Module

1.4
1.4 Sanitation

An equally important component

of protecting good health is an
appropriate sanitation system. The
connection of a good sanitation
system to good health will be
shown. This module will also
describe various toilet facilities and
construction techniques to build
them.
Module 1.4 Sanitation

1.4 SANITATION ...........................................................................................................................................1

WORLD SANITATION COVERAGE .........................................................................................................................2
ELEMENTS OF A SUCCESSFUL PROGRAM...............................................................................................................3
Demonstration Latrines............................................................................................................................5
EXCRETA DISPOSAL...........................................................................................................................................5
SIMPLE PIT LATRINE..........................................................................................................................................6
Pit.............................................................................................................................................................6
Slab...........................................................................................................................................................7
Site............................................................................................................................................................7
Superstructure..........................................................................................................................................7
Operation.................................................................................................................................................7
SANPLAT.........................................................................................................................................................7
VIP LATRINE...................................................................................................................................................8
POUR FLUSH LATRINE........................................................................................................................................9
DOUBLE-PIT LATRINES......................................................................................................................................10
ECOLOGICAL SANITATION.................................................................................................................................10
The Fossa Alterna...................................................................................................................................11
The Arbour Loo.......................................................................................................................................11
SMALL SCALE COMMUNITY SEWERAGE SYSTEMS................................................................................................12
RESOURCES....................................................................................................................................................12

World Sanitation Coverage

Environmental sanitation is defined as: “Interventions to reduce peoples’ exposure to
disease by providing a clean environment in which to live, with measures to break the
cycle of disease.” This usually includes disposal of human and animal excreta, refuse and
wastewater, the control of disease vectors, and the provision of washing facilities for
personal and domestic hygiene. Environmental sanitation involves both behaviours and
facilities working together to form a hygienic environment.
http://www.skat-foundation.org/publications/pdf/Aguasan_16.pdf (Apr 05)

The following table shows the impact of various interventions in reducing illness in the
population. Clearly, improved sanitation has a significant impact.

Reduction in diarrhoea morbidity from water, sanitation and hygiene interventions

Intervention Reduction in
diarrhoea morbidity
Improved Sanitation (excreta disposal) 37.5%
Hand washing at critical times 35%
Improved water supply 21%
Improvement of drinking water quality 45%
(such as point of use disinfection)
Source: http://www.who.int/water_sanitation_health/publications/facts2004/en/

Despite the fact that access to an adequate water supply and sanitation is a fundamental
need and, indeed, a right for all people, a recent survey shows that almost two and a half
billion people do not have access to improved sanitation (WHO 2000a).

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Module 1.4 Sanitation

As might be expected, sanitation coverage varies dramatically around the world. The
following table shows sanitation coverage for Africa and at the global level in 1990 and
2000. It can be seen that increases on a global scale are negligible, while in Africa
coverage is standing still or even decreasing.

It can been seen from the following table, that the situation is particularly severe in rural
areas, where coverage lags behind that reported in urban areas. However, increasing
urbanisation and concentrations of poor in urban slums is likely to be associated with
higher risks of disease transmission, thus posing much greater sanitation challenges.

Sanitation coverage in 1990 & 2000 globally and in Africa (WHO 2000a)
1990 pop. in millions 2000 pop. in millions
Total Pop. Pop. % Total Pop. Pop. %
Pop. served unserved served pop. served unserved served
Global
Urban 2292 1869 423 82 2844 2435 409 86
Rural 2974 1029 1945 35 3210 1201 2009 37
Total 5266 2898 2368 55 6054 3636 2418 60
Africa
Urban 197 166 31 84 297 249 48 84
Rural 418 205 213 49 487 217 270 45
Total 615 371 244 60 784 466 318 60

While these figures are disturbing in their own right, they do not tell the whole story as
sanitation is not just the presence of available facilities (although that is a start). To be
effective, the proper use and maintenance of the facilities is required.

Elements of a Successful Program

Although there are ‘technological’ answers, albeit of varying complexity, it is important
to remember that experience indicates that technology alone is inadequate to secure
health gains. Without local interest, involvement and commitment, facilities may remain
unused or fall out of use. As Samanta and Van Wijk (1998) point out, ‘access to a latrine
is not the same as adoption of sanitary practices in dealing with human waste’. Moreover,
technical measures for improved sanitary installations, excreta treatment and use or
disposal must be complemented by personal and domestic hygiene measures.

