Concerted sanitation programme in urban areas
In Haiti: Saint-Marc, an experimentation area for the national strategy
Running a drinking water supply project involves thinking simultaneously about a sanitation project and about the issues relating to wastewater disposal. All the more so given that a cholera epidemic has taken hold in the country. This requires collective reflection upon these two intertwined problems. Haiti's national drinking water and sanitation directorate (Dinepa) has therefore initiated a pilot study of urban sanitation in Saint-Marc, the first town in the country to have rehabilitated its drinking water system and implemented volume-based service billing.
In 2009, the new Framework law gave the task of reforming sanitation services [2] to Haiti's national drinking water and sanitation directorate (Dinepa].
To build its long term sanitation plan, Dinepa had to start from a situation of almost total absence of sanitation infrastructure and services in the country's towns, due mainly to the fact that the sanitation issue was not previously one of the Haitian authorities' priorities.
Haitian towns are characterised by highly diverse urban areas and problematic land management due to the absence of an urban land registry. In addition to this, demographic growth is strong, as a consequence of the migratory movements of the last twenty years, resulting from the political, economic, climatic upheavals and the earthquake of 12 January 2010. Most of the town centres are very dense, housing is highly concentrated and there are almost no sewage systems. Those that exist (in Port-de-Paix and Jacmel) are designed solely for rainwater drainage, and do not always fulfil this primary function, blocked by the piles of solid waste that build up between periods of rainfall and the clogging during heavy downpours.
Latrines and cesspits, oversized to postpone the need for emptying, are the reality of domestic sanitation facilities in these urban areas, and this is only true for the half of the population that is equipped with them. As a result of this situation, the excreta management is unorganised and even less supervised. It is generally carried out manually by informal emptiers who, in the absence of a dedicated discharge site, dump the extracted material into the sea or on nearby waste land. The grey water follows the rainwater channels, as it is mainly poured by households into their back yards, roads or open drains, which are badly maintained and turn into infectious nests in times of drought. These practises contribute to the spread of pollution and the risk of cholera epidemics, due to the infiltration of contaminated water into housing areas and into the water table.
Finally, we note the apparent lack of concern of the population, who often seem to relegate sanitation and sanitary hygiene, both on an individual and collective level, to the bottom of the scale of expectations of modernity, behind asphalting roads, collection of solid waste and of course, access to mobile phones.
The cholera epidemic: raising awareness
Ignoring the needs for sanitation means ignoring serious sanitary and environmental risks. Dinepa has succeeded, thanks to the international cooperation and the NGOs, in reducing, and to a large extent containing, the cholera epidemic that broke out in October 2010. The management of this crisis highlighted not only the risks relating to the inadequacy of the sanitation infrastructures but also the absence of a clear framework for intervention of the stakeholders concerned, which made coordination on the ground difficult on a national level. Dinepa became aware of the need to set up large-scale, long-term sanitation systems and services, and the related management mechanisms.
To this end, in 2012, Dinepa laid down formal policy guidelines and set an ambitious goal: all Haitian families must have a private toilet by 2022, starting with those residing in the priority areas where there is the greatest risk of epidemic [3].
Convincing households to install their own sanitary facilities
To achieve this, Dinepa is encouraging institutions and households to carry out the sanitation work, and is offering advice and guidance for appropriate use and upkeep. It plans to develop different incentive mechanisms and also to launch a large-scale national hygiene promotion campaign, a demand-lead approach which contrasts sharply with what NGOs currently offer in Haiti; the NGOs encourage the installation of sanitary facilities by means of subsidies or by building them themselves.
Dinepa clearly states in its policy document [4]: "Individual and family toilets will not be subsidised." And, by referring to the 1919 law on the hygiene service, Dinepa points out that "a toilet is an integral part of a house" and that it must comply with precise specifications and correspond to an approved Dinepa model.
The town of Saint-Marc, with approximately 130,000 inhabitants, is a typical medium-sized Haitian town, and one of the first to benefit from an improvement in access to drinking water. Therefore, direct consequences on the aggravation of the sanitation problems are to be expected as a result of the increase in the volume of water used. It was for this reason that, in 2012, Dinepa entrusted its partner Lysa [5] with an initial feasibility study financed by the Inter-American Development Bank (IDB) for the development of sanitation services and the local implementation of the national strategy in Saint-Marc, with an operational role which will make it possible to experiment incentive mechanisms and a new management framework for these services, involving the local stakeholders, and particularly the town council.
Dinepa's new strategy recommends "the setting up of a reliable and complete database on the situation of family toilets in the towns and villages". Obtaining a "Zero-condition" and precise data is an essential first step to understanding the local issues and the demand for sanitation facilities and then being able to measure progress and the efficiency of the management actions and mechanisms which have been put in place.
