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Ecological Sanitation Potential in Busia Town,Uganda

Emel Aysel TunaDegree project for Master of Science in

Environmental ScienceJune 2008

Department of Plant and Environmental Sciences University of Gothenburg

UNIVERSITY OF GOTHENBURG

SammanfattningTillgång till vatten och sanitet är alla människors rättigheter, men trots det finns det många människor i världen som inte har tillgång till de mest grundläggande behoven, främst i Afrika. Denna uppsats bygger på en fältstudie i Busia Town i Uganda. Bristen eller avsaknaden på grundläggande och enkla sanitära lösningar i Busia Town har orsakat flera problem som t.ex. direkta utsläpp av avloppsvatten till närmiljöer. Även bristen på tillgång till rent och känligt dricksvatten är påtaglig, och många människor tar sitt vatten från grävda brunnar eller från åar vars vattenkvalitet är undermåligt. Bristfällig eller total avsaknad av kontinuerlig avfallslösning och hämtning är också problem som leder till besvär för människor som lever i området. Dessa problem leder dels till kontamination av närmiljön dels till hälsoproblem. Malaria och mag-tarm sjukdomar är de vanligaste sjukdomarna i Busia Town, och det är speciellt redan utsatta och känsliga personer som drabbas av dem. Genom mycket enkla medel kan flera av dessa problem lösas, t.ex. genom införande av alternativa sanitetssystem som är anpassade till platsen i kombination med ökad upplysning och medvetenhet. Ekologisk sanitet är ett sanitetssystem som bygger på ett kretsloppskoncept, där fekalier och urin samlas in separerat, hygieniseras och sedan kan återanvänds som jordförbättrings- och gödningsmedel i bl.a. handelsträdgårdar, jordbruk m.fl. Detta resulterar i att närmiljön skonas från utsläpp, så att vatten- och jordmiljö inte kontamineras av patogener och närsalter. Denna avfallshantering och omhändertagande av biologisk avfall leder till mindre avfallsmängd och förstörelse i området. Busia Towns medborgare kan härigenom med enkla medel få en bättre närmiljö, hälsa och livskvalitet.

SummaryEvery human being has a right to basic water and sanitation access, but despite of that there are many people in the world especially in Africa who are without access to either clean water or simple sanitation system. This thesis is based on a field study on the situation in Busia Town in Uganda. Lack or absence on fundamental and simple sanitation in Busia Town has lead to several problems as for example direct discharge of wastewater to the surrounding environment. Even access to good water quality is missing and many people use water sources as dig wells and springs, which usually have inferior water quality. Lack of a continuous waste solution and collection is also a problem which leads to problems for people living in the area. These problems contribute to environmental contamination as well as to health problems. Malaria and intestinal diseases are the major diseases in Busia Town, where the most fragile and sensitive people are most affected. Through very simple means several of these problems can be solved, for instance by installation of alternative sanitation systems, which are adapted to the site in combination with enlightening and awareness. Ecological sanitation is a sanitation system build on a recycling concept, where faeces and urine are separated, sterilized and later reused as soil improver and fertilizer in gardening, agriculture etc. This means that the near surrounding and environment is protected from wastewater discharge, so that no water and soil environments are contaminated from pathogens and other pollutants. This kind of waste management takes care of the biological waste, and makes it into a resource, and so contributes to less waste amount and disturbance on the areas. Busia Towns citizens will by these very simple means get better environment, health and life quality.

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ForewordI would like to thank the administration in Applied Environmental Science at Gothenburg’s University and Swedish International Development Cooperation Agency (SIDA) for granting me the Minor Field Study scholarship, which made this study and my visit to Uganda during the period of 20 July to 4 October 2007 possible. I am thankful for my Swedish supervisors Zsofia Ganrot and Göran Dave at the Department of Applied Environmental Science at Gothenburg’s University for supervising and helping me with my continuing work after the field work back in Sweden. I am very thankful for my local supervisor Ina Jurga technical advisor German Development Service (DED) in Uganda for all her help, with advice, establishment of contacts and introduction with people. I want also to thank Boris Bisa technical advisor DED Busia Town Council, Kristina Mayr, Alice Akii and the remaining staff at DED Uganda for welcoming and helping me when it was needed.

Thanks to Peter Nabunwa health official, Teopista Nagajja, environment official, Tom Massa water department official and the remaining staff at Busia Town Council and Joyce Nabwire at Samia Bugwe North (Solo parish) Health Centre. I am very grateful for Youth Environmental Service (YES) help and guidance in Busia Town. I am especially thankful for Amosiah, Denis, Jane, Joseph, Gloria, Herbert, Rashid, Ritzik and Linet for their help (see Appendix F and Photo 10).

Finally would I like to thank my family for their support and encouragement with my thesis.

Emel Aysel Tuna

June 2008

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ContentSAMMANFATTNING .................................................................................................................................................................................................... 3

SUMMARY ...................................................................................................................................................................................................................... 3

FOREWORD .................................................................................................................................................................................................................... 4

1. INTRODUCTION...................................................................................................................................................- 3 -

1.1 UN’S MN GOAL..................................................................................................................................................- 3 -1.2 UGANDA..............................................................................................................................................................- 3 -

1.2.1 Laws, regulations etc. in Uganda................................................................................................................- 3 -1.2.2 Ecological Sanitation in Uganda................................................................................................................- 3 -1.2.3 Busia Town..................................................................................................................................................- 3 -

1.3 OBJECTIVES OF THIS STUDY................................................................................................................................- 3 -1.3.1 Purpose........................................................................................................................................................- 3 -1.3.2 Limitations...................................................................................................................................................- 3 -1.3.3 Questions.....................................................................................................................................................- 3 -

2 METHOD..................................................................................................................................................................- 3 -

2.1 LITERATURE........................................................................................................................................................- 3 -2.2 FIELD STUDY.......................................................................................................................................................- 3 -

2.2.1 Survey in Busia Town..................................................................................................................................- 3 -2.2.2 Questions.....................................................................................................................................................- 3 -2.2.3 Personal communication.............................................................................................................................- 3 -

2.3 QUESTIONNAIRE..................................................................................................................................................- 3 -2.3.1 Structure......................................................................................................................................................- 3 -

2.4 ADDITIONAL INFORMATION.................................................................................................................................- 3 -

3. RESULTS FROM LITERATURE STUDY..........................................................................................................- 3 -

3.1 SANITATION TECHNIQUES...................................................................................................................................- 3 -3.1.1 Dry techniques.............................................................................................................................................- 3 -3.1.2 Wet techniques.............................................................................................................................................- 3 -

3.2 WASTEWATER......................................................................................................................................................- 3 -3.2.1 What is wastewater?....................................................................................................................................- 3 -3.2.2 Wastewater treatment..................................................................................................................................- 3 -3.2.3 Effects on soil and water environments.......................................................................................................- 3 -3.2.4 Pathogens in wastewater.............................................................................................................................- 3 -3.2.5 Disease transmission...................................................................................................................................- 3 -3.2.6 Health aspects.............................................................................................................................................- 3 -3.2.7 Prevention and protection...........................................................................................................................- 3 -

3.3 ECOLOGICAL SANITATION PROJECTS IN UGANDA...............................................................................................- 3 -

4. RESULTS FROM THE FIELD STUDY...............................................................................................................- 3 -

4.1 SOCIAL AND CULTURAL ASPECTS........................................................................................................................- 3 -4.2 WATER ASPECTS..................................................................................................................................................- 3 -4.3 SANITATION ASPECTS..........................................................................................................................................- 3 -4.4 WITHOUT SANITATION ASPECT............................................................................................................................- 3 -4.5 WASTE ASPECT....................................................................................................................................................- 3 -4. 6 HEALTH ASPECT.................................................................................................................................................- 3 -

5. DISCUSSION...........................................................................................................................................................- 3 -

5.1 LITERATURE STUDY.............................................................................................................................................- 3 -5. 2 SURVEY STUDY...................................................................................................................................................- 3 -

6. CONCLUSION........................................................................................................................................................- 3 -

7. REFERENCES.........................................................................................................................................................- 3 -

8. APPENDIX...............................................................................................................................................................- 3 -

APPENDIX A MAP A. AREAS OF BUSIA TOWN COUNCIL..................................................................................- 3 -APPENDIX B MAP B. BUSIA TOWN WITH SOLO A AND MARACH PARISHES....................................................- 3 -APPENDIX C QUESTIONNAIRE...........................................................................................................................- 3 -APPENDIX D TECHNICAL FEATURES..................................................................................................................- 3 -APPENDIX E RESULT FROM FIELD STUDY.........................................................................................................- 3 -APPENDIX F PHOTOS.........................................................................................................................................- 3 -

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1. Introduction

1.1 UN’s MN goal Africa is the world’s poorest continent and has not been able to develop in economical, environmental and social level as the other continents. The current environmental aim in the world is, concerning many countries and United Nations, to achieve and solve some of the problems as access to safe and clean water and basic sanitation. United Nations stated in 2000 eight millennium goals, with purpose to improve many countries current situation to a better level, and there are some targets to be achieved to 2015 and forward. The seventh goal is about to ensure environmental sustainability, and it contains specific aims such as: ensure environmental sustainability and integrate the principles of sustainable development in to country policies and programmes, reverse loss of environmental resources, reduce half the proportion of people without sustainable access to safe drinking water and basic sanitation, and achieve significant improvement in lives of at least 100 million slum dwellers, by 2020 (UN, 2007a).

If the seventh goal of basic sanitation and safe access to drinking water can be achieved it will affect many people, especially women and children in Africa. Some UN reports indicate that lack of basic sanitation influence on children’s education, especially girl pupils, who do not tend to go to school if there are no accesses to school toilets. Most households in African countries, for example Uganda, do not usually have sanitation inside their houses (many households use and have access to shared pit latrines). Pit latrines are of various conditions, some safe to use while others due to fragile walls, insecure pit- holes etc. are not safe to use. An insecure and dangerous pit latrine is if it still is in use, dangerous to human safety, especially for small children, elderly persons and women. Women, who do not have access to sanitation, are forced to walk long distance to find an appropriate area as open field for urination and defecation. They tend to do it after darkness, because of the shame of being seen at daytime in that area. Because of the night activities small children and women risk being raped, snake bitten, encounter wild animals etc. Open defecation and urination is also contributing to great environmental and health problems to nearest surrounding as soil and groundwater contamination by faeces (and urine) of pathogens and nutrients as nitrates and phosphorus. Besides the environmental effects pathogens in water and soil are threatening for human health.

Water problem is also a major problem since access to safe and clean drinking water is not sufficient in many African countries. People (mostly children and women but also vendors) walk shorter or longer distances to collect water, regardless of the water quality. This time-consuming task puts children and women to spend most of their time to bring water to the household and affects their ability to do other more important work. Children helps with domestic work instead of going to school and get education and women lose opportunity to contribute with income to the family since they spend too much time with domestic work (UN, 2007c). Africa’s development and aim to ensure environmental suitability may take some time to achieve. Only 42 % of people in rural areas had access to clean water and 63 % of the entire population lacks access to basic sanitation facilities. It had decrease with 5% from 68% (lacking access to basic sanitation) in 1990, and if it develops at this rate the target to ensure of cutting this proportion by half in 2015 not be possible. The effects of climate change in the world are already disturbing some of the world’s most sensitive regions and will make it more difficult to achieve the millennium goals, especially on the subcontinent. Between 75 and 250 million people will be exposed to an increase of water stress according to projections by the Intergovernmental Panel on Climate Change and without adequate preparation, the impact could be devastating to rural economies and the livelihoods of the poor (UN, 2007b).

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http://www.un.org/millenniumgoals/docs/MDGafrica07.pdf

http://www.unmillenniumproject.org/documents/WaterComplete-lowres.pdf

1.2 Uganda Uganda is a republic and has approximately 28 million inhabitants where more than 1 million lives in the capital Kampala. English is the official language, but they have other local languages as well, the most widely spoken languages beside English are Luganda, Ateso, Swahili and Arabic. Uganda have a variety of mixed religious groups, Christians are the dominated group with Catholic 41% and Anglican 35 %, Muslims represents 12% of the population and the rest are traditional religions, with 0.7% classified as Hindus and Judaism. Uganda has substantial natural resources, including fertile soils and sizable mineral deposits of cupper and cobalt. Although Uganda is on the equator, its climate is warm rather than hot, and temperatures vary little throughout the year. Most of the territory receives an annual regular rainfall of at least 1000 mm. Agriculture is the most important sector of the economy, employing over 80% of the work force, with coffee accounting the bulk of export revenues. The main export countries are Kenya, Japan, USA, EU and India. According to IMF statistics in 2004, Uganda's GDP per capita reached 300 dollars per year. Uganda is an economical poor country with high unemployment rate; few have a regular work and many have irregular work as market sellers. Uganda has major environmental problems: green woodlands are diminishing when the trees, undergrowth vegetation is chopped down to give more soil areas for agriculture and an increasing population (Landguiden, 2007).

Uganda has, in general, not sufficient functioning water and sanitation system. The supply of hygienically safe drinking water and the disposal of wastewater are mostly poor/ lacking in urban areas. The rural areas have, considering to urban areas, more problems with distribution of fresh water, the water pipelines are limited and are consequently more expensive. Even if Uganda has rich water resources, water is still expensive, and the poor suffers mostly from the high prices. The wastewater problem is even more problematic compared to the water problem. In Kampala wastewater treatment is implemented. For other urban and rural areas the situation is much worse, since there is no wastewater managing at all. Currently only 70 % of the urban population in large towns and 65 % in small towns has access to a safe water supply, and only 8 % are connected to a wastewater system (GTZ, 2007c). Uganda’s water- and sanitation problem can be solved with some shifting in management and governance in the urban and rural water supply and sanitation sector. Living conditions particularly for the urban poor will worsen unless it is not possible to increase efficiency and effectiveness through reform in this sector (DED, 2007). Uganda has been receiving help in these problem areas and with help and support from foreign countries, NGO’s the water and sanitation problem in Uganda is gradually changing. The most important focus is on improved safe drinking water access and sanitary facilities for the poor people. Beside the above mentioned effort the German Development Service (DED) operates at present several ongoing ecological sanitation projects in Uganda (DED, 2007).

1.2.1 Laws, regulations etc. in Uganda.Uganda has environmental, water and health acts, regulations and policy’s regarding environment, water, sanitation, waste and health matters. The chapters, sections, principles and parts are well written even if most of the acts and regulations are mainly for the implementation and management designed for the authorities (but they are also directing to citizens to implement them in the ordinary life, take actions to protect the environment, health etc.). The national environmental act, health act, regulations etc. is relatively new and laws has progressively been more and more implemented with the development of local, district and governmental institutions. There are still some difficulties for the law enforcement in the environmental health improvement issues and the health officials and their duties continue to progress (The Republic of Uganda, 2005d). The National Environmental Act has been in use since 1995. Beside the general principles (principles of environment management and right to a decent environment) are the other following parts about and directed to instructional work and guidance (The Republic of Uganda, 1995c). Every citizen has the right to a healthy environment in Uganda where they (citizens) have a duty to maintain and enhance the environment and if there is any negative impact and effects on the environment due to citizens activities or omissions they are obligated to correct the faulty. A public official have right

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http://www.gtz.de/en/weltweit/afrika/uganda/16463.htm

http://www.landguiden.se/Uganda

to take measurements to prevent or stop the persons who with their activities affects the environment (National Environment Act, section three). Health officials in towns have from time to time inspected the sanitation situation in their district, especially in cholera epidemic situations have some citizens been arrested. Due to law break, not protecting the environment etc., where some citizens who lack basic/ proper sanitation facilities, have been arrested for failing to build toilets and contributing to contamination to the environment and endangering human health (Reuters, 2007).

The Ugandan Government originated and developed, to improve rural but also urban water and sanitation situation in the country, a program so that the small and large towns around the country through foreign aid and donors, prepare and finance the implementation and improvement of water and sanitation services in these towns. The government has provided targeted subsidies to promote the expansion of water services to ensure that services are sufficient, and to set tariffs at a level to ensure that water services are (in community management and maintenance of water system) commercially viable affordable to the poor households. In the water improvement projects have more than 96 % of the towns got a completed water supply system, where the management and liability is on private operators (The Republic of Uganda, 2005e) and in Busia Town Kalebu Ltd is the private water operator for the town. With sanitation help and guidelines from central government Ugandan town and village people will be informed and enlightened but also sensitized for implementation and improved of sanitation.

1.2.2 Ecological Sanitation in Uganda The first ecological sanitation project started in Kabale/ Kisoro region the South-Western Uganda 1996/7. Since then several ecological sanitation projects have taken place with the help from foreign development cooperation’s/organizations. DED is currently working in Uganda with several development projects, for example ecological sanitation, HIV, vocational training etc. DED has five ecological sanitation project towns and they are Busia, Arua, Luwero, Soroti and Lira, these five towns will receive help in sanitation improvement. In September 2007 the first town, i.e. Busia Town, started with the information and introduction of ecological sanitation. Town officials have been informed and a local expert has been appointed to work for DED and help the towns with their progress and development. Wangira Denis from Youth Environment Service Organisation (YES) in Busia Town has been appointed as local expert (Jurga, personal communication).

According to Oketch Michael from the Ministry of Water and Environment there are approximately 7000 ecological sanitation units in Uganda. But the number is probably more since private households, hotels, institutions etc. may have installed ecological sanitation without local and/or central administrations knowledge or information. Since ecological sanitation has been introduced in Uganda there have been some implementation difficulties of these techniques as an alternative to the conventional pit latrines. The implementation of ecological sanitation in Uganda has not been as effective and successful as predicted, and a major reason is differences among ethnical groups and their acceptance of ecological sanitation. The main obstructions for the implementation are fear and taboos to deal with faeces. For instance, among Karamojong women due to their beliefs are not encouraged to use pit latrines or other sanitation devices, so they are forced to use open defecation and urination (on open fields, behind bushes, plastic bags etc.). With great persistence and patience can (all) people be sensitized on ecological sanitation. The Ugandan government receives help from many foreign NGO’s and there are noticeable progresses in adjustment of ecological sanitation in Uganda (Oketch, personal communication).

1.2.3 Busia Town Busia Town is located in South-Eastern part of Uganda and borders to Kenya. During daytime the town’s population is doubled due to the commercial traffic from Kenya, where farmers and other traders comes to Busia Town to sell their merchandise. The population in Busia Town according to

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2002 statistics 37,842 with an estimated annual growth rate of 2.7%. Busia Town is divided in four parishes (Solo, Marach, Sofia and Arubaine) with diverse populations and the common used local languages are Lusamia/ Lugwe, Kiswahili, Luganda and official English see Appendix A Map A and Appendix B Map B for further information on Busia Town and location of the parishes. Busia Town topography is dominating undulating plain, the town is located in a flat area with some lowland areas that form small valleys and the most significant are those forming banks to river Solo and river Okame. The bedrock is granitite with high to medium grade metamorphosed formations and other rocks of mobilized and intrusive granites. Most of the soil is ferrallitic, which characteristically represent almost the final stage in tropical weathering, and ferrisols, which closely resembles ferrallitic soil. Rain season starts with a minor and shorter first rain season during March- June to a major and longer rainy season during August- November. Average annual rainfall in Busia Town is 1514 mm with average maximum temperature 28.7 °C and minimum temperature 16.2 °C. Busia Town’s groundwater seems to occur within one aquifers in the fractured granite rock aquifers and a second overlying weathered zone (regolith) aquifers (the thickness of thin layer ranges between 18 m and 40 m). Tests from water pumping have shown that both combined aquifers produce >10 m3/h water and can sustain long term withdrawals. Vegetation in Busia Town has as a result of continuous cultivation, burning and clearing for specific aims, undergone changes. Vegetation categories can be named as medium altitude forest, moist-, wooded-, grass savannas and swamps (Obernosterer, 2006).

