TECHNICAL PAPER # 56
AT THE COMMUNITY LEVEL
Bruce P. Davis
Ira J. Somerset
Dr. Romero Cartier
1600 Wilson Boulevard, Suite 500
Arlington, Virginia 22209 USA
Tel: 703/276-1800 * Fax:
Understanding Sanitation at the Community Level
1986, Volunteers in Technical Assistance
This paper is one of a series published by Volunteers in
Assistance to provide an introduction to specific
technologies of interest to people in developing countries.
The papers are intended to be used as guidelines to help
people choose technologies that are suitable to their
They are not intended to provide construction or
details. People are
urged to contact VITA or a similar organization
for further information and technical assistance if they
find that a particular technology seems to meet their needs.
The papers in the series were written, reviewed, and
almost entirely by VITA Volunteer technical experts on a
Some 500 volunteers were involved in the production
of the first 100 titles issued, contributing approximately
5,000 hours of their time.
VITA staff included Steve Oppenheimer
as editor, Suzanne Brooks handling typesetting and layout,
Margaret Crouch as project manager.
The author of this paper, VITA Volunteer Bruce P. Davis, is
public health engineer in the Wayne County, Michigan Health
Department, and has 20 years of experience in environmental
public health. The
technical reviewers are also VITA Volunteers.
Ira Somerset is with the U.S. Food and Drug Administration,
specializes in sanitation engineering and food
Romero Cartier is a registered civil engineer, land
sanitary engineer with wide experience for the World Health
Organization and other agencies.
VITA is a private, nonprofit organization that supports
working on technical problems in developing countries.
information and assistance aimed at helping individuals and
groups to select and implement technologies appropriate to
maintains an international Inquiry Service, a
specialized documentation center, and a computerized roster
volunteer technical consultants; manages long-term field
and publishes a variety of technical manuals and papers.
UNDERSTANDING SANITATION AT THE COMMUNITY LEVEL
VITA Volunteer Bruce P. Davis
Sanitation at the community level is not significantly
from sanitation at the individual level.
Sanitation means healthful
living conditions and clean practices for the handling of
water and food and the disposal of personal wastes.
in other words, means good hygiene.
At the community level, this
means provisions for a safe water supply, safe liquid and
waste disposal, and a sanitary food supply.
Understandably, most people are concerned first and foremost
Individuals must obtain food and water and prepare
them for use, relieve themselves, and find shelter.
the simplest and most convenient ways for individuals to
these personal needs are sometimes not in the best interests
the community as a whole.
It is essential, therefore, that the
meeting of these basic sanitary needs is viewed as a
Because poor community sanitation leads readily to
disease, the quality of community sanitation affects many
facets of community life.
Life expectancy of adults and
children, the physical condition of newborns, the
a healthy and productive work force, and the general
of the populace are all affected by the quality of the
Most of this paper deals with the broad conceptual issues
in choosing and implementing sanitary systems.
major areas covered are:
sanitary water supplies;
the disposal of liquid and solid wastes;
food supplies; and
the safe use of insecticides.
Within these broad areas, a discussion of sanitation at the
community level inv olves addressing several factors:
water courses or ground supplies; exposed excreta or
organic matter; exposed garbage and trash; collection and
delivery of water and wastes; control of flies, pests, and
rodents; food protection; and insecticide use.
There is more to effective sanitation than just technology.
Often, some highly unhealthy practices are part of the
and habitual lifestyle of the populace.
To implement new methods
of dealing with food, water, and wastes, the members of the
community must be persuaded that change is necessary.
education to have any impact, and for the needed resources
to be committed, the community's political and spiritual
must be supportive of efforts to promote sanitation.
II. COMPONENTS OF
A first step in the sanitary treatment of water is to
whether any biological or chemical contaminants are present
the existing supply.
If contaminants are found, their source
must be determined.
For example, there may be industrial wastes
or agricultural runoffs that are polluting the water
the water supply is from wells or other underground sources,
must be determined if the wells are protected from animal
(Step wells are so prone to contamination
that they should be avoided.)
Some sources of pollution may not be immediately
example, contaminants may enter the water far upstream.
of standard procedures exists to test for contaminants, and
to conduct a sanitary survey of the entire water
test kits are available that will determine if certain
(known as the "fecal coliform" group) are present
wastes. For other
kinds of pollutants, such as agricultural
chemicals and industrial wastes, most testing must be done
water samples are collected from several
sites and then sent to the laboratory.
