Jamie Bartram University of North Carolina at Chapel Hill

1. Building Communities: The Changing Principles of International Development. What does sustainability mean? And how do we achieve it? Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

2. Building Communities: The Changing Principles of International Development. What does sustainability mean And how do we achieve it? Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

5. Annual cost of not dealing with water, sanitation and hygiene Lives lost • 1.6 million annually due to diarrhoea alone • Especially children also malnutrition Health care costs: • US$7 billion per year to health agencies • US$340 million to individuals Value of time lost • US$ 63 billion per year Economic impact • estimated 1US$-4 trillion (2 – 7% of GDP).

6. WaSH = disease and poverty ? • Inadequate water supply • Unsafe sanitation • Inequitable access • Time, financial cost • Disease burden • Health care costs POVERTY

8. WaSH = motor for community development • Improved water supply • Safe water resources • Universal safe sanitation • HWTS where needed Development • Time, financial savings • Averted disease costs • Health & education

9. Building Communities: The Changing Principles of International Development. What does sustainability mean and how do we achieve it? Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

10. History WHO and UNICEF conduct pilot projects focusing on rural sanitation Reduce disease through introduction of safe water technologies and demonstration of excreta disposal methods. Changed universal access goal from 1990 to 2000 Water Supply and Sanitation Collaborative Council (WSSCC) established United Nations Conference on Water in 1977 Adopt programmes with realistic standards for quality and quantity to provide water for urban and rural areas by 1990, if possible • Report from the League of Nations Health Organization on water supply and sewage treatment 1936 1950s 1990 1970s Field activities Community Water Supply Health and Environment Water and Sanitation Health and Development Environmental Sanitation 1948 1960s 1980s 1990s • WHO established, Committee on Environmental Sanitation established • Promote the improvement of environmental hygiene, including sanitation. Minimize the burden of water associated ill-health. Established Community Water Supply (CWS) Programme Develop water supplies that were adequate, in quality and quantity, to provide for all public, agricultural and industrial needs International Drinking Water Supply and Sanitation Decade Priority to the poor, less privileged and to water scarce areas Emphasized focus on high-risk communities and sanitation

11. Development Targets and Monitoring Since 1960s (potentially 1930s) • Access to … • safe drinking water and basic sanitation … • for all • [recently ‘sustainable’] • [sometimes] … giving priority to less privileged

12. A Changing World In 1962 survey of 75 developing countries… In 2010 JMP survey… 44% of the people in developing countries lived in urban areas 49% of developing countries population served with piped water connections • 27% of the people in developing countries lived in urban areas • < 10% of population of developing countries had piped water connections

13. Millennium Development Goals • Target 7c (1990 – 2015): Halve, by the year 2015, the proportion of population without sustainable access to an improved drinking water source and improved sanitation, urban and rural

14. Trends in use of an improved drinking-water source 1990 – 2008 and projections to 2015 1990 23% un-served 1.2 billion 2015 (projected) 9% un-served 672 million Out-perform target (12%) Source: WHO and UNICEF, 2010. Progress on Sanitation and Drinking-water 2010 Update

15. Drinking water progress Optimistic assessment • About half at home • Much unsafe Health and population impacts: • Time savings (esp women) • Disease prevention (hygiene, safe consumption – morb, mort, qual of life) • Costs avoided (households, health systems)

16. Trends in use of improved sanitation1990 – 2008 and projections to 2015 1990 46% un-served 2.4 billion 2015 36% un-served 2.7 billion Under-shoot target by 1 billion Source: WHO and UNICEF, 2010. Progress on Sanitation and Drinking-water 2010 Update

17. Sanitation Progress Optimistic assessment • Especially in middle income urban settings (unsafe sewerage) Health population impacts: • Time savings • Disease prevention (morb, mort, qual of life) • Costs avoided (households, health systems) • School attendance esp girls Photo from WHO and UNICEF 2010 credited to WaterAid/Abir Abdullah

18. WaSH works! WaSH+ households and communities: • Healthier • Wealthier • Wiser

19. WaSH works! How to make it work for all? WaSH+ households and communities: • Healthier • Wealthier • Wiser Selected challenges • Community-managed rural water • Household water treatment • Rural sanitation challenge – CLTS to launch change • Behaviour!

