When there's no toilets in a community people "go" in the open, behind bushes, buildings, wherever they can find. If you visit lots of villages you soon get that whiff of exposed poo, and if you spend a bit of time with that community you get to understand what happens when people are in such close and regular contact with their "wastes", from the high levels of diarrhoea and a host of other water borne diseases they live with (and pay for in money for medicines and visits to distant clinics).
It's clear: dirty, unsafe water is almost always a result of contamination from faeces and sewage. And this continues to be one of the biggest causes for under-5 mortality, especially where there are no toilets. This has to be fixed.
|This UNICEF poster I saw last week on a wall in Sindh pretty much says|
it all. Surely it's not rocket science, and yet getting people to change
these habits and practices is one of the most challenging I have come across.
I have seen this in countless villages and urban areas across Pakistan but also Liberia and other countries. Globally the numbers are staggering: some 2.5 billion people lack access to proper sanitation; 1 billion still defecate in the open - both of these are estimated to cause almost a million unnecessary deaths a year.
Emerging evidence is also proving that lack of sanitation could be one of the leading drivers of malnutrition globally. This powerful story in the New York Times explains it better than most, explaining how constant infection in the gut prevents children from absorbing nutrients - regardless of how much food or money they have access to. This causes chronic stunting whereby the body and the brain fail to reach their optimal potential, a process that can't be reversed; stunted children thus can't function academically, economically on a par with their peers. The implications this has on Governments in poor countries is staggering: address water, sanitation and hygiene or half your people will be half as productive and smart as they could be.
This gets me thinking about recent trends from donors / banks to promote cash transfers (dubbed "social protection" or social safety nets). Billions of dollars are spent this way, and there's strong evidence to support that it works in some settings. But if water and sanitation aren't addressed in parallel... then these underlying drivers of vulnerability will just remain in place.
Other studies have looked at the economic costs of this shitty situation. In Pakistan it is estimated that poor sanitation costs the country some $5.7 billion annually in economic losses; while in India, which has the highest numbers of malnourished children in the world the losses are equal to a dizzying $54 billion - per year!
Thinking back to my time In Liberia, during the peak of conflict in 2003 (managing health agency MERLIN's emergency response), when half a million people fleeing the rebel attack poured over to "our" side of the city, as the country's biggest cholera epidemic in years was killing far more than the bullets and bombs. We set up a lot of cholera treatment units, water tanks, toilets, and saved many lives, for sure, but had there been adequate treatment in place already, I'm starting to think it could have reduced so much mortality. Note to self: find out how much of cholera-endemic Liberia remains without adequate sanitation and get writing to the Government!
But it's not just OD, it's also the scourge of untreated sewerage which seeps out of semi-urban and urban communities across Pakistan (and in so much of the world). This stinky sludge ends up contaminating our fresh water sources, killing off other plant and fish life, creating weird natural imbalances like algae blooms which when they die give off some other toxic liquid waste which is also really harmful, potentially lethal to fish, birds and humans.
So all in all, human waste is equal to untold suffering, disease, pollution and contamination for people and other forms of life. But - this is only the case if you don't treat it properly, if your systems for treatment isn't designed with full treatment in mind, or if it's only partially complete, which seems to be the case pretty much everywhere in the world I go.
Pit Latrines and treatment options
So... what are the options? Well first, it helps to understand the basics of the biology at play. Let's take an example of a pit latrine, it will hold the liquid and solids together in an underwater state which means that oxygen can't get in, so it's anaerobic. A multitude of harmful bacteria live in this state, which also produces loads of methane, and uric acid (from the pee) all of which smell bad. So if you step into one of these pit latrines you will want to get out as soon as possible. Really not ideal, but in an emergency, better than nothing when there are thousands of people living in a small area, and open defecation would be really dangerous for public health.
The alternative in this case is a compost toilet, which prevents the waste from becoming anaerobic by adding sawdust, straw, leaves or any dry thing (rich in carbon, crunched up cardboard will do). This absorbs a lot of the liquid and allows for little bits of air (thus oxygen) to get in and around the pile, which thus remains aerobic. A completely different, thermophyllic process kicks in whereby in heats up, pretty much like a compost heap. These are unique "heat-loving" bacteria which exist in any composting process; over time they reduce these natural processes eliminate the harmful germs and bacteria: they "treat" our wastes, making it safe. Moreover, it transforms it into a a really rich source of nutrients for plant growth. One of the best books, brimming with resources to understand all this is the humanure handbook.
