issue 12issue 14 february 1999 april 2000 waterfront - … · waterfront issue 12issue 14•...

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WATERfront ISSUE 14 • APRIL 2000 A UNICEF PUBLICATION ON WATER, ENVIRONMENT, SANITATION AND HYGIENE continued on next page unicef United Nations Children’s Fund Fonds des Nations Unies pour l’enfance Fondo de las Naciones Unidas para la Infancia his issue of WATERfront focuses on urban environmental sanitation. In response to a call for documenting good working experiences with urban communities, UNICEF Water, Environment and Sanitation profession- als sent articles about projects supported in their countries. In addition articles have been provided by institutions working in the sector. The projects described take place in well- known cities, such as Harare and Acapulco, as well as in cities more difficult to locate on the map: Resistencia (Argen- tina), Nouakchott (Mau- ritania) and Santiago (Cape Verde). Whether they live in a metropolis or small town, the chil- dren and their families in the case studies all have something in common: they are poor and live in harsh conditions due to inadequacies in hous- ing, water, sanitation, drainage, solid waste disposal and vector control—often in combi- nation with poor health and education systems and environmental pollution At the beginning of the 21 st century, about half of the world’s population lives in areas classified as urban. By 2025, it is expected to grow to almost two-thirds. 1 The most rapid Urban environmental sanitation: What can be done to improve the living conditions of children in low-income urban settlements? changes in urban demographics will occur in developing countries, and the majority of these people will live in low-income urban settle- ments. From a rights-based perspective aiming ‘to reach the unreached’, governments, inter- national agencies, donors and support organi- sations have but one choice: not to ignore these highly vulnerable children in such urban areas. As far back as 1961, 2 UNICEF’s position was very progressive: if need was the principal criterion for assistance, there was no justification for excluding urban chil- dren from its assistance. However it was not until 1971 that UNICEF’s urban area activities fully started, with the develop- ment of the community- based Urban Basic Services (UBS) pro- grammes. UNICEF’s UBS programmes paved the way for many other agencies to take an approach that directly in- volved the communities. What was learned was that without the involvement of the commu- nity, water and sanitation service programmes of almost any type were doomed. UBS programmes demanded that the com- munity establish priorities and that facilitating Table of Contents 1 Urban environmental sanitation: What can be done to improve the living conditions of children in low-income urban settlements 3 Strategic elements in water supply and sanitation services in urban low-income areas 7 Sanitation and child rights in poor urban areas of Harare 9 The link between indoor air pollution and acute respiratory infections in children 10 The struggle for water in urban poor areas of Nouakchott, Mauritania 13 Services for the urban poor: lessons learned 16 Rehabilitation of urban water supply projects—experience from Northern Iraq 19 Plight of poor living in Brazil’s dump areas 22 The shift to poor urban areas: A strategic approach to cost- effectiveness in water, environment and sanitation 24 Integrated sanitation and housing improvement in low-income communities in Argentina 27 User perceptions in urban sanitation provision: a briefing paper 28 ‘Prosperous’ Acapulco plagued by unplanned growth 32 In Istmina, we women have changed a lot T 1 Source: World Bank, Entering the 21 st Century. World Development Report 1999/2000, Oxford Univer- sity Press, August 1999. 2 Source: Cousins, William J., Urban Basic Services in UNICEF: An Historical Overview, UNICEF History Series, Monograph XIV, 1992. The most rapid changes in urban demographics will occur in developing countries, and the majority of these people will live in low-income urban settlements.

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Page 1: ISSUE 12ISSUE 14 FEBRUARY 1999 APRIL 2000 WATERfront - … · WATERfront ISSUE 12ISSUE 14• FEBRUARY 1999• APRIL 2000 A UNICEF PUBLICATION ON WATER, ENVIRONMENT, SANITATION AND

ISSUE 12 • FEBRUARY 1999

WATERfrontI S S U E 1 4 • A P R I L 2 0 0 0

A UNICEF PUBLICATION ON WATER, ENVIRONMENT, SANITATION AND HYGIENE

continued on next pageunicefUnited Nations Children’s FundFonds des Nations Unies pour l’enfanceFondo de las Naciones Unidas para la Infancia

his issue of WATERfront focuses on urbanenvironmental sanitation. In responseto a call for documenting good working

experiences with urban communities, UNICEFWater, Environment and Sanitation profession-als sent articles about projects supported intheir countries. In addition articles have beenprovided by institutions working in the sector.

The projects described take place in well-known cities, such as Harare and Acapulco, aswell as in cities moredifficult to locate on themap: Resistencia (Argen-tina), Nouakchott (Mau-ritania) and Santiago(Cape Verde). Whetherthey live in a metropolisor small town, the chil-dren and their families inthe case studies all havesomething in common:they are poor and live inharsh conditions due to inadequacies in hous-ing, water, sanitation, drainage, solid wastedisposal and vector control—often in combi-nation with poor health and education systemsand environmental pollution

At the beginning of the 21st century, abouthalf of the world’s population lives in areasclassified as urban. By 2025, it is expected togrow to almost two-thirds.1 The most rapid

Urban environmental sanitation:What can be done to improve theliving conditions of children inlow-income urban settlements?

changes in urban demographics will occur indeveloping countries, and the majority of thesepeople will live in low-income urban settle-ments. From a rights-based perspective aiming‘to reach the unreached’, governments, inter-national agencies, donors and support organi-sations have but one choice: not to ignore thesehighly vulnerable children in such urban areas.

As far back as 1961,2 UNICEF’s positionwas very progressive: if need was the principal

criterion for assistance,there was no justificationfor excluding urban chil-dren from its assistance.However it was not until1971 that UNICEF’surban area activities fullystarted, with the develop-ment of the community-based Urban BasicServices (UBS) pro-grammes. UNICEF’s UBS

programmes paved the way for many otheragencies to take an approach that directly in-volved the communities. What was learned wasthat without the involvement of the commu-nity, water and sanitation service programmesof almost any type were doomed.

UBS programmes demanded that the com-munity establish priorities and that facilitating

Table of Contents

1 Urban environmental sanitation:What can be done to improvethe living conditions of childrenin low-income urban settlements

3 Strategic elements in watersupply and sanitation servicesin urban low-income areas

7 Sanitation and child rights inpoor urban areas of Harare

9 The link between indoor airpollution and acute respiratoryinfections in children

10 The struggle for water in urbanpoor areas of Nouakchott,Mauritania

13 Services for the urban poor:lessons learned

16 Rehabilitation of urban watersupply projects—experiencefrom Northern Iraq

19 Plight of poor living in Brazil’sdump areas

22 The shift to poor urban areas:A strategic approach to cost-effectiveness in water,environment and sanitation

24 Integrated sanitation andhousing improvement inlow-income communities inArgentina

27 User perceptions in urbansanitation provision: a briefingpaper

28 ‘Prosperous’ Acapulco plaguedby unplanned growth

32 In Istmina, we women havechanged a lot

T

1 Source: World Bank, Entering the 21st Century.World Development Report 1999/2000, Oxford Univer-sity Press, August 1999.

2 Source: Cousins, William J., Urban Basic Services inUNICEF: An Historical Overview, UNICEF HistorySeries, Monograph XIV, 1992.

The most rapid changesin urban demographics will

occur in developing countries,and the majority of these people

will live in low-incomeurban settlements.

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Issue 14 • April 2000unicef WATERfront

partners, such as local governments andwater authorities, respond on a flexiblebasis—making clear that the ‘software’part was more important for the successof a project than the actual hardwareinstalled. In spite of the good work doneunder the UBS programmes, there havealways been problems getting others onstream to bring the urban programmesto scale. Even highly successful UBSprojects such as the Tegucigalpa Modelin Honduras and the ‘El Mezquital’project in Guatemala have largely beenfailures in terms of large-scale replica-tion in their respective countries.

Within the context of UNICEF’sFuture Global Agenda for Children,3

describing the focus of UNICEF beyond2000, three priority outcomes for chil-dren are that:

■ infants start life healthy and youngchildren are nurtured in a safe andcaring environment that enablesthem to be physically healthy, men-tally alert, emotionally secure, so-cially competent and intellectuallyable to learn;

■ all children, including the poorestand most disadvantaged, have accessto and complete basic education ofgood quality;

■ adolescents have opportunities tofully develop their individual capaci-ties in safe and enabling environ-ments and are helped to participateand contribute to their societies.

The challenge of coping with urbanwater, environmental and sanitationproblems beyond the year 2000 requiresan integrated approach (leaving the‘sectors’ and vertical approaches behind)

and it cannot beaccomplished with-out multiple part-nerships. The way toproceed is by devel-oping holistic ap-proaches dealingwith the specificcharacteristics ofurban low-incomeareas rather than bydeveloping isolatedpilot projects.

The challengesare significant. How-ever, the experiencesof the UNICEFWater, Environmentand Sanitation pro-fessionals, and theother partners inthis issue, serve asreminders that evenwith limited funds,there are feasible,doable strategiesthat can be under-taken. As the follow-ing case studiesvividly illustrate,many scenarios canaddress the subject.

■ Nouakchott, Mauritania’s capital,struggles for water. Its location at theedge of a desert makes water scarce,expensive and unfit for drinkingpurposes. At the request of the city’smayor, UNICEF supported the reor-ganisation of the stand-pipe manage-ment system, helping to improveliving conditions for the urban poorby stabilizing water prices and im-proving the organisation of watervendors.

■ In peri-urban Harare, a participatoryprocess was used, with communitymembers themselves identifying themost significant problems in theirliving environment. Women andchildren saw inadequate water supplyand full or unhygienic communitylatrines as their greatest concerns.After these priorities, they recog-nised the lack of formal employmentand the need for full day pre-schoolcentres.

■ In northern Iraq, UNICEF was re-sponsible for the rehabilitation ofurban water-supply projects dam-aged by the Gulf War. The experi-ences gained, particularly regardingthe process of planning, implementa-tion and management, will be useful

continued on page 23

Due to limited space availability, wewere not able to include all the UNICEFcountry experiences that we receivedfor this issue. These articles will be pub-lished in future editions of WATERfront,and will be made available onwww.unicef.org/programme/wes

3 UNICEF Executive Board DocumentE/ICEF/1999/10, 13 April 1999.

The way to proceed is bydeveloping holistic approaches

dealing with the specificcharacteristics of urban

low-income areas rather thanby developing isolated

pilot projects.

UN

ICEF

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Issue 14 • April 2000 unicef WATERfront

Strategic elements in water supply andsanitation services in urban low-income areasBy Madeleen Wegelin-Schuringa, IRC International Water and Sanitation Centre, Delft, the Netherlands

Voluntary Health Group at work, Kibera Settlement, Nairobi, Kenya

Introductionn many cities and towns in develop-ing countries, access to basic infra-structure services such as water

supply, sanitation, solid-waste collectionand drainage is inadequate for a major-ity of the residents, especially for thoseliving in low-income urban areas. Therapid rate at which the populations inthese areas are increasing compoundsthis situation and often leads to environ-mental living conditions that endangerthe health of the residents, with conse-quent losses in productivity and qualityof life.

Many governments have come torealise they will not be able to extendservices to all urban residents with con-ventional strategies. It is to this end thatinnovative approaches are being intro-duced, not only with respect to technicalsolutions, but also in ways to involvedifferent stakeholders. On the basis of

the experiences built up over the years, anumber of strategic elements can beidentified that affect the viability andsustainability of all activities aimed atimproving basic service provision inurban low-income areas. These elementsare legal and regulatory framework, thesocial context, the institutional context,the financial context, the environmentalcontext, technology and service levels.

A short introduction to these ele-ments is given below, as well as somekey options for actions to address them

in practice. Although it is clear thatsome of these options are beyond a par-ticular programme to change, it may bepossible to convince a municipality toadapt existing rules and regulations on atrial basis. If all have to wait until poli-cies or management structures havechanged, the conditions in low-incomeurban areas will deteriorate even further.

Legal and regulatoryframeworkSecurity and/or legal recognition oftenure is often a prerequisite for theinvestment of resources in basic infra-structure services for both the residentsand the municipal authorities. The resi-dents will not spend their money oninfrastructure if they are not sure theycan stay in the settlement. Municipalauthorities are often not allowed toprovide services in areas that are consid-ered illegal, even though a high percent-age of their population may be livingthere. Yet, to obtain legal recognitionnot only requires lengthy formalities andcomplicated bureaucratic procedures,but is often also a hot political issue. Inaddition, it can easily result in increasein value of land and houses and there-fore may lead to expulsion of tenantsand poor homeowners. Luckily, in manycities it has been demonstrated that defacto security of tenure can be as func-tional as legal recognition in mobilisinglow-income communities for infrastruc-ture improvements.

A second issue is that legal recogni-tion of tenure may only be obtainable ifhousing and infrastructure servicescomply with the standards that are set inthe regulatory framework. Often, thesestandards are set so high that they areneither functional nor beneficial to theresidents and tend to stifle rather than topromote development. In Kenya, the

Many governments have cometo realise they will not be able

to extend services to allurban residents with

conventional strategies.

I

Mad

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n W

egel

in-S

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regulatory framework was changed toincorporate a ‘deemed to satisfy’ regula-tion, which enabled the municipality tolower its standards for these areas.

Options for action■ Find ways to ensure de facto security

of tenure where legal recognitioncannot easily be obtained,

■ Introduce flexibility with regulationsor other legal impediments that pre-vent service provision in illegal areas,

■ Lower existing building and servicestandards to ‘deemed to satisfy’ solu-tions,

■ Make it possible for communities toregister as a legal entity, facilitatingcommunity management and owner-ship of WSS assets,

■ Promote a regulatory framework thatstimulates private-sector operators orpublic–private partnerships to pro-vide services.

The social contextJust like in rural areas, basic infrastruc-ture services in low-income urban com-munities have the best chance of beingsustainable if the community is moti-vated to improve the services, has beeninvolved in their planning from the startand has selected the technology andservice level. For this to happen, a com-munity needs to become organised andovercome internal differences. This canbe very difficult in urban areas as a re-sult of a heterogeneous composition interms of ethnicity, religion, occupationand economic conditions. This not onlycan create a lot of distrust between thedifferent groups, but the common lead-ership needed to overcome it, may wellbe lacking.

In areas where the proportion oftenants and absentee landlords is high,community organisation is very difficultbecause tenants do not feel responsiblefor improvements, while the absenteelandlords do not suffer from poor envi-ronmental conditions. Motivation forimprovement of basic services can be low,as the prime concern may well be a cheapand temporary place to live, the improve-

ment of economic conditions or theincrease of employment opportunities.

Another factor of influence on moti-vation is the degree of urbanisation ofthe residents. If primary attachment is tothe rural home, any savings are likely tobe spent in the rural areas. When the cityis acknowledged to be the home base,especially for the future generation,residents and especially resident ownersof structures are more inclined to spendeffort and funds towards improvingtheir neighbourhoods and adaptationsto suit high-density living.

In many cities, women head themajority of the households. Thesehouseholds usually also belong to thepoorest households in the community.Yet males often dominate organisationsand little effort is done to plan, imple-ment, operate and maintain basic serv-ices in such a way that gender-specificand poverty-related concerns are takeninto account. This may affect the priori-ties for development activities stated bythe community and hence may affect thedegree of participation by women, andtherefore the sustainability of the systems.

Options for action■ Ensure that the different segments of

the community (women, men, young,old, rich, poor, etc), their leaders andtheir organisations are identified

■ Develop an information and commu-nication strategy that addresses allsegments

■ Ensure that all segments are involvedin planning

■ Develop participatory hygiene-edu-cation activities based on self-assess-ment of existing conditions

The institutional contextMunicipal authorities have the mainresponsibility for the provision, opera-tion and maintenance of urban water-supply services. Their interest is thesmooth functioning of the water-supplyservice, low operating cost, adequaterevenues and the possibility to expandservices if necessary. They are not neces-sarily concerned with the provision ofservices to low-income areas. Theiroften poor performance is caused byinternal problems (lack of management,financial autonomy, decentralisation ofdecision making as well as lack of hu-man resources and capacity) and exter-nal conditions (political influence,unclear and/or conflicting responsibili-ties at different government levels, cen-tralisation of decision making).

