e alright it's here so you will find it here and basically we will have prominent people there we will have the minister of hydraulics from Burkina Faso we will have some very high institutionals from Germany and the objective of this meeting is to move ahead looking at institutions at operations and at research all together okay so you're very welcome to come there then in the afternoon on the Tuesday afternoon at 2 o'clock room 353 you will have the working group working group 12 where we'll go in the detail of the where we want to go how can we proceed it okay what is next so Lisette spoke of the World Toilet Day there will be also the bone meeting on the 11th and 12th of November and this is hosted by the German wash forum and Susanna as a role as a host online or what is it exactly Tilo the conference will be exactly one week before World Toilet Day we'll focus on bringing the two sectors together gearing us up for World Toilet Day and Susanna will basically be the online host reaching out spreading the discussions that are being had there through the community thank you there will be also an opportunity to share our research on wash and nutrition in the EEHF so Emergency Environmental Health Forum of Nairobi it's around the 15th of October and there will be a presentation of the last research done on the subject then the working group is also working on the publication so we have a fact sheet that is on the website this is Lisette who will share of course with you all this material but we uploaded quite a lot of material on the website and there are two publications so the WHO USA UNICEF 1 that Lisette just presented and which is going to be a sort of manual on the wash and nutrition and ACF UNICEF ECHO is going to produce for April 2016 an operational manual so you will have the Bible or the Holy Quran it will be the WHO one and then you will have the gospel you will have the basic manual to implement it at field level oriented to practitioners in terms of research sorry and it will be my last slide in terms of research we still try to understand the connections between the wash project and the sanitary environment the infection and the under nutrition both the acute under nutrition the wasting and also the the stenting the chronic under nutrition and basically where we've got the most problems is to characterize the connection between the wash project and the acute under nutrition this is a big question mark another thing is that we miss also evidence in sub-Saharan Africa we've got many evidences due in particular to Dinspir and the fantastic work done in India on the connection between sanitation and chronic under nutrition but we still miss evidences in the link between wash and acute so ACF is developing research on that Concern is developing also research on that in Chad and basically this research will be available in 2016 and will contribute to the to push this subject thank you thank you for that we will go to a small discussion in a second but before just maybe for those first two presentations some sort of questions of understanding I think you saw that John also has some other slides that he may give some more input on the issue perhaps at the end depending on how we run with time but the point here was that we get these main statements out first see if you have questions of understanding at this point otherwise we would go into a group discussion and then Trevor please it's not a question of understanding it's a question from our online participants that has come in for Lizette it's not one on clarifications I don't know if we want to reserve it I'll just read it out maybe we build it into conversation so via Twitter chat we have a question from Elizabeth Van Munch and she says this is for Lizette and it's a will your team at UNICEF also be looking into improving the Wikipedia article on World Toilet Day and washing nutrition thanks for that we will look at that done yes the answer is yes the Wikipedia World Toilet Day piece is being updated I'm not sure what the process is but it's been written and submitted perfect, good and this shows that our linking outward with the video through social media works so thereby also encouraging others online to post their questions because we can bring you into the discussion we'll have in a second now you see in your program that I would like first of all I would like our two speakers to please come to the front again and I would like to add Bella to the round the reason I'm bringing in Bella is because on the one hand from GIZ working with fit for school and we were thinking beforehand this is a challenge to bring together two silos to bring together different sectors and I think Bella is an excellent example of a person who has done this for years working with different sectors with the education sector with the health sector and that list could probably be continued bringing different aspects together the second being that you have a very specific sort of stakeholder group you're seeing sort of a small part of the whole picture but that very detailed at schools which are obviously very critical places for impacting society with either new trends or also with the connection of Washington nutrition so first of all I'd like to pose a question to you Bella and I'll give you the microphone just to ask whether first of all if you have experiences from your work that you would like to share where you see this link actually happening taking place where you see evidence of this and secondly maybe to sort of comment on the opportunities of this year and what's going on and how you view that in a greater picture I'm working here I'm working on school health in the area of water sanitation and hygiene in schools which is institutionalizing hygiene habits into everyday school life by institutionalizing hand washing, institutionalizing toothbrushing and also by annually warming but also institutionalizing taking care of toilets in school and institutionalizing cleaning and maintenance as everyday activities in school. Of course that is not something which is very natural to the education sector this is very new for the education sector and there's also quite a bit of resistance sometimes within the sector thinking this is work of another sector and of course with these activities you try to reach health goals you try to reach improved health and you do that the school is sort of a microcosmos where you can where different sectors come together but everything goes through the education sector because the education sector is calling the shots in schools and it can never every program will fail which will not go through the education sector which is just in a way hooked on schools but it has to work it has to go with the system in the schools so that's my background and when you look at areas where you have really the connection then you can say you have it in the area of water access to safe drinking water is for example a perfect thing which need to be in the school which is part of hygiene and part of nutrition drinking water and it's part of nutrition but you can also perfectly link that through existing school feeding programs and a good example for example is the government of India which is doing school feeding for all their 150 million children every day and now they're integrating daily hand washing prior to eating to the kids so that they will eat with washed hands but also as an example put that as a need for the people who prepare the food so that's also where hygiene comes together and where the school is a perfect place to institutionalize that sorry that was long but no no perfectly fine and concerning where do you see where do you see the huge potential that this year might bring are there any suggestions that you perhaps might have either maybe what is interesting with school is that it's a microcosm where it's a perfect place to share messages and to share good behavior but it's also a perfect place to share contamination and it's places where there is washed contamination also yeah the SDG I think are highlighting the need to ensure infrastructures in schools this is a great opportunity for all of us I think we should take care of ourselves on that yeah maybe let me reflect a perspective from the field that came from Indonesia there's a lot of talk about the evidence of wash interventions on nutrition wash also on every mother every newborn there is an increased interest in the evidence building but one person from Indonesia recently said it's also probably let the discussion on the what we need to know what is the evidence and the emerging evidence shows clear linkages or it's growing evidence I would say but there is definitely a need on the how and that's why I'm also looking at Jean that we're really looking forward to a practitioner's manual and probably more evidence on what can be done and therefore it's very important to understand also the context in which different programs operate so somebody this morning said we're usually preaching for our own parochial constituencies so we preach to the converted already and we need to if you want to work in washing nutrition same as you do in washing education or wash and nutrition or wash around midday meals in schools makes it even more interesting you need to understand what is the context what are the national programs where is your entry point where are is there for example in nutrition an infant and young feeding program with manuals and guidelines and other ways that you can get in your basic messages apart from having the issue addressed for the facilities but to look really at the entry points and to make sure that if there are meetings around and that makes it also a little bit more challenging we are also having a challenge to be in all the water and sanitation meetings at the moment but if you want to have a real integration you need to show respect to the other sector and you need to know what is the national planning what are the national programs when are the planning meetings who are the key players who is what is the network here where is the influencing happening and one thing I learned and somebody said about failing you need to have human resources there you need to have people who understand the language who are willing to invest time and then publish and document just that's a little one of the pillars of the Washington strategy and it has been already endorsed by different movements for example the sun movement the sun movement is 59 countries today who are involved in trying to develop political frameworks in order to connect the different sectors and to identify all the causal analysis of under nutrition so the wash is definitely part of that and the sun movement is scaling up nutrition we have a few comments from the floor so I'd like to bring those into the discussion I agree and support everything that's been said first off secondly just to add to Lizette's comments in terms of the linking at a very practical level I'll share our experience over ten years in providing the training and having it integrated in the training so when we're training health practitioners we have incorporated in at the basics on water and sanitation demystifying the whole arena and likewise when we're training technologists and engineers and the technical practitioners we're incorporating the basics on microbiology and epidemiology and what we find and we're talking at the very practitioner field level is that we find is that when people who are implementing have the information so it's not necessarily and I'll share one anecdote from a conference I was at last year where it was the conversation it was the World Bank and the UNICEF saying we have to push down the conversation that's happening up at the top level so to speak and I would argue that exactly is that when a health practitioner knows that they can take action on water or sanitation tomorrow they start doing it, they implement it into their decisions and likewise so do the wash practitioners when they understand that chlorination isn't going to take out cryptosporidia they take a different decision Yes, please do that and I'd like everyone else to also think about practical things that because we'd like to probably summarize this session with practical things that Susanna what can we do together to highlight this what you're saying because and let me go to healthcare facilities in Dakar at the Africa Sun meeting there was a session on water sanitation hygiene in healthcare facilities and there was one very respected, highly respected and really appreciated speaker who honestly said that at Sandy Cairn Cross who many of us know from the London school had asked for many many years to establish the link between poor water sanitation hygiene conditions in healthcare centers and with maternal and newborn health and she had refused there was a head of the maternal healthcare or the maternal health in one of the respected universities and she had refused for several years she said look this wash sector wants to look now at everything and then she was waiting for one grand to come through and she said let me look at it and she said it still gives me the chill and she gave some very excellent slides unfortunately I lost my hard disk so I don't have it with me but they are recuperating the data hopefully inshallah but there is a presentation out and I can try to get it for you that really showed the linkages and it's not that's at the higher level of the academic level and this was also result because WCHO, UNICEF and other partners UNC they started to look at what is the data out there so it links with the discussion this morning JMP and at the local level what data do you have available I just want to emphasize that you cannot wait you need to push also the academia on the higher level to look at what is happening and to show that there is a link but sometimes it takes more years and in the meantime we need to get our act together at the practitioners level a few more hands one back here then I'll go online again who was first I think a hand back here somewhere was first I think yours was first yes I my name is Antoinette and I'm from SNV nutrition I think you're very right that the work on the causal links is important but that we also need to talk about how and I think that if we talk about how in terms of integration that is really very confusing because it assumes that it's a merger whereas I think there will always be things in WCHO and in nutrition that are outside things in WCHO outside of nutrition and things in nutrition that are outside of WCH so I would like to see that that partially overlaps and in our practice two things that we're really struggling with is that nutrition sees their priority target group as mothers and children and not as an entire population so they define a target group of a program across many many many many districts over a huge geographical area but for us to make results in sanitation we need to work with local governments and trying to work on sanitation systems in an entire area which they feel is a little bit outside of what is relevant the other thing is that I'm struggling with when you gave the example of the extension worker is that in my experience health extension workers have so many modules that they already need to do and it becomes like you need to you need to you need to you need to right and we've learned in BCC that it's important to prioritize to do one message to face those messages etc now just adding messages that is undermining that earlier I think that we really learned in BCC thank you for those comments Jean has put up a slide and you can comment as well a brief answer on that what is magical with washing newt is that you don't need you are not asked to do new things you are asked to do the same thing you were doing but to do it in another way for example so