In many cases, it is possible to eliminate the sources of
Where this cannot be achieved, the water supply must be
disinfected and is sometimes cleaned by simple
can be built for the treatment of polluted streams.
usually use clean sand as a filter and add chlorine or other
disinfectant to the water to kill harmful bacteria.
wells can also be treated with chlorine.
However, these kinds of
treatments will do nothing to remove many pesticides or
chemicals; the only way to deal with chemical pollutants is
stop them from entering the water supply.
If the contaminants
cannot be eliminated or cleansed, then the water supply must
The same considerations that apply to the source of the
also apply to its transport.
Are the transport containers or
pipes that carry the water protected from
contamination? Are the
transport devices clean and safe?
In addition to water quality, there are several other
consider when managing water resources.
While we cannot discuss
them here in detail, they must at least be mentioned:
present quantity of water being supplied adequate for
future needs? What
effect does the removal of water at one site
have on the supply of water at other locations--downstream
neighboring wells, for example?
Special care must be taken to ensure the cleanliness of
the point where it is delivered to homes or to other
points within the community.
For example, if the water is transferred
into storage containers, it is important that the containers
be cleaned often. It
is also important that the people
who do the cleaning are themselves careful in their personal
Dip storage containers--that is, water containers into which
family dips its own smaller water containers--should not be
This is because each family, by dipping into the water
distributes its dirt and disease carriers into the water and
spreads them to the rest of the community.
In general, the
stored water supply should not come in contact with
persons or household containers; rather, the stored water
be transferred into private containers through a pipe or
Water containers should always be covered.
WASTES--LIQUID AND SOLID
If not properly handled, waste products serve as a breeding
ground for disease-carrying insects, mice, rats, and other
Moreover, poorly handled waste products can find their way
into the water supply or the food chain.
treatment, and storage of wastes is therefore essential for
The term "liquid wastes" refers to human and
animal excrement and
deciding what changes, if any, should be made in
the existing disposal systems, it is helpful to make a
the existing systems to answer the following questions:
Are the existing liquid waste disposal
number of people presently being served, and
number of people anticipated in the future?
Is the current system sufficiently isolated
water drinking and bathing sources? If
the system need to be moved to a different
can it simply be repaired to prevent
leakages? Would it be
possible/practical to move the
Are there sufficient numbers of comfort
holding and collection facilities in
Ideally, every possible step will be taken to control and
liquid wastes within the disposal system.
If possible, a planned
layout of the housing locations and the latrines (if these
outside the homes) should be carefully designed to minimize
Places of deposit of exposed excreta (such
as latrines and public comfort stations) must be screened or
otherwise protected from access by flies and other disease
such as rodents and mosquitoes.
Domestic animal manure
must be treated similarly.
A crucial aspect of liquid waste management is the
monitoring, and maintenance of a discharge location.
three main types of waste disposal facilities (there are
and disadvantages with each kind of disposal):
surface water discharge (into a stream or
ground surface deposit (onto or under the
pipe system to a treatment or disposal
Surface Water Discharge (into a Stream or River).
If a surface
water discharge system is already in place, it must be determined
if the discharge location is sufficiently distant and
from wells or other water sources.
Again, this determination
should be based in part upon the sanitary survey of the
pollutants found in a water supply are the same
as those in a nearby discharge location, then the discharge
location and the water supply are probably too close
Generally, discharge locations should be at least 45 meters
an underground water supply and as much as several
surface supplies, especially in the tropics.
The minimum separation
distance may vary depending on a number of factors.
important, a survey of the downstream waters is needed to
out if contaminants from the liquid wastes pose a danger to
downstream water users.
In general, naturally occurring biological processes tend to
cleanse the water.
The larger the volume of the surface water,
and the faster it moves, the quicker and more effective this
cleansing action will be.
Slow moving or small volumes of water
result in a longer time for the biological action to cleanse
water. During this
waiting period, disease organisms are alive
within the water, and unpleasant odors may develop.
some of the solid waste materials become lodged in debris or
the bends and turns of the surface water course, disease
fly populations may develop.
Bathers and people using the water
to wash clothes may also be affected.
If the downstream water quality is not safe, it may be
to prohibit its use.
Alternatively, it may be necessary to
discontinue the surface water discharge and find an
means of disposal.