The first step in the project, entrusted to Lysa and completed during 2012, therefore consisted in carrying out an exhaustive survey of 17,000 households in order to establish a precise inventory of the sanitary situation and the current practises of the Saint-Marc people.
Developing the sanitation sector and the concept of public service
The results of the survey indicate that 21.3% of Saint-Marc's population (equivalent to almost 3,500 households) have no household water supply or household sanitation. The majority (58%) are located in the towns' outer areas (at the foot of the hills) and on the coast, in dense and precarious quarters which have informal housing. These areas are beset by a whole range of difficulties, consequently restricting the feasible technical solutions, and all the more so if subsidies for access to a household infrastructure are forbidden: the plots are small, the physical constraints are great (steep slopes, or water table nearby, difficult access, etc.) and the people are very poor (little help from the diaspora).
The households that have no sanitary facilities mainly use their neighbours' toilets (70%), the others defecate outside. Moreover, 88% of housing has no domestic plumbing whatsoever. The survey also highlighted the reticence of the population to pay a monthly charge for the maintenance of sanitary installations, as they prefer to be invoiced separately for each specific service. Linked to this, the percentage of those surveyed who were not satisfied with their sanitary installations and with the service provided (78.3%) is an indication of the overall situation in Saint Marc.
However, there is also low demand for latrine emptying from the households surveyed: only 2 to 3% of the population stated that they had had their cesspit emptied by a third party, the majority did not even know whether it had ever been emptied. The reasons for this are the random prices charged by the manual emptiers, which are often totally arbitrary, and in general the absence of regulated emptying activities. Moreover, the cesspits in the current sanitary facilities have been deliberately oversized by the households, so as to postpone maintenance expenditure for as long as possible. Another important fact was uncovered: The vast majority of latrines and cesspits (87%) cannot be accessed without first breaking the concrete slab covering or the building structure.
In view of this situation, everything cannot be solved in just a few months, all the more so since the absence of domestic plumbing rules out, for the moment, any prospect of collective investment which, in any case, would not find the necessary funding, either from the users, from awarding agencies or from the State, to operate normally in the medium term.
One of the main challenges of this project is therefore to define a global framework for the development of various sanitation services in line with Dinepa's action plan and to start implementing the first concrete structuring measures which will make it possible to experiment various management models and to gradually build a real public sanitation service.
Among the measures which will be submitted to Dinepa for approval are:
- the local rollout of Dinepa's communication so as to stimulate individual hygiene and build latrines, a new strategy that the public have never heard of before, and a focus on concrete measures as part of its national hygiene promotion campaign, in collaboration with the town council and local stakeholders, such as new obligations relating to the issue of building permits;
- the creation of a sanitation development fund based on treatment taxes and water and household waste taxes designed to fund 0% loans for work to provide access to installations;
- the creation of a system of stonemasons certified by the town council and Dinepa, with the aim of standardising new individual installations given technical standards are currently being drawn up by Dinepa, in partnership with IOWater;
- a system of certification of the informal emptying workers and experimentation of a scheme for the supervision and promotion of manual emptiers and private operators to check the final destination of the by-products at the future treatment plant which is being built in Saint-Marc;
- experimentation with various management, financing and guidance models for the sustainable operation of collective toilet blocks which are to be built and financed by DINEPA: charged for in high-use locations (markets, bus stations, health centres) and free in public schools;
- with the aim of increasing access to basic sanitary installations, the experimental validation of low-cost technical solutions, such as: 1) cesspit emptying, which includes the transport and treatment of excreta for the benefit of peripheral areas with no sanitation facilities; 2) a semi-collective wastewater collection project in a pilot sector;
- increased capacity of municipal staff, in the context of the programme of support for municipalities. The aims are: 1) to improve the controls carried out for the issue of building permits (presence of a dedicated sanitary area, verification that the building regulations have been complied with); 2) to build a team of sanitary mediators, managed by Dinepa's sanitary technicians to promote hygiene in the urban areas and punish illegal dumping.
All these measures will be linked in with Sesam's campaigns which accompany the finalisation of the rehabilitation of the water network (Dinepa programme financed by the IDB) and which aim to provide the Saint-Marc area with a 24-hour drinking water supply. These campaigns will focus on raising the awareness of the community organisations on issues such as water economy and public hygiene and will dovetail with Dinepa's directives on sanitation.
[1]: www.Dinepa.gouv.ht
[2]: 2. Dinepa's mandate covers drinking water and the liquid component of sanitation (wastewater, excreta); the issues of solid waste remain the responsibility of the Ministry of Public Works, Transport and Communications and of the local authorities.
[3]: Dinepa, Conference on Sustainable sanitation (Pétion-Ville, 12-13 June 2012)
[4]: Dinepa, Haiti sanitation system policy guideline document, version 4 June 2012
[5]: In 2009, the management of the public drinking water service was delegated to the Société des eaux de Saint-Marc (Sesam), Lysa's subsidiary.