basically here you've got the five pillars of the washing newt strategy and it's in areas where where you have high malnutrition rates this is a pure strategic decision you're already doing wash activities if you focus these activities in areas where you have a high prevalence then you will impact on nutrition so it's not doing something new it's just doing it differently the issue of the minimum package we want to be sure that at all the levels of the society from the household let's say the public health centers there is a minimum standards of wash and this you are also doing it but of course it's a more comprehensive framework something very important also is to work to focus on the dyad between the mother and the child there are enormous connections on that you know for example that a woman who's got a low weight is going to produce a child with a low weight birth who is going to fall very easily in under nutrition so it's not to look only at one person but it's to look at the couple mother child behave your change and all the soft approach of wash is essential but this is also opening an opening door I mean we all know that building a latrine will not change the world if the person doesn't know how to use it or doesn't use it or doesn't want to use it and finally we need to improve our coordination intersectoral coordination it's exactly what Lisa was saying we are not working in a isolated silo we are working in an integrated framework and we need to keep that in mind maybe to add on that I think it is so important to understand that the different sectors use different languages and have different objectives and have different timeframes and it's extremely important to look and to work at the interface and it's not only wash and nutrition same is health same is governance we heard that this morning same is education so the interface is very complex and it's a big challenge how to address that and I think most important is to come up with very very simple approaches nothing what is the issue is complex but the genius thing is to develop different approaches which are very very simple and everybody can agree to so that people can step in from the other sectors and that you don't close the doors I think that is quite important just to endorse Antoinette Antoinette's point that you need to have strong sectors as some elements you need to you need to invest in understanding each other's sector but I'm not going to go into all of the sectors in one program I just come from Afghanistan where I actually suggested to have the water and sanitation section from UNICEF not integrated in health or education and why a simple one everybody many of us probably are familiar with some level of the Asian-French fusion kitchen if you have had a very nice meal I mean you really get excited about that what does it require a very good knowledge of the French kitchen a very good knowledge of the Asian kitchen and then you get an incredible menu can be done but if you just take a little bit of both you get maybe a soup maybe a salad you maybe lucky one time it works one time it doesn't work but you cannot repeat so I'm saying know your sector but start to really understand the other sector start to understand what the challenges are over health worker or a nutrition worker and see where the opportunities are that is such a nice lead over to lunch but you can just see everyone sort of begin to drool as you're speaking about this food and everyone but I did promise before we take one more online so in order to really make use of the people watching and listening well that was also a nice thing that Bella actually her last statement actually answered the question I'll just read the question up but Bella you don't need to repeat because you've already answered it the question was to you and was to say what advice do you have for other countries of how better they can connect to wash to the education ministry you've already answered that great answer lunches not too far away not only have we had this teaser that leads over to lunch I think you see there's much more to this topic that needs to be discussed and I hope this was a great teaser to get all of you to come to the seminar that's taking place on Tuesday at 11 please do come to that bring others that you feel would be relevant to this discussion and then we will carry over to the Susanna working group meeting which is then on the same day after lunch so it's yeah it's very close together and thereby I hope I can I can sort of justify cutting this discussion so short because we'll have plenty of time on Tuesday to discuss that in detail Trevor is showing we want to do a group photo so before everyone sort of runs off to grab a bite to eat to the restrooms where do we take the photo where do we meet how do we coordinate yeah in the corridor okay so a round of applause please for our panelists and then I would like everyone don't get caught up in chit chatter now take please move outside let's take the photo and then have a good lunch so so please please no forget if I get side tracks yeah better to do it a little bit earlier so are you based here no I'm with GIL Susanna okay so which one the first one okay perfect check if it's working it's working. Looks good. Thanks a lot. Here you go. Thank you very much. Can you wear any braids? You just join everybody and we'll be joining you. Yeah, I think it was fine. I think even maybe we will only use one for the dinner today. So I don't know how much we can get from the plane. I thought that you were there. But there was also for me. Oh yeah, David. Yes, I was present. I'm angry. I didn't know that you were part of the party. Yeah, but yeah, he was only doing it like a few seconds ago. I mean, you were. Yeah, ten minutes. Yes, we are.  Maybe it's disconnected. I know it's here. This one maybe? You just copy them. Do you have something in my teeth? No. Do I have something? No. Oh my god. So we are in session four. gender is gone. So we need, ah, there's Kate. Hi, hello. Yeah, we have the, um, the U.N. routine meeting. And I would like to say the name of the band. So. Yeah, thank you for with you and me. Kate. Hi. Hi. Yeah. Yeah. Yeah. No, it does. The last part of them. Um, we need to make them as always, particularly as long as I can say that. Excuse to leave. Can you take out? Yeah. I'll be you want to, um, switch with, uh, Catherine, because you're now the first one in the session. Yeah. If you want, you can just switch with. What do you do? You prefer. It was Q and A after, after the others, but not me. Is that right? So we wanted to have two presentations using Catherine's and then have a question and answer. Right. And then the other two together. It's not really an objective. Yeah. Okay. Yeah. Right. I think I've met you, but I've seen the same stuff. And, um, and Darren, he couldn't, uh, can you come to the circle? Yeah. So we have my friend who was chair of the session. Did you meet him already? No, I don't think so. Sorry. What did you say? It's Fred's alien. Oh. He was, uh, I'm going to introduce you to him. Yeah. I know all the speakers in the session, so we'll go and just look for him in a minute. So everything's running according to time? We're a little bit late in the morning. Yeah. We have a shorter lunch break. Yeah. We're running a bit late at the SDG and the discussion. Oh, yeah. We have interesting, interesting input, so it's always hard to, like, to shorten them down. Cut them down. Yeah. Everybody's super interested in SDG. There are still sandwiches if you haven't eaten. Oh, I have eaten. Thank you. Yeah. Okay. Hi, Megan. Hi. Hi. Now I hear you. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. Hi. So, thank you. Yeah. I mean, if it's too busy to take a Skype call, maybe it's enough, she only tries to listen to the mail, that's a nice thing to do. But I think it would be good if you had to talk to Kathleen or if you had a Skype call with three of us. Are you here the whole week or back in the office on Wednesday? So I think she comes from back in the week on Wednesday as well. I know what I can say, but to you when you've got time. Yeah, but otherwise just look, you can also Skype because she has already done the first. She knows already how she did it for the first time. I will try to join of course, but... No, I'm sorry. We can look for a time slot to fit in. Great, so the main thing is just the timing. Because I think everyone knows now, especially some of you guys, because they know now, they've got a lot of them agreed. Especially how quickly we've organised this whole thing. So we just need to make sure that they post and that they register with Susanna. They didn't, so we need to look for that and that they know. Some people are not familiar with doing a post on a forum. So we did last time what Katrin can offer is to have a Skype call with them and showing them live. Katrin can just componite and like go and do the... How to actually do it. Yeah. Thank you so much. You put it here somewhere? Yeah, it's really open. It's open. Okay, it's here. Okay, perfect. This is Britt, I just introduced him. Hi. Nice to finally arrive. Yes, I've been here since Thursday evening. You and also thanks for coming. Sorry. Okay. I'm sure your presentation is just one request. I mean, just to explain how the session was. I think you will be speaking about sanitation safety. Sanitation safety. Right. It's a tool that has been developed by WHO and hasn't been implemented yet. Yeah, it's been six months. It's been six months. I couldn't talk about this today. You would be more an expert in the presentation part. I think I'll just explain what the tool is. I'll just give a little brief taste of what's going on in some of the companies. Yeah. Yeah, it's a screenshot. Yeah. But my request to you would be by the end of the session, by the end of your presentation, could you just give me a form to take on this? Basically, giving Susanna members or more or less asking them what do you require from them or what can Susanna do in terms of developing the tool or using it somewhere and so on and so forth. The whole idea today for the session was what can Susanna members do in terms of developing the tool and how they can collaborate in an effort to help. I think I have a slide that's basically exactly for that. Yeah, but just near the end, when you... Yeah, I think my last slide is actually there. Okay. Can I turn it off? Anne, how do you pronounce your name? Middle class. Okay. Okay. Is that a busy day? Running around? Um... I don't know. Yeah. Yeah. And if you've seen the session, I'll put two presentations. We'll put them back to you. And then we'll have the questions. Yeah. Yeah. Yeah. Sanitation... Safety planning is more startable with the guidelines or based on what we use. Um, and then... If you want to be able to reply... Okay. Yeah. Welcome to you all to the fourth session of today, Cities and Planning. My name is Britt Sallian. Um, I represent ISAN Associates. Unfortunately, Darren Sabo couldn't make it for the meeting. So I have the honour and pleasure of taking the chair from him. Before I start, there's a little announcement Magdalena needs to make very quickly. I am the doorkeeper, you know, when I had some question and announcement for the last session. We were talking about knowing what the other sector is doing and vice versa. So, you know, we were talking about nutrition. Nutrition links up to the water and sanitation sector, but it also links up to the agriculture and the security sector. And water is linked to both food security and nutrition. And for your knowledge, there is a huge UN report being launched Monday afternoon. This is a report that has been developed by the Committee for Global Food Security, which consists of all the UN member states, the private sector and the civil society. They work together on these reports and they have a high level panel writing a report every year. This year, it's about water. We had a big battle with CV to be able to bring this very accurate and important report to the World Water Week and we will present it with our Secretary of State and the FAO representative from Ethiopia on Monday at four o'clock in the afternoon. And why is it important? Well, it's actually a report of the state of art the interaction of water, food security and nutrition. It has a lot of recommendations on both water and sanitation and one of the conclusions that these food security experts comes to that there will be no food security nor nutrition without wash. But we don't know about it. So we are most welcome. I just want to announce this and I hope to see many of you on this because this is where it's also very important that we have a civil society there because unfortunately the constituency so please join us and join the discussion about this very important report. We don't know anything about it but it's out and it will be decided on October. This is CUNCFS HLPE report number nine, Water for Food Security and Nutrition. So they have been doing this. This is more than 150 pages with recommendations for everyone. The government, the private sector, the civil society and the research. So welcome to this session and express your opinion about what you want to say regarding water, sanitation and nutrition. Thank you very much Mark Dillena for the timely announcement. Okay, let's start off the session, Cities and Planning. We have a very interesting lineup of four presentations in this session and of course given the hot topics that we are going to discuss will be shut. So I would kindly request the presenters to wrap up their presentation 10 minutes flat. We have two presentations back to back and then we will go in for a round of question and answers and discussion. Just hope it doesn't explode. Okay, without wasting any time I would like to invite our first presenter today Ms. Kate Middlecon. She is a technical officer for the water, sanitation, hygiene and health from the Department of Public Health and Environment, the World Health Organization. Kate. Thank you. I'm embarrassed to say actually this is the first Susanna meeting I've come to but I hope to be more of a regular a tender in future. And as was presented I'm the team leader for sanitation at WHO and I think maybe the reason I haven't been here in the past is because we haven't I think WHO is really well known for our work in drinking water safety but sanitation safety is becoming a bigger and bigger thing. So I'm here today to present to you the Sanitation Safety Planning Manual which we published just a couple of months ago on the back of around three and a half years' time. So no pressure on the time Trevor, I'll try and rattle through this but I just wanted to acknowledge the many people that helped in this effort specifically Airwagens was TPH, and lots of scientists and experts who contributed to the risk assessment. So I just wanted to give you a bit of a background about what this is all about and why WHO has a strong interest in this. We all know we always kind of have this rhetoric we do sanitation for health but actually kind of really understanding the specific health risks linked to sanitation systems often plays quite a small role in the planning and we're trying to kind of bring health back to the centre of sanitation safety planning. And on top of this we recently published the burden of disease estimates for diarrhea and they really clearly showed that yes sanitation is good for reducing diarrhea but if you can actually manage the sanitation chain the reduction in risk is actually a lot higher. And also a reference to the next speaker but the exposure through unintentional use of sanitation waste is really quite high. And we're also seeing this kind of this amazing time happening with sanitation businesses and the health risks associated with reuse are one of the big barriers to these sanitation