Sanitation comes third to Water and Hygiene where targeted funding and interventions in the WASH (Water, Sanitation, Hygiene) sector are concerned. This is also evident in the way that policies at the national level are formulated, and ministries and utilities mandated with service provision constituted. Added to this, the perceived ‘shaky’ link to health has sanitation appended to Public Health as a ‘soft issue’, not recognizing the immense contribution it plays in preventative health.
However, consciously prioritizing sanitation can work, and the returns are immense. Nakuru County, Kenya and Kampala City, Uganda, are changing the game for sanitation for their urban localities.
Contending with gaps in policies, including a lack of clear regulatory framework, financing streams specific to sanitation or guidelines for urban sanitation, these two urban areas are taking advantage of existing political goodwill to push forward the agenda for safely managed fecal waste. Champions in Nakuru’s County Government’s Department of Public Health and Kampala Capital City Authority (KCCA) have gone the extra mile to craft and/or support avenues for implementing and development partners, donors, civil society organizations, utility companies and communities to impact the sector.
Notably, most of these avenues do not have policy, legislation, regulatory standards or frameworks anchoring them. This then makes it critically important to have policymakers who understand the end goal and are willing to leverage on the profile of their offices, and relevant technical experience, to broker connections or partnerships along the sanitation value chain to significantly reduce fecal waste finding its way in to the environment.
Something out of nothing: The Nakuru Case
A 2017 World Health Organization Study (WHO) estimates that the Nakuru County uses 1 billion Kenya Shillings (USD 10 million) every year treating diarrheal diseases. Sewer Coverage is at 27% (Nakuru SFD, 2014).
Nakuru’s success in safe sanitation is largely pinned to willingness to invest in the piloting of proposed solutions before taking them to scale. Nakuru Water and Sewerage Company has worked with the Department of Public Health, to change perceptions on the reuse of products from fecal sludge, specifically organic fertilizer and briquettes. Notably, these briquettes are now used for cooking in hotels in the County. Basing their messaging on the fact that Egerton University had carried out rigorous testing and disseminating findings on there being no risk to human health, the KEBS (Kenya Bureau of Standards) then provided required certification for commercial production and sale.
Nakuru Water and Sanitation Services Company Limited (NAWASSCO) is drafting a Memorandum of Understanding (MoU) between the Department of Public Health and manual emptiers of pit latrines. The idea is to formalize the work of emptying pit latrines, and to address stigma associated with it. The stigma fuels drug abuse as a coping mechanism. Previous efforts to train and provide safety gear were unsuccessful due to the perceived illegal nature of the business, hence risky to identify as a manual emptier at a government-approved convening.
Public Private Partnership (PPP) saw an immediate win as the County Government understood that safe management of fecal waste was a challenge which the private sector was proposing to take off their hands. The private sector was bringing innovative solutions and had a small ask -provide land and access to the sludge at the Waste Water Treatment Plant (WWTP). This has been followed up with dialogue on formulating a PPP framework to guide and protect investment by small entrepreneurs in the sector. As things stand, private sector actors are not recognized by Treasury, hence agreements made risk not being honored.
Shifting Gear: The Kampala Case
Kampala is a fresh surprise because its stellar performance can be traced back to overhaul of staff at the Kampala Capital City Authority (KCCA). Institutional leadership with a focus on multi-sectoral approaches to achieving safely managed fecal waste is working, addressing a long standing challenge with service delivery in government institutions on the continent- the tendency to constitute a bloated workforce with unclear responsibilities, and often, with no performance evaluation.
The Authority also periodically convenes all actors in forums aimed at identifying new interventions and thus potential for collaboration, and reporting on ongoing and closed projects. In this way, they aim to avoid duplication of effort, increase number of beneficiaries, and identify new and existing technologies. Interestingly, KCCA is also continuously engaging with landlords to persuade them of the value of putting up communal toilets, alongside running public campaigns on the returns of safe sanitation across the city targeting residents.
Finally, KCCA has managed to formalize operations for manual and mechanized emptiers- those who make use of the Gulper technology (Gulpers Association), and mechanized trucks (Emptiers Association). The latter group are coordinated through a vibrant call center that ensures equal allocation of work, and boosts confidence of clients that they are engaging with professionals.
Going forward, Monitoring, Evaluation and Learning from Nakuru and Kampala will provide critical elements that can go in to generating clear roadmaps for urban sanitation in Africa. With 60% of or populations residing in urban informal settlements, we must position safe sanitation as the key to keeping their water quality high, the environment free of fecal pollution, and achieving desirable levels of hygiene to address preventable diarrheal diseases. The trees for the forest.