Appropriate Technologies for Environmental Hygiene

Author(s): M. G. McGarry
Source: Proceedings of the Royal Society of London. Series B, Biological Sciences, Vol. 209, No.
1174, More Technologies for Rural Health (Jul. 28, 1980), pp. 37-46
Published by: The Royal Society
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Proc. R. Soc. Lond. B 209, 37-46 (1980)
Printed in Great Britain

Appropriatetechnologies for environmentalhygiene

BY M. G. McGARRY
Health Sciences Division, International Development Research Centre,
P.O. Box 8500, Ottawa K1G 3H9, Canada

Appropriate technologies for environmental hygiene usually centre on

the delivery of adequate and accessible water supply, and proper treat-
ment and disposal of excreta and refuse. In the face of the International
Drinking Water and Sanitation Decade of 1981-90, several research efforts
are under way in the developing countries to develop technologies and
approaches for improving environmental hygiene in both rural areas and
urban squatter settlements. These are discussed and include the technical
development and field testing of infiltration galleries, low-cost slow and
fast filtration processes for water treatment, handpumps, on-site excreta
disposal using aqua-privy and compost toilets, and excreta treatment and
refuse through composting with refuse, biogas generation, fish culture and
use of excreta as crop fertilizer. The relevant technology 'hardware' is but
one of several components necessary for effective delivery of services. The
dearth of qualified manpower at all levels is described as being the major
constraint to the Water and Sanitation Decade.

Water supply and sanitation programmes have enjoyed strong international

support during the past decade. Typically, most of the funds have been absorbed
by the urban areas where unit costs of construction are lowest, and the ability to
instal and pay for the systems and the capacity to repay, the highest. Technology
selection has been in the hands of large international consulting engineering
firms with little or no consideration given to social aspects of the programme.
With the more recent shift of emphasis to the lower income population these
examples of engineering design have become irrelevant. This is particularly true
at the village level where modern water treatment plants and sewerage schemes
can neither be afforded nor maintained.
The coming Decade for Water Supply and Sanitation, 1981-90, with its euphe-
mistic objectives, raises some serious technological issues. If any significant
advance is to be made towards these objectives, the technologies of the past
decade will have to be drastically altered and improved. Most of these improve-
ments will have to be made by the developing countries themselves. Technology
development in the country in which it is to be applied has four distinctive
advantages over the conventional technology transfer process as instituted in the
past by aid agencies. First, research and development objectives are more likely
to reflect local priorities, thereby avoiding the pitfalls of projects that are con-
ceived abroad and exported in a well endowed package including foreign con-
sultants. Secondly, the innovative process is far more likely to respond to local
[ 37 1

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38 M. G. McGarry (Discussion Meeting)
conditions. Thus, distortions resulting from the need to respond to overseas
market conditions and tied-aid policies are less likely to occur. Thirdly, local
technology development implies that local institutions are supported and
manpower developed; the experience and confidence gained through the inno-
vative process and project management are important side benefits. Fourthly, the
expertise in and enthusiasm for the technology, once tested, remains in the country
to provide continuing support for its dissemination and implementation.
Most of the papers being presented at this symposium emphasize 'software'.
The relevance of this emphasis is recognized. However, successful implementation
of appropriate technology requires that both the equipment and its support
systems function on a continuing basis. This paper describes a few of the current
research activities taking place in the Third World that are aimed at technology
'hardware' development within the water supply and sanitation sector.

