Ch 1. Sustainable sanitation - a review Management & organisation Residents´ views & actions Physical arrangements including technology The challenge is to protect our health and the environment This challenge can be addressed, if management, residents, policies, technology and engagement are in place Jan-Olof Drangert, Linköping University, Sweden

1.1 Sanitary Conditions in the world How do we perceive sanitary conditions? What functions must a sustainable system fulfil? Learning objective: To become familiar with various sanitary conditions in the world, and to foster a critical understanding of data and functions Jan-Olof Drangert, Linköping University, Sweden

Sanitation – the silent crises 2.4 billion people (40% of the world's population) lack so called adequate sanitation 18% of the world's population lack safe water supply 10% of all wastewater in developing countries is treated Malnutrition is a major factor making us more vulnerable to disease and death, thus food security is important The combined effects of poor personal and domestic hygiene and lack of safe water and good environmental sanitation is considered the most important risk factor for disease and death Jan-Olof Drangert, Linköping University, Sweden

Diseases related to excreta and wastewater Disease:Mortality (death/year) Burden of disease* Comments Diarrhoea % of deaths occur in dev. countries; 90% in children Typhoid N/A Estimate: 16 M cases/year Ascariasis Estimate: 1.45 billion infections, of which 350 M suffer adverse health effects Hookworm disease Estimate 1.3 billion infections of which 150 M suffer adverse health effects Schisto- somiasis Found in 74 countries, 200 M estimated infected, 20 M with severe consequences Hepatitis A N/A Estimate: 1.4 M cases/yr Source: WHO 2006 * DALYs/year estimates the time lost due to disability or death from a disease compared with long life free of that disease (See Ch 3).

Stormwater, solid and organic waste Animals scavenging organic material and clogged storm water drains Stormwater drainage as a conduit for solid waste Copyright: Jan-Olof Drangert Jan-Olof Drangert, Linköping University, Sweden

Upgrading environmental sanitation in dense settlements Thor-Axel Stenström, SMI, Sweden beforeafter Thor-Axel Stenström, SMI, Sweden

Sanitation ladder upgrading Outside house: Private dry urine- diverting toilet Communal flush Open defecation Indoors: Local reuse Jan-Olof Drangert, Linköping University, Sweden

What sanitation is about Personal and household hygiene Clean environment incl. water Solid waste management Greywater disposal and treatment Safe excreta disposal Stormwater handling Traditional interpretation: Acceptance, affordable, convenience and pride Environmentally sustainable arrangements Additional perspectives : Jan-Olof Drangert, Linköping University, Sweden

Pathogen & hazardous waste reduction – indicators depend on flow stream Nutrient reuse – (i) X% of excreted N, P, K is reused for crop production, (ii) Y% of used water is reused Nutrient & hazardous waste containment – indicators depend on flow-stream Integrated resource management – indicators depend on flow-stream Access – (i) 24-hr access to facility year-round, (ii) privacy, personal security and shelter, (iii) preferrable indoors and accessible to men, women, children, elderly Greywater management – (i) no stagnant water in compound or in streets, (ii) no vectors (iii) no pollution A sanitation ladder for improved functions Adapted from Kvarnström et al., 2010 Excreta containment – (i) in use, (ii) no vectors, (iii) no faecal matter, (iv) hand-washing facility in use (v) can withstand stormwater events

Sustainable - more than a catch word The Bruntland Commission (1987) expressed sustainability as: …development that meets the needs of the present without compromising the ability of future generations to meet their own needs" … Sustainability comprises a variety of perspectives: Ecology, Economy, Social, Resource conservation, Reuse, etc. Sustainability criteria for sanitation arrangements may read (EcoSanRes): - protecting and promoting human health, - not contributing to environmental degradation or depletion of the resource base, - being technically and institutionally appropriate, economically viable and socially acceptable

Reuse or disposal in the history of sanitation Land area making use of organic waste from the city of Stockholm 1910 Karl Tingsten, 1911 Stock- holm 60km The silent highway man rowing on river Thames Illustration:

Proportion of households in major cities connected to piped water and sewers House or yard Connected to connection for water (%) a sewer (%) Africa 4318 Asia7745 Latin America &7735 Caribbean Oceania7315 Europe9682 North America Source: Stockholm Water Front, No. 4 December 2007

new Wastewater - collected and treated by effective treatment plants (median percentage) Source: UNDP& UNICEF 2003 (Fig )