Water supply is operated by a private operator (piped water system) and other water sources are from springs, boreholes, shadoofs (local hand-dug wells), streams and rainwater collection. There are total of 542 water sources in Busia Town, and the total water coverage is 80%.Of the total water sources 22 are functional boreholes, 5 are non functional boreholes, 17 are protected springs and 1 is an un-protected spring. There are 431 yard water taps, 46 institutional water taps, 18 standard/ kiosks water taps, 33 commercial water taps and 14 house water tap connections. The coverage of 80 % is based on the assumption that one borehole water point serves 300 people and one protected spring serves 150 people. And the distance to the safe water source from the households is estimated to be 20 m for shadoofs, and for boreholes and springs it is approximately 120 m. Of the approximated 9,500 households 14 households are connected to piped water system. The piped water system comprises to two separate systems, and each system pumps ground water to a chlorination house through reservoirs. Protected spring water quality varies, and in general it can be described as unsatisfactory. During the dry season when the shadoofs water level drop, the spring water demand is stressed. The water quality tests from the springs show a moderate degree of pollution. Boreholes (hand pumps) are free to use since there is no formal community management for these hand pumps, and the shadoofs (local hand-dug wells) are privately owned. Water quality tests showed contamination with E. coli bacteria, due to the proximity of latrines and septic tanks. Since water is withdrawn by bucket and windlass, the water can get unhygienic through handling. Streams in Busia Town are not permanent and are depending on three seasonal streams, and the water quality is not safe as drinking water due to pathogen contamination (Obernosterer, 2006). Waste management in Busia Town is not well practised and there are areas where open waste dumping occurs, which can also be seen in Appendix F Photo 5 and Photo 6.

Adequate sanitation, piped water and waste disposal facilities are not available in all areas in town. The sanitation coverage is 84% pit latrine, 0.4% sewage channels, 0.9% soak pit, 5% septic tank, 2% open infiltration, 8% V.I.P and 0% Ecosan. Pit latrines are commonly made of semi-permanent materials as mud and grass or of permanent materials as bricks etc. There are VIP latrines and a few water toilets. Sanitation coverage for the population is not enough and some people use neighbourhoods/ shared pit latrines (one pit latrine is an average used by 10 people). Poor sanitation management, open defecation and pit latrines close to water sources increase the risk for contaminations of dig water wells. Due to lack of soak pits in many households some households use their pit latrines as soak pits. When the systems get full it is either closed and a new site is dig, or it is manually emptied into a ditch, so that the old site can be continually used again. The space

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is limited so to build new latrines is usually not technically possible. Instructional, municipal and school sanitation facilities are very few in Busia Town (there are two at the market place and one in the taxi park area). 60 % of the population in Busia Town is Muslims and they are ’’responsible’’ for why Busia Town do not have ecological sanitation system (Obernosterer, 2006).

Increasing population and insufficient soil infiltration capacity to absorb wastewater with high organics content can cause overflow of pit latrines and septic tanks, which will end up in surface water drainage networks and cause contamination to streams and rivers. Pit latrines and septic tanks in Busia Town have contributed to a recognized ground water contamination. During the rain season pit latrines are affected due to a rise in water table, which also decrease ground water infiltration capacity. While the disposal often reaches water sources, water in boreholes (hand- or electrical pumps) are not affected since they are served by deeper groundwater aquifers. There is no sewage line system and sewage treatment plant in Busia Town. There is one governmental Health Centre and several clinics and pharmacies. These are not equipped sufficiently to handle Busia Town’s population of approximately 40,000. Citizens commonly seek medical care outside Busia Town. The most common diseases related to water and sanitation problem are malaria, diarrhoea, typhoid fever, worms, scabies. The most effective way to stop spreading diseases is through hand washing with soap after toilet visit and before food eating. The majority of the schools do not have hand washing facilities (no water, soap or toilet paper) and 60 % of the households in Busia Town have no hand washing facilities and lack domestic hand washing practice. Behaviour changes towards regular hand washing are needed (Obernosterer, 2006).

1.3 Objectives of this study1.3.1 PurposeThe aim of the thesis was to do a concrete field study on ecological sanitation in Uganda. Through contact with DED and Jurga Ina there was a possibility to join their started project in eastern Uganda. Busia Town was the first town, where introduction and implementation of ecological sanitation was planned, and the project started in the beginning of September. Besides ecological sanitation there are concerns for environmental impact on soil and water, health effects link to social and cultural aspects. With the possibility to join the project in Busia Town and also being able to gather empirical field information via participation, observation, interviewing, photographing and recording, the purpose was to find some answers to sanitation problem but also solutions to the problem. Furthermore the purpose was to collect and gather information from scientific literature about ecological sanitation.

1.3.2 Limitations The project was limited to a geographical area, i.e. to Busia Town (near Kenya border) to three parishes Solo A, Marach and Sofia. Solo A and Marach parishes were (more) interesting in sanitation and environment aspect as soil and water contamination, but also health and social aspects compared to Sofia parish, even if all of them have similar problem there were also some differences as population density, water quality, waste management, economical and social standard. From that point it was easy to identify Solo A and Marach as the survey areas. Besides the geographical limitations, the reuse of faeces and urine as fertilizer in agriculture will not be investigated in this theses. A comparison of three completed ecological sanitation projects will be made in this thesis, to understand how successful ecological sanitation projects are in Uganda today.

1.3.3 QuestionsThere are a lot of questions that would be interesting to investigate, but the main interesting questions of this thesis are:

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1. Why implement ecological sanitation in Busia Town (Uganda)? Are there other sanitation options/ technology?2. Experiences from existing ecological sanitation projects in Uganda.3. Busia Town and their sanitation situation and solution.4. Can ecological sanitation solve sanitation problem in Busia Town?

2 MethodThe method that has been used to achieve the objectives of this thesis was beside cooperation with DED and YES also literature studies, determination of survey area in Busia Town and construction of questionnaire and using it in the survey area.

2.1 LiteratureThis thesis is structured on literature studies, principally scientific literature (within environmental science), obtained documents from different environmental- and sanitation organisations/ groups as for example EcoSanRes (Ecological sanitation research group). Literature and information regarding Uganda has been obtained (with advice and help from Jurga Ina, DED) after arrival to Kampala. From The Ugandan Government’s homepage has some health statistics from The Ministry of Health have been obtained. Environment and Health Acts, Regulations and Recommendations have been obtained from Ministry of Health. Water Act and Regulations and other essential information have been obtained from Ministry of Water and Environment and from bookshops. From Internet information has been obtained from for example Wikipedia, UN, Ecosanres.

2.2 Field study2.2.1 Survey in Busia TownTwo parishes, Solo A and Marach, were identified as survey area with need for improved sanitation. To make a valid survey in Busia Town 40 households in Solo A and 40 households in Marach were included in the survey. Households in both parishes were randomly selected among approximately 250 household in Solo A and approximately 350 in Marach. In both parishes 10 Muslim and 10 Karamojong households were included. The survey was carried out during two days, between 10th and 11th September 2007 to 80 households.

2.2.2 QuestionsThe following four major questions were asked:

1. How is the sanitation, water, waste and health situation in Solo A and Marach?2. What is the major concern in Solo A and Marach? 3. Are there any solutions for these concerns; are there any possibility for Busia Town Council to solve these problems?4. Could ecological sanitation introduction and implementation be a solution, especially for Solo A and Marach parishes, but also for Busia Town Councils sanitation problems?

2.2.3 Personal communicationDuring July and August there was a communication with Kampala Town Council, about Kampala ecological sanitation project with Gitta Frances, ecological sanitation administrator. General information was obtained from Ministry of Water and Environment (DWD) Oketch Michael and from Ministry of Health and UNHCR a short communication was exchanged. With Busia Town council I had several meetings and communications with Environment official Nagajja Toepista., Health official Nabunwa Peter, Water operator Massa Tom, Technical Advisor Bisa Boris and from Samia Bugwe North (Solo parish) Health Centre, Health Centre administrator Nabwire Jane.

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Regularly communication with Youth Environmental Sanitation Group (YES), Ontagai Amosiah and other YES members, and with ordinary town citizens.

2.3 Questionnaire2.3.1 StructureThe questionnaire was constructed in accordance with the DED’s official questionnaire template. This questionnaire was however more comprehensive. The questionnaire was comprised to 18 pages and was divided into seven parts, with the following structure (for further information about this questionnaire see also Appendix C):

Part one: Background of the householdPart two: WaterPart three: SanitationPart four: Waste ManagementPart five: HealthPart six: Household Without Sanitation and Water FacilitiesPart seven: Social-and Cultural Background

The first part about the household’s background contained 15 questions, the water part contained 18 questions, the sanitation part contained 34 questions, the waste management part contained 13 questions, the health part contains 7 questions, the household without sanitation or water facilities contained 8 questions and the last part about social- cultural background contained 15 questions. The questionnaire contained totally 111 questions. The sanitation part was the largest part but also the most important part.

2.4 Additional informationDuring the survey of Solo A and Marach parishes information via photographs was collected. These are shown in Appendix F.

3. Results from literature study

3.1 Sanitation TechniquesSanitation techniques can be divided into two parts, one with dry technique and the other with wet technique. Dry technique includes pit latrines, VIP’s etc., where no water or only little water is used and where the waste is discharged to a septic tank or nearest surrounding. Dry sanitation is used in areas with little or limited water resources, and is used in many African countries. The wet sanitation technique includes flush toilets and requires a continuous water supply and connection to sewage system and is often used in Western countries. Africa, South America and Asia are continents where wet sanitation technique is less used for several reasons. The first reason is that most people living in these countries have poor living conditions and can not afford the “western” toilet style, and the second reason is that there is no continuous water supply. An average person in Sweden uses approximately 40 L water for toilet flush each day (Vattenportalen, 2007).

Kampala is the only town in Uganda with a sewage treatment plant, but it does not cover the entire town. Many households have septic tanks which collect the household wastewater before it is lead to the common sewage pipes. There are also households that have other sanitation solution like pit latrines beside flush toilets. Many slum areas in Kampala have no sanitation and connection to the sewage system (Gitta, personal communication). In Kampala’s slum areas people dispose their excreta to drainages, open fields as bushes, use plastic bags (Oktech, personal communication). Many towns as well as Busia Town do not have sewage system since they are small town and have limited economical resources to built a sewage system and maintain it (Bisa, personal

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communication). Flush toilets as sanitation technique are not common in Uganda, but 60% of the households in Kampala are located in areas with technical planed and functioned infrastructure connected to city sewage system.

3.1.1 Dry techniques3.1.1.1 Pit latrinePit latrine is the most common sanitation technique in the world and is constructed either inside or outside the house. It can also be constructed above or below soil ground. The sanitation building often contains walls and door, the dig-hole or constructed area is 1-3 m3. The pit latrine can last (if frequently used) some years, since if it is used by more than one household it will last shorter time. Most of the pit latrines are easily built and do not cost (depending on the construction material). Construction materials in Uganda and most of the African countries consist of ordinary bricks, clay, tree stocks. Because of the simple construction the fundament is often fragile and can collapse. A pit latrine without any connection to septic tank or to a sewage system has a directly discharge of wastewater out to the nearest surrounding and environment. Uganda is a country with good water supply and a high water table, and therefore a wastewater discharge will likely contaminate groundwater. Contamination by pathogens can result in diseases such as diarrhoea, cholera and other water born diseases. A full pit latrine is usually abandon rather than emptied (Wikipedia, 2007e).

Pit latrine coverage in Busia Town is according to a previous report 40 % (Obernosterer, 2006). Most of the pit latrines are made by simple building elements where walls are made by mud and there are often no door instead tree brunches or fabrics coverage (see Appendix F and Photo 3 and Photo 4). From a recently survey carried out by Busia Town Council in July 2007 among three parishes was the toilet possession for the households 86%, 61% possessed pit latrine, 21% VIP, and 4% other types i.e. flushing toilets (Tuhanmagyezi & Namukasa, 2007).

3.1.1.2 Ventilation Improved Pit Latrine (VIP)The VIP is a pit latrine with a ventilation pipe outside the building. The ventilation pipe prevents flies and smell, gives a more hygienic sanitation. But also as pit latrine, it has to be emptied or abandoned for a new sanitation when it is full. The environmental effects are also the same, if there is any leakage or contamination to the surrounding soil and water environments (Wikipedia, 2007j).

3.1.1.3 Septic tankThe septic tank is often stationed outside and below the ground, and the sewage comes from an indoor or outdoor toilet. The tank has a solid construction, and it needs to be emptied from time to time. The solids settle to the bottom and lighter forms flout around on the surface and degenerates by time through bacteria decomposition. It is very hygienic and do not require advanced technique to operate. The main cost is for emptying the tank occasionally but can in some cases it be very expensive and difficult in many African countries, where the wastewater sludge collection is usually managed by private operators (Wikipedia, 2007f).

Busia Town Council does not have sufficient economy for its own waste collection and is therefore forced to engage a private operator from Tororo (a neighbouring town) for collection of waste and wastewater (Bisa, personal communication). There has not been any possibility to gain information about collector fee. The most common form of wastewater collection or emptying septic tank is done by vendors or other day workers and the charge is in a range of around 6000 UGSH and up (Ontagai, personal communication).

3.1.1.4 Double –Pit Pour –Flush ToiletsDouble pit toilet with pour flush is an offset single pit-toilet with a second pit added and has to be utilized when the first pit is full. The first pit is left for approximately one year so that the content

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can be dried before emptying. Then the pathogens have been inactivated, and the content can safely be removed by hand and be used as soil improver. The offset pit-toilet can be connected to a septic tank and/or a soak pit. The sludge accumulating in the septic tank must be removed regularly. How often depend on site, number of users etc. and it is usually collected by a private operator (School sanitation, 2007).

3.1.1.5 Ecological SanitationEcological sanitation is not like the traditional and modern western sanitation form. The purpose with ecological sanitation is that both urine and faeces (since it contains important nutrients as phosphorous and nitrate) can be taken care of and reused in agriculture. If the faeces and urine are separated and treated separately, they can be reused as organic fertilizer and soil improver instead of expensive chemical fertilizers (Sanicon, 2007). The faeces are (always) covered and mixed with ash/ organic refuse after each toilet visit, so that pathogen destruction can occur, and when it is sterilised (after several months) it will be possible to reuses as soil improver (Wikipedia, 2007a).

For the Muslim and other groups, who use water for washing after urination or defecation, ecological sanitation is also applicable. Then a third hole is used for anal washing, but there is no storage for this wastewater (Ecosanres, 2007a). The wastewater can instead be directed through a pipe out to a storage tank or to a nearby garden where the discharged water can be used for plant and tree watering. With less water used (compared to a western sanitation system) there be reduced effects on the environment, since there will be a minimum of discharged wastewater, treated or untreated to the environment (Lboro, 2007; Ecosanres, 2007c). In Busia Town a local restaurant called “Pork Joint” has recently built ecological sanitation toilets, urine diverting toilets where the urine is directed out through the toilets, backside to a nearby maize field. The ecological sanitation toilets has been sparsely used and there is no further information about how the progress is regarding the use of toilets and reuse of urine as fertilizer so far. The major Muslim population in Busia Town can create a problem, when ecological sanitation toilets are introduced to different groups (Nagajja, personal communication).

3.1.2 Wet techniques3.1.2.1 Flush toiletA flush toilet or water closet (WC) is a toilet that disposes of the human waste by using water to flush it through a drainpipe to sewage pipes, septic tank etc. The pan or bowl of a WC is the receptacle into which waste is excreted; the pan is usually made of vitreous china, stainless steel or composite plastics and WC bowl may be pedestal, cantilever or squat in design. There are several types of pans in common use: wash down, washout, and siphon. The bowl of a flush toilet is a porcelain vessel with a built-in siphon, usually visible as a curved pipe protruding from the back as an S-bend. The bowl contains normally a small amount of water which is enough to form an air trap inside the siphon pipe, preventing foul air escaping from the sewer. When the toilet is used an amount of liquid flows through the siphon pipe as waste matter is added, but the flow volume is too small to fill the siphon. To flush the toilet an activation of the flushing mechanism is necessary; this mechanism pours a large quantity of water quickly into the bowl and creates a flow large enough to fill the siphon tube, causing the bowl to empty rapidly due to the weight of liquid in the tube. The flow stops when the liquid level in the bowl drops below the first bend of the siphon, allowing air to enter, which breaks the column of liquid. The amount of water that is flushed after each toilet use is depending on the construction, and varies from 3-12 L in Sweden (Vattenportalen, 2007) to 15-16 L in USA (Wikipedia, 2007c). This creates large quantity of wastewater that has to be taken care of. If the household is connected to a municipal sewage system the wastewater can be treated in a sewage treatment plant. Since this type of toilet does not handle waste on site, separate waste treatment systems must be built (Wikipedia, 2007c). There are 4 % flush toilets in Busia Town and they are all (probably connected) to an inside toilet system with water facility and septic tank (Tuhanmagyezi & Namukasa, 2007).

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http://en.wikipedia.org/wiki/Waste_treatment

http://en.wikipedia.org/wiki/Sewer

http://en.wikipedia.org/wiki/Porcelain

http://en.wikipedia.org/wiki/Siphon

http://en.wikipedia.org/wiki/Toilet

3.2 Wastewater3.2.1 What is wastewater?Wastewater is water (also sewage, storm water) that has been used and discharged from a residential, commercial entities etc. for various purposes around the community (Wikipedia, 2007k). Wastewater can contain pathogens, organic matter, oil and grease, inorganic materials, nutrients, solid materials and gases. Wastewater released to environment without treatment will contaminate and effect soil and water environments negatively (Kadlec & Knight, 1996). Pathogens as bacteria, protozoa, viruses and helminth if released to the environment without treatment can contaminate surrounding soil and water (Wikipedia, 2007g). Organic materials originate from plants, animals or synthetic compounds and enter wastewater through defecation, use of detergents, from agricultural, industrial sources and contain normally carbon, hydrogen, oxygen, nitrogen and other elements. Further more, organic materials are also proteins, carbohydrates, and fats that are biodegradable, and broken down by organisms in soil and water. If there are a large quantity of organic material from wastewater than the recipient is able to manage, the environment can be affected negatively. The oxygen demanding organism that biodegrades the organic materials in an oxygen lacking environment, will not be able to biodegrade the organic materials and affect the aquatic life in a water environment.

Oil and grease from animals, vegetables, and petroleum are stable compounds and are therefore not easily broken down by organisms (as bacteria) and contaminates the receiving environment. Inorganic materials as metals, minerals are relatively stable and also cannot be easily broken down by organisms (as bacteria) and therefore contaminate the environment. Some inorganic compounds are toxic and will affect animals, humans and accumulate in the environment. Wastewater contains large amounts of nutrients as nitrate and phosphate, which promotes plant growth and if there are a excess of nitrate and phosphate in receiving environment will this excess cause for example algae growth in water environments which depletes oxygen in the water environment. Solid material in wastewater can consist of both organic and inorganic materials and can be taken care by organisms if possible and be reduced. Inorganic material that is not taken care of will be discharged to receiving environment. The solid material can clog the soil absorption fields in onsite system if the soil is over saturated. Gases in wastewater as methane and ammonia causes odours and can be a potential threat for human health and aquatic life when there is an exposure to (is dissolved in) water environments (Cobweb, 2007).