There are numerous instances where public toilets, in particular, are poorly maintained
and the latrine contents inappropriately disposed. However, this is not always the case,
and successful schemes (often run on a franchise basis by profit-making organisations or
by social organisations) exist in a number of places including Ghana and India (Gear et
al. 1996; National Institute of Urban Affairs 1990).
Source: http://whqlibdoc.who.int/publications/2001/924154533X_chap5.pdf (Apr 05)

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The marketing of latrines as time-savers and for privacy is frequently mentioned as a key
reason for construction. Women, in particular, felt safer using their own latrines. Where
bathing facilities were constructed as part of the latrine complex, these were highly
appreciated for privacy and convenience. They tend to be kept very clean and are used by
all family members. Intense school health activities have brought more children and
teenage users of latrines.

Key points to be taught as part of a sanitation program include:

• protection of water sources
• water in transit and in the home
• personal hygiene, particularly hand washing after defecation and before handling
food
• food hygiene: storage, preparation, handling
• disposal of urine and faeces
• construction and use of latrines
• disposal of liquid and solid waste from animals
• faecal-oral transmission of disease
• prevention of diarrhoea
• treatment of dehydration

Barriers to progress in sanitation include:

• Lack of political will
• Low prestige and recognition
• Poor policy at all levels
• Weak institutional framework
• Inadequate and poorly used resources
• Inappropriate approaches
• Failure to recognize defects of current excreta management systems
• Neglect of consumer preferences
• Ineffective promotion and low public awareness
• Women and children last

A survey of rural households in the Philippines elicited the following reasons for
satisfaction with a new latrine. The reasons are listed in order of importance, starting with
the most important:
1. lack of flies
2. cleaner surroundings
3. privacy
4. less embarrassment when friends visit
5. reduced gastrointestinal disease
These results are echoed in other parts of the world. Candid personal reflection, even by
health sector professionals, often reveals that health is a less intense motivator for
sanitation than dignity, convenience and social status.

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The previous information was taken from an evaluation of Water Aid India’s projects.
http://www.lboro.ac.uk/departments/cv/wedc/garnet/allcasewateraid17.html (Apr 05)

Hygiene promotion is essential. The health impact of any water or sanitation program is
limited if the other elements are not included. Hygiene promotion can change people’s
hygiene habits and translate water and sanitation investments into health benefits.

Demonstration Latrines
Full-scale demonstration latrines, preferably showing the range of designs, should be
built in each village before the start of a sanitation project. It is vitally important that
families are enabled to provide themselves with what they prefer, not what is thought best
for them. Each family should be given detailed advice on siting.

Excreta Disposal
The main objective of excreta disposal is to reduce the transmission of diseases due to
environmental contamination by fecal matter or the proliferation of vectors. The choice of
method or technology will be decided more by local practices and socio-cultural factors
than by technical considerations. There are many excreta disposal techniques. In each
situation, the technique chosen should be adapted to the site conditions and the
population concerned. If this rule is ignored, the system may quickly become unused or
damaged and may even create a health risk in itself.

In general the choice of an excreta disposal technique depends on:

• cultural factors, particularly local attitudes and practices concerning defecation
• the physical nature of the site (soil type, natural drainage, rainfall patterns, water
resources)
• the space available and locally available materials and skills

Eight successive phases may be considered:

1. Identify the problem: site survey, questions, medical data, etc.
2. Initiate and organize participation of the population: consult local leaders, etc.
3. Collect information: geographic, climatic, demographic, socio-cultural, technical.
4. Propose alternatives: analysis of data and technical options.
5. Choose a method: needs, social suitability, resources (financial, material and
human), geography (soils, water, climate), space (family or collective systems).
6. Implement the system chosen: involve the population, control the costs, plan the
construction.
7. Use and maintain the system: inform, educate. Take special care with collective
systems.
8. Evaluate the system: sanitary inspection and monitoring system.

Open-air defecation spreads disease. Any latrine, provided it is used regularly, is an

improvement on no latrine. In rural areas, family pit latrines can provide satisfactory and

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acceptable sanitation. That is all that many people in the developing world can afford.
Given culturally sensitive guidelines and a little technical training, families can build
latrines for themselves at very low cost.