HANDPUMPS
The coming decade will see numerous large-scale handpump projects as a first
step in upgrading water supplies at the village level. The handpump is particularly
attractive to donor agencies with tied-aid policies in that the equipment can be
manufactured in the West. There is no other technical intervention which is so
easily given to the community as a whole. The imported pump enjoys high
visibility in the village centre and immediately provides a product: good clean
water. For installation purposes, village participation and commitment is not
required. Unfortunately, the handpump is as often a failure as it is a success.
Most pumps are badly designed and rapidly deteriorate under heavy use conditions
in the village. They quickly fall into disrepair and the people return to their
previous contaminated water sources. The village is seldom involved in the process
of technology or site selection and installation. Most often, the village has neither
a feeling of responsibility for maintaining the pump nor the technical capacity to
repair it.
There are two approaches that can be taken to overcome the maintenance
problem. The first is to overdesign the equipment, thereby reducing the chances of
early failure. In this case, village involvement is minimized and responsibility for
the pump is centralized at the water supply agency headquarters. Unfortunately,
priority is often placed on installing new handpumps, not on maintaining old ones.
Handpump project success is measured in numbers of pumps installed, not in
numbers maintained in continuous use. Communications being difficult and
response being slow, once the pump breaks down it often remains out of use for
several months, if indeed it is repaired at all.
Alternatively, the materials can be selected and the technology designed for
maintenance at the village or household level. As in the handpump programme in
Malawi, this approach must be designed so that the village itself feels responsible
for pump maintenance. The technology must be understood by the community

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 Appropriate technologiesfor environmentalhygiene 39
and a village repairman trained in its maintenance. Spare parts must be available
within a reasonable distance and time. This approach is being taken by a network
of research projects in Ethiopia, Kenya, Malaysia, Thailand, Sri Lanka, the
Philippines and Malawi, all supported by the Interna.tional Development Research
Centre. At present, emphasis is being laid on field testing the handpump itself.
The design, as developed at the University of Waterloo, Ontario, and laboratory
tested at the Consumers' Association (U.K.), has plastic subgrade components.
Above ground, the design incorporates oil-impregnated wood bearings, concrete
and galvanized steel pipe- all locally available. The design uses the same basic
principle as conventional handpumps but (1) does not require a separate drop pipe
for the piston and cylinder; (2) has a removable foot valve for maintenance pur-
poses; (3) has long wear characteristics.
In Malawi, the village first requests assistance from the Ministry of Community
Development through its local pump workshop and supplies store. The village
provides raw materials such as sand and cement but is given the plastic pump
parts. The wells are shallow and hand dug. They are brick lined and capped with
a concrete slab as constructed by the village with outside technical advice and
training. The pump is fixed to the well cover and a villager trained in its main-
tenance. The programme is extremely popular; the supply of pumps is having a
difficult time keeping up with the demand. Various pump configurations are being
tested by the Ministry with the assistance of the Polytechnic. Recently, the
Malaysian pump research team has undertaken laboratory investigations for
Malawi.
In Ethiopia the wells are deeper, the pump differs in design and the pistons use
a labyrinth seal; however, the basic principles described above are the same.
Pump insfallation and field testing are well under way. Leverage is necessary to
lift the water from the deepest wells. The above-ground mechanism and pump
handle are locally manufactured. The pump rod is made of 1 inch (ca. 1.2 cm)
locally available PVC pipe. For purposes of the research project the pumps are
installed by the Ethiopian Water Resources Authority but the intent is to develop
a technology that can be maintained by the village technician. Other variations
within the network of projects include studies of alternative but locally available
materials for pump construction in Malaysia, comparisons with imported pumps
in Thailand, and adaptations to suit local manufacturing capability in the Philip-
pines.
The concept of research and technology development through a network of
research projects has been found to be effective in terms of technology transfer
to several countries while at the same time ensuring that local research groups
and government agencies can usefully adapt the technology to local conditions.
The technology becomes the subject and responsibility of the local research effort.
It has, therefore, a far greater chance of taking root in that country than if it
were introduced by a foreign consultant or commercial firm. Most projects of
such a network are in some way connected to or are carried out by the Ministry

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40 M. G. McGarry (Discussion Meeting)
responsible for water and sanitation programmes. Once research is completed, the
technology has a far greater chance of being accepted by the Ministry and is
easily integrated into its projects. The nationals making up the research team are
available on a continuing basis for advice on implementation and, if necessary,
further adaptation and improvement of the project.