3.2.1.1 Faeces and UrineFaeces is normally a brown semisolid material, with a mucus coating that is defecated from a human or animal, contains a large amount of energy, 50% of the original food and pathogens. Faeces has many usage, as soil improver when it is mixed with ash and organic refuse, but it can also be used as burning material when it is mixed with dry grass etc. (Wikipedia, 2007b). Urine is a yellowish liquid discharged from human and animal body which helps the body to maintain the mineral balance and through excretion is the excess minerals thrown out of the body. Human urine contain mainly in form of urea and some aquatic organisms as fish excrete ammonia, birds and reptiles uric acid etc. urine is sterile (inside the body). However on the way out it can be contaminated by indirect or direct contact to pathogens in faeces (contaminated by pathogens from the surrounding skin parts). Urine has many usage areas as animal repellent, for dying textile products as wool but also as fertilizer in agriculture (Wikipedia, 2007i).

3.2.2 Wastewater treatmentIn most Western countries (as well as in other countries) the discharged household wastewater is connected to a municipal wastewater treatment plant. A wastewater treatment plant “cleans” the wastewater and releases the water to a nearby lake, wetland or sea. Wastewater treatment has been practised since 1800’s (Cobweb, 2007). Wastewater treatment plant has three processing steps; the first process is mechanical, the second chemical and the last process is biological (GRYAAB, 2007).

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3.2.3 Effects on soil and water environmentsWastewater can be infiltrated in soil, and the wastewater can be purified through contact with soil particles. The best purification occurs in fine grained soil, sandy soil and slit soil particles (Grip et al., 2003).

3.2.3.1 Phosphate and nitratePhosphate and nitrate are balanced in a natural soil and water environments, but the balance may be disturbed by anthropogenic activity. Many wastewater treatment plants are not effective and the effect from the effluents has been more and more visible. Even in Sweden with good functioning treatment plants the water environments around the treatment plants are often affected by eutrophication (due to overflow of nutrients, especially phosphorus from wastewater). Excess phosphorus nutrients stimulate the primary production, which further affects algal production, consumption and use of limited oxygen and oxygen scarcity of the aquatic surrounding as result (Freedman, 1995). The long duration of direct and indirect leakage of effluents from sewage and manure to the environment has sometimes lead to high concentration of nitrate and pathogens in groundwater (Knutsson & Morfeldt, 2002).

3.2.3.2 PathogensThe concern for soil is primarily related to health risks from direct contact or indirectly from contamination of water sources (Wikipedia, 2007h). Soil as a reservoir of certain bacterial pathogens has a larger role in the transmission of enteric diseases than previously known. Many of the diseases caused by agents from soil have been well characterized, although enteric diseases and their link to soil have not been so well studied. Gastrointestinal infections are the most common diseases caused by enteric bacteria, and they are for example cholera, dysentery (Ncbi, 2007). Occurrence of coliform bacteria has been used as an indicator for the environmental contamination by human faeces (Geoflow, 2007). The survival and transport of pathogens are affected by environmental conditions, physical and chemical properties of water and soil in the system as well as the physiological state of the organisms. Pathogens survive generally longer in water and soil environments where available organics matter can be used as nutrients and substrates. Rain fall, channel flow conditions and diffuse sources of faecal pollution are important for transportation of pollutions, since infiltration to soil is not possible and the transportation occur on soil surface and runs over the ground, where soil particles is transported from land to surface water. The spreading is also determined by how long the pathogens has been in the soil, conditions as storage and duration prior to land spreading, but also by factors that affects pathogens survival as high pH, competition. The pathogens size is also one of the factors that play role in transport. Low density micro organisms, which are strongly adhered to soil particles, are not able to transport as easily as those are floating freely in suspension (Tyrell, 2003).

The contamination of subsurface with pathogenic bacteria and viruses happens only in a situation in which contaminated infiltration water pass thorough the unsaturated zone. The bacteria can move readily through aquifer sand, but the transport is affected by water flow velocity, cell concentration and ionic concentration. The existence of a threshold retention capacity is determined by factors such as the proportions of porous materials, cell construction and ionic concentration of the bacterial suspension. Bacterial transport is enhanced at higher cell concentrations. Bacterial transport and spreading is determined by soil retention capacity, and if the retention capacity is reached the bacteria will be able to move more freely or to replace the retained bacteria (Yaron et al., 1996). Water contamination from pathogens and waste will after approximately 60 days clean in a water source without any new addition of contamination (Grip & Rodhe, 2003). Busia Town has many contamination sources both to soil and water environment. There are leakages and contamination of urine and faeces to the soil and water environment, since the water table is higher in some areas in Busia Town. Most people use spring water or well water as water source and the only water treatment in Busia Town’s is for the tap water system. The tap

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water is treated with chlorine, but the remaining water sources are not treated. Households boil their water or buy the water from tap water stances (Massa, personal communication).

3.2.4 Pathogens in wastewaterThere are four microbial pathogen groups; viruses, bacteria, protozoa and helminths. Most of the microbial pathogens originate from faeces. The pathogens from the faecal excreta contaminate the environment and groundwater, and these pathogens can later via these pathways gain access to new hosts (humans, animals) through ingestion from faecal-oral route (Toze, 1997).

VirusesAmong the pathogens viruses are most dangerous to humans, since they are more infectious and require smaller doses to cause infection compared to bacteria and protozoa. Viruses are also more resistant to treatment processes and an untreated wastewater can contain up to 103-104 virus particles/ L of wastewater. The most commonly detected pathogenic viruses in wastewater are the Enteroviruses, but there are also Adenoviruses, Rotaviruses, Astroviruses, Caliciviruse (Toze, 1997).

BacteriaThe most common microbial pathogens found in wastewater are bacteria. Many of the bacterial pathogens are enteric in origin. Some major bacterial pathogens are Vibrio cholera, Shigella species as well as some Salmonella species, E. coli (Enteropathogenic). Enteritis bacteria as Campylobacter, Helicobacter and Arcobacter and non-enteric bacterial as Legionella species, Leptospira interrogans. Toxin producing organisms as Staphylococcus, Salmonella spp., E. coli can cause outbreaks of food poisoning, due to food contamination by water containing toxin producing organisms. Opportunistic pathogens are micro organisms, which causes infections and diseases under optimal conditions (mostly in small children, elderly and immune-compromised persons) and these include Pseudonomas, Streptococcus species. These opportunistic pathogens can be found in both untreated and treated wastewaters, but they are also found in nature since they are members of natural microbial populations in the environment. If there are optimal conditions (nutrients for growth) in the environment these opportunistic pathogens can rapidly increase and present great risk for infectious diseases (Toze, 1997).

ProtozoaProtozoa pathogens are mostly detected in wastewater compared to other environmental sources and the most common are Entamoeba historytica, Giardia intestinalis, Cryptosporidium parvum and they are all enteric pathogens. The enteric pathogens are commonly detected in wastewater which has been contaminated by faecal matter. Infection from these protozoan pathogens occurs after consumption of contaminated food and water with cysts or oocysts. The cysts of the three parasites have increased resistance to temperature increase, change in pH, chlorination etc. Giardia and Cryptosporidium are ubiquitous in fresh and estuarine water and have been detected in many countries around the world. Entamoeba historytica is more widespread in tropical regions but can also be detected in other parts around the world. All the three pathogenic protozoa, Entamoeba historytica, Giardia intestinalis, Cryptosporidium parvum has the human body as reservoir, but they can also have animals (dogs, cats, birds, cattle, other domestic and wild animals) as hosts. These protozoas ability to have multiple hosts influences contamination of both water and wastewater and the risk for humans and animals. Treated or untreated ground water and wastewater, which has been stored in reservoirs or dams prior to use or reuse, generates a high risk to be affected by these protozoa cysts since they are resistant to destruction in the environment (Toze, 1997).

HelminthsHelminth parasites which are commonly detected in wastewaters includes round worm (Ascaris lumbricoides), and hook worm (Ancylostoma duodenale). Helminths (nematodes and tape worms)

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are common intestinal parasites, which as enteric protozoan pathogens are usually transmitted by the faecal-oral route. Some of these parasites need an intermediate host for development prior to becoming infectious for humans. Most of the helminths parasites are endemic in certain regions of the world depending on environmental and socio-economical conditions. The round worm (Ascaris lumbricoides) is endemic in underdeveloped regions as Africa and Asia, but it occurs also in developed regions as Europe, although the infection rates are much lower there compared with the rest of the world. Children have particular problem with helminth infections since it progresses to chronic infections which affect the children. Helminth eggs require moist soil for development of the egg and after a few days they are able to cause infections. An embryonated egg can be infectious and contaminate soil for up to ten years, so the contaminated soil can be a long-term source of these parasites (Toze, 1997). If reuse of untreated or treated excreta and wastewater in agriculture/ aquaculture is not accurately handled it can affect human health. The infections and health risks are greatest when human faecal material is used as a fertiliser for vegetables. Most sensitive are vegetables/fruits consumed without heating/ raw (Ecosanres, 2007a).

3.2.5 Disease transmissionPathogens do need transmission steps to cause damage or diseases in a host as a human body/ animal. The transmission to human body and animals are accomplished through wastewater, sludge, bioaerosol, foam, vectors, contaminated soil and water are. The transmission occurs by direct (from person to person) or indirect (through clothing and eating and drinking utensils) contact or by vehicles and vectors. Vehicles for disease transmission are food, water and air. Contaminated food and water, but also poorly managed water and food, as improper cooked or prepared food, are vehicles for disease transmission. Pathogens can also be transmitted and be present in bioaerosols, droplets, dust, mist and sprays. Pathogenic disease transmission can also have carriers or vectors as flies, mosquitoes, cockroaches, rats (Gerardi et al., 2005).

3.2.6 Health aspects Reuse of treated wastewater is practiced in many western countries today, and there has been some discussion about health effects of it. Although there is no evidence of a connection with reuse of wastewater and health there has been some concerns on health effects as cancer (Harrison, 1996).

3.2.6.1 Infection The first condition for infection to occur is (as mentioned in the Disease Transmission section) that the pathogens that enter the host have sufficient infectious dose or concentration. Depending on the pathogen, the necessary infective dose can be small or high. For Giardia lamblia is four to six cysts are sufficient. The second condition is that the invading pathogen is virulent (that it is active, capable of causing disease). Dead, weakened, damaged or affected pathogens cannot affect and cause diseases. The third condition is that the pathogen must overcome the host’s defence mechanisms, i.e. pathogens have to defeat the hosts (human body) immune-system to be able to affect and cause disease for the host (Toze, 1997).

3.2.6.2 SicknessAccording to statistics from the Ministry of Health in 1999 the malaria incidence was approximately 19 000 cases in Busia District, and totally 2,717,744 cases in whole Uganda. The cholera incident in Busia District was only 7 cases of totally 5,179 cases in Uganda (The Republic of Uganda, 2007f). In Busia Town, with approximately 40,000 citizens, malaria is one of several devastating diseases in the area, according to the health official in Busia Town Council. Even if there are no statistics for more recent years, there has not been any indication in malaria incidence changing in Busia Town. In Solo A’s health centre the monthly number of visitors is approximately 3000 persons, and most of them are seeking help for intestinal diseases, malaria, diarrhoea and there has not been any cholera incident in Busia Town for several years now (Nabwire, personal communication).

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BacteriaGastrointestinal infections are the most common diseases caused by bacterial pathogens and it includes diarrhoea. Some major bacterial pathogens are Vibrio cholera which causes cholera; Shigella species as well as some Salmonella species which causes dysentery; E. coli (Enteropathogenic) which cause dysentery-like infections; Salmonella typhiand which cause typhoid. Acute enteritis in humans is primary caused by Campylobacter, Helicobacter and Arcobacter, where Helicobacter pylori have also been implicated in causing stomach ulcers. Non-enteric bacterial diseases include Legionellosis disease (Legionnaire’s diseases, which is a potentially fatal pneumonia) which is caused by a Legionella species; a Leptospirosis disease (a zoonotic infection which is causing a febrile illness) which is caused by Leptospira interrogans etc. (Toze, 1997).

VirusesThe Enterovirus causes diseases in humans such as upper respiratory infections, aseptic meningitis, hepatitis etc. The other viruses cause, like the Enteroviruses, a range of infections including diarrhoea, pneumonia, conjunctivitis etc. The Rotaviruses, is the most infectious and health hazardous to high health risk groups among the enteric viruses. Small children, elderly and immune-compromised persons, are high health risk groups, and they have the highest infection rate from these viruses (Toze, 1997).

ProtozoaEntamoeba historytica causes dysenteric diseases, but it can also infect the liver, lungs, pericardium, skin and brain. Giardia intestinalis and Cryptosporidium parvum causes acute diarrhoea (Toze, 1997).

HelminthParticularly the smallest children as infants have problems with helminth infections, since it progresses to chronic infections, which affects physical and mental development of the children(Toze, 1997).

3.2.7 Prevention and protection One major prevention from wastewater pathogens is to have a secure sanitation system where no leakage and contamination to the soil or water occurs. The wastewater should not be discharged directly to the surroundings, since the pathogens contaminates and generates a health risk that is dangerous both for adult humans and children, but also for animals, since they can be carriers of some pathogens and the recycling of them in the environment (Ecosanres, 2007 a).

3.2.7.1 Human featureGood hygiene and hand washing is one of the best protections against infections and sickness. Most of the people tend to have problems in areas with insufficient water, when the water source may be fare away. The hygiene is a matter of water access for the households, if there is sufficient amount of water it can be used to also for hygiene, besides to food and water consumption. A proper handling of vegetables and fruits, washing them with water before food preparation and consumption is a good way to avoid pathogens and maintain a safe health (Schönning & Stenström, 2004; Ecosanres, 2007b). A study of diarrhoea morbidity has been made during the 1967 to 1997 (in East Africa). In Uganda 16- 21% of the households in the survey had a diarrhoea increase during a period of twenty years. There were several reasons for the diarrhoea morbidity and the most important reason was poor hygiene, unsafe disposal of excreta and wastewater, but also the level of education in the household head, quality of the water and the water source (Tumwine et al., 2002). To reduce and eliminate the hand-mouth diseases route a proper hygiene is important where the transmission of the micro organism can be taken care of by hand washing with soap, and never eating anything raw before washing it with safe water and to cook and boil

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water if it is unsafe to drink (Nagajja, personal communication). Mosquito net usage is also one of the factors that reduce malaria sicknesses (Nabwire, personal communication).

Promotional material and other handbooks for hand washing, proper and accurate water handling and use are one of the best and effective information tools to be in use in Uganda. Information through newspapers, radio programs, theatre performances, work shops can be used to inform the citizens about how to practice and maintain a good and healthy hygiene regarding water use (Ontagai, personal communication). From the Ministry of Health some guidelines are available for health workers, community leaders, teachers and individuals to ensure a safe water chain and gives further valuable information to the households on how to ensure safe water and hygiene behaviour (The Republic of Uganda, 2005a). When ecological sanitation is chosen as a sanitation option for an area, it needs both to be introduced and accepted for a successful result. The local authorities as for example town councils, administrative officials, health officials, teachers need to be informed and participate in introduction and implementation of ecological sanitation system. If different religious or cultural aspects exist ecological sanitation system should be adapted to the existing circumstances. When the necessary information has reached all levels in the society the ecological sanitation solution can be successful (Panesar et al., 2006).

3.2.7.2 Technical featurePit latrines should be located in buildings downstream from the nearest water source, and if the water table is high the pit should not be below ground to reduce risk of leakage to the surrounding. Uganda has many areas with high water table. The soil is not able to absorb wastewater discharge. The high water table is also one of the contributing reasons why wastewater remains above ground. There is a handbook from the Ministry of Health about how to construct pit latrine toilets on problematic areas. Depending on area geography as soil character, water table level and other important aspects there are different appropriate toilet solutions (The Republic of Uganda, 2002b). Wetlands have a high biological activity and can take care of and transform many common pollutants that occur in conventional wastewater into harmless by product or essential nutrient that can be used for additional biological productivity. This transformation of pollutants is obtained at a low cost and is also easy to operate and maintain (Kadlec & Knight, 1996). Ecological sanitation toilets with different technical constructions and solutions must be modified to suit the site. Promotional material, user guides and information regarding urine diverting toilets has been constructed for several countries around the world for proper operation and management (GTZ, 2007a). Most of the ecological sanitation projects have some difficulties in operating and maintenance according to the experiences, so there is no universal solution. The differences in cultural, geographical and demographic situation require various ecological sanitation technologies (Ecosan, 2007b). Flexibility in sanitation technology is very important in terms of choice of toilet type, use of material, and reasonable economical cost. Ability to replicate the sanitation techniques are essential and would be difficult if the solution was to technical, without subsidies, guidance and economical help is the construction not possible (Wsp, 2007), see also Appendix D and Table D for different sanitation techniques. Since May 2003 a total of 506 EcoSan toilets have been constructed in South Western Uganda. Among these there are 437 households, 36 institutional and 33 public facilities. Urine-diverting dehydration toilet (or Skyloo) is currently the most widely promoted, because it does not affect groundwater, can be built above ground and enables reuse of urine with minimal health risks (Wsp, 2007).

3.3 Ecological sanitation projects in UgandaThe first ecological sanitation project in Uganda started in Kisoro District and there have been many projects since then. In this section three of the ecological sanitation projects will be mentioned and described below.

Project One: In Kisoro District located in South- Western Uganda in Town Kisoro was the first ecological sanitation project in Uganda started in July 1996 (ecological sanitation toilet was built

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1999). The District has compared to remaining Uganda the most densely population, with a population density over 400 inhabitants per km2 in Kisoro Town. Kisoro District geology consists of chains of hill and mountainous region, mountain tops consisting of granite and covers with thin layer of soil, porous volcanic soil and stones. Kisoro District is one of the regions with least economical developed considering the subsistence agriculture. The aim of the project was to provide safe water and improve sanitation facilities to 19 small towns (rural growing centres with populations up to 500-5,000) Kisoro, Kabale and Rukungiri Towns. Sanitation based in Kisoro Town with its pre-urban areas has approximately 20,000 inhabitants. The main purpose with the ecological sanitation projects was to promote dry sanitation toilets in order to reduce possible contamination to ground water sources and environment. Through assurance of water services for all users and equity of access, ensure and make pumped water supply affordable for the community. Improve the sanitation situation in general including the treatment of all generated faecal matter contaminated wastewater. Minimize contaminated wastewater to the water sources and surrounding and reduce the burden of digging pit into the volcanic rocks. Ecological sanitation system was the decided sanitation technology solutions to be used, further implementation of apply composting toilet system. Over 250 units have been built: 1999 did the information campaign started for 140 composting toilets on household level and was built. 2000 was 107 dehydration toilet units built on household level, 4 public units and 3 units on institutional level (Ecosanres, 2007d). In the beginning used 90 % of the household’s pit latrines and had good knowledge of it, but no knowledge about ecological sanitation system and technology. As a consequent was the usage of sanitation system limited and operation of these units was problematic to start with. The users of the private facilities were more interested in a proper use of the toilets and in recycling the sanitised faeces and the reuse of faeces depend on agricultural activities. The household was more interested on employing somebody, to take care, the operation and maintenance of the toilets (for examples remove the products etc.) and to pay the hired person was the fee charged for the toilet use important. The households or owner of the dehydration or composting units was responsible for the products and had the main responsible for handling and reuse of the sterilised faeces material. Farmers were interested in reusing sterilized faeces as manure, collected from the private toilet units, where owner of the toilets sold or supplied the product to the farmers. The general conclusion is that there were still some concern to be solved, further information and promotional material and demonstration plots as campaign about the use of ecological sanitation facilities and the possibility of reuse of faeces and urine are necessary. The households should have more responsibilities in taking care of the sanitation units regarding operation, maintenance and reuse of the toilets (Ecosan, 2007a).

