Sanitation: Quo Vadis?

By Bonifacio B. Magtibay, Technical Officer, WHO

Published in 2013 by the Center for Advance Professional Studies

Introduction

Sanitation is defined differently by various organizations. Some of these definitions refer

to access to a toilet or the services required to empty, transport, treat and dispose of
excreta while other definitions include the necessity of removing wastewater, storm water
and solid waste.

According to the World Health Organization, "Sanitation generally refers to the

provision of facilities and services for the safe disposal of human urine and feces.
Inadequate sanitation is a major cause of disease world-wide and improving sanitation is
known to have a significant beneficial impact on health both in households and across
communities. The word 'sanitation' also refers to the maintenance of hygienic conditions,
through services such as garbage collection and wastewater disposal.

To simplify, sanitation can be defined as a measure for hygienically separating the

hazards of wastes from human contact to promote health.

Sanitation Coverage

The Joint Monitoring Programme of WHO and UNICEF is using improved sanitation as
an indicator of basic access to excreta disposal facilities that hygienically separates
human excreta from human contact. Globally, about 63 % of the population have access
to improved sanitation in 2010 wherein approximately 2.5 billion people (37%) are
underserved and about 1.1 billion (15%) resort to open defecation. The Philippines has a
better situation than the global average. The 2010 data shows that improved sanitation
coverage is about 79 % with only 8% of the population having no toilets at all.

Sanitation-related diseases

Inadequate and improper disposal of infected human feces and wastewater can lead to the
contamination of water sources. Specific animals, rodents and insects can get in touch
with infected feces and wastewater and spread the disease-causing organisms, such as
virus, bacteria, parasites and helminths. According to UNICEF, one gram of human feces
can contain 10,000,000 viruses, 1,000,000 bacteria, 1000 parasite cysts, and 100 parasite
eggs which are tantamount to cause a disease. Examples of sanitation-related
communicable diseases are intestinal infections and helminth infestations. These include,
diarrhea, cholera, typhoid fever, intestinal parasitism, schistosomiasis and filariasis. In
2004, WHO recorded that 4.6 billion people got sick and about 2.2 million died of
diarrhea.

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Sanitation as a human right

Cognizant of the impact of sanitation on health, international agencies as well as national

governments are promoting and implementing sanitation systems. This effort supports
the declaration of sanitation as a basic human right. To meet this requirement, sanitation
must be safe, physically accessible, affordable and culturally acceptable. Being a right of
every individual, governments are obliged to meet this need

Sanitation technologies

Various technologies are available to address the sanitation need of the population. Such
sanitation systems can be off-site or on-site. Off-site systems collect human waste from
the households and transport it to a treatment site located in a different place. For on-site
sanitation, collection and treatment of human waste is done at the household level. Septic
tank technology is one of the popular on-site sanitation systems.

There are about three levels of sanitation schemes on how to handle feces and
wastewater using appropriate technology. The first level is by using household-based
systems such as pit latrines and septic tanks. This is followed by community-based
system, such as the decentralized wastewater system. The third level is the conventional
sewerage system. It can be gleaned that as the level goes up it corresponds to the
investment needed.

Although sewerage system is available, only Metro Manila and a handful of cities are
sewered. The average national service coverage on sewerage is less than 10%. The
Philippine demographic survey of 2008 reported that about 68 % of the total
households are using septic tanks. Absence of sewer lines or prohibitive cost to connect
to existing sewerage systems are key factors on why majority are using septic tanks.

A septic tank is a watertight settling chamber that collects sewage or wastewater from
plumbing fixtures inside the house or other building. It performs at least three major
functions: (1) removes a good portion of the settleable and floatable matter; (2) effects
reduction in settled and floating organic matter, through anaerobic digestion; and (3.)
acts as storage for the remaining solids till removed. Concerning its efficiency, it can
remove 30-60% of BOD; about 80-85% suspended solids, and at least 50% of coliforms.

Sanitation regulations

The Philippine Sanitation Code (PD 856) and Clean Water Act (RA 9275) are the main
legislations supporting sanitation improvement in the country. The National Building
Code (PD 1096) provide details on the requirements for the design and application of
septic tanks in buildings, particularly for households. The Sanitation Code stipulates that
at least 25 meters distance of water supply systems from sources of pollution such as
septic tanks. The National Building Code also provides the design requirements, location
and installation of septic tanks.