businesses so we see sanitation safety planning as a tool and being able to proactively manage and communicate the health risks associated with these businesses. And some people say to me why is WHO promoting this stuff and the quick answer to that really is we're not necessarily promoting it but acknowledging that this is happening and that if it's going to happen then here's how it can be done more safely. And lastly just to say that we sort of see this tool as having a role to play in the equity discussion because often the health risks accumulate to the most vulnerable and often where the investment goes is not necessarily there so we hope this can bring that aspect into focus a little. So what is sanitation safety planning? Some of you may really be familiar with water safety planning. It uses the same risk assessment and management principles of water safety planning and it builds on the 2006 WHO guidelines for safe use of wastewater, greywater and excreta. But what we're seeing is applications of it a little bit broader than just those guidelines. So who's it for? This has to be anchored firstly with health authorities and eventually a policy and regulatory home but also with direct use by local authorities. We're seeing nice uptake by sanitation enterprises and farmers, interests from utilities and also as I mentioned these sanitation enterprises that are coming out of lots of community-based organisations and NGOs. So I'm just going to really quickly run you through what it's about. So it's a step-based risk assessment approach with six steps. So the first is really understanding who's involved in the sanitation chain really trying to get the main actors around the table and to develop a sanitation safety planning team. The second is to really understand what the system is. This sounds kind of basic but it's quite amazing. I'm sure you all know that quite often people don't know where the waste is coming from, where it's going to and how it's being used. So developing a system diagram or for those of you who are engineers like me, you may prefer something a bit more process-oriented and showing the key exposure groups at each of those steps of the sanitation chain. Then it's looking at the risk assessment itself. So for each of those parts, trying to understand what is the likelihood and severity of the hazards at each step. And then just a really simple kind of process of saying, okay, well if these are the risks, how can we prioritise what to do about it? How can we work with the resources that are available to us to make improvements all the way along the sanitation chain? So that's not necessarily just doing more treatment, but looking at other barriers along the chain. And then the final thing of course is monitoring. So understanding where are we going to monitor and what are we going to do when the system falls outside those operating limits. And then of course, this principle of continuous improvement in regular reviews, we all know that systems are not static, they change all the time, so building in a process of regular review. So I just wanted to give, I realise that's all quite theoretical and maybe I can ground this really quickly in some of the examples of where we've been working on this. So you'll see there there's H places, seven, eight cities we've been working on this approach and just to talk a little bit about what's been done there. This is I think one of our best examples that came out of the Philippines and we first started talking to the Philippines they were going, oh yeah, we'll do a sanitation safety plan for our main wastewater treatment plant. And then when we kind of got the stakeholders around the table they were like, you know we have no idea what's happening to Fecal Sludge in the city there's lots of it, let's do our SSP on that. And they came up with a really beautiful plan of investigating where it's going deciding what they were going to do about it and a monitoring plan which is which they're putting into practice now. Another is Lima might be a country lots of you are familiar with huge agricultural production of vegetables on the period in areas of Lima. Again I won't go into the details of this but they've used sanitation safety planning to look at how they ensure those vegetables which pile into the city are safer. Kampala as well, they've been working in the swamp area downstream of the wastewater treatment plant and are looking now with GIZ to see how they scale that up to build it into the city sanitation safety plan. Vietnam also, this was a slightly different kind of application of SSP and I'm trying to show you the variety because we're unlike water safety planning which is quite homogenous I would say the applications for SSP are really varied as varied as sanitation systems are but this one was an example where they were using the SSP for co-composting of fecal sludge and municipal solid waste to create organic fertilizer. And this is an example from which is on the Periurban areas of Bangalore and okay, I'm going. This is that one sorry, I went too fast for myself, hang on. Oh, it's moving really slowly. No pressure. I just wanted to say here, this is one from Portugal and Portugal have really embraced this so just to point out this is not for only for developing countries there's great applications in developing countries as well and the European Union is looking at a European-wide mechanism for safe reuse. So I mean this is the take-home piece what next, I mean we want to see this kind of picked up and used and adapted and we want to hear about what works, what doesn't work so I guess the final point to leave you on is please come by the WHO stand. There's a massive stack of the manuals you can pick up and use and not only that we don't want to just give you a manual and say there you go, we're actually on hand to send trainers out to organisations who are ready to give it a go and to support you through developing sanitation safety plans. So yeah, my contact details are there and if you're interested please get in touch. Thanks for keeping the time. So right, moving on to our second presentation which is also another tool I'd like to ask Catherine Robb to come over. Catherine is a public health programme associate at the Centre for Global Safe Water at Emroy University and Catherine is going to present the Sunnypad Rapid Assessment Tool. Hi, I'm Kate Robb and I'm the Associate Director of Research Projects at the Centre for Global Safe Water at Emroy University and I'll be talking about the Sandypad Rapid Assessment Tool the tool for assessing public health risks from unsafe vehicle sludge management in poor urban neighbourhoods. The cities of our world are rapidly growing. By 2050 the UN projects that 65% of the city's population are in poor urban neighbourhoods. And this rapid growth has outpaced the ability of many governments to provide basic services like sanitation. I've shown here a excreta flow or ship flow diagram which Arnie will talk more about in the next presentation but just briefly it shows the proportion of waste that's treated safely versus unsafe in a city. We can see down here at the end we see that in a city with a good amount of coverage in onsite sanitation still 98% of the vehicle sludge ends up back in the environment untreated. But questions remain about where is this should actually ending up back in the environment and what are the associated public health risks. In the urban environment there are multiple pathways of exposure to vehicle contamination. Exposure can occur through contact with open drains, consumption of municipal drinking water, flood water exposure to unhygienic public latrines, consumption of wastewater irrigated produce, contact with recreational or other surface waters and many other pathways. And given these complex exposure routes with different levels of contamination and different types of contact it's been difficult to determine what kinds of interventions might have the biggest impact on reducing exposure. Local governments and development partners lack evidence based tools to assess the relative public health risks from vehicle contamination. And little is known about what pathways of exposure pose the greatest public health risk. Or what are the public health implications of poor vehicle sludge management for poor neighborhoods. And policy makers prioritize sanitation investments that might have the biggest impact on reducing public health risk. To meet this gap we developed the Sanipath Rapid Assessment Tool which is designed to assess public health risks related to poor sanitation and to help prioritize sanitation investments based on the exposures that have the greatest public health impact. We designed the tool based on an in-depth risk assessment that we conducted in California and the tool is a systematic and customizable method to collect relevant data on exposure to vehicle contamination in low income urban environments. The tool is designed to be used by community government and development partners to help guide decision making and advocacy surrounding urban sanitation. And the tool synthesizes data using an open source software package. And the tool so far we've used it in Accra, India and Maputo, Mozambique. The following pathways in the public domain can be assessed using the tool. Flood water exposure to surfaces and public latrines, soil in public areas, surface waters, public drinking and bathing water, wastewater irrigated produce, and open drains. Two kinds of data are used as inputs for the tool. We use behavioral exposure data and environmental microbiology data. For the behavioral exposure data we conduct surveys on the reported frequency of exposure that leads to exposure to vehicle contamination. So for example we ask questions like how often do you come into contact with open drains? How often do you consume municipal drinking water? Things like that. For the environmental microbiology data we collect environmental samples from the relevant pathways. So samples of drinking water, samples of oil, samples of drain water. And we analyze those for E. coli, a common indicator of vehicle contamination. The data are then combined to show the relative risk of exposure. We show the first the frequency data and the contamination data separately. So in the pie chart we show the frequency of exposure to in this case raw produce of children in a neighborhood in Ghana. And we can see that the majority of children consume raw produce every day. About 6% consume raw produce never and the rest fall somewhere in the middle. And then we have samples of produce from that same neighborhood and this histogram shows the distribution of contamination on samples of raw produce. We then bring the behavioral frequency and the environmental contamination data together along with other parameters like intake volume duration of exposure, transfer efficiencies. Here we've shown the frequency and environmental data for public drinking water. We bring those together to form a risk profile. The tool uses a Bayesian analysis to estimate the distribution of contamination and the frequency of exposure. And then the mean dose and proportion of the population exposed are summarized in these risk plots which I'll explain on the next page. So these risk profiles here we see exposure to drinking water in two neighborhoods one in Ghana, one in India. The proportion of the population in red or pink are the people exposed green are the unexposed and the intensity of the red or pink color shows how high the average dose of fecal contamination is. So here we see that a greater proportion of the population is exposed each month in this neighborhood in India compared to the neighborhood in Ghana and that the average dose consumed is higher in India as evidenced by the darker color red of the people in the diagram. We can also use these diagrams to compare risks within a neighborhood so each of these plots are for the same neighborhood in Ghana and we see separately adults on the top and children on the bottom and by looking at the ratio of red to green we can see what proportion of the population is on average exposed each month and then looking at the darkness of the red color we can see how high the dose is. So here in this neighborhood it looks like raw produce is not only the darkest color red or the highest dose of fecal contamination but also the greatest proportion of the population exposed so in this neighborhood it may make sense to target an intervention towards reduction or reducing wastewater irrigated produce or finding alternatives so that there isn't as much wastewater irrigated produce in use. One thing I want to point out here is that you may be thinking for the open drains and drinking water that the color of the red is very similar and you may think open drains are much more contaminated so why is that? And that's because we take into account the intake volume. For the drain water people consume a very small amount whereas drinking water they consume a lot more and it ends up at least in this neighborhood averaging out to a similar dose. So in summary the tools used to guide users through the collection of relevant data to estimate relative public health risk. The tool provides users with an easy to use software interface for data collection that can be customized to fit different country contexts. The tool synthesizes data to guide community government and service providers in their decision making. Some of the limitations are that the tool is designed for use at a neighborhood level and not a city level and it doesn't actually measure health outcomes but stops at exposure. The tools will work in progress and we're working to try to get the tool used as much as possible so we can keep learning and keep improving the tool. Right now we're working on adapting the tool to optimize the user interface and some of the output. We're also working to identify candidate cities for tool deployment where major sanitation interventions are being considered and we're developing a stakeholder advisory board. In conclusion I'd like to make an appeal to the members of the Susanna forum for input. We're looking for suggestions about where we can deploy the Sandy Path Rapid Assessment Tool and ideas for partners who are working at the city level and interested in deploying the tool to inform sanitation interventions. We're looking for partners who could use these kinds of data in their work or institutions that would be good candidates to learn how to use the tool. Lastly we're also looking for suggestions for candidates for our advisory committee to help us understand more about what are the greatest challenges facing sanitation decision makers at what scale are decision makers most interested in safety versus neighborhood and how can we best engage potential users of the tool, how can we best convey risk results visually how can we facilitate the translation of the tool recommendations into actionable interventions. I'd like to thank everyone involved in this project from multiple institutions and you can download the Sandy Path Rapid Assessment Tool from SandyPath.com It's an older version that's there right now but we're working on a newer version that will be available sometime this fall. So thank you. Thank you very much Catherine. So gentlemen, ladies and gentlemen we've seen two tools quite handy I think for practitioners and quite interesting to use in the sanitation planning process I would say. I'd like to open the floor for question and answers. Let's take a set of five questions first before you state it. Before you state it please your name and organization as well as whom is the question or the comment directed to. Please. Let's have a show of hands. For the presentation I know from what the safety planning that there are these very nice risk assessment forms so that it's very well used to understand and then you immediately get a rank so how high is the risk of this water supply. So is there something similar that you have in this part? I mean that is especially relevant I think for decentralized systems so that was my first question. Second question, there was also developed a sort of wash safety plan so I know one publication somewhere around that. So what is the difference between wash safety planning? I am Susan Davis and I'm tired I'm going to sit down with Improved International and I'm curious with the water safety planning and you said there's a lot of well there's a lack of information about where fecal sludge is going and how do you find that out?  