EXCRETA DISPOSAL

Faecal material is the main carrier of diarrhoeal pathogens within the home.
An adequate water supply is alone insufficient to reduce diarrhoea if the household
remains faecally contaminated. The proper disposal of excreta and improvement
in hygiene practices are important components of the sanitation programme. In
low density situations, such as in rural areas, the more intractable problems
relate to changing defecation habits and improving household hygiene rather than
upgrading technology hardware. However, simple improvements such as venting
latrines and providing them with pits of adequate depth and more permanent
superstructure construction can greatly increase the acceptability of the latrine.
The recovery of human wastes in the form compost humus has been the basis of
research in Tanzania over the past four years. The 'Clivus multrum' compost
toilet was adapted to local conditions. Three basic and important problems were
encountered. Excessive moisture resulting from the use of ablution water interferes
with a compost process. Refuse used in the composting process as a carbon source
was unavailable in adequate quantity and grass had to be substituted. There is a
need for continuing education and encouragement in the proper use of the toilet.
Finally, there was a general reluctance on the part of the users to handle and
particularly to use the composted waste as a fertilizer for food crops. Despite
many efforts to adapt the continuous composting toilet based on the Clivus
principle of the sloping floor, this method was found generally unacceptable by
the users on technical and social grounds. The double vault latrine was more
acceptable as there is a clearcut physical separation between fresh and composted
material. The double vault process was more easily understood by the family
using the device. The project is in its evaluation phase at present. Some of the
latrines have been successfully used over the past 2 years whereas others have
failed. It is still too early to come to definite conclusions.
In Botswana, the limitations of inadequate and inappropriate toilet designs
became obvious during the formative stages of urban sites and services and of
projects for improving squatter accommodation. Faecal contamination of the
environment and lack of privacy are familiar problems in the low income areas.
Sewerage is prohibitively expensive and centralized collection services are not
available. The aim of the research project carried out by the Ministry of Local
Government and Lands in Gaberone was to devise a socially acceptable on-site
toilet system that could be afforded by the householder through soft loans within
the programme for squatters. Several designs were investigated, including aqua-

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 Appropriate technologies for environmental hygiene 41
privies using hand-carried water, composting and dry pit latrines. The national
importance of the latrine question was exemplified by the project's results reach-
ing cabinet level and a directive being issued that no other designs than those
devised by the project were to be used in urban development programmes. This
has caused some difficulty as some technical problems still require solution.
Three designs appear to be most promising. The vented improved pit latrine
is basically a conventional pit latrine with an upgraded superstructure, and an
offset vented pit. Offsetting the pit is useful in urban areas where land is limited.
Once the pit is full its contents can be removed and the facility put back into
operation without relocating the entire toilet facility. The pit is deep and vented
to ensure a continuous flow of air up the pipe and a supply of fresh air into the
latrine enclosure. These improvements are the subject of field evaluations in
Ghana at the University of Science and Technology.
The double vault toilet is basically a composting toilet in which the waste
material is left to digest in one vault while the other is utilized for defecation and
refuse disposal. The vaults are used alternately, the compost humus material being
employed locally as fertilizer. As mentioned above this is the most easily under-
stood and accepted form of compost toilet. An adaptation has been widely
accepted in Vietnam and is an integral component of the primary health care
programme. In Botswana an upgraded aqua-privy design was found to be socially
acceptable although expensive. A wash basin is located externally on the outside
of the privy for bucket carried water. The wash water flows through the drain
pipe to flush the toilet inside the cubicle. This design is not applicable to the
lowest income areas nor is it feasible in rock or impermeable soils.

FISH CULTURE
Diarrhoea is only one part of the disease-malnutrition-poverty cycle. Inter-
vention programmes are far more effective if adequate nutrition levels can be
assured. This can only be achieved on a permanent basis through locally grown
food crops. Where acceptable, reuse of excreta and refuse in the form of composted
fertilizer can be an important component in the process. The backyard fish pond
may also be used for excreta disposal and food production. The family latrine is
located over the small fish pond in the vicinity of the house and defecation takes
place directly into the pond. The wastes are used either as a direct source of food
for the fish or to provide essential elements for algae, zooplankton and aquatic
weed growth.
Such ponds and larger commercialized fish farms are common in several south-
east Asian countries. The practice is not widely publicized for obvious reasons.
Although the fish are an ideal source of animal protein, there are public health
implications. The Government of Indonesia is faced with a dilemma - as was
China. There are thousands of latrine-fed fish ponds operating in Java which are

