health aspects of ecosan toilets in nepal: study of...

Bipin Poudel

Kamal Adhikari

24 August 2012

Old Practice, New Technology (EcoSan)

use of fresh excreta in farms (Feco-friendly communities)

feeding the faeces to pigs

urine therapy in abdominal pain/other ailments

use of fresh human urine in cut wounds

use of cattle urine in wood seasoning

use of cow urine (Gahunt) in purifying human for religious purpose

Composting of cattle dung and organic matter

Khicha Moga

Naugal

Inception and Current Status First piloted in 2002

Several modifications in toilet pans have been made to suit local culture and ecology.

It is estimated that some 2000 EcoSan toilets (including both dry and wet type) are known to be in use in the country so far.

Types of EcoSan Pans

Major Institutions Involved in promotion of Ecosan in Nepal

Department of Water Supply and Sewerage(DWSS)

Environment and public health organization ENPHO

Lumanti

Center for integrated urban development (CIUD)

Community Development forum (CODEF)

Nepal Water for Health (NEWAH)

Development Networks (DNet) Pvt Ltd

Small Town Water Supply and Sanitation Project(STP)

Other supporting agencies are: WHO, Water Aid Nepal, UN-HABITAT, UNICEF, Practical Action, RWSSP-WN and RVWRMP

Background of Study In the year 2009, a study was undertaken by a multi-

disciplinary team of experts in 7 clusters of the country, representing different geographical location, ethnic groups and typology of technology, with the financial support of WHO Nepal.

The studied clusters were Khokhana, Siddhipur, Thecho and Tigani from Lalitpur district; Darechowk from Chitwan District; Sunwal from Nawalparasi district and Sabaithawa from Parsa district.

Objectives The specific objectives are :

To assess acceptability and suitability of EcoSan toilets;

To assess the current use and practices of handling human excreta as fertilizer;

To know the problems associated with the use, operation and maintenance;

To find out the impacts of EcoSan toilet on peoples' health;

To identify the health risks that may be associated through handling of excreta; and

To assess community knowledge on EcoSan

Study Area The study was undertaken in 7 clusters of the country

The studied clusters were Khokhana, Siddhipur, Thecho and Tigani from Lalitpur district; Darechowk--a midhill from Chitwan District; Sunwal from Nawalparasi district and Sabaithawa from Parsa district.

These clusters were selected purposively with a view to include : Both Midhill communities and tarai communities.

Both feco-friendly and feco-phobic communities

Both dry types and wet types.

Sample Size and Selection of the HH There were about 1100 ecosan toilet units constructed

in the country in 2009

clusters were given more emphasis than the numbers as an unit of analysis.

Altogether 108 households were visited (around 10%)

Methodology a list of all the households was obtained from the local

NGO/Clubs

every 3rd or 5th or 10th household (according to the total number of users), were included in the study, e.g. household number 1, 5, 10, 15, etc.

Interview (semi-structured questionnaire was used)and Observation were done

Result

Types of toilet

0%

20%

40%

60%

80%

100%

Sunawal Sabaithawa Darechowk Tigani Siddhipur Khokana Thecho

Clusters

Ho

useh

old

Wet

Dry

Practice of Using Human Excreta prior to Ecosan

Toilet

0%13%

57%

0%7%

29% 28%

0%

20%

40%

60%

80%

100%

Sunaw

al

Sabai

thaw

a

Darech

owk

Tigan

i

Siddh

ipur

Khoka

na

Thech

o

Yes

No

Safety measure while using excreta

nothing, 10%

handwashing with

soap , 90%

Safety Measures while Handling Excreta

Knowledge of users on different aspects of EcoSan

0%

10%

20%

30%

40%

50%

60%

70%

80%

Technology Maintenance Urine use Public health

Good

little

Low

Cleanliness

0%

10%

20%

30%

40%

50%

60%

70%

Personal Toilet Household

Good

Just

Poor

Duration between Application (Feaces) & Consumption of products

Sarja1; as required; 5%

Sarja1; 0-7 days; 8%



Sarja1; more than 30 days; 33%

Sarja1; NA; 44%

No. of cases of waterborne diseases after EcoSan installation

0%

5%

10%

15%

20%

25%

30%

35%

40%

No Cases Decreased Increased Same

Frequency of occurrence of Water Borne Diseases

Diseases

Frequency of occurrence within 1 yr

(last yr of study) N

0 1 2 3

Diarrohea 98 5 3 2 108

Typhoid 103 4 1 108

Jaundice

(Hepatitis) 108 108

Worm

Infestation 102 5 1

108

Dysentry 102 5 1 108

Local Champion

Local Champion

–Isobuthylaldehyde-di-urea IBDU

•Stuvite

Risks Use of feaces without considering the

storage time Storage period of 6 months in summer is

sufficient but in winter?? Use of urine directly in the field Cross contamination of urine with feaces Improper disposal of anal cleansing water UTI and other infections due to poor

drainage/blockage in the urine bowl Unhygienic toilets due to poor

maintenance and cleaning Demotivated users---OD; risk on public

health Improper design

Outcome of the Study : A guideline

Finally…. Ecosan system is one of the best solution to address the

sanitation problem in environment friendly way

BUT

STILL LONG WAY TO GO………..

Dhanyabad

health aspects of ecosan toilets in nepal: study of...

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