I mean track it down. Alan Reed from GOAL. Just a question on the sunny path you say it's a rapid assessment tool but it looked quite involved I wonder if you could just elaborate on your experience of you know maybe cost as well how long that takes and some cost but I'd also be interested in talking about Naropa as well. Yes thank you this is just a question from online for Catherine, I'll slightly paraphrase it basically just wanting to find out the work that you've been doing in sunny path for how much longer do you have funding to do it and if that is in the near future where is the funding going to come from to continue the work just so that folks have an idea of how long this work is going on for. Answer to your question, yes there are the same kind of risk assessment tools in there and you know you can apply them in the same way I think the thing that's really different is that with water safety planning you've just got one exposure group and that's the person who's drinking the water at the end of the pipe and for the sanitation safety planning there's multiple exposures and the risk assessment is a bit harder and I think that's a nice kind of link with sunny path there because the thing about water and sanitation safety planning is that we're targeting the people who manage these systems and they're not necessarily people who can do a complicated risk assessment so the tools are there we would always encourage that there's kind of someone from the local academia who can be involved to do it a really robust risk assessment but maybe to answer the question over here about how people do that in practice I mean there's this principle of continuous improvement so honestly with some of these the way they do it is just walking around sniffing and just looking at where things are going and that risk assessment can get more robust over time but we the point is applying these kind of principles with the risk assessment as the backbone of the approach by which you then start looking at improvement and monitoring that's within the means of the group doing it so this is all trying to get away from really kind of rigid threshold values for effluent and other things and trying to take a more pragmatic approach to managing systems when you asked about combining the water safety plans I think that's a really fair point I mean people if we were to be entirely holistic then we would do water and sanitation safety plans and I think all is one process I think that works quite well at a small community level where things are kind of compact enough that you can analyse it like that once you're getting to kind of the city scale the stakeholders and the approach becomes a bit unwieldy I think and it's probably a bit more acceptable to do water safety planning and sanitation safety planning separately but we certainly don't want to constrain people's use of it if you can make it work like that great thanks for the question so I'll start with the question about the rapidness of the Sanypath Rapid Assessment Tool so we call it rapid because the original study that we did to figure out how we wanted to do exposure assessment in urban slums took over a year and cost over two million dollars to try to assess all the different conceivable pathways of exposure to fuel contamination based on that study we really narrowed it down to what pathways and what kinds of methods were really giving us the most bang for the buck and we narrowed it down to now the study takes about a month in each place depending on how many relevant pathways there are so for example in ocean there's no surface water if people don't consume wastewater irrigated produce if there's ways you can cut down the different pathways and it's faster if there's lots of pathways then it can take a little longer and as far as the labor involved so you need a team of enumerators who can do the surveys and a team who can go out and do the sampling so usually we have between four and five enumerators and five environmental samplers and then several lab technicians who are analyzing the samples and we try to collect at least ten environmental samples per exposure pathway so the cost really depends on what local labor costs in a given context plus supplies for the microbial analyses which are several dollars on average if you already have the equipment per sample and as far as funding we just got a supplemental grant from the Bill and Melinda Gates Foundation to continue our work for the next two and a half years but one of the big goals of this new chunk of funding is to try to make the tool self-sustaining and so we're looking for ways that we can get the tool used more often and to have different cost sharing initiatives so that the tool is used by different governments that there's different capacity developed to use the tool independently and that eventually the tool won't require any involvement from Emory in order to deploy successfully. Thank you. Okay, one brief question to each presenter thank you very much both of you so Kate I just wondered how much this sanitation safety planning tool sort of incorporates the sort of retail methodology of the sanny path and of the shit flow diagram which we'll hear about in the next presentation and will it be necessary to update the publication Catherine I mean congratulations to Emory to your group for elaborating this tool which I think is simple but very necessary WSP is actually applying it to testing it as part of its vehicle sludge management diagnostic toolkit so it will hopefully sit within a toolkit that we're producing my question I mean it's I think we've made great advances but I just wanted the extent to which you think the tool is complete in mapping the pathways between the underlying risk which is the sort of the the fecal waste where it gets to and then how it gets onto people and into their mouths essentially so are you looking at the sort of fingers and food dimension and for fluids for drinking water are you taking samples from tap water and from the glasses that people drink from maybe in there drinking water source but if they treat it at home then you've sort of mitigated the risk partly or fully so yeah sorry the challenge but I think it's important to have a complete understanding of why people are getting sick thank you would you like to answer the question right away yeah so just in terms of those two other tools I think they're kind of complementary and especially the sanipath I mean I think the thing that's different with sanipath and sanitation safety planning is that tell me if I'm wrong but I think it's kind of more diagnostic and that's the part that the SSP manages quite struggle with and the SSP is more of a management tool so I think it can really be integrated to make the risk assessment stronger so that the management approaches are actually more relevant so I think we could certainly do that and then with the SFD stuff yes I think that works at the kind of the city or maybe even national scale that's all kind of in the wash but the SSP can be applied at lots of different scales and it really applies mostly to the management boundaries of the people who are so for example if you're a business who's co-composting fecal sludge and making compost then the kind of flow pathways are within that chain which is not necessarily the same chain as the SFD but so I think the principles can be applied and maybe we could update it, I haven't really thought about it that far though Thanks for your question and it's a good one so in our in-depth exposure assessment in Ghana that's where we really did a much more comprehensive look at what are these different exposure pathways and not just you know from drain water to the mouth but how it's actually getting there and how we have a number how many hours but several hundred hours of structured observation watching young children interact in their environment and how frequently they're putting their hand to the mouth how much time they spend in open drains what the contamination is in those open drains how often they're feeding, how often they're drinking water, what kind of water, all that and we're able to do a much more nuanced risk assessment with that with the rapid tool we've made a lot of different trade-offs in order to make it rapid so for example we just take municipal drinking water we don't take water samples within the home and part of that is because we see more of city level decision making happening at the municipal level and trying to improve municipal drinking water rather than more of a behavioral intervention of treating drinking water in the home so we don't take into account we actually do ask about whether or not people drink their water but right now our models don't take into account whether or not that water is treated although we certainly could try to do that in the future and there may be other relevant pathways and if any of you have ideas about maybe you're thinking of a city and there's an exposure pathway that we haven't captured we'd love to hear about that so we can include it but I guess in each of these pathways there's a lot of assumptions built in about what do we think our transfer efficiencies from soil to hand to mouth all that kind of stuff that is all kind of built into the tool in the back end and can be customized but it's one of the trade-offs in making it rapid we're running out of time I'll take four questions and yeah thank you very brief yes I I'm interested in how ultimately this leads to local governments being able to deliver better services yeah so I was going to explain that but there's no time for that but what we're seeing is in Indonesia for example there has been this tool which is environmental health risk assessment that was developed by Christine Seibesma from IRC and also with a lot of support from Isabel Blakke and that has now been implemented I think in over 100 cities and I think what we're seeing is it's also a neighborhood approach what we're seeing is that it does a lot to sensitize people about the importance but it doesn't really translate ultimately to better services and sometimes the tools we are making are very good to sensitize and put issues on the table but they're not as easy and practical to apply in order to really come to those better solutions so I'm asking you how do you see the future is this a research that you're doing with a lot of applications of Sunnypad and maybe even the sanitation safety plans where ultimately there will come some generic lessons and priorities out of this or do you see this as a tool that will continuously be used at local level to define their own priorities etc just a question related to the Sunnypad research how do you define children because you had adults and children very useful but children are also the zero to one to one to four adolescents very quickly thank you very much after WSP we have the SPP the water and sanitation plan we've got the sanitation safety plan what have you thought of maybe mixing the two because actually they're both relevant and they're both integrated actually water and sanitation so I think I liked about the WSP not the water and sanitation program of the World Bank but the water and sanitation plan that you had, the water safety plan you had this vision from the beginning to the end including sanitation as well so where are we now with this issue and then for the MRE I recognize also the excellent work that the MRE University is doing so great job and I'm just trying to share you know we just came back I was saying from Kinshasa we're trying to implement some sanitation issues because sanitation is almost zero there for 13 million people the thing is the technology we got different aspects and we try to you know get everything okay but the big issue was a business issue was trying to get this thing moving and sustainable and that it could be running by itself because going through a tax system was not possible going through cost recovery issues, traditional cost recovery was not a really issue so how do you get this moving actually financially so this business approach was actually the crucial thing to look at thank you very quick answers quickly on that linking again with water safety planning and sanitation safety planning absolutely and I think that's where it's heading but the application of them in the same place seems to be working best in some of the things that are coming out of the European region and small communities not to say it couldn't be done elsewhere but that's where we're at with it now to quickly pick up on your point with businesses and I think that's maybe a place where WHO can add a bit of value we're finding from the business side that they find it kind of helpful to be able to say yes we are proactively managing the system according to a methodology you know that's recommended by WHO so I think it gives them some legitimacy to some of these business that have been kind of forced to operate informally or with a lot of questions around their operation and then your question about planning and how you kind of embed this and I think maybe as a parting comment it's quite nice to see you know there's the other tool you mentioned there's SSP and but I think it's really great we're having a discussion at all about risk based sanitation planning whether we use that the sanding path brand or WHO's SSP brand it doesn't from our side it's kind of less important than the fact that we're doing risk based planning and I think where the SSP kind of helps as you say is to try and kind of embed this into a planning and management process so going beyond the identification of risks but really making a multi-sector plan about what to do about it within the resources that are available so we're learning and going ahead with it but it seems to be filling that purpose where we're trying it so far. Thanks so to answer the question about use of the tool by governments and kind of the future of the tool one of our research objectives for this new stage of our grant is to try to figure out how the tools actually could be used. Right now we've applied the tool in three places but we haven't actually seen up taking use of the results for any kind of policy or intervention decisions and that's something that we really want to try to see and so we're going to be one of our goals is to try to partner with groups who can use the tool and try to learn from how this information is used and I guess our goal is that it would be a tool that's used in different city or development partners indefinitely but I think another outcome that would be also very relevant is creating essentially a database of what exposure looks like in different cities that then could be used by other cities to say oh like this is this was a problem in this city we have a similar profile to the city you know maybe wastewater irrigated produce is a problem for us too or maybe it's open drains or whatever so I think we're open to seeing kind of how it evolves and that's definitely embedded within our research question for this grant as far as how we define children so in this rapid assessment it's children who are between the ages of about 8 to 12 and