambique.

Safe fecal sludge management (FSM) - the hygienic emptying, transport, and treatment for reuse or disposal of fecal sludge - is an essential part of safely managed sanitation, especially in towns and cities in low- and middle-income countries with limited sewer coverage. The need for safe and affordable FSM services has become more acute as cities grow and densify. Hygienic pit-emptying uses equipment that limits direct human exposure with fecal sludge and hygienic transport conveys fecal sludge offsite for treatment. We evaluated whether a program of on-site sanitation infrastructure upgrades and FSM capacity development in urban Maputo, Mozambique resulted in more hygienic pit-emptying and safe transportation of fecal sludge. We compared reported emptying practices among multi-household compounds receiving sanitation upgrades with control compounds, both from the Maputo Sanitation (MapSan) trial at 24-36 months after the intervention. Intervention compounds (comprising 1-40 households, median = 3) received a subsidized pour-flush latrine to septic tank system that replaced an existing shared latrine; control compounds continued using existing shared latrines. We surveyed compound residents and analyzed available municipal data on FSM in the city. Due to the recent construction of the intervention, emptying was more frequent in control compounds: 5.6% (15/270) of intervention compounds and 30% (74/247) of controls had emptied their on-site sanitation system in the previous year. Among those compounds which had emptied a sanitation facility in the previous year, intervention compounds were 3.8 (95% CI: 1.4, 10) times more likely to have to done so hygienically. Results suggest that the construction of subsidized pour-flush sanitation systems increased hygienic emptying of fecal sludge in this setting. Further gains in hygienic emptying in urban Maputo may be limited by affordability and physical accessibility.

Urban and rural sanitation in the Solomon Islands: How resilient are these to extreme weather events?

The Solomon Islands, like other small island developing states in the Pacific, face significant challenges from a changing climate, and from increasing extreme weather events, while also lagging behind the rest of the world in terms of drinking water, sanitation and hygiene (WaSH) services. In order to support planning for the implementation of national WaSH strategies and policies, this study contextualizes representative urban and rural baselines for Sustainable Development Goal (SDG) 6 ("by 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation"). We highlight specific threats to the current sanitation services under extreme weather events such as flooding and drought, both of which are commonly observed in the country, and provide suggestions for structural improvements to sanitation facilities to increase resiliency. As the first detailed nationally representative cross-sectional sanitation study in urban and rural areas in the Solomon Islands, the results of this paper inform national WaSH policy, strategic planning and programming by the Solomon Islands Government and stakeholders.

Impact of domestic wells and hydrogeologic setting on water quality in peri-urban Dar es Salaam, Tanzania.

In densely populated urban areas of many low-income countries, water scarcity, poor water quality, and inadequate wastewater management present complex challenges to ensuring health and wellbeing. This study was conducted in an impoverished peri-urban community in Dar es Salaam, Tanzania that experiences water scarcity and relies on domestic wells for drinking water. The objective of this study was to identify the sources of domestic well water contamination and assess the relationship and association of water contamination with three variables 1) the proximity of the well to a sanitation system, 2) well age, and 3) well depth. Out of the 71 wells tested, samples from >80% of wells contained Escherichia coli (E. coli) and 58% had nitrate levels above WHO guidelines. The average concentration of total dissolved solids (TDS) was 882 mg/L, which exceeded the WHO guideline of 600 mg/L. Bivariate correlation analysis showed a strong correlation between water contamination and proximity of the well to a sanitation system along with well depth. Univariate regression analysis confirmed the association of contaminants with distance of a well from a sanitation system and well depth (p < 0.05) but age of the well did not show any significant influence on water quality. Our findings indicate significant contamination of wells from nearby septic tanks and pit latrines. New regulatory mandates for the distance of domestic wells from sanitation systems are essential to prevent groundwater contamination and to protect human health.

Can a precast pit latrine concrete floor withstand emptying operations? An investigation from Malawi.

For fecal sludge from households in low- and middle-income countries to be treated offsite it needs to be removed, which can be greatly affected by the pit latrine floor design. However, it is unclear whether precast pit latrine concrete floors (latrine slabs) can withstand emptiers and their equipment. To investigate this issue, 28 prefabricated latrine slabs were purchased in two cities of Malawi. They were first visually evaluated, and then their compression strength was tested. Additionally, each seller was asked a series of questions to better understand their business, training, and construction practices. Results showed that households should perform due diligence to ensure that they are purchasing a safe precast latrine slab. Commonly reported problems included nonstandard reinforcement material and spacing, in addition to slabs that were not thick enough or were not large enough in diameter. The results of this research illustrate the inherent complexity in ensuring high-quality decentralized sanitation solutionsand how one component, the user interface, if implemented poorly, can affect the rest of the value chain. The findings from this work can help inform training and initiatives that engage artisans and suppliers who play a role in the provision of onsite sanitation service delivery.

Risk assessment to groundwater of pit latrine rural sanitation policy in developing country settings.

