"Towards inclusive, green city sanitation for Lusaka – achievements and way forward"

The Climate Friendly Sanitation (CFS) project provided support to stakeholders to develop on-site sanitation (OSS) and safe fecal sludge management (FSM) in Lusaka, Zambia. The project started in December 2016 and was implemented by GIZ on behalf of the German Federal Ministry for Economic Cooperation and Development in the context of the large, multi-donor Lusaka Sanitation Program (LSP).

The report "Towards inclusive, green city sanitation for Lusaka - achievements and way forward" reflects on the progress and impact of the CFS activities, including the deployment of the SaniPath Tool in four neighborhoods of Lusaka. The deployment was conducted in close collaboration with Lusaka City Council (LCC) and GIZ to inform risk-basked WASH interventions. LCC managed the data collection process, including collecting environmental samples from suspected contamination pathways, facilitating surveys, and collaborating with local laboratories. The recent report highlights the impact of using the SaniPath Tool in Lusaka.

"With the information generated by the SaniPath tool, LCC is already working from a more informed perspective. Inspections are becoming risk-based. SaniPath outputs have also proved useful for public education messaging: residents are more receptive to appeals backed by hard evidence."

Virtual launch of publication:

Comparison of SaniPath exposure assessments in low-income urban areas in eight countries

American Society of Tropical Medicine and Hygiene 2019

November 20-24, 2019

Wolfgang Mairinger, Yuke Wang, Suraja Raj, Habib Yakubu, Casey Siesel, Jamie Green, Sarah Durry, Christine Moe

Emory University, Atlanta, GA, United States

The SaniPath exposure assessment tool compares risks of exposure to fecal contamination in urban environments across multiple exposure pathways. The tool has been deployed in 39 neighborhoods in 8 cities: Accra, Ghana, Vellore, India; Maputo, Mozambique; Siem Reap, Cambodia; Dhaka, Bangladesh; Atlanta, United States; Lusaka, Zambia; and Kampala, Uganda. Ten exposure pathways were investigated (open drains, ocean water, surface water, floodwater, public latrines, soil, bathing water, raw produce, drinking water, and street food) through behavior surveys and environmental sample analyses. Exposure was expressed as monthly dose (average amount of fecal contamination ingested as measured by E. coli colony-forming units [CFU]) and the percent of population exposed to fecal contamination for each pathway. Magnitude of fecal contamination, frequency of exposure behavior, and estimated fecal exposures were compared across pathways, neighborhoods and cities. The most common dominant exposure pathways for adults were raw produce, open drains, and street food and for children were open drains, produce, and floodwater. For produce, the dose was usually very high (>106 CFU/ month), and a large percent of the population was exposed (>80%). For street food, average E. coli concentration ranged from 101.3 CFU/serving in one neighborhood in Lusaka, Zambia to 105.5 CFU/serving in one neighborhood in Dhaka, Bangladesh. Exposure to open drains resulted in high doses (>104 CFU/month), but the population exposed varied (5%-92%) even within the same city. Exposure to fecal contamination via floodwater, usually affected a high percent of population (>80%) but had variable doses (102.5-1010 CFU/month). Both dose and percent of population exposed varied for public latrines and municipal piped water. This information can help city governments choose effective interventions to reduce the risk of exposure to fecal contamination. Widespread risks from contaminated produce and street food within and across cities underscore the link between excreta management and food safety and need for global action.