Few municipalities have a section intheir water and sanitation departmentsin which staff is trained to work withand for communities, while co-ordina-tion with the departments that do havethis staff is usually weak. Yet participa-tory approaches to infrastructure im-provements require a specific attitudewithin the municipal authorities inwhich residents are seen as stakeholdersand clients rather than as receivers ofservices. They also require longer timeframes, more flexibility, a well-devel-oped information and communicationstrategy and training for municipal staff,different from conventional programmes.

The lack of performance of the mu-nicipal authorities has led to a situationwhere a majority of residents in low-income areas is dependent on otherservice providers for their basic services.These may be formal private-sectorproviders but they usually are informal,such as individuals, families and smallenterprises. They are engaged in similaractivities as formal enterprises, but on asmaller scale and usually confined toservice provision in low-income areas.The main interest of these enterprises isincome generation. Because they aresmall, they are flexible and able to re-

…basic infrastructure services inlow-income urban communitieshave the best chance of beingsustainable if the communityis motivated to improve the

services, has been involved intheir planning from the start

and has selected the technologyand service level.

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spond to demand from the consumers,while profits made are often reinvestedin the same area, therefore contributingto improvement of conditions.

A second form of informal serviceprovision is generated through commu-nity-based organisations and/or NGOs,who themselves may either becomeservice providers or assist the communi-ties and their organisations in the devel-opment of a sustainable service. In manycities, NGOs have developed a functionas a mediator between the communitiesand the municipal authorities. There is awhole range of different types of com-munity-managed service provision rang-ing from group taps andcommunity-managed kiosks to com-pletely autonomous community-basedsystems. Some of these systems sufferfrom local politics that are characterisedby patronage relationships betweenpoliticians and communities, in whichprovision of infrastructure becomes anattractive political power tool.

Options for action■ Establish a special section in the

municipality/utility to deal withservice provision in low-income areas

■ Promote training in municipal author-ities on issues and approaches forservice provision in low-income areas

■ Assess roles, responsibilities and insti-tutional relationships of all serviceproviders and other stakeholders inthe area, and involve and incorporatethem in planning for improvements

■ Promote establishment of public–private partnerships and informalsector operations

■ Assess legal impediments for informalservice provision and if dysfunctional,try to address them

■ Promote environmental concernsand hygiene education activities withinformal service providers

The financial contextAn often-used argument reasoning whyauthorities cannot provide water in low-income areas is that the residents cannotsufficiently pay for their water to operateand maintain the system, let alone to geta return on the capital investment. Thisis not true in most cities, as most peoplein low-income areas depend on vendorsfor their water or buy water per bucket.The prices paid for this are considerablyhigher per unit than through a connec-tion to the water-supply system. Thedifferentials in the cost of water (ratio ofprice charged by water vendors to pricescharged by the public utility) vary fromcity to city (from 5:1 to 100:1) and aredependent on various factors such asaccess to alternative sources and controland competition on the resale market.

A more valid reason why serviceprovision in these areas is low is thatmost utilities charge tariffs that are notbased on cost-recovery calculations, butare heavily subsidised. The determina-tion of tariffs is a political issue andgovernments profess to regard water as asocial good rather than an economicgood. However, since the higher- andmiddle-income residents are more likelyto be connected to the water network,the subsidies and the social good benefitthem rather than the poor. The result isinsufficient resources to extend the net-work, especially to the badly locatedlow-income areas. Of influence as wellon the resources—physical as well asfinancial—are the high rates of waterunaccounted for, common in manycities in developing countries, reachingextreme levels of 40–60% of the waterproduced.

Other basic infrastructure services(drainage, sewage and solid waste collec-tion) are commonly funded throughtaxes, which people in low-income areasoften do not pay. The financing of these

services is usually already a problem forthe whole city and the lack of tax collec-tion is therefore a welcome excuse fornon-service.

At the community level, financingand cost-recovery mechanisms are influ-enced by the degree of demand respon-siveness, but also by the mechanisms inplace for payments and contribution. Itneeds to be noted that contribution inkind (labour or materials) may be diffi-cult to organise because time is moneyand income opportunity lost.

Options for action■ Promote the concept of water as an

economic good and the use of subsi-dies, if at all necessary, to improveaccess to services by the poor

■ Promote a more equitable division ofbasic infrastructure services andadherence to cost recovery in princi-ple and in action

■ Remove impediments to an open,informal market as it drives up pricesfor the poor

■ Develop payment systems togetherwith the community representatives

■ Ensure that there are mechanismsthat allow access to services by thepoorest

■ Develop approaches that help commu-nities to select a system and level ofservice that they want and can pay for

The environmental contextThe environment in low-income urbanareas is often characterised by high den-sities and location on land that is notvery suitable for residential purposes,such as steep hills, riverbeds or swamps.The general lack of space in the areasstresses the interdependency and inte-grated nature of all infrastructure serv-ices. Improvement of water supplynecessitates improvement of drainage,which requires improvement of solid-waste collection; off-site sanitation op-tions require sufficiency of water supply.The condition and presence of roads,moreover, is connected to all these serv-ices. Yet authorities work sectorally,

The lack of performanceof the municipal authoritieshas led to a situation where

a majority of residents inlow-income areas is dependent

on other service providersfor their basic services.

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which makes integrated planning atcommunity level very difficult.

The hygienic disposal of wastes ismore difficult than bringing in water,while the provision of the water supplyhas more priority with the residents andis therefore more likely to be facilitatedby municipal authorities. The lack ofattention for disposal results in environ-mental conditions that pose a threat tothe residents’ health, especially becausesystems installed by householders them-selves often have a low technical qualityand contribute to deterioration of envi-ronmental conditions.

At a municipal and even regionallevel, the issue of water-resources man-agement is becoming more important ascities grow and demand surpasses sup-ply. Water resources are threatened notonly by increasing demand, but also bydiminishing quality caused by pollutionand saline intrusion, as well as reducedquantity caused by overexploitation ofwater catchment areas. They are alsothreatened by the competition for scarcewater between industrial, agriculturaland domestic use, which is becoming apolitical issue in many cities. This hasled to a cry for water demand manage-ment (defined as a strategy to improveefficiency and sustainable use of waterresources taking into account economic,social and environmental considera-tions) as the preferred alternative abovethe development of new sources to meetincreasing water demand.

Options for action■ Establish co-ordination mechanisms

between sectoral departments thatwork in the same low-income areas

■ Assess what environmental problemsare linked to the supply or non-sup-ply of water and sanitation services

■ Base activities on community assess-ment of their priority environmentalissue

■ Build on any activities that are alreadybeing undertaken by the community,or other actors, to ameliorate theproblems

Technology and service levelsTechnologies appropriate for low-in-come areas are those in which the tech-nical and organisational characteristicsof the infrastructure system are adaptedto the socio-economic and environmen-tal conditions in the community. Thereverse is common as municipal serviceproviders are focused on conventionalsystems. The prevailing technical stand-ards and regulations often hinder theapplication of appropriate technologies,and the systems are not adapted to ac-tual need and demand in low-incomeareas. Municipal engineers, moreover,are not trained in low-cost technologiesand regard these as substandard.

Many so-called appropriate tech-nologies have been developed for therural areas, but their adaptability for useand operation in low-income urbanareas is not always clear. Foremost, thetype of land and the densities of theseareas require specific technologies. Sec-ond, operation and maintenance re-quirements for these systems by thecommunity may be more difficult toorganise as a result of the nature of theurban communities. A third point is theenvironmental impact of technologies inthe high-density conditions prevailing inmost areas. Finally, appropriate technol-ogy options at community level willhave to link up with the hierarchicalnetwork of the whole city and can there-fore not be developed in isolation.

Options for action■ Develop an approach that ensures

the community has a choice in thetechnology and the service level, whilebeing aware of the cost implications

■ Ensure that the technology selectedcan be managed by the communityand does not have a negative impacton the environment

■ Train local engineers and techniciansin low-cost technologies

■ Support the development of tech-nologies appropriate for conditionsin low-income areas

■ Ensure that the technology and serv-ice provision links up with the mu-nicipal-level network

EpilogueThese strategic elements show how diffi-cult service provision in low-incomeareas actually is. While many aspects aremore difficult to address than in ruralareas, there are also aspects that make asustainable provision easier. For in-stance, there is a greater prevalence ofNGOs, facilitating a mediation rolebetween municipalities and communi-ties, and more civic organisations thatcan be prevailed upon for the manage-ment of systems. A money economy,more access to spare parts and repairservices and the existence of a privatesector enhance sustainability in urbanservice provision. Finally, the existingmunicipal service network at least en-sures one source of water supply.

Time, flexibility and effective com-munication in and between the munici-pality and the community is crucial.Moreover, capacity building is needednot only in the municipality and thecommunity but also in sectoral organi-sations or NGOs to ensure that, with thehelp of participatory approaches, com-munity-based development is stimulatedand appropriate technologies are applied.

The author of this article can be contactedat [email protected]

While many aspects aremore difficult to address

than in rural areas,there are also aspects that makea sustainable provision easier.

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Introductionnformal settlements on the outskirtsof Harare, the capital of Zimbabwe,have largely been fed by rural-urban

migration during the 1990s. Such migra-tion is expected to intensify throughoutthe country, but especially in Harare.While government commonly refersto these areas as ‘temporary holdingcamps,’ the Zimbabwe economy is insharp decline, and alternative plans forthese people are not in sight. In themeantime, basic services and infrastruc-ture to meet the needs of this rapidlygrowing population are alarminglyinsufficient and, in some cases, non-existent.

As part of its strategy to advocatewith a wide range of partners for im-provements in the lives of urban poordwellers around the country, UNICEFZimbabwe has been working with twolocal NGOs to take urgent action toaddress the needs of some of Harare’smost disenfranchised residents.

In 1998, the UNICEF Hygiene, Edu-cation, Water and Sanitation (HEWASA)programme supported emergency effortsin the Porta Farm settlement to providebasic sanitation facilities where noneexisted. Mvuramanzi Trust, an NGOwith expertise in the promotion offamily wells, household latrines andlow-cost technology development, built20 double-pit composting latrines andinvolved the residents in their construc-tion and continued maintenance.Mvuramanzi Trust also worked in coop-eration with another NGO, Inter-CountryPeople’s Aid (IPA) in improving schoolsanitation and providing hygiene educa-tion in Porta Farm.

Despite the success of these service-delivery activities, the persistent envi-ronmental problems in Porta Farm andother urban poor settlements, and the

Sanitation and child rights in poorurban areas of Harareby Mark Henderson, WES-officer, UNICEF-Zimbabwe

clear need to address them, promptedHEWASA to propose an urban poorwater and sanitation situation analysisthat would shift the emergency focus ofthe intervention to one of development.With UNICEF in the process of develop-ing Country Programme 2000–2004,there was also an opportunity for ex-panding the scope of the situation analy-sis so as to contribute to the thrust ofcommunity capacity building for child-rights protection. Three informal settle-ments were targeted for assessment andintervention.

BackgroundThe targeted settlements, all having amajority of children, are:

■ Porta Farm: 35 km. west of Harare;population 4,200

■ Dzivarasekwa Extension: 18 km. westof Harare; population 3,200

■ Hatcliffe Extension: 21 km. north ofHarare; population 8,100

Porta Farm residents were forciblymoved from other ‘spontaneous’ neigh-bourhoods in 1991. In 1992, the cityof Harare built wooden shacks atDzivarasekwa Extension for those atPorta Farm who were working or ableto pay rent. This was intended to be athree-month temporary solution to theovercrowding at Porta Farm whileproper houses were built, but nobodyhas received houses to date.

Hatcliffe Extension was created in1993 for people evicted from farms orother neighbourhoods. In 1997 the gov-

ernment built 803 log cabins, but thisproved inadequate for the population of8,100; a great number of people havenow built homes consisting of poles,plastic sheeting, tin and thatch. In 1997,the Ministry of Housing removed 16families to permanent housing sites onanother scheme.

Situation analysis findingsIPA was contracted to research andproduce a situation analysis of childrenand women in three urban poor settle-ments in which key problem areas wereto be examined:

■ Living environment (water, sanita-tion and environment)

■ Health and nutrition

■ Socio-economic environment ofwomen and children

■ Education

■ Children with special protectionneeds

Research within the settlements wascarried out between September 1998and November 1998 by a team includinginvestigators and assistants from theUniversity of Zimbabwe. Researchmethodologies included a literaturereview, a structured questionnaire forheads of households and in-depth inter-views with key informants from govern-ment, donors, NGOs and otherstakeholders. PRA techniques enabledthe communities to identify and ranktheir problems, to carry out mapping oftheir respective areas, to produce chartsindicating seasonal activities and todocument the daily activities of womenand children. An average of 60 womenand children in each settlement partici-pated in the process.

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None of the settlementshave adequate sanitation.

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Water and sanitationDzivarasekwa Extension and Porta Farmresidents reported having an adequatewater supply, although informants alsocomplained of long queues when waterpoints are down and of low pressure atcommunal taps. Hatcliffe Extension hasonly four boreholes working out of apossible 14. Residents at Hatcliffe Exten-sion, therefore, endure long queues atwater points and spend one hour or morefetching water at the expense of otherchores and income-generating activities.

None of the settlements have ade-quate sanitation, in stark contrast toformal urban areas in Harare wherecoverage rates for flush toilets is 94%.Residents stated that communal latrinesare too far away from their houses andhave no lighting, making them impossi-ble to use at night. Dzivarasekwa Exten-sion and Hatcliffe Extension do not havelatrines at their respective schools.

Practically all residents (99%) usecommunal VIP or pit latrines; only a fewhave their own latrine. Communal pitsin Hatcliffe Extension are full and mostare closed. Their utilisation is also re-duced because elders are not comfort-able using a squat hole next to a youngperson. Residents often defecate at homeand discard the waste in plastic bags inopen fields.

A majority of the heads of house-holds wash their hands before a meal,

but one third do not wash their handsafter visiting the latrine. Three quarterswash hands using a communal bowlwithout soap and only 14% wash underrunning water.

The living environment of each set-tlement is poor. Dzivarasekwa Extensionand Hatcliffe Extension do have councilbins for refuse disposal, but the city ofHarare only intermittently collectsthem. The population of Porta Farmdepends entirely on communal pits,dumping or burning of refuse.

HealthTwo of the three settlements have clin-ics, but they are not fully staffed or func-tional. About 70% of the population inall three settlements stated that it takesbetween one and five hours to travel tothe nearest clinic, receive treatment andtravel back home. One fifth reportedthis time to be six to 10 hours.

The top disease for children under14 is acute respiratory infection. Themain others are diarrhoea, skin diseases,injuries and eye diseases. For those aged

15 years and above,STDs are the mostcommon infection.Only 53% of house-holds reportedeating three meals aday.

Although healtheducation is, or hasbeen, provided ineach community,more needs to bedone to transformthis knowledge intopractice. Womenrequested moreinformation onHIV and AIDS inorder to protectthemselves and

their families.

Summary of other findingsSocio-economic■ 30% of inhabitants are not Zimba-

bwean

■ 46% of heads of households aremarried and living with spouse andchildren

■ 35% of heads of households are un-employed

■ Girls, orphans and children livingwith step-parents were more burdenedwith labour

■ 13% have access to TV and 43% ownradios

Education■ Each settlement has a primary school

that is not formally registered withthe Ministry of Education

■ Pre-school enrollment ranges as highas 400 children

■ Majority of residents have attendedat least primary school

■ 45% cited lack of money for schoolfee and uniforms as the reason whysome children are not in school

■ None of the schools have adequatelatrines

Existing development activities byNGOs and city of Harare■ Basic education; adult literacy classes

■ Paper making; women’s sewing group

■ Staffing of clinic and communityhealth workers

■ Provision of birth certificate

■ Training in nutrition gardens

■ Mobile clinic service; HIV/AIDSeducation

Primary concerns of women andchildrenThe most significant problems identifiedby women and children living in theseurban poor settlements included:

The top disease forchildren under 14 is acute

respiratory infection.

continued on page 15Lightweight Blair-type latrines are light to lift when made of strong,thin-walled ferrocement.