The following link is a short paper that describes a participatory program for sanitation
and hygiene in Lao PDR. This article contains the sanitation ladder – options for various
types of latrines that could be used. It also talks about the water ladder but does not
provide an example.
http://www.wsp.org/pdfs/eap_sanitation_lao.pdf (Apr 05)

Simple Pit Latrine

The simple pit latrine is one of the simplest and cheapest means of disposing of human
wastes. If well designed and built, correctly sited, and well maintained, it contributes
significantly to the prevention of faecal-oral disease transmission.

1. Effective volume of pit

2. Defecation hole
3. Slab
4. Cover
5. Superstructure
6. Roof
7. Slab seating
8. Drainage channel
9. Water table
10. Example of a concrete slab
11. Possible alternative: slab of logs
(covered with soil to make maintenance
easier; quality of wood is important: aging
+ termites = danger)

Pit
A family pit latrine should be about 1.2m diameter or square, (since that is the smallest
dimension that can be dug conveniently) with the pit wholly above the water table. It
should be at least 3m deep and if necessary to attain this depth, the floor level of the
building above it should be raised above ground level. With this capacity, the contents of
the pit should digest and in practice, the pit may never become full.

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In unstable ground, the pit walls should be supported with timber, bricks or blocks. Struts
spanning across the pit should be avoided as they will become fouled and will cause
smells.

Slab
The pit cover slab needs to be strong (for obvious reasons) and its top surface should be
smooth and easy to keep clean. Concrete is the best material; structural strength can be
achieved by a slightly domed shape, or by using steel reinforcement. Raised “footpads”
should be cast into the slab on each side of the squat hole, and the surface of the slab
should slope towards the hole.

Concrete cover slabs should not be cast over the pit. Casting the slab in two pieces can
reduce the weight to be carried. Ideally, communities should be supplied with well-
designed steel or timber shuttering for casting the slabs, and advice on concrete mix
proportions. Well-trained local craftsmen must supervise the mixing and placing of the
concrete in the slab.

Site
Pit latrines should be sited downhill and at least 50m from the nearest well or borehole.
When water is used for anal cleansing, this rule can be difficult to enforce and
hydrogeological advice should be sought. The latrine should be downwind and at least
5m from any dwelling. Latrines should also be placed away from trees and food
preparation or storage areas. A drainage channel around the latrine will prevent run-off
entering and will protect the walls of the pit.

Superstructure
A superstructure (latrine house) is needed to give privacy and can be built with bricks,
earth, wood, or plastic sheeting (preferably local materials). Local culture will determine
the form of the superstructure. It should have a door if local habits dictate. Otherwise a
spiral form may be used. The roof should slope towards the back of the structure

Operation
• Never put disinfectants (chlorine products, Lysol, etc.) in the pit: this only serves to
inhibit the natural decomposition of fecal material. The only situation in which it is
recommended to pour disinfectants into a latrine pit is during a cholera epidemic.
• On the other hand it is recommended that fire ashes be put into the pit after each use.
This gives a perceptible reduction of odours and accelerates decomposition.
• When the pit is nearly full (50 cm from the surface), demolish it, or move the
superstructure and slab to a neighbouring place and fill the pit with soil. Do not dig
this place again for at least two years.

SanPlat
The SanPlat System is a concrete platform for latrines that was initially developed based
on experiences and opinions from many people and many countries, mostly African

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countries, and it continues to develop today. So far, around 1 million SanPlats have been
built all over Africa.

Information on the SanPlat system is available on the following excellent web site, run by
a small NGO from Sweden. They have instruction material and construction kits to
economically build a floor for a pit latrine. There are also some interesting articles on the
web site about phasing out of subsidies and working with people. SanPlats are also a
potential opportunity for a micro business.
http://www.sanplat.com/ (Apr 05)

This part of their web site shows an excellent book titled Latrine Building – a must
especially in Africa. Latrine Building is a handbook for planners and field staff. It
presents much of the essential information of the SanPlat System with the focus on
technology, but also addressing promotion, hygiene education, planning, monitoring, and
evaluation. (208 pages, $20 US)
http://www.sanplat.com/lLatrine.htm (Apr 05)