World-wide statistics on backlogs (SEI 2005:40) UN Region: Urban sanitation Target population Rural sanitation Target population Urban water Target population Rural water Target population East Asia Eurasia Latin America & Caribbean North Africa Oceania South East Asia Southern Asia Sub-Saharan Africa West Africa TOTAL (Millions)

Hurry up in the toilet: 2.6 billion are waiting

Microbes multiply on substrates Sanitation viewed as less important People assumed to be uninterested Is less of a public concern, and attracts little public investment in poor urban areas up to now Residents do not perceive that they pay for sanitation Lessons to consider: The Millennium Development Goals deal more with water than sanitation issues, but sanitation is picking up with the new emphasis. Separate planning for sanitation and water leads to installation of piped supply long before proper disposal and wastewater treatment Jan-Olof Drangert, Linköping University, Sweden Microbes perish in water Water will do the trick Everyone wants water Water supply is a public concern, and attracts public and private investments Easy to charge for water if the supply is regular Sanitation versus Water

Requirements on sanitation arrangements In the bathroom and kitchen (old requirements): - hygienic and protecting human health - comfortable (indoors, no smell, easy to clean, security) Outside of the home requirements (new! ): - save resources (little/no water, reuse nutrients, little energy) - protect the environment (ground & surface water, soil, air) Lessons to consider: Requirements change over time, sometimes quickly Energy use is high for conveyance over long distances and for advanced treatment technology Jan-Olof Drangert, Linköping University, Sweden

Epidemics rather than endemics have shaped our views After John Snow discovered (1854) that cholera can be trans- mitted by contaminated well water, sanitary engineers focussed their interest on organic matter in water as an indicator of faecal contamination. Many rivers with high organic loads were wrongly labelled as hazardous since the origin of the organic was not from faeces but from humus! (Hamlin 1990) Example 2 Sanitary inspectors in Linköping (small city in Sweden) described the sanitary conditions in the workers´ living quarters with stagnant storm water and awful smell as deplorable and causing ill health (1870s). However, infant mortality in such areas did not differ from that in richer areas with piped water and sewers. Lack of sanitary precaution by all classes was the reason, and not until the general hygiene improved did the death toll figures come down! (Nilsson 1994, Esrey 1990) Example 1

Continued Example 3 Water issues have been in focus to the detriment of appreciating good sanitation. Cairncross (1989) and others have reached the conclusion that water quantity is more important to good health than water quality for many diseases. Enough water to clean the hands and body, wash clothes, clean the house, etc. is more important than improved drinking water quality at the margin. This supports and explains the results from Linköping in the 1870s. Lesson to consider: We need to measure the right parameters to be able to draw correct conclusions. Jan-Olof Drangert, Linköping University, Sweden

Ch. 1.2 Resources energy from waste via reuse to sustainability ? Where are the resources? What might be the problem to access them? Learning objective : To familiarise with a coordinated view on resources, and to understand the context and role of sanitation Jan-Olof Drangert, Linköping University, Sweden

Reflections on water and plant nutrients Water molecules cannot be manufactured or destroyed Water is renewable (sun- driven cycle) everywhere Water available in situ (rural, peri-urban) or imported (cities) Energy supplied by humans (rural) or electricity (urban) 70% of global water use is for crop production A balanced diet requires a loan of 1300m 3 /yr p person based on current practice. This is 70 times greater than the basic water need of 50 l per person per day. Phosphorus (P) cannot be manufactured or destroyed P is immobile and mined in only a few countries Food available in situ (rural) or mostly imported (cities) Energy supplied by humans and sun (rural) or fossil (urban) 90% of global rock P extrac- tion is for crop production A balanced diet results in depletion of 22.5 kg/yr of phosphate rock or 3.2 kg/yr of P per person based on current practices, of which 0.5 kg is found in the food. Jan-Olof Drangert, Linköping University, Sweden

agri- culture households excreta organics food fertilizer Losses on farm choice rain & irrigation water evapo transpi ration no choice manure Jan-Olof Drangert, Linköping University, Sweden Input to and output from the food chain loss

