Last week, FLUSH was a proud sponsor and attendee of the UNC Water and Health Conference. We joined over 3,500 people from across the global talk about a few of the pressing current issues in sanitation globally.
We shared several threads on Twitter to highlight some of the key things we heard during the conversations. Below is a recap of the sessions we followed.
On the first day, we listened in about wastewater epidemiology in the times of COVID-19 (see the Twitter thread here). The concept of using wastewater to test for viruses and outbreaks has boomed since COVID-19 took hold of the global platform. We learned that sewer data is noisy! A lot is going in there. With the different flow rates in different systems and the different methodologies to collect data, it's tricky to figure out how to make a clear, solid sense of what data we find. Can we segment sewers to identify and target smaller areas and communities with potential outbreaks? Possibly, but and while there are many potentials to use sewers to help identify pandemics, there are still many things to figure out.
On the second day, we learned about applying different financing mechanisms to sanitation solutions (see the Twitter thread here). Innovative finance can really be used for two key things - getting more resources and improving the efficiencies and effectiveness of aid. The biggest thing we want to share from that session was how well-designed financing wouldn't help a crappy program or one that has a lot of kinks. There still exist many data gaps to figure out more standard ways to cost out sanitation solutions. Also, Aquaya found that in low-income areas, the willingness to pay is much lower than the actual costs for sanitation solutions, which means that subsidies have to get used to increase coverage in some places. Whether we use subsidies for the households or the sanitation service provider is a matter of some debate.
This topic is something FLUSH is passionate about. We provide services that scope out business models and program designs to determine whether management teams need to address internal systems before innovative finance better. Reach out to find out more!
WASH in High-Income Countries
On the second day, we also discussed WASH issues in high-income countries like the US (see the Twitter thread here). High-income countries still have low-resourced areas. For example, Native American and First Nations are sequestered on reservations without any basic water or sanitation provisions. Some policies in place make it so that even if these communities want to help themselves and provide their own facilities, the federal system won't let them. Ultimately, there aren't many data collection efforts to understand just how many people in North America have less-than-ideal systems like septic tanks and well, and they're often not well regulated. In the US, approximately 0.11% of people open defecate - about 385,000 people! Also, about 1.45 people in the US do not have connected plumbing. As houselessness numbers increase over the last decade, we need to find more solutions to ensure everyone has access to safe drinking water and toilet facilities - this includes public toilets!
Inclusion & Diversity
On the third day, we joined the plenary discussion about equality in WASH (see the Twitter thread here). The discussion focused mostly on equality of service provision on the ground and the biases that make it hard for everyone to get equivalently good access to water and sanitation services. For example, rural communities often get less sophisticated or even just less good options because they're expected to "deal with" more basic services - like a handpump instead of tapped water. Also, we tend to blame people for being poor by what service we offer them.
One thing we wished had been discussed more was how the lack of equity in the WASH sector's leadership and workforce also contribute to sustainable access issues on the ground. The focus was often on service design and community engagement, which, though important, may not quite address the systemic issues with how equity is addressed in the sector overall. We are working on a study regarding this issue - stay tuned over the coming months!
The last session we could join was about sanitation systems (see the Twitter thread here). We jumped in a bit late, but what we picked up was a lively discussion about how sanitation doesn't have a lot of money, even though it doesn't cost that much relative to a lot of other global industries - like chocolate consumption.
Part of the issue could be how we pitch the story - we need to help governments support their people and the value of sanitation, not the need for investment. Another part is how governments have not figured out exactly how much money they need to budget annually to manage their sanitation needs because most studies with money still aggregate across governments. Barbara Evans shared that, "One of our big sanitation constraints is that a lot of innovation in finance and technology is still on the capital end of the business, but less on operating models. We've got to get smarter about service delivery." Also, many think sewers are more expensive than onsite sanitation because of direct upfront costs, but that's not really true - the cost of maintaining roads for transporting waste and other indirect costs can add up.
We will note that we hope that future conference platforms are more engaging and streamlined. People faced some technical issues with interacting during the conference because of different windows and platforms to juggle. Even so, we enjoyed participating and look forward to more future conversations and online conferences.