we ask children the survey questions in school so that's why we've kind of honed in on that target age group thinking that children younger than that probably won't have be able to really articulate how frequently they do these different activities and because a lot of these pathways aren't necessarily relevant for very young children we did do some of this in a sub-study in India where we did we do have some data on children under 5 but it's limited time sorry and you have any more questions comments you could always catch them for a coffee and without any further do I would ask Anna to come up and present the progress in the shit flow diagrams yes we were talking in many Susanna meetings when we were discussing the compendium of sanitation systems how important it is to have the systems approach not only to look at the toilet but to look at the chain that's been reflected in a number of presentations today as well so I was excited when I saw the first excreta flow or sludge flow or shit flow diagram presented by WSP two years back because there it was a diagram that has the systems approach has the hopeful chain looks at centralized and decentralized systems and brings it all into one picture I was really excited about it and I was even more excited when the discussion came up can't these diagrams be sort of hosted Harvard Susanna as a neutral place because more and more people are getting interested in it and that's why we got a one year grant from the Gates Foundation to get that going and we're currently talking about the next phase of three years so where are we and I have not talked in close enough to the mic I hope the people out there have heard something the origin is the review more detailed on fecal sludge management in 12 cities by WSP which appeared in March there the diagram is just one element it's as well very much on service delivery assessment in the different categories who is if there's no money to maintain an infrastructure if there's no capacity to run it properly then to put an investment is wrong so a number of analyzes was there and in April 2014 there was this missing link in sanitation service delivery research brief that's how it started I just phrased that and in last year it was Peter Hawkins from WSP who in this room explained the approach and in the core group meeting we said yes it's a great idea to have that on the website and to be have Susanna sort of the place where this happens so now we had workshops in Hanoi and Dhaka and this year in August we launch the portal and that will be in a longer event in on 26th launch of the SFD portal room FH 202 and then we'll have 90 minutes to go into more detail on that and in the afternoon there's another workshop where one of the tables as well will concentrate on the diagrams and their use the initiative is GIZ together with the University of Leeds Barbara Evans there WEDEC that's Rebecca the Airwark and from WSP it's Isabel Blackhead and Peter Hawkins who are involved in the Gates Foundation it's funding it thanks to the foundation and thanks to everybody of the group that they are thinking Susanna is a good place to do that this is now sort of if you think of all possible options then this is the summary of all options so the real ones are simpler but you see the chain on the top the upper half is sort of what happens in centralized systems and the lower half is what happens in onsite systems and the small one is an open defecation and I talked about visualizing tool that summarizes and presents what happens to excreta in cities one example is Moshi Tanzania this idea was brought in and for stakeholders for ministries of Moshi or from the administration came together in any case they wanted to have a strategy on how do they deal with sanitation so this idea to develop jointly a diagram was there and they got very excited about it and I think that's the best way to do it if the city itself is sort of then discussing is it so much or is it more and on what data we can rely because then it's very much owned by the cities and then you have the upper part which is usually the smaller one which is sort of legalized there are sewers treatment plans you can get data on them but you have the fecal sludge management which is open often informal or illegal so how can you get official data on something which is not official so there it comes that you have to guess that you have to estimate and that the data will not be it's important that the data are credible because you're transparent how you get them and what's the variation in them and it's the best situation if an administration itself is sitting together we always said that if this diagram now you had the example of Dhaka where it's where there's a very little central system and there's many percent of of onsite systems so if the reaction would be okay let's build a treatment plan but there's only 5 percent sewers so 95 percent of the problem is not addressed by any treatment plan so that's a very simple message but if you have parts in a central system is it? No, it's again the upper one is quite small but even if you have then it could be a mistake to build a large infrastructure if you don't have the money to maintain it and don't have the capacity to maintain it that's why we said that the context description on what sort of the service delivery context is very important not to have misleading messages that's sort of the diagram never comes alone it comes with general city information with a service delivery context what are the outcomes of services, how do they work which stakeholders were involved to produce the diagram what's the credibility of the data I was mentioning that and then what was the process of developing it and then list of data sources as well to be transparent there we're aiming to develop 50 of those and thereby influencing how the sector talks about sanitation not just toilet but having that sanitation chain approach there and looking at the whole picture and I think that would be a great achievement to come there we've made a web portal which is part of the Susanna portal where you'll find all the informations up to now mainly the I8 drafts of city cities and just sort of citing the 12 cities from the WSP study and the methodology and tools are coming in the next weeks and months because they were very busy to get them ready and there are lots of requests on how can I do it but that's exactly the aim what we want to achieve one thing is to spread the word here in Stockholm the other thing is that now really to include more Susanna partners feedback from Susanna once we have the tools there to really on the methodology how you like it how to roll it out and these are sort of the points of discussion, can SFD be a game changer for cities what are the challenges what are the opportunities I'm quite convinced that they can influence the discourse in the right direction that it's not toilet concentrated but it's on the chain are you on of the same opinion how to best put it into practice how to have many Susanna partners sort of promoting it getting it done and well how to address these opportunities with Susanna, thank you Thanks Anna unfortunately we are still quite short on time I would quickly ask Professor Thomas Kluub to come up for his presentation Thanks a lot for invitation I have ten minutes I know that I will give you a case study example and build some connections to my partners talking about how to improve sanitation practices I'm telling you from a case study in North Central Namibia Namibia is one of the triest countries of the world and the region where we are acting since ten years is characterised by a change of flooding time in rainy season and tri-season of seven to eight months and therefore we build it together with the national integrated water resources management plan a pilot project you can see it's located in south the border of Angola in North Central Namibia and what we shaped together with the people on the ground is a variety of sanitation facilities at first we did it together with the University of Technical University of Darmstadt with Namibian Ministry of Water Affairs and with our institute called Institute for Social Ecological Research what we realised here you can see is that we discussed first with the people what are the needs how we can shape sanitation facilities you see here the so-called check dwellers area there is people in self care and there are related erected houses very small houses and there we connected them to an sewage system and we built it up a wash house embedded in a informal settlement and the third thing we built it up is the so-called cluster power and hand washing facility and all this sewage is collected and brought to anaerobic pre-treatment where we also realising the sludge brain-toon drying bed so that the sludge is hygiene sized and we are using also mesongars for self-suntaining the electrical infrastructure and it's by an aerobic process pre-fight and we have after this rotating biological contactor a micro-straining because the population is affected by helmet X in a big percentage and after that it's an UV disinfection installed and this where we before derived energy it's full with nutrients like nitrogen, carium, phosphate and brought to this pond and then we take it by trip irrigation for irrigation that means we are closing the whole chain between sanitation and reuse and it is one of the key elements reuse for this region on the longer run to manage the water problem because this town we are working in the moment is doubling every three years and this is an approach where we can adapt to this enormous growing process and we are realising the semi-central approach also in China in parts of Germany and here also in Africa and I think the main message is from this project that we have to realise some I can say problems and also challenges how to organise the governance of maybe the wash house it's a frequency to 250 people per day people is coming from Mongolia and also from the town from the informal settlements and there is to find out the balance between the calculation of entrance fee and also the water amount is used in the cluster unit I want only to show that the committees organising these clusters it's a self-organised cleaning system there is a challenge also between the town council and the committees to organise this work in a good manner very simple is it in the check dwellers in the individual houses and if you look to this chain between wash house cluster units individual houses it's also a mirror in the development of the town on the longer run and challenges to deal in this context that means to look to the governance structure that it's working good the main challenge for us war where how is accepted to water reuse for irrigation means in human consumption to irrigate vegetables and I showed before the technical details and you can see that step by step it's 100 million equally and same water viruses it's diminished in the whole chain of purification that you can see you are on the shore side with this water and this is a precondition you cannot realise water reuse without technical line like this of the challenges I think for the future that we cannot go under this preconditions if you want to realise water reuse for human conditions for human consumption under these conditions this is one of the main messages I want to bring out we also had an open communication this communication in this project will only show you how it's in this indigenous language formulated you can see to wear gum boots and gloves and also hand washing applying pesticides and all these things if you are communicating in advance it is accepted also by the people the products are sold on the local market and very highly accepted if I have two minutes more I'm in time what we learned now is that in this region the normal wastewater flow goes to so-called evaporation ponds you see it here in these more technical slides the water is collected in ponds and they are filled up with sludge and on the top is water that's a normal situation and in every rainy season it's flooding over and colour breakout is coming into the people that's a normal situation and we are looking also to manage this in the sense that we are building here in first an anaerobic unit where we can build a trap for this sludge and to manage this sludge in the sense that it's hygienically good managed and after that on the end more simple techniques for purifying the water that means it's fit for purposes like irrigation for fodder, for animal fodder or something like that on the last here you can see this is the KUWUWATAS project approach but it's in a high technical state so we are looking in the moment also to deal with this system and I like to close with this remark that if we on the long run like to manage the water crisis in this country there's no way against water reuse and water reclamation because this whole country is on this part one and a half million people on the Konene river and the Konene river hasn't any more the eco flow in the moment and we have the third years of trinus and we have to look after the preconditions what does that mean water reuse and water reclamation in such country, parts of countries affected by climate change Thank you very much It's an interesting presentation on the practical application of water reclamation and reuse Alright, we have five minutes left floor is open for questions Just a question that came in from online from Elizabeth Vermoonch for Thomas Kluge she says how is O&M funded beyond September 2015 when the current funding ends What I showed is in full ownership of the town of Utapi and the project is ending this year in December and then it's in full property of the town of Utapi and the time was very short the biggest challenge was the capacity development that we were able to train the people in the manner on the field side and on this plant So it's full of working now Yeah, I had a question to Arne Is he around? So the prospects of rolling out the SFD analysis to more cities around the world is it still at the stage of you developing an appropriate technique an appropriate process or how close are you to being able to pull a lot of effort and have many cities 100,000 cities I think there are different dimensions one is that there is demand on different levels like in Moshi there are other examples where cities just see the diagram and it's a tool for them to talk to each other they don't care about the context description and some details of methodology they go with it and that's a trend and we try to support this and to go with that simple thing there's a second dimension where it's maybe the best example is India they have a very sophisticated process of city sanitation planning they have a national strategy for city sanitation and there the tool is just adding at a certain point and can be sort of embedded the question is will it be embedded it seems yes it seems it's really useful and there is then that we with this initiative try to bring the whole range of tools to say that what is a credible context description what's the minimum you need where I would say that we're getting simpler we're getting more user friendly but now we have eight up on the website in a draft version we hope in February to have 50 up there and in the second phase to concentrate on being closer to the demand of cities and to test what we have is it suitable for what cities can do and want so the short answer is it's not that we're ready now but I think we have done quite a part of the way in that direction thank you for your presentation I have another question to Arne and it's I want to look at the link to the SDGs and the monitoring one thing that what you're doing is a good inventory that could be possibly used for like the monitoring of the SDG is that something you have been