20. “Changing Principles of International Development”: Community Participation

21. Building Communities: The Changing Principles of International Development. What does sustainability mean and how do we achieve it? Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

22. What is Sustainability? Sustainable1 Sustainability is… “whether or not something continues to work over time.”2 (Len Abrams) “the possibility that human and other life will flourish on the planet forever.”3 (John Ehrenfeld) • Capable of being sustained • Of, relating to, or being a method of harvesting or using a resource so that the resource is not depleted or permanently damaged • Of or relating to a lifestyle involving the use of sustainable methods 1 Merriam-Webster Dictionary 2 Abrams, L. (1998). http://www.africanwater.org/sustainability.htm 3 Ehrenfeld, J. (2008). Sustainability by Design. Yale University Press.

23. Audience Participation! Q: Approximately what percentage of hand pumps in Sub-Saharan Africa are not functioning at any given time? < 25% 25 – 50% 50 – 75% > 75%

24. A: ~30% of handpumps are non-functioning in Sub-Saharan Africa Data collated by Peter Harvey, UNICEF Zambia, May 2007 http://globalwater.jhu.edu/magazine/article/the_myths_of_the_rural_water_supply_sector/

25. Basic questions: • What proportion of Rotary-supported handpumps (or latrines etc) are operating today? • Or lasted 5 years? • Do Rotary projects do as well as other NGOs (what is our benchmark)? • How well do we expect Rotary projects to perform? • How will we know when we get there? • How can we learn from the Rotary projects that perform best (or less-well)?

26. Functionality versus Sustainability 2006 Functionality of TZ rural water supply schemes by Age Source: WaterAid (2010). A framework for sustainable water and sanitation services and hygiene behaviour change

27. Functionality versus Sustainability 2006 Functionality of TZ rural water supply schemes by Age Functionality vs. Sustainability (Carter 2010) Functionality • Snapshot (cross-sectional) view of whether system is working or being used • Adequacy of service provision Sustainability • Why functional? • Future perspective Source: WaterAid (2010). A framework for sustainable water and sanitation services and hygiene behaviour change

28. Issues in Sustainability

29. Building Communities: The Changing Principles of International Development. What does sustainability mean and how do we achieve it? Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

30. Common Factors in Sustainability (Lockwood, Bakalian, & Wakeman 2003)

31. 1. Technical (Lockwood, Bakalian, & Wakeman 2003) • Maintenance • Preventative (2) • Major repairs/replacement (4) • Spare parts availability (2) • Electricity supply & affordability (4) • Standardization of components (4) • Tools & Equipment availability (4) http://2.imimg.com/data2/WQ/DE/IMFCP-2394967/hand-pump-tool-kits-757167-250x250.jpg

32. 2. Financial(Lockwood, Bakalian, & Wakeman 2003) • Adequate tariff for recurrent costs (1) • Adequate tariff for capital replacement or system expansion costs (3) http://2.bp.blogspot.com/_jebuCK78mWw/TRuY9YXHfwI/AAAAAAAAC5I/8gB6jRJd7lQ/s1600/deq-logo-financial_assistance_10384_7.jpg

33. 3. Community & Social(Lockwood, Bakalian, & Wakeman 2003) • Community management capacity (2) • User satisfaction, motivation & willingness to pay (2) • Involvement of women (3) • Social capital or cohesion (3) • Continued training & capacity building (3) http://farm3.static.flickr.com/2776/4393657927_91673781d4_z.jpg?zz=1