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cute respiratory infection (ARI) isthe most important cause ofdeath for children under five

years in developing countries. The mostserious type of ARI is acute lower respi-ratory infection, most of which is due topneumonia. At present, the main strat-egy for the control of ARI is the promo-tion of community-based earlydetection and treatment, with follow-up.

Recently, more attention has beenpaid to the potential for prevention ofARI through interventions that addressenvironmental risk factors such as airpollution, housing conditions, and over-crowding. One of these risk factors isindoor air pollution.

The Integrated Management forChildhood Illness (IMCI) strategy underleadership of UNICEF/WHO and oth-ers, has been developed to reduce childmorbidity and mortality from five majorchildhood diseases including acute res-piratory infections (ARI), diarrhoea,malaria, malnutrition and measlesthrough prevention and treatment. Itaims to improve the skills of healthworkers in case management improvehealth system delivery and strengthenfamily and community responses tochildhood illness. IMCI emphasisesprevention of disease through immuni-sation, careseeking behaviour, improvednutrition, exclusive breastfeeding andthe use of insecticide impregnatedbednets.

Health effects of indoorair pollution exposureStudies in many parts of the world haveconfirmed that open fires and simplestoves used inside small, often poorlyventilated homes lead to some of thehighest levels of air pollution in theworld. While smoke from biomass andother domestic fuels contains thousandsof chemical substances, total suspendedparticulate (TSP) is generally thought to

The link between indoor air pollution andacute respiratory infections in children

provide a good indication of the health-damaging potential of air pollution.

TSP levels during cooking withbiomass fuels typically range from sev-eral thousand to over 20,000µg/m3.Particulates of less than 10 microns indiameter (PM10) are able to penetrateinto the lungs and are regarded as morerepresentative measure of health risk.PM10 level in a poorly ventilated homeusing simple biomass fuel stove can be50 times higher than the standard rec-ommended by the World Health Organi-zation.1

Growing evidence strongly suggeststhat indoor air pollution at these highlevels of exposure is an important riskfactor for ARI. There is reasonable con-sistency among various studies trying tolink indoor air pollution with ARI, al-though some have not found an associa-tion. Most of the positive studies reportthat children exposed to a higher level ofindoor air pollution were between 2-5times more likely to develop ARI thanthose unexposed or exposed less.

A number of methodological weak-nesses must be taken into account whenassessing the findings. Few studies havedirectly measured exposure, using insteadproxies such as type of fire, reportedhours spent near the fire, or whether achild was carried on the mother’s backduring cooking. Also a number of thestudies drew their samples from amongalready hospitalised children. Others didnot deal adequately with confoundingsocio-economic factors.

Reducing exposure of childrento indoor air pollutionExposures can be reduced in four ways:by (1) modifying the stove, (2) improv-ing ventilation, (3) using cleaner fuels,

or (4) protecting the child from smoke.While these may appear straightforward,the central role that the fire or stoveplays in the activities of the household,providing for cooking, warmth, light,and social functions, makes it a challeng-ing task. Practical, financial, environmen-tal and behaviour change issues must beconsidered when designing interventionsto reduce human exposure to indoor airpollution. There is also a need to adopt abroader approach aimed at improvingthe whole home environment.

Indoor air pollution has not receivedsufficient research and policy attention,given the extent of exposure of so manyof the world’s most vulnerable popula-tions. One explanation is that histori-cally and in the media, air pollution isseen as arising from traffic and industryin the cities of the developed world.Another is that the scientific evidenceon the health effects of indoor air pollu-tion in developing countries has beenregarded by many as insufficiently robust.In addition, the poor, in particularwomen and children, do not have astrong voice in forums where globalenvironmental policy is determined.

As with policy in other aspects ofenvironment and health, action onindoor air pollution control needs to betaken on the basis of imperfect evidence.The appropriate action shall includemore applied health research, opera-tional research, policy research, programstrategy development, and concretestove and cleaner fuel projects.

(Extracted from Lowering Exposure ofChildren to Indoor Air Pollution toPrevent ARI: The Need for Informationand Action by Nigel Bruce, Departmentof Public Health, University of Liverpool,Capsule Report no.3, EnvironmentalHealth Project, January 1999 and withinput form the Health Section, ProgrammeDivision, UNICEF New York)

1 WHO recognizes that relatively small in-creases above the level of 20 µg/m3 PM10 havean impact on health.

A

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ater is scarce, expensive andunfit to drink in Nouakchott,

the capital of Mauritania. Thecity is located on Africa’s Atlantic coast-line at the edge of a vast desert. A wellabout 60 km from Nouakchott suppliesthe city with water. The present capacityof the groundwater extraction stationhas not been adapted to the city’s rapidgeographical and demographic growth,which has been boosted by rural migra-tion to urban areas because of a severedrought cycle.

From 1970 to 1995, Nouakchottexpanded fourfold, to more than 8,500hectares, and the city’s population in-creased, from 5,000 inhabitants to500,000. As a result, there is not only acapacity problem but also a shortage ofdistribution networks, especially in thecity’s urban poor areas. Access to waterin urban poor communities is scarce andexpensive. In addition the quality of thatwater is poor. Water availability in thesecommunities is estimated at 10 litres perinhabitant/day, which covers less than40% of the actual needs.

AssessmentSeveral factors make the water supply inthese areas both precarious and expen-sive. They include availability, accessibil-ity, organisation of the commercialnetwork, and water quality.

Availability: The distribution network isin bad condition. The water pressure istoo low given the water needs for indus-try and vegetable gardens.

Accessibility: Only 179 standpipes wereinstalled to cover the entire urban poorarea. This corresponds to a ratio ofabout one standpipe for 2,500 inhabit-ants; as compared to the national stand-ard of one standpipe for 1,100inhabitants. In addition the inefficient

The struggle for water in poor urban areasof Nouakchott, Mauritaniaby Arsène Azandossessi, WES-Officer, UNICEF-Mauritania

geographical distribution of the stand-pipes further worsens the situation.

Organisation: There are no mechanismsto regulate or to control water distri-bution in urban poor communities.Technical norms for the standpipes,regulations for the provision of services(authorisations, statutes, specifica-tions), financing mechanisms (muni-cipal taxes) and the modalities ofintervention or of partnership withother actors are yet to be established.This lack of organisation affects boththe management of standpipes andthe price of water.

Price of water: Commercial speculationin drinking water is rampant inNouakchott. As a result, the price ofwater is too expensive for poor people.Water sold by the National Water Soci-ety at US$ 0.37/m3 is sold at the end ofthe distribution chain by donkey-cartwater vendors at US$ 3.71. A price thatcan even rise to US$ 17.32 when watershortage occurs. Water supply absorbs14-20 % of the budget of a low-incomehousehold.

Water quality: Control and monitoringof water quality, an essential health fac-tor, is not given much attention. Storageand transportation conditions are gener-ally poor.

In view of the above, the municipality ofNouakchott and the local administra-tions involved—with the support ofother partners, including UNICEF—decided in 1998 to entirely reorganisethe management system of standpipes.The experience of pilot projects previ-ously initiated by UNICEF in the neigh-bourhood of Dar Naïm was used as areference model.

Standpipes were selected on the basisof geographical accessibility, water qual-

ity and production capacity. The projectwas initially programmed to rehabilitate25 standpipes. The higher volume ofdonor contributions than expected,made that 51 standpipes spread overeight of the city’s communities could berehabilitated.

The project had two objectives: (1)to contribute to poverty alleviation inNouakchott’s urban poor communities;and (2) to ensure the access to waterconforming to technical, sanitary, socialand economic standards.

StrategiesWith this in mind, two strategies wereimplemented:

■ the choice of intermediaries struc-tures (NGOs, unemployed gradu-ates) as relays between institutionalactors and beneficiary communities;

■ the establishment of User Committeesat the community level, representingthe communities involved and moni-toring the cost and quality of water.

The resultsManagement systemA new standpipe management systemwas established. New managers replacedthe previous owners and managers, whowere solely interested in making profits.The new managers are young previouslyunemployed university graduates,mostly with an economics background.In touch with the population’s dailypriorities, the new managers are eager toserve the interests of the community. Inaddition, they are eager to demonstratetheir abilities to future potential employ-ers. This management system is super-vised by the Commission on HumanRights, Poverty Control and Insertion(CHRPCI).

W

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PricesPrices are controlled at the source. De-spite the increased cost of water extrac-tion (use of new equipment, ensuring animproved water quality), the price ofwater was maintained and efforts arebeing made to lower it further. Wherestorage tanks were constructed to com-pensate for the absence of standpipes,the price of water remains stable.

Organisation of the waterdistribution in the communitiesWater-selling activities were organised,and roles were defined with more preci-sion. Young managers now have aclearer picture of the poverty profile.They are aware of the conditions andtripartite chains of distribution (stand-pipe, donkey-cart water vendors andhouseholds), and they are familiar withthe various political and social actors ofthe target communities. They have, forexample, developed a social dimensionin the water distribution system by rely-ing on the network of local associations.‘Water houses’, serving as local referenceand concentration centres on the vitalquestion of water, were established in allof the communities involved. NGOsbecame involved in the training andsupervision of new managers during thefirst six months of the project’s imple-mentation.

LobbyingThe successes, so far, are the results of afour-year negotiations between donorsand the traditional water vendors. Therewere three stages in this process:

1. Initially, pilot projects were estab-lished in the newest urban poor ar-eas. Far from the merchants’‘territories’. In these projects, a par-ticipatory approach was imple-mented, with management andoperation of the infrastructure beingthe direct responsibility of the com-munity. This led to a sense of owner-ship for the users and to a growingdistance between them and a fullarray of intermediaries.

2. Next, significant changes were ob-served concerning the cost of water.The price of a cubic metre of waterdecreased. This led to an increase inwater consumption. To ensure thisresult, a huge advocacy effort had tobe undertaken at all levels: decisionmakers, donors and communities.

The strategy was based on study-ing the water-supply mechanisms inNouakchott’s urban poor communi-ties. The conclusions have shed lighton the existing management systemand on the interests associated withit, generating much discussionamong development partners.

3. In the last stage, the strategy con-sisted of establishing a water lobby atthe donor level (French Develop-ment Agency, WHO, GermanAgency for Technical Cooperation,UNICEF) and at the national deci-sion-maker level (National Waterand Electricity Society, NationalHygiene Centre, Municipality ofNouakchott, CHRPCI). The aim wasto spread one message: ‘Clean waterat an affordable price forNouakchott’s poor communities’.The strong will of national authori-

ties to improve drinking water supply inurban poor communities, as part of thestrategy to control poverty, was a deter-minant factor in the extension of theapproach.

Lessons learnedStakeholders’ logic versusProject’s logicA major obstacle to extending the ap-proach was that the interests of allstakeholders of the current distributionsystem (standpipe owners or managers,donkey-cart water vendors, users) didnot merge with the project’s objectives.

While owners and managers clearlyunderstood and accepted the objectivesof price and quality, donkey-cart watervendors, for their part, have no interestin joining in an effort that would con-siderably reduce their profit margin. Theonly possible arbitrators in this debateare the users in urban poor areas, who,unfortunately, are difficult to mobilise.Even when user associations manage toestablish themselves, they often becomethe prey of politicians more eager todefend their own interests than those ofthe majority. It is obvious that, if usersdo not get involved in regulating theprice of water, results will remain partialand merely limited to the standpipe.

The standpipe: A strong alternativeThe strategy of the household waterconnection—allowing a larger numberof poor households to subscribe to theNational Water and Electricity Society—guarantees an improved water qualityand allows control of the price of water.However, it is not adapted to the current

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urban dynamics, characterised by a risingand uncontrollable spatial and demo-graphic growth, or to the economic andfinancial incapacities of poor households.

With this in mind, the standpiperepresents an interesting alternative forpoor households: The investment costsit requires are modest and it concretelyimproves drinking water distributionservices in the city’s poorest areas. In-deed, low retail prices are most adaptedto the limited savings capacity of poorhouseholds.

The results recorded so far may notbe entirely satisfactory for the entiredistribution system, where the cost ofdrinking water remains too high at thehousehold level. Yet, the new dynamicinitiated around the issue of drinkingwater in urban poor areas—the estab-lishment of new standpipes, the newmanagement system, the control ofwater quality involving users—repre-sents significant steps towards progres-sive regulation of prices and controlover the distribution network.

Since the greatest challenge is thecontrol of user prices, it is crucial todevelop large-scale awareness activitiesand to gradually eliminate intermediar-ies, such as donkey-cart water vendorsor private intermediaries whose onlymotivation is making profit, even if itseems detrimental to the poor urbanpopulations. Hence, there are reasons tobe hopeful that at the end of this ongoingeffort, the struggle for water, so crucialin arid Mauritania, will finally be won.

“Here, water is a major urban issue,” saysAichétou, a woman shaped by the passageof time and the harsh realities of a poorurban life with the almost total absence ofbasic social services. Aichétou is the presi-dent of a co-operative association of 100female heads of households. The associa-tion was initiated by UNICEF in Dar Naïm,an area in the suburbs of Nouakchott.

Dar Naïm, located northeast of the city,mushroomed after the 1980s, which hadbeen years of drought marked by a largerural exodus. Today, the area has almost80,000 inhabitants with six primaryschools, one junior high school and twohealth centres. By organising themselves,the women of the co-operative have de-cided to alter the course of their destiny bytaking into their own hands the area’smain problem: supplying drinking water totheir families.

Aichétou, her face serene and dreamy,likes to tell the story: “In the beginning, wedid not know exactly why we should gettogether to sell water, which did not yieldmuch direct profit for our members. Butfrom early on, we understood that the futureof our households depended on sellingwater. For example, prior to the project,my expenses for water for my five-memberfamily were US$ 1.25, every two days.This was about a quarter of the total familybudget. Even worse, not only was thewater insufficient for my needs, it was also

Aichétou: Women solving their water problems

unhealthy and contaminated.“Today, thanks to the project managed

by our association, I can obtain good qual-ity water at a reasonable price. We buy a200 litre barrel of water for US$ 0.35. Itused to cost US$1.38. Which makes it pos-sible for us to save money. For example,I can go into town more often by using themoney saved for transportation.”

Her smiling face bursts with satisfactionas she takes out her calculator, loses herselffor a moment in discussion with her vicepresident, then triumphantly declares:“I save $0.40 per day, or $144 per year.Apart from these savings, from now on Ican count on the solidarity of 99 women,for our fire hydrant project. There are nolonger isolated problems. The group canaddress all problems. If we do not find thesolutions, we send a delegation to speakwith the mayor.”

Filled with pride, she says: “The mayorreceives us anytime it’s necessary. It’s goodto be organised. Right now, despite the ab-sence of direct profit on the water, we arealready mobilised to begin other activities.”She then lists the endeavours:

• Shops. “We can sell basic necessities(tea, milk, sugar, oil, rice, wheat). Wewill sell these products cheaper thanthe local merchants, who take no pityon poor households like ours. And be-sides, having more shops will make it

possible for us to sell traditional toiletryarticles.”

• Community latrines and showers:“Here, in our community, it is difficultto find a household with a decentshower.” She bursts out laughing, “Weare of the desert, but a nomad whostops wandering has to stop…and be-gin to adapt to his new environment.”

• Garden: “The children’s garden willnot only give education to our childrenbut will free us up to do more interest-ing, valuable work.”

She continues, “This is why we thinkit is necessary to construct these infrastruc-tures here, in order to enable the womenin our group to improve their standard ofliving.”