Project Two: Pdimu Landing Site Ecological Sanitation Project in Masaka District located in Kyamamukaaka sub-country on the shores of Lake Victoria, South West of Kampala. Before 2002 were 2,000 citizens living and sharing four stances of lined pit latrine. In March 2002 was two blocks of with each having four stances of double vault latrines constructed with capacity of collecting 500-litre urine in each urine collection tank. A committee of members was constituted for the implementation of the project and co-ordinating the operation and maintenance of the project after completion. For the maintenance of the toilets, pay off cleaner, persuasion of soap, ash collection etc. were each household supposed to pay a fix fee each month for the use of the toilets and for other individuals 1000 UGSH each month for use of the toilets and the other individuals pays for each visit a fee. Of approximately 300 households was only 120 paying the fee from the beginning, which later dropped to 10 paying household. The latrine according to the statistics was used more by women than men and children than adults, mostly of the citizens was still using bushes for defecation. The general effects of the sanitation construction has lead to improved sanitation conditions in the area, the more common used plastic bags for defecation has been long ceased since a sanitation alternative has been provided for the citizens. Women and children has a improved life quality since they no longer need to go to bushes for defecation, they are more secure (less dangerous for them) and have restored their human dignity. There are some challenges that need to be solved since some citizens still use the old existing latrines, and the

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motivation among people to pay a small fee and get proud of using a sanitation facility. People need to be sensitized about basic sanitation and ecological sanitation use, to accept the use of sanitation facilities, instead of bushes etc. Use of water is also not recommendable- as it is urine diverting toilet and faeces is dehydrated for pathogen destruction etc. and is not acceptable among Muslim who use water for anal cleansing. The operation and maintenance of the toilets may still be a problem, a suitable amount of fee and improved supervision of the toilets needs for a better maintenance (Watsanuganda, 2003).

Project Three: Kalungu Girls Secondary School, Kalungu in Masaka District was commenced 2000 and finalized 2003. The girl school had an existing sanitation which needed to be improved both for the pupils and for the school staff. They had approximately 35 pit latrines and no wastewater treatment of any kind and due to shallow ground water table was the wastewater discharged contaminating and threatening the village’s water source. To preserve and protect the environment and water sources a project was started with two options where the first option was of ecological concept and the second option was of conventional sanitation concept. In the ecological sanitation concept with dry urine diversion toilets was 45 units and sewer line for gray water in horizontal subsurface flow constructed wetland approximately 100 m2 considered. In the conventional sanitation concept was flush toilets for students (30 units) separate sewage system for black water, mechanical pre-treatment, pumping station and a vertical surface flow constructed wetland with approximately 500 m2. In Kalungu School was pit latrines replaced by urine diverting dry toilets and the remaining wastewater treatment were taken care by a constructed wetland. Need for improvement of the existing water source supply was also necessary and was solved by renewal of spring catchments’ including filtration, storage, pumping and overflow to provide the local population with water. The sensitizing of ecological sanitation toilets was required and all involved persons as teachers and other staff but also pupils were initiated and sensitized for the use, management and maintaining of the toilets. Reuse of faeces for agriculture is also implemented and a vegetable garden is in use for the purpose (GTZ, 2007b).

4. Results from the field studyThe results from the survey in Busia Town’s two parishes are based on 80 household’s answers (79 available results, since one questionnaire is missing). Comments and result from interview with town officials, health official and YES were also included. From the questionnaire has several aspects been considered and the interesting/ appropriate questions has been analysed from the survey in this chapter. The questions have been divided to several aspects to provide a better understanding. The division of the questions are seen below and for further information see Appendix C. Some of the questions are included in several aspects but will only be covered in one aspect area. The questions that was selected for further analysis from the questionnaire is following:

Socio-cultural (background) aspects with questions 3,4,5,7,9,12,13,15,79,96,97, and 108Water aspect with questions 16,18,19,20,22,23,24,25,26,28 and 29Sanitation aspect with questions 34-38, 40-44, 46-53,55-58, 60-61, 63, 66-67, 108 and 110Without sanitation and water facility aspect with questions 88-89, 93, 95 and 110Waste aspect with questions 68, 72, 73, and 74Health aspect with questions 33, 81-83, 85-87, 100, 103, 106 and108.

4.1 Social and cultural aspectsTribes and religious groupsMost of the people are belonging to tribes as Karamojong, Mugishu, Musamia, Musoga, Samia, Somalians and according to Ontagai Amosiah (YES) is the Somalia'n group in Busia Town large and they have been there (and surrounding towns) more than 10 years. Karamojongs are nomadic tribe and they have their origin in the western part of Uganda (Wikipedia, 2007d), in Busia Town

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does the majority of Karamojongs reside in Solo A. In Both Solo A and Marach are a variety of different religious groups common, in Solo A are 41% Muslims, 26% Catholic, 21% Protestant and in Marach are 35% Muslims, 25% Protestant, 18% Catholic, see Appendix E Table 1 for further information.

Household size and age?People living in Sola (Solo A) have a bigger area compared with Marach and there is even an indusial area with trailer park and market place. The average family size in Solo A consists of 4 persons and in Marach 5 persons. From experience and observation in both parishes the real household size is higher, since an average Ugandan family has more than 6 members. Even if the result gives a low household size the accurate family size is much bigger since some of the households can withhold correct information for different reasons, see Appendix E and Table 2 and Table 3 for further information.

Education level?Educational level in Busia, both for Solo A and Marach is low. According to the results from the respondents the majority are only graduated from primary and secondary school and only one respondent had University bachelor's degree. In Solo A had 43% attended primary school, 36% secondary school, 3% university bachelors degree, 15% no education and 2% had not answered the question. In Marach had 55 % attended primary school, 23 % secondary school, 20% no education and 2% other as answer.

House/ compound ownership status and source of income? Ownership of a house/compound is an indication of the households or families economical level. In Solo A was 54% a tenant, 36% a house owner/landlord and 10% other, while in Marach was 50% a house owner/landlord, 45% a tenant and 5% other. Most of the household’s reside in houses/ compounds/ huts with very few rooms (and with often shared pit latrine). Both Solo A and Marach are poor parishes and the families/ households that are living there are also poor (Ontagai, personal communication). Families in Solo A obtain their income from 36% business (trade, market seller), 33% other (the answer could be anything), 23% peasant (daily worker), 5% salary and 3% don’t know (as answer will this be assumed as not answered the question). In Marach obtained the families income from 53% business (trade, market seller), 28% other (the answer could be anything), 15% peasant (daily worker), 3% salary and 2% no answer. The most common for the families and households are that the income is not regularly (Ontagai, personal communication).

Is here anything the household would like to change/add to their compound/house and availability of piped water supply in the area?Many families are not satisfied with their living conditions and would like to improve it (Ontagai, personal communication). 35% of the households in Solo A would like change/add to the house/ compound a toilet, 26% a wash stand, 23% outside (probably a toilet unit constructed outside), 9% other, 5% inside (the answer could be anything but probably a toilet unit and water facility inside the house) and 2% had not answered the question. 33% of the households in Marach would like to change/add to the house/ compound a toilet, 28% outside (probably a toilet unit constructed outside), 26% a wash stand, 7% inside (the answer could be anything but probably a toilet unit and water facility inside the house), 2% other and 2% had not answered the question.Since all pit latrines is constructed outside due to several reasons would many households like to own a toilet (pit latrine) and have it constructed outside (pit latrine building outside is tradition in many African countries as well as in Uganda). Many house owners when they build houses do not usually build a toilet system (or water pipe system) which results house rents to be cheaper (Ontagai, personal communication). Many households in Busia Town are not connected to pipe water system, there are approximately 3000 paying costumers even if many households pay daily for water that has been obtained from a guarded tap water source (Massa, personal

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communication). Not many households in both Solo A and Marach has accessibility to piped water, in Solo A has 77% of the households not access to pipe water, 21% yes and 2% other. In Marach has 58% of the households access and 42% no access to pipe water. The pipe water system is not covering all Busia Town, only approximately 60% of the town area, the infrastructure and pipelines need to be improved and that is not possible (Massa, personal communication)

Access roads in Solo A and Marach?Busia Town is a low land with some wetland areas, in Solo A is the wetland areas more compared to Marach and it affects the Karamojong tribes mostly (Nagajja, personal communication). The roads in Solo A consist of 55% footpath, 28% murray, 11% all weather road and 6% other (the answer could be anything) and in Marach 70% footpath, 19% murray and 11% all weather road.

Who is responsible for waste refuse dumping and cleaning of pit latrines?The household work, waste dumping is often laid on women and/or children and Busia Town Council together with YES has started on-door collection in specific areas which do not include Solo A or Marach (Ontagai, personal communication). In Solo A the responsible person for household waste dumping to nearest dumping place are 37% women, 37% children, 12% others, 6% housekeeper, 4% men and 3% on door collection by local authority (only in certain access able areas). In Marach 47% women, 33% children, 8% housekeeper, 7% men and 5% on door collection by local authority. Toilet cleaning responsibilities is often laid on women, children and tenants and many pit latrines are usually locked for outsiders so that there are not usages beside a small group of household members etc. (Ontagai, personal communication). The pit latrine cleaning responsibility in Solo A is on 31% tenants, 37% house owner/ landlord, 14% adults, 10% others (probably by a peasant or daily worker etc.) and 2% not answered the question. In Marach 43% tenant, 36% house owner/ landlord, 14% adults, 2% others (probably by a peasant or daily worker etc.), 2% don’t know and 2% not answered the question.

4.2 Water aspectsWhich source of water do the household use and how far away is the main water source?There are water quality problems in Busia Town, and according to latest water analyses there were several contaminated water sources and the water quality is still insufficient, see Appendix F Photo 1 and Photo 2 for different water sources. There are no economical resources to mend contamination and if there were any possibilities to shut down the contaminated water sources would Town Council do it (Nagajja, personal communication). In Solo A 45% of the households are using springs, 16% rain water, 14% tap water and 12% digd well. In Marach 32% of the households are using tap water, 30% springs, 18% rainwater and 9% borehole, see Appendix E Table 4 for further information. Most of the households both in Solo A and Marach has some distance to the nearest water source, and in Solo A 41% of the household had a distance (to water source) of 100 to 200 steps, 36% less than 100 steps, in Marach had 39% less than 100 steps and 27% 100 to 200 steps, see Appendix E Table 5 for further information.

Water quality, safe for drinking, if boiling before drinking and then why?Most of the households consider having safe and good quality water in Busia Town since many still use spring water and other unprotected water sources (Nagajja, personal communication). The water quality in 44% of the households in Solo A is good, 36% average and 10% not good, while 53% of the households in Marach consider having good, 25% average and 22% not good water quality, see Appendix E Table 6 for further information. Many households both in Solo A and Marach believes that the water is safe to use and in Solo A do 54% of the household think the water is safe for drinking, 33% no and 12% don’t know. In Marach 65% of the households believe that the water is safe for drinking, 20% no, 13% don’t know and 2% not answered the question. Many households in Busia Town boil their drinking water, they are well aware of the health risks if it is not boiled (Nagajja, personal communication). In Solo A did 56% of the households not boil

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the water and 44% boil, while in Marach did 58% of the households not boil and 38% boil the drinking water, see Appendix E Table 7 for further information. One reason for the households to boil their drinking water is to avoid germs, see Appendix E and Table 8 for further information.

How much water does each household use per day for drinking/food preparation/ clothes washing? The average household water consumption for Solo A is 60 L/ household or approximately 13 L/ person each day (average household size divided to average water consumption) and for Marach 73 L/ household or approximately 14 L/ person each day for food preparation and drinking. Water consumption for cloth washing etc. is much lesser then the consumption for food, in Solo A is the average water consumption each day 69 L/ household or approximately 15 L/ person (average household size divided to average water consumption) and for Marach 80 L/ household or approximately 15 L/ person. Average total water consumption for drinking/ food preparation and washing clothes etc. would be for both Solo A and Marach 29 L/ person water each day.

If the households pays for water and how much?Water from guarded tap water stances is charged and the price is depending on water source location, the price is in general higher in Solo A compared to Marach (Ontagai, personal communication). In Solo A 47% of the households pays per jerry can and 51% did not pay, while in Marach 65%did pay and 20% not for their water, see Appendix E Table 9 for further information. The average jerry can price is in Solo A was 50 UGSH and in Marach less than 50 UGSH and despite the price differences can many household's not afford to pay the price since many of the families are poor (Ontagai, personal communication). According the results the average water price that the household’s pays in Solo A is 41 UGSH and in Marach 39 UGSH per jerry can, see Appendix E Table 10 for further information.

If the available water is sufficient for the households needs and what kind of problems are there concerning water supply and distribution?Most of the households in both Solo A and Marach consider that they had sufficient water and in Solo A 77% of the households have answered yes, 21% no and 2% has not answered the question. In Marach has 68% answered yes and 32% no if the available water is sufficient for the households needs. Some of the problems regarding water supply that households have in Solo A are 40% far distance, 18% too much people at the water source (especially during dry seasons) and 11% expensive (if they engage a vendor for the water collection). Concerns among households in Marach are 23% too much people at water source (especially during dry seasons), 20% expensive (if they engage a vendor for the water collection), 18% far distance and 14% lack of water during dry season, see Appendix E Table 11 for further information.

4.3 Sanitation aspectsWhat kind of sanitation and system does the household use?Households in Busia Town has different sources of sanitation system as own sanitation, shared with neighbours etc. and there are no public toilet units around the town (Ontagai, personal communication). The pit latrine coverage in Busia Town is generally known to be 60% according to some previous researches and many people use any available pit latrines or open fields as bushes etc. (Nagajja, personal communication). In Solo A 41% of the households use own sanitation and in Marach 45% use own sanitation, for other kind of sanitation that the households are using, see Appendix E Figure 1.

Most of the households in Busia Town are using pit latrines and most of the pit latrines are locked by the owners, and the users usually ask for permission to us the pit latrine. In Solo A use 65% of the households pit latrine, 16% bush and in Marach 83% pit latrine, see Table 1 (next page) for further information.

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Table 1. What kind of sanitation is used in Solo A and MarachKind of sanitation Solo A.

HouseholdSolo A. Percent

Marach.Household

Marach.Percent

Bush (defecation to open fields) 7 16 0 0Plastic bag 4 10 1 2Pit latrine 28 65 38 83Ventilation Improved Pit latrine 0 0 0 0Dry toilet with urine diversion 0 0 0 0Flush toilet with soak away 0 0 0 0Flush toilet with septic tank 0 0 1 2Other 1 2 0 0Don't know 0 0 0 0No answer 3 7 6 13Total 43 100 46 100

Episodes of infectious diseases associated with poor hygiene and sanitation among the households? Many household members that seek help from health centres are there for malaria, diarrhoea and intestinal diseases. The health centre in Solo treats approximately 3000 patients each month and they treats patients from all Busia Town, even if there are many poor families do most of them seek help for their problems. In Busia Town there has not been any cholera episode in 5 years (Nabwire, personal communication). Most of the households both in Solo A and Marach are suffering from malaria and diarrhoea diseases, see Appendix E Table 12 for further information.

How many people and who use this sanitation system?Since many of the households use shared pit latrine with their neighbours each unit has more than 10 users (Nagajja, personal communication). From observations in Solo A are a majority of the detected pit latrines often locked for outsiders (only family members, neighbours etc. are allowed to use the pit latrines). The number of people that use sanitation in Solo A are 33% 11-20 people, 26% 5-10 people and 22% more than 20 people, in Marach 33% 5-10 people, 27% 11-20 people and 27% more than 20 people, see Appendix E Table13 for further information. Sometimes can the pit latrines be used by guests, neighbours, and a person who pass by and takes the opportunity to use an available pit latrine (Ontagai, personal communication). According to the results in Solo A and in Marach is the pit latrines used by adults, guests, children etc., see Appendix E Table 14 for further information.

What kind of sanitation system does the households know about?Many of the households have knowledge of pit latrine, since pit latrines are common in Uganda. But people also have knowledge of other sanitation systems as VIP, flush toilet etc. (Nagajja, personal communication). In Solo A has 72% and in Marach has 78% of the households knowledge of pit latrine, see Appendix E Table 15 for further information.

Who build and paid the sanitation system and how is the sanitation system equipped?The house owner, landlord or a neighbour are often the one who built the sanitation system. In Solo A was 79% of the sanitation system built by house owner and in Marach 92% of the sanitation system was built by house owner, see Table 2 (next page) for further information.

Pit latrines can be of various standards and from observation in both Solo A and Marach are most of them are very simple built with walls, door and roof. The walls are often made by a combination of mud and straws, the doors made of wood, branches, straw waived or other simple plain material from nature. The roof made by simple brunches, straws, mud, metal pieces etc. and a few sanitation systems are equipped with electricity (constructed inside houses and most likely a flush toilet).

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Table 2. Who has built and pay for the sanitation in Solo A and Marach?Who built, paid the system? Solo A.


Marach.Household

Marach.Percent

House owner/ members 31 79 37 92.5Local authorities 0 0 0 0Neighbour 3 8 3 7.5NGO’s 0 0 0 0Other (Organisations etc.) 1 3 0 0Don't know 0 0 0 0No answer 4 10 0 0Total 39 100 40 100

Most (all) pit latrines are built outdoors and there are usually no electricity connection to the sanitation system for outdoor pit latrine (Ontagai, personal communication). See Appendix F and Photo 3 and Photo 4 that shows the state of some pit latrines located in Solo A and Marach. In both Solo A and Marach are the most common pit latrines equipped with roof and door, see Table 3 for further information.

Table 3. What is the sanitation system equipped with in Solo A and Marach.What is the sanitation equipped with? Solo A.


Marach.Household

Marach.Percent

Door 29 38 29 36Roof 34 43 39 49Toilet pedestal 1 1 4 5Toilet cover 4 5 2 2Window 4 5 3 4Electricity 0 0 2 2Other 3 4 1 1Don't know 0 0 0 0No answer 4 5 0 0Total 79 100 80 100

Pit latrine maintaining and observation of pit latrinesFrom the pit latrines observations indicates that in Solo A is 41% clean and in Marach is 62% clean, see Appendix E Table 16 for further information. The conditions for the pit latrines are similar for both Solo A and Marach regarding smell, flies, maggots from the observed pit latrines, see Appendix E Table 17 for further information.

How is the household’s toilet system functioning?According to 47% of the households in Solo A and 48% in Marach that the households toilet system is functioning good, see Appendix E Table 18 for further information.

Is hand washing facility available?The question concerning if the households have water facility available is to complex to explain, but 23% of the households in both Solo A and Marach has no hand washing facilities available outside/ near the toilet, see Appendix E Table 19 further information.

How often is the toilet system emptied, where will the content be disposed/ emptied, who does emptying the toilet and what are the costs? Most of the households in Busia Town empty their pit latrine depending on how frequently it is used, and the emptying is done by both household members, daily workers and vendors because it is the cheapest way to empty the pit latrine. They discharge the waste to open fields, probably to a nearby bush since it’s often very expensive to take care of waste on other ways as paying for a

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waste collector operator (Ontagai, personal communication). In Solo A has 77% of households and in Marach has 83 of the households never emptied pit latrine before, see Table 4 for further information.

If the pit latrines are emptied will the content probably be discharged to an open field or to nearest drainage by a worker/ vendor, since emptying by a private operator is usually too expensive for many households (Ontagai, personal communication). Many households in both Solo A and Marach has not answered where the content would be disposed/ emptied, who does the emptying and how much it costs (see Appendix E Table 20, Table 21 and Table 22 for further information). Three households had according to the results paid for emptying pit latrine and only one household in Marach had paid 6000 UGSH (to a vendor) for emptying pit latrine.

