This sub-Saharan country is making progress on WASH (Water Sanitation and Hygiene), but formidable obstacles remain on the way
According to a World Bank report, Ethiopia had moved quite considerably on the sanitation front in terms of building toilets, ending open defecation and ensuring toilet hygiene. In 2000, only 14 per cent of the rural and 72 per cent of the urban population had access to safe drinking water, and this improved by 2015 when 52 million people out of a population of 80 million had access to safe drinking water and 26 million people had access to sanitation services. According to the report of March 2016, the World Bank had invested US$860 million for safe drinking water and sanitation services in the country.
USAID in its evaluation report of May 2018 finds the situation in Ethiopia on the Water, Sanitation and Hygiene (WASH) front under the Millennium Water Alliance-Ethiopia Program (MWA-EP) quite unsatisfactory. It says, “Despite of decades of efforts to improve water, sanitation and hygiene (WASH) in Ethiopia, its key WASH indicators remain some of the lowest in the world. As of 2015, only 30 per cent of the rural Ethiopian population had access to water that meets its basic needs; 4 per cent used improved, non-shared sanitation; and 99 per cent lacked any handwashing facility.”
What are some of the problems facing Ethiopia on the sanitation front? According to the USAID report, most households have latrines and they are being replaced once they are filled. The problem is that many of the original latrines are still in use and the replaced ones are not maintained well. The USAID report notes, “Though latrine users widely reported using their latrines, Health Extension Workers (HEWs) indicated that latrine usage is likely not as high as people indicate and the observation data support this. Despite education on the importance of latrines, usage lags behind latrine construction.”
The other major challenge is that washing one’s hands after using the latrine. The USAID observation makes for grim reading. It says, “People likely overstate the extent of handwashing. Though most latrine owners reported washing their hands regularly, observation data and interviews with HEWs suggest this is an overstatement. None of the observations revealed handwashing stations or other signs of handwashing, and the HEWs noted significant challenges convincing people to wash their hands regularly.”
WASH Alliance International in its best practices report 2011-2015 spells out the challenge facing Ethiopia, and by implication other countries in the same situation. It says, “Traditional solutions focused on building infrastructure are not sustainable and cannot meet the needs of the growing population.” In Dire Dawa municipality, which is 550 km away from the national capital of Addis Ababa, a new model for construction of latrines in households got evolved. Instead of depending on the government, families were encouraged to build a latrine on their own by accessing credit from the micro financial institutions (MFIs). And businesses have been created to convert waste into useful product. These enterprises, which created jobs for youth in the town, were again supported by financial institutions who created the credit channels.
From extending credit facilities to households and communities to build toilets comes the next idea of turning construction and maintenance of toilets as a profitable venture through pay-for-use model. This project is underway in Addis Ababa. FitsumGelaye, a native of Addis and a graduate from the Massachusetts Institute of Technology (MIT) in architecture in a report, “Toilets for Proft”, written for Archimedes Reporton November 23, 2017, refers to the World Bank funded project of creating a business model for creating sanitation facilities in Addis. Gelaye writes: “From my research, I have found that the NGOs that work in the field – which thus have all been international organisations – have been forging a path to move sanitation from a type of basic service that is solely provided by the government to a profitable business that can create employment for many while decreasing the health and hygiene challenges that the city faces.” She says that the World Bank has marked out US40 million for building toilets in Addis Ababa as a business enterprise and the project is called Ethiopian Sanitation Marketing and Business Development Initiative Program. Loans of US25000 will be provided to local cooperative businesses to construct public toilets. The bank is also providing “a six-module lesson on business administration that is available in multiple languages.”
The World Bank loan is to be distributed through the government and NGOs, and it is to be repaid over a period of 38 years, with an eight-year grace period, reports Gelaye. She says that it is not just the World Bank which has turned sanitation into a business affair, but Population Services International (PSI) has also entered the field. PSI has started a pilot project of four Liyu or special class facility at Addis Ketema, one of the densely populated sub-cities of Addis Ababa, which covers 20 square metres land and costs US$5000, with separate gender-designated toilets, shower and outdoor sink for washing hands. The charges are 1 birr (equivalent to 4 US cents) for urinals, 2 birr for toilets and 10 birr for shower.
Addis Ababa Water and Sewage Authority (AAWSA) has also entered the fray of “toilets for profit” and auctioned it to differently-abled people to run it. Gelaye writes her impression of the AAWSA-built public facility: “I was able to visit one of the facilities in a peri-urban neighbourhood of Addis informally called Koshe. I initially walked past this Public Toilet and Rest Stop facility, mistaking it for a small public garden, with a quaint coffee and tea café. I was later able to learn that AAWASA has a specific design for these toilets that includes a small garden in the forefront with carefully selected flowers.”
Gelaye looks at the challenges involved in this now model of toilets-for-profit business. She argues that the use charges are quite high and this would exclude the poor people from using the public facilities, and it is the poor who need them the most. The second issue is that of cleaning up the septic tanks periodically. She says the waste collected is pumped out once in 10 days, and she points out that when the septic tanks are full people stop using the facility because of the overwhelming smell. She also moots the idea that it is not necessary to think of disposing of the waste and there could be a business model for recycling it as well, especially for the urban farms around Addis Ababa.
Most of the information that is available about sanitation issues is provided by international organisations. We do not have hard data and analysis from Ethiopian sources – governmental and non-governmental. But from a cursory survey of available data put forward by global aid organisations like the World Bank, UNICEF and others it can be seen that there has been much progress on the sanitation front in Ethiopia. It is however evident that it would not be possible to find a permanent solution because there is need for change in strategies as conditions change.
One of the insights that emerges from the reports is that there is need to create the sanitation infrastructure of more toilets both at the household and community levels, but there remains the more important challenge of changing the mindset of people, in making them use latrines and making them wash their hands after using the latrines. It may appear that these are obvious matters and that they do not merit discussion. But as we gather from the data, these are the issues that make the goal of sanitation facilities to all so much more difficult and complex as well.
There are the harsh economic realities which create a vicious circle of its own. It has been noticed that when latrines are full and when they are replaced, people had a tendency to dismantle the replaced latrine structures made of wood. The USAID report notes: “None of the MWA-EP-supported public latrines are functional today. People dismantled them for firewood, indicating that the community’s short-term demand for firewood outstripped perceived benefits of public latrines.”
There has been significant economic growth in Ethiopia in the last decade, which has made it the fastest-growing region in sub-Saharan Africa. This economic growth should help solve the sanitation and public health challenges that this country faces.
© 2016 Sulabh Swachh Bharat. All Right Reserved