looking at and the second one is also grey water for example more integrated waste water management how do you incorporate that kind of questions into your models to be very inspiring so if you talk with somebody has a new idea how to use it use it for emergency camps use it for mapping of health exposure use it for mapping of business opportunities use it for a national level and we're trying to as well sort of harvest these ideas and to document them we're starting with that so that's one dimension and the other thing is that in the morning we were saying that actually we need cities and nations to be motivated to gather data only then we can get the data we need on the higher level so SFDs are seen to have potential to to support this process and the project is actually then asking the question can you never compare to cities because every city will make use of the diagram and the tool will make use so different from the second city so then how can you aggregate it so the effort of the project is quite a bit to say that can we do it in a standard way even if that might be slightly less suitable to the individual city so maybe we do twice one that's Moshi and how Moshi wants to do it and one that would be to the standardized of the 50 there are quite some expectations and that's why I was so as well happy about the morning there's more flexibility to learn while going to get the right answers because that's the question we have we have purposefully not included that in the project because that's sort of overwhelming it's clear that what we want to do wants to be at service for that but if we would include that into our tiny little project it's a follow up to that more of a kind of a you could actually better answer the question perhaps it's a pretty unanswerable kind of question at the moment but just to say that those of you who have been following the SCG process we have the outcome document now which is great we've got a water goal so that's a huge step forward we have these targets now 6.2 and 6.3 which cover the sanitation chain wastewater and sanitation which nicely brings together from basic sanitation through to reuse and the indicator framework the proposed indicators I think will really allow us to use this framework and that's certainly what we've proposed the question that keeps me up at night now is how the hell we do it because I mean this is super useful at the city level but for the global assessment we have to have it has to be statistically based and I think we have to kind of go from what's been done at the city level which is great but a lot of it's secondary data and key informant interviews which is perfect at the city level but it's going to be harder to use that for national level assessments and global level statistics to say well this was based on a key informant interview so we have to kind of build in that statistical component and that's where we're headed now and if I was to kind of imagine in five years time I would love to see the same kind of SFD base kind of template with all the boxes the same with slightly different ways of estimating the flows in those boxes for cities which is more action oriented at the city level and for national and global level kind of comparisons and statistics based so yeah that's I think we're all headed in the right direction is the short answer but a lot of work to go there's a shelf out here very briefly it's a thank you to GIZ for taking up the charge I guess in terms of representing sanitation as a sanitation chain and putting that out there so broadly it's time and I really appreciate that that's what you're doing the other thing that I appreciate is that first and foremost you put in the center place is what is going to be most useful for the cities to progress towards their end goal because ultimately that's like rolling out the statistics what we want to see is that on the ground people have better work sanitation thank you one more question or comment yeah I think it's an exciting project and I'm looking forward to all the data but leaving the flowers aside I've been yeah arguing in several occasions now that for the shit flow diagram it's a real shame that we have containment only and that we have not aligned with the airwark the airwark sanitation value chain that we made which has user interface and then containment because what we are seeing in a lot of the cities in Asia I know it's different in Africa is that people do have toilets but there's no containment that's actually and when you're making a shit flow diagram where the containment is red because people don't actually have a septic tank it goes directly to the drain etc then that bit is red but for the city who has just achieved so called full coverage that's really disappointing so I would like to see the user interface as a separate category in a shit flow diagram and then make that green and then say to people yeah but do you see that septic tanks that they have are no septic tanks or especially in the wet countries that is a big issue because it goes directly to the drain because it overflows etc etc thanks so much thank you alright I think it's time I leave it with a thank you because the question is what is the septic tank we come back to the question to the functional definitions and so on but these are the right discussion let's put it like this I think these are the right discussions that's what I would say alright thanks a lot for the four speakers a round of applause please for the discussions I'd like to close the session or two hi thanks very much so the next session is going to be on addressing long term sustainability and market development and apologies from Eric Yosefison I hope I said that correctly from people unfortunately he has taken ill so is unable to be here today to chair the session so I will do my very best right maybe just a quick word about how the session is going to work so all of you can know what to expect so there's four topics we're not going to group them so what I'm going to do is we're going to be very strict ten minutes presentation max if you want more question time then talk less and then five minutes question time after each presentation and then I'll take us up to the hour and then we will not endanger our coffee break so first up about post implementation monitoring Tilo will give us an idea okay thank you Trevor it's actually not me speaking now it's Stefan Siemann from Weltungerhöfe who couldn't be here and sends his regards so Weltungerhöfe is one of the largest German NGOs they come sort of from the food security direction hence it's sort of a little bit displaced I'll be speaking a lot about water not about sanitation but about supplies to sanitation as well you'll see so Stefan Siemann who heads the knowledge exchange quality management unit within Weltungerhöfe was quite shocked by a study he read by the rural water supply network which basically showed that in many places half or less than half of water supply systems are functioning and he sort of said well let's look at our projects and he began to look closer at their projects and how are these functioning and working and they did a study in Kenya and one in Myanmar with 141 points and basically found out that his fear was true it was basically the same type of failure rate or more than 50% of the things not fully functioning so he's got a bunch of graphs and I'll just sort of point out that sort of down here you see that only 13% are fully functional after 5 years where I said this all relates to sanitation they've done something similar since in Ethiopia looking at it I don't have those slides because that's sort of newer but it was worse so basically a point just being how do you get sustainability going here and the underlying reasons they sort of identified were that in many cases there's just no post construction support meaning that when the project ends, when the financing ends people are sort of left to themselves and there's nothing really to follow up another interesting thing that they found was that in many cases that the water committees for example giving the ownership to the people wasn't truly working so in terms of sort of their business as usual what they were doing it wasn't like they were only building hardware they were very much putting a lot of resources and energy into organization and training of these water use committees who were supposed to then manage their water supply assets so they were working on the hardware and on the software and what Stefan is basically saying now what they're seeing what is more necessary is to actually within implementation of the project to really set up external support to both the hard and the soft infrastructure so really shifting to try to have services that last because they've just realized that there's a limited ability to maintain with these committees so in identifying critical factors they found on one hand cost recovery and secondly that they need to really how to post construction post project follow up on the project and so we have began to sort of think well what is it what does it really need we need evidence to see what works and what doesn't we need to support local service providers a lot of times getting also private sector involved to share data with other stakeholders in the country for their monitoring systems and at the end he was basically saying is this our role as an NGO are we able to do this being project financed we don't really know what we need to measure we don't need really know how long do we need to monitor and then interestingly enough questions even came up and if we find out we failed what do we do where do we take those resources how do we repair what it's like a bottomless pit so basically he was saying how do you finance these post implementation activities so instead of sort of burying his head in the sand he initiated we're going to have initiated a workshop and the reason I was asked to present this because I was the one facilitating that workshop in Addis and you see the logos of at the bottom of sort of organizations that were that were involved and the questions were basically how do we integrate our roles and responsibilities for this long-term monitoring how do you hand projects over how do you really and the interesting thing was that our it was so difficult to keep people on track because we just came back to the to the typical sustainability issues that everyone knows from their projects but that wasn't what we were trying to discuss we're trying to discuss how we set up these structures for for for looking beyond when the project ends not only within the project and how we can trigger broader discussion we realized we need to have the different actors discussing to each other and this is a larger issue we need to take it outside of our meeting room and so one thing that we've done as German toilet organization together with the German wash network is that we took the the notes from this meeting and the results and we put them into sort of an e-paper which now we've sort of handed over to Susanna and Susanna is assisting with with the translation to different languages so we'll get these results spread as extensively as possible and the next steps that Stefan is basically proposing in collaboration with Susanna is that on the one hand we want to do a thematic discussion series and I think Wehrthof has even said to finance I guess that what it takes to do that then there is the option I guess of saying if this is interesting to us currently we don't have a working group that says monitoring somewhere which I think is worth a thought so perhaps it could take a working group on this Wehrthof is actually employing someone who will spend 50% of his working capacity on this sort of issue within the next time and they're doing several pilots and they're very happy to Viva Kwanakwa a sort of very innovative German fundraising that will go for Wash that will be supporting this project because it is very out of the box and you don't really know what return you'll get on it and there is supposed to be I guess we aren't a working group yet but just to let all of you know who are interested in this issue that on Wednesday 26th at 11.30 there will be people getting together who want to discuss this further and I I'll step outside of my role as being Stefan and applaud him for not only identifying an issue but then really getting mobilizing his organization to deal with this because basically when you step out like that as an organization that's normally fundraising saying we do great projects and you basically deal that openly with we have a huge problem and I think that's something to really be applauded so looking forward to people's thoughts on this and if people have other things to add thank you I'll Tilo stay at the mic just to answer some questions so we'll take five minutes of questions can you put me on five minutes okay so okay thank you just a suggestion to when you move this discussion forward in Tamil Nadu in India and I forgot the name that's H but there was the Tamil Nadu Water and Drainage Board they really looked at why there was so much focus on new construction and instead of repair and rehabilitation and there is a Tamil Nadu and I was trying to get it on the web but they have made a pledge because there needs to be a big shift within the within the organization, the institution itself and you need to get the engineers and the people on board because they come in as constructors and instead of constructors they now have to go and shift to a diagnosis and to listen and to learn and blah blah blah so it's very maybe interesting to look at that experience and to look at the pledge, how they got the institution and the staff of the drainage board towards accepting that and also see what has happened after that if they sustained it okay I'll get back to you on that thank you Lizette perfect so Jean, thank you for the one who were in the WEDEC last month in Los Boros University there was a session about sustainability with a PhD run in Malawi exploring the failures of sustainability and it was a robust I mean with a robust sampling and it comes to a total opposite conclusions that these conclusions for example they show that the most important thing was not the water point committee but was the quality of the water point a water point committee was reinforcing inequalities it was not trusted by the people and it was basically creating an artificial governance system in a system where the governance is already very very low so I think that it shows that it's extremely contextual it shows that if we want to discuss that we really need to have robust sampling and I don't think it was so robust 41 but if not it's very difficult to compare and I think you're right I think it could be really interesting to have a sort of thinking on sustainability comparing the context why the subject yes last track of hands Steph and then you speaking next so one second thank you also for presenting these very honest but very obviously I just wanted to find out from the paper that you have written have you seen a difference between the post implementation monitoring that is needed for water supply and sanitation and where are your thoughts going what are the similarities and what are the differences between the two alright do you have any responses otherwise we have two minutes so I can take one more question or responses I'll just respond to that last one because I think the differences between water and sanitation are important because with water a lot of times things are easier to monitor than with sanitation there was sort of we had certain monitoring experts also in the room who were trying to explain different tools that could be used and one for example was sort of you had like a sensor in the water pump that basically shows is the pumping water or