Trained health workers should evaluate the
water quality, and contribute to discussions of the various
alternative courses of action in the event the water quality
Ground Surface Deposit.
If liquid wastes are being deposited in
or on the ground, it is necessary to determine where the
is depositing the wastes.
Some of the possible sites include
latrines, pit privys, roadways, drainage ditches, and
There are several possible problems with the surface
of liquid wastes, particularly if the wastes are not
stored and isolated.
Liquid waste depositories can be breeding
grounds for disease-carrying flies and a source of parasitic
worms. As a result,
there is a high potential for the transmission
of internal diseases, especially to children who may have
direct contact with the polluted waters while playing.
to the risks of disease, there is a strong nuisance odor
associated with these deposits.
These problems may be alleviated in a number of ways.
area comfort stations should be provided in sufficient
for the population.
If the wastes are not to be transported to a
separate location (via sewers or other transport), an
septic tank should be used and the effluent disposed of in
or oxidation ponds.
An oxidation pond is a shallow pool or
pond in which the wastes are decomposed by the action of
over a specified period of time.
Air must be available to the
oxidation pond, and is sometimes even forced into the pond,
help the bacteria do their work.
Once the waste has been reduced
by the bacteria, it is relatively clean and can be
into a stream. A
soakway is a kind of oxidation pond lined with
pebbles; the pebbles hold onto the human fecal matter and
organic material, while allowing the purely liquid part of
human waste to drain into the ground.
Oxidation ponds and soakways are always covered with some
both because the bacteria require some moisture to work, and
because the water helps to control odors.
In rare cases, liquid wastes can simply be deposited on the
ground and covered with soil.
An estimate must be made of the
amount of area needed, given the number of years of expected
The waste deposit area must not be in close proximity to
or surface water sources, wells, or bathing or play
important, it must be determined if adequate quantities of
will be available to cover the wastes.
Alternatively, liquid wastes may be composted for use as
for vegetables (but not green leaf vegetables).
wastes should be treated with disinfectant before
If liquid wastes are not to be stored at the location of the
comfort stations, or transported through sewers, then
must be made for the pickup of the wastes and delivery to
storage site. In the
design of a transport system, a number of
The people designated to pick up the wastes
must be trained by health workers on the proper handling of
wastes. A variety of
containers and transport vehicles may be
used, including tank trucks or wagons, buckets, and lined
Whatever ground surface deposit method is used, it is
to avoid stagnation (or ponding) of the wastes.
of wastes are breeding grounds for insects and other
infection and disease, especially in crowded or congested
Pipe System. The
movement of liquid wastes by a pipe system
eliminates many sewage collection and delivery problems,
those associated with fly breeding and disease, and
pipes are costly and difficult to install,
especially in areas with winding streets or unstable
pipes require routine maintenance and
checking and water to carry the waste.
Because sewer pipes significantly reduce the risks of
water supply contamination, their installation should be
One way to reduce the total costs and construction involved
is to utilize the pipes in conjunction with community
Provided a sufficient number of latrines are
available to handle the needs of the population, this can
to be an effective approach to waste and disease control.
When sewer pipes are used, discharge is usually into a
an oxidation pond, or other treatment/disposal
location of the oxidation pond must be decided based on a
of partly conflicting factors.
On the one hand, it should be
located as far from the living areas as possible, in order
minimize odor and disease problems.
On the other hand, to conserve
sewage pipe, the pond should be located as centrally as
the pond should be located so that all the
pipes run downhill to reach it--since gravity is what brings
wastes to the pond--to avoid costly pumping.
The final choice of
location will reflect a balance or compromise among these
For an oxidation pond to be functional, some water may
have to be added; in a dry climate, this approach may not be
"Solid wastes" refers to ordinary household
garbage and trash;
refuse from eating houses, markets, and hospitals; and any
items disposed of by people or businesses.
These wastes may
include everything from animal carcasses and manure to
metal, and food scraps.
Sometimes excreta collected from roadside
deposits is included.
Because of the variety of materials
in solid wastes, they can pose an unpredictable degree of
To avoid the breeding of flies and vermin, the best approach
to collect, transport, and dispose of this material in a landfill
that is covered daily by at least 15cm of earth.
By following a
few simple guidelines, it is possible to create a remarkably
effective and sanitary solid waste disposal system.
