Post on 13-Jan-2016
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Peter Kjær JensenAssistant Professor
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
School Latrines -- do we know it School Latrines -- do we know it all?all?
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Why do the latrines look this way?
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Benefits of latrine to 320 households in rural Benin (Average importance rating, scale 1-4)
Avoid discomforts of the bush 3.98Gain prestige from visitors 3.96Avoid dangers at night 3.86Avoid snakes 3.85Reduce flies in compound 3.81Avoid risk of smelling/seeing faeces in bush 3.78Protect my faeces from enemies 3.71Have more privacy to defecate 3.67Keep my house/property clean 3.59Feel safer 3.56Save time 3.53Make my house more comfortable 3.50Reduce my household’s health care expenses 3.32Leave a legacy for my children 3.16Have more privacy for household affairs 3.00Make my life more modern 2.97Feel royal 2.75Make it easier to defecate due to age/sickness 2.62Be able to increase my tenants’ rent 1.17For health (spontaneous mention) 1.27
Source: Jenkins MW (1999) PhD thesis, UC Davis, Civil Engineering
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Importance of making multidisiplinary research
An Vietnames example
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Rationale behind the study•80 % of rural people have helminth infection in north Vietnam•Approx 1 billion have Ascaris infection in Asia•At risk: Children and farm workers•Effect: School, productivity, and general health•Possible cause: Use of unsafe human excreta in the agriculture (or that is what we think)
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Latrine compostin
g/ hydration
Garden Compostingcold/hot
Application to the field
Processes involved Processes involved CompostingComposting
Transport Transport
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
What have we done• Reviewed the sanitation legislation.- (a
little late)• 512 household interviews inc. In IEC
and non IEC communes. Conducted 12 focus group discussions and (many) key informant interviews.
• Composted 1 ton of human excreta, with inserted helminths eggs, to measure the survival acc. Temp, pH, moisture, and NPK.
• Followed 15 latrines in the filling process.
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Second cropJune
Third cropSeptember
First cropJanuary
Second cropJune
Third cropSeptember
First cropJanuary
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Fertilizer use for the different crops
The human excreta using as fertilizer for Number of households Percentages
Only first crop in January 35 7%
Only second crop in June 3 0.6%
Only third crop in September 74 16%
Both first and second crop in January and June 80 17%
Both first and third crop in January and September 156 33%
Both second and third crop in June and September 21 5%
All 3 crops 90 19%
At least 1 crop per year 459 98%
At least 2 crops per year 347 74%Only 2 crops per year 257 57%
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Compost or not?
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Important parameters
0
10
20
30
40
50
60
70
80
7,0
7,5
8,0
8,5
9,0
9,5
% Eggs survival
Moiusture %
Kejldal N mg/kg
pH
2 pr. bev. gnsn. (Kejldal N mg/kg)
2 pr. bev. gnsn. (Moiusture %)
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Findings
Not composting– mean different from actual temp
May be possible to have compost in 3-4 months if the pH is high
If the guidelines should work they need to contain lime addition
Nutrient loss ??– we need to sell the message,,, but take care of the smell
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
• One kg excreta approx = 1000 dong = 0,067 US$
• 100 kg per person per year• 30 million rural population• 3 million tons of excreta!!• ~ 200.000.000 US$ for
Vietnam per year
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGENThink upstream before you
measure!
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Water sources in the village
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Village water tank and open well
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Drawing water from tank and open well
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Household water pipes in water tank
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Water quality in 10 villages
0
0,5
1
1,5
2
2,5
3
JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY
Seepage Surface
(Geometric mean number of E. coli / 100 ml, 3273 samples)
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Source associated to domestic WQ
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Water quality and availability
Incidence rate of diarrhea
RR (95% CI)
Seepage 4.04 1
Surface 3.53 0.87(0.72-1.06)
Connected + storage 2.62 1
Connected, no storage
3.52 1.34(1.11-1.62)
Not connected 5.02 1.91(1.55-2.36)
Under five children in 200 households, Hakra 6R
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
The mantra of the lecture
Ten buckets a day keep diarrhoea away
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Sanitation Sanitation Management/PromotionManagement/Promotion
DEPARTMENT OFINTERNATIONAL HEALTHUNIVERSITY OF COPENHAGEN
Louis VIII