Department Sanitation, Water and Solid Waste for Development

Disaster-induced displacement often causes people to live in temporary settlements that have limited infrastructure and access to water, sanitation, and hygiene (WaSH). Reducing the risk of diarrheal diseases in such situations requires knowing how housing influences the presence of pathogens in water and the interaction between human settlements and exposure to pathogens. A cross-sectional study was conducted in May 2017 in two communities hard-hit by the Nepal 2015 earthquake: one recovered with newly reconstructed houses, and one recovered with residents still living in sheet metal temporary shelters constructed after the earthquake. We collected 60 water (30 drinking water and 30 cleaning water), 30 hand rinse, and 90 environmental swab samples (30 toilet handles, 30 utensils, and 30 water vessels) from selected households in each location and quantified 22 bacterial pathogens using microfluidic quantitative polymerase chain reaction (mfqPCR). A total of 59 samples were randomly selected for amplicon-based sequencing of the 16S rRNA, and it identified bacterial community profiles between these two settlements and their association with target genes of pathogenic bacteria. Target genes like uidA of Escherichia coli and the mip gene of Legionella pnuemophila showed significantly high frequency in specific sample types in temporary settlements than in permanent settlements. A significantly high concentration was observed in temporary settlements for Enterococcus spp. and S. typhimurium, specifically in swab samples. There was a sharp distinction of microbial community profiles between water and hand rinse samples with environmental swab samples, with a large abundance of potentially pathogenic bacteria in swab samples in both settlements. This observation highlighted that fomite could be an important transmission route for pathogens in rural settings and designing key interventions to target different stages of transmission pathways is essential. Overall findings from this study suggest that the recovered settlement with higher quality housing may be less impacted by fecal contamination than recovering settlements and that interventions should be designed to disrupt multiple transmission pathways to reduce pathogen exposure.

Access to water, sanitation, and hygiene (WASH) has been a challenge to south Asia’s rapidly growing and climate change-sensitive region. Nepal, a water-abundant country, faces obstacles to fulfilling the highly prioritized WASH Sustainable Development Goal 6 (SDG 6). This review offers details about Nepal’s WASH status from 2000 to 2020 with regard to the challenges Nepal had in delivering reliable WASH services to the people, as well as opportunities for a sustainable way forward, and provides insights that can be applied to other developing countries. From analysis of national-level assessments, estimates point toward healthy progress in extending WASH access to the population. However, large inequalities persist at the subnational level between urban and rural residents, between poor and rich residents, and between genders. Many local constraints such as a lack of long-term infrastructural capacity to provide and maintain WASH services, financial issues, and institutional and policy incompatibilities are some of the key factors that technical considerations and private sector involvement could address. We also propose roles for Nepal’s central, provincial, and local governments for identification and adaptation to the undeniable risks of climate change. Furthermore, there is a need to capitalize on the potential opportunities for developing a much-needed robust and climate-resilient WASH sector in Nepal, safeguarding the rights of future generations to safe and clean water.

This policy brief presents the main result and policy recommendations from the field level assessment of sanitation facilities in the flood risk communities of Madhesh Pradesh. The field-level data were collected from twelve local government units (eight municipalities and four rural municipalities) spread across the province's four districts. The study found several factors causing slippage in sustainable toilet use. Some households do not have toilets, while some households with toilets are still practicing open defecation (OD). The dysfunctionality of toilet is one of the most significant factors driving these households to practice open defecation. The impacts of floods have further exacerbated toilets' dysfunctionality, making them less usable for households. Furthermore, households with poor finances are already practicing OD to avoid recurring costs associated with desludging. However, to reduce this in the long run, effective public-private investments are required around building public toilets and creating a sustain-able sanitation market and services. Also required would be the establishment of proper financing mechanisms for households to access funds to build and maintain a toilet, so that it is affordable and accessible for all throughout the year.