GRF 2nd One Health Summit 2013: Presentation by Janet Hering, Swiss Federal Institute of Aquatic Science & Techology EAWAG

1. The Intersection between
One Health and WaSH
Prof. Dr. Janet Hering, Director
GRF Davos One Health Summit
Davos, Switzerland, 17-20 November 2013
Eawag: Swiss Federal Institute of Aquatic Science and Technology

2. An idea from 400 BCE
“And I wish to give an account of the other kinds of waters,
namely, of such as are wholesome and such as are
unwholesome, and what bad and what good effects may be
derived from water; for water contributes much towards
health.” (emphasis added)
Hippocrates (trans. F. Adams)
On Airs, Waters and Places
http://classics.mit.edu//Hippocrates/airwatpl.html

3. One Health includes "the environment"
sanitation

4. but not sanitation

6. Why should we care?
http://www.cdc.gov/nceh/vsp/pub/norovirus/norovirus.htm
http://www.cruiselawnews.com/2012/11/articles/norovirus/norovirus-outbreak-on-royal-caribbeans-voyager-of-the-seas/
http://www.cruiselawnews.com/2010/02/articles/norovirus/can-sick-cruise-ships-cause-norovirus-outbreaks-in-ports/

7. Poor sanitation contributes to disease
transmission
in feces
in urine
http://www.onhealth.com/schistosomiasis/article.htm
http://oneinsevenpeople.co.uk/urogenital-schistosomiasis/

8. Global sanitation coverage 1990-2010
(projected to 2015)
http://www.unicef.org/media/files/JMPreport2012.pdf

9. The open defecation problem
http://www.unicef.org/media/files/JMPreport2012.pdf

10. No shortage of sanitation technologies
http://www.eawag.ch/forschung/sandec/publikationen/compendium_e/index_EN

11. Technology is not enough – an enabling
environment is also necessary
government
support
social and
cultural
acceptance
legal and
regulatory
framework
implementation
of technical
solutions
financing
Two examples
institutions
skills and
capacities
1. Promoting good hygiene
2. Converting waste to a resource
Source: Sandec/Eawag

12. Example 1: Good hygiene practices
http://water.worldbank.org/shw-resource-guide/sanitation-and-hygiene-why-they-matter

13. Haitian earthquake – cholera outbreak
http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m5948a4f2.gif
http://i.dailymail.co.uk/i/pix/2010/01/15/article-1243540-07DCFE9B000005DC-496_964x659.jpg

14. Good hygiene is an important part of
cholera prevention
What activities are effective in promoting hand washing?
http://www.unicef.org/cholera/

15. Promotional activities used in Haiti
effect on handwashing
faeces-related
positive
Radio spot

Radio program
negative
food-related
positive
negative


Announcement using megaphone
Group discussion
Hygiene training

Home visit
Demonstration and material distribution


Information from neighbor


Focus group


Cinema show

Theater

Special hygiene day
Quiz
Stickers/posters/paintings


Community club
Hygiene songs


Contzen and Mosler (2013) J. Public Health, DOI 10.1007/s10389-013-0577-4
activity

16. Behavioral factors and corresponding
change techniques
R
A
N
A
S
http://www.eawag.ch/forschung/sandec/publikationen/general/dl/sandec_news_13.pdf

17. Example 2: Converting waste to a
resource
closing the loop
"one-way"
nutrients are lost
the environment is polluted
nutrients are recovered
the environment is protected

18. Dry toilets in Durban, South Africa
Urine discharged to soil
• loss of nutrients
• (eventual) pollution of groundwater
Contact: Kai.Udert@eawag.ch

19. VUNA - Nutrient harvesting in South Africa
Project elements
• Reactor technology
• Network management
• Socio-economic opportunities
Cooperation with eThekwini
Water and Sanitation and the
University of KwaZulu-Natal
http://www.eawag.ch/forschung/eng/gruppen/vuna/index_EN

20. Alternative models for urine collection
Institutionalized approach
• utility collects urine from households
Incentive approach
• households are paid to drop-off urine
tanks at a collection point

21. Pilot studies and optimization
Institutionalized approach
Pilot study
(2012-2013)
Incentive approach
1.6 ZAR per liter
Urine collected 600-700 liter
per round (45 households)
Urine produced by household
(3 liters per day)
2100 ZAR per household
per year
Optimized
system
(start 2014)
2 ZAR per liter
1100 ZAR per household per
year
(Preliminary results)
Work in progress
0.8 ZAR per liter
590 ZAR per household per
year
Challenges – difficult terrain, rural area with long distances, limited acceptance
of dry toilets, low usage and limited urine production
Optimization potential – institutional: transportation frequency and distances,
the collection procedures; incentive: number and density of collection points,
monetary incentive per household
VUNA Meeting September 2013: Elizabeth Tilley, Theresa Rossboth, Hope Joseph, Heiko Gebauer

22. Costs of alternative sanitation systems
Dodane et al. (2012) Environ. Sci. Technol. 46: 3705-3711.
http://www.susana.org/images/documents/07-cap-dev/b-conferences/12-FSM2/p2.1-fsm2-strande-eawag-switzerland.pdf

23. Little (SB) or no (FSM) valorisation of endproducts
Dodane et al. (2012) Environ. Sci. Technol. 46: 3705-3711.
Distribution of costs

24. Opportunity for valorisation through use
as fuel
http://www.eawag.ch/forschung/sandec/publikationen/general/dl/sandec_news_14.pdf

25. Pilot-scale project with industry
http://www.susana.org/images/documents/07-cap-dev/b-conferences/12-FSM2/p2.1-fsm2-strande-eawag-switzerland.pdf

26. Concluding comments
The importance of sanitation and hygiene as key components of
One Health deserves greater recognition, promotion and study.
Adequate sanitation and hygiene require good technologies and
technological concepts but ALSO an enabling environment.
Enabling and incentivizing sanitation and hygiene can profit from
good business models and financing plans, including valorisation
of end-products.

27. Thanks to….
Heiko Gebauer
business management
Department: ESS
Hans-Joachim Mosler
environmental psychology
Department: ESS
Linde Strande
environmental engineering
Department: Sandec
Kai Udert
process engineering
Department: ENG

28. Visitors welcome!
Dübendorf
http://www.eawag.ch/index_EN
http://www.eawag.ch/medien/publ/index_EN
Kastanienbaum
Contact: anke.poiger@eawag.ch