The water cycle – dynamics does the trick but, H 2 O is always on the move... Instant snap shot: Ice caps 2.7% Rivers % Lakes 0.007% Oceans 96.5% Clouds 0.001% Groundwater 0.7% Shortage of freshwater ! A dynamic perspective gives a better description: years years 8 days years 280 days Renewable rain gives in 2000 years as much water as is in the oceans!!! Jan-Olof Drangert, Linköping University, Sweden

Annual renewal and use of fresh water CountryH 2 O m 3 /person/ year km 3 /yr total in country Rivers from/to countries Portion being used Total use per year per person - by house- holds - by indu- stry - by agri- culture Sweden % 479 m 3 36% 55% 9% Holland % m 3 5% 61% 34% Saudi Ara % 255 m 3 45% 8% 47% Lebanon % 271 m 3 11% 4% 85% India % 612 m 3 3% 4% 93% Tanzania % 36 m 3 21% 5% 74% Kenya % 48 m 3 27% 11% 62% Egypt % m 3 7% 5% 88% USA % m 3 12% 46% 42% Chile % m 3 6% 5% 89% China % 462 m 3 6% 7% 87% Source: P. Gleick, 2003

Global scarcity of plant nutrients - a new driving factor for sanitation Phosphorus is a limited resource, and large untapped reserves will eventually only be found on sea shelves and as anthropogenic depositions in lake sediments. 95% of mined potash goes to the fertiliser industry and has no substitute. Exhausted in some 50 years. 60% of mined sulphur goes to fertilizer industry and has no substitute. Exhausted in some 20 years. Costly to recover these plant nutrients from lake sediments compared to trapping them directly at the source i.e. output from households and industries. Nitrogen can be manufactured from the N in the air, but this requires much energy (1 litre of oil to produce 1 kg of nitrogen). D. Cordell & J-O Drangert, Linköping University, Sweden

Phosphate Rock – Worldwide Estimates (thousands of metric tons) P scarcity is worse than oil scarcity because P CANNOT be substituted in food production Courtesy of Ian Caldwell, Stockholm Envrionment Institute, Sweden

Food, water and nutrient flows food H2OH2O 1.5 l 1.1 l transpiration & evaporation 0.9 l Urine: 1.5 l Faeces: 0.15 l Jan-Olof Drangert, Linköping University, Sweden + nutrients Virtual water 4 cu.m.

NUTRIENTS – and demography World Total 16 th - 21 st century Billion people Jan-Olof Drangert, Linköping University, Sweden 20 th century 9 rural urban 21 th century

Actual reuse of nutrients for urban agriculture & food security (in Swedish towns 1850 – 2000) 100% 50% waste pits + urine diversion + WC only WC + WWTP stop Jan-Olof Drangert, Linköping University, Sweden Proportion nutrients being reused Glass, tins, ceramics Heavy metals

Human resources: capacity to manage sanitation arrangements Utility Household Work hoursPaying fees Level of management User contribution pit latrine urine- diverting toilet flush toilet, WWTP, wetland Grease trap, Organic waste septic tank sewerage water supply, biogas drainage Jan-Olof Drangert, Linköping University, Sweden sewerage Organic waste biogas

Manpower blindness: driver of new responsibility sharing We tend to account only for what is done by governments and projects in water and sanitation What is done by residents and small entrepreneurs is rarely appreciated, if at all recognized (blindness) Yet, many urbanites survive thanks to such local initiatives Here, we pledge that both kinds of initiatives are needed to solve current sanitation problems Our pre-conceived views play a role Jan-Olof Drangert, Linköping University, Sweden

1.3 Physical Resource Flows From where do resources come, and where do they end up? versus Learning objective: to grasp how resource flows are created and manipulated, and to become familiar with methods of analysing resource flows and the challenges they pose. Linear flow Loop

What comes in …… Water kg/p/day Food 2 kg/p/day Energy > 1 kg/p/day Consumer goods 1- ? kg/p/day Jan-Olof Drangert, Linköping University, Sweden house- hold

… must go out Greywater kg/p/day Solid waste 1 - ? Kg/d/p Faeces 0.3 kg/d/p Urine kg/d/p Jan-Olof Drangert, Linköping University, Sweden house- hold pollutants