When asked if everything is perfect inthe co-operative, Aichétou seems to loseher earlier eloquence and pauses beforesaying, more convincingly, “Our mainproblem at the moment is that the women’slevel of knowledge is very low. I have asecondary school education, and I canwrite more or less properly. But that is notthe case for my sisters, who have onlyknown Koran schools and, even then, onlya few have enjoyed this privilege. I thinkthat when all women can read and write,they will better understand their duties andrights with regard to the co-operative.”

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The Environmental Health Project (EHP)continues to advocate for more attention toperi-urban environmental health andplays a leadership role in the Water Supplyand Sanitation Collaborative Council’sWorking Group on Services for the UrbanPoor. Both EHP and its predecessor WASHhave published reports documenting theirproject experience and providing guidanceand encouragement for other externalsupport agencies involved in the challeng-ing peri-urban environment. In peri-urbanenvironmental health EHP has foccussedon capacity-building for institutionspositioned to play an important role indelivering environmental health servicesin such communities. This article relateslessons learned so far.

Environment threatens lifeand health

n 1990, an estimated 600 millionpeople in the developing world livedin urban environments that con-

stantly threatened their lives and health,according to the United Nations Confer-ence on Human Settlements (Habitat).Inadequacies in housing, water, sanita-tion, drainage, solid waste disposal andvector control, combined with poorhealth care, create harsh conditions andcontribute to a heavy disease burden insuch communities. The toll from infec-tions and parasitic diseases is particu-larly extreme, perhaps as much as 50times that of industrialized countries.Providing basic urban environmentalhealth services—water supply, excretacollection and disposal, solid wastemanagement, and drainage—to poorfamilies living in peri-urban areas of thedeveloping world has remained an elu-sive goal. Yet, the number of familiesliving in peri-urban areas without basicservices continues to increase.

Through work with USAID missionsin Jamaica, Haiti and Peru, EHP has hadthe opportunity to apply principles andapproaches for work with the urban

Services for the urban poor: lessons learnedby Eduardo Perez, Urban Environmental Sanitation Specialist, USAID-Environmental Health Project

poor to field condi-tions. In each loca-tion, demonstrationprojects providedurban environmentalservices to familiesliving in peri-urbanareas. The projectsassisted in a range ofenvironmental serv-ices, including watersupply, sanitation,solid waste manage-ment and drainage.In addition to fur-nishing technicalassistance duringproject implementa-tion, EHP contrib-uted to monitoringand evaluation ef-forts. EHP technicalassistance to theseprojects has ended,but the project activi-ties continue.

These projectshave shown that it is feasible to providecost-effective urban environmental serv-ices and that urban environmentalhealth conditions, even the most dire,can be improved. In addition to thesethree projects, EHP has helped commu-nities and local authorities in Tunisia,Zambia, Benin and elsewhere to adopt amore broad-based, participative ap-proach to urban environmental man-agement.

Lessons learnedLesson One: NGOs can play aneffective role in providingenvironmental health services inperi-urban areas where municipalstructures are weak or absent.A major constraint to providing envi-ronmental services to the urban poor isthe disconnection that exists betweenthe urgent needs of peri-urban commu-

nities and the political will, the legalmandate, and the technical and institu-tional capacity of municipalities. EHPexperiences show that NGOs can oftenfill the gap. They are socially committed,flexible and able to improve their abilityto work effectively with poor urbancommunities. Key to this success is thewillingness they have demonstrated toset aside their normal NGO role as ‘im-plementor’ for a new role as ‘facilitator’,or broker, between the informal com-munities and the formal private andpublic sectors. In all cases, EHP assistedthe NGOs to experiment with their ap-proach, to monitor their effectivenessand to develop a sustainable model toserve as an example for the municipali-ties. Along the way, the NGOs were ableto identify policies and regulations inneed of reform for NGO efforts to bereplicated and scaled up.

I

UN

ICEF/M

arcus Halevi

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Lesson Two: Providing environ-mental health services to peri-urbancommunities requires a range ofdisciplines.The traditional urbanization paradigm isbased on the use of national or munici-pal utilities overwhelmingly dominatedby engineers. Too often, a problem isconsidered as fundamentally a technicalservices delivery problem requiring anengineering solution. Experience hasshown, though, that this paradigm doesnot apply to peri-urban areas. The ur-banization process in such areas is morecomplicated. For example, families settle(often illegally) on poor-quality landand put up houses before urban infra-structure is in place; in formal urbanareas, the process is reversed. In peri-urban areas, families generally earn theirliving in the informal economy and maybe unable to afford infrastructure andservice levels designed for formal settle-ments. In order to provide environmen-tal services in the peri-urban setting,planners must draw from a wide rangeof disciplines, including institutionaldevelopment, public health, social sci-ence, law, urban planning, and finance,in addition to engineering.

Lesson Three: Communities willprovide the support needed tomake community-based institutionseffective if the NGO gives themfull-partner status.Significant time was spent at the start ofeach project consulting with the com-munities about their needs, anticipatedproblems and ideas about realistic solu-tions. The process insured that the solu-tions were appropriate. And, moreimportantly, the process created aneffective relationship between the NGOsand the communities, helping to developamong the residents a sense of owner-ship for solutions.

Lesson Four: Community-basedinstitutions can provide qualityenvironmental health servicesin peri-urban areas at acompetitive price.In Haiti, a careful pre-project analysisrevealed that households were paying

significant amounts of cash for waterfrom private vendors. Calculationsshowed that the special water districtbeing established could charge the sameamount, or even less, and provide morereliable and better-quality water, and itcould also operate and maintain the waterdistribution system. When implemented,the resulting surplus was used to financeother critical environmental health serv-ices, such as solid waste collection.

Lesson Five: The level ofenvironmental health services inperi-urban areas should beappropriate to income levels.NGOs in all three locations carried outcareful analysis of the community de-mand and willingness to pay for servicesand then provided services at those levels.Charging for their services allowed allthree institutions to recover costs andbecome financially self-sufficient.

Lesson Six: Demand for environ-mental health services can becreated among residents of peri-urban areas.Environmental health experts generallyagree that service levels should be con-sistent with community demand andwillingness to pay for them, but they aresceptical that demand can be created.EHP’s experience shows that, if anattempt is made to understand andrespond to the perceptions and priori-

ties of the community, it is possible tocreate demand. In each of the three EHPprojects, the NGOs provided informa-tion on the effect of environmental con-ditions on the health of families and, inparticular, on children. Information wasmade available on possibilities for im-proving those conditions and what itwould cost. Demand for environmentalservices was thus created—even for serv-ices usually considered low-priority, suchas solid waste collection and sanitation.

Challenges to successExisting policies and regulations areconstraints to providing services to theurban poor. While these EHP projectsshow that services could be effectivelyprovided, most NGOs had to revealcreativity and boldness in ‘bending’ therules to achieve results. Political will tolower such barriers posed by municipalor national policies or regulations isoften lacking. The ultimate goal is tochange policies, not to bend them.

Legal land title is the most promi-nent policy constraint because of theunwillingness of formal authorities toaddress the question. Typically, peri-urban dwellers are considered squattersand they have no prospect for obtaininglegal title to the land on which they havebuilt. Thus, a sense of impermanencereduces household incentive to makeimprovements, such as latrines.

Access to credit is still denied theurban poor. In spite of repeated demon-strations that the urban poor operate inthe cash economy and are willing to payfor the services they want, ready accessto credit remains a major obstacle. Thesuccessful project activity in Jamaicaprovided households with market-ratecredit for the capital to build their sani-tary solutions. Nevertheless, this was anexceptional case, and it is unclearwhether new sources of credit will bemade available in the future.

Formal institutions must changesignificantly if they are to be able to servethe urban poor. Even as municipalitiesand utilities begin to recognize the effec-tiveness of a more flexible, interdiscipli-nary, community-based approach inperi-urban areas, they still resist devel-

Lucas Clavijo

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oping the skills and management systemsneeded to serve the urban poor.

Disaggregated health data is neces-sary. Data on peri-urban or informalurban areas should be separated fromdata on formal urban areas. Increas-ingly, anecdotal evidence suggests thathealth conditions are significantly worsein peri-urban areas than in formal urbanareas, yet health and municipal officialsdevote little attention to peri-urban areas.A partial explanation for this inconsist-ency is that health and environmentaldata on peri-urban areas are rarelydisaggregated from urban data, or thatdata-collection systems may miss peri-urban areas entirely because they areneither rural nor urban. So long as theurban poor and their health conditionscontinue to be ‘invisible’, their problemswill not be effectively addressed.

‘New’ EHPIn July 1999, the U.S. Agency for Inter-national Development (USAID) awardedthe continuation of EHP to the consor-tium led by Camp Dresser and McKeeInternational Inc. The ‘new’ EHP, im-plemented through USAID’s Population,Health and Nutrition Center, conductsoperations research and promotes poli-

cies and new approaches to supportUSAID objectives in child health andinfectious diseases. There is an emphasison reducing the burden of diarrhoealdiseases, malaria and acute respiratoryinfections in children under the ageof five. The five-year project will alsoprovide technical assistance to USAIDprogrammes, addressing a range of envi-ronmental health problems—from leadpollution to occupational health to airpollution—depending upon missionand bureau requests.

USAID has charged the new EHPwith implementing and promoting newor improved cost-effective and scaled-up environmental health interventions.The challenge is to develop interven-tions that lead to maximal health resultsfor each dollar spend.

Continuity and innovation will char-acterize the new EHP. Basic approachesfor community-based activities andbehaviour change will continue to beemployed and refined. Water, sanita-tion, hygiene behaviour and tropicaldisease control will carry on as primarytechnical areas. The new EHP contract,however, leads off in new directions, withmore attention paid to acute respiratoryinfections, infectious disease surveillance,

and the relationship between naturalresource management and environmen-tal health, including a component thatwill award small grants to developingcountry NGOs.

Several firms in the Camp Dresserand Mckee consortium have been partof the team since EHP’s pedecessor, theWASH Project, began in 1980 andended in 1994. These are Associates inRural Development (ARD), Interna-tional Science and Technology Institute(ISTI), Research Triangle Institute(RTI), and Training Resources Group(TRG). The EHP team also includesJohn Snow Inc. (JSI); the Manoff Group,Inc.; Tulane University, School of PublicHealth and Tropical Medicine; and anewcomer, the Harvard Institute forInternational Development (HIID).

A new EHP Home Page is beingdeveloped on line and part of it is alreadyup and running. Visit the site to keep upto date on EHP plans and directions forthe future: www.ehproject.org

UNICEF and EHP worked together in theelaboration of the Handbook on BetterSanitation Programming. At the moment,they are investigating new areas of possiblefuture cooperation.

■ Lack of formal employment

■ Lack of latrines, causing disease anda polluted environment

■ Inadequate water supply

■ Need for full-day pre-school centres

■ High levels of violence againstwomen, and prostitution

Advocacy and action onchild’s rightsLaunch of situation analysisGuided by the UNICEF Monitoring andEvaluation Unit, the situation analysiswas reviewed, finalised and printed dur-ing the first half of 1999. It will be used topublicize the plight of these marginalised

urban poor residents to decision makersand help mobilise resources for the im-provement of their health, educationand environment. A launch is being

While the Blair VIP latrinehas long been the standardin Zimbabwe, the special

conditions found in these threesettlements, particularly thelimited space available andlow income, have posed achallenge for innovation inwaste-disposal technology.

organised for late 1999 for representa-tives from a broad spectrum of govern-ment and NGO partners: City of HarareHealth Services, Ministry of LocalGovernment, Ministry of Health, com-munity organisations, rights groupsand churches.

Sanitation and child-rights projectConcurrently to the situation analysis, aproject was developed to implementsome of its most urgent recommenda-tions, that is, to address poor sanitationconditions and to support communityinitiatives for child protection. Financedby the UNICEF Child Rights ProtectionUnit under an existing agreement with

■ Urban poor Harare from page 8

continued on page 21

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Backgroundhe years of military conflict lead-ing up to the Gulf War in 1991and the subsequent civil unrest

caused considerable damage to all basicinfrastructures, including water supplyin northern Iraq. Even before the GulfWar there was widespread damage to alarge number of villages, and new townswere created to accommodate thispopulation. There were large-scale mi-grations of people to the cities. This re-sulted in a skewed urban-ruralpopulation, with the urban populationconstituting over 70 % of an estimated 3million total population. This, in turn,put a lot of pressure on the urban basicservices. The pressure was greater inthree cities, viz. Erbil, Dohuk andSulemaniyah, where more than threefourths of the urban population lived.

The urban water supplyscenario in northern Iraqin 1996While the number of urban centersincreased from 79 in 1990 to 157 in1996, the estimated water supply fromwater projects dwindled from 297,000m3 to 254,000 m3 per day. As per themultiple indicator cluster surveys(MICS) of 1996, over 95% of urbandwellers (encompassing both urban andsemi-urban) in north Iraq, consisting ofthree governorates, viz. Erbil, Dohukand Sulemaniyah, had access to safewater. However, a lowering of the watersupply indicated a low per capita avail-ability of water in 1996 when comparedto that in 1990. Due to the UN sanctions,there was a ban on import of machineryand equipment for water projects (newand for replacement), and also on mate-rials for the distribution network. Manyof the pumps were old and worn outand were working much below theircapacity. Lack of repairs to the existing

Rehabilitation of urban water supply projects—experience from Northern IraqBy B.B. Samantha, WES-officer, UNICEF, Erbil, Northern Iraq

water distribution network resulted inan increase of up to 35% to 40% waterloss due to leakage, further reducing thequantity of water ultimately available tothe people. Water quality also suffereddue to the absence of adequate watertreatment facilities and damage to theinstallations. Non-availability of watertreatment chemicals like aluminiumsulfate, chlorine gas and chlorine pow-der added to the problem.

Why the WES Programme innorthern Iraq is unique:Although UNICEF has been working in

northern Iraq since 1991, its activities inwater and environmental sanitation(WES) have grown both in terms ofmagnitude and complexity in recentyears. As part of the humanitarian pro-gramme established by SCR 986 in 1995,UNICEF has been identified as the lead-ing UN agency in WES sector; the otherpartners are UNCHS/Habitat andWHO. Unlike central and southern Iraq,where the UN agencies are expected toplay the role of an observer, their role inthe north is that of an implementingagency. This is unique for UNICEF inWES when compared to most other

Status of Urban Water Supply in 1996 and 1999(Northern Iraq)

Type of Scheme 1996 1999

Deep wellNo. working 709 737Total supply (m3/day) 13,712 17,319% using chlorinator 36 64

Water treatment plantsNo. of treatment plants 10 10No. of working pumps (intake) 24 41No. standby 7 11Intake (cum/day) 170,345 228,299No. of booster pumps working 28 33Total supply (cum/day) 156,558 211,538

GravityNo. existing 23 26Total supply (cum/day) 21,072 23,232% having facility for treatment 100 100

Others (surface/shallow well)No. existing 7 7No. of pumps working 39 44Total supply (cum/day) 49,300 53,750% having facility for chlorination 100 100

Source: Local authorities

T

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countries. Due to the embargo, everyitem to be imported to this region needsthe approval of the sanctions committeeat the UN in New York, which makesplanning more complex. Under SCR986, the amount allotted to UNICEF forWES has been close to US$125 millionup to mid-1999. This constitutedaround 60% of the total allocation madeto UNICEF so far under SCR 986 andmakes the WES programme in northernIraq probably the largest in the world.Around 70% of this amount is earmarkedfor activities in the urban sector thatincludes semi-urban areas as well; urbanwater supply accounts for three fourthsof this with an estimated budget ofUS$80 million.

The rehabilitation strategy inurban water supplyKeeping in mind high coverage in termsof access to safe water and the worn-outmachinery, equipment and the distribu-tion network that need replacement andrepair, the focus of UNICEF interven-tions in northern Iraq has been to reha-bilitate the existing projects. This is to notonly sustain the high coverage but alsoto increase the per capita availability ofwater by increasing the intake capacityof the existing water projects. Simulta-neously, care has to be taken to ensurewater quality through the provision ofwater treatment facilities and by pluggingthe leakage in the distribution network.Strengthening the capacity of the localauthorities for greater sustainability alsoformed an important part of the strategy.

