Closing schools for poor sanitation?

I have blogged about different approaches used to encourage improved sanitation, but Uganda has again stepped it up (at least in theory).  Today’s Daily Monitor reports that Kampala City Council is closing schools that don’t conform to city sanitation standards.  While this may be a crucial step to show the importance of sanitation I have a few questions as to the cost vs. benefits of this approach.

-I wonder if these schools have funding to improve their own sanitation conditions.  If not, as I suspect, how could they possibly deal with this?

-What happens to the children from these schools?  Do they stay at home where the sanitation situation is presumably just as poor?  Are they forced to go to another school farther away that probably has a dismal student to teacher ratio?

Apparently they have already closed three schools….What is next?

Ugandan Primary School Students Painting a Latrine with Health Messages

O&M first

Most of us have seen water projects throughout the developing world in some state of disrepair.  Whether it is a handpump equipped borehole missing a few parts or an old gravity fed water system with broken pipes, the world is littered with poorly managed water systems.   Many people have identified Operations and Management Systems as a critical weakness in the sustainable provision of drinking water but few have come up with real solutions.  One common solution which I have rarely seen function well (only in really engaged communities) is the training of community management committees.  Oftentimes these committees are asked to “manage” their own systems with almost no training or resources…

I always wondered how fast the health impacts of new potable water sources are negated with intermittent system failures/breakdowns.  A relatively new article “Estimating the impact on health of poor reliability of drinking water interventions in developing countries” attempts to model the health implications of people reverting back to raw surface water (from a piped system with conventional treatment) for different time periods.   Although this model is not perfect and it’s outcomes are heavily based on raw water quality and treatment efficiency (in this study from Uganda), it shows that just a few days without access to treated water can neutralize many if not all the annual health benefits gained from the access to “clean” water.

Annual Risk of Infection from Consuming Untreated Water for Different Time Periods

For those who are more observant, there are some gaps in this paper including issues surrounding immunity after infection, however this paper still shows just how important O&M is with water infrastructure.  If we want to have significant public health impacts by providing improved clean water sources we must make sure they will be functional 100% of the time!