Ideally, covered individual or commercial collection
should be placed on the streets, making sure that enough are
available to handle the refuse created by the populace.
practice, however, refuse containers in poor, densely
neighborhoods are apt to find other uses--for storage or
costs could be substantial, so communities
should address the need for surveillance.
If used, bins should be disinfected and sprayed with
on a frequent basis.
Collection bins should be kept covered, and
sprayed with insecticides once a day.
Spillage from these bins
must be cleaned up promptly (otherwise it becomes a breeding
ground for insects).
All collection containers must be designed
for ease of use, both in terms of putting material in and in
terms of unloading it.
The astute reader will have noticed that there has been no
of rats or cockroaches, despite the obvious sanitation
problems these pests represent.
In fact, the only way to control
them, as well as flies, mosquitoes, and other rodents, is
Chemical methods are of limited effectiveness
with these pests, so the easiest way to control them is to
limit their access to food and water.
That, in turn means
keeping food off the ground and the streets, and keeping
To transport the waste from the collection bins to the
site, some kind of vehicle should be used.
Whether powered by
man, animal, or engine, the transport device should have
sides, bottom and top to contain the trash.
The disposal site should be at least one kilometer from the
living areas, and should also be in the downwind
site should not be waterlogged, marshy, or near the edge of
waterway. The site
must be kept covered by soil, both to prevent
trash from blowing away and to keep pests from using the
a breeding ground.
Sufficient soil must be available to cover
the site on a daily basis, so that flies, rodents, and other
pests, will not be able to breed.
Surface water must be diverted away so that chemicals will
drained from the site or leach through it.
Seepage water from
these dump sites will also be highly polluted; steps must be
taken to prevent this water from reaching water courses used
water supplies or for water contact such as bathing and
Because unemployment is often a problem in the same areas
by poor sanitation conditions, a large labor force may be
available to aid in the collection of wastes.
Indeed, in some
urban areas, a significant portion of the force is employed
the collection and reprocessing of waste.
A key issue here is that many resources can be recycled, and
resources--such as paper, aluminum. rags, glass, ferrous
etc.--can be recycled with relatively low levels of
Recycling of wastes should be considered as an important
option, because it offers at least three advantages:
the amount of dry waste that must be dumped and covered; it
offers a cheap source of raw materials (wood pulp, metal,
etc.) that would otherwise be expensive; and it offers
gainful employment to members of the community.
must be given, however, to the potential for personal injury
for the spread of disease.
Collection for recycling should be subject to the same
for sanitation as collection for disposal; similar
for the spread of disease and pests exist in both
The people doing the collection/recycling should be educated
about the hazards of their job and the role they themselves
pLay in the spread of disease.
At the community level, good sanitation procedures for food
mainly with the routes by which the food reaches the
This means that the primary focus of sanitation efforts is
conditions at the markets; at the working locations of the
food vendors; and in the storage, preparation, and serving
of permanent food establishments.
While control is difficult,
certain objectives have a very high priority.
First, safe and sanitary water supplies must be made
This is especially important in the marketplaces where
congregate. In these
same markets, it is important that facilities
be provided for the sanitary disposal of liquid wastes.
Flies and other vermin must be controlled, mainly by
the sites where they breed such as garbage dumps or food
in the street. All
food, and the utensils used to handle it,
should be kept as clean as possible.
All efforts to improve the
personal hygiene of those who handle the food will
the overall health of the community.
Depending on the resources available, several possible
may be used to implement these objectives.
Ideally, new markets
should be constructed that would be carefully designed to
the disposal of wastes and supply adequate quantitites of
water to the vendors.
A major source of contamination, particularly
for green vegetables, is the practice of washing these
vegetables with polluted water.
One possible solution is to
provide safe water supplies along the vendor travel routes,
well as at the markets.
Some of the greatest sanitation problems occur at fairs,
and religious events.
The sudden increase of population in
small areas must be handled by provision of additional
for waste disposal and provision of clean water, as well as
measures during such events should include the
monitoring of the sale of cut fruits and uncooked
the insistence that all food be covered or otherwise
against flies. The
quality of the water and ice (if available)
used to prepare food and drinks should be carefully
Provisions should also be made for the cleaning and
of cooking utensils.
A further step is to promote single use
containers, such as those made from leaves and burnt clay.