Parallel global rise in pit-latrine sanitation and groundwater-supply provision is of concern due to the frequent spatial proximity of these activities. Study of such an area in Malawi has allowed understanding of risks posed to groundwater from the recent implementation of a typical developing-country pit-latrine sanitation policy to be gained. This has assisted the development of a risk-assessment framework approach pragmatic to regulatory-practitioner management of this issue. The framework involves water-supply and pit-latrine mapping, monitoring of key groundwater contamination indicators and surveys of possible environmental site-condition factors and culminates in an integrated statistical evaluation of these datasets to identify the significant factors controlling risks posed. Our approach usefully establishes groundwater-quality baseline conditions of a potentially emergent issue for the study area. Such baselines are foundational to future trend discernment and contaminant natural attenuation verification critical to policies globally. Attribution of borehole contamination to pit-latrine loading should involve, as illustrated, the use of the range of contamination (chemical, microbiological) tracers available recognising none are ideal and several radial and capture-zone metrics that together may provide a weight of evidence. Elevated, albeit low-concentration, nitrate correlated with some radial metrics and was tentatively suggestive of emerging latrine influences. Longer term monitoring is, however, necessary to verify that the commonly observed latrine-borehole separation distances (29-58m), alongside statutory guidelines, do not constitute significant risk. Borehole contamination was limited and correlation with various environmental-site condition factors also limited. This was potentially ascribed to effectiveness of attenuation to date, monitoring of an emergent problem yet to manifest, or else contamination from other sources. High borehole usage and protective wall absence correlated with observed microbiological contamination incidence, but could relate to increased human/animal activity close to these poorly protected boreholes. Additional to factors assessed, a groundwater-vulnerability factor is recommended that critically relies upon improved proactive securing of underpinning data during borehole/latrine installations. On-going concerns are wide ranging, including poorly constrained pit-latrine input, difficulties in assessing in-situ plume natural attenuation and possible disposal of used motor oils to latrines.

Safe distances between groundwater-based water wells and pit latrines at different hydrogeological conditions in the Ganges Atrai floodplains of Bangladesh.

BACKGROUND: Groundwater drawn from shallow tubewells in Bangladesh is often polluted by nearby pit latrines, which are commonly used toilets in rural and sub-urban areas of the country. METHODS: To determine the minimum safe distance of a tubewell from a pit latrine in different hydrogeological conditions of Bangladesh, 20 monitoring wells were installed at three study sites (Manda, Mohanpur and Bagmara) with the vertical and horizontal distances ranging from 18-47 to 2-15 m, respectively. Water samples were collected three times in three seasons and tested for faecal coliforms (FC) and faecal streptococci (FS) as indicators of contamination. Soil samples were analysed for texture, bulk density and hydraulic conductivity following standard procedures. Sediment samples were collected to prepare lithological logs. RESULTS: When the shallow aquifers at one of the three sites (Mohanpur) were overlained by 18-23-m-thick aquitards, the groundwater of the monitoring wells was found contaminated with a lateral and vertical distances of 2 and 31 m, respectively. However, where the aquitard was only 9 m thick, contamination was found up to lateral and vertical distances of 4.5 and 40.5 m, respectively. The soil textures of all the sites were mainly composed of loam and sandy loam. The hydraulic conductivities in the first aquifer at Manda, Mohanpur and Bagmara were 5.2-7.3, 8.2 and 1.4-15.7 m/h, respectively. CONCLUSIONS: The results showed that the safe distance from the tubewell to the pit latrine varied from site to site depending on the horizontal and vertical distances of the tubewell as well as hydrogeological conditions of a particular area.

Greywater Disposal Practices in Northern Botswana--The Silent Spring?

Disposal of greywater is a neglected challenge facing rapidly growing human populations. Here, we define greywater as wastewater that originates from household activities (e.g., washing dishes, bathing, and laundry) but excludes inputs from the toilet. Pollutants in greywater can include both chemical and biological contaminates that can significantly impact human, animal, and environmental health under certain conditions. We evaluate greywater disposal practices in nonsewered, low-income residential areas in Kasane (264 dwellings/ha), Kazungula (100 du/ha), and Lesoma (99 du/ha) villages in Northern Botswana through household surveys (n = 30 per village). Traditional pit latrines were the dominant form of sanitation (69%, n = 90, 95% CI, 59%-79%) while 14% of households did not have access to onsite sanitation (95% CI 0%-22%). While greywater disposal practices varied across villages, respondents in all sites reported dumping greywater into the pit latrine. Frequency varied significantly across villages with the highest level reported in Kasane, where residential density was greatest (p < 0.014, χ² = 9.13, 61% (n = 23, 95% CI 41%-81%), Kazungula 41% (n = 22, 95% CI 20%-62%), Lesoma 13% (95% CI 0%-29%). Disposal of greywater in this manner was reported to limit contamination of the household compound and reduce odors, as well as pit latrine fecal levels. Some respondents reported being directed by local health authorities to dispose of greywater in this manner. Environmentally hazardous chemicals were also dumped directly into the pit latrine to reduce odors. With high household to pit latrine ratios particularly in rental properties (4.2 households, SD = 3.32, range = 15 units, average household size 5.3, SD = 4.4), these greywater and pit latrine management approaches can significantly alter hydraulic loading and leaching of chemicals, microorganisms, and parasites. This can dramatically expand the environmental footprint of pit latrines and greywater, increasing pollution of soil, ground, and surface water resources. Challenges in greywater disposal and pit latrines must be addressed with urgency as health behaviors directed at minimizing negative aspects may amplify the environmental impacts of both greywater and pit latrine excreta.