In other words: The problem and source of so much disease and suffering has the potential to be a great resource for regenerating a denuded garden, tree planting, and so much positive growth.
Pour flush toilets and sewage treatment
The other types of toilets are the pour flush ones that most people living in cities or richer countries use every day. Squat plate or sit-on-top they both hold a bit of water to receive your delivery, then water is added and it disappears, through a U-bend into a septic tank where it sits in that same anaerobic environment discussed above. Millions of naturally occurring anaerobic tolerant bacteria in the tank consume the solids, changing it over time from solid to less dense and then floating scum, which then rise and leave the tank as more waste arrives.
Now, here's the gross and deeply unsettling part: septic tanks only partially treat this sewage. It is still highly contaminated and is known to be one of the largest sources of ground-water contamination. Bacteria, viruses, parasites (including worms and protozoans) are the types of pathogens in sewage waste and run-off from septic tanks. The bacteria can cause numerous diseases including typhoid, dysentery, gastroenteritis, cholera; the viruses meanwhile include such infamous horrors as polio, hepatitis A, viral gastroenteritis.
|Example 2: raw sewerage running through a semi-urban|
area of Jacobabad, Pakistan. These channels
are often blocked with garbage and overflow into the street.
Next stop: the nearest irrigation canal.
|Example 3. Another overflowing latrine (Punjab)|
another aid project, this time a good example
of the algae bloom, causing very hazardous
toxins. Is this any better than open defecation?
I have hundreds of examples; the point is that a septic tank alone does not treat the sewerage waste. Most designs recommend a soak-away pit. This is basically a hole in the ground filled with some gravel where the septic water seeps into, through a perforated pipe, or just straight into the gravelly hole. And then, into the ground, maybe into the ground-water, we don't really know. I've heard it said that soil acts as an excellent filter, but there's little research to show what happens when hundreds of households seep their waste-water into the same soil, it eventually builds up, and leads to contamination of ground water.
|Built by IDEP in Bali, this constructed wetland is only about |
18 months old and is seriously flourishing.
The water at the end of it smelled fresh.
The trees were growing at a phenomenal rate
These are gravel-filled sealed tanks, into which water-tolerant plants are set. There is no soil, only gravel. The roots transform the nutrients from the sewage waste (nitrogen, ammonia and urea) into plant growth. The roots oxygenate the water.
|Constructed wetland by IDEP, at|
Ulluwatu in Bali.
|Ecological treatment of wastes can go up to large scale - as shown here.|
Thanks to Florence Cattin for this photo and for so much valuable advice on the theory and practice of waste water gardens.
There are other wetland system too, like Jay and Clara Abrahams of biologic design, who build "wetland ecosystem treatment or WET systems". These too are remarkable and I have visited many of their installations in England. Jay points out these WET systems are not simple horizontal or vertical flow reedbeds; instead the WET systems use soil as the purification medium, not gravel as do conventional reedbed treatment systems.
|A small portion of a WET system in the South of England, mid-winter.|
from a quiet large institution, this treated
all sewage and grey-water wastes.
The waste flows from one pond to the other through the soil banks that separate each. The extensive root networks and living soils provide a living filtration process. Fish and ducks can be introduced. Larger, older systems are like forests, attracting birds and enabling the return of biodiversity and health to the overall environment. Moreover, these systems promote rapid growth of high value species which can earn the owner serious money. In this case willow is planted which is harvested and sold locally.
Lastly, there's biogas. Human manure has less potential energy than that of cows, but it is still an organic material and will produce methane. It's such an obvious way to get energy from waste, but I doubt it would perform very well if the sewage weren't combined with other wastes, like sawdust and chopped up food waste, from kitchens or fruit markets. We installed such a system in our home, described in this blog, but we haven't lived there enough since then to really learn from it. But there is copious evidence already out there; we are well passed proof of concept. Check this 2 minute video for one. Crucially, we now know that biogas digesters are very effective at treating harmful pathogens, though not completely, so care should be taken of the slurry emerging as a bi-product. Again, not a problem if properly designed at the beginning.
It's clear that ecological systems can treat our sewage waste if we allow it to: the problem becomes an opportunity - and part of a solution for another problem. We need to start making these links.
It need not cost much more than we are currently spending, if we adopt the right designs, for which we need more testing, experimentation and research. Last week I joined a team from IDEP Bali who were teaching local NGOs in Pakistan how to build basic constructed wetlands - so we can start to learn from these results soon.
|An earth bag school under construction in Nepal, before the|
earthquake. This one, a school, built by the local community with design and
training help from Edge of Seven, others shown below.