The trick is to bend today´s many linear resource flows Solid waste is the most visible output. It may be discarded or sorted and recycled. Scavengers perform an important service Faecal matter is very small in volume, but is a major health threat unless treated and used wisely Urine (urine) volumes are small. Smells may be a problem unless urine is returned to the soil Grey water is voluminous and a major challenge in dense areas but can be a useful product if handled well Storm water may be a serious problem or it can augment household and irrigation supplies Energy is invisible but heat may be recovered Jan-Olof Drangert, Linköping University, Sweden

Water and nutrient kretslopp Rural home City with linear flows Sorting city food Wastewater = (grey water, urine, and faeces) WWTP wastewater food chemicals J-O Drangert, Linköping University, Sweden Leaking pipes water

Three examples of kretslopp thinking Fraction: Solid waste Organic waste Faecal matter Urine (urine) Grey water Storm water In Stockholm sorted in 8 fractions, collected and reused organics composted together with hygien- ised dry faecal material collected and trucked to farm in situ after biological treatment infiltration (no heavy rains) In Kimberley No sorting, collected and put on landfills dried and composted used in situ or by truck to council gardens Grey water to pond after biological treatment, and rainwater to the same pond. Little rain. In Kampala No sorting, burnt in situ, the rest to landfill banana peels etc to animal feed dried and composted in situ or collected Infiltrated in situ and to drains In drains but flooding due to heavy rains Jan-Olof Drangert, Linköping University, Sweden Provides heating/energy Provides soil conditioner Liquid fertiliser Irrigation water and biogas Groundwater recharge Soil conditioner Liquid fertiliser Soil conditioner Liquid fertiliser Soil conditioner

Material Flow Analysis for human settlements MFA uses the principle of balance: input = output + accumulated stock in the system and provides a systematic description of the flow of goods, materials or substances through various processes and out of the system. Process 1 Process 2 input Process 3 output Jan-Olof Drangert, Linköping University, Sweden

A resource flow model for a hamlet 39 Courtesy of Jenny Aragundy, Ecuador

40 The Stockholm model to improve sustainability Courtesy of Stockholm Water Company

food hydrosphere waste handling consumption deposit/ landfill livestockagriculture urine faeces Modelling the situation (MFA) Select the material, product or chemical you are interested in Include all the flows, uses, losses and disposals Find estimates for all flows and stocks 4 STEPS in modelling: (1) Description of the system (2) Formulation of model equations, (3) Calibration, and (4) Simulation incl. sensitivity and uncertainty analysis Decide the boundaries of your system (dashed line) Jan-Olof Drangert, Linköping University, Sweden

Example 1: Actual reuse of nutrients from households in urban agriculture 100% 50% waste pits + urine diversion +WC only WC+WWTP stop Jan-Olof Drangert, Linköping University, Sweden Proportion being reused Heavy metals Glass, tins, ceramics

Ex. 1 con´t Examples of ranges for parameters Neset and Drangert, 2010

Ex. 1 con´t Sensitivity analysis The filled curves represent calculated averages, while coloured areas between the dotted curves indicate uncertainty ranges due to estimated input data (in kg phosphorus per capita per year) Source: Neset and Drangert, 2010 Phosphorus reuse and phosphorus losses

Example 2: Eutrophication of Lake Dianchi, China 55% of TP 45% of TP Kunming city Farmland P leakage river downstream 385 tonnes 33 tonnes Jan-Olof Drangert, Linköping University, Sweden

Dianchi faeces flush urine flush laundry kitchen bath industrial discharge HH denitrificationstreet runoffroof runoff runoff comb. sewer infiltration incl. river water exfiltration wrong connection storm sewer separate storm water drainage treated wastewater overflow out of CSO tank overflow out of combined sewer WWTP sludge CSO tank Ex. 2 Cont Urban P flow to Dianchi Lake, China Source: Huang et al., 2007

Ex 2 Con´t Outcome to guide a new strategy 1. Even with the best available treatment technology (BAT with 98% P removal etc.) the discharge would still be twice what the lake can accommodate. 2. A major problem is that during heavy rains the wastewater bypasses the WWTP and washes all wastewater straight into the lake. 3. Groundwater and stormwater enter the poor-quality sewers and make up a large portion of the water coming to the WWTP 4. Source-control measures such as urine-diversion toilets and P- free detergents and body care products are necessary to avoid discharging untreated wastewater downstream the lake and just moving the environmental problems. Source: Huang et al., 2007

Example 3 : P flows through Hanoi City Source: Montangero et al., 2004

Ex. 3 con´t Phosphorus flows in Hanoi City Courtesy of Agnes Montangero, 2007 Composting Agriculture Market Sewerage & drainage Landfill Organic waste collection On-site sanitation House- holds Water supply

Ex. 3 cont Feeding the people of Hanoi - a sensitivity analysis Source: Montangero et al., (3 M) Business as usual 2015 (5 M residents) No septic tanks No-meat diet

Example 4: Nutrients and food security – a global view Only 1/5 of the P in mined rock reaches the food on our forks!