not and if it's not pumping it sends sort of just by a quite cheap chip like a signal which can be sent to someone from the private sector that knows there's a pump for me to repair because it was shown that after sort of three days of not the pump being used people revert back to sort of their own the old water source that I think type of comparison for sanitation or particularly for hygiene behavior becomes very very difficult in sort of installing somehow a sort of system that long term will then will sort of lead to people jumping in at the right time to take it to that next level there was one thing that didn't come out properly here was I think was also the close linking because we were talking about sort of that it might be surpassing government systems or there was some comment made there it was interesting when we began the workshop we did have a lot of government officials in the room as well from some different countries and at the beginning we sort of did a line up to look who's working in PIM so far and who isn't and many people were sort of standing at well when our project ends it's over at sort of one end of the room of we don't really do this the ones who are standing at 100% that's what we do because they saw it then as their duty but it became really clear that this integrating of how do you really hand over how do you really exit a project how is the responsibility actually handed over to the government at that point became really really important if there are 30 seconds the only person I'd ask to add something would be Ryan because you were part of the workshop if I don't know if you felt there was part that perhaps was missing or misrepresented or something so I wanted to add concerning the questions 20-25 one thing which I took away but also maybe it's because something I strongly supported was the idea that PIM is really an implementing organization perspective because it's about implementation so it begins and ends and so one thing was that the government I think said was there the monitors but the idea that anything that's designed to be PIM whether it's water sanitation or hygiene needs to be supporting the national systems correct all right thank you very much I am going to ask the next speaker and Susan also had a question so if she wants to use some of her presentation time to ask Tilo and at Bridges then she's very welcome to ask Susan Davis or Davis to speak about the failing forward and future proofing sanitation failures and what we can learn from them and you have 10 minutes very much thank you good afternoon I'm Susan Davis with improve international and I like to use toilets almost every day probably more than once a day I used one here it's very nice there's soap there's hot water there's towels and as I think everybody in this room already knows that is not the case for millions of people and it's not just that they don't have access to a toilet some people have access to a really filthy toilet some people use their toilet until it fills up and then they go back to open defecation some people use their toilet but don't have a place to wash their hands so they're actually getting more contamination so I just want to start with a quick question so from the presentation you just saw before this one what did anything surprise you was anybody shocked to hear that post construction support is needed or that water committees need to be strengthened and the lack of spare parts all this stuff is any of this a surprise no it's not and so that's why I called this failing forward let's fail differently let's stop making the same failures over and over again I've been in the past four years since I found it improve a bit of a failureologist and I collect these little nuggets of failure and the point isn't to be depressing but which it is but to really start showing that we're failing in a lot of different places so let's stop doing that and start failing differently fail forward and so this idea of future proofing is a cool way to say building in sustainability and I'm sorry it shouldn't be toilets it should be sanitation that's the word I use for non-wash people so all of the stuff is snapshots it's not a rigorous academic study but it's things that I've been collecting over the years and you know a lot of times when we talk about failure especially with water points but sometimes with toilets we talk about functionality right the lack of functionality and that's where you start seeing a lot of stats but there's all kinds of different failures I mean the big one the big message point for this year is the MDGs right we didn't reach them for sanitation and in fact we probably had some slippage if you count in the fact that some people stopped using toilets or weren't using the toilets that they supposedly had access to there's failures with understanding customers and what they want understanding the market there's failures in implementation, design and quality poor construction pits that collapse inappropriate technology stuff that's requiring a lot of water and water scarce areas for example failures in monitoring and follow up as we just saw failures in sustained hygienic use of the toilet even if it exists failures in sustaining open defecation failures failures in fecal sludge management so we all know this stuff I know I'm preaching to the choir but I think the point is let's learn from these and let's share the word and let's talk about failure more because then we can learn from that and we can all say like I did as I was watching your presentation oh my god I just did the same work and I need to get it translated into German so you guys can look at it we looked at a lot of different failures so just some examples of implementation failure there was a study in itchewar block and the official data showed that there was 38% coverage but only 19% of the toilets were functional and most of that they found was due to poor construction or incomplete construction the supplies were never delivered there's functionality and maintenance issues in Peru and the Laredo region an estimated 85% of the toilets were unusable in Madagascar a wash sustainability check showed that 46% of the households did not have functional toilets UNICEF did a study of schools all over Asia and they found pretty high numbers in Afghanistan 45% of toilets in public schools across the country needed extensive repair or replacement similar numbers in Pakistan extensive repair replacement Maldives 27% Bhutan 30 to 40% of toilets needed extensive repair or replacement sorry this is really depressing but there's a light at the end of the tunnel failures in coverage let's see showing up but we know that we missed the MDG target by about 700 million people and that wasn't even a goal for universal access the percentage people with access to a toilet shared by only one family between 1990 and 2012 declined in Nigeria from 37 to 28% so 16 million more Nigerians defecate outside today than 1990 Nigeria has the highest percentage of unserved population in Africa but they only receive 6.1% of the aid compared this to Kenya which has 4.2% of the need and receives 9.4% of the aid so there's failures in equity and failures in how we target our aid dollars and in many parts of the developing world up to 4 out of 10 schools and health care facilities lack basic water and sanitation water sanitation and hygiene facilities there's a recent study that came out there and I can't get this to go there we go so failure to understand customers somebody mentioned earlier health is often not the motivator that's why we're doing this a lot of times it's all motivated by health but that's not why people want a toilet or want to use a toilet there was a great squat survey it was aptly named in northern India and people actually preferred to go outside they like to take a nice walk in the morning over 40% of households with a working latrine have at least one member who defecates outside still people who own a government constructed latrine defecate in the open anyway so we don't quite understand what people want in Cambodia in areas where CLTS was used only about 15% of the households with a latrine used it regularly in Ghana 60% of new latrines only 60% are being used in rural areas and even if we do think health is the issue this is a really interesting Emory study in schools in Kenya where they actually the kids had increased hand contamination after toilets were installed even with hygiene promotion and they suggested that that might be because they weren't actually they were using the toilets but they weren't actually practicing hand washing and anal cleansing materials aren't frequently available in Kenya's schools and they weren't provided as part of the project and they said whoa this is really scary and we all know shit flow diagrams we but I would like to kind of think of this as we failed to understand the value of shit there are some people who are doing really interesting stuff with waste of fertilizer and waste to energy but not really at scale so what have we learned I think we have learned some things obviously there's a sustainable sanitation alliance it's really important but it has to be beyond the access and more towards the services and to get to that to get to universal access and universal services we need political will, leadership funding, coordination affordable and appropriate technology sustained local capacity so not swooping in and doing a project and this big thing is this cultural shift now if we knew how to do all this stuff we wouldn't need these forums we could all go sit out in the sun but I would just encourage us all to continue to learn this is a great time to start thinking differently and start working differently and stop doing business as usual because we have the new sustainable development goals and it's time to put these learnings into practice and future proof sanitation gains that we've achieved thank you and I have a lot more really ugly stats on our website improveinternational.org and we just with help from Elizabeth set up some failure stats on the Wikipedia wash page as well if you have any to contribute in the interest of learning thank you thank you very much are there any questions for Susan we have three or four minutes for questions thank you very much for I think it's a new science field or something you said for me really it's interesting to hear all of the examples you gave and sometimes in my mind maybe because I'm still very wired and supported by the society which I exist to think more on success but I'm wondering sometimes at what point do we really declare or see something as a failure because if you think of interventions and all of these in a spectrum or in a continuum of some sort these programs are at certain levels on that continuum so at what point is it exactly a failed project because that's one thing but then the flip side of it it will be more interesting for me if and that is where I think learning would really be happening if the examples of failures we have we're also documenting examples of successes so things have been done to address the specific failure so that way it really closes the loop and I don't know what can you do with that probably have to check out the website but just my daughter I'll go back to the microphone because yes that was a perfect question actually to ask I love that I know people say that a lot well you're telling us what doesn't work what can you tell us what does work we just started some research with Catholic Relief Services CRS on sanitation successes over the long term so we're doing it's still kind of high level we're doing a desk review and interviewing different people but we are trying to document and find where there is documentation on successes and it doesn't matter what approach we're just kind of looking at a bunch of that so we should have that desk review oh god it's due at the end of this month next month but so we are looking at that and we're ideally if we find some good examples we'll go do more detailed case studies what's worked over the long term and why and what are the what's the sort of performance envelope to steal Darren Saywell's term what are the factors that contributed to that and you know was it money was it cultural was it water scarcity or water availability that sort of thing and then the other piece that you mentioned which is what do you do when you find these failures who is doing these sorts of things that is another project that we're working on we're calling it you're calling it PIM we're calling it resolution so it's identifying problems first of all by monitoring and going back and then what what is the responsibility of the various stakeholders you know is it should the NGO do something should the community do something should the local government do something and we we tried to come up with that for water problems so we do have a we'll pitch that report it's very probably very similar to the one you came up with but resolution of problems with sanitation seems to be a different animal and to go back to your very first question is like I said these are all snapshots you know we don't really have good except for the JMP numbers we don't really have good numbers over time for the same place right you know this toilet you know the pit filled up or in this community the pits filled up and then they replace them we don't have good long-term data like that as far as I've seen if somebody has it that would be great to share so it's declared a failure kind of like with water the day we showed up the water wasn't flowing it's the day we showed up the pit was full or the latrine appeared not to be used or it was collapsed I think some of these are obvious failures some of them are they have potential to be fixed but we often don't get to that level of detail of hey it looks like your pits full what are you going to do about it and then follow up and say did they do something about it so you're right and that's the challenge is we need more data or we need more information we really need to kind of understand why right there's a last question here from Anna maybe it's not exactly a question it's a thank you because I might be surprised about the results but about the seriousness which with both presentations try to follow them up and there's sort of a comment or thought the two cases and maybe you don't need more data if you need other examples it's Dick van Rijnhofer it's definitely the Dutch who said that they'll do the post implementation monitoring and only the money flows if it's still there after 10 years as a result those taking the money were saying well we have to make different projects now so there are examples where the way you give the money has effects so it would be maybe interesting to look at them and I don't know if I have a romantic perception of the Nepal SNV thing what come to my mind and Antoinette might comment on that is there's a simple form of a biogas it's businesses who select the farmers who take them and they get some money for doing it but there's a share of money which only comes after 3 years so there's built in a system that on a micro level you think long term and I would like to see more examples of this long term thinking in the planning and maybe that would be interesting if I could just quickly say thank you so much for saying that I think we've started with we identify failures more at the technology level this is what happened with this pump or this toilet and then we've kind of expanded to this is what the community did wrong and then we've kind of gone to well this is what the implementer did wrong but we haven't quite gotten to this is what the donors are doing wrong because we don't want to offend anybody but really if the donor says the measurement of success is you build these number of toilets in 2 years or 1 year and that is the