Water production anddistribution: A need-basedapproachThere were difficulties in the planningprocesses for water supply in urbanareas during the initial period. Therewere three major reasons for this: First,the local authority had no developmentplan, which was mainly due to the fluidpolitical situation. Second, due to theshort-term nature of each phase underSCR (each phase is of six months dura-tion), it was difficult to take even a me-dium-term perspective of the urbanwater supply. Third, under SCR 986 the

focus was more on the distribution ofhumanitarian supplies like food, medi-cine and books, and initially it was notrealised that for WES, distribution ofmaterials is not enough.

In order to overcome these difficul-ties, at the beginning of phase IVUNICEF undertook a quick assessmentand prepared a distribution plan basedon the need instead of an action planbased on the supplies received, as wasdone in the first three phases. The distri-bution plan for each phase was linkedwith that of the previous phase to have asynergistic impact. For water produc-tion, a two-pronged approach wasadopted. First, an assessment was doneof the potential for increasing the intakeand the scope for phasing out the oldand worn-out pumps. Second, the engi-neering college of the local universitywas commissioned to carry out a map-ping exercise of the water distributionnetwork to identify the areas needingrepair and extension. These efforts haveresulted in more systematic planningand speedier implementation, as maybe seen below.

As of 31 August 1999, a total of 345pumps have been installed, 95% of theseduring a period of 15 months precedingthis date. The population benefitingfrom this is close to 1 million. Similarly,over 200 kilometers of the water distri-bution network has been repaired orextended during the same period, cover-ing around 600,000 people. In addition,146 pumphouses have been constructedor rehabilitated, increasing the pumps’efficiency by reducing the breakdowntime and improving water treatmentfacilities by providing space for the chlo-rinators. Keeping in mind the erraticpower supply, UNICEF has also pro-vided generators to certain strategiclocations. All these efforts have resultedin increasing the supply of water from254,000 m3 per day in 1996 to over320,000 m3 per day at the beginning of1999, an increase of 25%. This was pos-sible due an increase in the number ofdeep wells from 709 to 737 and thenumber of low-lift pumps (for intake)from 31 to 52. These achievements werepossible due to careful planning, close

rapport with the local authorities,proper monitoring and following up.

Water quality improvement:A multi-pronged strategyDuring the first phase (1997), UNICEFwas responsible for not only providingthe water treatment chemicals but alsomonitoring the water quality, for whichit had to procure chemicals for watertesting as well. Subsequently, from thesecond phase onwards, WHO took theresponsibility of water testing whileUNICEF continued to take the responsi-bility of providing water treatmentchemicals.

In 1996, before the SCR 986 pro-gramme was introduced, the percentageof water samples in the urban areas(including semi-urban) reporting bacte-riological contamination varied from16% in Dohuk to 30% in Erbilgovernorates; Sulemaniyah reported22% contaminated water samples.Therefore, improving the water qualitybecame a priority for UNICEF. Theinterventions included supply of water-purifying agents such as aluminiumsulfate, chlorine gas and chlorine pow-der and installation of powder chlorina-tors. Once the supplies arrived in early1998, attempts were made to use thesein a phased manner. During the initialfew months—although these interven-tions had a positive impact in reducingcontamination in all the three governor-ates—the impact was more pronouncedin Dohuk (from 16% to 6%) andSulemaniyah (from 22% to 11%).

As there was only a marginal declinein the level of contamination in Erbil(from 30% to 26%), an investigationwas made to find out the reasons. Itturned out that a multiplicity of sources,illegal connections, lack of an adequatenumber of pump operators, togetherwith the worn-out distribution networkand inadequate monitoring of the waterpurification, had contributed to a highlevel of contamination. Of the 737 deep-well pumps existing in all of northernIraq, around 450 (more than 60%) arein Erbil governorate and half of thesepumps are in Erbil city. The governor ofErbil organised an inter-agency work-

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shop in June 1998, at the request ofUNICEF, to discuss the problems ofwater contamination. Based on the de-liberations of this workshop, the gover-nor introduced several measures tocheck contamination that included in-volvement of the religious leaders toeducate people on water conservation,the adverse impact of illegal connections,punishment for illegal connections, thecreation of around 200 pump operatorposts and wide publicity in print andelectronic media. UNICEF providedmobility support to the DWS for bettermonitoring of chlorination by the pumpoperators and ensured that all chlorina-tors received were installed. A pro-gramme was also launched to replace asizeable length of leaking pipes.

All these measures had the desiredeffect of reducing the level of water con-tamination in Erbil city from 38% inJune 1998 to less than 5% by March1999. This was possible due to properidentification of the causes of contami-nation, timely corrective action andstrong coordination between UNICEFand WHO, along with the local authori-ties. A similar approach has also beenadopted in Dohuk and Sulemaniyahgovernorates with successful results. Asof 31 August 1999, UNICEF suppliedover 1,100 tons of aluminium sulfate,450 tons of chlorine gas and installed390 powder chlorinators in deep-wellpumping stations. All the installationshave now adequate water purifyingagents.

Maintenance of water systems:A move towards sustainabilityAs mentioned earlier, most of the urbanwater systems are very old and needfrequent maintenance, repair and some-times complete replacement. Also, mostof the equipment and machinery were offoreign origin. Non-availability of genu-ine spare parts in the local market andthe formalities for importing spareswere a big problem. At times, itemsrequested for old equipment were re-portedly out of production.

An analysis of the expenditure avail-able from two governorates, Erbil andDohuk, indicates that in 1990, the Min-

istry of Municipalities and Tourism(which is the nodal ministry for watersupply and sanitation in urban areas)spent less than US$300,000 on repairand maintenance of both water andsanitation systems. This was reduced toa paltry US$120,000 in 1996. As part ofits strategy to sustain the water systems,UNICEF embarked upon a plan to im-port essential spares and also providedthe required cash for repair of watersystems. The total amount earmarkedfor this purpose was close to US$3 mil-lion In addition, it was instrumental inpersuading the local authorities to in-crease the number of maintenanceteams to look after water treatmentplants, chlorinators, deep wells and thewater distribution network. As a result,the number of maintenance teams in-creased from 32 in 1996 to 40 in 1999.The increase in the number of engineersand technicians handling repair andmaintenance is more impressive, from78 to 118.

Simultaneously, a massive trainingprogramme for pump operators wastaken up in 1999. So far, around 300operators havebeen trained inpump operationand maintenanceand in the use ofchlorinators.Training on theuse of computersto facilitate projectplanning andmonitoring hasbeen imparted tothe concernedengineers. Ar-rangements havealso been made toprovide servicetraining to engi-neers and techni-cians in theoperation andmaintenance ofpumps and controlpanels in collabo-ration with thepump manufac-turer. All these

efforts will contribute to sustaining thegains already achieved.

Summing upThe humanitarian programme imple-mented by the UN in northern Iraq isunique both in context and complexity.As a lead agency for water and sanita-tion, UNICEF is handling a largenumber of urban water supply projects,with an investment exceeding US$80million. In spite of the fact that this isrelatively a new area for UNICEF, theprogress achieved within a short span of15 months has been considerable. Whilethe rehabilitation strategy for watersystems, both production and distribu-tion, has proved effective in maintainingthe high coverage, the coordinated ap-proach adopted for improving waterquality has paid rich dividends in reduc-ing water contamination. Strengtheningthe maintenance system is expected tocontribute significantly to greater sus-tainability. Considering the require-ments of the region, a lot of things arestill to be done. This makes the futuretasks of UNICEF equally challenging.

Status of Maintenance Teams for UrbanWater Projects

Project 1996 1998

Water treatment plantsNo. of Teams 4 6Engineers 7 9Technicians 10 17Workers 37 57

Chlorinator/laboratoryNo. of Teams 5 8Engineers 2 3Technicians 15 20Workers 12 13

Deep well/gravityNo. of Teams 6 8Engineers 5 11Technicians 19 24Workers 25 37

Water distribution networkNo. of Teams 17 18Engineers 9 13Technicians 11 21Workers 134 166

Source: Local authorities

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In 1998, 1,500 Brazilian children andadolescents moved from a life in Brazil’sdump areas to a life that includes school-ing. How did this happen? For one thing,a startling incident took place in the early1990s. And more recently, an awarenessprocess under way at the country’snational level, concerning the problem ofwaste disposal with a broader perspective,has the social dimension as a key element.UNICEF is at the centre of this unprec-edented phenomenon.

Backgroundesearch indicates that nearly 45,000children and young persons liveand work in dump areas all over

Brazil. Many were born in these places,to parents who themselves were born inthem. From an early age, these young-sters have been exposed to the movementof trucks and heavy machines, to dust,to fire, to perforated and contaminatedobjects, and to rotten food. Most of these

Plight of poor living in Brazil’s dump areasby UNICEF-Brazil

boys and girls do not attend school. Thedump area is their classroom, their en-tertainment, their food and their sourceof income. Thousands of families eatwhat they find in dump areas. And wherethere are families, there are children.

Two studies were carried out overthe past two years. The first, by UNICEF,was organized by Institute of Water andLife and concluded in September 1998.The second is the compilation of ques-tionnaires sent to all mayors in Brazil,upon the launching of the campaigncalled ‘Children in Waste Dump Areas,Never Again’. 1,956 municipalities ac-knowledge having children and teen-agers living and working in dump areas.Half are in Brazil’s Northeast region,18% in the Southeast, 14% in the North,7% in the Centre West and 12% in theSouth. Sixty percent of them live incities with up to 50,000 inhabitants.

UNICEF’s work in the area of wastedisposal dates back to 1992 and resulted

from an incidentthat drew theattention of theentire country.Several peopleworking in thedump area ofAguazinha, inOlinda City, werepoisoned andhospitalized aftereating hospitalwaste. There wassuspicion thathuman flesh wasamidst the out-door garbage,together withother kinds ofwaste. Five mu-nicipal projectswere developed,three in theNortheast(Olinda, Palmeira

dos Indios and Petrolina) and two in theNorth (Manaus and Rio Branco).

The lessons learned after half a dec-ade of substantive work, are found inthe publication Child, Trash-Picker,Citizen, published by UNICEF-Brazil in1998. Reflection on this experience hasconsolidated into the approach called‘Participatory Management of UrbanWaste’. The difference from simpleurban cleaning services, which arepurely an engineering service, is a farmore comprehensive intervention thatinvolves the components of education,health, environment, housing, incomeand employment generation, and thepromotion of rights. The actions thisapproach takes can only succeed in thepresence of strong coordination amongvarious interrelated sectors: federal, stateand municipal governments; NGOs;companies; workers’ unions; associa-tions; and other segments of society.

Taking children and their familiesaway from dump areas without addi-tional interventions is useless, concludedthe National Forum ‘From Waste toCitizenship’: Either they return or othersreplace them.

‘Children in Waste DumpAreas, Never Again’The Forum, which consists of 42 NGOsand Government Agencies working inwaste, started in June 1998, one yearbefore the launching of the ‘Children inWaste Dump Areas, Never Again’ cam-paign. Coordination for the creation ofthe Forum and the launching of thecampaign to fulfil the goals of the Forumwere headed by UNICEF. The idea toestanlish a Forum was the result of thework UNICEF was carrying out in theNortheast and North.

The National Forum has the follow-ing goals:

■ eradicate child labour from dumpareas;

UN

ICEF/H

Q97-0996/Jerem

y Horner

R

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■ enroll all children living in dumpareas at school;

■ reduce child mortality;

■ generate employment and incomefor families living in dump areas;

■ recuperate regions degraded bydump areas;

■ elect trash-pickers as priority part-ners for selective waste collection;

■ eradicate dump areas.

To achieve these goals, the Forumfocussed on nine activities: a nationalmobilization campaign; contest ofexperiences; coordination with theProsecutor’s Office; creation of a databank; creation of a national trainingprogramme; coordination with fundingagencies; identification and recommen-dation of solutions for social and educa-tional inclusion; qualification of thedemand and diagnosis.

The national mobilization campaignlaunched in June 1999 was very success-ful. The media gave unprecedented broadcoverage to the question of sanitation,with the subject appearing in the head-lines of the largest Brazilian newspapersand the issue discussed by the media. Aspart of the ‘Children in Waste DumpAreas, Never Again’ campaign, all ofBrazil’s mayors received a questionnaireon the situation of waste disposal intheir city, as well as a Letter of Commit-ment by which they could adhere to thecampaign. The mayors who returned thequestionnaire and signed the letter thenreceived a kit containing five publications:

■ The Mayor’s Manual;

■ Child, Trash-Picker, Citizen (thepublication mentioned above);

■ The Trash-Picker’s Manual (pro-duced by the ‘Entrepreneurial Com-mitment’ for Recycling, CEMPRE);

■ The Selective Waste Collection Manual(produced by Institute Polis);

■ The Prosecutor’s Manual (producedby the Federal Prosecutor’s Office).

Of the 5,507 mayors, about 25%filled out and returned the questionnaire

and signed the Letter of Commitment.Most of them manage cities with up to25,000 inhabitants, which, taken to-gether, comprise 11,244 children andadolescents working and living in dumpareas. Of these, 62% of the returnedquestionnaires came from the South andSoutheast regions, the most developedin the country.

An overall assessment of the cam-paign indicates that the mobilizationwas successful, especially due to thefollowing reasons:

1. The question of waste disposal isclosely related to everyone, as every-one generates waste.

2. A child in a dump area presents apicture that raises indignation, re-gardless of a person’s place and po-litical vision.

3. UNICEF has high credibility both inthe sphere of public opinion and ofthe government and non-governmentsectors working in the social field.

Campaign resultsDuring the 12 months leading up to thewriting of this article, UNICEF has sup-ported 10 projects of the ‘From Waste toCitizenship’ campaign, mostly in theNortheast region, at a cost of US$360,000.00. As a direct result of projectactivities, it is estimated that 1,500 chil-dren and adolescents were taken out ofdump areas, given their birth certificatesand enrolled at school.

In addition to implementing com-munication activities, disseminatingexperiences, and meeting the demand,the UNICEF Office in Brasília organizedin August 1999, as part of the NationalForum Workplan, the National TrainingProgramme in Urban Management inBrazil and a Monitoring and EvaluationSystem for the Programme.

The innovative aspect of the trainingprogramme lies in its coordination withthe various sectors involved in wastemanagement. Thus, each part continuesto take on specific share of responsibilitybut also acquires an overall vision of theproblem. For example, an engineer whoprepares a plan for a sanitary waste de-

posit is supposed to alert the local au-thorities about the situation of familiesliving there.

No monitoring and evaluation in-strument has yet been applied in accord-ance to the proposed model, and for thisreason it has not been possible to deter-mine the actual results achieved.

Representatives of the institutionsthat are members of the National Forum‘From Waste to Citizenship’ are enthusi-astic about the results achieved so farand the perspective that this type ofcoordination represents. There is gen-eral agreement about the innovativemanner in which this work is beingconsolidated. The disputes that wouldhave otherwise hindered the coordina-tion of this group have given way tocollaboration and the gathering of ef-forts to implement the work proposedby the Forum.

UNICEF’s role of maintaining thefocus on children is seen as a key one,thanks to its neutral position and highcredibility. This approach facilitatesprofessionals from various governmentareas to work together, as they knowbeforehand that credit will not be givento one specific ministry only, or to an-other. It can thus be stated that the Na-tional Forum ‘From Waste toCitizenship’ is actually managing tobreak a rooted taboo and implementinga national plan in a smooth way.

At the request of the National Forum,the Brazilian Institute of Geography andStatistics will include a number of ques-tions about solid waste management inthe year 2000 census, set to begin inApril 2000. The census is expected tobegin producing results during the firstquarter of 2001. Therefore, importantand detailed information will becomeavailable about exactly how many andwhich municipalities have dump areas,the number and ages of children andadolescents who work and live in them,the living conditions, and so on.