Critical points are: these are extremely earthquake resilient, energy efficient
and require a fraction of the logistics of importing bricks and cement up the damaged roads, etc.
The incredibly powerful earthquake which struck Nepal on 25th of April this year has killed over 7,500 people and injured at least twice as many. Latest reports are indicating that over 255,000 houses have been destroyed, with another 215,000 "damaged". Humanitarian coordination is already up and running and huge amounts of data and information is being placed online and updated regularly. The relevant entry point is here.
The suffering and loss reported by the media and humanitarian agencies has been immense, unbearable for those families worst affected. Save the Children and UNDAC report
It reminds me of news, around ten years ago of the earthquake in Kashmir, Pakistan, which was actually slightly less intense than the one in Nepal (7.6 and 7.8 respectively, on the richter scale), but claimed more than 80,000 lives. At least, thus far, mortality in Nepal has been lower, by a a huge margin.
|The main sectors in the UN Flash appeal|
including target numbers of beneficiaries.
So there are lots of areas to deal with and to the extent possible the local Government NGOs (and a whole range of “civil society” actors will be leading the response). These appeals and the consequent scaling up of UN and international NGOs try, to a large extent, to support these local efforts, rather than overwhelm things with outsiders and foreign stuff.
With over a quarter of a million houses damaged, there's a massive shelter and housing challenge - that has to be addressed ASAP before the winter - indeed before the monsoon rainy season which can start as early as June and go through September.
- People need immediate (emergency) shelter now if they have lost their home and are sleeping out in the open or with friends and family.
- For those families who remain in or near their villages reconstruction and recovery starts right away. The concept of there being phases: emergency shelter, followed by some transitional affair, then “build back safer” durable and “earthquake compliant” shelter is not very close to their reality – or affordable.
- There will not be enough money. The UN has already asked for almost half a billion USD – for the first three months alone! (OK most of it for food and cash vouchers), but how much money do you think the donor community has to spare? (Don’t forget that the latest appeal to support Lebanon is for $2.2 bn, which doesn't include the needs inside Syria, Jordan, Yemen; let alone South Sudan, Ebola recovery and so on). So: whatever is done has to be extremely good value (read: low cost and robust). Or chose to support only a small percentage of the total caseload with a full price (all signing all dancing) reconstruction package.
- News update as of 8th May, the UN says it's only received about 5% of it's $415m appeal (that's around $22m). This usually happens at the beginning of an appeal, but 5% is really low, so, as I said, money is going to be tight.
- Immediate life-saving shelter interventions such as tarpaulins, basic tools and fixings for damaged homes for displaced people, along with the appropriate non-food items. (And the shelter cluster provides a pretty cool info sheet on how to strap down your tarp in the best way possible).
- Cash for the "most vulnerable" families (which in itself can be challenging to decide as so many have lost their homes and are vulnerable) to address urgent needs. Actually, I think that cash right now would be really useful and appropriate - assuming shops and markets are around. Much better than donating a tent or cooking sets, which cost a lot of money plus serious transport costs and hassle. People know what they need and they know how to get ahold of it, if they have money. However, I've also heard that building materials are really hard to buy right now and to transport to the more isolated areas. Moreover, cash alone doesn't pay for critical water and sanitation work to be done.
I heard from another colleague that it’s really difficult to buy or access materials out in the more remote areas; there’s not a lot of salvageable wood from the rubble and roofing sheets are damaged.
In which case - a really excellent resource - for anyone working with bamboo and tarps is this "reciproboo" system, developed by Shaun Halbert, which uses smart but really simple geometry to greatly reduce the amount of bamboo or sticks needed per shelter.
|Earth bag shelter built in Pakistan after the 2005 earthquake by|
Cal Earth Pakistan - see link and reference below.
|Earthbag building in Mexico.|
|Some of the really useful information managemnet data coming out of the shetler cluster in Khatmandu. This is a poor quality snapshot - go check out their website and links to all their docs here.|
|Another interesting one showing numbers of shelter items distributed so far, by who. |
Source: as above (Shelter cluster Nepal)
|Focus area of the earthquake and worst-affected districts|
|A breakdown of requested funds per sector from the UN flash appeal|
|Serious structural cracks already seen on this building. It would be a miracle if it remained standing|
|lots of bizarre looking tall and thin structures like this|
have been built over the last ten years. I don't know
how well they handled the earthquake, as many of the buldings
around them appear really vulnerable.