Table 4. How often do the household empty the toilet system in Solo A and Marach?How often do the household empty the toilet/ sanitation

Solo A. Household

Solo A. Percent

Marach.Household

Marach.Percent

Never emptied before 30 77 33 83Less than once per year 0 0 2 5Annually 2 5 1 2Twice a year 1 2 0 0Other 2 5 0 0Don't know 0 0 0 0No answer 4 10 4 10Total 39 100 40 100

Where do the households dispose/empty of the households discharged washing water etc.?In Solo A 63% of the households dispose their water to open field, 21% other (the answer could be anything), 12% to drainage, 5% to a pit latrine while in Marach disposed 51% of the households their water to open field, 22% to pit latrine, 12% sink and sewer, 10% other (the answer could be anything), 3% to drainage and 2% not answered the question

How deep toilet system has the households?Pit latrines in Busia Town, especially in Solo A and Marach parishes are not so deep since there are some wetland areas and the water table is high (Nagajja, personal communication). In Solo A 53% of the pit-holes are deeper than 10 feet, 15% 5-10 feet, 12% other (the answer could be anything) and 18% not answered the question. In Marach 55% of the pit-holes deeper than 10 feet, 15% 5-10 feet, 10% other (the answer could be anything), 2% don’t know and 18% not answered the question.

What is the distance to the nearest water source and the household’s pit latrine?Most of the pit latrines in both Solo A and Marach have more than 20 steps from water source and the pit latrines. 67% of the households in Solo A has a distance more than 20 steps, 13% other (the answer could be anything), 10% 10-20 steps, 3% 2-10 steps and 8% not answered the question. In Marach has 73% a distance more than 20 steps, 8% 10-20 steps, 5% other (the answer could be anything) and 5% of the households had not answered the question.

Why did the household select this kind of sanitation system and what kind of sanitation system did the household use before (before the current one now)?29% of the households in Solo A have selected the sanitation due to tradition, 22% by knowledge from before, 26% for other reason, 20% cost (cheap to built) and 3% don’t know. In Marach 68% of the households have selected the sanitation system because of knowledge, 20% tradition, 5% cost, 5% has no answer for the question and 3% for other reason. Many households in Solo A and Marach has shared pit latrines with their neighbours where 32% in Solo A and 53% in Marach has shared pit latrines, see Appendix E Figure 2 for further information.

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Which problem do the household have concerning the toilet system?According to the results has most of the households in Solo A and Marach concerns regarding smell, flies, cleanliness, difficult use for children, waste dumping, lack of security for women etc., see Appendix E Table 23 for further information.

What are the challenges for the household regarding sanitation improvement?The challenges that households in Solo A and Marach has regarding sanitation improvement are similar. In Solo A 44% has economic limitations, 25% not participation of other people and 10% no challenges, while in Marach has 30% of the households economic limitations, 23% no challenges and 10% not participation of other people, see Appendix E Table 24 for further information.

If the household could consider to use ecological sanitation toilets, in form of separation between urine, faeces and cleansing water from each other in different containers and why?64% of the households in Solo A could consider to use ecological sanitation, 18% not, 13% don’t know and 5% not answered the question and in Marach could 88% of the households consider to use ecological sanitation and12% not. Some of the explanations for why the households could consider using ecological sanitation in both Solo A and Marach are listed in Table 5.

Table 5. Why the household would consider to use (not use) ecological sanitation toilets in Solo A and Marach. Consideration to use Solo A.


Marach.Household

Marach.Percent

Many people can use it 3 8 2 5Because it is costly/ economically limitations 5 13 5 12Not secure, collapse during rain 0 0 1 3Because it is not costly 2 5 2 5Personally not useful 1 3 0 0Good with separation of urine/faeces 1 3 1 2Easy and good to use 7 18 25 58Hygienic 7 18 4 9Fertilizer/soil improver 3 8 1 2High water table 2 5 0 0No space to build 1 3 0 0No information before 1 2 0 0Don't know 1 2 1 2No answer 5 12 1 2Total 39 100 43 100

Could the household consider to reusing urine or faeces as a fertilizer and soil improver in crops, framing, fruit and other tree kinds etc., explain why?This question was to complex formulated, which affects the understanding and possibility to explain the answer, see Appendix E Table 25 and Table 26 for further information. Depending on usage (crops, farming etc.) and what to use as fertiliser or soil improver many households in both Solo A and Marach has considered to use (or not ) fertiliser/ soil improver. 11 households in Solo A and 22 households in Marach did not answer the question, but the households in Solo A were more interested in reuse of urine/faeces compared to the households in Marach. The explanation for why the households could consider using or not using ecological sanitation can be seen in Table 6 for further information.

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What would the household like to do with urine and faeces and the reason why?17% of the households in Solo A could consider to use urine as fertilizer and 17% faeces as soil improver while 10% of the households in Marach could consider to use urine as fertilizer and 10% faeces as soil improver, see Appendix E and Table 27 for further information. Explanation on why households would like to do with urine/faeces in Solo A and Marach, see Appendix E Table 28 for further information.

Table 6. Why the households could consider to reuse or not urine/faeces in Solo A and Marach?Reason for why the household could use/not use urine/ faeces?

Solo A. Household

Solo A. Percent

Marach.Household

Marach.Percent

Because it can increase production 3 8 2 5Not hygienically to handle with u/f 4 10 0 0Soil improvement 9 23 5 12No garden 4 10 7 18Don’t know 3 8 2 5No answer 16 41 24 60Total 39 100 40 100

How much would the household be willing to pay for ecological sanitation system?10% of the households in Solo A was willing to pay 20 000 UGSH, 15% to pay 10 000 UGSH while in Marach was 13% willing to pay 20 000 UGSH and 22% to pay 10 000 UGSH. In Solo A was 23% of the households and 10% in Marach willing to pay less than 1 000 UGSH, see Appendix E Table 29 for further information.

Have the household heard about ecological sanitation system, if yes then from whom and would the household recommend it to other, give reason for the response!The source from where the households had heard about ecological sanitation system in Solo A are 34% from others as health workers (NGO’s), 26% from friends, 17% from sanitation projects, 13% from media, 8% from church and 2% from masons. In Marach had the households heard about ecological sanitation 26% from others as health workers (NGO’s), 24% from friends, 24% from sanitation projects, 19% from media and 7 % from church. Many households would both in Solo A and Marach recommend ecological sanitation to others. In Solo A would 87% recommend it to others and 13% would not recommend, while in Marach would 98% recommend and 2% would not recommend ecological sanitation system to others. Reason for why households would recommend (or not) ecological sanitation to other people is often because of improved sanitation. In Solo A could 73% and in Marach 86% of the households recommend ecological sanitation to other people due to sanitation improvement, see Table 7 for further information.

Table 7. Reason for why the households would recommend to other people in Solo A and Marach.Reason Solo A.


Marach.Household

Marach.Percent

Can be used by many people 4 10 4 10Sanitation improvement 28 73 35 86Have never used it before 2 5 1 2Dispose of waste 1 3 0 0Cheap to construct 1 2 1 2Don't know 1 2 0 0No answer 2 5 0 0Total 39 100 41 100

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4.4 Without sanitation aspectHow do household dispose of excreta?For people without any sanitation system of their own, use different solutions to solve their sanitation situation. Some of them use other peoples pit latrines (if possible), plastic bags, bushes, open fields (Nagajja, personal communication). Both in Solo A and Marach do households without pit latrine solve their sanitation problem by using public toilet, bush etc., see Table 8 further information. But regardless of the result in Table 8 do most of the households in both Solo A and Marach use open defecation (flying plastic bags, bush, other, don’t know and no answer could be interpreted as that the households has no sanitation system to use) and there are only a few public toilets in Busia Town and common citizens has not access to them (Ontagai, personal communication).

Table 8. How do the household dispose of human excreta in Solo A and Marach?How do the household dispose of human excreta

Solo A. Household

Solo A. Percent

Marach.Household

Marach.Percent

Flying bags 7 12 0 0Bush 12 20 0 0Public toilet 16 27 16 38Neighbours 10 17 8 19Other 11 18 5 12Latrine 1 1 0 0Own 0 0 2 5Don't know 0 0 0 0No answer 3 5 11 26Total 60 100 42 100

If the households would like to have sanitation system, if yes what prevents from obtaining it and if no, why does the household not want it?Many households would like to obtain sanitation system both in Solo A and in Marach. 82% of the households in Solo A would like to have sanitation system, 10% don’t want sanitation system and 7% has not answered the question. In Marach would 70% of the households like to have sanitation system, 15% don’t want sanitation system and 15% has not answered the question. The most common reason that prevents the households to build or access a sanitation system in both Solo A and Marach is economical, see Appendix E Table 30 for further information. Many households do not want to have own pit latrine since it costs to build one or that they are a tenant and the responsibility is on the house owner/ landlord (Ontagai, personal communication). The reason to why the households do not want to building/accessing a sanitation system in Solo A and Marach are for many households economical. The question has not been answered by many households so there is a lack of information, see Appendix E Table 31 for further information.

If the household would like to have sanitation, which sanitation system would be best for the household and reasons for the choice?Many households needs to be sanitized about ecological sanitation, they need to be informed about the benefits of an ecological sanitation system usage; how to construct, operate and maintain it but also how to carry on with the reuse of faeces/ urine in agriculture since it is a good and beneficial system (Nagajja, personal communication). Many households in Solo A and Marach are still interested in pit latrine as sanitation option, in Solo A 38% and in Marach 42% of the households would like to have ecological sanitation, see Table 9 (next page) for further information.

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Table 9. If the household wants sanitation, which sanitation system would be best for the household in Solo A and Marach?Choice of sanitation Solo A.


Marach.Household

Marach.Percent

Pit latrine 18 45 12 29VIP’s 1 2 1 2Flush toilet with septic tank 2 5 5 12Ecosan 15 38 17 42Other 0 0 0 0Don't know 0 0 0 0No answer 4 10 6 15Total 40 100 41 100

The choice of the households regarding sanitation form is often depending on economical, traditional and maintenance reasons. 31% of the households in Solo A and Marach in 43% would choose it because it is easy to use, see Appendix E Table 32 for further information.

What kind of water facility would the household like to have and where?Since most households are renting their houses/ compounds are they not willing to pay for a piped water facility (to expensive to have water inside the houses). Many households would still like to have access to water facility of some kind to kitchen, toilet etc. (Ontagai, personal communication). 26% of the households in Solo A and 25% in Marach would like a water facility for kitchen, see Appendix E Figure 3 for further information.

What kind of challenges do the household meet in dealing with sanitation improvement?Most of the households in Busia Town regarding sanitation improvement challenges are due to economical limitations but also due to that the people need to be more sensitizing on sanitation (Ontagai, personal communication). See Appendix E Table 33 for what kind of challenges the households in Solo A and Marach do deals with regarding sanitation improvement.

4.5 Waste aspectWhat kind of waste do the households have?The kind of waste is very mixed in Busia Town, most common for the households is to have organic refuse, paper and plastic waste (Ontagai, personal communication). The kind of waste that households in Solo A has is 51% organic and food refuse, 22% paper, 18% plastic, 3% glass, 3% metal and 3% other waste products. The households in Marach has 44% organic and food refuse, 24% plastic, 22% paper, 3% glass, 5% other and 1% metal waste products.

How far is nearest dumping facility for the household?There are few existing waste dumping facilities (bunkers) in Busia Town and most of them are either full or not sufficient for household wastes. Waste collection by private operator is not occurring regularly (Ontagai, personal communication). 54% of the households in Solo A has distance to dumping facility less then 100 steps, 20% 100-200 steps, 13% more than 1000 steps, 8% 200-500 steps and 5% 500-1000 steps to the nearest waste facility. 43% of the households in Marach has distant to dumping facility less then 100 steps, 30% 100-200 steps, 13% 500-1000 steps, 7% 200-500 steps, 5% more than 1000 steps and 2% had not answered the question.See Appendix F Photo 5 and Photo 6 for further information on waste dumping in Solo A and Marach parishes.

Where do households dump their waste refuse?When the households dumps their refuse do they generally deposit it within their near area, to an open field or plot, (if available) to a bunker. The organic refuse are collected and delivered to local

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farmers in Busia Town’s vicinity as composting and soil improver for agriculture. Busia Town has started collection of organic refuse from Solo parish’s market area and the people are aware of organic waste collection, see Appendix F Photo 7 (Ontagai, personal communication). In Solo A 35% of the households dumps to open dump/ field and 23% to collection bunker, while in Marach 29% of the households dumps to open dump and 22% collection bunker, see Appendix E Table 34 for further information.

How often is the skip/bunker emptied by Busia Town’s local authorities?Busia Town council do not own their waste collection truck and has to rent from private operators from other towns as Totoro, and the waste collection occur several times a month. YES members and other volunteers clean up Busia Town from time to time (Bisa, personal communication). See Appendix E Table 35 for further information on how often the skip/bunker is emptied by Busia Town’s local authorities.

4. 6 Health aspectWhich health problems are transmitted through unsafe water?For the households is the most common health problems in Solo A 25% diarrhoea, 20% cholera, 18% typhoid, 17% dysentery, 17% intestinal infectious diseases, 3% other (which can be anything) and 1% had not answered the question. In Marach 28% typhoid, 26% diarrhoea, 16% dysentery, 14% cholera, 12% intestinal infectious diseases and 3% other (this can be anything).

Do the household members seek help for the treatment of the diseases?Most of the households seeks help for their diseases and in Solo A seeks 82% help, 15% does not seek help and 3% not answered the question. In Marach seeks 98% of the households help and 2% does not seek help for treatment of diseases.

Do the household members practise hand washing and have the household members been informed about good hygiene behaviour etc.?Most of the households are practising hand washing, in Solo A are 92% and in Marach are 88% practising hand washing, see Appendix E and Table 36 for further information, when household members practise hand washing (as after defecation, before food preparation etc.). The household members have been (gained) informed about good hygiene behaviour from several sources as through radio, churches, schools etc. In Solo A obtained 28% of the households formation about good hygiene behaviour in hand washing through radio and theatre groups, 25% through school and educators, 19% via community activities, 17% through newspapers and posters/brochures, 9% via government and 2% has not been informed about hygiene behaviour. In Marach obtained 28% of the households information about good hygiene behaviour in hand washing through school and educators, 25%through radio and theatre groups, 17% through newspapers and posters/brochures 19% via community activities, 7% via government and 4% has not been informed about hygiene behaviour.

What disease vectors in this area do the household relate due to poor waste management?The most concerned disease vector for the households in Solo A are 30% mosquitoes, 29% flies, 22% rats/ mice, 11% stray dogs, 8% other, while in Marach are 33% mosquitoes, 30% flies, 21% rats/mice, 7% other, 6% stray dogs and 2% don’t know as answer to the question.

Have the household made any changes in hygiene behaviour to avoid disease transmission, when did the changing start? Has neighbourhood changed their hygiene behaviour during the last year?Many households has made some sort of changes in their hygiene behaviour to avoid diseases, see Appendix E Table 37 for further information about what kind of changes the households has made in Solo A and Marach. Many households believes that behaviour change can prevent diseases and 95% of the households in Solo A believes that the diseases can be prevented by behaviour change,

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3% does not believe in behaviour change and 2% had not answered the question. 98% of the households in Marach believe that diseases can be prevented by behaviour change and 2% had not answered the question. The behaviour change according to the results from the households shows that 58% of the households started behaviour change in Solo A within or shorter than 12 months, 24% made changes longer than 12 months, 10% has not answered the question and 8% did not know. In Marach has 58% of the households made behaviour changes within or shorter than 12 month, 22% made changes longer than 12 month, 15% did not know and 5% has not answers the question. During the last one year did some of the households in Solo A and Marach believe that their neighbours /tenants had made changes in their hygiene behaviour. In Solo A believes 42% of the households that their neighbours /tenants has changed behaviour, 34% do not think that their neighbours has made any changes, 18% don’t know and 6% has not answered the question. In Marach believes 52% of the households that their neighbours/ tenants has changed behaviour, 10% do not think that their neighbours has made any changes, 33% don’t know and 5% has not answered the question. Many of the household member or respondent would voluntarily participate in cleaning up activities in the near locality and home stead. 89% of the households in Solo A would voluntarily participate, 5% would not participate, 3% don’t know and 3% has not answered the question while 90% of the households in Marach would voluntarily participate for clean up activities, 5% would not participating and 5% would hire (pay) someone for the cleaning up activities in the near locality and home stead.

Are there any reasons (for the household to know) why people/community doesn’t use toilets some times in the locality, is the reason traditional or cultural?Karamojong is one of the tribes who usually do not use any sanitation kind, it is mostly associated to their living traditions and cultural background (Nagajja, personal communication). See Appendix F and Photo 8 and Photo 9 where open defecation occur in both Solo A and Marach Many households in Buisa Town lack own sanitation system and they usually share pit latrine with many households (Ontagai, personal communication). But according to a survey done by Busia Town Council has 86% of the households in Busia Town (in some way) accessibility to a sanitation system (Tuhanmagyezi & Namukasa, 2007). In Solo A has 22% of the households giving reason to why people/ community does not use toilets because that there are no toilet around/ lack of space for toilet and 15% because of cultural believes. In Marach 27% of the households has giving reason to why people/community does not use toilets because of cultural believes, 22% no toilet around/ lack of space for toilet, see Appendix E Table 38 for further information. For result of why people in the community do not use toilets in their locality, see Appendix E Table 39 for further information.

5. Discussion

5.1 Literature studyThe most common used sanitation techniques in Uganda are pit latrines and VIP’s (flush toilets exists but it is not so widespread). Besides the sewage channel and the wastewater treatment plant in Kampala most households in other towns and villages have no wastewater treatment at all. The discharged untreated wastewater leads to contamination of the nearest recipient (water and soil environments) and affects people’s health and daily life. Many people in Uganda catch diseases as malaria, diarrhoea, cholera. To protect environment and prevent diseases from wastewater and pathogens a secure sanitation system and wastewater treatment is crucial. But the citizens can also practice improved hygiene behaviour to protect and maintain a good health, which can be achieved by information from promotional materials, radio etc. Ecological sanitation is a sanitation concept where wastewater from the sanitation system is taken care of and has a minimum effect to environment. Ecological sanitation system has great capacity (many people can use it), cheap construction (depending on material and technique), easy to maintain and operate compared to other sanitation systems if the users are well-informed. Differences in demographical, geographical and cultural situation require various ecological sanitation technologies and solutions that must be

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modified to be successful as a sanitation option. Flexibility in sanitation technology is very important in term of choice of toilet type, use of material, economical cost, and according to experiences from ecological sanitation projects, citizens need to be sensitized and informed about it. Ecological sanitation has been implemented in Uganda since 1996 (by help from foreign countries) and has been slowly changing the people’s perception and acceptance. More than 7000 ecological sanitation units have been built and there are a lot of ecological sanitation projects on-going in many districts and towns in Uganda. The implementation and operation of ecological sanitation have been slow due to reasons as cultural and traditional prejudice but also lack of knowledge about ecological sanitation. To overcome these obstacles the projects have been modified to fit the operated areas and the citizens. Every area has specific conditions and the sanitation solution has to be adapted to the conditions, since there is no universal solution. Certain flexibility is necessary for ecological sanitation as sanitation option to succeed in Uganda. Experience of ecological sanitation projects in Uganda is that the citizens have to be informed and sensitized about ecological sanitation, when the sensitizing and adaptation is accepted will ecological sanitation as sanitation option be successfully. A general conclusion from ecological sanitation projects is that more information and promotional material needs to be given to the citizens on ecological sanitation and hygiene behaviour. Sensitizing on ecological sanitation systems (toilets) is required and all involved parts in the society as local leaders, officials, teachers, parents and children needs to be initiated and sensitized on the toilets usage, management and maintenance.