Meanwhile, state and municipal‘From Waste to Citizenship’ forums aretaking shape in various parts of Brazil,with different characteristics from placeto place. In the state of Ceará, the pro-gramme started as a UNICEF initiative.

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In the state of Santa Catarina, the Chil-dren’s Court made the first step towardscoordinating the institutions in supportof municipal governments. In the statesof Rio Grande do Sul and Minas Gerais,the initiative was taken by the respectiveSecretariats of the Environment. Inevery case, two underlying principlesform the basis for work: an integratedvision of the problem involving varioussectors, and the assurance of politicalsupport from the local government.

Challenges due to demandThe movement is expanding, and thepresent challenge is to face the demandgenerated by the campaign. A minimuminfrastructure has to be formed to meetthe demand and coordinate the internaland external actions of the NationalForum. The government staff who aremembers of the Executive Secretariat ofthe National Forum are there becausethey were authorized, albeit informally,by their supervisors to perform tasksother than their regular ones. There is

recognition that UNICEF has carriedout most of the activities, ranging fromcoordination at various levels to routineoffice tasks. But the mobilization result-ing from the activities of the NationalForum ‘From Waste to Citizenship’ hasgenerated an increasing level of demandfor which UNICEF is not prepared.There is no central office, administrativesupport, or efficient communicationsystem among the Forum members, theongoing projects and the public at large.

ConclusionsThe main lessons learned during thisprocess are summarized as follows:

1. The approach to the question ofwaste management—with the focuson children and adolescents andinvolving various sectors in an inte-grated manner—has been very wellreceived by government authoritiesand institutions dealing in the issue.The press and public opinion alsonoted the approach, due to the im-

portance of the theme, the ethicaldimension of the presence of chil-dren in dump areas, and UNICEF’swidespread credibility. There is thusa favourable environment for a basiccultural change in the country inso-far as social questions are concerned,based on an experience that resultedfrom combating the permanence andwork of children and adolescents indump areas.

2. In addition to its valuable technicalcooperation, UNICEF plays an im-portant role in the establishment offorums and programme implementa-tion: It implements political coordi-nation. Being politically neutral withno partisan viewpoint, and havingunquestionable credibility through-out the country, UNICEF has themobilization capacity that is funda-mental to the elaboration of a planwhose main goal is to put into prac-tice: ‘Children in Waste Dump Areas,Never Again’.

the city of Harare, the project againdraws upon the expertise of MvuramanziTrust in sanitation technology andhygiene education and of IPA in PRAand child-rights promotion. The projectperiod is to be July 1999 through Decem-ber 1999.

The project has two parts:

1. Child-rights promotion in HatcliffeExtension, including:■ PRA research to understand ex-

isting community structures thatpromote child rights, and com-munity workshops for planningchild rights interventions

■ Training of community leadersand rights committee members inleadership skills and child rights

■ Promotion of child rights in thewider community

2. Sanitation, participatory health andhygiene education in Dzivarasekwa

Extension and Hatcliffe Extension,including:■ PRA research of key issues sur-

rounding water, waste disposaland community health, and com-munity workshops for planningimplementation

■ Training of community membersin environmental health issues

■ Latrine design, testing and con-struction

■ Water point rehabilitation andtraining of management com-mittees

Innovative latrine designs are a keycomponent of this project. While theBlair VIP latrine has long been thestandard in Zimbabwe, the special con-ditions found in these three settlements,particularly the limited space availableand low income, have posed a challengefor innovation in waste-disposal tech-nology. Concepts of eco-san for recy-

cling waste as a precious fertilizer havealso directed the work.

During project implementation inDzivarasekwa Extension and HatcliffeExtension, several low-cost designs forhouseholds will be built and tested usinga variety of materials. Community ac-ceptance, convenience and durabilitywill determine which options will be inmost demand.

ConclusionThis project has incorporated the bestprinciples of good programming: assess-ment and analysis of the situation ofchildren, participatory approaches, in-ternal and external partnerships, inter-sectoral collaboration, advocacy,community capacity building and em-powerment. It is hoped that such par-ticipatory approaches can be modeledfor use in other marginalised communi-ties throughout Zimbabwe.

■ Urban poor Harare from page 15

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Backgroundn archipelago of volcanic islands

off the Atlantic coast of WestAfrica, Cape Verde has a popu-

lation of approximately 417,000 people(1998). About 50 percent live in urbanareas. The population growth rate forthe entire country is estimated at about2.5 percent. However, the growth ratefor urban areas stands at 4.5 percent.

Water supply and sanitation coveragein rural areas has always lagged behindthe urban areas of the country. The situa-tion has reached critical proportions onSantiago, the most populated island ofthe archipelago and home to more than50 percent of the country’s population.

The government of Cape Verde andUNICEF established the rural and poorurban areas on the island of Santiago aspriorities in the current ProgrammeCycle (1995–1999). So far, more than20,000 people, mainly in Santiago’srural areas, have gained access to drink-ing water.

Intervention strategyHigh per capita costs have presentedmajor obstacles in efforts to increase thecoverage in the widely dispersed ruralareas. Because of the large migration ofpeople from rural areas to cities, the

The shift to poor urban areas: A strategicapproach to cost-effectiveness in water,environment and sanitationBy Antero de Pina, Assistant Project Officer, UNICEF-Cape Verde

government and UNICEF have startedto pay more attention to the poor urbanareas.

The project implemented in thecommunity of Chao Bom in the Districtof Tarrafal in Santiago is a good exampleof effective partnership among the gov-ernment, UNICEF, the municipality andNGOs. Chao Bom is a urban poor com-munity located about one kilometerfrom the main urban centre of theTarrafal District. A large community,Chao Bom’s population, bigger eventhan the urban center, numbers an esti-mated 6,500 people in the year 2000 andis expected to rise to about 8,000 in 2010.

From the project’s inception, in1997, the municipalities, the NGOsrepresenting the community, the centralgovernment and UNICEF were involvedin the discussion of the Terms of Refer-ence for the preparation of plans toexecute the project. The process pro-gressed slowly, as many interests were atstake. At first, UNICEF was very con-cerned about the costing of the project,because the costing would allow forproject sustainability. However, thediscussion process was so successful thatall partners were convinced that thepreconditions existed to start the largest

single community project supported byUNICEF-Cape Verde.

The project, which concluded inApril 1999, included the following com-ponents:

■ Equipment for a bore hole (capacityof 30 m3/hr) with a 40 KVA generatorand a submersible pump (SP 27-282).

■ Construction of a reservoir with astorage capacity of 300 m3 (two cells)with control chamber.

■ Network of about 4.5 km of waterlines.

■ Construction of two major waterdistribution points; rehabilitation ofone water point and connection totwo old water points.

■ Water connection to two primaryschools and one kindergarten.

A public state enterprise and theNational Water Resources ManagementInstitute constructed the project. Themunicipality of Tarrafal, UNICEF andNGOs monitored the implementation.

Community participation in theproject took place in the planning stagethrough two local NGOs (Associationfor Promotion of Women/MORABI andAssociation of Friends of Chao Bom/AACB). The two NGOs then representedthe community in all the stages of theproject. MORABI was able to gather

0

20

40

60%

80

100

Santiago Cape Verde

Rural Urban Total

Water coverage (1996)

01,0002,0003,0004,0005,0006,0007,0008,0009,000

1970 1980 1990 2000 2010

Population growth and projectionin Chao Bom (1970–2010)

The project…is a good exampleof effective partnership among

the government, UNICEF,the municipality and NGOs.

A

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funds to construct a new water distribu-tion point, and AACB provided volun-tary labour on weekends in the rehabili-tation and enlargement of one majorwater distribution point in cooperationwith the municipality.

Community participation in theoperation and maintenance costs willintegrate a scheme to allow the NGOs tomanage directly some water points un-der a special contract with the municipalwaterworks services. What’s more, thecommunity is willing to pay for thewater production costs (water tariffs areestimated at US$1-$1.5/m3).

Direct investment costs of the pro-ject totalled approximately $300,000.1

UNICEF contributed $85,000 (28 per-cent); the government, $200,000 (67percent); and NGOs, $15,000 (5 percent).

Considering the actual and the potentialcoverage, per capita cost is estimated atabout $100, very low, considering thatmost of the water projects supported by

UNICEF-Cape Verde need per capitainvestments of more than $200. Thehigh population concentration was oneof the major factors in the cost reduc-tion. In addition, the effective participa-tion of other partners in all the projectphases—planning, construction, moni-toring—was a major motivating factorto speed up the implementation.

Results andimpactFive public waterpoints now serve thecommunity. Themunicipality, in co-operation with theNGOs, takes care ofthe operation andmaintenance of thesystem. A contractualagreement withNGOs for water-point operation andmaintenance is under

1 All dollars are US.

Typical water distribution point that includes washing standsand showers.

…there is great potentialto improve coverage in

urban poor areas of Santiagoat lower than traditional costs.

consideration. The drinking water pro-vided to the community has increasedfrom 60 m3/day to about 200 m3/day.Hence, per capita consumption has thepotential to increase from 10 to 30 lpd.In addition, water connection in twomajor primary schools stands to benefitsome 1,200 school children and tostrengthen hygiene education efforts.

Due to the high operation and main-tenance costs of the existing system, themunicipality has now established as apriority the implementation of house-hold connections. The community iswilling to pay for water productioncosts, estimated at between $1 and $1.5per m3 on average. The waiting list forhousehold connection is so long that themunicipality is preparing a specific im-plementation plan.

ConclusionThis experience has shown that there isgreat potential to improve coverage inurban poor areas of Santiago at lowerthan traditional costs. Furthermore,while the involvement of various part-ners might slow down the planningphase of the project, it is instrumental inthe construction and monitoring stages,as there is a synergistic and gap-fittingeffect that creates an inertia during theconstruction. This holistic approach towater projects in urban poor areas hasgiven UNICEF a higher visibility withother major donors, and an opportunityto leverage resources and take on theexperience in the next Country Pro-gramme (2000–2004).

in handling urban water projects inother areas with similar socio-eco-nomic and political environments.

■ The Integrated Management of SolidWaste Project taking place in Istminia,Colombia, has succeeded to em-power women and generate an in-come for them. The programme wasimplemented with the participationof local and national authorities andthe community, in particular women.

■ Despite its notoriety as a tourist des-tination, Acapulco is a city withmany disparities between rich andpoor, and it is one of the most pol-luted cities in the world. Through theimplementation of an ecologicalsanitation project for the urban poor,UNICEF has shown an alternativesolution to alleviating the environ-mental health problem.

■ In one of the poorest regions of Ar-

gentina, UNICEF promoted the im-plementation of programmes in basicintegrated health, including the pro-vision of drinking water, environmen-tal health and housing improvement,and training programmes.

■ In Santiago, Cape Verde, the Govern-ment ‘learned’ through UNICEF’sexample that water coverage in peri-urban areas can be increased and

■ Urban environmental sanitation from page 2

continued on page 30

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Backgroundhaco Province, located in the

northeast part of the country,is one of the poorest parts of

Argentina. The province was in the gripof a widespread crisis that was increasingalready existing structural poverty. Thecrisis further worsened the living condi-tions of large sectors of the population,particularly the most vulnerable: womenand children. According to current indi-cators, 48% of the population does nothave access to drinking water and 86%does not have acceptable sanitationsystems.

Faced with this situation and armedwith the objective of seeking alternativesin order to improve living conditionsand reduce health risks of these popula-tions, UNICEF, at the end of 1994,signed co-operation agreements to pro-mote solutions with particular attentionto children. The first was signed with theChaco Lottery and subsequently withthe provincial government. In this con-text from 1995 to 1998, UNICEF en-couraged implementing a number ofcommunity experiences—in basic inte-grated health, including the provision ofdrinking water supply systems, environ-mental health, housing improvementand training programmes—in suburban areas in thesouthern zone ofResistencia, capital ofChaco Province.

Proposal criteriaFrom a child rights perspec-tive, the activities developedare aimed at generatingsocial, economic, physicaland environmental condi-tions that promote childhealth, both at the familylevel (the home) and in thechild’s immediate environ-

Integrated sanitation and housing improvementin low-income communities in Argentinaby Martin Delucchi, Consultant, UNICEF Argentina

ment (the neighbourhood and commu-nity). These activities make it possible toestablish adequate conditions for thechild’s growth in harmony with theenvironment and give particular atten-tion to the influence that water andsanitation have on child health.

The provision of basic sanitationservices, and adequate domestic equip-ment to make the most appropriate useof them, was identified as the most ap-propriate strategy in light of the highlevel of unsatisfied demand and chroni-cally inadequate resources.

The development of the projects toprovide drinking water and environ-mental sanitation to low-income subur-ban settlements was set out in aninnovative proposal with a traditional

focus, making it possible to generate aprogressive and sustainable process toimprove living conditions.

The projects presented here wereundertaken with the basic intention ofestablishing a gradually evolving pro-ductive process for housing and theenvironment. They begin with the nec-essary territorial consolidation of thepopulation by means of land and urbanregularisation mechanisms in order toachieve the necessary legal tenure ofland and the optimum spatial organisa-tion for use of the networks and services.

Through collective actions, the com-munity gains the ability to organise andmanage so that it can participate andmake decisions to improve the neigh-bourhood (the provision of basic infra-structures). The communitysubsequently operates and maintains theservices installed according to the capac-ity and skills developed.

From the organisational structurethat develops through implementing thebasic sanitation project, it becomes pos-sible to extend these improvements tothe neighbourhood and family unit byintroducing these services to every homeand by constructing adequate sanitationand environmental installations for the

most appropriate daily fam-ily and domestic use of thewater recipients. This will bethe source of housing im-provement and sustainablesocial development.

MethodologyguidelinesA series of basic theoreticalpremises underpin the de-velopment of a strategy tomeet objectives that ad-equately address the state ofchronic resource insuffi-ciencies and the historical

PHASES LEGALIZATION OFLAND RIGHTS

PRO

DU

CTIO

N P

ROCE

SS F

OR

PRO

GRE

SSIV

E H

ABI

TAT URBAN

IMRPOVEMENTHOUSING

IMPROVEMENT

LEVEL

MAINOBJECTIVES

SECONDARYOBJECTIVES

ACTORS

Informal settlements Under-serviced suburbanneighbourhoods

Provision of basicsanitation and

environmental repair

Community and familygroups

Home sanitation andprogressive housing

development

Urban consolidation ofland and populations

Organization of residentsMunicipalityLand legalizationProgramme/NGOsPrivate owners

Local committeesMunicipalityPublic services companyMinistry for healthSecretary for socialdevelopment/NGOsEmployment programme

Local associationsMunicipalityFinancial organizationsHousing departmentPrivate companiesNGOs/universityEmployment programme

Development of particip.management guidelinesLand and urbanregularizationNeighbourhood andcommunity organizationDevelopment of trainingmechanisms

Community organizationfor constructionArticulation of actorsand resourcesSelf-management by thecommunity for the provision of the servicesHealth and environmentaltraining

Construction of integratedsanitation systems bythe communityCommunity improvement and facilities for social servicesSolidary mechanisms toimprove housingProductive, sustainabledevelopment

…the projects to providedrinking water and

environmental sanitation tolow-income suburban

settlements [were] set outin an innovative proposalwith a traditional focus…

C

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characteristics of the social context giv-ing rise to such situations. The principalpremises are the mobilisation of fundingsources and the integrated participationof all of those involved.

Present conditions in society make itnecessary to promote actions that willhave a high impact on the life of itsmembers so that all sectors can developby undertaking the construction ofhousing through shared efforts, partici-pation, co-responsibility, sufficient in-formation and active participation. Themain objective—an acceptable quality oflife—is achieved in two simultaneous,interactive ways: by satisfying basicphysical needs and by strengthening thecapacity of those involved to take actionappropriately according to the rules of ademocratic society.

