Despite global monitoring efforts, the world is underestimating the sanitation crisis and its impact on the economy, public health and the environment, a recently released study reveals. Globally, almost two-thirds of human waste is unsafely managed, with access to safe sanitation lowest in South Asia and the sub-Saharan cities.
The number of residents in global urban areas who lack access to safely managed sanitation has increased from 1.9 billion in 2000 to 2.3 billion in 2015. This translates to USD 223 billion a year in health costs, lost productivity and wages. Those households that cannot afford safe sanitation, often resort to unsafe and temporary sanitation practices, which can put the entire city at risk, adds the report.
As per the report published by the WRI Ross Center for Sustainable Cities, 62 per cent of sewage and human waste is unsafely managed at different points of the sanitation service chain across the 15 cities that it has studied in Latin America, Sub-Saharan Africa and South Asia. Further, in most of the cities, human waste and household waste are dumped directly into stormwater drains or other waterways.
South American cities have fared better, with Santiago de Cali, Caracas, Cochabamba, and São Paulo, having the highest percentage of households with a private sanitation facility at 99–100 per cent. What has helped the region is the political changes which took place in the 1980s and 1990s which led to the expanding and extending of citywide sewer systems. These changes included the shift to elected mayors and city governments, having more open and transparent city governments, and adopting participatory budgeting. “In some nations, city governments saw substantial increases in their funding base as the result of decentralisation reforms. There was also a new generation of mayors elected as well as professionals (engineers, academics, medical doctors, and architects) who were committed to expanding and extending core urban services, including water and sanitation,” the report adds.
The Sub Saharan cities of Lagos, Kampala and Nairobi had the lowest percentage of homes with sanitation facility, less than a third. Further, in informal settlements, the percentage of households without access to facilities was the highest in Mumbai, at 55 per cent. Cities that do not have access to on-site sanitation facilities, opt for alternatives such as pit latrines and septic tanks, which may not be a less expensive alternative.
According to David Satterthwaite, lead author and senior fellow at the International Institute for Environment and Development, universal access to safe, affordable sanitation services is an issue that has received very little attention from most governments and aid agencies, especially for the urban under-served.
Mumbai and Bengaluru: Work in progress
Sanitation remains a challenge in Indian cities. Households often do not have access to safe, reliable, and affordable public sanitation services in densely populated urban areas, hence, need to self-provide their sanitation solutions. They also often do not understand what happens to human waste after it leaves the house or the plot. From the perspective of cities, investments in off-site sanitation services (sewer infrastructure) and investments in treatment plants to treat both off-site and on-site human waste are very expensive for cities.
“In addition, the ability to safely manage human waste for the entire sanitation service change requires a great deal of public sector capacity. This is especially true when multiple systems of containing, transporting, treating, reusing, and disposing of human waste are operating simultaneously, and with a mix of actors (for example, private households, informal sanitation service providers, private sector septic tank services, and so on) involved,” explains Victoria A. Beard, co-author, fellow at WRI Ross Center for Sustainable Cities, and professor of city and regional planning at Cornell University. However, once these investments are made, they tend to last a long time, upwards of 50 years.
In Mumbai, the city sewer network covers only 60 per cent of the planned area. In unplanned areas, the sewer lines are not laid, and these areas are often connected with open drains. Though Mumbai has recently been declared as open defecation-free, it is estimated that around eight to 12 per cent of the population still have no toilet facilities in slum areas. Further compounding the problem, reliable data on access to sanitation in the slums of Mumbai is not available.
In Bengaluru, while a higher percentage of its population - 79 per cent of households use sewers, water is only available on average for three hours, three days a week across different locations in the city. Sewers, however, need daily water supply to function. Further, the cost to construct a public toilet facility connected to a private septic tank is similar to the cost to construct a facility connected to sewers given the charges made by the utility; however, the cost to empty the septic tank is more than three times the cost of initiating a household sewer connection.
Work is in progress, though. In Mumbai, 40 per cent of households are in informal setups, a figure which could be much higher if the entire metropolitan area is taken rather than just the municipality. However, the Swachh Bharat programme is seeking to eliminate open defecation by providing public community toilets. Where, earlier the Municipal Corporation of Greater Mumbai (MCGM) did not provide any sanitation facility in non-notified slums, under Swachh Bharat Mission, the Corporation is building sanitation facilities even in non-notified slums.
Lack of sanitation facilities impacts women much more than they do men, primarily because the responsibility for managing sanitation and water needs at a household level, often falls on women. Also, in the case of public toilets, women are affected disproportionately, especially if they have to rely on public toilets which are located in poorly lit areas or are difficult to access at night. Communities are, however, looking to solve these issues – by either ensuring that women using the toilet in the night go in groups or through community policing. In Mumbai, the problem of men insisting on the first right of using a public toilet and jumping queues was addressed by setting up separate facilities for men and women.
Mumbai also shows the way in terms of community involvement in sanitation. The MCGM supported the Mahila Milan, a federation of slum dwellers’ savings groups, along with women living in informal settlements or on sidewalks, to manage public toilets, hence providing improved facilities to the half a million residents. While the local government paid for the construction, the community pays for operation and maintenance costs. Monthly passes are provided that allow household members access to the facilities for less than Rs 140/month. The charges help with the maintenance of the toilets and also allow the community to hire a toilet manager.
The way forward
In order to tackle the sanitation crisis, public sector investment and regulation is required. The report recommends that cities extend the sewer network to households and communal toilets, and, in the absence of sewer systems, cities need to support on-site sanitation options such as pit latrines and septic tanks in the short- and medium-term. Cities also need to upgrade informal settlements and make sanitation services more affordable for low-income households. To action sanitation plans, cities require more workable and accessible sanitation data.
“For too long, urban policymakers and governments have turned a blind eye to the problem of untreated human waste in cities, and pretended, because it was handled by households and out of sight, that the problem was taken care of. But the fact is that this presents a huge public health risk as well as a drag on the economy,” Beard says.