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42 M. G. McGarry (Discussion Meeting)
important as protein sources. The value of excreta is recognized and the practice
found socially acceptable. Naturally, it would be desirable to propagate the prac-
tice elsewhere. However, the health authorities have warned against obvious
dangers to public health. The transmission of pathogens either passively or by
use of the fish as an intermediate host is both possible and probable but has not
yet been investigated. Certainly, an intervention in the form of simple treatment
by storing excreta before its discharge to the pond would go a long way to reducing
the pathogen content of the waste and thereby the potential for disease trans-
mission.
In Taiwan there are several thousand hectares of fish ponds surrounding the
town of Tainan using nightsoil which is carted directly from the household to the
ponds. Similarly, settled sewage from Calcutta is used to feed numerous fish ponds
on the city outskirts. These provide the Calcutta market with some 9 t of fish per
day. Research projects in Kenya, Israel, Malaysia and Thailand have been
established to define the best configurations of the process. Three approaches
appear to have potential. Each depends on the method of collection of excreta,
the local population density of the contributing community and the local economic
status.
Where sewers are available in urban areas, sewage can receive oxidation
treatment (either anaerobic or facultative) before being fed to the fish pond.
The fish acts both to provide further treatment and produce food. In Thailand,
potential annual yields of tilapia of up to 20 t/ha per year are reported.
Most urban centres and the smaller rural towns cannot afford sewers to collect
their wastes. Exereta or nightsoil is deposited in vaults located beneath the
toilets and beside the household. Vacuum trucks are used to collect the waste.
This is the prevailing practice for exereta collection in Japan, Korea and China.
Treatment by anaerobic digestion before discharge to the fish ponds is possible
and this is probably the most economic approach. The excreta is concentrated and
therefore the process is not continuous; make-up water is required to overcome
evaporation losses.
An integrated approach is being evaluated at the Asian Institute of Technology,
Bangkok. Nightsoil from the household vault is first digested in a biogas plant. The
methane is collected and used as a fuel and the effluent slurry, thus partially treated,
is fed directly to the fish pond, Tilapia are grown to a point whereby maximum
yields are achieved and are harvested before reaching marketable size. Steam
pasteurization of the fish will be used to minimize the possibility of pathogen
transfer. The pasteurized fish will then be fed to ponds producing carnivores such
as catfish, shrimp or prawns. Admittedly, extending the biological food chain in this
way is less efficient in terms of nutrient reclamation but will likely be more cost-
effective as the carnivores command a far higher price on the fish market. This
approach would also overcome the disease transmission problem. Studies in Israel
have shown that fisK grown in heavily contaminated water not only suffer from

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 Aprpropriate technologies for environmental hygiene 43
low levels of oxygen but also from invasion of bacteria in their internal organs and
muscles. Invasion appears to occur at certain threshold concentrations of bacteria
in the pond water. This threshold concentration depends on the fish species,
oxygen levels and general environmental stress conditions including the density
of the fish population during growth. The research is aimed at getting a better under-
standing of the mechanism of bacterial invasion and at determining threshold
levels from which pond loading parameters can be defined. Investigations are
continuing into methods for cleaning the fish. A depuration technique employs a
pond containing clean water in which the fish is placed for 2 or 3 weeks. The fish
tends to rid itself naturally of the invasive bacteria in the clean water environment.
Most of the above activities emphasize reuse of the waste through the by-
production of food or feed. Conventional projects for latrines have suffered from
a lack of tangible or readily understood economic returns or other benefits. By
placing a value on human wastes through processes that transform them into
usable by-products it is felt that positive incentive will be created to provide
motivation for excreta collection and treatment.