5. 2 Survey study5.2.1 Social and cultural aspects Both in Solo A and Marach Karamojong, Mugishu, Musamia, Musoga, Samia and Somalian are the major groups, and the Muslim population in Busia Town is 60%. In Solo A 41% and in Marach 35% of the households was Muslims, while in Solo A 31% and in Marach 63% of the households was Christians. According to officials and experiences from ecological sanitation projects have there been concerns on ecological sanitation implementation and adaptation for the Muslim group as well as for Karamojong regarding acceptance of ecological sanitation. The Muslim and Karamojong groups in both parishes are not in majority and will therefore not be a problem for implementation of ecological sanitation in Solo A and Marach or in other parishes in Busia Town. Most of the households in Busia Town especially in Solo A compared to Marach are poor families with low income level with an average family size of four persons (probably more than four since many Ugandan families consist on more than four family members). In Solo A are there more tenant households compared to Marach and even if many households lives under simple conditions many of them would like to improve their living standard. Households in both Solo A and Marachi would like to add toilet- and water facility, usually outside, since all pit latrines are constructed outside due to common tradition in Uganda. Usually house owners prefers not to built toilet and water facilities since it is costly and not ’’necessary” and the standard is often accepted by tenants since the rent is cheaper without toilet and tap water facilities. Domestic work as pit latrine cleaning, waste dumping, and collection of water in both Solo A and Marach is in charge on women and children. Busia Town has many wetland areas and it affects people’s daily life, especially Karamojong tribe who lives in Solo A area.

5.2.2Water aspects The water pipe system coverage in Busia Town is 60%, and it is not available for all households, depending on the town’s infrastructure and accessibility for the houses. Therefore households use alternative water sources as springs, dig wells and shadoof (which does not cost) or tap water stances (cost per jerry can). Households in Marach have access to tap water more than households in Solo A ,but households in both parishes generally use other water sources as spring, shadoof and a majority of the households has more than 100 steps to nearest water source. Some of the concerns regarding water supply and source for the households are far distance, to many people at

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the water source and shortage of water during dry seasons. Busia Town’s private water operator is the only responsible for water distribution and the only treatment tap water gets is by chlorine. Other water sources as springs, dig wells, boreholes etc. are not protected and the water quality are questionable even if a majority of the households in both Solo A and Marach think that their water quality is good and safe to use. Despite ’’good and safe’’ water households in Solo A (44%) and in Marach (38%) boil their water to avoid germs. The average household water consumption for food preparation, drinking, cloth washing, hygiene etc. are similar in both parishes; total water consumption is 29 L water per person each day. Many of the households in both Solo A and Marach thinks that the available water is sufficient for the household consumption, even if the consumed water quantity is lower compared to a western standard.

5.2.3 Sanitation aspects In Busia Town is the pit latrine coverage 40 % and it is often shared by many people. They are usually in various condition and standard. Most of the toilets are in a distance of more than 30 m from the houses/compounds, which indicates that most of the households use a common shared pit latrine (Tuhanmagyezi & Namukasa, 2007). The Muslim group and Karamojong tribes in Busia Town are, according to many people, some of the groups who need to be sensitized about ecological sanitation when it is introduce in Busia Town, the different tribes and groups need to accept ecological sanitation as a sanitation option to be successful (Ontagai, personal communication). Many households in both Solo A and Marach have own sanitation (41% in Solo A and 45% in Marach) and shared sanitation with neighbours (26% in Solo A and 18% in Marach) according to the results. Pit latrine was the kind of sanitation many households used both in Solo A and Marach, in Solo A 65% and in Marach 83% of the households use pit latrine. Even if the survey results from the households indicate a higher number of pit latrine and sanitation users, open defecation and lack of substantial sanitation in these parishes can not be insignificant. Many households in both Solo A and Marach has never emptied a pit latrine and due to high water table and wetland areas pit latrines are not built deep, and have usually a distance of more than 20 steps to water source. But the effect and contamination to water and soil occurs due to the leakage from the pit latrines. Many households in Solo A (64%) and in Marach (88%) could consider using ecological sanitation despite the fact that many households has not answered the question if they could consider reuse urine/ faeces as fertilizer/ soil improver in agriculture. Some of the explanation for why the households could consider using ecological sanitation is that it is easy to use, it is hygienic. Other reason not to use it is because it is costly and the persons have no reasons to use fertilizer/ soil improver in agriculture. Households have heard of ecological sanitation system from NGO’s, health workers, friends, sanitation projects, church’s and would recommend other households of ecological sanitation due to sanitation improvements in the surrounding and health improvements. In Solo A 73% and in Marach 85% of the households would recommend ecological sanitation because of sanitation improvement.

5.2.4 Without sanitation For people without any sanitation system of their own use neighbours/ shared pit latrines, plastic bags, open fields and bushes. Open defecation is common in both Solo A and Marach and occurs mainly during night time for the adults especially women and men, while children defecates both day and nighttimes. Most of the households without sanitation system would like to have a sanitation device and usually a pit latrine since they are most comfortable and is most common in the area. But due to economical reasons (they can not afford it) or since they are a tenant the toilet building often controlled by the landlord. In Solo A 82% and in Marach 70% of the households would want own sanitation, and the household’s choice of sanitation system is often depending on economical, traditional and maintenance reasons. Many households in Solo A and Marach would like to have sanitation system as pit latrine, ecological sanitation and flush toilet, since it can be used by many people, easy to use and cheap to build. In Solo A 45% of the households would like to have pit latrine, 38% ecological sanitation, while in Marach 42% of the households would like to have ecological sanitation, 29 % pit latrine and 12% flush toilet. The kind of challenges the

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households meets in dealing with sanitation improvement are economical but also that they need more sensitizing about sanitation etc. There is need of more information about sanitation constructions, operation and maintaining of ecological sanitation system and dealing with reuse of faeces and urine (as fertilizer and soil improver) in agriculture.

5.2.5 Waste aspectThere are few existing waste dumping bunkers in Busia Town and most of them are either full or not sufficient for many of the household’s wastes, the collection by private operator is not regular since Busia Town has limited economic resources and waste collection by a private operator is expensive. The waste that in both parishes is similar and the biggest waste product is organic and food refuse, plastic and paper, while glass, metal and other waste product is in smaller quantity. Only organic refuse from Solo A’s market place is regularly collected and the collection started 2007. One of the reasons for organic refuse collection is that the market area has to be kept clean and the refuse can also be used as compost in agriculture and as animal food for local farmer’s cattle. There are future plans on collection and reuse of organic waste and plastic waste in Busia Town. A majority of the households in both Solo A and Marach has not far to a dumping site, less than 100 steps, which indicates that they dump their waste to near surroundings and affects their near environment. Busia Town Council empties waste bins near the Town Council and major road areas regularly if it is possible. Beside Busia Town Council are YES members and other town citizens active in cleaning up the surroundings. YES has a clean up Friday each month where a part or area of Busia Town open waste and other dumping sites are taken care of and cleaned up.

5.2.6 Health aspect Many households in Busia Town are suffering from diseases as malaria, diarrhoea and other intestinal diseases. There are several health centres where people can get help and Solo parishes health centre receive approximately 3000 patients each month. The disease vectors in the area according to both households in Solo A and Marach is related to poor waste management; mosquitoes, flies, rats and mice. Proper and good hygiene information is according to the households mainly obtained from school and educators, community activities, newspapers and posters/brochures, radio and theatre groups. The behaviour changes that the households have made to avoid disease transmission or contact is to conduct and maintain a better hygiene to prevent sickness, and many households in both Solo A and Marach have made changes to prevent sickness and maintained better hygiene. In Solo A and Marach would many households and member voluntarily participate in clean up activities in their locality and areas and one of many reasons for why people/ community not use toilets in their locality is lack of sanitation systems in the community but also cultural and traditional reason for not using sanitation.

6. ConclusionThe field study observations in Busia Town indicates that many households in Busia Town have no access to sanitation, only 41% of the households in Solo A and 45% of the households in Marach has own sanitation. For a sustainable development is the situation in Busia Town not tolerable, due to many reasons. Citizens need to change their behaviour and lifestyle as much as it is possible, to obtain good health and environment.

Why implement ecological sanitation in Busia Town (Uganda)? Are there other sanitation options/ technology?Ecological sanitation system is a solution for areas where no wastewater treatment plant is existing and where there are limited water sources. With ecological sanitation system there will be no wastewater discharge and limited water consumption (for this kind of system), and where contamination to the soil and water environment will be minimized. When ecological sanitation toilets are used properly it will provide urine and faeces as fertilizer and soil improver products which can be used in agriculture. The households will gain income for selling their fertilizers and the farmers will gain natural and cheap fertilizer instead of expensive chemical fertilizers.

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Even if cities like Kampala has other sanitation techniques as flush water toilets and wastewater treatment plant the remaining Uganda is not as well developed as Kampala city. To build and maintain a well functioning infrastructure and operate it requires a good economy and management in a town and many towns and districts in Uganda has not the capacity due to lack of economy. Flush toilet that is connected to a septic tank is an option but it also requires a good management, since the septic tank needs to be emptied from time to time. Many households can not afford either to have flush toilet or maintaining it since the system require a lot of water and many households have no tap water connection to the house. The traditional pit latrine with septic tank connection is an alternative but is also requires a good maintenance and emptying from time to time. If the wastewater content is not properly discharged and taken care of there will still be problem with pathogens and other material that will affect and contaminate the discharged area.

Experiences from existing ecological sanitation projects in Uganda.Result from the three mentioned ecological sanitation projects is that they all are successful even if there has been some problem with the operation and maintenance of the toilets. One of the major obstacles that ecological sanitation needs to achieve is that the people need to be better sensitized about different sanitation techniques and functioning. When the people has been informed and sensitized about operation and maintenance but also for reuse of the products many of the fears and problems regarding ecological sanitation will diminish. There have been concerns about Muslim and Karamojong population and ecological sanitation and their unwillingness to use it as sanitation. As with the other groups in the Ugandan society every group and part needs to be sensitized about ecological sanitation and the advantages with it compared to other common sanitation kinds in Uganda.

Busia Town and their sanitation situation and solution.The sanitation situation in Busia Town (as well as in many other towns) needs to be improved, since many households have no access to own sanitation. Lack of sanitation forces people to use other kind of solutions as to urinate and excrete near bushes, in plastic bags etc., which affects and contaminate soil and water environment. Many people have due to the contamination of pathogens in soil and water environment health problem. As long as the contamination of the environment is continuing will the problems remain, and there will not be any improvement for humans (health) and the environment. With proper sanitation and waste management, good health behaviour etc. the situation in Busia Town will change to the better.

Can ecological sanitation solve sanitation problem in Busia Town?Ecological sanitation will solve Busia Towns problem regarding soil and water contamination when it is properly managed. There will not be direct discharge to the environment as a common pit latrine would have. One of the advantages with ecological sanitation is that the toilet is cheap to build and can be used by many people. For Muslims in Busia Town there will not be any problem with ecological sanitation toilet, since there are also sanitation options for them (a sanitation kind where anal washing is possible). Various ecological sanitation techniques can be implemented for different situation and conditions in a town as Busia and still be a success.

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http://www.gtz.de/de/dokumente/en-ecosan-tds-02-c2-dehydration-toilets-user-instructions-2006.pdf

http://www.gryaab.se/default.asp?ulid=20&lid=3&show=1#

(http://www.sanicon.net/titles/topicintro.php3?topicId=17)

School sanitation (2007) Water Flush Toilets. World Bank, 6pp. (http://www.schoolsanitation.org/BasicPrinciples/WaterFlushToilets.html)

Schönning, C. & Stenström, T. A., (2004) Guidelines on the Safe Use of Urine and Faeces in Ecological Sanitation Systems. Stockholm Environment Institution. Stockholm, Sweden, 44 pp.

The Republic of Uganda (2005a) Handbook on Safe Water Chain. Ministry of Health, Environmental Health Division. MUVA Printers & Stationers Ltd. Kampala, Uganda. 21pp.

The Republic of Uganda (2002b) Construction of Demonstration Latrines in Different Areas. Ministry of Health, Enviornmental Health Division. MUVA Printers & Stationerts Ltd, Kampala, Uganda. 10pp.

The Republic of Uganda (1995c) National Environment Act, chapter 153. LDC Publishers, Kampala, Uganda. 3637-3712pp.

The Republic of Uganda (2005d) National Environment Health Policy. Ministry of Health, Environmental Health Division, Kampala, Uganda. 19pp.

The Republic of Uganda (2005e) Status of Implementation of Urban Water and Sanitation Projects and Rural Growth Centres. Ministry of Water, Land and Environment, Directorate of Water Development. Kampala, Uganda. 33 pp.

The Republic of Uganda (2007f) MALARIA INCIDENCE IN UGANDA IN 1999http://www.health.go.ug/health_stat.htm

Toze, S. (1997) Microbial Pathogens in Wastewater: Literature Review For Urban Water Systems Multi- divisional Research Program . Technical Report No 1/97, June 1997, 103 pp.(http://www.clw.csiro.au/publications/technical97/tr1-97.pdf)

Tuhanmagyezi, E. & Namukasa, E. (2007) A Sanitation Survey report for Busia Town Council July 2007. Busia Town Council, Uganda, 18pp.

Tumwine, K. J., Thompson, J., Katua-Katua, M., Mujwajuzi, M., Johnstone, N., Wood, E. & Porras, I. (2002) Diarrhoea and effects of different water sources, sanitation and hygiene behaviour in East Africa. 7 pp.(www.balckwellpublishing.com/journal.asp?ref=1360-2276)

Tyrell, S. F. & Quinton, J. N. (2003) Overland flow transport of pathogens from agricultural land receiving faecal wastes. Journal of Applied Microbiology 2003, 94, 87S-93S, 7 pp.(http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1365-2672.94.s1.10.x)

UN -United Nations- (2007a) What are the Millennium Development Goals? (http://www.un.org/millenniumgoals)

UN -United Nations- (2007b) Africa and the Millennium Development Goals 2007 update. Published by the UN Department of Public Information. DPI/2458 — June 2007, 4 pp.(http://www.un.org/millenniumgoals/docs/MDGafrica07.pdf) UN -United Nations- (2007c) Health, dignity and development: what will it take?. Lenton, R., Wright A. M., Lewis, K. UN Millennium Project Task Force On Water and Sanitation 2005, 228 pp. (http://www.unmillenniumproject.org/documents/WaterComplete-lowres.pdf)

42

http://www.unmillenniumproject.org/documents/WaterComplete-lowres.pdf

http://www.un.org/millenniumgoals/docs/MDGafrica07.pdf

http://www.un.org/millenniumgoals

http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1365-2672.94.s1.10.x

http://www.balckwellpublishing.com/journal.asp?ref=1360-2276

http://www.clw.csiro.au/publications/technical97/tr1-97.pdf

http://www.health.go.ug/health_stat.htm

http://www.schoolsanitation.org/BasicPrinciples/WaterFlushToilets.html

http://www.sanicon.net/titles/topicintro.php3?topicId=17

Vattenportalen (2007) Vattenförsörjning och sanitet i Sverige. Water resources and sanitation in Sweden, Stockholm, Sweden, 5 pp. (http://www.vattenportalen.se/fov_sve_djup_sot_vattenforsorjning.htm)

Wateraid (2007) The Skyloo's the limit. Wateraid Uganda, 2 pp.(http://www.wateraid.org/uganda/news/5461.asp)

Watsanuganda (2007) Pdimu Landing Site EcoSan Project: A Case Study of Masaka, Uganda. Water and Sanitation Recourse Centre Uganda, 2 pp.(http://www.watsanuganda.watsan.net/page/298)

Wikipedia (2007a) Ecological sanitation. From Wikipedia, the free encyclopedia, 6 pp.(http://en.wikipedia.org/wiki/Ecological_sanitation)

Wikipedia (2007b) Faeces. From Wikipedia, the free encyclopedia, 5 pp.(http://en.wikipedia.org/wiki/Faeces)

Wikipedia (2007c) Flush toilet. From Wikipedia, the free encyclopedia, 9 pp.(http://en.wikipedia.org/wiki/Flush_toilet)

Wikipedia (2007d) Karamoja. From Wikipedia, the free encyclopedia, 4 pp.(http://en.wikipedia.org/wiki/Karamoja)

Wikipedia (2007e) Pit toilet. From Wikipedia, the free encyclopedia, 3 pp.(http://en.wikipedia.org/wiki/Pit_toilet)

Wikipedia (2007f) Septic tank. From Wikipedia, the free encyclopedia, 5 pp.(http://en.wikipedia.org/wiki/Septic_tank)

Wikipedia (2007g) Soil contamination. From Wikipedia, the free encyclopedia, 6 pp.(http://en.wikipedia.org/wiki/Soil_contamination)

Wikipedia (2007h) Pathogens. From Wikipedia, the free encyclopedia, 2 pp. (http://en.wikipedia.org/wiki/Pathogen#Transmission_of_pathogens)

Wikipedia (2007i) Urine. From Wikipedia, the free encyclopedia, 4 pp.(http://en.wikipedia.org/wiki/Urine)

Wikipedia (2007j) Ventilated improved pit latrine. From Wikipedia, the free encyclopedia, 3 pp. (http://en.wikipedia.org/wiki/Pit_toilet#Ventilated_improved_pit_latrine_.28VIP.29)

Wikipedia (2007k )Wastewater. From Wikipedia, the free encyclopedia, 5 pp.(http://en.wikipedia.org/wiki/Wastewater)

Wsp -Water and Sanitation Program- (2007) A Review of EcoSan Experience in Eastern and Southern Africa. Sanitation and Hygiene series, Water and Sanitation Program 2005, 16 pp. (http://www.wsp.org/filez/pubs/af_ecosan_esa.pdf)

Yaron, B., Calvet, R. & Prost, R.(1996) Soil Pollution, Processes and Dynamics. Springer-Verlag Berlin Heidelberg, Germany, 313 pp.

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http://www.wsp.org/filez/pubs/af_ecosan_esa.pdf

http://en.wikipedia.org/wiki/Wastewater

http://en.wikipedia.org/wiki/Pit_toilet#Ventilated_improved_pit_latrine_.28VIP.29

http://en.wikipedia.org/wiki/Urine

http://en.wikipedia.org/wiki/Pathogen#Transmission_of_pathogens

http://en.wikipedia.org/wiki/Soil_contamination

http://en.wikipedia.org/wiki/Septic_tank

http://en.wikipedia.org/wiki/Pit_toilet

http://en.wikipedia.org/wiki/Karamoja

http://en.wikipedia.org/wiki/Flush_toilet

http://en.wikipedia.org/wiki/Faeces

http://en.wikipedia.org/wiki/Ecological_sanitation

http://www.watsanuganda.watsan.net/page/298

http://www.wateraid.org/uganda/news/5461.asp

http://www.vattenportalen.se/fov_sve_djup_sot_vattenforsorjning.htm

Personal CommunicationBisa Boris, Technical Advisor (DED), Busia Town Council, Uganda. Cell phone +256-0774440851. [email protected]

Gitta Francis, Ecological Sanitation Administrator, Kampala Town Council, Uganda. Cell phone +256-0772428741. [email protected]

Jurga Ina, Technical Advisor, German Development Services, Uganda. Cell phone +256-0773291630. [email protected]

Massa Tom, Water Department Official, Busia Town Council, Uganda.

Nabunwa Peter, Health Official, Busia Town Council, Uganda. Cell phone +256-0751645743

Nabwire Joyce, Health Centre administrator in Samia Bugwe North Health Centre (Solo parish), Busia Town, Uganda.

