Evaluation of Open Defecation Free (ODF) Toilets in Flood-Prone Regions of Nepal
The Open Defecation Free (ODF) concept started with the introduction of Community-Led Total Sanitation (CLTS) in Nepal. From 2000 to 2010, sanitation coverage in Nepal has improved from 27% to 43% due to the introduction of sanitation initiatives like the ODF movement, and this coverage further increased to >97% in 2019. In September 2020, all 77 districts in Nepal were declared free from open defecation. However, several reports about the sub-par quality of the constructed toilets in the Terai districts raise questions about its long-term sustainability. Furthermore, extreme weather events like flooding, which is quite common in the region, pose additional risks. Flooding events can make toilets partially or entirely unusable, forcing the residents to open defecate in the fields. Overflowing of the pits or leaching of fecal matter in the groundwater also can cause diarrheal diseases outbreak during such events. Therefore, the provision of suitable and safe sanitation facilities that are low-cost and socially and culturally acceptable still remains a challenge in flood-prone regions.
This study was led by Dr. Sital Uprety (Eawag Postdoctoral Fellow, Sandec Dept) from 2021-2023. It examined the structural status of toilets constructed during the ODF campaigns in the Terai region and the influence of extreme weather events on toilet use.
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title => protected'Microbial assessment of water, sanitation, and hygiene (WaSH) in temporary a nd permanent settlements two years after Nepal 2015 earthquake' (138 chars)
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description => protected'Disaster-induced displacement often causes people to live in temporary settl ements 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 a nd the interaction between human settlements and exposure to pathogens. A cr oss-sectional study was conducted in May 2017 in two communities hard-hit by the Nepal 2015 earthquake: one recovered with newly reconstructed houses, a nd one recovered with residents still living in sheet metal temporary shelte rs constructed after the earthquake. We collected 60 water (30 drinking wate r and 30 cleaning water), 30 hand rinse, and 90 environmental swab samples ( 30 toilet handles, 30 utensils, and 30 water vessels) from selected househol ds 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 ide ntified bacterial community profiles between these two settlements and their association with target genes of pathogenic bacteria. Target genes like <em >uidA</em> of <em>Escherichia coli</em> and the <em>mip</em> gene of <em>Leg ionella pnuemophila</em> showed significantly high frequency in specific sam ple types in temporary settlements than in permanent settlements. A signific antly high concentration was observed in temporary settlements for <em>Enter ococcus</em> spp. and <em>S. typhimurium</em>, 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 abunda nce 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 tar get different stages of ...' (2319 chars)
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title => protected'Water, sanitation, and hygiene of Nepal: status, challenges, and opportuniti es' (78 chars)
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description => protected'Access to water, sanitation, and hygiene (WASH) has been a challenge to sout h Asia’s rapidly growing and climate change-sensitive region. Nepal, a wat er-abundant country, faces obstacles to fulfilling the highly prioritized WA SH 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 opportuni ties for a sustainable way forward, and provides insights that can be applie d to other developing countries. From analysis of national-level assessments , estimates point toward healthy progress in extending WASH access to the po pulation. However, large inequalities persist at the subnational level betwe en urban and rural residents, between poor and rich residents, and between g enders. Many local constraints such as a lack of long-term infrastructural c apacity to provide and maintain WASH services, financial issues, and institu tional and policy incompatibilities are some of the key factors that technic al considerations and private sector involvement could address. We also prop ose roles for Nepal’s central, provincial, and local governments for ident ification and adaptation to the undeniable risks of climate change. Furtherm ore, there is a need to capitalize on the potential opportunities for develo ping a much-needed robust and climate-resilient WASH sector in Nepal, safegu arding the rights of future generations to safe and clean water.' (1508 chars)
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title => protected'ODF assessment in Madhesh Pradesh. Findings and recommendations' (63 chars)
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description => protected'This policy brief presents the main result and policy recommendations from t he field level assessment of sanitation facilities in the flood risk communi ties of <em>Madhesh Pradesh</em>. The field-level data were collected from t welve local government units (eight municipalities and four rural municipali ties) spread across the province's four districts. The study found several f actors causing slippage in sustainable toilet use. Some households do not ha ve toilets, while some households with toilets are still practicing open def ecation (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 alrea dy practicing OD to avoid recurring costs associated with desludging. Howeve r, to reduce this in the long run, effective public-private investments are required around building public toilets and creating a sustain-able sanitati on market and services. Also required would be the establishment of proper f inancing mechanisms for households to access funds to build and maintain a t oilet, so that it is affordable and accessible for all throughout the year.' (1291 chars)
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Microbial assessment of water, sanitation, and hygiene (WaSH) in temporary and permanent settlements two years after Nepal 2015 earthquake
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.
Uprety, S.; Sherchan, S. P.; Narayanan, P.; Dangol, B.; Maggos, M.; Celmer, A.; Shisler, J.; Amarasiri, M.; Sano, D.; Nguyen, T. H. (2023) Microbial assessment of water, sanitation, and hygiene (WaSH) in temporary and permanent settlements two years after Nepal 2015 earthquake, Science of the Total Environment, 877, 162867 (11 pp.), doi:10.1016/j.scitotenv.2023.162867, Institutional Repository
Water, sanitation, and hygiene of Nepal: status, challenges, and opportunities
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.
Shrestha, A.; Bhattarai, T. N.; Acharya, G.; Timalsina, H.; Marks, S. J.; Uprety, S.; Paudel, S. R. (2023) Water, sanitation, and hygiene of Nepal: status, challenges, and opportunities, ACS ES&T Water, 3(6), 1429-1453, doi:10.1021/acsestwater.2c00303, Institutional Repository
ODF assessment in Madhesh Pradesh. Findings and recommendations
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.
Uprety, S.; Adhikari, A.; Shrestha, A. M.; Sainju, S.; Marks, S. (2023) ODF assessment in Madhesh Pradesh. Findings and recommendations, 7 p, doi:10.55408/eawag:31579, Institutional Repository
Uprety et al. Assessment of Open Defecation Free (ODF) toilets in flood-prone areas of Nepal: implications for global sanitation challenges. In review.