REFUSE REUSE
Refuse is another resource that is often wasted in open dumps, to the detriment
of the surrounding environment and health of the often nearby slums. In South
Korea, efforts are being made to adapt the Chinese thermophilic composting
process to local conditions. This method also uses nightsoil and is therefore a
treatment and reclamation process for both urban nightsoil and refuse. The
technology itself is not complex, is labour intensive and requires a minimum of
maintenance once the compost 'pile' has been formed. Non-compostables such
as rubber, glass plastics and metals are separated from the refuse by hand. These
wastes have a commercial value; profitable businesses relying on the resale
value of the material already exist in most urban areas of.Asia. The residual
compostable refuse is mixed with nightsoil and heaped in piles that are provided
with air vents to ensure aerobic conditions. Pile temperatures under aerobic
composting conditions reach 60 ?C over extended periods, at which temperature
nearly all pathogens are killed thereby providing a barrier against transmission to
the food crop that is fertilized by the humus product. A straw/mud layer is
packed onto the outside of the compost pile as insulation against heat loss and to
prevent ingress of flies. This method of combined treatment and reuse of urban
refuse and nightsoil holds considerable promise for;the rural towns of Korea where
the increasing quantity of nightsoil and deteriorating aquatic environment is
giving cause for concern and for a search for appropriate treatment methods.
Research is continuing on the fertilizer value of the product and the design of the
collection, treatment and reuse system for a typical rural town of Southern Korea.

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44 M. G. McGarry (Discussion Meeting)

Low COST WATER TREATMENT

Ground water is an important and economic resource for supply to the smaller
rural communities. Larger and more concentrated populations, as exist in the
rural towns and cities, exert demands that commonly exceed the capacity of
ground water supplies. Under these conditions, surface waters become the more
economical alternative; these however, are invariably polluted and require
treatment before distribution. The treatment objective is to remove turbidity
and pathogens from the raw water. The lowest cost technology for treatment
incorporates slow sand infiltration whereby the particulate matter is removed by
passing the raw water through sandbeds; this treats it both mechanically by
filtration and biologically by bacterial decomposition of the trapped organic
matter. The product water is not 'pure' but is vastly improved in terms of its
bacterial content. When clogged, the sand is removed and manually replaced with
fresh sand. This project is the subject of research by network of projects in
Thailand, India, Kenya, Sudan and Ghana assisted by the International Reference
Centre of Holland.
Situations exist where the size of population and water quality necessitate use
of a higher technology involving chemical coagulation, flocculation and settling
the raw water before filtration. In such cases, if technical capacity exists and
capital cost reductions permit, use is made of high rate filtration. High rate
filtration uses back washing to flush the sand free of debris. The flocculation-
high rate filtration process is commonly used in the industrial states for water
treatment. Transfer of this technology has typically been carried out by inter-
national consulting engineers and equipment firms. This has resulted in the design
and installation of many fully automated plants employing a myriad of electrical
and chemical remote control instruments, valves and even computers. Such
designs are capital-intensive and suitable only for higher labour cost situations. A
tendency towards complex equipment in such water treatment plants is reinforced
by the terms of payment (which are often based on the capital cost of the facility)
used by some firms of consulting engineers. This results in a continued dependence
on the donor country for spare parts and repair services.
A gap has existed between a low cost sand filtration process applicable to the
rural community and the much higher technology incorporating the high rate
filtration method. The Pan-American Centre for Sanitary Engineering and Envir-
onmental Sciences (CEPIS), Peru, has recently completed a research project on a
full-scale declining range filtration plant near Lima.
The main objective was to evaluate the declining rate filtration plant which
had been specifically designed to reduce initial capital costs, maintenance require-
ments and technical complexity. The only mechanical equipment in the plant
were the influent water pump, a chemical pump and a normally operated valve -
all quite within the technical competence and repair capability found in rural
towns. It was found that only local materials and relatively unskilled labour were

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 Appropriate technologies for environmental hygiene 45

required during construction, and capital costs were reduced to some 50% of
those required for conventional or patented water treatment plants. The plant
itself functioned efficiently and effectively, although its operation required
personnel that had been specifically trained in water treatment plant maintenance.
The treatment plant design required some modifications and these are being
disseminated within Peru and other Latin American countries.