only measurement of success and it's not about building local capacity and it's not about working with local governments and it has nothing to do with the time dimension then yes I think the donors are part of the problem so thank you for bringing that up thank you very much Susan next applause I'm trying to keep it on time so we can all the questions that were not asked we can ask in the coffee break next up is she's here and she'll be chatting about activating the supply chain for rural sanitation in Bihar, India so Genevieve you have 10 minutes, welcome thank you thank you Trevor, I'm going to do my very best to make this brief but if I go through anything too quickly or I skip over a point that you'd like me to clarify please feel free to just raise your hand I don't mind I'll make sure we get everything explained so the topic now is actually just an example of how PSI is attempting to make our project sustainable and to take all of these lessons from the room forward and hopefully we won't fail but we'll actually have a success story to add to Susan's list so the project is called 3SI supporting sustainable sanitation improvements and it's in the state of Bihar in India it's funded by the Bill and Melinda Gates Foundation and we are partners with Path, Water for People and Monitor Deloitte and it's a five year project and it started in August 2012 ok so for those of you who aren't familiar Bihar is the second poorest state in India it's a bit of a country on its own it has a population of about 105 million and that statistic is about 4 years old it has 88% open defecation and it's one of the states that was surveyed in the squat report in which open defecation is certainly the social norm and often preferred hence the huge challenge additionally something that we found while preparing to work in Bihar as well as throughout the process is it's notoriously corrupt there's a strong perception that the government is skimming off the top that's both demonstrated and perceived and what we found was that this was one of the large reasons why despite fairly good coverage of microfinance in India in Bihar itself it was about 3% of the population had ever accessed a formal loan so just for a quick overview of the project the way it started out as Gates asked us to do it was to create and test sustainable business models to increase demand for improved sanitation and to increase access to finance and so what we did for the first years of the project was to really focus on that first component which is to design and test these business models so it was very very supply side focused and then we incorporated in the demand creation through a direct sales model and now we are very focused on increasing access to finance because once we have the product we drove down the cost of the product we found that in order to have a product that was both sustainable long lasting and desirable to the consumer there was still sort of a price point that's more than most households could afford in cash hence the need for access to financing so the project by the numbers is actually one thing I just want to clarify is that this increasing access to finance essentially the idea was that we are going to start selling toilet loans not just toilets and that's why our target is now two Gates we adjusted this target to say that we would sell 100,000 toilet loans and then another 50,000 in cash directly between the household and the enterprise we aimed to activate 214 enterprises so that means both taking existing and potential operators and training them in how to produce the toilet that path and water for people helped us to design we have about 2 million US dollars allocated towards the financing component of this project and I'll explain that in a second we have three large MFI's and one small one with whom we have signed agreements to move this forward we have 14,800 toilets to date which is not much compared to our target of 150,000 in the next two years however the vast majority of these actually 14,000 of those are cash and despite the fact that we found that financing was the huge constraint we're seeing that we're kind of getting some of those higher income households that have made the cash purchases and once we get financing fully activated we're hoping we'll see a sudden uptake in loans and we have 175 enterprises activated so far just which is to emphasize that we really focused on the supply side for the start of the project to get things in place okay so the gist of this is that we have this 2 million dollar pot of money it's partly from within the budget from Gates as well as a contribution by the Unilever Foundation through their domex toilet academy and so take a pot of money give it to a fund manager based in India fund manager then disperses it to local micro finance institutions who then disperse it either as consumer loans to the household for the purchase of a toilet sorry I keep doing this or to the enterprise for working capital and so it probably sounds like the least sustainable thing in the world to just dump a bunch of money however the idea is that the the idea is that because we found due to this corruption and the fact that purchasing a toilet is a non-income generating loan a lot of these micro finance organizations were really reluctant to invest in Bihar and so the theory is that by giving this initial capital into the system we can demonstrate that there is demand for toilet loans as well as kind of absorb some of the risk for the micro finance institutions and then I have these highlighted little blue mini MFI's which are the NGO arms of each of the MFI's which are actually able to receive grants from this fund so not just a loan but an actual grant and that's for demand creation. So this is essentially what the strategy looks like so 3SI over here that's 3SI slash PSI who we are giving a grant to this fund manager which is friends of women's world banking in India who then are on lending the money to MFI's who then on lend the money to consumers and toilet operators and then in turn goes through the supply chain for the construction of toilets in addition to the loan to the MFI for the capital there is also a grant to the NGO arm of the MFI which is very common in India I'm not sure about elsewhere but I know in this case it's often just the NGO arm can actually receive a grant whereas the MFI itself cannot and then in the meanwhile PSI is busy doing communications and facilitation as well as demand creation in the background and strengthening establishing the supply chain but the idea is that a lot of this communications facilitation this green arrow will be taken over by the NGO arm of the MFI in the future have I lost anybody because I know I'm probably rushing through this okay alright so more numbers as I mentioned we have just over 800 consumer loans dispersed thus far and 39 enterprise loans and the idea is that the pot of money that we're giving to FWWB again that's the fund manager this friends of women's world banking they actually the signed agreement is that they will leverage this pot of money three to four times and that's by leveraging their ability to take loans from other commercial lenders then the MFI in turn in exchange for receiving this grant towards the NGO arm of the MFI they have a signed agreement with FWWB to also leverage the loan to borrow more money to also bring cash into the system specifically specifically for sanitation loans getting into the details FWWB operates at a margin of about 6% they lend to the MFI at about 6 to 8% so very little is going to MFI or FWWB for their operating costs and then MFI's are lending to the consumers and enterprises at 20 to 24% which is standard for the market so we're aiming not to distort it at that level so the cost of the toilet is about 240 US dollars or 16,000 rupees and then the loans are available for between 6 and 12,000 rupees to the consumer so up to 75% of the cost and there are two modes of receiving the loan both where the household essentially puts in a deposit to a and then upon constructing the toilet and getting confirmation receives the loan directly from the MFI and then there's another one in which the portion of the loan goes to a a cement ring manufacturer provides a pan and some rings in the ground actually in kind to the household and then the household and we found this is building off of what was the existing practice is that households um I guess I better get going but the point being is that we gave households the opportunity to contribute in kind towards the loan and we actually like monetize for bricks and pans and different things based on what was available and interestingly we have about a 40% rejection rate which isn't terribly surprising but PSI is working to to reduce that sorry that's for the loan application enterprises again those can be up to 50,000 rupees um and those are at a rate of 20% payable back in six months and 39 dispersed okay so the whole point of the presentation so actually what was really interesting in this project was that again our hypothesis was that by injecting this capital into the system we'd kind of lubricate financing we'd absorb some of the risk and there would be money dedicated to sanitation loans and then that would you know spark demand and everything would be up and running interestingly what we found was that a lot of MFI said we actually have the capital we need to lend it's just that we're not necessarily interested in doing all of the demand creation required for increasing awareness of the loan um as well as the fact that this loan um is non-income generating and so uh the cost associated with that as far as um the risk um so as a result we've only actually dispersed about 60,000 US dollars of our 2 million dollar pot um because we actually need to find MFI's who are willing to take the capital um but what we're looking at is trying different approaches to see where and when um finance is needed to sort of helps kick start the process um for implications of repayment um lesson learned is the need to lower the delivery time um just especially with how the idea is that a loan um you start repaying after a month usually so that means we need our toilet built within a month and that's a huge challenge for the supply chain at times um because we're allowing households to contribute in kind towards their loan often it means that there's less standardization of the product and so the set for the US dollars isn't always what it is and there's opportunity to add tiles or a more artist in a wooden door and that kind of thing and that's raised in the cost of the toilet and that's a challenge we're facing uh the definition of a constructed toilet some of our toilets are built close to water sources as a constraint of space can we can we count that toilet um some of them don't have doors or they just have a cloth in front of them um so they're still used but they're not fully constructed can we count that toilet so that's something we're working on and um one thing we're excited about is the opportunity to monitor this at scale which is leveraging existing microfinance organizations and the loan officers and their touch point with households um which is creating a feedback loop for us so we'll PSI will learn really quickly if a loan's if a toilet isn't getting constructed because a loan isn't getting constructed in time and then the MFI's are going to come to us um but one thing we did find is that we have very high rates of customer satisfaction as a result of these frequent touch points um and of consumers being able to ask um questions as needed from from their loan officer and that's it very good we we have one minute for a question because you went a little bit over your time that was intentional so one question I see there's three hands four half questions no um we'll go over here because Belinda hasn't asked a question yet um and the other questions I'd ask the folks to to ask Genevieve in the coffee break which will be in a couple minutes because you're funded by Bill and Melinda Gates foundation do you know the work that was done with vision fund path WSP in Cambodia and because I was one of the review and it's very similar results so following on Susan's presentation how are you able to take some of that learning into what you're doing now because yours seems to be still ongoing yeah so that's a great point um my understanding is that there was not a huge capital infusion into that if if if I'm correct there so I think that's what's a little bit different um from this model but absolutely we're leveraging those lessons earned both with um having direct sales of toilets and trying to turn loan offers into sales agents um basically they were saying they're operating costs to manage the small loans at the end of the day Belinda we need to have our mic I think one of the key findings besides something you mentioned is the microfinance for them to get really involved and this is really a key crux to your to your work is that the operation cost for them to manage these infusions these changes is so much more than the loan itself and how do you connect that to other home improvement loans and other things so I really think moving forward um it would be really good to again learn on those lessons because it is quite an in-depth work with Vision Fund yeah and absolutely and one thing that's a little bit different from our project versus those in Cambodia with Vision Fund is the cost of the product itself and so the loan is actually significantly larger um I know that um having worked in Cambodia the toilet was around 35 to 50 US dollars mostly for the underground components right right yeah no it's next some point yeah just to build to that I think one of the big lessons also we need to incorporate is to whether we go to individual financing and microfinancing or whether we have the community as a collective there's very interesting research that's coming out from Bangladesh now Bangladesh might be a little bit more homogeneous um communities um there's a lot happening also there at policy level so look at the context before you translate uh findings from one country but the key was there that it's cuts alone didn't work finance didn't alone marketing didn't work alone but cuts with community collective financing did work so cash transfers to the communities that might also reduce the cost for the the micro agencies to finance and it did result in the poorest um reached also there's very interesting briefing from Bangladesh but it needs to be looked at the collective financing or individual financing yeah and I would love to talk with you about it further afterwards because in the interest of time I can expand on all the details but there is actually a collective household component in one of the financing schemes within this um trying to build in some of that all right thank you very much Genevieve um so next up we have uh Antoinette Korma from SNV and she'll be talking about urban sanitation uh finance from macro to micro level and this is basically a bit of feedback to to the community on our thematic discussion that we just had last couple of weeks which Antoinette was involved in as one of the experts so Antoinette over to you thank you so I arrived this morning from Jakarta and it's about 9 p.m. for me now and I'm an irrigation engineer trying to say something about finance and Guy Hutton is standing in the middle of the room it's a really scary situation I should skip that so let me try um to say something about that discussion um in an old fashioned paper based way first of all who was in that discussion anybody who participated vaguely who wrote themselves so majority lurkers right in any email discussion that you're doing it appears that you have about 10% of the people who write and the rest are lurkers and within that 10% there's 2% who alw