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Rethinking sanitation services

A guest post from As in many parts of the developing world, failure is the norm for urban sanitation services in Ghana. Of the approximately 60 wastewater and faecal sludge treatment plants that exist in the country, less than half have any functional capacity, and fewer than five are operating as designed. The absence of adequate sewage collection and treatment imparts an enormous public and environmental health burden in particular in Ghana’s urban areas where the risk of epidemics is highest given the large number of people in a confined area.

One of the pathways with highest risk of disease transmission is the widespread consumption of raw vegetables irrigated with surface water which is heavily polluted with excreta related pathogens. Over 200,000 people eat such dishes every day in the Accra fast food sector. While most local consumers might have a higher resistance to the diarrhea causing-rotavirus than Ghana’s average tourists, there is no resistance when it comes to cholera, as the current outbreak in Zimbabwe shows.

Most sanitation models are imported from the developed world and seldom fit the conditions and capacities in low-income countries – which explains the catastrophic statistics given above - and jeopardizes their purpose of safeguarding public health. Until this situation changes, it may make sense to challenge the traditional approach and outsource some sanitation-related public services from the financially constrained public sector to those who benefit from the waste stream, like farmers and vegetable sellers. The IWMI works with the World Health Organization and many local partners on various practical options to reduce the health risks on farms and in the street food sector where most dishes with raw vegetables are sold. Some of these findings are summarized in videos we’ve posted on YouTube.

With the support of and Canada's International Development Research Council, an international expert group brainstormed under the leadership of IWMI the about research needs to address the health risks in such situations where public sanitation services are constrained. The meeting concluded with the Accra Consensus and a renewed commitment to "rethink" sanitation. We hope you will share your thoughts on this challenge with us after viewing the videos and reading the Accra Consensus document.

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