Co-defining WASH (In)Security challenges among people experiencing homelessness. A qualitative study on the Human Right to Water and Sanitation from Bonn, Germany.

INTRODUCTION: Access to safe and affordable drinking water, sanitation and hygiene (WASH) for all is needed to safeguard human health, high on societal and political agendas. According to official estimates, populations in high-income countries (HICs) are well served. Vulnerable communities at the margins of rich societies, including people experiencing homelessness, however, are often underserved and overlooked. For them, safe WASH is often a dream rather than reality. To date, no study has been conducted in Germany - one of the countries most affected in Europe. METHODS: We chose a qualitative mixed-method approach to understand WASH (in)security challenges that people experiencing homelessness are facing. Data were collected in Bonn, Germany, from 25 people experiencing homelessness (in-depth interviews, arts-based workshops, group discussions), their service providers (social workers), and (un)available public infrastructure (inspections), in 2023. Data were analyzed following the dimensions of the Human Right to Water and Sanitation (HRTWS): availability; accessibility; affordability; acceptability; quality and safety. RESULTS: People experiencing homelessness largely lack available, accessible, affordable, acceptable and safe WASH. Open urination and defecation are often the only alternative, resulting in substantial health risks and diseases. Women face particular challenges, especially while menstruating. Extreme weather events complicate existing WASH insecurity further, creating additional hardships for unhoused people and their service providers. The missed realization of the HRTWS has far-reaching consequences, making it harder to transition out of homelessness. CONCLUSIONS: Much remains to be done to serve unhoused people in HICs better with WASH. Their experiences shed light on the underlying complexities, and the implications of different often interconnected challenges, including instability, mobility, preexisting diseases, mental health conditions and substance use disorder. Different insecurities exist among different sub-groups (e.g. women, people with limited mobility). They are valuable key informants for targeted health messaging and interventions.

Fate of faecal pathogen indicators during faecal sludge composting with different bulking agents in tropical climate.

In recent years, composting has increasingly been promoted as a reliable method for sanitizing Faecal Sludge (FS) from onsite sanitation systems, particularly where there are opportunities to use the recovered nutrients in agriculture. However, there remain gaps in our understanding of the fate of infectious faecal pathogens during composting, particularly in tropical climates. This study investigated the influence of different locally available bulking agents on the inactivation efficiency of composting by tracking the fate of four key indicator organisms (E. coli, Salmonella spp., Enterococci spp., and viable helminth eggs). Dewatered FS was mixed with different bulking agents - i.e. Sawdust (SD), Coffee husks (CH) and Brewery waste (BW). Compost piles of FS:SD, FS:CH, and FS:BW in a volumetric ratio of 1:2 were set-up in duplicate (3 m3 each), composted on a pilot scale and monitored weekly for the survival of pathogen indicators for a period of 15 weeks. The study findings suggest that the different bulking agents have a statistically significant (p < 0.05) effect on the temperature evolution and survival of pathogen indicators in compost. CH was the most suitable bulking agent for composting with FS as piles containing CH exhibited higher pathogen inactivation efficiency and shorter inactivation periods of 6 weeks compared to 8 weeks for SD and BW piles. Time-temperature was the most important factor responsible for pathogen inactivation. However, other mechanisms such as indigenous microbial and toxic by-products such as NH4+-N also played an important role in the inactivation of pathogens. The results suggest that co-composting of FS with a sawdust, coffee husk or brewery waste for 8 weeks with thermophilic temperatures of about 48-60 °C sustained in the composting piles for more than 38 days, using 7 days turning frequency, is sufficient to ensure complete sanitization of FS before reuse in agriculture.