APHA

APHA2009

As many of you probably know, the theme at the American Public Health Association’s Annual Meeting, taking place in Philadelphia next week, is “Water and Public Health.” The speakers look great as and if you haven’t already checked out the line up I suggest you do.

hygiene and sanitation falling through the cracks?

Just thought someone would enjoy this photo I doctored up for a presentation a few weeks ago.  What does it all mean?

Cracks

Original from http://infosecurity.us/?p=10054

the safe water biz

What do PepsiCo, GE, Rotary Club, Harvard, Johns Hopkins, ARD, and Tata Trust all have in common?

An interesting group of academics, private sector representatives, and people from Governmental/International Organizations came together last week to discuss the Small Water Enterprises (SWEs). What is an SWE? SWE refers to the management of water as a business, for or non-profit, by non-state entities. SWEs provide opportunities for supplying safe water to many underserved populations throughout the world but also raise ethical challenges.

Donkey Cart SWE (Photo Taken by WhiteAfrican)

A small water entrepreneur at work

From a company in Ghana packaging and distributing drinking water sachets to a community owned high-tech membrane treatment plant kiosks in India, SWEs come in many forms. Small water enterprises illustrate one solution where governments fail in providing safe water to communities. Where do governments fail? We find examples everywhere, from far away hard to reach rural areas to urban slums…Who will supply water to an “illegal” squatter settlement? Will a government fulfill their duty of providing water while in the same action recognizing and investing in an illegal settlement ?

By definition, SWEs do not require economic viability on their own. Some models rely on subsidies while others are run for profit. The users of SWEs often pay more for their water than those served by public utilities (think economies of scale). While paying more for their water, these users may also receive an inferior product. Recent reviews of existing SWEs (see links below) cite the lack of regular water quality monitoring as a serious barrier to successful growth.

In thinking about what would happen if SWEs take off (some would argue they already have), my continually reverts back to two realities:

Reality #1: SWEs gain traction throughout the world through financing schemes and recognition by governments. They end up serving the majority of people in previously underserved in communities but the most vulnerable are left out (or they are taken care of in some communities with stronger cohesion and social mechanisms).

The people with any political capital in places served by SWEs are probably able to afford the water. Is it likely that they would continue to lobby for water if their needs are met? Will politicians really see the needs in these communities or will it be masked by the coverage of SWEs? Will the government have any real incentives to invest in water utilities in these areas after most of the people are covered by an SWE?

Reality #2: SWEs gain traction throughout the world and communities are slowly lifted out of poverty. This leads to a wealthier community with few people who cannot afford the water and stronger communities that will take care of their poor. (a bit too simplistic and reductive but it will work for this blog)

What concerns me the most is SWEs leaving the most vulnerable behind. Pro-poor policies within certain governments who choose to recognize the legitimacy of SWEs could help with this – but do you really think it could happen?

SWEs can provide some amazing opportunities to get safe (not just “improved”) water to people who need it, but in the long run will this come at a cost to these very same people? As SWE popularity increases with entrepreneurs, international organizations, and private companies , we will just have to wait and see (hopefully set up some useful studies too).

If you want to learn more about SWEs check out these resources:

Also, check out some of the work of EcoTact Ltd. in Kenya who applies this model to sanitation…Pretty interesting and promising stuff!

Golden Poo Awards

PooP Creative (yep that is POOP creative) and the London International Animation Festival joined forces in creating the Golden Poo awards. The objective was to create short and funny animation videos about key hygiene and sanitation issues. Well – some of the contestants did a really great job. Check out these two:

the case for good coordination

I just went through some old photos of my time in Northern Uganda and found this great one.

a waste of 5000 USD in Northern Uganda

a waste of 5000 USD in Otara, Northern Uganda

If you can’t tell, the borehole in the foreground had just been drilled despite the fact that there is one <50 m away in the background (and neither one was dry or had water quality issues)…This is what happens when people stop using their brain and forget to talk to one another!

zim cholera

The BBC posted a photo series on Cholera in Zimbabwe yesterday.  Check it out here.

peepoo

While many of you have heard of the peepoo product, the worlds first marketed “flying toilet” like solution.  Many may not have seen it in action.  Here are two interesting videos about the PEEPOO. (I found these videos on http://watersanitationhygiene.org ).  These appear to be having some positive impacts on the Kibera Community in Kenya so if you are interested check out this impact assessment funded by GTZ .

myopia

The terms myopia and myopic (or the common terms short sightedness or short sighted) have also been used metaphorically to refer to cognitive thinking and decision making that is narrow sighted or lacking in concern for wider interests or longer-term consequences.” -Wikipedia (8/9/09)

I started to think about this term after reading a paper from Environmental Health Perspectives called Public Health Strategies for Western Bangladesh That Address Arsenic, Manganese, Uranium, and Other Toxic Elements in Drinking Water. The authors of this paper sampled a number of tube wells in Western Bangladesh to investigate the water quality, not only with respect to Arsenic but an array of other potential toxicants.   They found levels exceeding WHO health-based drinking water guidelines for Uranium, Manganese, Arsenic, Chromium, and Lead along with significant levels of other important elements like Antimony.  Why is this interesting one may ask?

After drilling millions of tube wells to save people from the morbidity and mortality related to gastrointestinal illnesses, UN agencies and the Bangladesh Government realized that they had exposed millions of people to arsenic.  This arsenic shifted the causes of illness and death related to water to other ailments like cancer (lung/bladder/skin).  Most of you know how this happened but in case you don’t…They simply didn’t test the water for Arsenic!!!

With so much focus on dealing with the arsenic problem, are we forgetting about other potential toxicants in the water?  This study seems to suggest we may be – at least in some parts of Bangladesh.  The government of Bangledesh is focused on testing each and every well for As but does not look at many of these other elements mentioned in the article (it should be noted that Arsenic probably poses the biggest threat to the population but the possible effects of the others are by no means negligible).   The authors note that in wells exceeding limits for As Uranium was not often found in quantities above the limit. However, the household treatment technology that many use to remove arsenic could actually increase the dissolved Uranium concentration (by making otherwise insoluble form soluble)….

This type of myopia happens all the time the water and sanitation sector.  We want to focus only on provision of clean water but don’t want to think about the multiple other pathways for enteric pathogen transmission.   We focus on toilets but forget that there is no readily accessible water to wash hands….Hopefully it won’t take another mass poisoning for us to wake up and look at the big picture.

Check out the article it is pretty interesting (oh and try to estimate the carbon footprint of the samples that made their way from India to Dubai to France to Vermont,USA)

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