Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems aim to protect human health by providing a clean environment that will stop the transmission of disease, especially through the fecal–oral route.SuSanA (2008). Towards more sustainable sanitation solutions . Sustainable Sanitation Alliance (SuSanA) For example, diarrhea, a main cause of malnutrition and stunted growth in children, can be reduced through adequate sanitation. There are many other diseases which are easily transmitted in communities that have low levels of sanitation, such as ascariasis (a type of intestinal worm infection or helminthiasis), cholera, hepatitis, polio, schistosomiasis, and trachoma, to name just a few.
A range of sanitation technologies and approaches exists. Some examples are community-led total sanitation, container-based sanitation, ecological sanitation, emergency sanitation, environmental sanitation, onsite sanitation and sustainable sanitation. A sanitation system includes the capture, storage, transportation, treatment and disposal or reuse of human excreta and wastewater. Reuse activities within the sanitation system may focus on the nutrients, water, energy or organic matter contained in excreta and wastewater. This is referred to as the "sanitation value chain" or "sanitation economy". The people responsible for cleaning, maintaining, operating, or emptying a sanitation technology at any step of the sanitation chain are called "sanitation workers".World Bank, ILO, WaterAid, and WHO (2019). Health, Safety and Dignity of Sanitation Workers: An Initial Assessment . World Bank, Washington, DC.
Several sanitation "levels" are being used to compare sanitation service levels within countries or across countries. The sanitation ladder defined by the Joint Monitoring Programme in 2016 starts at open defecation and moves upwards using the terms "unimproved", "limited", "basic", with the highest level being "safely managed". This is particularly applicable to developing countries.
The human right to water and sanitation was recognized by the United Nations General Assembly in 2010. Sanitation is a global development priority and the subject of Sustainable Development Goal 6.WHO and UNICEF (2017) Progress on Drinking Water, Sanitation and Hygiene: 2017 Update and SDG Baselines . Geneva: World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), 2017 The estimate in 2017 by JMP states that 4.5 billion people currently do not have safely managed sanitation. Lack of access to sanitation has an impact not only on public health but also on human dignity and personal safety.
Definitions
There are some variations on the use of the term "sanitation" between countries and organizations. The World Health Organization defines the term "sanitation" as follows:
Sanitation includes all four of these technical and non-technical systems: Excreta management systems, wastewater management systems (included here are wastewater treatment plants), solid waste management systems as well as drainage systems for rainwater, also called stormwater drainage. However, many in the WASH sector only include excreta management in their definition of sanitation.
Another example of what is included in sanitation is found in the handbook by Sphere on "Humanitarian Charter and Minimum Standards in Humanitarian Response" which describes minimum standards in four "key response sectors" in humanitarian response situations. One of them is "Water Supply, Sanitation and Hygiene Promotion" (WASH) and it includes the following areas: Hygiene promotion, water supply, excreta management, vector control, solid waste management and WASH in disease outbreaks and healthcare settings.Sphere Association (2018) The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response , fourth edition, Geneva, Switzerland, 2018.
Hygiene promotion is seen by many as an integral part of sanitation. The Water Supply and Sanitation Collaborative Council defines sanitation as "The collection, transport, treatment and disposal or reuse of human excreta, domestic wastewater and solid waste, and associated hygiene promotion."Evans, B., van der Voorden, C., Peal, A. (2009). Public Funding for Sanitation - The many faces of sanitation subsidies . Water Supply and Sanitation Collaborative Council (WSSCC), Geneva, Switzerland, p. 35
Despite the fact that sanitation includes wastewater treatment, the two terms are often used side by side as "sanitation and wastewater management".
Another definition is in the DFID guidance manual on water supply and sanitation programmes from 1998:WELL (1998) DFID guidance manual on water supply and sanitation programmes WELL Loughborough University UK
Sanitation can include personal sanitation and public hygiene. Personal sanitation work can include handling menstrual waste, cleaning household toilets, and managing household garbage. Public sanitation work can involve garbage collection, transfer and treatment (municipal solid waste management), cleaning drains, streets, schools, trains, public spaces, community toilets and public toilets, sewers, operating sewage treatment plants, etc.PRIA (2019): Lived Realities of Women Sanitation Workers in India: Insights from a Participatory Research Conducted in Three Cities of India . Participatory Research in Asia, New Delhi, India Workers who provide these services for other people are called sanitation workers.
Purposes
The overall purposes of sanitation are to provide a healthy living environment for everyone, to protect the natural resources (such as surface water, groundwater, soil), and to provide safety, security and dignity for people when they defecate or urinate.