Vamos embora amanhã, por isso queriamos agradecer por todos os cafés que você nos serviu, todos os pães e outros presentes que você nos deu, mas principalmente para a boa energia e felicidade que você traz para a aldeia e os seus visitantes.
Obrigado por tudo, Dominik & Matic
|Tripoli, looking East over the mountains towards Syria|
Imagine Britain or France taking in 20 million people, and the kind of impact that would have on public services that people often complain aren't good enough as it is. Well, it's not really any different for Lebanon, except that their public services have been in worse shape than those in rich European countries. Talking of Europe, it appears that the entire EU block has offered asylum to a grand total of 134,000 Syrian refugees, so around 10% that Lebanon has taken. Yet the population difference is so great it means that Europe is offering refuge to 1,000 times fewer refugees compared to Lebanon.
And let's not forget Lebanon's 15 year civil war, ending in 1990 - not that long ago. In fact it's quite incredible that the country seems relatively "normal" and quite organised, considering the deep sectarian and political divides that burned the country for so long. Or that over 300,000 Palestinian refugees live here, some for generations, others recently displaced again from Syrian, who have built entire urban neighbourhoods of their own (called "camps"), supported by UNRWA, an agency created specifically for this community, but constantly in financial crisis.
spill-over" of the Syrian conflict. As usual, it's complicated, but in essence Tripoli is home to what some call the most conservative Sunni Muslims, which continue to enjoy Saudi Arabian funding, and some Shia Allawite Muslims, aligned to the Syrian regime, but resident in Tripoli and Northern Lebanon for generations.
Meanwhile, I kept hearing that the Government in Beirut has marginalised Tripoli for years which has led to economic decline, unemployment and failing public services. A recent UN study found that 77% of local residents are economically "deprived" (aka: the poverty line) and 35% have miserable accommodation (OK they used different language but that's the gist).
|Here I'm checking out roofing options to stop the constant|
leaking in the dwelling of refugees below. With Ahmad
Al-Ayyoubi of LRC
The vast majority of refugees in Lebanon rent a place to live, that's just the norm. There are quite a few small informal settlements around, but not really in or around Tripoli, where most rent really basic flats in overcrowded blocks. Refugees pay between $200 and $400 a month which sometimes includes electricity and water, but not always. We visited quite a few such places and they were pretty basic, though they did include small kitchens and toilet. Actually I was quite impressed at the extensive sewerage piping network that has been built, often retrofitted to temporary shacks. OK, there's no such thing as sewage treatment: it all flows into the closest water course which is of course completely contaminated, as will be the ocean where it all ends up. But still, compared to the open sewers across South Asia...
|In a typical damp refugee dwelling, costing $200 a month, with|
Rayan El-Fawal, project coordinator of Lebanon Relief Council
one of CARE's partner NGOs.
We also heard from quite a lot of refugees how they can't afford to send their children to school - despite international donors providing upwards of $60m so far to support local schools to accommodate some refugee kids (to pay registration fees, staff, etc.). But even so Syrians have found it really hard, stigmatised and academically challenged as subjects are taught in English and French in Lebanon, rather than Arabic they were used to back home. Some reports indicated a 70% drop out rate while in some areas of the country it works better. Of the refugees I met, about half said they couldn't afford the fees for schools or hadn't been accepted into the UN/NGO school support programme. And when you meet kids who have no choice but to spend all day at home - a dingy room with nothing to do, is when the desperation of the situation really hits home.
|Widad Sharan and her three children from Homs in Syria.|
Hiba Daher, her daughter, far left, is 13 (my daughter Kira's age!) is polite, intelligent, really friendly - hasn't been to school since leaving Syria in 2013. Her siblings neither.
I asked if anyone within the Syrian community had organised some kind of community school, within these very rooms, or outside, or wherever. After all there must be teachers among the refugees and other adults who can teach kids literacy and maths and all that. Apparantly not, so far anyway. Why? because any adult who isn't home looking after kids has to be out trying to find work - to pay for rent and food and living.
Our mission was not education however, it was shelter, or rather proposing a strategy for housing. But soon enough I realised that it's wrong to separate out the accommodation woes from all the other ills of local society.