VIP Latrine
The ventilated improved pit (VIP) latrine is
similar to a conventional pit latrine, but has an
offset pit to accommodate a vertical ventilation
pipe beside the superstructure. It was introduced
in Africa in the 1970s and has proved successful
in rural areas in overcoming problems with flies
and odours. The following web site describes
the origin of the VIP or Blair latrine in
Zimbabwe. It also includes the lessons learned
from the development of this device.
http://www.wsp.org/pdfs/af_bg_zim.pdf (Apr 05)

The interior of the superstructure should be

darker than the daylight outside and the
superstructure building should be well
ventilated to allow the flow of air into the pit.
The top of the ventilation pipe must be fitted
with a fly screen. Flies which are drawn by
smell into the pit will be attracted up the vent
pipe by the brightness of daylight at the top, but
cannot escape because of the screen. Wind
passing over the vent pipe will cause an up
draught, removing any smell and helping to
draw flies to the top of the pipe.

Sound design, good planning and staff

training are important

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The design of the VIP latrine looks deceptively simple. But it is the result of thorough
and careful design and development by professional researchers. The selection of field
workers who put it into practice is important (i.e. environmental health extension staff).

People identify with home-grown technologies

Sanitation technologies need to suit local materials and building practices, local economic
conditions, and local cultural practices and beliefs. In this way, many practical problems
can be avoided, and ‘ownership’ of the technology is more likely to develop.

Different people want different latrines

Latrine programs need to provide a range of options. Standard designs (such as the brick
VIP latrine) are often comparatively expensive because they have to function in a variety
of conditions, and so they seldom cater to all the population.

Sanitation subsidies need to be carefully designed

Some sector professionals oppose direct subsidies for individual latrines, partly because
these are private expenditures as opposed to the community water supplies. In Zimbabwe,
however, direct latrine subsidies have been the accepted norm for many years – both in
recognition that people’s health depends on their neighbours’ sanitation and because
subsidies can assist in expanding latrine coverage rapidly.

Pour Flush Latrine

In regions where people use water for anal cleansing, pour flush latrines are suitable.

Water-seal (or pour-flush) latrines are similar to simple

pit latrines, but instead of having a squatting hole in the
cover slab, they have a shallow toilet pan. Excreta is
flushed into the latrine pit when the pan is flushed with a
small quantity of water. The squatting slab is sited a
metre or two away from the pit, to which it drains via a
communication pipe. The squatting plate and pit cover
are easier to construct and are just as satisfactory. To
prevent smells rising from the pit, a U-bend water seal
can be incorporated. U-bend water seals are only
advantageous if they are flushed properly; otherwise, a
close-fitting squat-hole cover reduces odour just as well.

Pour-flush latrines can be connected at a later stage with a small-bore sewer system or a
septic tank, the effluent from which can be disposed of by means of subsurface-soil
absorption.
http://www.who.int/water_sanitation_health/hygiene/emergencies/em2002chap8.pdf (Apr 05)

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Double-pit latrines
Double-pit latrines are useful where there is limited room for digging new pits or a high
water table. The filled side can be emptied via an access hatch while the other side is
being used. If the filling of one side takes sufficient time (at the very least, 6 months,
better 2 years), emptying can be delayed until anaerobic decomposition has killed the
pathogens.

Double-pit latrines may be ventilated or non-

ventilated. A variation on this technique is the
twin-pit latrine used with water-seal toilets. Two
separate pits are used, joined to a water-seal toilet
with a pipe with a Y-junction in an access chamber.
Each separate pit is used in turn, as with the
double-pit system, switching between pits being
achieved by blocking one half of the Y-junction.
Raised or mound latrines can be used where there
is a high water-table.

(Franceys, Pickford & Reed, 1992).

Ecological Sanitation
Ecological Sanitation (EcoSan) is a rejuvenated approach on sanitation that not only
helps manage human excreta at the source, but also helps revitalize agriculture practices.
This approach closes the loop on sanitation by recycling and reusing urine, faeces and
wastewater as resources in the food chain. It blends historical sanitation and agricultural
customs in scientific ways to:
• Protect ecological integrity
• Conserve and protect freshwater
• Promote dignified and healthy living
• Recycle nutrients from human excreta for use in agriculture

Conventional sanitation systems, such as waterborne sewerage, consider human excreta

an unpleasant and dangerous product to be disposed of in the most convenient way.
Ecological Sanitation refers to 'dry toilets', approaches to managing urine and faeces
without water. Current human attitudes towards excreta are not sustainable, and EcoSan
represents the need paradigm shift.