The organisational and operationalstructure of the projects was developedwith this general direction. The struc-ture also serves as an experimentalframework for a model of organisationalmanagement, with a view to promotingthe participation of the actors and themobilisation and optimisation of re-sources on a community, public andprivate level.

The organisational model wasdeveloped on three interrelated levels—financing, co-ordination and implemen-tation—with the different actorsinteracting according to their skill andcompetency levels in a participatorymanagement process to develop thevarious phases of the projects.

The Inter-Institutional Board, inwhich the model finds itsmost complete expres-sion, integrates all theactors involved (techni-cal, institutional andcommunity representa-tives). It is responsible forconducting project op-erations, channellingcommunications andmanagement among theinstitutional and socialparticipants, resolvingconflicts and promotingagreement among thoseinvolved.

The basis of an operational structureto best accomplish the established objec-tives is found in a methodological planaiming to create among the differentactors involved the maximum spacepossible for concerted and mutuallyagreed action on an equal level.

The underlying aim of the pro-gramme is to use the experience fromthese projects to replicate and generatelocal projects. This will make it possible,using the organisational structure, toestablish a suitable technical and admin-istrative network to respond to the

needs identified, promoting efficientinstitutional operational decentralisa-tion and better use of social investments.

A preliminary survey of the areawhere over 4,000 inhabitants had noaccess to safe drinking water or pur-chased it from private vendors made itpossible to identify different situationsin the settlements with varying degreesof complexity. These were land owner-ship; places where the environment hadbeen contaminated by excavation pitsserving as dumps; the heterogeneoussocio-economic profiles of the families;contrasting levels of representation inexisting formal organisations; various

forms of inter-community conflict; andvarying degrees of need and availableresources in the communities.

The project started in mid-1995 withthe installation of a drinking water net-work in the five neighbourhoods. Thisinvolved the extension of water networksto integrate the area into the urban in-frastructure, the adaptation of familydwellings from unsafe methods of get-ting and using water, and personal anddomestic hygiene training.

From a social operations point ofview, the intervention method appliedlinked the components of the process inan interactive manner as follows: inter-institutional participation, inter-com-munity organisation (given the scarceexisting links among the neighbourhoodcommittees) and undertaking publicworks projects. The strategy of establish-ing an inter-community organisationmade it possible to increase the partici-pation of the rest of the inhabitants inthe various project components; to in-crease the inhabitants’ confidence andcredibility with regard to implementa-tion, such as in community and inter-community representation; to decreaseparty political participation in the devel-opment of the project; and to incorpo-rate more democratic mechanismsestablished among the neighbours andthe Manzeras (‘woman in charge of theblock’) Inter-Community Committee.

The existence of a settlement onillegally occupied government lands andthe existence of a garbage excavation pitcontaining a high degree of environ-

mental contamination werethe determining factors forinitiating land regularisationand the elimination(landfill) of the dump. Onthe one hand, it made itpossible to carry out a rede-sign experiment of the settle-ment; and on the other, tocomplete the water networkand house connections.

Based on the premise ofmaximum participation andusing the inter-neighbour-hood organisational struc-ture established in the first

Management Model for Drinking Water Network Neighbourhoods:Don Alberto, Fecundo, Peron, Villa Nueva and Palermo 2

Chaco lottery UNICEF

Fund

Community

Ministry for LaborPROAS Programme

UNICEF

ICoHa

Communityorganizations

ICoHaNGO

Municipality ofResistencia SAMEEP

ProvincialMinistry for

Health &Social Action

Financing

Coordination

Implementation

The organisational model wasdeveloped on three interrelatedlevels—financing, co-ordination

and implementation….

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project, the task of regularisation of theneighbourhood was carried out. Usingparticipatory techniques, the necessaryspace for negotiation was created be-tween the inhabitants and the techni-cians (by the Municipality and IcoHa) inwhich priorities, necessities and hopeswere brought into line with spatial pos-sibilities (number of families to beplaced and land available) and legalpossibilities (municipal regulations forthe sale of government lands).

The outcome of the participatorydesign was: all families were mapped, asagreed between the inhabitants and thetechnicians, and the resulting mappingwas subsequently submitted to the Mu-nicipality for its approval. The Munici-pality of Resistencia carried out thesurvey at the start of a second project,with community participation in man-agement and monitoring. Once this wascompleted, steps were taken to legalisethe process.

The project’s objective was to de-velop a pilot experiment in integrated(family and community) sanitation andto contribute to a progressive housingsolution, based on the criteria of gradualdevelopment of the habitat through thereinforcement of grassroots organisa-tions managed in the first project.

Throughout the process, acquiringthe tools and skills to participate inmaking important project decisionsstrengthened the community’s organisa-tion capacity. In this way, the peopleand technicians involved were able tocarry out a joint evaluation of the area.This made it possible to create space forthe relationships necessary to negotiateand develop the proposal in order tobring needs and hopes into line withpossibilities and financial realities. Theresult was a proposal for physical inter-vention on two levels: the family and theneighbourhood.

At the family level, a proposal wasdeveloped based on the criterion ofequality in finding solutions. It involvedan effort to balance the situations ob-served so that all could arrive at a com-mon solution. The proposal was alsobased on progressive solutions. It enabledfamilies who had one or more dwellings

constructed to build a small sanitaryunit (indoor bathroom). This wouldcontribute to the dwelling’s developmentin a way that would have been impossi-ble for the families to achieve with theirown resources. A decision was also takento build houses with indoor bathroomsfor families living in unsafe dwellings.

The neighbourhood improvementscheme was based on the treatment andelimination of liquid sewerage, which,together with the house-to-house instal-lations, made it possible to integrate thewater circuit, introducing an innovationfrom a technological point of view. Theinnovation was the design and imple-mentation of a small-scale seweragenetwork with home septic tanks, whoseupkeep is the community’s responsibility.

With regard to social organisation, itwas possible to strengthen the channelsand mechanisms for participation andorganisation as a way of continuingthe process initiated in the first projectthrough an interactive and dynamic sys-tem of group cohesion. This was adaptedfor the inhabitants of each block andtheir block representative, who workedtogether at different levels of action andresponsibility in the framework of aninter-community organisational struc-ture and who had active participationin decision-making, management andproject implementation.

Community representation on theinter-institutional level assigned par-ticipation according to the skills anddexterity acquired in decision-making,negotiation strategies and reaching com-promises. As a corollary, the communityundertook responsibility for maintain-ing the sewerage network through thecollection and monthly administrationof an established minimum quota ear-marked for the operation and mainte-nance of the system.

On completion of the project, as afurther step in consolidating the commu-

nity’s development of social organisationbased on demand from neighbourhoodinhabitants, UNICEF, using donatedfinancial resources, established a centrefor child development. The neighbour-hood community was actively involvedin its management and construction.

An area close to the previous inter-vention site was chosen because of thecompletion of the installation of thedrinking water network in the southernzone of the city and the territorial prox-imity of all parties involved. This inter-vention site presented physicalcharacteristics similar to those of thefirst project.

A preliminary study carried out inthe first phase of the project revealedmany similarities in land ownership: themajority were, or were about to become,tenant-owners; the remainder were non-owner tenants; and a small proportionwere occupying government lands thatwere about to be resolved. These simi-larities were also apparent in the socio-economic profile of the population—relatively young and having few re-sources, with most of the populationactively employed, yet a high percentageunemployed.

The development of a social projectsimilar to the first project was madepossible by applying an interventionmethod. It brought together processesrelated to social organisation, inter-institutional co-ordination and the con-struction of a drinking water network.However, this experience differed fromthe first projects in that the operationalwork units were established through theparticipation of ‘sector representatives’(identified based on norms and criteriaof physical proximity adopted by theirown neighbours) replacing the ‘blockcommittee representative’. They becamea link between each resident, the inter-neighbourhood organisation and theproject.

Because of this community’s organi-sation, co-responsibility with the WaterCompany was possible by developing asystem of macro measuring. Now, thecommunity is in charge of the internalcollection to pay for the service. This

Now, the community is incharge of the internal collection

to pay for the service.

continued on page 30

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In 1998, the Water, Engineering andDevelopment Centre (WEDC) publishedthe findings from three years investigationinto on-plot sanitation1 in low incomeurban communities. This work raised someinteresting points regarding discrepanciesbetween user and sector professionals’assumptions about the appropriatenessand efficacy of household latrine sanitationsystems. This article discusses some ofthese issues.

Backgroundhe most important feature of theinvestigation was that it focusedon the perceptions of the users of

on-plot sanitation. All too often, assess-ments and judgements on effectivenessand appropriateness are made from atechnologically biased and purely exter-nal perspective. One can observe thatmany evaluations are done by those whoare hardly likely to themselves be regularusers of improved pit latrines. Thus,most attention has focused on an at-tempt to establish what the concerns ofthe users of on-plot systems were inurban areas and to reflect these in guide-lines for selection.

Key FindingsUser satisfaction■ Householders’ decisions to invest in

domestic sanitation are typicallydriven by socio-cultural rather thanhealth factors;

■ In all but one case, users express highdegrees of satisfaction with theirlatrine (in excess of 80% recording‘satisfied’ or ‘very satisfied’). Bucket/

User perceptions in urban sanitationprovision: a briefing paperby Darren Saywell and Andrew Cotton, Water Engineering & Development Centre, Loughborough University, United Kingdom

pan latrines record by far the highestlevels of dissatisfaction;

■ Many users do not perceive there tobe a problem with their latrine.Where problems are recorded, themost common include ‘emptying’,‘smell’ and ‘insects’, although abso-lute figures are low;

■ Of these three problems, ‘emptying’and ‘smell’ have the most impact onsatisfaction levels and ability for theuser to use the latrine.

Odour and insect nuisance■ Only small percentages of house-

holds perceive odour and insect nui-sance to be a common problem withtheir latrine (although nuisance ofthis kind does have a significant im-pact on satisfaction levels);

■ Bucket/pan latrines register the high-est nuisance levels of all latrine types.

■ Relative to other latrine types, VIP’srecord higher than anticipated levelsof odour and insect nuisance. Thereis little conclusive evidence to suggesta link between odour and insectnuisance and height of vent aboveroof line, presence of fly screens, ventpipe colour and diameter of pipe;

■ Anecdotal evidence raises doubtsabout domestic latrines as the primarysource of insect nuisance on-plot.

Absence of household latrines■ A key reason for the lack of house-

hold latrines is poverty, rather thanlack of available space on-plot. Pov-erty, and/or the inability to savefunds to invest in longer term sanita-tion facilities are key constraints;

Plot size■ Levels of user satisfaction were not

significantly affected by the incidenceof small plot size;

■ There is little indication that plot sizeis associated with particular opera-tional problems. Where the mostcommon latrine problems were noted,they were spread across all size cat-egories.

DiscussionThe assertion that on plot sanitationsystems are inappropriate for low in-come urban areas does not match withexperience from the field. Findings fromthis research indicate that a variety oflower cost systems are found to be per-forming well on small plot sizes, withlimited odour/insect nuisance, withoutsignificant operational problems and tothe satisfaction of the end user. How-ever, there still exists a significant gulfbetween the perceptions of sector pro-fessionals and those of the communitywhen regarding the appropriateness ofon-plot sanitation in the urban context.This in turn may limit the opportunitiesfor widening sanitation options at thelocal level. The findings from this workshow that professionals’ understandingof key issues such as insect/odour nui-sance, or the operational problems asso-ciated with on-plot systems must beadvised by the opinions and perceptionsof those who actually use the system.

Clearly a participative exchange ofopinions and experiences is requiredbetween communities and local authori-

1 On-plot sanitation systems are those whichare contained within the plot occupied by thedwelling. On-plot sanitation is associated withhousehold latrines, but also includes facilitieswhich are shared by several households livingtogether on the same plot.

Householders’ decisions toinvest in domestic sanitation aretypically driven by socio-cultural

rather than health factors.

continued on page 29

T

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The project came to the attentionof the media when a reporter

published a story of twofamilies who saved their livesby hiding in one of the latrines

during the hurricane.

IntroductionAcapulco: the city known worldwide as aprosperous holiday resort like manyothers suffers problems of unplannedpopulation growth. The migration ofindigenous people from rural areas toAcapulco is one of the major causes. Insearch of a better place to live and anincome that averages about US$80 permonth, ‘thanks’ to the tourist sector,they often end up residing in a housemade of tree branches and leaves, with-out access to safe drinking water orsanitary services. This article relates afirst experience in a periurban ecologicalsanitation project developed and imple-mented in Acapulco, in the state ofGuerrero, one of the poorest and mostmarginalised of Mexico.

The municipality of Acapulco is afast-growing city with more than 1 mil-lion inhabitants. Divided into 52 urbandistricts, it has about 130 rural commu-nities. In 25 of the 52 districts, one canobserve a growing and expanding terri-tory of indigenous immigrants fromother states. Local citizens and govern-ments have traditionally closed theireyes to the problem.

BackgroundUNICEF entered the picture in 1995,when it implemented a pilot project,today referred to as a ‘learning project’.The objective was to draw the attentionof governments as well as Mexican soci-ety as a whole to Acapulco’s problems.In one low-income urban district ofAcapulco, in cooperation with the localhealth jurisdiction and the State HealthMinistry, UNICEF planned and organ-ized the construction of 100 ecologicallatrines to improve the living conditionsof families there. When this pilot projectwas executed in January 1996, a small

‘Prosperous’ Acapulco plagued byunplanned growthEnvironmental sanitation project turns into a multisectoral programme

By Dirk Glas, WES Consultant, UNICEF-Mexico

group of counterparts formed a Munici-pality Committee to work together withUNICEF on a second phase of theproject. The committee was made up oflocal entrepreneurs, hotel owners,schoolteachers and representatives ofthe Municipality Office.

UNICEF wanted this private-sectorgroup’s involvement since it was theonly guarantee of continuity for theproject, because Guerrero has proved tobe politically unstable. In the previous

four years, three different governorstook the highest position in the state,and Acapulco changed mayors threetimes, each with his own priorities.

The project’s second phase gainedmore urgency when it was decided that$24 million would be invested in theconstruction of periurban sewerage. Theimpact of this system on the local natu-ral habitat and its ecosystems in generalwould be disastrous, and it was con-cluded not to be a long-term sustainablesolution. In addition, a sewerage systemof that dimension requires:

■ a complex and cost-intensive infra-structure for its construction, func-tioning, maintenance and operation;and

■ a continuous flow of maintenanceand rehabilitation costs.

Furthermore, the system would keepon contaminating the bays of Acapulcoand need water to function, which isbecoming scarcer.

The second phaseAfter the pilot project was evaluated—looking at the costs per beneficiary ofeach latrine (US$50), the communityorganization and the hygiene educationaspects—UNICEF produced a promo-tional video for fund-raising and dis-semination purposes. During a statemeeting where the results were presentedto the media, the Working Group offi-cially announced the start of the project’ssecond phase, showing a video and mak-ing an appeal to Mexican society todonate funds to execute the project,which comprises:

■ construction of 10,000 ecologicallatrines in 25 target districts over athree-year period;

■ education of 50,000 people in domestichygiene;

■ training of local bricklayers;

■ organizing of local committees tohelp organize community participa-tion and to be focal points for hy-giene education.

Additional objectives are:

■ design and implementation of amodel, which could be duplicated inother cities with similar characteristics;

■ reallocation of federal, state andmunicipality funds.

Important project strategies are:

■ social mobilization and communica-tion content for the project’s self-financing; continued on next page

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■ strengthening of the decentralizationprocess of the health sector;

■ citizen participation in the organiza-tion, execution and evaluation of theproject;

■ active private-sector participationin fund-raising and disseminationactions;

■ institutional capacity-building, be-cause of the infrastructure and be-cause the internal organization of thehealth jurisdiction is not able to co-ordinate the project.

The chronology of the different activitieswithin the project cycle:

■ Analysis of the situation, data inter-pretation and problem setting.

■ Identification of possible solutions,design, implementation and evalua-tion of the pilot scheme.