MANPOWER DEFICIT AND THE HEALTH-TECHNOLOGY DILEMMA

The focus of this paper has been on hardware aspects of appropriate technology
for water supply and sanitation and, in particular, has reported on research being
carried out in the Third World to solve some of the problems encountered by
direct technology transfer. Apart from the several problems discussed by Feachem
(this symposium) in relation to community participation and appropriate tech-
nology, mention should be made of two factors of outstanding importance that will
be encountered as major bottlenecks as we move into the U.N. Water Supply and
Sanitation Decade of 1981-90.
First, increased investment in this sector over the past 10 years has over-
committed existing personnel and institutions, sometimes to the breaking point
and certainly well beyond the point of maximum efficiency. The dearth of trained
and competent manpower exists at all levels. There is little being done to identify,
innovate, evaluate, adapt and expand 'unconventional' levels of personnel.
The exceptional examples of the village level barefoot engineer in Malawi
who receives a 3-week training course on the job and the rural water engineer
(a para-engineer) of Agua del Pueblo in Guatemala are moves in the right
direction. It has been conservatively estimated that a minimum of 100000 water
and sanitation personnel need to be trained and developed each year over the
coming 10 years. Rational and comprehensive plans to accommodate this demand
are not in place.
Secondly, despite sanitation's inclusion in the title of the Decade, emphasis
has almost exclusively been on water supply to the larger communities. Water
supply alone, even in quantity, will do little to improve health if not accompanied
by parallel improvement in household hygiene and excreta disposal.
On the other hand, the vast majority of water supply projects are presumably
justified on the basis of water's impact on health. Real health improvement
implies a village level presence that incorporates an equipment maintenance
programme and a continuing sanitation education activity - a capability which
very few water supply agencies can muster. Major shifts in institutions and their
approaches will be required if emphasis on water supply technology and improve-
ments in health is to be transferred from the urban areas to rural communities.
Undoubtedly, there will be several outstanding examples of successful programmes
in the coming years, but for the majority the prognosis is not good.

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46 M. G. McGarry (Discussion Meeting)

Discussion
Professor Charles Elliott queried Dr McGarry's implication that health benefits
result just from improving water supplies. Unless attitudes and practices are also
improved, substantial dangers to health remain in the use of contaminated col-
lecting and drinking vessels and the traditional habits associated with water
handling and use. Comprehensive water projects which include community educa-
tion seem seldom to be undertaken. Dr Richard Feachem said that there is a need
for comparative epidemiological data showing the significance of contamination
at source contrasted with home water handling behaviour. Dr Margaret Cammaert
suggested that community participation from the outset in water supply improve-
ment schemes may be an essential factor. Dr McGarry stressed that engineers are
almost as conservative as medical people and that there is a need for substantial
numbers of barefoot-level water technicians to be trained.
Discussion moved on to the topic of training techniques, with Professor Morley
mentioning 'distance learning' methods, since conventional universities were,
he maintained, the worst possible agents of change. Dr Elsa Woodward took up
the theme, saying that it was clear that the use of technology in rural areas poses
special training problems. She had been developing self-instruction as a method
of training people in medical laboratory work (Woodward 1979) and had tested
some self-instruction material (s.i.m.) in The Gambia, where the response of the
students was encouraging.
The s.i.m. is not merely a correspondence course. It is designed to stimulate the
student's curiosity and active participation, to help him discover things for
himself and develop learning skills.
The s.i.m. approach to job training has been inspired by the distance-learning
methods of the Open University, but there are some important differences, because
the s.i.m. is designed specifically for use in a place of work, to exploit the stimulus
of a job as an aid to learning. Thus while Open University students following a
particular course take the same examination at the end, students using s.i.m. to
learn in connection with a job, must apply what they learn to different circum-
stances, because no two jobs are exactly alike. The s.i.m. therefore incorporates
the principle of 'guided interaction', which is intended to help the student apply
basic principles to his own particular work situation.

REFERENCE (McGarry)
Woodward, E. 1979 J. biol. Educ. 13, 221-227.

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