Nagajja Teopista, Environmental Official, Busia Town Council, Uganda. Cell phone +256-0752640208

Ontagai Amosiah, Chairman, Youth Environmental Sanitation Group, Busia Town, Uganda. [email protected]

Oktech Michael, Ecological Sanitation Administrator, Ministry of Water and Environment, Directorate of Water Department, Kampala, Uganda. Cell phone +256-0782843648. [email protected]

Wangira Denis, Local Expert, Youth Environmental Sanitation Group, Busia Town, Uganda. Cell phone +256-0782422520

44

mailto:[email protected]

mailto:[email protected]

8. Appendix

Appendix A Map A. Areas of Busia Town Council

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Appendix B Map B. Busia Town with Solo A and Marach parishes

46

Appendix C Questionnaire

THE REPUBLIC OF UGANDATOWN COUNCIL

PUBLIC SURVEY ON WATER, SANITATION, WASTE AND HEALTH

PART ONE: BACKGROUND

1. Location / RespondentDate:…………………………………………………………………………Name of respondent: ……………………………………………………...Gender of respondent:…F / M………………………………………..District:………………………………………………………………………Sub-county:………………………………………………………………….Name of village/ LC1: .……………………………...………………….....House hold identification/Compound/household no:………………………………………………………………………………..

Interview complete/incomplete (%):……………………………………...Interviewer:………………………………………………………………… Result code:

TickCompletedNot at home Refused Postponed Others specify

RESPONDENT INITIALS …………AND LINE NUMBER ………..

2. What is your marital status?Tick

Married SingleOther

3. Educational level of respondent?Tick highest achieved level

Primary school Secondary schoolUniversity Bachelors degree University Masters degree University PhD degreeNoneOther

4. Household size?Write number

FemalesMalesTotal

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5. Age groups of household members?Write number

Younger than 5 years 5 – 14 years15 – 24 years25 – 34 years35 – 44 years45 – 54 years55 – 64 yearsOlder than 65 years

6. Are all your children going to school?Tick

YesNoOther

7. Ownership status? Tick

Are you a tenantA landlordOther

8. How long have you stayed/lived in this locality/residence?Tick

Since birth Less than 10 or 20 yearsOther

9. Is here anything you would like to change/add to your compound/house?Tick for several options

ToiletWash standInsideOutsideOther

10. How often do you read newspaper or listen /watch radio/TV?Tick

Every daySeveral times a weekSeveral times a monthNot oftenNeverOther

11. What is your source of income?Tick

SalaryBusinessPeasantOthers

(a)How much do you earn per day?.....................................................................................(b)How much do you spend per day?...................................................................................

12. Local characteristics

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Location area TickUrbanRural

Terrain TickLow landGentle slopeRaised landWetlandOther

13. Availability of piped water supply in the area?Tick

YesNoOther

14. Availability of instructions (how to use these facilities)?Tick for several options

SchoolsMarketsHealth unitsNoneOther

15. Access roadsTick for several options

All weather roadMurrayFootpathOther

PART TWO: WATER

16. Which source of water do you use?Tick sources used by household

BoreholeStandpipeTap (Private Operator)SpringsRainwaterDigd well/ shadoofsOther

17. Who collects water for the household?Tick for several options

ChildrenWomenMenVendorsOther

18. How far away is your main water source?Tick (Help to estimate distance)

In the houseIn the compound

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Less than 100 steps100 to 200 steps200 to 500 steps500 to 1000 stepsMore than 1000 stepsOther

19. Do you think your water is safe for drinking?Tick

YesNoDon’t know

20. Do you boil your water before drinking?Tick

YesNoOther

Yes/ No why?....................................................................................................................................

21. Do you like the taste?Tick

YesNoDon’t know

22. How is your water quality?Tick

Very goodGoodAverageNot goodOther

23. How much water does your household use per day for drinking/food preparation?Put in number of Jerry cans

Small Jerry cans (20 Litres)Big Jerry cans (25 Litres)Other

If no Jerry cans in use(mainly/only tap water) tick here

24. How much water does your household use per day for washing cloths etc.?Put in number of Jerry cans

Small Jerry cans (20 Litres)Big Jerry cans (25 Litres)Other

If no Jerry cans in use(mainly/only tap water) tick here

Water from Tap

25. Do you normally pay for your water?Tick

Water from Tap

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Yes – per Jerry canYes – per bill (monthly)NoOther

26. How much do you pay?Put in price per Jerry cans

UGSH per small Jerry can (20 Litres)UGSH per big Jerry can (25 Litres)UGSH per month/ tap Private Operator

Other

If tap-user does not know, ask for bill from Private Operator to check

27. Is the price for water fair?Tick

YesNoDon’t know

28. Is water available sufficient for your needs?Tick

YesNoDon’t know

29. List 3 problems you face concerning water supply and distribution.………………………………………………………………………………………………………………..

30. What solutions could solve the problems above?..………………………………………………………………………………………………………………

31. How clean are the containers used for transporting water?Tick

Very cleanClean“Average” cleanNot so cleanDirtyOthers

32. How do you store your water?(a)

Tick for several optionsJerry cansBucketWater bottleOpenNo storageOther

(b) How do the communities and you treat water?………………………………………………………………………………………………………………….

33. Which health problems are transmitted through unsafe water?Tick for several options

Diarrhoea

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DysenteryCholeraTyphoidIntestinal infectious diseaseOther

PART THREE: SANITATION

34. What kind of sanitation system does your household use?Tick

OwnPublic Neighbours/ shared OtherNon

Tick for several optionsBushPlastic bagPit LatrineV.I.P. – Ventilation Improved PitEcoSan Toilet (dry toilet with urine diversion)Flush toilet with soak awayFlush toilet with septic tankOther

35. Have you ever had episodes of infectious diseases associated with poor hygiene and sanitation in your family? If Yes, which episodes have you noticed in the last twelve months. PROBE

Tick for several optionsYes No

MalariaDiarrhoeaCholeraTyphoidIntestinal infectious disease/worms Dysentery

(a) How much did it cost you in total for management of the above disease?Write

Time (days, hours)Distance (steep)Drugs (cost)Lost work days (days)Other

(b) Do you have any comments about sanitation management in your village/area?.…………………………………………………………………………………………………………….....

36. What kind of sanitation system do you know about?Tick

Pit LatrineV.I.P. – Ventilation Improved Pit latrineEcoSan Toilet (dry toilet with urine diversion)Flush toilet with soak awayFlush toilet with septic tankOther

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37. How many people use your sanitation system?Tick

Less than 55 to 10 11 to 20More than 20Other

38. Who use this toilet?Tick for several options

AdultsChildrenGuestsAll in the householdOther

39. How do you dispose off the children’s faeces and urine?……………………………………………………………………………………………………………….

40. Who built and paid the system?Tick

Household owner/ membersLocal authoritiesNeighbourNGO’sOther

41. Is your system equipped with the following?Tick for several options

DoorRoofToilet pedestal Toilet coverWindowElectricityOther

42. How is the toilet system maintained? (Own observation!!!!)Tick

Very CleanCleanDirty Very DirtyOther

43. Could you observe the following? (Own observation!!!!)Tick ‘Yes” ,’No’ or ‘ Sometimes’

Yes No Some timesSmellFliesMaggots

44. Is a hand washing facility available? (Own observation!!!!)Tick

Yes, directly insideOutside toilet

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NearbyNoOther

Tick ‘Yes” ,’No’ or ‘ Sometimes’Yes No Some times

Water available? Soap available? Towel available? Other?

45. How old is your toilet systemTick

46. How is your toilet system functioning?Tick

Very goodGoodNot so goodBadOther

47. How often do you empty your toilet system?Tick

Never emptied before Less than once per yearAnnuallyTwice a yearOther

(If never emptied before, skip questions from 48 to 50)

48. Where will the content be disposed or emptied?Tick

DrainageWaste Dump siteField Collected by truckDon’t knowOther

49. Who does the emptying?Tick

Local AuthorityPrivate CompanyHousehold MembersOthers

50. What are the costs for emptying per time?State the costs if any

NoneUGSH?....................................

Less than 1 yearLess than 5 years5 to 10 yearsMore than 10 yearsOther

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Other

51. How deep is your toilet system?Tick (Help to estimate, compare to body size, tree, house)

Less than 5 feet5 to 10 feetMore than 10 feetOther

52. What is the distance from the nearest water source and your toilet?Tick

1 Step2 to 10 steps10 to 20 stepsMore than 20 stepsOther

53. Which problems do you have concerning your toilet system?Tick for several options

SmellFliesCleanlinessWaste dumpingAccess during dayAccess during nightLack of Security for womenDifficult Use for small childrenDifficult use for elderly

Others………………………………………………………………………………………………

54. What solutions could solve the problems above?………………………………………………………………………………………………………………..

55. Where do you dispose/empty off the rest of your household water, washing etc.?Tick

DrainageFieldInto toiletSink and sewerOthers

56. Why did you choose this form of sanitation system?Tick

TraditionKnowledgeCostOther

57. What sanitation system did you use before you built this one?………………………………………………………………………………………………………………….

58. Could you consider using ecological sanitation, in form of separation between urine, faeces and cleansing water from each other in different containers?

TickYesNo

55

Don’t knowOther

Explain why?………………………………………………………………………………………………………………….

59. Do you have a garden?Tick

Yes / No Garden?What size?What type of plants?Use of any fertilizer, If yes how much and for what costs?Could you consider using urine as liquid fertilizer? Could you consider using dried faeces as soil improver (mixed with ash)

60. Could you consider to reuse urine or faeces as a fertilizer and soil improver in crops, farming and fruit trees and other tree kinds etc.?

Tick Crops Farming Fruit trees Other trees

YesNoDon’t knowOther

Explain why?………………………………………………………………………………………………………………….61. What would you like to do with urine and faeces?

Tick for several options…Urine Faeces

Fertilizer Soil improverSell SellDispose off Dispose offOther Other

Explain why?………………………………………………………………………………………………………………….

62. Would you like to change anything about it?Tick

YesNoOther

If yes, what would you like to change?..........................................................................................

63. How much would you be willing to pay for this kind of sanitation system (UGSH)?…………………………………………………………………………………………………

64. If there were a subsidy in the construction/building of your toilet would you still choose this kind of sanitation system?

Tick

56

Explain why?………………………………………………………………………………………………………………….

65. In the event of a subsidy, how much would you be willing to pay to have such a toilet (UGSH)?………………………………………………………………………………………………………………….

66. Have you ever heard about ecological sanitation system, if yes then from whom?Tick

67. Would you recommend it to others?Tick

YesNoDon’t knowOther

Give reason for your answer?…………………………………………….…………………………………………………………………

PART FORE: WASTE MANAGEMENT

68. What type of waste does your household mainly have?Tick

Organic/ Food refusePlasticPaperGlassMetalOther

69. Do you separate plastic and organic/food refuses?Tick

YesNoOther

70. What do you do with plastic refuse?Tick

Burn (on compound)DumpRecycle/SellOther

71. What do you do with organic refuse?

Urine diversion Urine and faecal diversionYesNoDon’t knowOther

Sanitation projectsMasonChurchMediaFriendsOther

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TickBurn (on compound)DumpCompostFeed the animalOther

72. How far is the nearest dumping facility?Tick (Help to estimate distance)

Less than 100 steps100 to 200 steps200 to 500 steps500 to 1000 stepsMore than 1000 steps

73. Where do you dump your refuse?Tick

Skip (Metal)BunkerLandfillOpen dumpBushCompost PitOther

74. How often is the skip/bunker emptied by the local Authority?Tick

Several times a weekWeeklyFortnightlyMonthlyIrregularNeverOther

75. Do you think this is sufficient?Tick

YesNoDon’t know

76. Are you happy with the waste management in town?Tick

YesNoDon’t know

77. Would you pay for improved solid waste management in your parish?Tick

YesNoDon’t know

78. If yes, how much per month?Tick

Less than 2000 UGSH2000 – 5000 UGSH

58

More than 5000 UGSH

79. Who normally takes the refuse to the dumping facility?Tick for several oprions

ChildrenWomenMenHousekeeperOn-door collection by Local AuthorityOthers

80. Do you have any comments about solid waste management in your area?……………………………………………………………………………………………………………….

PART FIVE: HEALTH

81. Has any member of your household suffered from the following diseases in the last three months?

Tick ‘Yes’ or ‘No’ or ‘Don’t know’Yes No Don’t know

MalariaDiarrhoeaCholeraTyphoidIntestinal diseases as worms

82. Do you seek help for the treatment of the diseases?Tick

YesNoOther

83. Do you practise hand washing?Tick for several options

Yes NoAfter defecationBefore food preparationBefore eating Before child feeding

Tick for several optionsWater onlySoapRubbing with ash or soilRubbing with leavesOther

84. Which danger do you relate to poor sanitation (water, waste, sewage water)?Tick for several options

Diseases & illnessBreeding of disease vectorsBad odourEnvironmental pollutionOptical disturbance Others

85. What disease vectors in this area do you relate to poor waste management?

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Tick for several optionsFliesRats/ MiceMosquitoesStray DogsNoneOther

86. What could you observe at the source of your water?Tick for several options

Waste dumpingOpen defaecationLatrines dischargeWashingAnimalsOthers….

87. Have you been informed about good hygiene behaviour, such as hand washing? Tick for several options

PART SIX: HOUSEHOLD WITHOUT SANITATION OR WATER FACILITIES

88. How do you dispose human excreta?Tick for several options

89. Would you like to have sanitation system for your household?Tick

If yes, what is it that prevents you from building/accessing a sanitation system?………………………………………………………………………………………………………………….If no, why not?………………………………………………………………………………………………………………….

90. How much would/could you be willing to pay (UGSH)?………………………………………………………………………………………………………………….

91. What would make a sanitation system appealing to you?………………………………………………………………………………………………………………….

Yes No Don’t knowCommunity activitiesEducatorGovernmentRadioTheatre groupsNewspaperBrochures/ posterIn school

Flying bagsBushPublic ToiletNeighboursOther

YesNoDon’t know

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92. Where would you want the sanitation system installed?Tick

93. If the family wants sanitation, which sanitation system would be best for your household?Tick

Give reasons for the choice of system?………………………………………………………………………………………………………………….

94. Would you pay if water supply was installed in your compound?Tick

If possible, how much would you pay (UGSH)?………………………………………………………………………………………………………………….

95. What kind of water facility/s would you want and where?Tick for several options

PART SEVEN: SOCIAL & CULTURAL BACKGROUND

96. What is your religion?Tick

97. Which tribal group do you belong to?………………………………………………………………………….......................................................

98. Which of the following did you do for the last diseases?

Yes No Don’t know (a) Sought advise from the a friend or relativeYes No Don’t know (b) Used medicine that you had at home.Yes No Don’t know (c) Sought advise from a herbalistYes No Don’t know (d) Sought advise from the a clinic, hospital or health worker.Yes No Don’t know (e) Obtained drugs from clinic or health worker.Yes No Don’t know (f) Bought medicine from drug shop or pharmacy or market

Inside the houseOutside the houseOther

Pit latrineVIP’sFlush toilet with septic tankEcosanOther

YesNoDon’t know

For kitchenFor toiletBathroomGardenOther

MuslimProtestantCatholicPentecostalOthers

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Did you tell any of your neighbours about the last episode?………………………………………………………………………………………………………………….

99. (a) Have you had any of the following diseases as Typhoid, Diarrhoea, Malaria, Dysentery, Cholera, and Intestinal infectious diseases?

(b) How can it be avoided? Tick

Yes No Don’t know Tally questions(i) Drinking clean and boiled water(ii) Avoiding using toilets(iii) Not washing hands before touching food(iv) Using mosquito nets(iv) Staying in a clean place.(v) Drinking an boiled water(vi) Staying with un hygienic people(vii) Crude dumping of waste(viii) Using clean water container(iv) Observing better hygiene and sanitation(x)Buying prepared uncovered food sold at the road side(xi)Defecating near the water source(xii)Dumping waste products in water streams

100.Do you know some signs of diseases of poor hygiene and sanitation? Probe………………………………………………………………………………………………………………..

101. Have any relative or friend ever had a disease associated with poor hygiene and/or sanitation? Write the disease

Hygiene SanitationYesNoNot sureDon’t know

102.What are the chances that you might get the infection? Tick

No chanceModerate chanceGood chanceDon’t know.

103.Have you personally made any changes in your hygiene behaviour to avoid disease transmission or contact?

Yes/No, explain why?.......................................................................................................................

(a) If yes when did you start making the changes? Tick

With in 12 monthsShorter than 12 monthsLonger than 12 monthsDon’t know

(b)Do you believe that this disease can be prevented by behaviour change?Tick

Yes

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NoDon’t know

(c)If No, why?………………………………………………………………………………………………………………..

(d) If yes, what kind of changes did/can you make (Probe/record)?………………………………………………………………………………………………………………..

(e) During the last one year, do you think your neighbours /tenants have changed their hygiene behaviour?

TickYesNoDon’t know

104.Would you say that 3years ago the hygiene behaviour has not changed or has improved?………………………………………………………………………………………………………………….

105.What is the main change you have noticed from your neighbourhood and tenant in town council as a whole (probe?)

……………………………………………………………………………………………………………….

106.Would you voluntarily participate in keep clean activities in your locality and home stead?Tick

YesNoWould pay for cleaningDon’t know

107.In your own opinion, is the current number of deaths due to poor hygiene among children less than 5 years increase, decrease or stable as compared to 10 years ago?

TickIncreasingDecreasingStableDon’t know

108. Who is responsible for cleaning the household/ shard toilet?Tick

TenantsLandlordChildrenAdultsOthersDon’t know

(a) Do you know any reason why people/community don’t use toilets some times in your locality? Probe…………………………………..……………………………………………………………………………

(b) Is the above reason traditional or cultural or religious?………………………………………………………..………………………………………………………

(c) Is any of the above linked to toilets/or use of toilets?……………………………………………….……………………………………………………………….

63

(d) How do you link hygiene-water with your religious and cultural practices?………………………………………………………………………………………………………………..

(e) Are there orders in your religion about hygiene behaviour? ………………………………………………………………………………………………………………..

(f) Do you believe your traditional rules and regulations have a positive impact on that behaviour, and are these rules still followed like in the last 20 years?……………………………………………………………………………………………………………….2

109.Do you cooperate in the decision making to impose on sanitation at home?………………………………….……………………………………………………………………………

110.What are the challenges in your household regarding sanitation improvement?………………………………………………………………………………………………………………..

111.Own observations from the household area?Sanitation (smell, look, condition etc.)…………………………………………………………………………………………………………………Water (smell, look, condition etc.)…………………………………………………………………………………………………………………Waste management (smell, look, condition etc.)…………………………………………………………………………………………………………………Environment (smell, look, condition etc.)…………………………………………………………………………………………………………………

64

Appendix D Technical features Table D. Sanitation techniques. Sanitation kind

Features Reasons for Cost Comment

Arborloo/ simple pit latrine1

Simple portable structure where soil, ash, organic waste is used for composting. One years capacity recommended then move and plant a (fruit) tree.

Valued in areas of poor soil fertility. Compost as soil improver will fertilize fruit trees to grow better than ordinary soil.

Least expensive material

Simple and good in poor soils and may be a good choice as introduction for ecological sanitation and reuse.

FossaAlterna/ altering between two pit latrines1

Two pits with movable drop hole, typically with a concrete slab any superstructure. Soil, ash is needed as composting material. After one year is the pits change/ empty content after one year rest

Limited involvement with content-sprinkling soil and ash. Permanent construction for the location. Contents look harmless and do not smell. The compost can be valued in areas with low soil fertility

One investment cost.