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In the Philippine context, despite existing regulations, there are some issues relevant to
septic tank system. The following conditions are commonly observed in any of the
provinces or cities in the country.

1. Clear distance between water supply system and septic tanks. Although 25 meters
were provided as the safe distance, this is not strictly followed, particularly in the
urban areas. There are some residential subdivisions where lot area is less that 50
square meters (i.e. 5 meters by 10 meters) . If there is a handpump within the
property perimeter, the farthest distance could be less than 12 meters.

2. Floor slab. In some cases, floor slab of septic tanks is not installed. This condition
is popularly known as bottomless septic tanks. The incomplete construction is
risky to the safe quality of groundwater. Due to gravity, wastewater has the
natural tendency to percolate to the lower ground and mix with the groundwater
if the water table is shallow. Such contaminated groundwater could be pumped
for drinking water purposes if the water facility is a handpump with tubewell and
the clear distance is not followed.

3. Efficiency of septic tanks. Depending on the robustness of design and

construction, septic tank efficiency ranges from 30 to 85 % in removing organic
matter. The unremoved organic matter is still with the effluent that sometimes is
disposed to the drainage.

4. Desludging. Septic tanks are designed to be full in five years time and should be
desludged. However, in the past years, there is an absence of a guideline on how
to hygienically desludge septic tanks and where to dispose the septage. Thus,
some desludgers are disposing the septage in any convenient place to the
detriment of the bodies of water that will absorb it. Nowadays, disposal of septage
away from septage treatment plant is prohibited by the current implementing rules
and regulations of the Sanitation Code and some water utilities are investing on
the treatment facilitie, like Maynilad or Manila Water.

5. Treatment facility. Installation of septage treatment facility is still on its initial

stage and very few LGUs and water supply providers are knowledgeable and
willing to invest. An example of these LGUs are Dumaguete City and San
Fernando City.

The future of sanitation

It can be projected that sanitation universal coverage could be met in the near future with
the initiative of governments in fulfilling sanitation as a human right. Although there are
challenges in meeting their targets in developing and under-developed countries, it is just
a matter of time before they can reach full access to sanitation systems.

Sanitation efforts must not stop after reaching zero open defecation targets. There are
other environmental influences such as climate change and disasters that threaten the

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resilience of sanitation services. Increase in temperature could lead to drought that will
minimize the availability of water for water-dependent sanitation. In this case, however,
waterless sanitation schemes could be an alternative as promoted by ecological sanitation
program.

On the other hand, higher volume of precipitation could cause flooding and submerge
sanitation systems. To provide appropriate sanitation services, efforts were made to
introduce floating toilets but the system is still inadequate to address storage and
treatment efficiency. In general, efficiency of some sanitation systems must be improved.
Septic tank design must be revised so that the removal of organic matters must be at least
more than 90 per cent.

A new concept is coming up to create better linkage between sanitation and health.
Sanitation safety plan, a parallel of water safety plan, is now in the drawing board. It
applies risk management principles to ensure that the hazards will be contained, reduced
or removed from the system by providing appropriate measures. It will also involve
effective monitoring system for the operation of control measures and verification
system to ensure that the plan is working as designed. Its management procedures can
tackle the impact of disasters and climate change. With this new approach, it is envisaged
that all the hazards that may come in could be identified and assessed and provided with
appropriate mitigation measures to ensure that health-based targets are met.

References:

Barrenberg, Eva (2010). Concept Note on Sanitation Safety Plans (SSP):A vehicle for
guideline implementation. Geneva:WHO

COHRE, WaterAid, SDC and UN-HABITAT (2008). Sanitation: A human rights

imperative, Geneva..

DOH (2011). Philippine Sustainable Sanitation Roadmap.Department of Health, Manila,

Philippines

Franceys R, et al (1992). A guide to the development of on-site sanitation. Geneva: WHO

WHO (2006). Safe use of wastewater, excreta and greywater. Geneva

WHO and UNICEF (2010) Progress on sanitation and drinking-water: 2010 update.
Geneva: WHO and UNICEF.

WHO (2010) GLAAS 2010: UN-Water Global Annual Assessment of Sanitation and
Drinking- Water (GLAAS) .Geneva: WHO

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World Bank (2005). Philippine Sanitation Sourcebook and Decision Aid. World Bank-
Water and Sanitation Program.