Ex 4 cont. Securing a sustainable phosphorus future The future is not all dark! Source: Cordell, Neset, White & Drangert 2009

Principle: Organic other solid waste Stormwater sewage Industrial household wastewater Black toilet water greywater Faeces urine Strategies for sanitation improvements Jan-Olof Drangert, Linköping University, Sweden

1.4 Demographic Change Is urbanisation a solution or a problem for improving sanitation? Learning objectives: to gain insights about the role of demography in sanitation planning and implementation Jan-Olof Drangert, Linköping University, Sweden

The Urban Sanitation Challenge World population (in billions): (estimate) Total 6 Rural 3 Urban Jan-Olof Drangert, Linköping University, Sweden Thus, new housing on virgin land in new cities provides excellent opportunities for new sanitation options to fulfil the Millennium Development Goals for sanitation 9

Population growth rates and the proportion living in informal settlements: means for the largest cities (%) % Source: UNDP& Unicef 2003 LA & C = Latin America and the Caribbean

Treated waste- water City council capacity to do its part Source: UNDP& Unicef 2003 % Proportion of wastewater being effectively treated

Demografic patterns are decisive: The growth-infrastructure hypotheses Population Time transi- tion Slow develop- ment of the infrastructure Lowering portion or even absolute decrease of infrastructure Rapid improvement Jan-Olof Drangert, Linköping University, Sweden

How to manage sanitation arrangements? Turn-key management where the utility (private or public) provides the service and the residents just pay the bill Own-key management where single households or housing associations initiate, build and control, while they put to use available skills, materials, and other local resources Turn-key Own-key WC & sewerage Dry urine- diverting toilet Dug latrine Aqua privy Jan-Olof Drangert. Linköping University, Sweden A key question is about control, not decentralisation. Two extremes:

Example : Evolution of w & s in Kisumu town, Kenya Turn-key Own- key Jan-Olof Drangert, Linköping University, Sweden 350, , , ,000 50,000 Population Indepen- dence

Example: Evolution of w & s in Norrköping, Sweden Jan-Olof Drangert, Linköping University, Sweden Norrköping (thousands) First piped water Town area expansion

Hypotheses on best management option Population transi- tion own-key Jan-Olof Drangert, Linköping University, Sweden proportions Turn-key Time

Water Closets becoming popular in capital city Newly installed WCs discharging to ditches, Hagley Road Ordure is emptied anywhere at nightfall; The citys first public wash house opened in Kent Street Mind where you tread, Sir, for the children have been here' One third of city using unimproved pit latrines First sewage farm acquired City trying to convert to bucket latrines as improvement 'One in three artisan families still had to share external toilet with neighbours' 45% households access bucket latrines (1 per 10 HHs) 15% using unimproved pit latrines; Over half houses get WCs - most still outside open 'drainage [in one slum court] is so vile that the air seems positively putrid' 20% lacking a WC Still shared toilets for slums Household toilets generally achieved 'Cost reflective tariffs' required for newly privatised providers (300 year sewer replacement cycle?) Source: Cranfield university, UK Economic development and w&s in Cranfield, UK National GDP per person real with 0.88% and 2.15% per year trend lines

Evolution of indoor water taps in rural Sweden % 10 Mil 17% % 29% 63% 70% 10% 90% Gradual improvement towards full coverage BUT, what about the impact of urbanisation? 5 Mil Jan-Olof Drangert, Linköping University, Sweden

Why do we often act as if we were only a few hundred million people on earth? Small farmers understand and practise reuse, but urban residents do not Ever more people live in big villages and towns Most farmers have had access to chemical fertilisers this far Change comes with a cost But, there is also a saving; better food security Local experience global understanding Jan-Olof Drangert, Linköping University, Sweden However we still act as if we were a few hundred million people on earth