■ Decision to continue the initiative,formulation of a second phase andprogramming of start-up funds.

■ Dissemination of results and organi-zation of a multisectoral workinggroup.

■ Agreement for collaboration withlocal university of medicine to place‘disposal’ students at the projects, whowill assist in the education at commu-nity level (seven district committeeswere created) and at family level.

■ Initiation of the second phase and

dissemination of this initiative.

■ Constant process of monitoring bycommunity and district health pro-moters, who are responsible for ana-lysing the impact of the project on thehealth status of the target population.

Hurricane delaysIn 1997, hurricane Pauline blew throughthe area, interrupting the project andleaving behind much destruction in thecoastal zone of Guerrero and Oaxaca.The project came to the attention of themedia when a reporter published a story

of two families who saved their lives byhiding in one of the latrines during thehurricane. Project delays lasted for morethan six months. Due to the misdeeds ofimportant politicians during the post-emergency situation, local and stategovernments changed and, again, localand state governments had to be con-vinced to allocate funds to the project.Thanks to the private-sector committeeand their influence in the municipalityorganization, it was agreed that the mu-nicipality would buy cement and otherconstruction materials and that the StateSecretary for Social Development wouldobtain funds for manual labour and foreducation.

By the end of 1997, the project ex-tended its target areas to some damagedrural communities. Ecological latrineswere built, water purification systemswere installed, open shallow water wellswere protected and improved. A strongdomestic hygiene education programmecalled ‘Health Starts at Home’ began,and a domestic waste campaign to sensi-tize the people on how and why toprocess domestic waste was organized.Another important factor took place: thelocal government decided to invest more

The support of universities insocial development processes in

general is invaluable…

■ User perceptions from page 27

ties. The participation of communitiesin the development process has becomea critical element in contemporaryproject design and management. Insome cases, project financing is condi-tional on the application of participatoryprocesse. However, it is clear thatachieving effective participation, andbringing about a closer alignment ofperspectives is more difficult to achieve.

The reasons for this are diverse, andhave been documented elsewhere(Wright, 1997; Abbot, 1996; UNCHS/CityNet, 1997). A key constraint is thepractical problem of integrating twostakeholders with different definingcharacteristics (i.e., the formal/rigidprocedural nature of local authorities,and the relatively more flexible anddynamic nature of community basedorganisations) (Siddiqui and Rashid,1997). These interfaces, or points at

The assertion that on-plotsanitation systems are

inappropriate for low incomeurban areas does not match

with experience from the field.

which different stakeholders interact, arecritical to engendering wider stakeholderparticipation. Frequently, however, theinstitutional arrangements and workingculture of local government can con-

spire against effective communicationbetween different partners. For instance,the capacity of local authorities as insti-tutions may be constrained by factorsincluding a lack of legislative or admin-istrative authority, limited political sup-

port, inappropriate organisational struc-ture, skills, staff or systems to effectivelyintegrate participation into the processof delivering infrastructure services. Tocompound this situation, many localauthority officials may fail to accept ormisperceive the role and value of com-munity participation in what was previ-ously the domain of technical staff.

The identification of differencesbetween user and sector professionalperceptions of technology choice andperformance is instructive as a reminderof the need to constantly question in-built assumptions. Beyond this, thereare wider and potentially more challeng-ing questions to be asked about the mosteffective way in which the gulf betweenthese perceptions can be spanned.

The authors can be contact [email protected]

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money in the investigation and moni-toring of the project to be assured thatthe latrines constructed were being usedproperly. Step by step, the project thatstarted as an environmental sanitationproject for periurban zones turned intoa multisectoral programme.

Lessons learned■ Environmental sanitation is a

multisectoral issue: Aspects such associal-cultural environment, economicenvironment, health environmentand domestic environment are indi-cators one can apply for feasibilitystudies.

■ Dry ecological sanitation is becomingan important rival for conventionalsolutions such as sewerage systems.

■ Dry ecological sanitation is an appro-priate answer for sanitation problemsof low-income urban areas and re-sponds to the needs of the localpopulation.

■ Evaluation and the dissemination ofthe results is an important tool forcreating political will. Special agree-ments with local media companiesfacilitate this process.

■ The support of universities in socialdevelopment processes in general isinvaluable, and they are normallywilling to cooperate. Having beeninvolved in a UNICEF project oftenmeans a step ahead for students whoare at the point of finishing theirstudies and applying for jobs.

■ Private-sector involvement in theproject, as well as in the dissemina-tion and fund-raising activities, is akey strategy for the sustainability ofthe project.

ConclusionsAlthough the project will not finishaccording to its time schedule and someobjectives will not be reached, theproject is considered a success. Itachieved the involvement of an amplerepresentation of Mexican society, astrong collaboration with local universi-ties, reallocation of state and municipal-ity funds, expansion to other target areasand, last but not least, it generated ademand from the local population forthe latrines.

■ Urban environmental sanitation from page 23

made much less costly when using‘non-traditional’ approaches. Thejoint country programme now re-flects this shift in focus.

■ In Hyderabad, India, UNICEF urbanbasic services projects were so suc-cessful that the local municipal cor-porations and the state governmentof Andhra Pradesh developed state-wide urban area projects along thoselines to be implemented in all thecities and towns.

These are just some examples.Clearly, there remains a long way to gobefore we will be able to address all theneeds of the millions of people living inurban slums in a constructive manner.

Also this issueOther articles in this issue come fromthe USAID-Environmental HealthProject (EHP, USA), the InternationalWater and Sanitation Centre (IRC, theNetherlands), and the Water Engineer-ing & Development Centre (WEDC,UK). These institutions are importantsources for new developments in urbanenvironmental sanitation. EHP’s article

focuses on the opportunities and con-straints of working in services for theurban poor and writes about six lessonslearned through field testing of theirapproaches and principles. IRC high-lights strategic elements for water andsanitation services in urban low-incomeareas. And WEDC describes user per-ceptions in the provision of urban envi-ronmental sanitation.

UNICEF and UrbanEnvironmental SanitationDuring the New York UNICEF Work-shop on Environmental Sanitation andHygiene, in June 1998, urban environ-mental sanitation was one of four focusareas. Three important lessons learnedfor the success of urban environmentalsanitation projects were identified as thefollowing:

■ Community management of sanita-tion systems, deciding on technology,tariffs, speed of repayment and op-eration and maintenance.

■ Recognition of local solutions.

■ Funding by a mixture of public sub-sidy and private funding.

Workshop participants made a rec-ommendation to intensify the collec-tion, compilation and dissemination ofexperiences and best practices to build aknowledge base on the subject of urbanenvironmental sanitation. This issue ofWATERfront represents part of thateffort and should be seen as a steptowards increasing the attention givento children living in high-risk circum-stances in the cities of the developingworld.

allows the company to reduce adminis-trative costs, which benefits inhabitants,and allows the community to maintainthe capacity it acquired for organisation.

This article is a short version of the verydetailed article written by Martin Delucchi.For the complete version, contact theWES-section in UNICEF-New York([email protected])

■ Argentina from page 26

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approval of the project re-awakened along-standing dream in the municipalitywith regard to waste management andrecycling, which were fundamental com-ponents of the basic sanitation workbeing carried out.

Training, name change andpilot phaseSo it was that in March, shortly after theproject was approved, a large meetingtook place and the training of 90 womenwas begun, with the support of SENA.Then, between June and July, GuillermoLozano, an expert in the field with expe-rience in similar projects implementedin Ecuador, came to help outline theproject, which was re-christenedNúcleos Empresariales de LimpiezaPública (NELP) (Public Sanitation Man-agement Groups). The NELPs, as theyare known, are small private companieswith a community spirit. The membersof the groups are owners and workers.They all carry out the fieldwork and alsoperform administrative duties (manage-ment, company representation, humanresource management, finances) on arotation basis. No capitalist members

are not allowed, nor are absentee orinactive members. The sustainability ofthe NELP depends on their ability toprovide a quality service to their owncommunities.

In conjunction with the training ofwomen, a widespread initiative wascarried out among the community toincrease public awareness, with talks inprimary schools and junior high schools,presentations at meetings and radioannouncements. At the end of 1997,the women of NELP, with their yellowblouses, aprons and blue slacks, hats and

rubber boots, began the pilot collectionphase in the Cubis neighbourhood.

In the pilot phase, each collectiontruck was assigned to a clearly definedarea, a collection route, collection daysand a timetable. In each area a collectionsite was identified, where bags of wastewere deposited for subsequent place-ment in the truck. Once the truck wasfull, it would proceed to the sanitarylandfill. Each collection site was keptspotlessly clean to avoid its becoming arubbish dump. The neighbours, actingas civil vigilantes, helped to keep it clean.As a result of their increased awareness,they strictly enforced the recommenda-tion that garbage be kept in plastic bags(in the beginning, they provided themfree of charge, to encourage the habitamong their neighbours), since the sys-tem is not designed to cope with heavywaste such as building debris, or rubblefrom excavations, or heavy volumeitems such as mattresses and furniture.

The sanitary landfillThe final disposal of waste in a technicaland acceptable form, from an environ-mental point of view, is the last stage inthe integrated management of the solidwaste and the people of Istmina chose asanitary landfill. Because we were deal-ing with a small population, the landfillwas largely maintained manually, andheavy equipment was only used to adaptthe site for the excavation of protectivematerial, an operation that is carried outperiodically, in accordance with materialrequirements and the availability ofmachinery.

The Istmina landfill is called ElBorojó, named after a typical fruit in theregion, and is an Area Type landfill withstair-like banks and ditches that collectrain water and draw it away from thelandfill area. The ditches serve as drain-age channels when the waste reaches acertain level and vent pipes were alsoconstructed to allow gases to escape.The channels are filled with round stones(boulders) and sealed with dry ferns toprevent the waste from obstructingthem and impeding the flow of the per-colated liquids. To complete the site’sadaptation, the area was also fenced off

to prevent livestock from gaining access,the hut’s design was adapted to make itpossible to keep tools there, and so thatthe workers could change their clothes,and a shower unit with a lavatory andsink were installed. The site was alsosign-posted clearly. Three men, in shiftsof 6 hours per day, manage the landfill.

CommentsThe population takes a positive view ofthe experiment. The most frequent,simple and convincing comment is thefollowing: the waste that formerlyclogged up the river and the streets isnow in a place where we can contain it.The women involved in the project havea wider vision: “The NELPs have beenvery important because they solved thetwo biggest problems in the municipal-ity: lack of income and inadequate wastemanagement. Many of us are heads ofhouseholds and we think that if themother brings more income into thehome, her children will enjoy a betterstandard of living. There is also a verystrong desire to contribute to local de-velopment. We are beginning to gettraining in cooperation and we are hold-ing workshops to learn how to makematerials from glass and other recyclableproducts.” One of the young landfillworkers concludes: “With the collectionof waste, we are all winners. The riverwins because there is less pollution. Thepeople win because we have fewer dis-eases and less waste in the streets. Andwe win because it’s another source ofincome, and we have work, thank god.”

This is one of the three articles UNICEF-Colombia prepared on their experiences withUrban Environmental Sanitation. Due tospace limitations, only one could be printedin this issue. The other two articles can beobtained through [email protected] orcan be found at www.unicef.org/pro-gramme/wes

■ Istmina from page 30

The approval of the projectre-awakened a long-standingdream in the municipality withregard to waste management

and recycling…

“…they solved the two biggestproblems in the municipality:

lack of income and inadequatewaste management.”

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Issue 14 • April 2000unicef WATERfront

A newsletter for information exchange on Water,Environment, Sanitation, and Hygiene Education

UNICEFProgramme Division

Water, Environment andSanitation Section

Please send articles, illustrations and correspondence to:

The Editor, WATERfrontUNICEF Programme Division, WES Section

Three United Nations Plaza, TA 26ANew York, N.Y. 10017. U.S.A.

Telephone 1-212-824-6000Fax No. 1-212-864-6480e-mail: [email protected]

Web: www.unicef.org/programme/wes

WATERfront

efore, I did not speak to anyonedirectly, and now, as you can see,I talk to everyone and have am

not afraid to say what I feel. The trainingmakes you stronger….” Like someonelooking in a mirror and taking stock ofthe changes that have occurred, RosaCruz Murillo tells her story of personaltransformation, which took place intandem with the formation and consoli-dation of her community group.

Rosa lives in Istmina, a municipalityin the Department of Chocó on thebanks of the San Juan river, in a jungleregion that is one of the rainiest in theworld. The municipality has 45,000inhabitants, 12,000 of whom live in theinner city. They are mostly black, thoughthere are some indigenous people, someof mixed race and whites who comefrom the interior. 165 years ago, Istminawas a slave settlement. Today it is thesecond largest city in the Department. Itis 75 km by well-kept road from Quibdó,the departmental capital, and 780 kmfrom Bogotá, the far-off capital of theRepublic. The San Juan river flows intothe Pacific ocean, and travelling by bothwaterways, one arrives at Buenaventura,another key destination for the men andwomen of Istmina, and the country’smost important Pacific port.

Istimina’s inhabitants are mostlypoor. The majority cannot read or write,there are few sources of work and theworkforce is poorly trained. Many chil-dren die from preventable diseases. Thereare many female heads of households insituations of poverty and for most of thepopulation there is an abundance ofunsatisfied basic needs. Business—controlled by “paisas”, or people fromthe interior—agriculture and mining,are the principal economic activities.Plantains, maize, yuca, yams, pineapples,borojó (a local fruit) and chontaduro(an abundant local plant) are grown.

This article describes how, over thepast few years, a large group of female

In Istmina, we women have changed a lotby UNICEF-Colombia

heads of households in Istmina changedthe face of the town, and in the process,took control of their own lives in orderto improve them.

New women’s mattersSince 1996, the Program for Local De-velopment, sponsored by UNICEF andstarted by Cimder1, has been workingwith women in the poorest parts of themunicipality, providing training to helpthem to take better decisions to benefittheir health and personal growth, and tofind ways to increase their income. Thisis a new experience for many of them,

who are not used to leaving their homesto attend meetings, much less talking toother women about their situation andseeking a solution to their problems.Despite this, women from other neigh-bourhoods gradually joined the initialgroup of women from San Agustín: theycame from Eduardo Santos, Primero deMayo, Diego Luis Córdova, Cubis andCamellón.

“So”, they say, “we began to workboth from the inside and outside of thegroup. With other groups in the neigh-bourhood and the municipality, we tookpart in a workshop to analyze healthindicators, comparing the general situa-tion of Istmina with that of the SanAgustín neighbourhood. We also workedjointly with other groups, to discoverthe history of the neighbourhood. Wethen took part in more workshops: com-munication for assertiveness; humanrelations; and prevention of drug de-pendency and alcoholism were some ofthe issues discussed. In February 1997,

in collaboration with the UNICEFWater and Sanitation Programme andthe Mayor’s office, we presented anurban cleaning and solid waste manage-ment project, which we named theNúcleo Empresarial de Limpieza Pública(NELP) (Public Sanitation ManagementGroup) to the Solidarity Network.

Plans on the tableIn a participatory exercise initiatedmainly by the Progamme for LocalDevelopment, eleven employment gen-erating projects were presented to themunicipal board of the Solidarity Net-work, among which was one called“Generation of Employment throughSanitation and Recycling”, presented bythis group of women, with the supportof Miguel Angel Guerrero, Coordinatorof the Programme for Drinking Waterand Sanitation. The garbage collectioncomponent of the project was the first tobe approved, with the following plan forinstitutional support: contributionsfrom the Network would be used to paysalaries, the mayor’s office would supplythe necessary materials (uniforms, bicy-cles, bags and brooms) and UNICEFwould provide training and technicalsupport for the remaining activities con-sidered in the sanitation project. The

B

1 Centro de Investigaciones Multidisciplinarias dela Facultad de Salud de la Universidad del Valle

continued on page 31

…a large group of female headsof households in Istmina

changed the face of the town…

Printed on recycled paper