The Human Right to Water and Sanitation was recognized by the United Nations (UN) General Assembly in 2010.Human Rights Council resolution 15/9, Human rights and access to safe drinking water and sanitation, (6 October 2010), available from http://www.right2water.eu/sites/water/files/UNHRC%20Resolution%2015-9.pdf It has been recognized in international law through human rights treaties, declarations and other standards. It is derived from the human right to an adequate standard of living.
Effective sanitation systems provide barriers between excreta and humans in such a way as to break the disease transmission cycle (for example in the case of fecal-borne diseases).Thor Axel Stenström (2005) Breaking the sanitation barriers; WHO Guidelines for excreta use as a baseline for environmental health , Ecosan Conference, Durban, South Africa This aspect is visualised with the F-diagram where all major routes of fecal-oral disease transmission begin with the letter F: feces, fingers, flies, fields, fluids, food.
Sanitation infrastructure has to be adapted to several specific contexts including consumers' expectations and local resources available.
Sanitation technologies may involve centralized civil engineering structures like sewer systems, sewage treatment, surface runoff treatment and solid waste landfills. These structures are designed to treat wastewater and municipal solid waste. Sanitation technologies may also take the form of relatively simple onsite sanitation systems. This can in some cases consist of a simple pit latrine or other type of non-flush toilet for the excreta management part.
Providing sanitation to people requires attention to the entire system, not just focusing on technical aspects such as the toilet, fecal sludge management or the wastewater treatment plant.Tilley, E., Ulrich, L., Lüthi, C., Reymond, Ph. and Zurbrügg, C. (2014). Compendium of Sanitation Systems and Technologies. 2nd Revised Edition . Swiss Federal Institute of Aquatic Science and Technology (Eawag), Duebendorf, Switzerland The "sanitation chain" involves the experience of the user, excreta and wastewater collection methods, transporting and treatment of waste, and reuse or disposal. All need to be thoroughly considered.
Economic impacts The benefits to society of managing human excreta are considerable, for public health as well as for the environment. As a rough estimate: For every US$1 spent on sanitation, the return to society is US$5.50.
For developing countries, the economic costs of inadequate sanitation is a huge concern. For example, according to a World Bank study, economic losses due to inadequate sanitation to the Indian economy are equivalent to 6.4% of its GDP. Most of these are due to premature mortality, time lost in accessing, loss of productivity, additional costs for healthcare among others. Inadequate sanitation also leads to loss from potential tourism revenue. This study also found that impacts are disproportionately higher for the poor, women and children. Availability of toilet at home on the other hand, positively contributes to economic well-being of women as it leads to an increase in literacy and participation in labor force.
Types and concepts (for excreta management)
The term sanitation is connected with various descriptors or adjectives to signify certain types of sanitation systems (which may deal only with human excreta management or with the entire sanitation system, i.e. also greywater, stormwater and solid waste management) – in alphabetical order:
Basic sanitation
In 2017, JMP defined a new term: "basic sanitation service". This is defined as the use of improved sanitation facilities that are not shared with other households. A lower level of service is now called "limited sanitation service" which refers to use of improved sanitation facilities that are shared between two or more households.
Container-based sanitation
Community-based sanitation Community-based sanitation is related to decentralized wastewater treatment (DEWATS).
Community-led total sanitation
Dry sanitation
The term "dry sanitation" is not in widespread use and is not very well defined. It usually refers to a system that uses a type of dry toilet and no sewers to transport excreta. Often when people speak of "dry sanitation" they mean a sanitation system that uses urine-diverting dry toilet (UDDTs).Platzer, C., Hoffmann, H., Ticona, E. (2008). Alternatives to waterborne sanitation – a comparative study – limits and potentials . IRC Symposium: Sanitation for the urban poor – partnerships and governance, Delft, The NetherlandsFlores, A. (2010). Towards sustainable sanitation: evaluating the sustainability of resource-oriented sanitation . PhD Thesis, University of Cambridge, UK
Ecological sanitation
Emergency sanitation
Environmental sanitation Environmental sanitation encompasses the control of environmental factors that are connected to disease transmission. Subsets of this category are solid waste management, water and wastewater treatment, industrial waste treatment and noise pollution control. According to World health organization (WHO) Environmental sanitation was defined as the control of all those factors in the physical environment which exercise a harmful effect on human being physical development, health and survival. One of the primary function of environmental sanitation is to protect public health.
Fecal sludge management
Improved and unimproved sanitation
Lack of sanitation