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

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

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

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

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

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

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

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

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

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

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

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

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

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

WaSH works! WaSH + households and communities: Healthier Wealthier Wiser

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

Supply-Driven Model Community participation (Free labour) Community Management Community Empowerment in Decision- Making Demand- Driven Model (Community Control) Community Management PLUS Changing Principles of International Development: Community Participation

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

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

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

A: Data collated by Peter Harvey, UNICEF Zambia, May myths_of_the_rural_water_supply_sector/ ~30% of handpumps are non- functioning in Sub-Saharan Africa

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

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

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

Measures of Sustainedment Is it working? For how long? Ex: % of days handpump non- functional annually, over 5 years Project Characteristics Project-level manipulables within our control Ex: Provide training & ongoing support for financial planning Compensate for Poor Enabling Environment Ex: Supply provision in absence of regional supply chain Enabling Environments Larger contextual background that is impacts sustainability, but is not directly manipulable at the project level Ex: Sociopolitical environment; access to roads Ex: Harmony & coordination at national and sub- national levels Issues in Sustainability

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

Sustainability TechnicalFinancial Community and Social Institutional & Policy Environmental Common Factors in Sustainability (Lockwood, Bakalian, & Wakeman 2003)

Maintenance – Preventative (2) – Major repairs/replacement (4) Spare parts availability (2) Electricity supply & affordability (4) Standardization of components (4) Tools & Equipment availability (4) 1. Technical (Lockwood, Bakalian, & Wakeman 2003)

Adequate tariff for recurrent costs (1) Adequate tariff for capital replacement or system expansion costs (3) 2. Financial (Lockwood, Bakalian, & Wakeman 2003) Q/s1600/deq-logo-financial_assistance_10384_7.jpg

Community management capacity (2) User satisfaction, motivation & willingness to pay (2) Involvement of women (3) Social capital or cohesion (3) Continued training & capacity building (3) 3. Community & Social (Lockwood, Bakalian, & Wakeman 2003)

External follow-up support (1) Cont. training & support to sanitation & hygiene education interventions (2) Private sector involvement (goods, services, mgmt contracts) (3) Legal frameworks for recognition of water committees & ownership (3) Supportive policy & regulatory environment (3) Clarity over roles for O&M (4) 4. Institutional & Policy (Lockwood, Bakalian, & Wakeman 2003) %20Water%20Supply_0.jpg

Water source protection, quality and conservation (2) 5. Environment (Lockwood, Bakalian, & Wakeman 2003)

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

Memorandum of Understanding

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

2010 Water and Health Conference October 25-26, 2010 Diversity of WaSH Community represented

Water & Health Where Science Meets Policy 2011 Conference Bringing together academic research and professional development workshops October 3-7, 2011 Chapel Hill, NC

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

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

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

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

Sanitation lags behind water SanitationDrinking-water Current benchmarkImproved sanitation at home 61% MDG off track Collect water from an improved source 87% MDG on-track

Water lags sanitation SanitationDrinking-water Current benchmarksImproved sanitation at home 61% served MDG off track Collect water from an improved source 87% served MDG on-track Household level benchmarks Improved sanitation at home 61% served MDG off-track Improved water at home 57% served MDG off track

Water lags sanitation SanitationDrinking-water Current benchmarksImproved sanitation at home 61% served MDG off track Collect water from an improved source 87% served MDG on-track Household level benchmarks Improved sanitation at home 61% served MDG off-track Improved water at home 57% served MDG off track Safe water at home Even more off track!

Why do we care? Source: United Nations Population Division, World Population Prospects, The 2008 Revision.

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