The use of insecticides to control insect pests is one of
most powerful techniques for maintaining good community
At the same time, it involves serious risks.
are exposed improperly or excessively to these substances,
can be seriously harmed.
If insecticide use is considered, costs,
benefits, and alternatives should be carefully evaluated.
There are a few basic considerations involved in the safe
proper use of these pest control substances.
Great care must be
taken that these poisons do not enter water supplies.
these substances must not be sprayed at or near uncovered
Insecticides should always be used according to directions;
will not prove any more effective than the amount specified.
Persons using insecticides must be properly trained, and
provided with protective clothing and masks.
must be stored in well marked containers away from food,
and water, and secured in a safe place.
Common sense plays an
important role here, such as avoiding spraying into the wind
using one's hands to mix solutions.
OF SANITATION MEASURES
As a prelude to designing and implementing a community level
sanitation system, it is important to assess the existing
and life conditions in the community.
Sanitation is meaningless if survival is at stake.
can begin to think in terms of their health and cleanliness,
must already have the basics of food, water, and shelter
If these basic needs have not been met, then it makes
sense first to devote community resources to fulfilling
However, sanitation must be considered simultaneously to
food, water, and shelter safe enough for human survival, to
a crisis such as an epidemic.
Once a serious sanitation problem
has developed, it may be too late to resolve it
PLAN OF ACTION
To implement a sanitation system, it is necessary to
plan of action. This
plan is a series of specific steps that
will put each piece of the sanitation system in place.
To begin with, a determination must be made of the problems
needs of the community, and priorities must be assigned to
needs. For example,
perhaps liquid wastes are finding their
way into the water supply.
Then there is a need for some way to
dispose of the liquid wastes without affecting the
water. It may
be decided that a new source of water is needed, and that
must be built.
Another example: perhaps garbage
is piling up in
the streets, creating a breeding ground for flies,
and rats. Then a
system must be developed to collect the waste
from the streets and dispose of it in a safe place.
Once the community's sanitary problems and needs have been
priorities must be assigned among these needs.
it may be decided that the need for a safe water supply is
more important than the need to remove the garbage.
So the water
supply problem would be dealt with first, and the garbage
later if only one can be resolved at a time.
A list of the problems and sanitary needs of the community
the building blocks of a plan of action.
Once these needs have
been determined, several further factors must be assessed:
What are the resources available to meet
each of the
What are the anticipated problems and
the goals of the plan?
What are the specific sites for latrine
or the pickup and delivery points for
Who will monitor and supervise the operation
of the sanitation
Apart from all the designing, planning, and construction,
the most difficult aspect of implementing a sanitary system
the task of educating the people.
Education is difficult even in
the best of circumstances, and much more so in overcrowded
conditions and poverty-stricken communities.
Interest and motivation
are difficult factors to arouse in people, particularly if
hunger and disease persist strongly in the population.
Yet, education is essential because the implementation of a
system may require the people to change long-established
habits. For example,
the people may be called upon to draw their
drinking water from a different source than they are
to, to use different toilet facilities, or to handle their
differently in the marketplace.
There may be strong resistance
among the people to changing old habits.
Consideration should be
given to minimizing changes, if this can be done without
the effectiveness of the sanitation efforts.
Another kind of education is also essential:
must receive special training to make sure that their
do not make them into sanitary risks in their own
example, collecting wastes from homes and public places may
one important step.
However, the people doing the collecting may,
if they are not careful, acquire diseases that they will
along to the rest of the community.
The same is true for those
people handling community water supplies and food.
For all such individuals involved in the running of
systems, it is imperative that they be fully educated about
sanitation/health hazards in their jobs, and on the best
achieve personal hygiene.
This kind of detailed education should
generally be provided by trained health care workers, who
explain the interactipn between personal hygiene and
hygiene, and the role that all people play in the common
of ensuring public health.
Health care workers also play a significant role in the
of the general community.
But the most important figures in
community education are the political and religious leaders,
the community elders--whichever leaders can hold the
the people. These
leaders should set out to make people aware of
the problems, and the advantages to solving them, and help
the best approaches to take.
Ultimately, to be effective, a sanitation system must reach
whole community, both in its physical extent and in the
of the people to take advantage of it.
The community can provide
the most modern water and waste disposal systems available;
if large segments of the people are not served by these
a major breakdown in the sanitation level is likely to
with the accompanying potential for the spread of disease
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