Together with Daniel Delati, my Tripoli guide and programme coordinator at CARE who had recruited me for this job, we realised that this was much more an integrated strategy. We needed to re-frame this problem as one of social stability for the entire area. We'd visited quite a few Lebanese families living in equally dire accommodation across the city. Meanwhile refugee and locals alike suffered from the lack of any kind of meaningful and sustained employment. We had to find donors that would support a kind of social-economic recovery programme for the entire area. In fact given the recent "troubles" between Sunni and Shia communities, one could argue that investment in livelihoods, business, public services and urban regeneration could mitigate future conflict. And the refugee community could be part of this regeneration. Much better than focusing entirely on the refugees and ignoring the equally needy local people who had already done so much to host these war-affected people.
|A typical scene in Tripoli, garbage and a wasted opportunity for community|
farm or gardens.
For solar lighting in the often black-out neighbourhoods. For a new industry of lime-based building materials, given that the entire country appears to be built on limestone. For ecological treatment of sewage through constructed wetlands and smart design - a practice barely understood by the global WASH community, local Governments or donors anywhere, but with potential to re-green denuded cities and landscapes and to generate new and sustained income streams. Yes it means thinking quite far out of the box, and challenging quite a lot of preset models and ideas, but these are desperate times and fairly radical solutions are needed.
|Almost a garden. With the right design help these people|
could direct their grey water (or even post septic-tank water)
into constructed wetlands (for black water) and gardens for
Opportunities for employment exist, that's for sure. But there are certainly challenges too. For example the Lebanese Government has come out with increasingly draconian regulations on the rights of Syrians to work - or rather that they are not allowed to work. In fact to stay in Lebanon, officially, every Syrian must pay $200 a year and sign a declaration that they will not work, or face detention. I think every Government anywhere would have to do the same thing, given the pressure from voters and taxpayers on jobs; many local municipal Governments have shown enormous flexibility and understanding anyway and have not enforced these regulations. But to move forward, the international community will have to negotiate shared benefits of new investment in economic regeneration.
A presentation on the strategy I drafted for CARE is given here.
For now, the international community has one of its finest humanitarian leaders running the show on behalf of the UN - the indomitable Ross Mountain, now the UN Humanitarian Coordinator (who I first encountered in 2004 doing a stirling job in post-war Liberia). Ross appears to have quickly grasped the need to address the fragility of the crisis as can be seen in this really well drafted Lebanon Crisis Response Plan (this link takes you to the 8 page brochure and highlights). In fact I'll leave you with a quote from this document, this appeal for a little over $2bn, to address this crisis. I suppose it's fair to assume that if we fail to support Lebanon in this hour of need, the consequent crisis could cost much more, and it would be a humanitarian nightmare without precedent.
The number of poor currently in Lebanon has risen by nearly two-thirds since 2011, and Lebanese unemployment has doubled. Children and youth are most affected after four years of economic hardship and limited access to essential services. Lebanese national health, education and infrastructure services are overstretched and a third of Lebanon’s young labour force cannot find work. For many of the poorest and most vulnerable communities, including displaced Syrian families and Lebanon’s long-term Palestine refugees, daily life is increasingly dominated by poverty and debt, fewer cooked meals, rising waste and pollution, long queues at health centers, over-full classrooms, disease outbreaks, falling water quality, and increased competition for work.
(LCRP, Dec. 2014)
And some more photos from the trip in Tripoli:
|Looks like a typica refugee rented property|
but could just as well be a Lebanese family in there.
|Near the old souk, market area, signs of the vernacular|
architecture, mostly from Ottoman period, which lasted
about 500 years.
|Perfect spot for a raised bed garden!|
|Passion fruit vines anyone? |
Vertical garden heaven right here, yet nobody plants anything - why?
|The kitchen - bathroom set up in a rented property|
|The infamous garages - upgraded from mechanics workshops or shops to rent out to refugee families. Miserable, dark, cold and unventilated.|
|Local kids, well Lebanese - Egyptian, but local|
|How the fossils fall. Plastic waste below a block. The inevitable|
result of a dysfunctional city waste management system.
|The scars of war in Tebennay district of Tripoli|
where things are slowly returning to some kind
of normality (albeit with well armed military checkpoints
on most corners).
Jeroen took a course on beekeeping organised by the local beekeepers co-operative some time ago, when we originally purchased our hives. I’ve never had any training in beekeeping though, so I was thrilled when The Hive offered another Introduction to Beekeeping Workshop. The Hive are a local cultural co-operative focussing on sustainable education.
Apiculturist Kev talked our small group through some theory and showed us the necessary equipment, then we suited up and braved the weather to take a look at some operational hives up on the hillside nearby. Bees buzzing all around is a tremendous feeling and I enjoyed the session immensely.
Then back to The Hive for a delicious lunch and chat. Many thanks to the Hive team and Kev for a superb day.