34. 4. Institutional & Policy(Lockwood, Bakalian, & Wakeman 2003) • External follow-up support (1) • Cont. training & support to sanitation & hygiene education interventions (2) • Private sector involvement (goods, services, mgmt contracts) (3) • Legal frameworks for recognition of water committees & ownership (3) • Supportive policy & regulatory environment (3) • Clarity over roles for O&M (4) http://www.sswm.info/sites/default/files/toolbox/WSP%202002%20Chaos%20in%20Water%20Supply_0.jpg

35. 5. Environment(Lockwood, Bakalian, & Wakeman 2003) • Water source protection, quality and conservation (2) http://www.usgcrp.gov/usgcrp/images/ocp2003/ocpfy2003-fig5-1.htm

36. Building Communities: The Changing Principles of International Development. What does sustainability mean And how do we achieve it? WASRAG – Water Institute at UNC cooperation Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

37. Memorandum of Understanding

38. … work together to develop monitoring and tracking tools and appropriate indicators for baseline assessment, monitoring and evaluation of … WaSH projects. • … develop, test and refine an interactive monitoring and evaluation system that will advance sustainability Memorandum of Understanding The WI and WASRAG will: :

39. 2010 Water and Health ConferenceOctober 25-26, 2010 Diversity of WaSH Community represented

40. Water & HealthWhere Science Meets Policy2011 Conference Bringing together academic research and professional development workshops October 3-7, 2011 Chapel Hill, NC

41. Monitoring and Evaluation Sustainability Key Conference Issues • Scaling up hand washing and Community-Led Total Sanitation – a focus on behavioral sustainability convened by WASH Advocacy Initiative, Water and Sanitation Program and Plan International • Household Water Treatment Network meeting convened by WHO, UNICEF and others • Intersection of water and economic issues with environmental and social sustainability convened by Duke University, Research Triangle Institute (RTI) and UNC • Sustainable Water on Campus convened by UNC • Post-2015 WaSH Development Targets and Monitoring with WHO and UNICEF. • Simple Indicators/NGO workshop "WASH Commitment” convened by Water For People and others . • The New Age of Rapid Methods for Water Quality Applications: Blending Scientific Advancement with Routine Monitoring Needs convened by Institute of Marine Sciences at UNC. • Simplified on site water quality testing organized by Bristol University and UNC/WaterSHED

42. Behaviours Advocacy and Partnership Key Conference Issues • WaSH Advocacy what is it and how to do it. A learning workshop convened by WASH Advocacy Initiative and others • A total of around 30 workshops convened by partnerships, networks and Communities of Interest • Household Water Treatment Network meeting convened by WHO, UNICEF and others • Scaling up hand washing and Community-Led Total Sanitation – a focus on behavioral sustainability convened by WASH Advocacy Initiative, Water and Sanitation Program and Plan International • Simplified on site water quality testing organized by Bristol University and UNC/WaterSHED

43. Building Communities: The Changing Principles of International Development. What does sustainability mean and how do we achieve it? WASRAG – Water Institute at UNC cooperation Keynote I World Water Summit IV New Orleans, USA 20 May 2011 Jamie Bartram University of North Carolina at Chapel Hill

44. Thank You! Jamie Bartram University of North Carolina at Chapel Hill

46. Sanitation lags behind water

47. Water lags sanitation

48. Water lags sanitation

49. Why do we care? Source: United Nations Population Division, World Population Prospects, The 2008 Revision. http://www.prb.org/Educators/TeachersGuides/HumanPopulation/PopulationGrowth.aspx

50. Functional Sustainability in WASH • A sustainable intervention “continues to work over time” (Abrams 1998) • Continued functionality suggests (Carter 1999): • It is being USED • It is being MAINTAINED • Maintenance is being FINANCED • The service is PERMANENT – no time limit • What if beneficial impacts are not sustained over time? • Not cost-effective • Progress towards a service coverage target is undermined • Discouragement of HHs, communities, and local government or NGOs • BUT successful sustainable interventions encourage confidence among communities and supporting institutions that may lead to future local initiatives