Intermediate ecosan; robust and likely to ignorant use. Needs education and demonstration to overcome taboo on digging out and reuse. Good in poor soils and where fertilizer is expensive

Skyloo/Urine diversion dehydrating2

Urine diversion pan or drophole needs regular addition of wood ash or lime. Single pit/ chamber needs emptying for further composting and double pit/camber avoids this.

Permanent construction and can be used inside/ outside house. Can be above ground and overcome high water table or rocks.

Expensive in form of building materials.

More operation and maintenance needs here, valued in difficult ground conditions and harsh climates. Needs considerable more user education, user may choose to pay someone to empty and dispose of contents.

Pit latrine with septic tank3

A digd or above ground uplifted drop hole. Needs regularly check up and emptying of septic tank.

(Simple) permanent constructions that can be used inside or outside house and is connected to a septic tank for later taking care of The wastewater in septic tank needs to be emptied and collected by a operator.

Expensive depending on construct material etc. Septic tank emptying by a operator is usually expensive.

User friendly when it is correct used. If not correct handled will there be problem with smell etc.

Flush toilet with septic tank4

Connected to a water facility for functioning. “Very hygienic” and comfortable to use.

Permanent construction where the toilet is either set inside or outside the house.

Expensive in use of material, water and emptying.

Needs some kind of water facility or connection to water for functioning. Easy to use and maintain. The septic tank needs to be emptied regularly.

1 (Ecosanres, 2007e)2 (Wateraid, 2007)3 (Aquamor, 2007)4 (Wikipedia, 2007e; Schoolsanitation, 2007)

65

Appendix E Result from field studyTable 1. Which tribal group do the household belong to? Tribe Solo A.


Marach.Households

Marach.Percent

Samia 8 21 10 25Musoga 8 21 4 10Luyen 0 0 3 8Mugishu 3 8 6 15Karamojong 6 15 1 3Muganda 1 2 0 0Ateso 1 2 1 2Musamia 6 15 5 13Neleham 1 2 0 0Baganda 1 2 0 0Amusonga 1 2 1 2Bagishu 0 0 1 2Chsturu 0 0 1 2Munyoro 0 0 1 2Mulingwara 0 0 1 2Ahur 0 0 1 2Luo from Kenya 1 2 0 0From Sudan 1 2 0 0From Somalia 0 0 4 10No answer 1 2 0 0Total 39 100 40 100

Table 2. Household size?Gender Solo A.


Marach.Households

Marach.Percent

Females 94 55 106 51Males 76 44 102 49Total 172 99 208 100

1% or 2 households in Solo A has no answer, has not responded the question.

Table 3. Age groups of household members?Age Solo A.


Marach.Households

Marach.Percent

Younger than 5 years 9 12 12 13 5 – 14 years 13 18 14 1515 – 24 years 18 24 27 2825 – 34 years 18 24 23 2435 – 44 years 11 15 9 945 – 54 years 4 5 8 855 – 64 years 1 1 1 1Older than 65 years 0 0 0 0Don't know 0 0 0 0No answer 0 1 1Total 74 100 95 100

66

Table 4. Kind of water source that is used in Solo A and Marach.Water source Solo A.


Marach.Households

Marach.Percent

Borehole 3 5 5 9Standpipe 2 3 6 11Tap water 9 14 18 32Springs 28 45 17 30Rainwater 10 16 10 18Digd well/ shadoofs 8 12 0 0Other 4 6 0 0Don't know 0 0 0 0No answer 0 0 0 0Total 64 100 56 100

Table 5. Distance to water source for the households in Solo A and Marach.Distance Solo A.


Marach.Households

Marach.Percent

In the house 0 0 2 5In the compound 0 0 3 7Less than 100 steps 14 36 16 39100 to 200 steps 16 41 11 27200 to 500 steps 5 13 3 7500 to 1000 steps 1 2 3 7More than 1000 steps 0 0 2 5Other 2 5 0 0Don't know 0 0 0 0No answer 1 2 1 2Total 39 100 41 100

Table 6. The households water quality in Solo A and Marach.Water quality Solo A.


Marach.Households

Marach.Percent

Very good 4 10 0 0Good 17 44 21 53Average 14 36 10 25Not good 4 10 9 22Other 0 0 0 0Don't know 0 0 0 0No answer 0 0 0 0Total 39 100 40 100

Table 7. If the household boils the drinking water?Boiling of drinking water Solo A.


Marach.Households

Marach.Percent

Yes 17 44 15 38No 22 56 23 58Other 0 0 1 2Don't know 0 0 0 0No answer 0 0 1 2Total 39 100 40 100

67

Table 8. Answer why the household boil or not boil water in Solo A and Marach.Yes/ No why Solo A.


Marach.Households

Marach.Percent

No money for water boiling (chare coal) 5 13 4 10No problem with water 13 33 20 50No pot for storage 1 2 0 0To avoid germs 16 41 13 33To have good drinking water 1 2 0 0Don't like the taste 3 8 0 0Don't know 0 0 0 0No answer 0 0 2 5To have good drinking water 0 0 1 2Total 39 100 40 100

Table 9. If the household normally pay for your water in Solo A and Marach?Payment for the water Solo A.


Marach.Households

Marach.Percent

Yes – per jerry can 18 47 26 65Yes – per bill (monthly) 0 0 3 8No 20 51 8 20Other 1 2 0 0Don't know 0 0 0 0No answer 0 0 3 7Total 39 100 40 100

Table 10. How much do the household pay in Solo A and Marach?Charge in UGSH Solo A.


Marach.Households

Marach.Percent

per small jerry can (20 L)20 1 2 2 525 2 5 2 550 6 15 15 38100 5 13 5 12200 1 2 0 0per big jerry can (25 L) 0 0 020 0 0 0 025 0 0 1 350 2 5 4 10100 2 5 0 0200 0 0 0 0250 1 2 0 0per month for tap water operator 0 0 1 3Other 2 5 1 2Don't know 0 0 1 2No answer 17 44 8 20Total 39 100 40 100

68

Table 11. Problems that the households in Solo A and Marach are concerning water supply and distribution.Problem concerning water supply and distribution

Solo A. Household

Solo A. Percent

Marach.Households

Marach.Percent

Not sufficient 2 4 1 2Lack of water during dry season 3 7 8 14Don't know since women is the one who collects water

1 2 0 0

Too much people at the water source 8 18 13 23Far distance 18 40 10 18Poor sanitation 3 7 4 7No problem 3 7 6 11Expensive (transport, guard etc.) 5 11 11 20Water is not safe for use 1 2 1 2Don't know 0 0 0 0No answer 1 2 0 0Dirty during rain season 0 0 2 4Total 45 100 56 100

Figure 1. The sanitation system that is used in Solo A and Marach.

What kind of sanitation does the household use

41

1326

310

08

45

15 18

0 0 0

23

0

20

40

60

80

100

Ow

n

Publ

ic

Nei

ghbo

urs/

shar

ed

Oth

er

Non

Don

't kn

ow

No

answ

er

Answer

%

Solo A Marach

Table 12. Episodes of infectious diseases associated with poor hygiene and sanitation in the households in Solo A and Marach?Episodes of infectious diseases Solo A.


Marach.Households

Marach.Percent

Malaria 33 41 35 42Diarrhoea 16 20 13 15Cholera 6 8 3 4Typhoid 12 15 16 19Intestinal infectious disease/worms 10 13 9 11Dysentery 2 2 6 7Don't know 0 0No answer 1 1 2 2Total 80 100 84 100

69

Table 13. Number of people that use this sanitation in both Solo A and Marach.Number of people that use this sanitation Solo A.


Marach.Households

Marach.Percent

Less than 5 3 8 2 55 to 10 10 26 13 3311 to 20 13 33 11 28More than 20 8 22 11 27Other 2 5 2 5Don't know 0 0 1 2No answer 3 8 0 0Total 39 100 40 100

Table14. Who use this sanitation in both Solo A and Marach?Who use this toilet Solo A.


Marach.Households

Marach.Percent

Adults 20 20 31 25Children 19 19 30 25Guests 21 21 29 24All in the household 26 26 22 18Other 9 9 9 7Don't know 0 0 0 0No answer 4 4 1 11Total 99 100 122 100

Table 15: Households sanitation system knowledge in both Solo A and Marach.What kind of sanitation system the household know about.

Solo A. Household

Solo A. Percent

Marach.Households

Marach.Percent

Pit Latrine 34 72 35 78Ventilation Improved Pit latrine 4 9 2 4Dry toilet with urine diversion 2 4 1 2Flush toilet with soak away 0 1 2Flush toilet with septic tank 3 6 1 2Other (Bush)1 3 6 1 2Don't know 1 2 0 0No answer 0 0 4 9Total 47 100 45 100

1 The knowledge about bush etc. is common; the answers do not indicate it although.

Table 16. Condition of the toilets in both Solo A and Marach.Observation of toilet system maintenance Solo A.


Marach.Households

Marach.Percent

Very Clean 2 5 2 5Clean 16 41 25 63Dirty 14 36 13 32Very Dirty 3 78 0 0Other 0 0 0 0Don't know 0 0 0 0No answer 4 101 0 0Total 39 100 40 100

70

Table 17. Observation on toilet (pit latrine) condition in both Solo A and Marach.Solo A, % of the household Marach, % of household

% Yes % No % Yes % No Smell 32 13 Smell 34 7Flies 30 8 Flies 27 14Maggots 7 5 Maggots 5 13No answer (%) 5 No answer (%) 0Total (%) 100 Total (%) 100

Table 18. The functioning of toilet system among households in Solo A and Marach.How is the toilet functioning? Solo A.


Marach.Households

Marach.Percent

Very good 0 0 0Good 18 47 19 48Not so good 16 41 17 42Bad 1 2 4 10Other 0 0 0 0Don't know 0 0 0 0No answer 4 10 0 0Total 39 100 40 100

Table 19. If the toilet has hand washing facilities is avaleble in Solo A and Marach.Is hand washing facility available Solo A.


Marach.Households

Marach.Percent

Yes, directly inside 1 1 2 2Outside toilet 3 2 8 6Nearby 3 2 0 0No 27 23 29 23Other 1 1 0 0YesWater available? 7 6 8 6Soap available? 5 4 9 7Towel available? 0 0 1 01Other? 2 2 0 0NoWater available? 19 16 21 17Soap available? 18 15 17 14Towel available? 18 15 20 16Other? 3 23 1 1

Don't know 1 1 0 0No answer 8 6 8 6Total 116 100 124 100

Table 20. Where will the content be disposed or emptied in Solo A and Marach?Disposal of pit latrines etc. Solo A.


Marach.Households

Marach.Percent

Drainage 0 0 0 0Waste Dump site 0 0 0 0Field 0 0 3 8Collected by truck 3 8 1 2Don’t know 1 2 10 25Other 1 2 0 0No answer 34 87 26 65Total 39 100 40 100

71

Table 21. Who does the emptying in Solo A and Marach?Who empties Solo A.


Marach.Households

Marach.Percent

Local authority 1 2 0 0Private company 3 8 2 5Household members 0 0 0 0Others 1 2 3 8Don't know 0 0 0 0No answer 34 87 35 87Total 39 100 40 100

Table 22. What are the costs for emptying each time in Solo A and Marach?Cost for emptying Solo A.


Marach.Households

Marach.Percent

None 0 0 0 0UGSH? 1 2 2 5Other 2 5 0 0Don't know 1 2 0 0No answer 35 90 38 95Total 39 100 40 100

Figure 2. What kind of sanitation system the households used before the household built the current one? (Many household has shared pit latrine as the chart also displays).

What kind of sanitation system did the household use before the current one that is now in use?

2.5

32.522.5

5 5

32.5

0

52.5

2.5 0

25 20

0

20

40

60

80

100

Non

Pit l

atrin

e -

own/

shar

ed

Bus

h

Hol

e in

the

grou

nd

Don

't kn

ow

No

answ

er

Answer

%

Solo A Marach

Table 23. Which problems do you have concerning your toilet system?Concerns for toilet system Solo A.


Marach.Households

Marach.Percent

Smell 22 19 28 29Flies 21 18 20 21Cleanliness 14 12 9 10Waste dumping 11 10 6 6Access during day 5 5 6 6Access during night 5 4 1 1Lack of security for women 10 9 9 9Difficult use for small children 12 11 7 7Difficult use for elderly 8 7 2 2Others 1 1 8 8Don't know 0 0 0 0No answer 5 4 1 1Total 114 100 97 100

72

Table 24. What are the challenges in your household regarding sanitation improvement?Challenges regarding sanitation improvement

Solo A. Household

Solo A. Percent

Marach.Households

Marach.Percent

High water table 3 7 0 0Economical/ resource limitation 17 44 13 30Some people don't want to participate 10 25 4 10No challenges 4 10 10 23To much rain 1 3 0 0More sensitizing on sanitation 0 3 7Lack of sanitation 1 3 4 9Don't know 1 3 2 5No answer 2 5 7 16Total 39 100 43 100

Table 25. If Solo A’s household could consider reusing urine/faeces to crops, farming etc.Solo A’s response Crops Farming Fruit trees Other trees TotalYes 10 10 8 7 35No 10 11 10 6 37Don’t know 6 3 3 2 14Other 1 1 1 1 4Total 27 25 23 16 90No answer 11Total multiple response/ answers from the households 101

Table 26. If Marach’s household could consider to reuse urine/faeces to crops, farming etc.Marach response Crops Farming Fruit trees Other trees TotalYes 7 7 7 3 24No 9 7 7 4 27Don’t know 2 2 2 1 7Other 0 0 0 0 0Total 18 16 16 8 58No answer 22Total multiple response/ answers from the households 80

Table 27. What would the households in both Solo A and Marach like to do with urine and faeces?Solo A, Percent 2

Urine Faeces Marach, Percent 2

Urine Faeces

Fertilizer/ soil improver 17 17 Fertilizer/ soil improver 10 10Sell 3 5 Sell 6 6Dispose off 21 17 Dispose off 28 22Other 7 7 Other 1 1No answer 6 No answer 16Total 100 Total 100

2Households has answered multiple in both Solo A and Marach.

73

Table 28. Explanation of why (household would like to do with urine/faeces in Solo A and Marach)Why Solo A.


Marach.Households

Marach.Percent

Because it can increase production 3 8 2 5Not hygienically to handle with u/f 4 10 0 0Soil improvement 9 23 5 12No garden 4 10 7 18Don’t know 3 8 2 5No answer 16 41 24 60Total 39 100 40 100

Table 29. Households willingness to pay for the sanitation system.UGSH Solo A.


Marach.Households

Marach.Percent

20 000 4 10 5 1310 000 6 15 9 225 000 3 8 3 8<1 000 9 23 4 10Don't know 9 23 9 22No answer 8 21 10 25Total 39 100 40 100

Table 30. If yes, what is preventing the household from that building/accessing a sanitation system in Solo A and Marach?What is preventing from building / accessing sanitation

Solo A. Household

Solo A. Percent

Marach.Households

Marach.Percent

High water table 2 5 0 0Economical reason 25 64 21 53No guidance from local authority 1 2 0 0Don't know 1 2 3 7No answer 10 26 16 40Total 39 100 40 100

Table 31. If no, why does not the household want to building/accessing a sanitation system in Solo A and Marach?If no, why not? Solo A.


Marach.Households

Marach.Percent

Economical reasons 0 0 7 18A tenant 2 5 1 2No answer 37 95 32 80Total 39 100 40 100

Table 32. Give reasons for the choice of system?Choice Solo A.


Marach.Households

Marach.Percent

Accessed by children 2 5 0 0Because it does not smell 4 10 2 5Easy to use 12 31 17 43The most common 1 2 0 0Easy to construct (cheap) 10 26 8 20Good choice 1 2 2 5Maintain it 5 13 0 0Don't know 0 0 1 2No answer 4 10 10 25Total 39 100 40 100

74

Figure 3. What kind of water facility would the households want in Solo A and Marach?

What kind of water facility would the household like to want and where?

2619

26

315

012

25 27 24

0

17

07

0

20

40

60

80

100

For

kitc

hen

For t

oile

t

Bat

hroo

m

Gar

den

Oth

er

Don

'tkn

ow

No

answ

erAnswer

%

Solo A Marach

Table 33. What are the challenges for the household regarding sanitation improvement in Solo A and Marach?Challenges regarding sanitation improvement

Solo A. Household

Solo A. Percent

Marach.Households

Marach.Percent

High water table 3 8 0 0Economical / resource limitation 17 44 13 30Some people don't want to participate 10 25 4 9No challenges 4 10 10 23To much rain 1 2 0 0More sensitizing on sanitation 0 0 3 67Lack of sanitation 1 2 4 9Don't know 1 2 2 5No answer 2 5 7 16Total 39 100 43 100

Table 34 Where do the households dump their waste in Solo A and Marach?Where occurs the dumping Solo A.


Marach.Households

Marach.Percent

Skip (Metal) 0 0 6 15Bunker 10 23 9 22Landfill 2 5 3 7Open dump 15 35 12 29Bush 7 16 3 8Compost pit 5 12 7 17Other 4 9 0 0Don't know 0 0 0 0No answer 0 0 1 2Total 43 100 41 100

Table 35. How often is the skip/bunker emptied by the local authorities in Solo A and Marach?How often is skip/bunker emptied Solo A, % of household Marach, % of householdSeveral times a week 13 23Weekly 21 15Fortnightly 0 0Monthly 13 8Irregular 5 7Never 8 13Other 21 15Don't know 13 17No answer 8 2Total 100 100

75

Table 36. Do the household (respondent/ member) practise hand washing in Solo A and Marach?Practice of hand washing3 Solo A.


Marach.Households

Marach.Percent

Yes 36 92 35 88No 0 0 0 0Don't know 0 0 0No answer 3 8 5 12Total 39 100 40 100

After defecation 34 19 33 18Before food preparation 29 16 32 18Before eating 30 17 34 19Before child feeding 19 10 23 13Water only 25 14 27 15Soap 30 17 24 13Rubbing with ash or soil 3 2 0 0Rubbing with leaves 2 1 0 0Other 9 5 6 3Total 181 100 179 100

3 (Due to several options in this question has the answers been many for each household in both Solo A and Marach.)

Table 37. If the household have taken actions to make changes to avoid diseases in Solo A and Marach. Taken actions to make changes Solo A.


Marach.Households

Marach.Percent

Bought medicine 1 3 0 0Prevent disease/sickness 17 44 21 49Maintain hygiene 13 33 20 47No available information 1 3 0 0Using protected/ guarded water 1 3 0 0No change at all 2 5 1 2Don't know 3 8 1 2No answer 1 3 0 0Total 39 100 43 100

Table 38. Do the household (member/ respondent) know any reason why people/community doesn’t use toilets some times in Solo A and Marach?Reasons for not using toilets in some areas Solo A.


Marach.Households

Marach.Percent

No toilet around/ lack of space for toilet 9 22 10 22No toilet build 3 8 0 0High water table, digging is difficult 2 5 0 0Because of cultural believes 6 15 12 27Women won't be conceiving 6 15 1 2Other reason 4 10 0 0Some people is not willing to change 0 0 2 5Toilet fee to costly 0 0 1 2Dirty toilets 0 0 6 13Don't know 10 25 12 27No answer 0 0 1 2Total 40 100 45 100

76

Table 39. Is there a traditional / cultural / religious etc. reason why people/community doesn’t use toilets in Solo A and Marach?Kind of reason for not using toilet in the areas

Solo A. Household

Solo A. Percent

Marach.Households

Marach.Percent

Economical reasons 0 0 1 3No toilet 0 0 4 10Cultural 12 31 4 10Traditional 12 31 21 52Don't know 12 30 9 23No answer 3 8 1 2Total 39 100 40 100

77

Appendix F Photos

78

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