EcoSan regards what is typically seen as 'human waste' as a valuable resource which can
and should be recycled and utilized for agricultural purposes. Urine is a valuable source
of nitrogen, phosphorus and potassium, while desiccated faeces is a good and safe soil
conditioner. The excreta of one person (average 500 litres urine and 50 litres faces per
person/year) contain a significant percentage (80-90%) of the nutrients needed to produce

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the annual food demand (equivalent to 230 kg of cereal) of one person. Recycling and
reuse of “waste” from the system can substitute for chemical fertilizers which otherwise
consume a billion tons of natural minerals, energy, and money for production and
transportation.

Furthermore, mixing human excreta with water optimizes the survival chances of
pathogens. In order to destroy pathogens, the ideal condition is dry, with high pH, good
oxygen supply, low moisture and high temperature. These conditions are created in an
ecological sanitation environment.

The following is a good, recent report on EcoSan, with pictures of urine diversion toilets.
http://www.wecf.de/download/eco_san.pdf (Apr 05)

The Fossa Alterna

The Fossa Alterna uses two permanent shallow pits that are partially lined. A moveable
latrine slab is placed on the first pit. Soil and ash are deposited into the latrine after each
use to facilitate the transformation of the faeces and urine into compost. Once the first pit
fills, the latrine slab is moved to the second pit and the first pit is covered with an
additional layer of soil and left to transform into compost. When the second pit is full, the
contents of the first pit are removed to a secondary composting point or, if enough time
has passed, used directly as compost. The latrine slab is then returned to the first pit, and
the process starts again.

The Arbour Loo

The Arbour Loo is a simple ecological sanitation system that does not require families to
directly handle transformed excreta. A latrine slab covers an unlined pit, and a moveable
superstructure surrounds the pit. The 60 x 60 square SanPlat slab is proving to be an
excellent slab option for the Arbour Loo. Soil/ash mixtures are included after each use to
facilitate the transformation of the excreta. The slab is removed once the pit is two-thirds
full and the pit is filled with garden compost, kitchen wastes and/or soils. The contents
are then watered down and a young tree is planted the following day. Trees currently
being tested in Arbour Loos include guava, mango, orange, avocado, and local fruit trees.

Instructions on how to build an Arbour Loo.

http://aquamor.tripod.com/ArborLoo2.HTM (Apr 05)

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Small Scale Community Sewerage Systems

In high-density population areas, it is sometimes possible to install a piped sewerage
system. Advantages are improved health and a great reduction in smells. However,
limitations are the relatively high capital cost, construction difficulties in congested areas,
and disposal of the effluent at the end of the system. The topography of the area may be a
deciding factor. Some community systems have been very effective where there has been
strong community leadership and a real desire in the community to improve conditions.

Resources
This is a very interesting web site on the history of the modern toilet. It also describes
the Sulabh Toilet Museum, located in New Delhi, India.
http://www.sulabhtoiletmuseum.org/index.htm (Apr 05)

Community system – India’s Sulabh Organization

http://www.sulabhinternational.org/pg05.htm (Apr 05)

This site has simple instructions on how to build a trench latrine, simple pit latrine, and
VIP latrine. It also has a good glossary for words frequently used in the sanitation sector.
http://www.refugeecamp.org/learnmore/latrines/vip_latrine.htm (Apr 05)

This is a 15 page document that describes how to build a VIP latrine in Mexico. It is a
little more “American” than other latrine plans described for other parts of the world but
still a very good document.
http://www.teamcasa.org/images/PDFfiles/latrine.pdf (Apr 05)

The Arch loo - how to construct the structure using the catenary arch.
http://www.lboro.ac.uk/wedc/papers/25/035.pdf (Apr 05)

This is an excellent reference that describes some options that may be used in areas
where there is shallow ground water.
http://www.lboro.ac.uk/orgs/well/resources/fact-sheets/fact-sheets-htm/%23lcsasg.htm (Apr 05)

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