Agotamiento emocional laboral en docentes universitarios

norms and

standards for

sanitation

services

can be very

challenging

should be possible to treat household and neighborhood sanitation infrastruc- ture and services as private facilities exclusive to the communities concerned. Many cities in the developing world, such as Manila and Jakarta, have achieved this minimal level of sanitation service at the household level for millions of people. In most cases, however, such investments have not been followed by the development of community- or public-level sanitation infrastructure, such as feeder and trunk sewerage systems, to convey the household-level wastes away from the community for treatment and safe disposal. As a result, septic tank and feeder network effluents regularly flow into open streams and drainage channels, creating public health risks, environmental damage, and unpleasant living conditions. Even in the many cities of Latin America where relatively complete feeder and trunk sewerage systems have been constructed, only about one third of them have sewage treatment plants. Public health concerns are thus generally addressed in the immediate neighborhoods, but environmental damage from untreated waste continues unabated, often affecting the poor who live downstream.

The term “sanitation ladder” is often used to describe these types of plan- ning approaches that seek to make progress in a gradual way (figure 6.1). Starting with immediate, household-level access to sanitation facilities, then moving gradually toward collective infrastructure components, such as feeder sewerage at the community or neighborhood levels, and eventually to trunk sewers and treatment plants. This approach has clearly helped to make prog- ress in cities that would otherwise have taken much longer to move toward the top of the sanitation ladder. At the same time, achieving localized sanitation improvements can actually generate environmental pollution and, at times, health risks for downstream neighboring communities. How should such Figure 6.1

Urban water and sanitation services are much more expensive than simpler rural services

Note: Estimated costs include overhead charges of 15 percent, as well as operation and maintenance costs. Costs in dollars per person are not to scale.

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Experiments

with reversing

the service

provision

chain for

urban

sewerage

have occurred

in several

developing

countries

tradeoffs—between the short and long term and between access to basic sani- tation services (on one hand) and health- and environment-related benefits (on the other)—be managed? How long a transitional period should be tolerated between the attainment of basic sanitation for households and concomitant production of negative environmental externalities? These are difficult policy questions with which countries and their international development partners will continue to grapple.

Breaking the full set of sanitation objectives into manageable steps—from the safe collection, storage, and disposal or reuse of human excreta to the treatment and disposal, reuse, or recycling of sewage effluents and hazard- ous waste—can help create opportunities for progress where the entire chal- lenge seems overwhelming. In many cases, more progress can be made by first focusing on a few solvable problems rather than by waiting until adequate resources and support are available for a full-scale intervention. Indeed, this phased approach was pursued in many of the countries that now enjoy uni- versal access to sanitation services. This is not to say that the approaches of 100 years ago should be followed blindly. Much more is known today about, for example, environmental protection, which should generate more effective and sustainable solutions. Yet, while it may be desirable to develop a holistic strategic plan for improving sanitation, practicality and resources may dictate that a phased or stepped approach must be taken for implementation of such strategic plans. An important first step to addressing this problem is to clearly define responsibilities for household, community, and public level sanitation service provision.

Alternative planning approaches for rural sanitation

The scale problems in sanitation are even greater in rural areas, where the absolute poor in low-income countries most off-track in reaching the sanita- tion targets tend to be concentrated. The majority of the rural population lives in sometimes remote, dispersed settlements; others, in countries such as Egypt, live in very high density settlements. The number of such communities and the wide areas over which they tend to be distributed makes reaching them a formidable task. What is required is a significantly scaled-up approach that can be applied simultaneously over a wide area—an approach that centers on community mobilization and actions that support and encourage such mobi- lization. That kind of approach supports community members in their efforts to discuss sanitation practices with households that are within their boundar- ies and to devise locally appropriate and affordable strategies for improving services. Where necessary, government, civic, and external organizations may support these community-planning processes by providing information, tech- nical support, or even financial support or loans for facility construction.

One such approach is the franchise approach described earlier. It is being tried in community-based sanitation programs in Indonesia, where parent

An important